This thesis conducts a theory comparison to determine which theory of social justice is best suited to address health inequalities. The theories used are the capability approach by Amartya Sen and Göran Therborn's theory on inequalities. Within the capability approach, two accounts specified on health capabilities will be regarded as well. These are the health capability approach by Ruger and the theory of health justice by Venkatapuram. The theory comparison is done by making use of a non-ideal theory framework, based on the theory by John Rawls and the critiques on it given by several authors, as well as the developments in the ideal/non-ideal theory debate. Non-ideal theory provides guidance towards reducing inequalities and enhancing justice and can therefore be useful for a theory on health inequalities. The developed non-ideal theory framework consists of five criteria to which the respective theories are compared to determine whether they fulfil the criteria. Comparing the theories to the framework will give an insight in which theory is best suited for reducing health inequalities. Therborn's theory on inequalities has proven to fulfil most of the criteria in the non-ideal theory framework and can therefore be regarded as best suited to reduce health inequalities.

Objetivo: Estimar la brecha de desigualdad de la distribución de la mortalidad por COVID-19 en función de 3 determinantes sociales en los distritos de Lima metropolitana y Callao en el periodo entre marzo y junio del 2020. Métodos: Se realizó un estudio ecológico a nivel distrital. Los datos se obtuvieron a partir de bases pertenecientes a instituciones públicas del Perú. Se estimaron los índices de kuznets absoluto y relativo. Posteriormente, se utilizó un modelo de para examinar la relación entre tres indicadores sociales y las tasas de mortalidad de COVID-19 en los distritos mencionados. Resultados: La tendencia de la tasa de mortalidad es similar para los 3 estratificadores sociales, aumenta conforme mejores indicadores se encuentran. Se obtuvo una curva de concentración negativa (a favor de los menos privilegiados) en todos los casos. A su vez, observamos que el 20% de distritos con mayor desventaja acumulan el 18% de la tasa de mortalidad, mientras que 20% más aventajado acumula el 22% de la tasa. Conclusiones: Los determinantes sociales de salud son claves al evaluar el impacto de una pandemia sobre la población. Analizar su relación permite a las autoridades crear y mejorar medidas sanitarias para disminuir las repercusiones de la enfermedad. Encontramos para los 3 estratificadores analizados que la tasa de mortalidad aumenta conforme la población es más privilegiada. Poner más énfasis en disminuir la fragmentación de nuestro sistema de salud y generar estímulos para fomentar la descentralización de los profesionales ayudaría en gran medida a acortar la brecha de desigualdad. Al discrepar de la bibliografía analizada, es necesaria la realización de más estudios para tener una mejor perspectiva. / Objectives: To estimate the inequality gap of the distribution of mortality from COVID-19 based on 3 social determinants in the districts of metropolitan Lima and Callao during March-June of 2020. Methods: An ecological study was conducted at the district level. Data were obtained from databases belonging to public institutions in Peru. The absolute and relative Kuznets index were estimated. Subsequently, a random regression model was used to examine the relationship between three social indicators and COVID-19 mortality rates in the mentioned districts. Results: The mortality rate trend for the three determinants evaluated raise as better indicators were found. A negative concentration curve was found (in favor of the most disadvantaged) in every case. Further, districts at the bottom 20% of better determinants of health concentrates up to 18% of the mortality rate, while the 20% at the top concentrates up to 22% of the rate. Conclusions: The social determinants of health are key when evaluating the impact of a pandemic on the population. Analyzing their relationship allows the authorities to create and improve health measures to reduce the repercussions of the disease. We found for the 3 stratifiers analyzed that the mortality rate increases as the population is more privileged. Placing more emphasis on reducing the fragmentation of our health system and generating incentives to promote the decentralization of professionals would greatly help to reduce the inequality gap. Disagreeing with the analyzed bibliography, it is necessary to carry out more studies to have a better perspective. / Tesis

