The aim of this study was to examine how women’s sexuality is constructed in consent research, and to discuss hypothetically how this construction could come to affect practical social work. We believe that the way that sexuality is defined and discussed can have an impact on how professionals treat women who have been subjected to sexual assaults and rape, and work with adolescents in the field of social work. We wanted to explore this further. By doing a critical discourse analysis on research articles about women’s sexuality and consent, we found that traditional sexual scripts were widely reproduced and the concept of women’s own desire was nonexistent. We then problematised this by discussing how it might be affecting practical social work in a negative matter, whilst trying to formulate possible reforms. Our conclusion was that it is possible that the discourses presented in the examined articles could contribute to retrogressive perspectives on women’s sexuality, which in turn could influence the practical social work and its approach to female clients.

Introdução: A episiotomia é intervenção instituída rotineiramente no Brasil, a partir da hospitalização do parto, em meados do século XX. Tida como facilitadora do parto no período expulsivo, vem sendo questionada pelas evidências científicas. Comprovou-se que a intervenção não impede lacerações importantes, incontinência urinária, dispareunia ou disfunções sexuais, e é associada a mais dor pós-parto e a complicações da episiorrafia. No Brasil, há médicos que fazem o procedimento rotineiramente, enquanto outros a praticam de modo seletivo ou, mais raramente, nunca o fazem. Este estudo buscou compreender o processo por meio do qual tais profissionais aprenderam e iniciaram sua prática, se esta foi revista, e as razões do posicionamento técnico e ético quanto ao procedimento, na atualidade. Objetivos: descrever e analisar o processo vivenciado pelos médicos obstetras, e que os levou ao posicionamento com relação à prática da episiotomia, tendo em vista sua formação, sua prática, o posicionamento de seus pares e o ambiente institucional. Método: Trata-se de estudo qualitativo, com análise temática a partir do referencial de gênero. A população de estudo foi composta por 12 médicos(as) obstetras que atendiam partos pela via vaginal, obedecendo ao método snowball. Os dados foram obtidos por meio de entrevistas norteadas por questões semiestruturadas. Resultados: A educação médica, no recorte da episiotomia, dá-se em escalonamento hierárquico, sem que o aluno aprenda por meio de professor, mas entre alunos, do mais graduado para o menos graduado. Transmite-se a insegurança técnica e o impedimento de questionar as indicações, a segurança do procedimento ou lesões decorrentes. Não se discute a autonomia da paciente, os direitos reprodutivos, o direito à integridade corporal ou a real informação para o consentimento. Vários entrevistados relatam dificuldades para deixar de praticar a episiotomia, o que resulta de pressão exercida pelos pares, pela corporação e pela instituição em que atende. Conclusões: É imprescindível a reforma na educação médica, para que professores, atualizados com as evidências científicas, transmitam as técnicas de modo adequado às taxas preconizadas internacionalmente. Sugerese alterar a didática e conteúdo de disciplina que discuta bioética, tornando-a mais conectada com a prática e a ética médica, além de contextualizar a lei vigente. Conclui-se, enfim, pela necessidade de exigir a justificativa em prontuário para a intervenção, a anotação de toda episiotomia realizada e de toda lesão espontânea, além da aplicação de ferramentas de segurança da paciente, adotando uma assistência que promova a integridade genital no parto. / Introduction: Episiotomy is an intervention routinely established in Brazil, from birth hospitalization, in mid-twentieth. Considered as a facilitative intervention in the expulsive stage of birth, it has been questioned by scientific evidences. It was concluded that the intervention does not prevent main lacerations, urinary incontinence, either dyspareunia or sexual dysfunction, and is related to after-birth pain and complications developed from episiorrhaphy. In Brazil, there are physicians that perform it routinely, while some perform it selectively or never use it. This ressearch aimed to understand the way those professionals learned and started their practice, if it has been reviewed, and the reasons for their technical and ethic positioning about the intervention, nowadays. Objective: Describe and analyze the process experienced by obstetricians, and what took them to their positioning regarding to episiotomy practice, in terms of their professional education, their practice, their peers positioning and institutional environment. Method: This is a qualitative study, with thematic analysis, based on gender references. The study population was composed by 12 obstetricians, who attended vaginal births, following snowball method. Data were obtained by interviews guided by semi-structured questions. Results: The medical education, on episiotomy, occurs in a hierarchical scheduling, and the student doesnt learn through a teacher, but through a more graduate student, resulting on technical uncertainty and the impossibility to question indications, the procedure safety or resulting injuries. Patient autonomy, reproductive rights, body integrity or information to the consent are not questioned. Many physician finds it difficult to stop practicing episiotomy, because of intense pressure from peers, corporative and institution. Conclusions: Some changes are essential in medical education, so that teachers, updated on scientific evidences, transmit the techniques adequately to the internationally recommended rates. It is suggested to change teaching and disciplines that discuss bioethics, making it more connected with the practice and medical ethics, and contextualize it to the current law. It follows, finally, the need to require physicians to justify interventions in medical charts, the annotation of all performed episiotomy and all spontaneous lacerations, as well as applying patient safety tools, adopting an assistance that promotes genital integrity at birth.

