A tuberculose entre pessoas em situação de rua é um grave problema de saúde pública, que carece de entendimentos e respostas melhor construídas. Questões envolvendo a dimensão coletiva do controle da doença, a dimensão individual do tratamento e o caminho para cura desta população são trazidos neste trabalho que tem como objetivo investigar os aspectos relacionados ao processo de gestão dos tratamentos e busca da cura nesta população. Para isto foram realizados estudos etnográficos junto as equipes de Consultório na Rua da cidade de São Paulo e no Hospital Leonor de Barros, em Campos do Jordão (SP), referência para internação deste grupo. A presença do uso de drogas, as co-infecções com o HIV, DSTs e as Hepatites Virais e o passado de tráfico e criminalidade são elementos presentes na história de vida dos internados, muitos dos quais já com passagem em presídios e alguns com problemas de saúde mental. Mesmo se sujeitando as regras do local em busca de um alento a seu estado de saúde, os pacientes buscam no uso de drogas escondido e no sexo discreto e não comentado, uma alternativa mediadora para suportarem as limitações a que estão expostos. A situação ainda revela uma dificuldade das instituições de internação no lidar com o tema a prática da estratégia de Redução de Danos ao uso de álcool e outras drogas, notando-se uma tendência a destacar práticas proibicionistas em qualquer ação desenvolvida. O entendimento do paciente frente à realidade encarada, revela-se principalmente pelas formas de resistência que eles desenvolvem para o período de reclusão que estarão submetidos durante o tratamento. Ao final se conclui que as diferenças sociais, oriundas de acessos dificultados, preconceitos, segregações e outros atos discriminatórios tem forte influência no processo de adesão do tratamento e cura. Além disto, percebeu-se a existência de vários enfoques de moralidades, envolvendo principalmente os profissionais de saúde e pacientes que refletem na gestão da atenção e cuidado e ainda a presença de uma diferenciação entre o conceito de ficar doente e ficar bom entre estes atores, criando um distanciamento de entendimentos e práticas. / The TB among people living in streets is a serious public health problem, that lacks understanding and better built answers. Issues involving the collective dimension of disease control, the individual perspective and the way to the cure of this population are brought in this paper, that aims to investigate the aspects related to the management process of the treatments and the way to the recovery. For this, ethnographic studies were conducted with the teams of Office in the Street in the city of São Paulo and in the Leonor de Barros Hospital, in Campos do Jordão (SP), reference for hospitalization of this group. The presence of drug use, the co-infections with HIV, STD and Viral Hepatitis and the past of trafficking and crime are present elements in the life story of the hospitalized, many of whom with passages at prisons, and some with mental health problems. Even if subject to local rules in search of a breath to their health, the patients search in the hide drug use and in the discreet and not commented sex a mediating alternative to tolerate the limitations they are exposed. The situation reveals a difficult of the admission institutions to deal with the Harm Reduction in alcohol and drug use theme, noticing a trend to highlight prohibitionist practices in any developed action. The understanding of the patients face to the seen reality is revealed mainly by the resistance forms that they develop to the reclusion time to which they will be submitted during the treatment. At the end is concluded that social differences, coming from hampered access, prejudice, segregations and other discriminatory acts have strong influence on the treatment adhesion and cure process. Besides, the existence of various morality approaches was noticed, primarly involving health professionals and patients, reflecting on the attention and care management, and also the presence of a differentiation between the concepts of get sick and get well among these actors, creating a distance of understandings and practices.

