RESUMO

Spondylocarpotarsal synostosis syndrome (SCT) is a very rare skeletal dysplasia characterized by vertebral, carpal, and tarsal fusion; growth retardation; and mild dysmorphic facial features. Variants in FLNB, MYH3, and RFLNA have been implicated in this dysplasia. We report the clinical and radiological follow-up of seven SCT pediatric cases associated with biallelic FLNB variants, from four Argentinian families. The seven cases share previously described facial characteristics: round facies, large eyes, and wide based nose; all of them had variable height deficit, in one case noted early in life. Other findings included clinodactyly, joint limitation without bone fusion, neurosensorial hearing loss, and ophthalmological compromise. All cases presented with spinal fusion with variable severity and location, carpal bones coalition, and also delay in carpal ossification. The heterozygous carrier parents had normal height values to -2.5 score standard deviation, without skeletal defects detected. Three different FLNB variants, one nonsense and two frameshift, were detected, all of which were predicted to result in a truncated protein or are degraded by nonsense mediated decay. All cases had at least one copy of the nonsense variant, c.1128C> G; p. (Tyr376*), suggesting the presence of a common ancestor.

RESUMO

Tarsal coalition is an abnormal bony, cartilaginous, or fibrous bridge between 2 or more tarsal bones. Adolescent athletes with tarsal coalitions typically present with symptoms that include foot and/or ankle pain and limited range of motion. Loss of mobility can lead to abnormal loading, articular instability, deformity, and joint degeneration. Nonoperative management includes immobilization, physical therapy, and custom foot orthosis. Surgical options include coalition excision and fat graft interposition, foot realignment, or a combination of these. Surgical treatment requires evaluation of the coalition type, foot alignment, and degenerative changes in the adjacent joints.

RESUMO

INTRODUCTION: Little research on the association of neighborhood environment with physical activity in resource-poor communities has been done. This study assessed changes in perceptions of the neighborhood environment and the association between those perceptions and physical activity in Mexican Americans on the Texas-Mexico border in an area where there would be community efforts to enhance pedestrian and cycling infrastructure and programming. METHODS: We analyzed data from a population-based cohort of Mexican American individuals on the Texas-Mexico border. From 2008 to 2018, interviewer-administered questionnaires were used to collect perceptions of neighborhood environment and physical activity at baseline, 5- and 10-year follow-ups, and at other ancillary study visits, with an average of 3 data points per participant. We conducted multivariable longitudinal logistic regression analyses to assess if the changes in odds of positive perceptions of the neighborhood environment over the study years differed by physical activity patterns. RESULTS: The sample (n = 1036) was mostly female (71%), born in Mexico (70%), and had no health insurance (69%). We saw improvements in the perceptions of several neighborhood environment attributes from 2008 to 2018, though we saw different longitudinal trajectories in these perceptions based on an individual's longitudinal physical activity patterns. By 2014-2018, we saw significantly higher positive perceptions of the neighborhood environment for those who consistently met physical activity guidelines compared with those who did not (adjusted rate ratio = 1.12, P = .049). DISCUSSION: We found that perceptions of many neighborhood environment attributes improved between 2008 and 2018, and that overall positive perceptions were associated with consistently meeting physical activity guidelines over time.

Assuntos

RESUMO

Developing operationally strong community coalitions is critical to actualizing their potential for public health improvement. The purpose of this study was to measure how substance use prevention coalitions in Mexico functioned across their first 1.5 years, and to test associations between initial community contextual factors and subsequent coalition functioning and outcomes. Members of 19 coalitions participated in three waves of surveys about coalition context and functioning. We used paired t-tests to assess changes in coalition functioning and outcomes. Regression models estimated associations between coalition functioning and outcomes and initial community context. Among coalition functioning factors, over coalitions' first 1.5 years, member engagement increased, as did coordinator skill and participatory leadership style. Two initial community context factors - community support for prevention and community champions - predicted several measures of process competence, but only community champions predicted perceived community improvement. Thus, community champions may play a pivotal role in later coalition success. The observed increases in member engagement and process competence may support subsequent coalition sustainability, a crucial component to realizing their potential impact on public health.

Assuntos

RESUMO

Abstract The relation between taxation and partisanship is a widely studied topic in Political Science. However, previous works have provided conflicting findings without clarifying which parties are most prone to progressive taxation. These studies also did not consider one distinctive feature of Latin American politics: coalition governments. Using the level of direct tax collection as a proxy for progressive taxation and panel data of Latin American countries since 1990, we investigate how progressive taxes vary across a scale of ideology observed in the executive branch along with the ideological heterogeneity of its coalition. The results show that ideologically heterogeneous governments present a policy drift, as the policies being enacted depart from parties' original preferences. Homogeneous left-wing governments collect more direct taxes than ideologically heterogeneous coalitions led by governments with the same ideology. The same dynamic is observed with homogeneous right-wing governments, which collect more indirect taxes in ideologically homogeneous coalitions. These results create new paths of research highlighting the need to include the government's composition in the analysis to understand policy design and the need to unravel the mechanism through which policy drift occurs in ideologically heterogeneous governments.