La formation du contrat suppose la rencontre de deux ou plusieurs volontés en vue de créer des effets de droit. Elle repose sur un échange de consentements des parties, dont est a priori exclue la figure du tiers. Le tiers est, en effet, classiquement défini par la négative en opposition aux parties, comme celui qui ne peut subir les effets du contrat ni profiter de ses bénéfices, car il n’y a pasconsenti. Toutefois, la présence des tiers lors de l'élaboration du contrat n'est pas inconnue en droit positif. Mais le délitement de l'Etat tiers garant du contrat et l'avènement de la contractualisation se sont accompagnés d'une multiplication de tiers intervenant au stade de la formation du contrat.L’objet de cette étude est de démontrer que l'intervention de tiers est de plus en plus sollicitée lors de la phase d'élaboration de l'accord. Le tiers ne doit plus être considéré seulement comme étant celui qui est étranger à la volonté des parties. Il influence, voire même, contraint cette volonté. Il semble important aujourd'hui d'élargir la qualité de tiers au contrat. Les interventions de tiers au stade de la formation de l'accord, qu'elles aient pour but de protéger les intérêts particuliers des contractants et/ou l'intérêt général, constituent une limite à la volonté autonome des individus et, par conséquent, restreignent la liberté contractuelle des contractants en influençant tant la rencontre des consentements que la détermination du contenu contractuel. / The formation of the contract requires the meeting of two or more minds in order to create legal effects. It is based on an exchange of the parties consent’, from which any third party is theorically excluded. The third party is, indeed, classically negatively defined by opposition towards the parties as one that cannot suffer the contract’s effects or enjoy its benefits because it has not consented to it. However, the presence of third parties during the agreement of the terms of the contract is not unknown in positive law. But the State disintegration as a third party guarantor of the contract, and the advent of contractualization, are accompanied by a proliferation of third party interventions during the contract formation stage. The purpose of this study is to demonstrate that third party interventions are increasingly requested during the formulation phase of the agreement. The third party should no longer beconsidered purely as an alien to the parties’ wills. It influences, and even, compels this will. Today it would seem important, in contract matters, to broaden the capacity of a third party. Third party interventions during the agreement formulation, whether to protect the interests of contracting parties and / or the public interest, constitute a restriction to people’s individual autonomy, and, therefore, limit contractual freedom by influencing both the meeting of theminds and the determination of contractual content.

In this thesis, I argue that the interdependence between personal identity and practical concerns is overstated. In paradigmatic places where philosophers and common sense suggest that personal identity constrains how we should reason and care, or vice versa, the two spheres are in fact neutral to each other. I defend this claim by considering four specific cases. First, a rough characterization of the distinction between the complex and the simple view is that the former takes personal identity to consist in other relations, whereas the latter does not. I argue that the extreme claim according to which the complex view fails to give reasons for future-directed concern can be resisted. We maintain forward-looking attitudes and projects not because someone will be us, but because we relate to future selves in other, more important ways. Second, I argue that intuitions in a range of popular imaginary cases are contaminated by practical concerns whose relevance for personal identity is far from straightforward. Third, I argue that on a closer look, the complex versus simple distinction is confused. It thus cannot be what grounds differences in judgements on what matters. Debates about personal identity should be framed in terms of better understood notions. Finally, I argue that it is not a constraint on rational transformative choice that decision-maker and transforming individual are identical. Moreover, whether we are deciding for ourselves or for others - the importance of informed consent for transformative treatments is not diminished by the decision-maker's failure to projectively imagine the outcomes.

