Notas sobre o pesquisar em cena(s) / Notes on researching in scenes / Notas sobre la investigación en escena(s)

O presente artigo tem como objetivo apresentar a construção metodológica desenvolvida em uma pesquisa de mestrado, na qual sustentamos a escrita de cenas como método de pesquisa da escuta clínica. As cenas do trabalho em questão foram recolhidas ao longo do tempo, no contorno da experiência de um projeto de extensão universitária de atenção à infância e adolescência em situação de vulnerabilidade social, situado em uma comunidade periférica. Apresentamos, neste texto, as interrogações que se elaboraram em torno da escolha pelo trabalho com cenas, e compartilhamos o resgate histórico dessas como um método de escrever a clínica, bem como a retomada de sua análise a partir da tradição psicanalítica. Amparadas nesta teoria e em leituras e contribuições do filósofo francês Jacques Derrida, embasamos a noção de que a cena se constitui como um lugar de produção, ao engendrar a configuração particular de elementos significantes nos processos de subjetivação e de construção social. A cena não é, então, compreendida aqui como uma representação do que acontece na clínica, mas como um modo de produzir a escuta e os seus processos de investigação.(AU)

This article aims to present the methodological construction developed in a master's research, in which the writing of scenes as a method of clinical listening research was endorsed. The scenes from the study in question were collected over time, from the experience gained in a project conducted within a university extension program on care in childhood and adolescence in social vulnerability, in a peripheral community. In this study, we present some questions that were elaborated surrounding the choices of working with scenes; and we share the historical rescue of this work as a method of writing on clinic practices and resuming their analysis from the psychoanalytic tradition. Based on the psychoanalytic theory and on the readings and contributions of the French philosopher Jacques Derrida, we corroborate the notion that the scene is constituted as a place of production, engendering the particular configuration of significant elements in the processes of subjectivation and social construction. Here, the scene is not a representation of clinical practice but one mode of producing listening and its research processes.(AU)

Este artículo tiene como objetivo presentar la construcción metodológica desarrollada en una investigación de maestría, en la que sostenemos la escritura de escenas como método de investigación de la escucha clínica. Las escenas del trabajo en cuestión se recogieron a lo largo del tiempo desde la experiencia en un proyecto de extensión universitario de atención a la niñez y adolescencia en situación de vulnerabilidad social aplicado en una comunidad periférica. En este texto, presentamos los interrogantes que se elaboraron en torno a la elección por el trabajo con escenas y compartimos el rescate histórico de las mismas como un método de escribir la clínica y la reanudación del análisis a partir de la tradición psicoanalítica. Amparadas en el psicoanálisis y en lecturas y contribuciones del filósofo francés Jacques Derrida, nos basaremos en la noción de que la escena se constituye como un lugar de producción, engendrando la configuración particular de elementos significantes en los procesos de subjetivación y de construcción social. La escena no es aquí una representación de lo que pasa en la clínica, sino un modo de producir escucha y sus procesos de investigación.(AU)

Trabalho doméstico remunerado e resistência: interseccionando raça, gênero e classe / Paid domestic work and resistance: intersecting race, gender, and class / Trabajo doméstico remunerado y resistencia: intersección entre raza, género y clase

No Brasil, o trabalho doméstico remunerado é essencialmente feminino e emprega cerca de 5,9 milhões de mulheres, correspondendo a 16,8% da ocupação feminina. Desse contingente, 61 % são compostos por mulheres negras. As empregadas domésticas estiveram historicamente submetidas a uma série de aspectos excludentes, como baixa remuneração, contratações à margem da legalidade e discriminação de gênero e raça. Esta pesquisa objetivou compreender a resistência enquanto categoria fundamental para compreensão do trabalho doméstico. Ao falar sobre essa categoria, destacamos a subjetividade que constitui os fenômenos sociais, partindo de uma compreensão dialética e histórica do sujeito e da relação indivíduo-sociedade, inserida em uma historicidade. Os resultados encontrados, coletados por meio de documentos, notícias, reportagens, participações no sindicato da categoria e da realização de entrevistas com cinco domésticas apontam a existência de formas de resistência no campo do trabalho doméstico, compondo movimentos de oposição e reação ao modus operandi colonial e às hierarquias de gênero-raça-classe que formam a sociedade brasileira. A psicologia sócio-histórica foi escolhida como abordagem teórico-metodológica, pois possibilita compreender do homem como ser ativo, social e histórico. Ao investigar as formas de resistência presentes nesse tipo de trabalho, compreende-se a trabalhadora doméstica não como mera consequência da realidade social em que se insere, mas como sujeito ativo que constitui essa realidade e é simultaneamente constituído por ela. Com esta pesquisa, pretende-se contribuir com a crítica à ideologia dominante que subalterniza essas trabalhadoras e as relega à subcidadania, uma condição sem reconhecimento e direitos.(AU)

In Brazil, paid domestic work is essentially female and employs about 5.9 million women, corresponding to 16.8% of the female occupation. Of this contingent, 61% is made up of black women. Domestic workers have historically been subjected to a series of exclusionary aspects, such as low remuneration, hiring outside the legal system and gender and race discrimination. This research aimed to understand resistance as a fundamental category for understanding domestic work. When talking about this category, we highlight the subjectivity that constitutes social phenomena, starting from a dialectical and historical understanding of the subject and the individual-society relationship, inserted in a historicity. The results found, collected from documents, news, reports, participation in the category union and interviews with five domestic workers, point to the existence of forms of resistance in the field of domestic work, composing movements of opposition and reaction to the colonial modus operandi and the gender-race-class hierarchies that make up Brazilian society.Socio-historical psychology was chosen as a theoretical-methodological approach, since it provides an understanding of man as an active, social and historical being. When investigating the forms of resistance present in this type of work, the domestic worker is understood not as a mere consequence of the social reality in which she is inserted, but, as an active subject, who constitutes this reality and is simultaneously constituted by it. This research intends to contribute to the criticism of the dominant ideology that subordinates these workers and relegates them to a sub-citizenship, a condition without recognition and rights.(AU)