The objectives of this study are to provide a comprehensive assessment of inequalities in infant and under-five years¿ child survival, access to and utilisations of child health services among different socio-economic groups in Ethiopia; and identify issues for policies and programmes at national and sub-national levels. This thesis examines the effect of parental socioeconomic status, maternal and delivery care services, mothers¿ bio-demographic and background characteristics on the level of differences in infant and under-five years¿ child survival and access to and utilisation of child health services. Descriptive and multivariate analyses were carried out for selected variables in the literature which were consider as the major determinants of infant mortality rate (IMR) and under-five years¿ child mortality rate (U5MR); access to and utilisations of child health services based on data from Ethiopian demographic and health survey (EDHS), covering the years 2000-2005. In the multivariate analysis a logit regression model was used to estimates inequalities in infant and under-five years¿ child survival, and inequalities in access to and utilisation of child health services. In Ethiopia, little was known about inequalities in IMR and U5MR, and inequalities in access to and utilisation of child health services. Besides, there is no systematic analysis of health inequalities and into its determinants using logistic regression. According to the available literature, this is the first comprehensive and systematic analysis of inequality of health in Ethiopia. The findings show that compared to under-five years¿ children of mothers¿ partners¿ with no work, mothers¿ partners¿ in professional, technical and managerial occupations had 13 times more chance of under-five years¿ child survival for 2000 weighted observations. In addition, compared to infants of mothers who were gave birth to one child in last 5 years preceding the survey, infants of mothers who were gave birth to 2 children in last 5 years preceding the survey had 70% less chance of infant survival while infants of mothers who were gave birth to 3 or more children had 89% less chance of infant survival for 2000 weighted observations. Moreover, this study finding also indicates that inequalities increased significantly in the five years period between 2000 and 2005 among mothers with different birth interval. Most of the relations between birth interval and receiving childhood immunisation for vaccine-preventable diseases were statistically significant. Moreover compared to non-educated mothers, mothers who completed secondary and higher education were nearly 10 times more likely to receive DPT3 immunisation for their young children. This study concludes that policy measures that tackle health inequalities will have a positive impact in the implementation of health sector strategy of Ethiopia. Health inequalities studies in Ethiopia and Sub-Saharan Africa (SSA) countries should focus on systematic analysis of different socio-economic groups. The finding of this study support investing in the Ethiopia¿s health extension package (HEP) is a necessary but not sufficient condition for addressing rural poor health problem. HEP is successful in increasing primary health care coverage in rural Ethiopia to 89.6% (FMOH, 2009) but unable to reduce Ethiopia¿s higher level of IMR and U5MR. HEP is one of the success stories that address the rural poor health problem and can also be adapted to developing countries of SSA. The finding also shows that the success stories such as health insurance programs like Rwanda (World Bank, 2008a) and Ethiopia (FMOH, 2009/10) will play a key role in achieving country¿s health care financing goal of universal coverage. This can also be replicated in the developing SSA countries.

The research examines New Labour’s Third Way policies and the impact New Deal for Communities (NDC) regeneration programme had on participation in health care. This longitudinal study (1998-2007) explores participatory joint working, welfare state, social capacity, health inequalities, citizen involvement and community capacity. It captures the experiences of local community and front-line workers whilst delivering the Health Focus Group (HFG) in the NDC programme. Using action learning reflection techniques, the study analyses a purposeful sample of 15 from the local community, front-line workers, and strategic respondents involved in the NDC health programme. The research demonstrated the NDC did increase participation, joint working and involvement of local actors 1998–2003. The importance of communication, leadership and relationships was recognised as an important catalyst for developing community governance models. The new action learning spaces initiated, designed and delivered 19 new models of joint local clinical, community and complementary health and well-being projects. In 2001, New Labour introduced public private finance initiatives with the Primary Care Trust (PCT) which conflicted with the local actors’ involvement in the participatory joint decision-making. The reconfiguration of health and social care services and the new public health models introduced complex governance and monitoring models, further distancing the local actors from the process. Strategic staff changes in key governance positions also adversely affected the communication and trust established with local actors. The research concluded operational, tactical, and strategic alignment is necessary to maximise joint participation in decision-making.