Resumen La relación entre tributación y partidismo es un tema ampliamente estudiado en Ciencias Políticas. Sin embargo, trabajos previos han proporcionado hallazgos contradictorios sin aclarar qué partes son más propensas a la tributación progresiva. Estos estudios tampoco consideraron una característica distintiva de la política latinoamericana: los gobiernos de coalición. Utilizando el nivel de recaudación de impuestos directos como indicador de la tributación progresiva y datos de panel de los países de América Latina desde 1990, investigamos cómo varían los impuestos progresivos a lo largo de una escala de ideología observada en el poder ejecutivo junto con la heterogeneidad ideológica de su coalición. Los resultados muestran que los gobiernos ideológicamente heterogéneos presentan un policy drift, ya que las políticas que se promulgan se apartan de las preferencias originales de los partidos. Los gobiernos homogéneos de izquierda recaudan más impuestos directos que las coaliciones ideológicamente heterogéneas lideradas por gobiernos con la misma ideología. La misma dinámica se observa con gobiernos homogéneos de derecha, que recaudan más impuestos indirectos en coaliciones ideológicamente homogéneas. Estos resultados crean nuevos caminos de investigación que destacan la necesidad de incluir la composición del gobierno en el análisis para comprender el diseño de políticas y la necesidad de desentrañar el mecanismo a través del cual se produce policy drift de políticas en gobiernos ideológicamente heterogéneos.

Resumo A relação entre tributação e partidarismo é amplamente estudada na Ciência Política. Entretanto, trabalhos anteriores não só apresentaram resultados contraditórios - sem esclarecer quais partidos são mais propensos a instituir tributos progressivos - como nenhum considerou um elemento particular da política latino-americana: os governos de coalizão. Usando o nível de arrecadação com tributos diretos como uma proxy para tributação progressiva e adotando um banco de dados em painel, investiga-se a receita com tributos progressivos considerando uma escala da ideologia da liderança executiva e a heterogeneidade ideológica da coalizão que forma o governo. Os resultados indicam que governos ideologicamente heterogêneos apresentam policy drift, já que as políticas sendo implementadas se distanciam das preferências originais da liderança executiva. Governos homogêneos de esquerda têm receitas maiores com tributos diretos do que governos formados a partir de coalizão ideologicamente heterogênea sob as mesmas lideranças. A mesma dinâmica ocorre com governos homogêneos de direita, que têm receitas maiores com tributos indiretos. Os resultados indicam novos caminhos para pesquisa, destacando a necessidade de se incorporar a composição de um governo à análise de políticas públicas, como a importância de se compreender o mecanismo pelo qual policy drift ocorre em governos ideologicamente heterogêneos.

Assuntos

RESUMO

The current nativist and ethnocentric policies and rhetoric put forward in the United States have compromised the safety of undocumented Hispanic/Latinx Americans. Many in these communities abstain from overt action toward change. Nonetheless, there are examples of community members who embrace the narrative "undocumented and unafraid." Through in-depth individual interviews and focus groups, we qualitatively examined how undocumented Mexican community coalition members (N = 10), focused on enacting socio-political change on behalf of their predominantly Mexican southwestern community, understood the role of their group as a venue for bridging resources and social action. Findings centered on three specific broad themes: (1) Meeting Community Needs: A Disconnection from Resources; (2) Community Coalition as a Space for Bridging Resources; and (3) Community Coalition as a Space for Activism and Social Change.

Assuntos

RESUMO

Resumo O artigo examina as mudanças na escolarização das pessoas com deficiência (PcD) no Brasil, advindas da difusão de ideias e ações governamentais que introduziram a perspectiva da inclusão na educação especial. Com base na teoria das coalizões de defesa, analisaram-se o subsistema nacional de educação especial (SEE), as coalizões de defesa que o integram e as crenças em disputa, além dos fatores elucidativos das modificações observadas no setor. Trata-se de um estudo de caso que abrangeu reconstrução histórica, análise documental, revisão bibliográfica e levantamento de dados secundários. Entre os resultados, identificaram-se duas coalizões no subsistema: a do atendimento exclusivo (coalizão 1) e a da educação inclusiva (coalizão 2). A primeira foi dominante entre 1973 e 2002, e a segunda surgiu na década de 2000, tornando-se hegemônica em 2008, com a promulgação da Política Nacional de Educação Especial na Perspectiva da Educação Inclusiva. Também se verificou que a coalizão 1 se pauta na separação dos estudantes conforme os tipos de deficiência e capacidades de aprendizagem, enfatizando a importância do atendimento clínico especializado e das escolas especiais. Em contrapartida, a coalizão 2 concebe que todos são capazes de aprender, sobretudo quando inseridos em classes comuns de escolas regulares, dentro de sistemas inclusivos. Como fatores explicativos das mudanças no SEE, sobressaíram as variáveis exógenas, principalmente a mudança do governo federal em 2003, a disseminação mundial e nos subsistemas de concepções sobre educação inclusiva, além do feedback de políticas públicas do SEE e de outros setores.