El trabajo doméstico remunerado en Brasil es predominantemente femenino y emplea casi 5,9 millones de mujeres, lo que corresponde al 16,8% de la ocupación femenina. El 61% de este grupo está compuesto por mujeres negras. Históricamente, las trabajadoras del hogar han sido sometidas a una serie de aspectos excluyentes, como la baja remuneración, la contratación fuera del sistema legal y la discriminación de género y raza. Esta investigación tuvo como objetivo comprender la resistencia como categoría fundamental para entender el trabajo doméstico. Al hablar de esta categoría, se destaca la subjetividad que constituye los fenómenos sociales a partir de una comprensión dialéctica e histórica del sujeto y la relación individuo-sociedad, insertada en una historicidad. Los datos recogidos de documentos, noticias, participación en la categoría unión y entrevistas con cinco sirvientas permitieron concluir que existen formas de resistencia en el ámbito del trabajo doméstico, que se componen de movimientos de oposición y reacción al modus operandi colonial y a jerarquías de género-raza-clase que conforman la sociedad brasileña. La psicología sociohistórica fue el enfoque teórico-metodológico utilizado, ya que proporciona una comprensión del ser humano como ser activo, social e histórico. El análisis de las formas de resistencia presentes en este tipo de trabajo permite identificar la trabajadora doméstica no como una mera consecuencia de la realidad social en la cual se inserta, sino como sujeto activo que constituye esta realidad y, a la vez, es constituido por ella. Se espera que esta investigación pueda contribuir a la crítica de la ideología dominante que subordina a estas trabajadoras, relegándolas a una subciudadanía, una condición sin reconocimiento y sin derechos.(AU)

Percepção de danos físicos, psíquicos e sociais no trabalho de ser mãe universitária / Perception of physical, psychological, and social damages in the work of being college student mothers / Percepción de los daños físicos, sociales y psicológicos en el trabajo de ser madre universitaria

A vida universitária de mulheres mães apresenta questões que precisam ser mediadas quando comparadas com a mesma dinâmica em estudantes que não são mães. O referencial teórico da psicodinâmica do trabalho reconhece o estudar e o maternar como trabalho, pois demandam esforço cognitivo, físico e temporal com finalidade social. O objetivo deste artigo foi avaliar os danos advindos desses dois trabalhos, sobretudo, em suas dimensões física, psicológica e social, na vida de mães universitárias com filhos de até cinco anos de idade. Utilizou-se a metodologia quantitativa com ajuda da aplicação da Escala de Avaliação dos Danos Relacionados ao Trabalho (EADRT), e adaptada para o contexto estudantil e materno. A pesquisa foi respondida por 453 mães universitárias. Dessa forma, foi encontrada uma amostra heterogênea, cujas respostas apontaram para diferenças na percepção dos danos; correlações dos fatores; e associações com as variáveis sociodemográficas. Logo, discute-se a presença de danos físicos, sociais e psicológicos considerados graves para as duas atividades. No entanto, quando as mães universitárias residem com um companheiro ou têm maior renda, os danos sociais e psicológicos se mostraram menores. Com efeito, esta pesquisa ampliou o conhecimento sobre quem são as mães brasileiras na graduação e que tipo/grau de danos à saúde elas vivenciam, destacando que o acúmulo dos dois papéis acarreta níveis críticos que podem ser atenuados pelo apoio familiar e pela assistência às questões de vulnerabilidade econômica. Por fim, reforça-se a preocupação em analisar cientificamente essas realidades, servindo de embasamento para políticas públicas e estratégias futuras de intervenção.(AU)

The student life of college mothers shows complementary issues that need to be evaluated when compared with the same dynamic in students that are not mothers. The theoretical framework of the psychodynamics of work recognizes studying and mothering occupations as work activities, since they demand cognitive, physical, and temporal effort with a social purpose. The aim of this article was to assess the damage arising from these two workloads, especially, in their physical, psychological, and social dimensions, to the lives of women undergraduate students who have children up to five years old. We used a quantitative methodology with the application of the Work-Related Damage Assessment Scale (EADRT), adapted to the university and maternity context. The scale was answered by 453 college student mothers. Thus, we found a heterogeneous sample, whose answers pointed to variations in the perception of damage; correlations between factors; and connections with the socio demographic variables. Therefore, we discuss the presence of physical, social, and psychological damages considered severe for both activities. However, when the student mothers live with a partner or have a higher income, the social and psychological damage are lesser. In conclusion, this study expanded the knowledge about who are the Brazilian undergraduate student mothers and the type/degree of damages to their health they experienced, highlighting that the build-up of the two roles leads to critical levels that can be mitigated by family support and by assistance to issues concerning economic vulnerability. Finally, the importance to scientifically analyze these realities, serving as foundation for public policies and future intervention strategies, is reinforced.(AU)

La vida universitaria de madres tienen demandas diferentes que necesitan discusión en la comparación con la vida universitaria de mujeres que no son madres. El marco teórico de la psicodinámica de trabajo reconoce el papel de madre y de estudiante como trabajos, ya que para hacerlos se requiere esfuerzo cognitivo, físico y temporal, con finalidad social. El objetivo de este estudio es avaliar los daños que acompañan estos dos trabajos en sus dimensiones física, psicológica y social, en la vida de mujeres brasileñas estudiantes de grado que tienen hijos de hasta 5 años de edad. Se utilizó la metodología cuantitativa a partir de la aplicación de la Escala de Evaluación de Daños Relacionados al Trabajo (EADRT), adaptada al contexto estudiantil y de maternidad. La encuesta fue respondida por 453 madres universitarias. Como resultado, se encontró una muestra heterogénea, con diferencias entre la percepción de daños, correlaciones entre los factores y asociaciones entre los daños y variables sociodemográficas. Se discute la presencia de daños físicos, sociales y psicológicos considerados graves para los dos papeles. Sin embargo, cuando las madres universitarias viven con un compañero o tienen ingresos más grandes, los daños sociales y psicológicos son menores. Se concluye que este estudio permitió ampliar el conocimiento acerca de las madres brasileñas en el grado y qué tipo/nivel de los daños a la salud tienen, que destaca que la acumulación de los papeles genera niveles críticos que pueden ser mitigados por el apoyo familiar y asistencia en cuestiones de vulnerabilidad económica. Se destaca la preocupación por analizar científicamente las realidades de madres universitarias, sirviendo de base para políticas públicas y estrategias de intervenciones futuras.(AU)