Reposant sur l’analyse sociologique de quarante-neuf entretiens qualitatifs auprès de contribuables et spécialistes de l’évitement fiscal, ainsi que sur la lecture des philosophes majeurs de quatre grandes doctrines contemporaines de la justice sociale, cette thèse de doctorat vise à décrire et à comprendre les pratiques actuelles d’évitement fiscal des contribuables, personnes physiques et entreprises.La norme sociale s’avère plutôt favorable à l’évitement légal de l’impôt, et relativement permissive vis-à-vis de l’évitement illégal. Une analyse en sociologie de la déviance montrera les dangers que cette dynamique fait penser sur les finances publiques et sur la capacité de l’État à lever l’impôt dans le futur. Alors, l’étude des cadres axiologiques de ces phénomènes sociaux permettra d’établir une typologie idéal-typique des contribuables à partir des doctrines utilitariste, égalitariste libérale, libertarienne et communautarienne. Elle tentera de comprendre pour chaque groupe d’individus ainsi constitué les manières de penser et d’agir face à l’impôt, à partir notamment de la modélisation du « ras-le-bol fiscal ». Cette typologie pourra aussi être appliquée aux pratiques d’évitement des multinationales.Finalement, des recommandations originales et argumentées permettront de passer d’une vision comptable et juridique des finances publiques à une perspective de long terme basée sur les principes de justice. / This thesis is based on a qualitative survey among forty-nine taxpayers and tax specialists, as well as the study of the major philosophers of four different theories of social justice: utilitarianism, liberal egalitarianism, libertarianism and communitarianism. It aims at bringing to light tax avoidance and tax evasion strategies as well as the social and individual frames that allow such practices. This is conducted based on a social deviance analysis. Our work will confirm why taxpayers generally are in favour of (legal) tax avoidance. We have also observed a certain acceptance of (illegal) tax evasion. Our sociological and philosophical analysis will provide explanations for this situation. It will also offer new perspectives about the direct and side effects of this dynamic. We have established an ideal-type analysis grid that has allowed to better understand the social norm about tax, both from individual and firm perspectives. We have also created a theoretical model to explain the so-called tax “ras-le-bol”, as a breakeven threshold for taxes. We have eventually proposed original criteria for social justice based on our experience and research work that intends to open up new horizons for rebuilding a fair and sustainable tax and redistribution system.

