Doença de Chagas e previdência social: estudo caso-controle em uma área urbana, Goiás, Brasil

One hundred and twenty subjects with Chagas' cardiopathy and 120 non-infected subjects were randomly selected from first time claimants of sickness benefits in the National Institute of Social Security (INPS) in Goiás. Cases of Chagas' cardiopathy were defined based on serological test, history of residence in an endemic area and, clinical and/or electrocardiogram (ECG) alterations suggestive of Chagas' cardiomyopathy. Controls were defined as subjects with at least two negative serological tests. Case and controls were compared in the analysis for age, sex, place of birth, migration history, socio-economic level, occupation, physical exertion at work, age at affiliation and years of contribution to the social security scheme, clinical course of their disease and ECG abnormalities. Chagas' disease patients were younger than other subjects and predominantly of rural origin. Non-infected subjects presented a better socio-economic level, were performing more skilled activities and had less changes of job than cases. No important difference was observed in relation to age at affiliation to INPS. About 60% of cases have claimed for benefits within the first four years of contribution while among controls this proportion was 38.5%. Cases were involved, proportionally more than controls, in "heavy" activities. A risk of 2.3 (95%CL 1.5 - 4.6) and 1.8 (95%CL 1.2- 3.5) was obtained comparing respectively "heavy" and "moderate" physical activity against "light". A relative risk of 8.5 (95%CL 4.9 - 14.8) associated with the presence of cardiopathy was estimated comparing the initial sample of seropositive subjects and controls. A high relative risk was observed in relation to right bundle branch block (RR = 37.1 95%CL = 8.8 - 155.6) and left anterior hemiblock (RR = 4.4, 95%CL = 2.1 - 9.1).São descritas as características sociais e ocupacionais de um grupo de pacientes chagásicos em área urbana no intuito de se estudar a importância médico-social da doença de chagas como causa de incapacidade laborativa. Cento e vinte pacientes portadores de cardiopatia chagásica e 120 pacientes controles, não infectados pelo Trypanosoma cruzi, foram selecionados ao acaso entre os requerentes de auxílio doença-previdenciário no Instituto Nacional de Previdência Social (INPS) de Goiás (Brasil). Os dois grupos foram comparados em relação a idade, sexo, local de nascimento, história de migração, nível sócio-econômico, esforço físico no trabalho, idade de filiação e anos de contribuição ao INPS, evolução clínica e presença de alterações eletrocardiográficas. Verificou-se que os indivíduos chagásicos apresentavam nível sócio-econômico mais baixo, desenvolviam atividades profissionais de menor especialização e recorreriam à previdência social para benefícios por incapacidade em idade mais jovem e com menor tempo de contribuição quando comparados ao grupo controle. O esforço físico ocupacional estava associado a um risco relativo de 2,3 (LC95% 1,5-4,6) e 1,8 (LC95% 1,2-3,5) comparando-se, respectivamente, atividades físicas ''pesada" e "moderada" em relação a atividades ocupacionais "leves". Comparando-se a amostra inicial de soropositivos e soronegativos (controles), foi estimado um risco relativo associado à cardiopatia de 8,5 (LC95% 4,9-14,8). Riscos relativos de 37,1 (8,8 - 155,6) e 4,4 (2,1 - 9,1) foram obtidos para o bloqueio de ramo direito e hemibloqueio anterior esquerdo, respectivamente

Virginia Pioneers Mental Health Transportation Alternative for Children Under Temporary Detention Order

Children in Virginia who are experiencing a mental health crisis have traditionally been shackled while they are transported to a mental health facility for treatment. Such shackling is traumatizing for children and detrimental to their cognitive and emotional development. Shackling has been required by law enforcement personnel, the default providers of mental health transportation. However, alternative transportation options to law enforcement exist and are actively being explored in Virginia in order to de-stigmatize mental health crises and minimize trauma caused by the transportation process. The Virginia Department of Behavioral Health and Developmental Services funded a pilot program in southwestern Virginia that allowed many adults experiencing mental health crisis to be diverted from law enforcement to a third party for transportation. The program was so successful that the Virginia Department of Criminal Justice Services established an alternative transportation workgroup to analyze the efficacy of adopting a statewide program. The workgroup adopted recommendations based on the pilot program, explored potential alternative service providers, and expanded their program to be child-inclusive. The General Assembly has adopted a three-year phased implementation of this proposal to allow for continual evaluation and assessment. This alternative transportation program is critical to ensuring better long-term care for children in crisis, as it represents a critical step away from the criminalization of juveniles and mental health issues to the rehabilitation of children and a treatment-focused approach to mental health

Racial Justice Allyship in White Non-Adopted Individuals with Adopted Siblings of Color

The ongoing prevalence of racial injustice in the United States demonstrates the growing importance of White allies and co-conspirators supporting people of Color to combat the social systems which consistently favor White individuals and disadvantage people of Color. While recent psychological research on allyship has touched on issues of racial injustice, a gap in research on transracial adoption and its impact on allyship presents an opportunity for further knowledge and progress to be made. Bridging research on transracial adoption, outgroup ally development, and factors that affect racial attitudes, the research presented in this study examines predictors of racial justice allyship among non-adopted White individuals who have an adopted sibling of Color. We hypothesize that being raised with and internalizing colorblind racial attitudes will be related to decreased racial justice allyship, and that a sense of closeness with one’s adopted siblings, as indicated by the inclusion of the adopted sibling of Color in one’s sense of self, will be related to increased allyship. To test this, a sample of White non-adopted individuals with adopted siblings of Color will be recruited from a variety of adoption-focused organizations to complete a survey on adoption experiences and racial attitudes. The results of this study will provide insights into the ways in which colorblind racial attitudes and close relationships across ethnic and racial lines can impact racial justice allyship, thus allowing for future progress in developing settings in which allyship can be increased on a large scale

Modelo para formação de preços a partir do valor percebido pelo mercado

Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro Tecnológico. Programa de Pós-Graduação em Engenharia de Produção.A maior pressão dos consumidores sobre os preços torna o mercado mais competitivo e, nesse contexto atual, a definição correta dos preços tem uma importância relevante. O trabalho tem como objetivo desenvolver uma política de preços mais eficaz, através de uma metodologia que leve em conta o valor percebido pelo mercado e a relação com os outros elementos do composto mercadológico. São descritos todos os fatores para definição dos preços, bem como as estratégias de preços mais utilizadas. A dissertação mostra que a política de preços deve se originar a partir da percepção de valor do mercado e não a partir dos custos. São descritas as várias técnicas para medir a resposta do mercado aos preços e escolhida a Análise Conjunta como a mais adequada para ser usada no modelo proposto por esse trabalho. A Análise Conjunta mede o valor percebido de cada atributo do produto, possibilitando definir o preço a partir do valor percebido total. Para a comprovação da eficácia do modelo proposto, é feita uma aplicação com um produto de cercamento urbano. Os resultados mostram que o modelo desenvolvido define mais coerentemente a política de preços e contribui para melhorar o produto, com base no valor percebido pelo mercado