This paper harnesses the strengths of the recent affective turn in citizenship studies. It makes three contributions to the literature. First, against proponents and critics of neoliberalism who ...neglect the reinventions of citizenship under 'neoliberalism', it emphasises the politics of hope advanced by socially excluded people. Second, while sympathetic to the affective turn in citizenship it addresses what it believes to be its key limitations: a neglect of the care people expect from the state and the feelings of solidarity that remain central to citizenship. Third, by reflecting on the experience of neighbourhood in Sao Paulo, the paper challenges the overwhelming focus of the affective citizenship literature on the Global North by drawing on perspectives from a key city in the Global South.
Responses to COVID-19 have included top-down, command-and-control measures, laissez-faire approaches, and bottom-up, community-driven solidarity and support, reflecting long-standing contradictions ...around how people and populations are imagined in public health-as a 'problem' to be managed, as 'free agents' who make their own choices, or as a potential 'solution' to be engaged and empowered for comprehensive public health. In this rapid review, we examine community-engaged responses that move beyond risk communication and instead meaningfully integrate communities into decision-making and multi-sectoral action on various dimensions of the response to COVID-19. Based on a rapid, global review of 42 case studies of diverse forms of substantive community engagement in response to COVID-19, this paper identifies promising models of effective community-engaged responses and highlights the factors enabling or disabling these responses. The paper reflects on the ways in which these community-engaged responses contribute to comprehensive approaches and address social determinants and rights, within dynamics of relational power and inequality, and how they are sometimes able to take advantage of the ruptures and uncertainties of a new pandemic to refashion some of these dynamics.
As a means of dealing with shortcomings in the coverage, quality and efficiency of the public health care sector, several municipalities in the state of São Paulo, Brazil, have started to contract ...pre-certified non-profit or non-governmental organizations to take part in the delivery of health care services.
This paper explores the impact of introducing these contracts in the primary health care sector. Using data on the 645 municipalities in the state of São Paulo and difference-in-differences methods, we estimate the effect of contracting out in the primary health care sector on various dimensions of mortality and health care use. The results show that implementation of the contracting out strategy significantly increases the number of primary health care appointments by approximately one appointment per user of the national health care system per year. Point estimates indicate a reducing effect on hospitalization for preventable diseases.
Afin de remédier aux lacunes en matière de couverture, de qualité et d’efficacité du secteur de la santé publique, plusieurs municipalités de lÉtat de São Paulo ont commencé à externaliser la prestation des services de soins de santé à des organismes à but non lucratif ou non gouvernementaux préalablement agréés.
Le présent article explore l’impact de l’introduction de ces contrats dans le secteur des soins de santé primaires. Grâce aux données collectées auprès des 645 municipalités de lÉtat de Sao Paulo et aux méthodes d’écart dans les différences, nous estimons l’incidence de l’externalisation dans le secteur des soins de santé primaires en nous basant sur divers aspects de la mortalité et de l’utilisation des soins de santé. Les résultats montrent que la mise en œuvre de la stratégie d’externalisation entraîne une notable augmentation du nombre de rendez-vous pour les soins de santé primaires d’environ un rendez-vous par utilisateur du système national de soins de santé par année. Les estimations ponctuelles indiquent une incidence sur la réduction des hospitalisations pour les maladies évitables.
为了应对公共卫生部门覆盖率、质量和效率的缺陷, 巴西圣保 罗州的几个城市与取得认证的非营利性或非政府组织签约, 让 这些组织参与提供卫生保健服务。
本文探讨初级卫生保健部门引入这类合约的影响。我们使用 圣保罗州645个城市的数据, 采用双重差分法, 估算初级卫生 保健外包对死亡率和卫生保健使用各个维度的影响。结果显 示实施外包显著增加了初级卫生保健预约数量, 每位国家医疗 体系使用者每年约增加一次预约。点估计值提示该措施降低 了可预防疾病的住院率。
Con el fin de abordar las deficiencias en la cobertura, la calidad y la eficiencia de la atención de salud del sector público, varias municipalidades en el estado de Sao Paulo, Brasil, han comenzado a contratar organizaciones previamente certificadas sin ánimo de lucro o no gubernamentales para participar en la prestación de servicios de salud.
Este artículo explora el impacto de la introducción de estos contratos en el sector de atención primaria de la salud. Utilizando los datos de las 645 municipalidades del estado de Sao Paulo y métodos de diferencias en diferencias, estimamos el efecto de la contratación externa en el sector de la atención primaria de salud en varias dimensiones de la mortalidad y el uso de la atención de la salud. Los resultados muestran que la implementación de la estrategia de contratación externa aumenta significativamente el número de citas de atención primaria de la salud por aproximadamente una cita por usuario del sistema nacional de salud por año. Las estimaciones puntuales indican un efecto reductor sobre la hospitalización por enfermedades prevenibles.