How did South Africans with disabilities experience COVID-19? Results of an online survey

Background: People with disabilities are a large, disadvantaged minority, comprising approximately 12% of the population. The South African government has ratified international and regional disability treaties but deals with disability rights within general anti-discrimination legislation. There are no specific frameworks to monitor justice for people with disabilities. The study aims to inform further development of disability inclusive mechanisms relating to crises including pandemics. Objectives: This study explored the perceptions of South Africans with disabilities, to understand their experiences during coronavirus disease 2019 (COVID-19), focussing on socioeconomic, well-being and human rights aspects. Method: An online survey tool generated quantitative and qualitative data. Widespread publicity and broad recruitment were achieved through project partners networks. Participants responded via mobile phone and/or online platforms. Results: Nearly 2000 people responded, representing different genders, impairments, races, socio-economic status, education and ages. Findings include: (1) negative economic and emotional impacts, (2) a lack of inclusive and accessible information, (3) reduced access to services, (4) uncertainty about government and non-government agencies' support and (5) exacerbation of pre-existing disadvantages. These findings echo international predictions of COVID-19 disproportionally impacting people with disabilities. Conclusion: The evidence reveals that people with disabilities in South Africa experienced many negative impacts of the pandemic. Strategies to control the virus largely ignored attending to human rights and socioeconomic well-being of this marginalised group. Contribution: The evidence will inform the development of the national monitoring framework, recognised by the South African Government and emphasised by the United Nations as necessary to ensure the realisation of the rights of people with disabilities during future crises including pandemics.

Relação entre adesão a crenças meritocráticas e a renda familiar / Relationship between adherence to meritocratic beliefs and family income / Relación entre adherencia a las creencias meritocráticas y al ingreso familiar

A meritocracia pode ser considerada uma ideologia que coopera na justifi-cação das desigualdades entre as classes existentes no sistema econômico. Isso se dá com a valorização de características como a competitividade, a habilidade e o esforço individual, desconsiderando fatores históricos, culturais e socioeconômicos. O objetivo da pesquisa foi caracterizar a adesão a crenças meritocráticas, vinculando as respostas obtidas à condição social do partici-pante. Uma amostra de 1.233 adultos respondeu uma entrevista estruturada, indicando o grau de concordância com três sentenças a respeito do papel do esforço individual para o sucesso, a relação entre habilidade e remuneração e a desigualdade social. Os resultados indicaram que a renda dos indivíduos está associada à percepção da lógica meritocrática, posto que sujeitos com maiores rendas tenderam a questionar as generalizações, mas não deixam de aderir a sua lógica com veemência, valorizando esforço e manutenção das diferenças salariais pautadas no valor social agregado a determinadas habilidades. Já sujeitos com menor acesso a recursos demonstraram crer na meritocracia com menores questionamentos, emergindo assim as características ideológicas da meritocracia e as concepções dominantes de classes sociais mais abastadas.

Meritocracy can be considered an ideology that cooperates to justify the inequalities between the classes existing in the economic system. This is done by valuing characteristics such as competitiveness, ability and individual effort, disregarding historical, cultural and socioeconomic factors. The aim of the research was to characterize adherence to meritocratic beliefs, linking the responses obtained to the social conditions of participants. A sample of 1.233 adults completed a structured interview, indicating the degree of agreement with three sentences regarding the role of individual effort for success, the rela-tionship between ability and remuneration, and social inequality. The results indicated that the income of the individuals is associated with the perception of the meritocratic logic, since subjects with higher incomes tended to question the generalizations, but they did not stop adhering to their logic with vehemence, valuing effort and maintenance of wage differences based on social value added to certain skills. In contrast, subjects with less access to resources have shown to believe in meritocracy with less questioning, thus emerging the ideological characteristics of meritocracy and the dominant conceptions of more affluent social classes.

La meritocracia puede considerarse una ideología que coopera para justi-ficar las desigualdades entre clases en el sistema económico. Esto ocurre con la valoración de características como la competitividad, la habilidad y el esfuerzo individual, sin tener en cuenta los factores históricos, culturales y socioeconómicos. El objetivo de la investigación fue caracterizar la adhesión a las creencias meritocráticas, vinculando las respuestas obtenidas con la condición social del participante. Una muestra de 1.233 adultos respondió a una entrevista estructurada, indicando el grado de acuerdo con tres oraciones con respecto al papel del esfuerzo individual para el éxito, la relación entre la habilidad y la remuneración y la desigualdad social. Los resultados indicaron que el ingreso de los individuos está asociado con la percepción de la lógica meritocrática, ya que los sujetos con mayores ingresos tienden a cuestionar las generalizaciones, pero se adhieren fuertemente a su lógica, valoran el esfuerzo y mantienen las diferencias salariales basadas en el valor social. agregado a ciertas habilidades. Ya los sujetos con menos acceso a los recursos mostraron creer en la meritocracia con preguntas menores, surgiendo así las características ideológicas de la meritocracia y las concepciones dominantes de las clases sociales más ricas.