Made available in DSpace on 2016-04-27T13:10:23Z (GMT). No. of bitstreams: 1 Adilson Peron.pdf: 1186813 bytes, checksum: 5ebb7419e0360630b3d63cef39acfe9f (MD5) Previous issue date: 2014-02-12 / Introduction: Cholelithiasis is very prevalent surgical disease, with approximately 60,000 admissions per year in the Unified Health System in Brazil (Sistema Único de Saúde - SUS). Is often asymptomatic or oligosymptomatic and major complications arise from the migration of calculi to biliary low tract. Despite these complications are severe and life threatening, many patients refuse surgical treatment. Objectives: To understand the reasons why individuals with cholelithiasis refuse cholecystectomy before complications inherent to the presence of gallstones in the bile duct and pancreatitis occur. Methods: To investigate the justifications for refusing to submit to surgery we performed individual interviews according to a predetermined script. In these interviews, we evaluate the degree of knowledge of individuals about the disease and its complications and the reasons for the refusal of surgical treatment. We interviewed 20 individuals with cholelithiasis who refused or postponed surgical treatment without a plausible reason. In these interviews, we apply the thematic analysis (MINAYO, 2006). Results: The majority of participants has good knowledge of their disease and its possible complications, were well oriented and had the right surgical indications by their physicians. The refusal for surgery is based primarily on negative experiences of themselves or family members with surgery, including anesthesia; unexplained fears of surgery and, some, cannot specify the reason for the denial or prefer to get the risk and wait for complications to then have to solve them compulsorily. Conclusions: The reasons for the refusal to surgical resolution of cholelithiasis are diverse, but are closely related to personal negative surgical experiences or related persons or complex problems of psychological nature that must be adequately addressed by the surgeon and other qualified professionals. Our study has the proposal of an informed consent that brings all the information about the surgery, its preoperative and postoperative risks, as well as figures with friendly format intended to inform and to help the patients in their decisions / Introdução: A colelitíase é uma doença de resolução cirúrgica muito prevalente, com aproximadamente 60.000 internações por ano no SUS. Muitas vezes é assintomática ou oligossintomática e as principais complicações advêm da migração dos cálculos para as vias biliares baixas. Apesar das complicações serem graves e com risco de morte, muitos pacientes se recusam ao tratamento cirúrgico. Objetivos: Entender as razões pelas quais os indivíduos com colelitíase recusam a colecistectomia antes que ocorram complicações inerentes à presença de cálculos na vesícula, nas vias biliares e a possível pancreatite. Métodos: Para conhecer as justificativas da recusa à cirurgia realizamos entrevistas individuais segundo um roteiro de perguntas pré-determinadas. Nestas entrevistas procuramos avaliar o grau de conhecimento dos indivíduos sobre a doença e suas complicações e as razões para a recusa do tratamento cirúrgico. Entrevistamos 20 indivíduos portadores de colelitíase que se recusavam ou adiavam sem uma justificativa plausível o tratamento cirúrgico. A estas entrevistas aplicamos a análise temática (Minayo, 2006). Resultados: A grande maioria dos entrevistados tem bom conhecimento de sua doença, das possíveis complicações, foram bem orientados e tiveram a indicação cirúrgica pelos seus médicos assistentes. A recusa para a cirurgia foi baseada (principalmente) em experiências negativas próprias ou de familiares com o ato cirúrgico, incluindo aí a anestesia; medos inexplicáveis do ato cirúrgico e alguns não conseguiram especificar a razão para a recusa, preferiram correr o risco e esperar pelas complicações para então ter que resolvê-las. Conclusões: As razões para a recusa à resolução cirúrgica da colelitíase são diversas, mas estão intimamente ligadas às experiências cirúrgicas negativas pessoais ou de pessoas relacionadas ou a complexos problemas de natureza psicológicas que devem ser adequadamente abordados pelo cirurgião e por outros profissionais habilitados. Nosso estudo faz a proposta de um termo de consentimento livre e esclarecido que traz todas as informações sobre a cirurgia, seus riscos pré e pós-operatório assim como figuras com formato amigável que pretendem informar e ajudar o paciente na sua decisão.

Dans le champ de la recherche en génomique, comme dans d'autres domaines très informatisés, les bases de données et les biobanques sont organisées en infrastructures. Ce nouveau modèle organisationnel doit permettre de soutenir l'effort technique et collaboratif requis pour traiter des Big Data, c'est-à-dire des jeux de données trop volumineux et complexes pour être traités en utilisant les méthodes classiques. L'établissement de ces nouveaux environnements constitue un véritable défi technique et philosophique. Il requiert, pour être opérationnel, des cadres réglementaires adaptés, ouverts à la fois à l'internationalisation et à des perspectives de long terme, mais certains de ces changements ne sont pas compatibles avec les procédures éthiques courantes, notamment la procédure de consentement éclairé. L'éthique de la recherche en génomique doit donc être repensée. Faut-il puiser dans la technique les nouvelles solutions de gouvernance de la recherche ? Ou bien est-il plus juste de répondre à ces évolutions en analysant les situations de tension morale suscitées par de nouveaux développements et en décidant de les traiter en fonction de ce à quoi nous tenons collectivement ? L'enjeu de ce travail, qui relève d'une approche pragmatiste, consiste à cultiver une attitude réflexive à propos des changements en cours dans la recherche en génomique. Cette tâche suppose d'expliciter le rôle des biobanques et des bases de données dans la production, la validation et la publication de la recherche génomique. Il est également nécessaire de rendre compte des tensions auxquelles le développement de ces dispositifs donne lieu lorsqu'ils sont incompatibles avec les procédures actuelles. On peut alors examiner si les dispositifs tels qu'ils sont conçus sont désirables dans les contextes où ils sont développés, soulignant ainsi la dimension politique de l'éthique de la recherche. Cette thèse repose sur l'analyse de situations concrètes issues de projets de recherche dans lesquels nous avons été impliquée. Nous utilisons aussi plusieurs disciplines étudiant la science telle qu'elle se fait (philosophie, anthropologie, sociologie et histoire). Au cours de cet examen, l'idée régulatrice de personne-membre est proposée, pour favoriser la prise en compte des appartenances sociales et politiques du sujet de l'éthique de la recherche en génomique. / In genomic research, as in other highly computerised scientific fields, databases and biobanks are today (re-)organised into infrastructures. This new organisational model should support the technical and collaborative effort needed to deal with Big Data, that is, data sets that are too large and too complex to be treated with conventional methods. Establishing these new environments is an actual technical challenge that requires, in order to be operational, appropriate regulatory frameworks that are both open to internationalisation and long-term prospects. But some of these changes are not consistent with current ethics procedures, including the informed consent process. The ethics of genomics research must therefore be reconsidered by asking whether it is in technology that we must draw new solutions for the governance of research or whether we must respond to these evolutions by proposing a political treatment to clarify what we value collectively. This work, which is based on a pragmatist approach, intends to cultivate a reflexive attitude on the changes being made in genomic research by describing situations of moral tension. This requires elucidating the role of biobanks and databases in the production, validation and publication of genomic research; accounting for the conflicts of values to which the development of these devices can give rise when they are incompatible with the current procedures and thus to examine whether the devices as conceived are desirable in the contexts where they are developed. This thesis is based on the analysis of concrete situations, resulting from research projects in which we have been involved or from studies of science in practices (philosophy, anthropology, sociology and history). During this examination, the regulatory idea of a person-member is proposed, in order to favor the consideration of the social and political affiliations of the subject of ethics to research in genomics.