Resumen El artículo examina los cambios en la educación de las personas con discapacidad (PwD) en Brasil, derivados de la difusión de ideas y acciones gubernamentales que introdujeron la perspectiva de la inclusión en la educación especial. Con base en la teoría de coaliciones de defensa, se analizó el subsistema nacional de educación especial (SEE), las coaliciones de defensa que lo integran y las creencias en disputa, además de los factores que explican los cambios observados en el sector. Se trata de un estudio de caso que incluyó reconstrucción histórica, análisis documental, revisión de literatura y recolección de datos secundarios. Entre los resultados se identificó la existencia de dos coaliciones en el subsistema: atención exclusiva (coalición 1) y educación inclusiva (coalición 2). La primera fue dominante entre 1973 y 2002 y la segunda surgió en la década de 2000, volviéndose hegemónica en 2008, con la promulgación de la Política Nacional de Educación Especial desde la Perspectiva de la Educación Inclusiva. También se encontró que la coalición 1 se guía por la separación de los estudiantes según los tipos de discapacidad y habilidades de aprendizaje, enfatizando la importancia de la atención clínica especializada y de las escuelas especiales. Por otro lado, la coalición 2 concibe que todos son capaces de aprender, especialmente cuando se insertan en clases comunes de escuelas regulares, dentro de sistemas inclusivos. Como factores explicativos de los cambios en el SEE, se destacaron las variables exógenas, principalmente: el cambio en el gobierno federal en 2003, la difusión mundial y en los subsistemas de concepciones sobre educación inclusiva, además del feedback de las políticas públicas del SEE y de otros sectores.

Abstract This article examines the changes in education for people with disabilities (PwD) in Brazil, arising from the dissemination of ideas and government actions that introduced the perspective of inclusion. Based on the advocacy coalition framework, we analyzed the national special education subsystem (SES), the advocacy coalitions that integrate the SES, the beliefs in dispute, and the factors that explain the changes observed in the sector. This case study included historical reconstruction, document analysis, literature review and secondary data collection. The results identified the existence of two coalitions in the subsystem: specialized and exclusive care (coalition 1) and inclusive education (coalition 2). The first was dominant between 1973 and 2002, and the second emerged in the 2000s, becoming hegemonic in 2008 with the promulgation of the National Policy for Special Education from the Perspective of Inclusive Education. It was also found that coalition 1 is guided by the separation of students according to types of disability and learning abilities, emphasizing the importance of specialized clinical care and special schools. On the other hand, coalition 2 conceives that everyone is capable of learning, especially when inserted in standard classes of regular schools, within inclusive systems. As explanatory factors of the changes in the SES, exogenous variables stood out, particularly the changes in the Brazilian federal government in 2003, the worldwide dissemination of the inclusive education conceptions - reaching the education subsystems, and the feedback of public policies from the SES and other sectors.

Assuntos

RESUMO

Abstract The Brazilian presidential elections of 2018 brought large-scale changes in the Brazilian environmental policy subsystem. The purpose of this article is to analyze these changes through the lenses of the Advocacy Coalition Framework - ACF. First, we introduced some of the main characteristics of this subsystem, then we presented a hemerographic analysis to describe and analyze the effects of four recent shocks in this subsystem. Two of these shocks were external: (i) the election of a new political elite in power that brought a clear discourse of denial of the relevance of environmental policy and (ii) calamitous environmental events that occurred in Brazil in 2019. The other two shocks were internal: (i) the capture of key positions and resources by dominant coalition members and (ii) the rise of conflict and polarization among the coalitions in the subsystem. The results showed: (i) the rise of a hyper-adversarial environmental policy subsystem; (ii) a realignment between non-dominant coalitions in a cooperative direction; (iii) the imposition of clear barriers to negotiation; (iv) changes in the use of scientific information by more politicized discourses with a high degree of bias. The article contributes to the understanding of the processes of institutional change in environmental policy, especially in contexts of large-scale change generated by increasing electoral polarization and fierce political disputes. It also contributes to the analysis of the limits and possibilities of the ACF in the Brazilian environmental agenda.

Resumen Las elecciones presidenciales brasileñas de 2018 introdujeron cambios de gran escala en el subsistema de política ambiental del país. El propósito de este documento es analizar estos cambios a través de las lentes del Advocacy Coalition Framework - ACF. Para ello, exponemos algunas de las características principales de este subsistema y, luego, presentamos un análisis hemerográfico para describir y analizar los efectos de cuatro shocks recientes en este subsistema. Dos de estos shocks fueron externos: (i) el ascenso de una nueva élite política al poder, la cual ha traído un claro discurso de negación de la relevancia de la política ambiental y (ii) catastróficos eventos ambientales que ocurrieron en Brasil durante 2019. Otros dos shocks fueron internos: (i) la captura de posiciones y recursos claves por los miembros de la coalición dominante y (ii) el surgimiento de conflictos y polarizaciones entre las coaliciones del subsistema. Los resultados mostraron: (i) el ascenso de un subsistema de política ambiental hipercontradictorio; (ii) el realineamiento de las coaliciones no dominantes en una dirección cooperativa; (iii) la imposición de claras barreras en los procesos de negociación; y (iv) cambios en el uso de información científica por discursos más politizados con un alto grado de sesgo. Este artículo contribuye a la comprensión de los procesos de cambio institucional en la política ambiental, especialmente en contextos de cambios de gran escala generados por un aumento en la polarización electoral e intensas disputas políticas. También contribuye al análisis de los límites y posibilidades del ACF en la agenda ambiental brasileña.