Consequences of COVID-19 on access and delivery of mental health care in two rural Ethiopian districts. A mixed method study

Introduction: The impact of COVID-19 on people with Severe Mental Health Conditions (SMHCs) has been neglected. We aimed to describe the effect and explore the consequences of COVID-19 on people with SMHCs and mental health services in rural districts of Ethiopia. Methods: We conducted a mixed-method study nested within well-characterized population cohorts in Butajira and Sodo districts. We sampled 336 people (168 people with SMHCs, 168 comparisons) in a cross-sectional survey. We conducted qualitative key informant interviews with psychiatric nurses (n=3), primary health care workers (n=3), service users (n=4), family members (n=6) and community members (n=2). We assessed wellbeing (WHO wellbeing index), social support (Oslo social support scale; OSS) and food security quantitatively and used thematic analysis to explore impacts. Results: People with SMHCs reported significantly lower wellbeing (WHO wellbeing score 52 vs. 72; p<0.001), less social support (OSS score 8.68 vs. 9.29; p<0.001), worse living standards (47.0% vs. 29.0%; p<0.001) and increased food insecurity (26.0% vs. 12.5%; p<0.001). Household economic status worsened for over one-third of participants. Participants reported increased relapse, exacerbated stigma due to perceived susceptibility of people with SMHCs to COVID-19, and increased restraint. In mental healthcare settings, there was decreased patient flow but an increase in new cases. Innovations included flexible dispensing of medicines, longer appointment intervals and establishing new treatment centers. Conclusions: COVID-19 had negative consequences on people with SMHCs and mental health services, which must be anticipated and prevented in any future humanitarian crisis. Adaptive responses used during COVID may increase health system resilience

Impact of COVID -19 on population health and economic wellbeing in Ethiopia: A national pilot survey

Introduction: The COVD-19 pandemic has resulted in unprecedented global health and economic crisis, particu-larly in countries struggling with poverty. We conducted a national survey to understand the economic and health impacts of COVID-19 in Ethiopia. Methods: A pilot, population-based, cross-sectional survey was conducted among adults randomly selected from the Ethio Telecom list of mobile phone numbers. Participants underwent a comprehensive phone interview about the impact of COVID-19 on their economic well-being and the health-related risks associated with COVID-19. Results: Of 4,180 calls attempted, 1194 were answered, of which a successful interview was made with 614 par-ticipants. COVID-19 affected the family income of 343 [55.9%] participants, 56 [9.1%] lost their job, 105 [17.1%] perceived high stress in their household, and 7 [1.14%] reported death in their family in the past month. The odds of having a decreased income due to COVID-19 were 2.4 times higher among self-employed [adjusted odds ratio (AOR) 2.4, 95% CI (1.58-3.77)] and 2.8 times higher among unemployed [AOR 2.8, 95% CI (1.35-5.85)] participants. Two-hundred twenty-one [36%] participants had comorbidity in their household with hypertension, 72 [11.7%], diabetes,50 [8.1%], asthma, 48 [7.8%], and other chronic diseases, 51 [8.4%]. Forty-six [7.5%] participants had COVID-like symptoms in the previous month, where cough, headache, and fatigue were the most com-mon.

Sexual behaviours and their associated factors among young people in the Dodowa Health and Demographic Surveillance Site (DHDSS) in Ghana

Objective: This paper describes sexual behaviours and their associated factors among young people. Design: The study design is cross-sectional. Setting: Dodowa Health and Demographic Surveillance Site (DHDSS) in Ghana's Shai-Osudoku and Ningo Prampram districts. Participants: Young people aged 10 to 24 years, median age 17 years. Outcome measures: Self-reported to have ever had sex, non-use of a condom at last sex, and ever been pregnant or gotten someone pregnant. Results: Of the 1689 young people; 42% reported having ever had sex, not using a condom at last sexual activity (64%), and ever been pregnant or gotten someone pregnant (41%). The proportion of non-use of condoms at last sex was high across all age groups but was highest (93%) in a small proportion of 10 to 14-year-olds who have ever had sex. Higher proportions of females than males; were reported to have ever had sex (46%), not using a condom at their last sex (66%) and ever been pregnant or getting someone pregnant (56%). Age group (20 to 24), females, primary or junior high school, living alone and lower household socio-economic status were risk factors associated with all three outcome measures. Conclusion: Risky sexual behaviour is high among young people in the Dodowa HDSS. Therefore, interventions that promote safer sexual practices and help young people make timely decisions on their sexual and reproductive health care needs are required.

Access, perceived quality and uptake of antenatal services in urban communities of Osun state, Southwest Nigeria

Quality antenatal care (ANC) is one of the key interventions to improve intrapartum care uptakes and to reduce the menace of maternal deaths globally. Yet, ANC coverage has remained low in many developing countries like Nigeria. It becomes imperative to contextually understand factors associated with ANC uptake in Nigeria. The study assessed level of utilization, perceived quality, level of satisfaction and determinants of ANC utilization among women of reproductive age-group in Oshogbo, South-west Nigeria. Cross-sectional study design was employed and cluster sampling method was used to recruit 420 consenting respondents. Data were collected using pretested interviewer-administered, semi-structured questionnaire. Both descriptive and inferential statistics were done at p<0.05. The mean (±SD) age of the respondents was 30.84±6.0 years. Almost three-quarters (73.9%) of the respondents had at least 4 ANC visits. Main reasons for non-ANC usage were high cost of care, long waiting time at the clinic, long distance to the clinic and unsatisfactory service quality. Only 59.9% of respondents were satisfied with services received while 63.1% of them rated the service quality as excellent. Main determinants of ANC uptake were respondents' age (AOR=2.35;95%CI=1.34-5.89), level of education (AOR=0.56;95% CI= 0.42-0.71), socio-economic status (AOR=5.22; 95%CI=2.02-6.65) and monthly family income (AOR=0.89; 95%CI=0.02-0.90). Although the rate of ANC use was high in the study setting, the proportion of women who were satisfied with service quality was sub-optimal. There is need for implementation of multi-pronged intervention to make ANC services more available, accessible, affordable and acceptable to the Nigerian women

Mortalidad adolescente por causas violentas y Necesidades Básicas Insatisfechas. Argentina, trienios 2006-2008 y 2012-2014 / Adolescent mortality from violent causes and Unsatisfied Basic Needs. Argentina, 2006-2008 and 2012-2014 triennia

A partir de considerar el incremento de la violencia en el mundo, sus implicancias para la población joven y la escasez de estudios relativos al tema según sector socioeconómico, se planteó el objetivo de analizar la mortalidad adolescente por causas violentas según nivel de Necesidades Básicas Insatisfechas (NBI), en Argentina, entre los trienios 2006-2008 y 2012-2014. Para ello, se llevó a cabo un estudio cuantitativo y descriptivo, desde un enfoque sociodemográfico, con base en información estadística oficial. Se calcularon tasas de mortalidad para la población de 10 a 19 años, desagregadas por nivel de NBI, sexo, edad y grupo de causas violentas. Los resultados mostraron un incremento de la mortalidad para el conjunto de causas violentas independientemente del nivel de NBI, mayormente en varones de 15 a 19 años. En particular, aumentó la mortalidad por accidentes de transporte y eventos de intención no determinada (todos los niveles de NBI), otros accidentes y suicidios (mayores niveles de NBI) y homicidios (menores niveles de NBI). Surge así la necesidad de desplegar acciones "a medida" para reducir la mortalidad en todos los casos