Background: Sexual consent is often defined as the voluntary agreement to participate in a sexual act, though the differing definitions across and within countries make legal consensus difficult. In recent years, due to popularization through social media, nonconsensual condom removal, termed stealthing, is becoming common, especially among young adults. Yet, little to no empirical evidence exists on this sexual behavior. Methods: In this exploratory sequential mixed methods approach, we aimed to address the current perception of stealthing among young adults. College students were recruited from general education courses at a medium-sized four- year public university. Focus groups were conducted to understand the current perception of stealthing, including knowledge, perceived influence, and outcome, followed by quantitative assessment of knowledge, attitude, and self-efficacy of sexual consent. Results: Results demonstrated central theme of health-decision making with associated themes of consent, which further included subthemes of privacy, trust, and violation, followed by consideration of stealthing as sexual assault and social norm and acceptance of stealthing. Quantitative assessment showed that knowledge and awareness of stealthing remains low, though sex differences exist on the perception of stealthing being considered sexual assault; with higher rates among males as compared to females. Conclusion: The act of stealthing has been popularized in social media. Our results demonstrate that there is a need for health educators to assess the prevalence of such a behavior among young adults and policy makers to assess the legal implications of nonconsensual condom removal.

Understanding how students endorse affirmative consent in their sexual relationships is essential to sexual violence prevention. Some research has indicated that LGBT students and students with disabilities may negotiate and endorse consent uniquely because of socially constructed traditional sexual scripts. Research indicates gender differences may exist as well. The proposed research examines differences based on gender, LGBT status, and disability in affirmative consent endorsement and peer norms around sexual violence. Results indicated that women, nonbinary students, LGBT students, and students with disabilities were significantly less likely than their privileged counterparts to indicate low endorsement of affirmative consent. Results also indicated that women and some LGBT students are significantly less likely than their privileged counterparts to indicate high peer norms supporting sexual violence. Limitations, implications, and future directions are discussed.

Thesis (MA. (African Languages)) --University of Limpopo, 2013 / Tsenguluso iyi yo bvisela khagala matshimbidzele a mbingano ya Vhavenḓa zwi tshi kwama zwine mbingano iyi ya vha zwone, u dzhenelela ha vhabebi, maambisele, u lugiselwa ha mbingano, lumalo u swika kha u vhinga kana u vhingwa. Yo dovha ya bvisela khagala khaedu dzo livhanaho na iyi mbingano ṋamusi dzine dza vha u sa dzhenelela ha vhabebi kha mbingano dza vhana vhavho. U ḓiṱoḓela vhafunwa ha vhaswa ano maḓuvha, zwiitisi zwa u sa malwa ha vhafumakadzi khathihi na u sengulusa uri ndi ngani vhanna ano maḓuvha vha si tsha mala vhafumakadzi vhanzhi.