Mobilizing for democracy P. Coelho, Vera Schattan; Lieres, Bettina von
2010., 2013, 2010, 2010-09-09, 2013-04-04, 20100101
eBook
Mobilizing for Democracy is an in-depth study into how ordinary citizens and their organizations mobilize to deepen democracy. Featuring a collection of new empirical case studies from Angola, ...Bangladesh, Brazil, India, Kenya, Nigeria and South Africa, this important new book illustrates how forms of political mobilization, such as protests, social participation, activism, litigation and lobbying, engage with the formal institutions of representative democracy in ways that are core to the development of democratic politics. No other volume has brought together examples from such a broad Southern spectrum and covering such a diversity of actors: rural and urban dwellers, transnational activists, religious groups, politicians and social leaders. The cases illuminate the crucial contribution that citizen mobilization makes to democratization and the building of state institutions, and reflect the uneasy relationship between citizens and the institutions that are designed to foster their political participation.
Resumo A promoção da literacia saúde mental em adolescentes tem recebido particular atenção na saúde pública, dado a adolescência ser vista como um período crítico para prevenção de problemas de ...saúde mental na idade adulta. Apesar da consistência empírica sobre a eficácia dos programas face a face de literacia da saúde mental para adolescentes, pouco se sabe sobre as características e o efeito de intervenções mediadas pela tecnologia para este objetivo. A presente revisão sistemática teve como finalidade sistematizar conhecimento empírico sobre os efeitos de programas mediados pela tecnologia de promoção da literacia em saúde mental em adolescentes. Procedeu-se a um levantamento sistemático da literatura até dezembro de 2019, tendo sido selecionados quatro estudos empíricos que avaliaram os efeitos deste tipo de programas em diferentes indicadores de saúde mental. Os resultados revelaram que os programas mediados pela tecnologia apresentaram efeitos positivos no aumento da literacia em saúde mental, sendo o sexo e a idade moderadores destas associações. No entanto, o seu efeito na redução do estigma e nos comportamentos de procura de ajuda profissional foi inconsistente. As limitações dos estudos incluídos na revisão são discutidas.
Abstract As adolescence is considered a critical period for preventing mental health issues in adulthood, adolescents became the primary audience of public health campaigns aimed at promoting mental health literacy. Despite empirical consistency on the effectiveness of face-to-face mental health literacy programs for adolescents, little is known about the characteristics and effects of technology-mediated interventions for this goal. This systematic review seeks to systematize the empirical knowledge on the effects of technology-mediated programs promoting mental health literacy among adolescents. We conducted a systematic literature search until December 2019 and selected four empirical studies that evaluated the effects of these types of programs on different mental health indicators. Results show that technology-mediated programs had positive effects on increasing mental health literacy, with gender and age moderating these associations. Their effect on reducing stigma and prompting professional help-seeking behavior, however, was inconsistent. The limitations of the studies included in the review were also discussed.
It is widely recognized that socio-emotional learning (SEL) interventions can contribute to supporting students' positive development of socio-emotional skills (SES) and positive relationships with ...peers and teachers. Thus, interest in promoting students' SES through universal evidence-based programs is spreading around the world, including in Portuguese schools.
This quasi-experimental study examines the efficacy of a SEL classroom-based program, infused into the curriculum, on students' communication, self-regulation, and classroom peer relationships. Participants included 208 third- to fourth-grade students from three Portuguese public elementary schools: 143 in the intervention group (54.5% boys;
= 8.72;
= 0.61); 65 in the comparison group (52.3% boys;
= 8.66;
= 0.59). Measures included: Study on Social and Emotional Skills, parent, child, and teacher versions; and Classroom Peer Context Questionnaire, completed by students. The study followed a pre- and post-test design, with a 16-week intervention.
For the overall participants, results show a positive effect of the program on students' assertiveness (family report), peer conflict and peer cooperation. Effects were analyzed separately by school grade. A statistically significant positive effect of the program on third-grade students' assertiveness and sociability was found. For fourth-grade students, a positive effect was found on - emotional control). classroom conflicts, isolation, cooperation and cohesion behaviors.
These positive effects support the expansion of universal interventions when aiming at strengthening SEL in Portuguese school settings, underlining the relevance of embedding SEL into the curricula and daily practices at schools.