Given the increase in violence in the world, its implications for the young population and the scarcity of studies related to this subject according to socioeconomic sector, the objective of this paper was to analyze adolescent mortality from violent causes by level of Unsatisfied Basic Needs (UBN) in Argentina, between triennia 2006-2008 and 2012-2014. For this purpose, a quantitative and descriptive study was carried out, using a socio-demographic approach, based on official statistical information. Mortality rates were calculated for the population aged 10 to 19, disaggregated by level of UBN, sex, age and group of violent causes. The results showed an increase in mortality considering all violent causes regardless of the level of UBN, mostly in males aged 15 to 19 years. In particular, mortality from transport accidents and events of undetermined intention (all levels of UBN), other accidents and suicides (higher levels of UBN) and homicides (lower levels of UBN) increased. Therefore, "tailored-made" actions must be taken to reduce mortality in all cases

Association between COVID-19 diagnosis and economic class, race/skin color and social distancing in Brazilian university students / Associação entre o diagnóstico de COVID-19 e a classe econômica, raça/cor da pele e distanciamento social em universitários brasileiros

ABSTRACT: Purpose: To determine the association between diagnosis of COVID-19 and the economic class, race/skin color, and adherence to social distancing in Brazilian university students. Methods: This is a nationwide cross-sectional study carried out with online questionnaires applied to Brazilian university students, at 94 universities in the public and private education network. Self-reported age, sex, economic class data, race/skin color, COVID-19 diagnosis, and adherence to social distancing measures were collected. Results: 5,984 individuals were evaluated. No significant association was found between the diagnosis of COVID-19 and economic class and race/skin color in the multivariable analysis. However, we observed that there were significant associations between the diagnosis of COVID-19 and partial adherence to social distancing, with leaving home only for going to work (PR: 1.35; 95% CI: 1.10­1.66; p < 0.01) and with non-adherence to social distancing (PR: 1.96; 95% CI: 1.29­2.97; p <0.01). Conclusion: The diagnosis of COVID-19 was associated with age, non-adherence and partial adherence to social distancing measures in Brazilian university students, but was not associated with race/skin color and economic class.

Objetivo: Verificar a associação entre o diagnóstico de COVID-19 e a classe econômica, raça/cor da pele e adesão às medidas ao distanciamento social em universitários brasileiros. Métodos: Estudo transversal, de abrangência nacional, realizado com universitários brasileiros. Foram coletados dados autorreferidos de idade, sexo, classe econômica, raça/cor, diagnóstico do COVID-19 e adesão às medidas de distanciamento social. Resultados: 5.984 indivíduos foram avaliados. Não foi encontrada associação significativa entre o diagnóstico de COVID-19, a classe econômica e raça/cor na análise multivariável. Observamos que houve associações significativas entre o diagnóstico de COVID-19 e adesão parcial ao distanciamento social (RP: 1,35; IC 95%: 1.10­1.66; p < 0,01) e com a não adesão ao distanciamento social (RP: 1,96; IC95%: 1.29­2.97; p < 0,01). Conclusão: O diagnóstico de COVID-19 foi associado à idade, não adesão e adesão parcial às medidas de distanciamento social em universitários brasileiros, mas não se associou à raça/cor e classe econômica. (AU)

Investment case for the national health strategy 2021-2025

The Government and stakeholders in the health sector aspire to realize improved health outcomes for all, including the vulnerable and marginalized, to enhance Zimbabwe's human capital development towards a prosperous and empowered upper-middle income society. Zimbabwe's National Health Strategy (2021- 2025) was therefore developed, not only to advance its vision and goal for the next 5 years, but to also act as a guide on priority health interventions in the sector in order to improve the country's economy and overall wellbeing of the citizens. As such, the strategy is aligned with the National Development Strategy 1 (2021-2025). Chief among the NDS 1 priorities will be sustainable economic growth, anchored on sector specific growth enablers ­ such as infrastructure, human resources, technology, macroeconomic stability, financial stability, and sustainable public debt management. Focus on transformational value chains, international re-engagement, enablers for improved social welfare and inclusive growth (such as health, food security, effective governance and community and youth participation) complete the priority list of the NDS 1 2021-2025. The NHS 2021-2025 also considers a number of programme specific strategies in the health sector. These include the Human Resources for Health Strategy, National Infrastructure Development Plan, the HIV and AIDS Strategy, the Non-Communicable Disease Strategy, Mental Health Strategy, and the Community Health Strategy. The NHS 2021-2025 is anchored on the concept of an Investment Case. The NHS investment case outlines how the Government of Zimbabwe (GoZ), in partnership with donors, will efficiently save lives, improve health and nutrition outcomes and accelerate the attainment of national goals in line with the Sustainable Development Goals (SDGs). The NHS investment case considered the results and lessons learnt from the Mid Term Review of the National Health Strategy 2016-2020 and the Multiple Indicator Cluster Survey (MICS) 2019. NHS Investment Case used the World Health Organization (WHO)'s One Health Tool, which focuses on estimating the cost of Health Services and Health Systems Strengthening while the effectiveness of health interventions was estimated using the disease specific Impact Models and the Lives Saved Tool (LiST). Results were customized to the Ministry's Programme Based Budgeting format, which required that programmes be grouped first into 4 broad categories; Policy and Administration, Public Health; Curative Services and Bio- Medical Science Engineering and Pharmaceutical Production. The development of the National Health Strategy Investment Case was spearheaded by a taskforce led by MoHCC with technical assistance from its development partners. Technical Working Groups (TWGs) on Investment Case and Health Financing were set up to support the costing of the NHS. These TWGs drew membership from the MoHCC, MoFED, Development Partners and NGOs and Civil Society Organisations. These technical working groups identified the interventions and activities to be costed and also assisted in the prioritization of the interventions. 13 Mini