Die vorliegende Dissertation untersucht theoretisch und empirisch gesundheitliche Selektionsprozesse auf dem deutschen Arbeitsmarkt und wie diese durch soziale Kontextfaktoren beeinflusst werden. Aufbauend auf der Humankaiptaltheorie werden eine reihe von Hypothesen aufgestellt über den kausalen Effekt der subjektiven Gesundheit und der krankheitsbedingten Fehltage auf den Jobstatus. Die Humankapitaltheorie wird so erweitert, dass der Effekt der Gesundheit mit dem Grad der Benachteiligung einer Person und dem Grad der sozialen Schließung des Jobs variieren kann. Konkret werden die moderierenden Einflüsse des Geschlechts und des öffentlichen versus privaten Sektors sowie der Geschlechteranteile im Beruf untersucht. Die empirische Analysen werden auf Basis des Sozio-oekonomischen Panels (SOEP) durchgeführt. Verschiedene Methoden werden angewandt, um kausale Effekte der subjektiven Gesundheit auf den Jobstatus zu schätzen. Weiterhin wird eine Dekomposition der gesamten gesundheitlichen Ungleichheit in zeit-konstante und zeit-variante Faktoren und auf gesundheitlicher Selektion basierende Prozesse durchgeführt. Die Ergebnisse zeigen, dass gesundheitliche Selektion für Frauen im privaten Sektor gefunden werden kann, nicht aber im öffentlichen Sektor und auch nicht für Männer. Für krankheitsbedingte Fehltage kann ein kausaler Effekt für Männer im privaten Sektor gefunden werden, nicht aber im öffentlichen Sektor oder für Frauen. Unter den gewählten Bedingungen der Studie, sind gesundheitliche Selektionsprozesse daher eher in offenen Positionen und für Gruppen, die einer Benachteiligung gegenüber stehen zu finden. / In this PhD-thesis the social context of health selection processes on the German labor market are investigated theoretically and empirically. Based on human capital theory a number of hypotheses about the causal effect of subjective health and sickness absence on job status are derived. The theory is modified to allow the effect of health to vary with the degree of disadvantage a person faces and the degree of social closure of the job. In concrete terms, the moderating effect of gender and public versus private sector are investigated, as well as the occupational gender composition. The empirical analyses are based on the Socio-economic panel study (SOEP) using different methods to estimate causal effects of subjective health on subsequent job status. A decomposition of overall health inequalities into effects attributable to time-constant, time-varying confounders and into health selection processes is presented. The results show that health selection is present for women in the private sector, but not for men nor in the public sector. Sickness absence shows the strongest effects for men in the private sector, but not for women nor in the public sector. For the chosen setting, health selection processes are strongest in open positions and for groups that are disadvantaged.

Bakgrund: Flertalet studier har påvisat förekomsten av skillnader i hälsa mellan olika sociala grupper i samhället. De tidigare studierna visar att det finns olika förhållanden mellan utbildningsnivå, ålder, socioekonomisk status, socialt stöd respektive kön och den självskattade hälsan. Syfte: Syftet är att undersöka den självskattade hälsan hos kvinnor med olika utbildningsnivåer i Västmanlands län, beskriva åldersskillnader samt om det finns några samband mellan självskattad hälsa och socialt stöd, ekonomisk situation och sysselsättning. Metod: Metoden utgår från en kvantitativ ansats där befintlig data från befolkningsundersökningen Hälsa på lika villkor 2012 i Västmanland har använts till analys. Resultat: Resultatet visar att det förekommer signifikanta skillnader i självskattad hälsa hos kvinnor i Västmanland med olika utbildningsnivåer, åldrar, socialt stöd, ekonomisk situation och sysselsättning. Det finns samband mellan dålig självskattad hälsa och förgymnasial- och gymnasial utbildningsnivå, ålder (50-64 år), bristande socialt stöd, ekonomiska svårigheter respektive sjukskrivning/ förtidspension samt arbetslöshet. Slutsats: Samband har identifierats mellan självskattad hälsa och utbildningsnivå samt mellan självskattad hälsa och faktorerna ålder, socialt stöd, ekonomisk situation och sysselsättning. Däremot visar studien att skillnaderna i självskattad hälsa mellan utbildningsnivåerna bland kvinnor i Västmanland med större sannolikhet beror på åldersskillnader, skillnader i socialt stöd, ekonomiska svårigheter och sysselsättning än enbart på grund av utbildningsnivån. / Background: Several studies have demonstrated the existence of differences in health between social groups. The previous studies show that there are different relationships between educational level, age, socioeconomic status, social support, sex, and self-rated health. Aims: The aim of this study is to examine differences in self-assessed health among women with different educational levels in Västmanland, describe age differences and study whether there is any associations between self-assessed health and social support, economic situation and employment. Method: This method is based on a quantitative approach where existing data from the population health survey ”Health on equal terms 2012” in Västmanland is used for analysis. Results: The results show that there are significant differences in self-rated health among women in Västmanland with different levels of education, age, social support, financial situation and employment. There is also associations between poor self-rated health and lower educational levels, age (50-64 years), lack of social support, financial hardship and sickness/ disability and unemployment. Conclusion: Correlations have been identified between self-rated health and level of education as well as between self-rated health and age, social support, financial situation and employment. However, the study shows that the differences in self-rated health between educational levels among women in Västmanland more likely due to age differences, differences in social support, financial difficulties and employment than simply because of the level of education.