Resumo As eleições presidenciais brasileiras de 2018 trouxeram mudanças em larga escala no subsistema de política ambiental do país. O objetivo deste artigo é analisar essas mudanças através do Advocacy Coalition Framework - ACF. Para isso, introduzimos algumas das principais características do subsistema de política ambiental e, a seguir, apresentamos uma análise hemerográfica para descrever e analisar os efeitos de quatro choques recentes no subsistema em análise. Dois desses choques foram externos: (i) a ascensão ao poder de uma nova elite política que trouxe um discurso claro de negação da relevância da política ambiental e (ii) eventos ambientais calamitosos que ocorreram no Brasil em 2019. Dois outros choques foram internos: (i) a captura de posições e recursos importantes pelos membros da coalizão dominante e (ii) o surgimento de conflitos e polarizações entre as coalizões no subsistema. Os resultados mostraram: (i) a ascensão de um subsistema hiper-contraditório; (ii) o realinhamento entre coalizões não dominantes em direção à cooperação; (iii) a imposição de barreiras claras à negociação; e (iv) mudanças no uso da informação científica por discursos mais politizados com alto grau de viés. O artigo contribui para a compreensão dos processos de mudança institucional na política ambiental, especialmente em contextos de mudança em larga escala gerados pelo aumento da polarização eleitoral e intensas disputas políticas. Contribui também para a análise dos limites e possibilidades do ACF na agenda ambiental brasileira.

Assuntos

RESUMO

Abstract The article discusses advocacy coalition formation and the roles of key actors in science, technology and innovation (ST&I) policies for social inclusion in a subnational context. The policy subsystem category and concept of advocacy coalition are used in the context of the advocacy coalition framework and address the need to understand the influences of key actors (policy broker and policy entrepreneur) on it. The policy subsystem was outlined using case-oriented research and the discourse was analyzed in order to understand the policy actors' beliefs. The analysis of two cases of ST&I policy processes for social inclusion (assistive technology and social technology) highlighted policy broker and policy entrepreneur key roles in the emergence of policy subsystems, but had different effects on advocacy coalition formation. The policy entrepreneur had a closer relationship with advocacy coalition building when setting up regular mechanisms to share beliefs and policy-oriented learning, as well as taking initiatives to coordinate the collective action of members in the early advocacy coalition. Although relevant in agenda setting and maintaining a specific social inclusion agenda in the policy process, the policy broker did not achieve a positive relationship with advocacy coalition building. The article corroborates the possibility of incorporating the concept of policy entrepreneur in analyses of the advocacy coalition framework and highlights this actor's characteristics through this analytical model.

Resumen El artículo analiza la formación de coaliciones de defensa y los roles de los actores clave en las políticas de ciencia, tecnología e innovación (PCTI) para la inclusión social en un contexto subnacional. Considerando el modelo de coalición de defensa (MCD), se utilizaron como referencia las categorías analíticas del subsistema de la política y de la coalición de defensa, para comprender las influencias de los actores clave, específicamente del policy broker (intermediario) y del emprendedor de políticas. El subsistema de la política se delimitó mediante el método de investigación basado en casos y se usó el análisis del discurso para comprender las creencias de los actores en la política. El análisis de dos casos del proceso de la PCTI para la inclusión social (tecnología social y tecnología de la rehabilitación) resaltó los roles de los actores clave en la aparición de subsistemas de la política, sin embargo tuvieron diferentes efectos en la formación de coaliciones de defensa. El emprendedor de políticas tuvo una mayor relación con la formación de una coalición de defensa al establecer mecanismos regulares para comunicar sus posiciones y aprendizajes orientados a la política, así como al tomar iniciativas para coordinar la acción colectiva en la naciente coalición de defensa. El policy broker no logró una relación positiva con la formación de las coaliciones de defensa analizadas, pero sí fue relevante para el establecimiento de la agenda y la permanencia de la pauta de inclusión social en el proceso de la política. Este trabajo corrobora la posibilidad de incorporar el concepto de emprendedor de política en los análisis de MDC y señala las características de este actor clave en el modelo analítico estudiado.