A tuberculose entre pessoas em situação de rua é um grave problema de saúde pública, que carece de entendimentos e respostas melhor construídas. Questões envolvendo a dimensão coletiva do controle da doença, a dimensão individual do tratamento e o caminho para cura desta população são trazidos neste trabalho que tem como objetivo investigar os aspectos relacionados ao processo de gestão dos tratamentos e busca da cura nesta população. Para isto foram realizados estudos etnográficos junto as equipes de Consultório na Rua da cidade de São Paulo e no Hospital Leonor de Barros, em Campos do Jordão (SP), referência para internação deste grupo. A presença do uso de drogas, as co-infecções com o HIV, DSTs e as Hepatites Virais e o passado de tráfico e criminalidade são elementos presentes na história de vida dos internados, muitos dos quais já com passagem em presídios e alguns com problemas de saúde mental. Mesmo se sujeitando as regras do local em busca de um alento a seu estado de saúde, os pacientes buscam no uso de drogas escondido e no sexo discreto e não comentado, uma alternativa mediadora para suportarem as limitações a que estão expostos. A situação ainda revela uma dificuldade das instituições de internação no lidar com o tema a prática da estratégia de Redução de Danos ao uso de álcool e outras drogas, notando-se uma tendência a destacar práticas proibicionistas em qualquer ação desenvolvida. O entendimento do paciente frente à realidade encarada, revela-se principalmente pelas formas de resistência que eles desenvolvem para o período de reclusão que estarão submetidos durante o tratamento. Ao final se conclui que as diferenças sociais, oriundas de acessos dificultados, preconceitos, segregações e outros atos discriminatórios tem forte influência no processo de adesão do tratamento e cura. Além disto, percebeu-se a existência de vários enfoques de moralidades, envolvendo principalmente os profissionais de saúde e pacientes que refletem na gestão da atenção e cuidado e ainda a presença de uma diferenciação entre o conceito de ficar doente e ficar bom entre estes atores, criando um distanciamento de entendimentos e práticas. / The TB among people living in streets is a serious public health problem, that lacks understanding and better built answers. Issues involving the collective dimension of disease control, the individual perspective and the way to the cure of this population are brought in this paper, that aims to investigate the aspects related to the management process of the treatments and the way to the recovery. For this, ethnographic studies were conducted with the teams of Office in the Street in the city of São Paulo and in the Leonor de Barros Hospital, in Campos do Jordão (SP), reference for hospitalization of this group. The presence of drug use, the co-infections with HIV, STD and Viral Hepatitis and the past of trafficking and crime are present elements in the life story of the hospitalized, many of whom with passages at prisons, and some with mental health problems. Even if subject to local rules in search of a breath to their health, the patients search in the hide drug use and in the discreet and not commented sex a mediating alternative to tolerate the limitations they are exposed. The situation reveals a difficult of the admission institutions to deal with the Harm Reduction in alcohol and drug use theme, noticing a trend to highlight prohibitionist practices in any developed action. The understanding of the patients face to the seen reality is revealed mainly by the resistance forms that they develop to the reclusion time to which they will be submitted during the treatment. At the end is concluded that social differences, coming from hampered access, prejudice, segregations and other discriminatory acts have strong influence on the treatment adhesion and cure process. Besides, the existence of various morality approaches was noticed, primarly involving health professionals and patients, reflecting on the attention and care management, and also the presence of a differentiation between the concepts of get sick and get well among these actors, creating a distance of understandings and practices.

Cette recherche vise à étudier trois problèmes sociétaux au Portugal. Les bonus attribués aux dirigeants, les restructurations des entreprises et le sans-abrisme. La première étude examine l’acceptabilité perçue par le public des bonus attribués aux dirigeants. Deux cent huit participants, ayant différents niveaux de formation en économie, ont répondu à un certain nombre de scénarios. Les scénarios ont été composés de quatre facteurs. Cinq positions personnelles qualitativement différentes ont été trouvées. La deuxième étude a examiné l’acceptabilité perçue par le public des plans de restructuration des entreprises. Deux cent sept participants, ayant différents niveaux de formation en économie, ont répondu à un certain nombre de scénarios. Les scénarios ont été composés de trois facteurs. Six positions personnelles qualitativement différentes ont été trouvées. La troisième étude vise à étudier les motifs psychologiques pour lesquels les sans-abris ne se réinsèrent pas facilement au travail. L’échantillon était composé de 202 hommes adultes Portugais en situation de sans-abri. Les participants ont répondu à un questionnaire sur les motifs possibles à leur non réinsertion dans le marché de travail. Une analyse factorielle exploratoire a mis en évidence quatre facteurs. Le rejet de la société, de l’exploitation et de l’autorité sont les motifs évoqués avec le plus de force. / This research aims to study three societal problems in Portugal. The executive bonus, restructuration and homelessness. The first study aimed to explore and map the views of Portuguese laypersons regarding the legitimacy of bonuses for senior executives. Two hundred eight participants, with various levels of training in economics, were presented with a number of concrete scenarios. The scenarios were created by varying four factors. Five qualitatively different personal positions were found. The second study aimed to explore and map the views of Portuguese laypersons regarding the acceptability of downsizing and restructuration measures during a recession. Two hundred seven participants, with various levels of training in economics, were presented with a number of concrete scenarios. The scenarios were created by varying three factors. Six qualitatively different personal positions were found. The third study aims to explore the psychological motifs for which the homeless people do not easily reintegrate the work. The sample was composed of 202 Portuguese’s men homeless. They were presented with one questionnaire that contained items about possible motifs about their non-integration into the labour market. The exploratory factor analysis revealed four factors. According to the results of the study only two types of motifs were important: the motifs of refusal the society and the motifs of refusal the submission to labor’s authorities.