The collapse of the communist regimes in Central and Eastern Europe in 1989-1990 heralded the beginning of an economic transition from central planning to market economies. The subsequent period was marked by malfunctioning of these countries’ social sectors, including their health care systems, raising serious issues of equity. This thesis examines the impact of the transition period and the introduction of social insurance on equity in health care provision in Bulgaria. Equity in health care is investigated with respect to function - i.e. financing (according to ability to pay) and delivery (according to need) - and outcomes - i.e. health status, income inequality and poverty. Differences in health, health care financing and delivery are explored by income, education, ethnic, employment, marital status, age and sex groups. Furthermore, the thesis outlines the impact of health care provision, in particular social insurance, on poverty and health inequalities. The thesis employs empirical analysis based on household data. Its methodology includes concentration and decomposition analysis, and provides new ways of modelling health care financing and delivery, as well as the link between health and health care delivery. The thesis concludes that social insurance does not provide a uniform means of improving equity and that the root cause of the problem lies in the large proportion of out-of-pocket payments and the rather limited size of the health insurance sector. Inequity in health care provision leads to poverty and untreated illness. The data suggests that there are differences between socio-economic groups as regards their likelihood to seek treatment for their ill health, which result in differences in their health status. The social factors that have impacted the most on health are low education and low income.

La prévalence du tabagisme a diminué dans les dernières décennies, mais les inégalités sociales reliées au tabagisme s’accentuent. Les stratégies de dénormalisation du tabagisme ont amené la stigmatisation des fumeurs. Le lien entre celle-ci et la défavorisation de quartier est mal compris. Cette étude qualitative a comparé les expériences de stigmatisation de quinze jeunes femmes fumeuses dont la moitié vivait dans des quartiers très défavorisés de Montréal et l’autre moitié résidait dans les quartiers les moins défavorisés. Dans ces derniers, stigmatiser les fumeurs fait partie de la norme. Le tabagisme est vu comme un symbole de pauvreté, entraînant l’utilisation de stratégies pour se distancer du stigma. Dans les quartiers défavorisés, les participantes rapportaient une stigmatisation basée sur le genre et elles tentaient d’y échapper en se cachant pour fumer. Les résultats mettent en lumière les effets non attendus des politiques anti-tabac et pourraient contribuer au développement de politiques plus équitables. / Smoking prevalence decreased in the last decades, but social inequalities in smoking increased. Strategies aiming to denormalize smoking have led to the stigmatization of smokers. However, what is not well understood is the connection between this stigmatization and neighbourhood deprivation. This qualitative study compared experiences of stigma from fifteen young women who smoke. Half lived in the most deprived neighbourhoods of Montreal and the other half, in the least deprived neighbourhoods. In the latter, stigmatizing smokers was part of the norm. Smoking was seen as a symbol of poverty, resulting in the use of strategies to distance themselves from stigma. In the most deprived neighbourhoods, participants reported gender based stigma which they attempted to escape by hiding when smoking. These findings bring to light unexpected effects of anti-tobacco policies and could contribute to the development of more equitable policies.