Resumo O artigo discute a formação de coalizão de defesa e o papel de atores chaves em políticas de Ciência, Tecnologia e Inovação (CT&I) para inclusão social em um contexto subnacional. No âmbito do Modelo de Coalizão de Defesa (MCD), utilizou-se as categorias analíticas do subsistema da política e da coalizão de defesa como referência e buscou-se compreender as influências de atores chaves nestas, especificamente o policy broker (mediador) e o empreendedor de política. O subsistema de política foi delimitado pelo método de pesquisa baseada em caso e a análise de discurso foi mobilizada para compreender as crenças dos atores da política. A análise de dois casos do processo de política de CT&I para inclusão social (tecnologia social e tecnologia assistiva) realçou os papéis de atores chaves na emergência dos subsistemas de política, porém estes tiveram diferentes efeitos sobre a formação de coalizões de defesa. O empreendedor da política teve maior relação com a formação de coalizão de defesa ao estabelecer mecanismos regulares para compartilhamento de crenças e aprendizados orientados para a política, bem como ao tomar iniciativas de coordenação da ação coletiva na coalizão de defesa nascente. O policy broker não alcançou relação positiva substancial com a formação das coalizões de defesa analisadas, embora tenha sido relevante para o agenda-setting e a permanência da pauta de inclusão social no processo da política. O artigo corrobora com a possibilidade de incorporação do conceito de empreendedor de política em análises do MDC e aponta características deste ator chave iluminadas pelo modelo analítico.

Assuntos

RESUMO

Resumo O processo orçamentário brasileiro tem sido historicamente questionado pela suposta presença de barganha política na inclusão e na execução de emendas ao orçamento, fato que interfere nas premissas, nos critérios e nas práticas das escolhas alocativas. Este artigo, sustentado pela Teoria da Formação de Coalizões, investiga a existência de uma possível relação de barganha política entre os poderes Executivo e Legislativo no processo orçamentário na esfera federal. Tal pesquisa ocorre por meio da análise das execuções de emendas parlamentares singulares ao longo de cinco legislaturas (entre 2000 e 2017) e das decisões dos deputados na votação de projetos propostos pelo Executivo. Analisaram-se dados referentes à execução de emendas singulares, bem como aqueles concernentes à posição política do parlamentar com relação ao Executivo no instante da proposição das emendas. A metodologia envolveu técnicas econométricas que lidam com a correção do viés de seleção para avaliar a presença ou não da referida relação de barganha. Os resultados obtidos corroboram a hipótese de existência de barganha política entre os poderes Executivo e Legislativo, pois o parlamentar com maior aporte de execução de suas emendas singulares foi aquele que, além de ter exercido apoio ao Executivo através de votos favoráveis aos projetos enviados ao congresso nacional, era de fora da coligação de governo, alvo do Executivo na formação do quorum mínimo para a aprovação de seus projetos.

Resumen El proceso presupuestario brasileño ha sido históricamente cuestionado por la supuesta presencia de regateo político en la inclusión y ejecución de enmiendas al presupuesto, hecho que interfiere con las premisas, criterios y prácticas de las decisiones distributivas. Este artículo, apoyado en la Teoría de la Formación de Coaliciones, investiga la existencia de una posible relación de regateo político entre los poderes Ejecutivo y Legislativo en el proceso presupuestario a nivel federal. Dicha investigación se da a través del análisis de las ejecuciones de enmiendas parlamentarias singulares en cinco legislaturas (entre 2000 y 2017) y de las decisiones de los diputados en la votación de proyectos propuestos por el Ejecutivo. Se analizaron datos referentes a la ejecución de enmiendas singulares, así como los referentes a la posición política del parlamentario frente al Ejecutivo al momento de la proposición de las enmiendas. La metodología involucró técnicas econométricas que tratan la corrección del sesgo de selección para evaluar la presencia o ausencia de la referida relación de regateo. Los resultados obtenidos corroboran la hipótesis de existencia de regateo político entre los poderes Ejecutivo y Legislativo, ya que el parlamentario con mayor aporte de ejecución de sus enmiendas singulares fue quien, además de haber apoyado al Ejecutivo a través de votos a favor de los proyectos remitidos al Congreso Nacional, era ajeno a la coalición de gobierno, objetivo del Ejecutivo en la formación del quórum mínimo para la aprobación de sus proyectos.

Abstract The Brazilian budgetary process has historically been questioned based on the alleged use of political bargaining in the inclusion and implementation of amendments from deputies to the executive's budget, which affects the principles, criteria, and practices of allocative choices. Supported by the theory of coalition formation, this article examines a possible political bargaining relationship between the executive and legislative branches in the budgetary process at the federal level. The study analyzed the execution of amendments from deputies over five mandates (between 2000 and 2017) and the deputies' votes on projects proposed by the executive. Data regarding the execution of singular amendments were also analyzed, together with information concerning the deputies' political position toward the executive when proposing amendments. Econometric techniques were employed to correct selection bias, assessing the presence of political bargaining. The results corroborate the hypothesis that there is political bargaining in the relationship between the executive and legislative branches in Brazil. The deputy who had more of their amendments executed by the government was also the one that voted with the government in the bills sent from the executive to the legislative, even though they were not part of the governing coalition in the Congress. Therefore, the executive targeted deputies who were not part of the governing coalition to increase the number of votes in Congress.