Cambios en el calendario de uso de condón masculino en la primera y última relación sexual en distintas cohortes de mujeres / Changes in male condom use at first and last sexual intercourse in different birth cohorts

Resumen: Objetivo: Caracterizar el uso de condón en la primera y última relación sexual en diferentes cohortes para observar posibles diferencias entre grupos generacionales. Material y métodos: Mediante la Encuesta Nacional de Niños, Niñas y Mujeres 2015, representativa a nivel nacional, se ajustaron modelos de regresión Poisson para buscar asociación de variables de interés con el uso del condón en la primera y última relación sexual. Resultados: Las cohortes más jóvenes, con mayor educación y riqueza tienen mayores posibilidades de usar condón en su primera y última relación sexual; hablar lengua indígena se asocia con menores posibilidades de uso en ambos eventos. El uso de condón en el debut sexual incrementa la posibilidad de uso en la última relación sexual. Conclusiones: Existe un cambio generacional en el uso del condón en la primera y última relación sexual entre las más jóvenes. La utilización del condón en el debut sexual favorece su uso posterior.

Abstract: Objective: Characterize the use of condoms in the first and last sexual intercourse in different birth cohorts, to observe possible differences among generations. Materials and methods: Using the National Survey of Boys, Girls and Women, 2015, representative at the national level, we adjust Poisson regression models to find associations between variables of interest and the use of condoms in first and last intercourse. Results: Women from younger cohorts, with higher education and wealth are more likely to use a condom in their first and last sexual intercourse; speaking an indigenous language is associated with a lower likelihood of condom use at both events. Using condom in sexual debut increases the likelihood of using in last intercourse. Conclusions: There is a generational change in condom use at first and last sex among younger cohorts. The use of the condom in sexual debut favors its later use.

Determinación social del malestar psicológico y el estrés en hombres que ejercen violencia familiar en la Ciudad de México / Social determinants of psychological distress and stress in men who perpetrate family violence in Mexico City

RESUMEN El objetivo es describir y analizar la determinación social del malestar psicológico y el estrés en dos grupos de hombres de la Ciudad de México que asistían a programas reeducativos por violencia familiar. Para ello, se realizó un estudio no experimental, transversal, descriptivo con metodología cualitativa y enfoque interpretativo, en el que se aplicó un cuestionario y se realizaron grupos focales. Los síntomas de estrés reportados fueron dolores musculares; insomnio y pesadillas; náuseas, dolor de estómago e indigestión; dolores de cabeza, mareos, irritabilidad o mal humor. Los principales problemas que podrían estar generando esta sintomatología serían la economía personal y familiar; la salud de ellos y sus familiares y los malestares mentales, entre otros aspectos. Existen diferencias relacionadas con las condiciones de vida y los efectos de la violencia doméstica. Los abordajes que solo consideran la masculinidad hegemónica o el género para el trabajo con varones en sus diferentes condiciones y problemáticas, sin considerar la desigualdad social y, en especial, las condiciones de vida, pueden ser insuficientes para explicar y modificar las causas de las afectaciones generadas y experimentadas por los varones.

ABSTRACT The social determinants of psychological distress and stress are described and analyzed in two groups of men attending reeducation programs for family violence in Mexico City. A non-experimental, descriptive, transversal study was conducted employing a qualitative methodology and an interpretive approach, in which questionnaires were utilized and focus groups were held. Symptoms of stress that were reported included muscle aches, insomnia and nightmares, headaches or dizziness, irritability or bad mood, nausea, stomach pain and indigestion. The principal issues that could be identified as the root of these symptoms included personal and family finances, their own health or that of their family members, and mental distress, among others. Differences with respect to living conditions and the effects of domestic violence were present. We argue that initiatives directed at men and their particular conditions and problems which are based on a hegemonic view of masculinity and gender are likely to be limited in their capacity to explain and modify the causes of situations generated by and experienced by men.

Asociación entre marcadores de posición social y adherencia al tratamiento de la hipertensión arterial en Colombia / Association between social position indicators and hypertension treatment adherence in Colombia

INTRODUCCIÓN: Generar evidencia sobre los efectos de la posición social en la adhe-rencia terapéutica en personas con hipertensión arterial (HTA) en Colombia. MATERIALES Y MÉTODOS: Se realizó un estudio transversal, a partir de mediciones cuan-titativas del Programa de Determinantes Sociales e Inequidades en el Control de la HTA en Colombia. Se desarrollaron análisis descriptivos e inferenciales (regresión logística) para modelar las asociaciones. RESULTADOS: Se evidenció una alta proporción de adherencia, siendo mayor para cumplimiento farmacológico y las citas (>50%). Las personas con menor educación e ingresos tienen menor posibilidad de adherirse al tratamiento farmacológico; mientras que quienes tienen mejor posición socioeconómica tienen menor posibilidad de adherirse a las citas y a las conductas saludables. Los afrocolombianos tienen menor posibilidad de adherirse al tratamiento farmacológico, a las citas y a la actividad física. DISCUSIÓN: Existe una brecha en el logro de la adherencia a tratamiento de HTA en Colombia, debido a condiciones socioeconómicas y étnica/raciales.