RESUMO: Este estudo correlacional pretende caracterizar os contextos pré-escolares inclusivos portugueses relativamente aos formatos de atividade, analisar relações entre eles e a qualidade do tom ...emocional e estimulação cognitiva e da linguagem do educador, e as relações entre formatos de atividade e envolvimento de crianças com incapacidades, em risco e com desenvolvimento típico. Participaram do estudo 198 crianças (47 com incapacidades; 60 em risco; 91 com desenvolvimento típico). O envolvimento das crianças e os formatos de atividade foram observados com o Child Observation in Preschool; tom emocional e estimulação cognitiva com o Teacher Observation in Preschool. Os resultados revelaram que o tom emocional dos educadores nas interações registou valores moderados, sendo mais elevados nas atividades de grande-grupo. O grande-grupo registou níveis de envolvimento mais baixos para todas as crianças. Os três grupos de crianças registam níveis semelhantes de envolvimento em jogo-livre. Concluise que, apesar dos formatos de grande-grupo apresentarem qualidade mais elevada no tom das interações, é nestes que crianças com e sem incapacidades apresentam níveis mais baixos de envolvimento, destacando-se o jogo-livre como um formato onde todas as crianças se envolvem mais. Os resultados salientam a importância da intencionalidade educativa no planeamento das interações e dos formatos das atividades, para assegurar a promoção do envolvimento das crianças.
ABSTRACT: This correlational study aims to characterize the Portuguese inclusive preschool contexts regarding activity-settings, to analyze relationships between them and the quality of the educator’s emotional tone and cognitive and language stimulation, and the relationships between activity-settings and involvement of children with disabilities, at-risk and typically developing. A total of 198 children participated in the study (47 with disabilities; 60 at-risk; 91 typically developing). Child engagement and activity-setting were observed with Child Observation in Preschool; emotional tone and cognitive stimulation with Teacher Observation in Preschool. Results revealed that the educators’ emotional tone in interactions registered moderate values, being higher in whole-group activities. The whole-group activities registered lower levels of engagement for all children. The three groups of children presented similar levels of engagement in free-play. It was concluded that, although the whole-group activity-settings show higher quality regarding the tone of interactions, it is in these activity-settings that both children with and without disabilities show lower levels of engagement, with free-play emerging as an activity-setting where all children are more engaged. Results highlight the importance of educational intentionality in planning interactions and activity-settings to ensure the promotion of children’s engagement.
Purpose: This study aims to explore the role of three specific factors within the child-environment interaction process - engagement, independence and social interactions - in influencing development ...and learning of children with disabilities in inclusive preschool settings. The main question is whether children can be categorised in homogenous groups based on engagement, independence and social interactions (proximal variables within a biopsychosocial framework of human development). The study also examined whether children with the same diagnosis would group together or separately, when trying to identify clusters of engagement, independence and social interactions, and additionally whether such clusters vary as a function of individual child characteristics, and/or as a function of structural and process characteristics of preschool environment.
Methods: Data was taken from an intervention study conducted in mainstream preschools in Portugal. A person-centered cluster analysis was conducted to explore group membership of children with various diagnoses, based on their engagement, independence and social interaction profiles.
Results: Results show that children clustered based on similarity of engagement, independence and social interaction patterns, rather than on diagnosis. Besides, it was found that quality of peer interaction was the only predictor of cluster membership.
Conclusion: These findings support the argument that participation profiles may be more informative for intervention purposes than diagnostic categories, and that preschool process quality, namely peer interaction, is crucial for children's participation.
In Portugal, substantial changes occurred in early childhood intervention and special education with the Decree-Law 3/2008 (2008). This legislation stresses the importance of a multidimensional ...approach to assessment-intervention processes, setting the International Classification of Functioning Disability and Health (ICF) as a critical tool in determining children’s functioning and participation. To establish criteria for eligibility and defining the standard for developing assessment-intervention procedures in accordance with the ICF model, became topics of great relevance for researchers, practitioners, and policy-makers. Assuming that young children develop through proximal processes, such as playing and interacting with adults/peers/materials, their participation in everyday environments becomes a crucial outcome regarding learning and development, as highlighted by the ICF conceptual model. Children’s participation can be defined as encompassing two dimensions: frequency of activities attended by children, and their level of engagement. This observational study analyzes engagement and time spent in activities with different levels of social complexity, in children with heterogeneous developmental functioning (DF). By focusing on different levels of DF, we aim to explore how functionality measures based on ICF can be useful to characterize all children, thus ensuring an inclusive assessment. Participants were 247 preschool-aged children: 54 with disabilities (low DF), 78 at-risk (medium-low DF); 115 with typical development (high DF). DF was assessed by a short-version of the Matrix for Assessment of Activities and Participation. Engagement and time in activities were observed with the Child Observation in Preschool. Analyses of Variance were conducted to explore differences between the three groups of children. The three DF groups differed significantly on the proportion of time spent in activities with different levels of social complexity. Children with disabilities spent less time in cooperative and social play (activities with higher social complexity) and their levels of engagement were significantly lower than the other groups. Discussion focuses on assessment demands posed by legislation and the ICF model, highlights the need to ensure all children’s participation in different everyday activities, and underlines the role of environmental adjustments for children with disabilities and at risk to guarantee their right to fully participate in inclusive settings.
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