Assuntos

RESUMO

BACKGROUND: Community health workers (CHWs) are widely recognized as essential to addressing disparities in health care delivery and outcomes in US vulnerable populations. In the state of Arizona, the sustainability of the workforce is threatened by low wages, poor job security, and limited opportunities for training and advancement within the profession. CHW voluntary certification offers an avenue to increase the recognition, compensation, training, and standardization of the workforce. However, passing voluntary certification legislation in an anti-regulatory state such as Arizona posed a major challenge that required a robust advocacy effort. CASE PRESENTATION: In this article, we describe the process of unifying the two major CHW workforces in Arizona, promotoras de salud in US-Mexico border communities and community health representatives (CHRs) serving American Indian communities. Differences in the origins, financing, and even language of the population-served contributed to historically divergent interests between CHRs and promotoras. In order to move forward as a collective workforce, it was imperative to integrate the perspectives of CHRs, who have a regular funding stream and work closely through the Indian Health Services, with those of promotoras, who are more likely to be grant-funded in community-based efforts. As a unified workforce, CHWs were better positioned to gain advocacy support from key health care providers and health insurance companies with policy influence. We seek to elucidate the lessons learned in our process that may be relevant to CHWs representing diverse communities across the US and internationally. CONCLUSIONS: Legislated voluntary certification provides a pathway for further professionalization of the CHW workforce by establishing a standard definition and set of core competencies. Voluntary certification also provides guidance to organizations in developing appropriate training and job activities, as well as ongoing professional development opportunities. In developing certification with CHWs representing different populations, and in particular Tribal Nations, it is essential to assure that the CHW definition is in alignment with all groups and that the scope of practice reflects CHW roles in both clinic and community-based settings. The Arizona experience underscores the benefits of a flexible approach that leverages existing strengths in organizations and the population served.

Assuntos

RESUMO

BACKGROUND: Fibrocartilaginous coalition of the third tarsometatarsal joint has been indicated as an extremely rare form of tarsal coalition in the radiological literature, and most articles concerned with tarsal coalition do not mention involvement of this joint. Only two reports written in the English language that approach this subject were found, an orthopedic report and an anthropological report. PURPOSE: To evaluate the prevalence of this finding and discuss and illustrate the radiological characteristics of this coalition. MATERIAL AND METHODS: A retrospective analysis of 614 computed tomography or magnetic resonance imaging scans of the ankle and/or foot, acquired at a health service within a period of three months, was performed to assess the prevalence of this coalition. RESULTS: Of the examinations characterized as valid for analysis for the purposes of the study, 17 cases compatible with fibrocartilaginous coalition of the third tarsometatarsal joint were found, thus indicating an involvement of approximately 2.97% of the examined feet. CONCLUSION: Our radiological findings are typical, and the prevalence found in this study was statistically significant, being similar to that described in the anthropological report (3.2%-6.8%).

Assuntos

RESUMO

ABSTRACT We aimed do analyze the configuration of the relationships established among intergovernmental/transnational organizations that have been ahead for institutionalizing the idea of the right to sport from 1968 to 1978. We used analysis of documents under the theoretical perspective of the Advocacy Coalition Framework. It was seen that the organizations started a coalition to defend a belief system regarding the idea of the right to sport. However, such a movement was not contrary to the elite sport. It can be concluded that the institutional construction process of the idea of the right to sport in an international context occurred in a nonconflicting way with a partnership of actions, despite a certain difference of beliefs.

RESUMO Objetivamos analisar a configuração das relações estabelecidas entre organizações intergovernamentais/transnacionais que estiveram à frente da institucionalização da ideia de direito ao esporte entre 1968 e 1978. Pautamo-nos na análise de documentos sob a perspectiva teórica do Advocacy Coalition Framework. Identificamos que as organizações formaram uma coalizão de defesa de um sistema de crenças relativo à ideia de direito ao esporte. Contudo, tal movimento não era contrário ao esporte de elite. Concluímos que o processo de construção institucional da ideia de direito ao esporte em âmbito internacional ocorreu de maneira pouco conflituosa, havendo parceria de ações, apesar de certa diferença de crenças.

Assuntos

RESUMO

Este artigo parte da análise da ruptura ocorrida na Marcha das Vadias de Porto Alegre no ano de 2014, para pensar como se negociaram as políticas de aliança e coalizões dentro de um campo de tensões dos feminismos contemporâneos. Trata-se de um recorte de uma pesquisa de mestrado que acompanhou o processo de organização da Marcha das Vadias em caráter etnográfico e entrevistou sete pessoas que fizeram parte desse momento político. Aqui, são apresentadas brevemente as personagens a fim de refletir como se compôs a pluralidade em um campo de disputa que parecia ser polarizado. Essa análise busca ainda trazer uma reflexão mais ampla em relação aos movimentos políticos contemporâneos, suas pluralidades e negociações em campo identitário. Conclui-se que para pensar as alianças nas pautas é necessário considerar os marcadores sociais que se atravessam nos diferentes modos de fazer política feminista.

Marcha das Vadias de Porto Alegre: uma análise das políticas de aliança. Psicologia Política, 19(45), p 216-228 The aim of this article is to apply the analysis of rupture that occurred in the SlutWalk, during 2014 in Porto Alegre, to explore how alliances and coalitions were negotiated in a contemporary feminism tension field. This is part of a master's research that followed the SlutWalk organization, in an ethnographic process, and interviewed seven people who were part of this political moment. Here, the characters are briefly introduced in order to reflect how the plurality was composed in a dispute field that seemed to be polarized. This analysis also seeks to bring a broader reflection on contemporary political movements, their pluralities and negotiations in the identity field. In conclusion, in order to think about the alliances in the feminist guidelines, it is necessary to consider social markers that are crossed in the different ways of doing of feministpolitics.