INTRODUCTION: To generate evidence on the effects of social position on therapeutic adherence among individuals with hypertension (HT) in Colombia. MATERIALS AND METHODS: A cross-sectional study was carried out, using quantitative data from the Social Determinants and Inequities in the Control of HT Program in Colombia. Descriptive and inferential analyses (logistic regression) were developed to model the associations. RESULTS: The prevalence of adherence was high, especially for pharmacological treat-ment and compliance with appointments (>50%). Individuals with less education and lower income are less likely to adhere to pharmacological treatment, while tho-se with higher socioeconomic status are less likely to adhere to appointments and healthy behaviors. Afro-Colombians were less likely to adhere to pharmacological treatment, appointments, and indications regarding physical activity. DISCUSSION: There is a gap in HT treatment adherence in Colombia, due to socioeco-nomic and ethnic/racial conditions

Relações intergrupais e sistema de cotas: percepções de estudantes de direito / Intergroup relations and affirmative action: law students perceptions / Relaciones intergrupales y sistema de cuotas: percepciones de estudiantes de derecho

A adesão às cotas promove a convivência entre grupos de status econômico e cultural distintos. Estudos de mapeamento de interação entre cotistas e não cotistas demonstram tendência a baixa interação entre esses grupos em cursos concorridos. Este trabalho analisa a trajetória discursiva de grupos focais compostos por 30 estudantes de direito (21 não cotistas e 9 cotistas) de uma universidade pública sobre a interação entre cotistas e não cotistas. Os estudantes identificam a separação entre os grupos e refletem sobre fatores influentes. Diferenças de renda, tendência a associação por semelhança, discriminação por parte dos professores e uma cultura de competitividade são indicados como possíveis causas da baixa interação. Evidencia-se a necessidade de um projeto pedagógico e organizacional condizente com a adesão ao sistema de ingresso por cotas.

Adherence to quotas promotes coexistence between groups of distinct economic and cultural status. Interaction mapping studies between quota and non-quota students show a tendency for low interaction between these groups in crowded courses. This paper analyzes the discursive trajectory of focus groups composed of 30 law students (21 non-quota students and 9 quota students) from a public university on the interaction between quota students and non-quota students. Students identify the separation between groups and reflect on influential factors. Income differences, tendency to association by similarity, teacher discrimination and a culture of competitiveness are indicated as possible causes of low interaction. The need for a pedagogical and organizational project consistent with adherence to the quota entry system is evident.

El ingreso universitario a través del sistema de cuotas promueve la convivencia entre grupos de status económicos y culturales distintos. Estudios de mapeo de interacción entre estudiantes que ingresaron por el sistema de cuotas y los que no muestran tendencia a la baja interacción en carreras universitarias de expresiva concurrencia. Este trabajo analiza la trayectoria discursiva de grupos focales compuestos por 30 estudiantes de Derecho (21 del sistema de cuotas y 9 no) de una universidad pública sobre la interacción entre estudiantes que ingresaron por el sistema de cuotas y los que no. Los estudiantes identifican la separación entre los grupos y reflexionan sobre factores influyentes. Las diferencias de renta, tendencia a la asociación por similitud, discriminación por parte de los profesores y una cultura de competitividad, se indican como posibles causas de la baja interacción. Se evidencia la necesidad de un proyecto pedagógico y organizacional acorde con la adhesión al sistema de ingreso por cuotas.

La formación de masculinidades hegemónicas en la clase dominante: el caso de la sexualidad en los colegios privados de elite en Chile / A formação de masculinidades hegemónicas na classe dominante: o caso da sexualidade em colégios privados de elite no Chile / The formation of hegemonic masculinities among the ruling class. The case of sexuality in Chilean elite private schools

Resumen: Sobre la base de 41 historias de vida, de hombres y mujeres (de 19 a 45 años), ex-estudiantes de tres tipos de colegios privados de elite en Santiago de Chile, este artículo analiza el proceso de construcción de masculinidades hegemónicas en la clase dominante chilena. Se examina la forma en que la producción de distintos patrones de masculinidades se relaciona con cambios en la parte alta de la estructura social y se analiza el modo en que la sexualidad conecta la formación simultánea de estas masculinidades y de la clase dominante. Se contrasta la forma como estos colegios abordan la sexualidad y las prácticas sexuales de ex-estudiantes varones con mujeres de distintas clases sociales, especialmente, lo que los entrevistados llaman el "chaneo". Finalmente, se discuten las implicaciones de estos hallazgos para el estudio del poder y del privilegio en una sociedad de mercado.

Resumo: A partir de 41 histórias de vida de homens e mulheres (de 19 a 45 anos), ex-estudantes de três tipos de colégios privados de elite em Santiago do Chile, este artigo analisa o processo de construção de masculinidades hegemônicas na classe dominante chilena. Examina-se a forma como a produção de distintos padrões de masculinidades se relaciona com mudanças na parte alta da estrutura social e se analisa o modo como a sexualidade conecta a formação simultânea destas masculinidades e da classe dominante. Contrasta-se a forma como estes colégios abordam a sexualidade e as práticas sexuais de ex-estudantes homens com mulheres de distintas classes sociais, especialmente o que os entrevistados chamam de "chaneo". Finalmente, discute-se as implicâncias destes achados para o estudo do poder e do privilégio em uma sociedade de mercado.

Abstract: Based on 41 life-history interviews with men and women (19-45 years-old), former students of three different types of elite private schools in Santiago, this paper analyses the construction of hegemonic masculinities in the Chilean ruling class. The paper examines the way in which the production of different patterns of masculinities is related to changes in the top-end of the social structure, and analyzes the way in which sexuality connects the simultaneous making of these masculinities and the ruling class. The ways schools address sexuality is contrasted with former students' sexual practices with women from different social classes, particularly, the practice that they call "chaneo". Finally, the paper discusses the implications of these findings for the study of power and privilege in a market society.

Factores asociados a la deserción en estudiantes de Medicina en una universidad peruana / Associated Factors With Medical Students Dropout In Peruvian University

Objetivo: identificar los factores asociados a la deserción de estudiantes de la facultad de Medicina Humana de una universidad peruana durante el periodo 2010-2013. Métodos: en el estudio se utilizó un diseño no experimental, analítico-casos y controles. El tamaño de la muestra se obtuvo a partir de un antecedente considerando la proporción de casos y controles expuestos según vocación, este fue de 46 personas en ambos grupos, los cuales fueron escogidos a partir de un muestreo probabilístico aleatorio simple sin reemplazo. Se utilizaron los instrumentos que evalúan el nivel socioeconómico y el que mide la fuerza de motivación para la escuela de medicina (SMMS), además de una encuesta conformada por preguntas cerradas y abiertas dirigidas a indagar los aspectos individuales y académicos. Resultados: en ambos grupos, la fuerza de motivación indicó ser frecuentemente "muy baja", además, en su mayoría refirieron haber desaprobado al menos un curso durante los primeros años de la carrera; los cursos de Química médica, Filosofía y Embriología humana y Genética básica fueron las materias más frecuentes en su desaprobación. Los estudiantes de género femenino resultaron ser las más frecuentes en deserción. Conclusiones: la edad de inicio de estudios, la desaprobación de las asignaturas de filosofía, asignatura de bioestadística, horas de estudio por semana y puntaje de fuerza de motivación son factores asociados a la deserción médico estudiantil(AU)