INTRODUÇÃO: O conceito de equidade enfatiza a diversidade como condição humana e propõe que a diferença seja tratada como princípio orientador das políticas públicas. O objetivo dessa investigação foi verificar a equidade na atenção à saúde de pessoas com indicativos de transtornos mentais comuns (TMC) na cidade de São Paulo. Foram analisadas a procura e utilização dos serviços de saúde, bem como o gasto com saúde no último mês de pessoas com indicativos de TMC, que referiram morbidade quinze dias precedentes à entrevista domiciliar, segundo características sociodemográficas e de condições de saúde. MÉTODOS: Foi realizado um estudo de corte transversal e utilizados os dados do Inquérito de Saúde no Município de São Paulo (ISA - Capital) de 2008. Foram selecionados sujeitos com 16 anos ou mais e com indicativos de transtornos mentais comuns; estes foram avaliados por meio do instrumento Self Reporting Questionnaire (SRQ-20). Foram analisados a procura e utilização de serviços de saúde, e o gasto com saúde no último mês, correlacionando com aspectos sociodemográficos e de condições de saúde. RESULTADOS: A procura pelo serviço de saúde foi menor entre as mulheres, maior na faixa etária dos 30 aos 44 anos e na faixa etária de 60 anos ou mais. A proporção de pessoas que procuraram pelo serviço e obtiveram atendimento foi elevada, o mesmo ocorreu para aquelas que procuraram por médico e foram atendidas por meio de consulta. A procura pelo SUS foi menor entre as pessoas de cor branca, de renda per capita elevada, com união estável e entre as pessoas com ensino superior. A cobertura pelo SUS foi menor para as pessoas das faixas etárias de 45 a 59 anos e de 60 anos ou mais, com renda per capita elevada, com Ensino Médio ou Técnico e Ensino Superior. As pessoas que gastaram mais com a saúde da família foram aquelas com idade igual ou superior a 60 anos, de cor branca, das faixas de renda per capita mais elevadas, com união estável e com Ensino Superior. Em relação à posse de plano de saúde, pessoas de cor branca, com renda per capita elevada e indivíduos com doença crônica apresentaram maiores chances de possuir este serviço. CONCLUSÕES: Foi observado, na população com indicativos de TMC, que não houve desigualdades no acesso e utilização dos serviços entre as pessoas que buscaram por ajuda diante de morbidade. Verificou-se que o SUS atende e cobre os gastos majoritariamente dos mais pobres, denotando uma cobertura desigual que favorece os mais necessitados, porém, considerando o fator idade, ficou explícita uma situação de iniquidade, pois foi constatado que o SUS oferece maior cobertura para a população mais jovem e não contempla as necessidades da população mais idosa. Além disso, verificou-se também uma demanda reprimida de pessoas que não acessaram o serviço, indicando barreiras que antecedem à busca / INTRODUCTION: The equity concept emphasizes diversity as a human condition and proposes this aspect as a guiding principle of the public policy. The objective of this investigation was to verify the equity in health care of people with signs of common mental disorders (CMD) in the city of São Paulo. We analyzed the demand and use of health services and the expenses on health in the last month of people with signs of CMD who reported morbidity 15 days before the home interview, according to socio-demographic characteristics and health conditions. METHODS: We developed a cross-sectional study and used the data from São Paulo\'s health survey (ISA - Capital) of 2008. We selected subjects with 16 years of age or older and with signs of common mental disorders; who were evaluated using the Self Reporting Questionnaire (SRQ-20). We analyzed the demand and the use of health services, and the health expenses in the last month, correlating them with sociodemographic and health condition aspects. RESULTS: The demand for health services was lower among women, higher in the age group from 30 to 44 years old and in the age group of 60 years old or more. The proportion of people who sought the service and were cared for was high, and the same thing happened to those who sought medical attention and had an appointment. The demand for SUS was lower among white people with high per capita income, married and among people with higher education degrees. The coverage of SUS was significantly lower for people aged between 45 and 59 years old and those aged 60 years old or more, with high per capita income, with high school, technical or college degree. The people who spent more on Family health were those with 60 years old or more, white, with high per capita income, married and with college degree. Regarding health care insurance ownership, white people with high per capita income and individuals with chronic diseases presented higher chances of owning a health care insurance. CONCLUSIONS: We observed, among people with signs of CMD, that there were no inequalities in the access and use of health services for those who sought for help faced with morbidity. We verified that SUS serves and covers the expenses mainly of the poorer, denoting an unequal coverage that favours the ones who need it the most, however, taking the age factor into account, a situation of inequity was explicit, since it was verified that SUS offers a wider coverage to the younger population and does not contemplate the needs of the elderly. In addition, there was also a repressed demand of people who could not access the health service, indicating barriers that precede the search