Este artículo parte del análisis de la ruptura ocurrida en la Marcha de las Putas de Porto Alegre en el ano 2014, para pensar cómo se negociaron las políticas de alianza y coaliciones dentro de un campo de tensiones de los feminismos contemporáneos. Se trata de un recorte de una investigación de maestría que acompanó el proceso de organización de la Marcha de las Putas en carácter etnográfico y entrevistó a siete personas que formaron parte de ese momento político. Aquí, se presentan brevemente los personajes para reflejar cómo se compuso la pluralidad en un campo de disputa que parecía ser binario. Este análisis busca aún traer una reflexión más amplia en relación a los movimientos políticos contemporáneos, sus pluralidades y negociaciones en campo identitario. Se concluye que para pensar las alianzas en las pautas feministas es necesario considerar marcadores sociales que se atravesan en las diferentes formas de feminismos.

Cet article commence par l'analyse de la rupture survenue lors de la SlutWalk de Porto Alegre en 2014, afm de réfléchir à la manière dont les politiques d'alliance et de coalitions ont été négociées dans un champ de tensions du féminisme contemporain. Il s 'agit d 'une partie de la recherche d 'un Master qui a accompagné le processus d 'organisation de la SlutWalk à caractère ethnographique et qui a interrogé sept personnes qui faisaient partie de ce moment politique. Ici, les personnages sont brièvement présentés afm de refléter la composition de la pluralité dans un champ de controverse qui semblait être polarisé. Cette analyse cherche également à apporter une réflexion plus large sur les mouvements politiques contemporains, leurs pluralités et leurs négociations dans le domaine de l'identité. Il est conclu que, pour penser les alliances dans les lignes directrices, il est nécessaire de considérer différents marqueurs sociaux croisés dans les différentes formes de féminisme.

RESUMO

Lunotriquetral coalition and ulnar impaction syndrome are among the spectrum of pathology encountered at the medial wrist. The co-existence of these entities in the same wrist is rare. The purpose of this pictorial essay is to present the etiology, clinical course, imaging findings, and treatment of lunotriquetral coalition and ulnar impaction syndrome, and co-existing disease.

Coalizão lunatotriquetral e síndrome da impactação ulnar estão incluídas no espectro de doenças do punho medial. A coexistência dessas entidades no mesmo pulso é rara. O objetivo deste ensaio pictórico é apresentar a etiologia, o curso clínico, os achados de imagem e o tratamento da coalizão lunatotriquetral e da síndrome da impactação ulnar, e a coexistência dessas doenças.

RESUMO

Abstract Lunotriquetral coalition and ulnar impaction syndrome are among the spectrum of pathology encountered at the medial wrist. The co-existence of these entities in the same wrist is rare. The purpose of this pictorial essay is to present the etiology, clinical course, imaging findings, and treatment of lunotriquetral coalition and ulnar impaction syndrome, and co-existing disease.

Resumo Coalizão lunatotriquetral e síndrome da impactação ulnar estão incluídas no espectro de doenças do punho medial. A coexistência dessas entidades no mesmo pulso é rara. O objetivo deste ensaio pictórico é apresentar a etiologia, o curso clínico, os achados de imagem e o tratamento da coalizão lunatotriquetral e da síndrome da impactação ulnar, e a coexistência dessas doenças.

RESUMO

Objective: This article describes Mayors Mentoring Mayors (3M), an initiative of the Arkansas Coalition for Obesity Prevention (ArCOP), which expanded to five states to become the signature community initiative of the Mid-South Transdisciplinary Collaborative Center (Mid-South TCC) for Health Disparities Research. Methods: The 3M program is an extension of the Growing Healthy Communities (GHC) program, which sought to build capacity within communities to reduce obesity by implementing policy, system and environmental (PSE) changes that support healthy living. GHC where the mayor was involved had the most significant changes toward better health. These mayors were recruited to share their successes, lessons learned, and best practices with their colleagues through a series of Lunch & Learns. Following the GHC and 3M models, a multi-state approach to expand 3M to five additional states was developed. ArCOP partnered with the Mid-South TCC to recruit mayors in the five states. Results: Five Lunch & Learn events were held across Arkansas between March and May 2015, with a total of 98 participants (40 mayors, 37 community leaders, 21 guests). Each regional Lunch & Learn had 1-2 host mayor(s) in attendance, with a total of 9 host mayors. For the 3M regional expansion project, eight GHC Recognition Applications from five states were submitted. Five communities, designated as Emerging, were funded to implement GHC projects. Conclusion: ArCOP successfully engaged mayors, elected officials, and stakeholders who can influence policy across Arkansas as well as in an additional five states in the Mid-South TCC region to implement obesity PSE prevention strategies.