Objective: To identify factors associated with dropout in students of the College of Human Medicine in a Peruvian university during the period 2010 ­ 2013. Methods: Anon-experimental, analytical design was used in the study - Cases and controls. The sample size was obtained from an antecedent considering the proportion of cases and controls exposed as vocation; it was 46 people in both groups; which were selected from a simple random probabilistic sampling without replacement. Instruments that assess the socioeconomic status and measures the strength of motivation for medical school (SMMS), and a survey with closed and open questions to explore individual and academics aspects were used. Results: In both groups, the strength of motivation was often "very low"; also, most reported having at least one course disapproved during the first years of the career; being the most frequent disapproved courses "Medical Chemistry, "Philosophy" and "Basic Human Embryology and Genetics". the female students were the most frequent in dropout. Conclusions: The age at onset of study, disapproval of the subjects of philosophy, the subjects of biostatistics, study hours per week and strength of motivation score are factors associated with medical student dropout(AU)

O nível socioeconômico dos pacientes hipertensos atendidos em Unidades Básicas de Saúde na região oeste da cidade de São Paulo São Paulo / The socioeconomic level of hypertensive patients from the Health Basic Units in the West of Sao Paulo City

Introdução: Vários fatores podem interferir na adesão ao tratamento dos hipertensos e conseqüentemente no controle da doença. Dentre estes se destaca o contexto socioeconômico em que vivem os hipertensos. Objetivos: Caracterizar hipertensos atendidos em unidades básicas de saúde de acordo com o nível socioeconômico em relação às variáveis biossociais, econômicas, crenças, atitudes, conhecimento sobre a doença e tratamento, falta e interrupção do tratamento; e associar o nível socioeconômico com essas variáveis. Casuística e método: O estudo foi realizado em três unidades básicas de saúde na região oeste da cidade de São Paulo. Para avaliação econômica foi feito o cálculo do índice de bens acumulados, por meio da somatória de preços de eletrodomésticos constantes na residência do paciente, dividido este por doze e posteriormente pelo valor do salário mínimo para equivalência do poder aquisitivo mensal. Os dados foram processados no sistema SPSS v.7.5. O nível de significância adotado foi de 0,05. Resultados: Foram estudados 440 hipertensos. A maioria era do sexo feminino (66%), cor branca (51%), casados (56,8%), com ensino fundamental (52%), índice de massa corporal 29,99±6,0 kg/m², idade de 57±12 anos e renda mensal familiar de 1 a 3 salários mínimos (43,6%). Do total de hipertensos estudados que interromperam o tratamento (34,8%), verificou-se que interrompeu menos de forma significativa (p<0,05) quem possuía mais televisão a cores. Em relação a faltar às consultas médicas houve associação significante (p<0,05) com geladeira diplex, verificou-se que aqueles com maior posse eletrodoméstico faltavam menos às consultas. Os hipertensos que não concordaram com a crença de que "não há nada que se possa fazer para evitar a pressão alta" apresentaram índice de bens acumulados com valores significativamente mais elevados (1,25± 0,36 vs 1,17±0,35, p<0,05). Em relação às atitudes frente ao tratamento, os hipertensos ) que afirmaram nunca chegarem atrasados às suas consultas apresentaram índice de bens acumulados com valores significativamente mais baixos (1,20±0,3 vs 1,31± 0,32, p<0,05). Na avaliação de como os pacientes "se sentiam em relação a sua vida como um todo", a referência de tristeza se associou com índice de bens acumulados com valor significativamente mais baixo (0,98 ± 0,35 vs 1,28 ±0,36 e 1,25±0,32, p< 0,05). Conclusão: A condição econômica dos hipertensos se associou com alguns aspectos relativos à adesão ao tratamento.

Introduction: A lot of factors can interfere at the adherence in the treatment and consequently control of the disease and detached among them the socioeconomic context where the hypertension people living. Objectives: To make up the people with the hypertension attending in the health basic units in agree with the socioeconomic level and the biosocial economics variables such as believes, attitudes, knowlodge about the disease and treatment, lack and interruption of the treatment; and associating the socioeconomic level with these variables. Casuistic and Methods: The study was relized on three health basic units in the west region os São Paulo city. To economic survey was done a calculating of the accumulated capital assets from the sum up of the domestics appliances prizes in the patient residence divided for twelve and on the minimum salary value for equivalence of the monthly acquisitive power. The data were processed in the system of significance adopted were 0.05. Results: Were studied 440 hypertensive patients. The great majority were females (66%), white colour (51%), married (56,8%), with fundamental degree (52%), body mass index 29,99±6,0 kg/ m², 57±12 years of age and familiar income of 1 to 3 minimum salary monthly (43,6%). From the total of studied hypertensive patients with the interrupted the treatment (34,8%) was verified whom less significant way (p<0.05) those with the coloured television. In relationship no attendance to the medical appointment have significant association (p<0.05) with duplex freezer, those who have major posses of theses domestic appliances were less absent the medical consults. The hypertensive patients that have not agreed with the belief that "they can not do anything about the high blood pressure" showed accumulated capital assets index with the values significantly more elevated (1.25± 0.36 vs 1.17±0.35, p<0.05). About the attitudes to the treatment the hypertensive patients to referred never were late to a medical appointment showed accumulated capital assets index with lower values (1.20±0.3 vs 1.31± 0.32, p<0.05). In the evaluation of the patients with "How to feel with the life" the reference with sadness have a association with accumulated capital assets index with lower values (0.98 ± 0.35 vs 1.28 ± 0.36 e 1.25±0.32, p< 0.05). The economic situation of the hypertensive patients is linked with some aspects related to the adherence of treatment.