Submitted by Ricardo Cedraz Duque Moliterno (ricardo.moliterno@uefs.br) on 2017-02-20T23:56:38Z No. of bitstreams: 1 Dissertacao final-kelly.pdf: 2966404 bytes, checksum: 270972253f907c890371ecccbf1c9dfd (MD5) / Made available in DSpace on 2017-02-20T23:56:38Z (GMT). No. of bitstreams: 1 Dissertacao final-kelly.pdf: 2966404 bytes, checksum: 270972253f907c890371ecccbf1c9dfd (MD5) Previous issue date: 2016-04-14 / Funda??o de Amparo ? Pesquisa do Estado da Bahia - FAPEB / Prematurity is the leading cause of neonatal morbidity and mortality and the second leading cause of death in children under five years in all countries of the world. Its etiology is not well known and many risk factors have been blamed for their occurrence, among them are those related to social inequality, low education, poor access to health services and the black race. There are several evidences that ethnic and racial disparities can lead to premature birth, however, in Brazil, there are few studies that seek to evaluate the association of race/skin color and the occurrence of prematurity. To analyze the incidence of prematurity and maternal racial differences is necessary so that ethnic and racial disparities can be considered when planning programs to improve health outcomes. The aim of this study is to analyze the association between race/color maternal and prematurity among pregnant women assisted in the prenatal public network, residents in Santo Ant?nio de Jesus - Bahia. The design of this study was through conducting a meta-analysis and cross-sectional study nested in a prospective cohort study of a random sample of pregnant women assisted in the prenatal public health network services. For the meta-analysis were analyzed 17 articles of observational epidemiological studies. The meta-analysis indicates a positive association to the risk of prematurity according to race / skin color, where the black women had a risk of 51% more premature birth, compared with non-black women (RR: 1.51; 95% CI: 1.39 to 1.65). In the cross-sectional study in a sample of 938 pregnant women, 18 to 45 years old the prevalence of preterm birth was 11.8% and the probability of prematurity was higher in black women (PR = 2.16, CI: 1.12 to 4.17) when compared with non-black women. The results highlight the variation in the prevalence of prematurity according to race / color, even after adjustment of covariates. / A prematuridade ? a principal causa da morbimortalidade neonatal e a segunda maior causa de morte em menores de cinco anos em todos os pa?ses do mundo. Sua etiologia n?o ? bem conhecida e muitos fatores de risco t?m sido responsabilizados pela sua ocorr?ncia, dentre eles est?o os relacionados a desigualdades sociais, como baixa escolaridade, dif?cil acesso aos servi?os de sa?de e a ra?a/cor da pele negra. H? evid?ncias de que as disparidades ?tnico-raciais podem levar a prematuridade gestacional, no entanto, no Brasil, poucos s?o os estudos que buscam avaliar a associa??o da ra?a/cor da pele e a ocorr?ncia da prematuridade. Analisar a ocorr?ncia da prematuridade gestacional e diferen?as raciais maternas se faz necess?rio, para que as disparidades ?tnico-raciais possam ser consideradas no planejamento de programas para melhorar os resultados de sa?de. O objetivo desse estudo ? analisar a associa??o entre a ra?a/cor materna e a prematuridade entre as gestantes acompanhadas no pr?-natal da rede p?blica, residentes no munic?pio de Santo Ant?nio de Jesus ? Bahia. O delineamento deste estudo se deu atrav?s de realiza??o de uma meta-an?lise e um estudo de corte transversal aninhado a uma coorte prospectiva de uma amostra aleat?ria de gestantes acompanhadas nos servi?os de pr?-natal da rede p?blica de sa?de. Para a meta-an?lise foram analisados 17 artigos de estudos epidemiol?gicos observacionais. A meta-an?lise indicou uma associa??o positiva para o risco da prematuridade segundo a ra?a/cor da pele, onde as mulheres negras apresentaram um risco de 51% a mais de parto prematuro, se comparado com mulheres n?o negras (RR: 1,51; IC 95%: 1,39-1,65). No estudo de corte transversal em uma amostra de 938 gestantes, de 18 a 45 anos de idade a preval?ncia da prematuridade gestacional foi de 11,8% e a probabilidade da prematuridade foi maior nas mulheres negras (RP= 2,16; IC: 1,12 ? 4,17) quando comparadas com as mulheres n?o negras. Os resultados revelam varia??o na preval?ncia da prematuridade de acordo a ra?a/cor da pele, mesmo ap?s o ajuste das co-vari?veis.