Assuntos

RESUMO

Resumo Este artigo analisa os efeitos das estratégias do presidente de como gerir sua coalizão sobre os custos de governar ao longo do seu mandato. Foi desenvolvido um Índice inédito de Custo de Governo (ICG) considerando as transferências políticas e monetárias feitas pelo presidente aos partidos da sua coalizão. O ICG foi calculado a partir de análise de componentes principais. As relações entre as variações de estratégias de gerência e seus custos foram estimadas por meio de um painel não balanceado em primeiras diferenças, tendo como variável dependente o ICG e como variáveis explicativas o tamanho da coalizão, a heterogeneidade ideológica e a alocação proporcional de poder entre parceiros. Os resultados indicam que coalizões grandes, ideologicamente heterogêneas e desproporcionais tendem a ser mais caras ao longo do tempo. As decisões presidenciais de como gerenciar suas coalizões influenciam os custos de governo, mesmo controlando por aspectos exógenos, como fragmentação partidária na Câmara dos Deputados e popularidade presidencial. Além disso, gastar mais recursos políticos e financeiros com os aliados da coalizão não significa necessariamente maior apoio político no Legislativo.

Resumen Este artículo analiza los efectos de las decisiones presidenciales del manejo de la coalición en los costos para gobernar. Se utiliza el análisis de componentes principales para crear el Índice de Costo de Gobierno (ICG) y se utiliza un panel de primeras diferencias para estimar la relación entre el índice y las variables de gestión de la coalición: el tamaño de la coalición, la heterogeneidad ideológica y proporcionalidad de poder con aliados. Los resultados indican que coaliciones demasiado grandes, desproporcionadas y ideológicamente heterogéneas tienden a ser más costosas a lo largo del tiempo. Los resultados también sugieren que las decisiones presidenciales sobre cómo manejar las coaliciones influyen en los costos, aún controlando por las limitaciones exógenas como fragmentación partidaria y popularidad presidencial. Además, gastar más recursos políticos y financieros con los aliados de la coalición no implica necesariamente un mayor apoyo político para el Presidente en el Congreso.

Abstract: This paper examines the effects of a president's coalition management decisions on the costs of governing. An innovative Governing Costs Index (GCI) was developed, taking into consideration political and financial transfers made by the president to coalition parties. GCI is calculated employing a principal component analysis. The relationship between the variations on the management strategies and the costs were estimated using a first-differences panel. GCI was considered as the dependent variable and the coalition size, ideological heterogeneity, and cabinet proportionality among partners as the explanatory variables. Results indicate that large, ideologically heterogeneous coalitions and disproportional cabinets tend to be more expensive over time. The results also suggest that presidential decisions about how to manage coalitions influence governing costs in important ways, even when controlling exogenous constraints like party fragmentation at the Congress and presidential popularity. In addition, spending more political and financial resources with coalition allies does not necessarily lead to greater political support for the president in the Congress.

Assuntos

RESUMO

OBJECTIVE: The objective of this project was to develop a community-academic coalition partnership to conduct community-based participatory research (CBPR) to address health disparities in older adults with chronic conditions living in the Quebrada Arriba community. METHODS: We used the 'Developing and Sustaining CPPR Partnerships: A Skill-Building Curriculum', to create the Quebrada Arriba Community-Academic Partnership (QACAP). We assessed the meetings effectiveness and the CBPR experiences of the coalition members in the community-academic partnership. RESULTS: The stepwise process resulted in: the development of The Coalition for the Health and Wellbeing of Older People of Quebrada Arriba; the partnership's mission and vision; the operating procedures; the formulation of the research question, and; the action plan for obtaining funding resources. The mean levels of satisfaction for each of the items of the Meeting Effectiveness Evaluation tool were 100%. The mean agreement rating scores on variables related to having a positive experience with the coalition, members' representativeness of community interest, respectful contacts between members, the coalition's vision and mission, the participation of the members in establishing the prioritized community problem, and sharing of resources between the members was 100%. CONCLUSION: The steps used to build the QACAP provided an effective structure to create the coalition and captured the results of coalition activities. Partners' time to build trust and developing a sufficient understanding of local issues, high interest of the community members, flexibility of the partners, capitalization on the partners' strengths, and the shared decision building process were key contributors of this coalition's success.

Assuntos

RESUMO

Protected areas are the cornerstones of conservation policies worldwide. However, only few researches are led to analyse the way they emerge, except for criticising top-down governmental choices. Yet, the historical approach and strategic analysis of public policy building over the long term allows a better understanding of the stakes of action capacity of these policies. We therefore mobilize the advocacy coalition framework to show that protected areas creation is always due to coalitions of actors who belong to different professional fields and act at different scales but nevertheless share common stakes. On the basis of a comparative study in French and Brazilian Amazon, we show that if all coalitions for protected areas share a common objective of limited deforestation, they are still very different according to the type of conservation they promote (strict biodiversity conservation, population-based conservation or sustainable forest management). We also show that the ability of the coalitions to build efficient public policies is highly depending on internal factors (i.e. their ability to gather strategic resources) and on external factors (i.e. socio-political context and international pressure). Finally, the comparative analysis of coalitions pleading for the same type of protected areas in two different countries allows us to insist on the importance of qualitative embedded researches when it comes to understand why some protected areas have more chances to reach environmental effectiveness in one socio-political context than in another one.

Assuntos