Le phénomène du sans-abrisme évoque la plupart du temps des images d’hommes, seuls, exposés dans les espaces publics et pratiquant la mendicité. Or, le sans abrisme se conjugue également au féminin. Cette thèse de sociologie propose d’interroger l’expérience des femmes sans abri à partir des modalités d’accueil et des pratiques de catégorisation des sexes observées dans les dispositifs d’accueil et d’hébergement à Saint-Etienne et à Montréal. Au croisement de la sociologie du sans-abrisme et de la sociologie du genre, ce travail vise à comprendre d’une part la place des femmes sans abri dans le monde de l’assistance et d’autre part, comment l’assistance participe à fabriquer le genre des individus qui y ont recours. Au moyen d’une ethnographie comparative, je montre que, si au Québec l’itinérance des femmes est devenue un problème public, en France, les femmes tendent à être accueillies et prises en charge avec les hommes (mixité des sexes) et « comme » des personnes singulières. L’observation de cette différence de traitement des femmes en France et au Québec a permis l’élaboration de deux grammaires de l’assistance : celle de la « personne » qui tend à désexualiser les individus et qui souligne la nécessité de reconnaissance de la singularité des êtres accueillis, faisant du genre et des catégories de sexes des « petits troubles » situés à la marge des situations et celle de la « vulnérabilité de genre » qui insiste explicitement sur les violences multiples dont les femmes sans abri sont l’objet et qui induit une forme de justice sociale basée sur la reconnaissance de la différence de l’expérience des femmes. / Homelessness often evokes images of lonely men, exposed in public spaces and begging. However, the phenomenon of homelessness also includes women. This doctoral dissertation in sociology proposes to investigate the experience of homeless women based on the welcoming methods and gender categorization practices observed in day centers and shelters in Saint-Etienne (France) and Montreal (Canada). At the crossroads of sociology of homelessness and sociology of gender, this work aims to understand the place of homeless women in the world of assistance and how assistance contributes to the making of gender in/for people who use it. Drawing on a comparative ethnography, we demonstrate that, while in Quebec women's homelessness has become a public problem, in France, women tend to be welcomed and cared for among men (“gender mixity”) and "as" singular people. The observation of this difference in the treatment of women in France and Quebec has led to the elaboration of two grammars for assistance: (1) a grammar of "person" who tends to desexualize individuals and who emphasizes the need to recognize the singularity of the people being welcomed, making gender and gender categories of the "small troubles" located at the margin of situations (2) and a grammar of "gender vulnerability" which explicitly insists on violence undergone by homeless women, and implies a form of social justice, based on the recognition of the difference of women’s experience.

The aim of this doctoral thesis is to investigate the practices of rough sleeping and inhabiting public space, with a focus on the modern city of Rome. By inhabiting public spaces, people who are homeless expose their private sphere to public view. Paradoxically, this public exposure of the private becomes a means of exclusion according to Judith Butler and Athena Athanasiou (2013). Scholars acknowledge public space as constructed by the actions that people carry out in public (Lefebvre 1991; Tschumi 1996; Harvey 2012; Jon Goodbun et al. 2014). People who are homeless certainly contribute to the construction of public space (Petty 2016). However, as asserted by architectural scholar Gill Doron, certain practices 'reveal how the public space is restricted to a very small spectrum of activities, and how many other activities are not permitted' (Doron 2000, p.254). These practices put into question what public these spaces are designed and designated for, questioning why only some activities are regarded as public and why some others take place only at night when spaces are temporary urban voids. Rough sleeping in Rome takes place mostly at night, exposing the city to its own fragilities and contradictions. Public space emerges as precarious. It is defned by social and cultural boundaries, within which urban practices alternate one with the other. These are irreconcilable poles within a parallax gap (Žižek 2009). The theoretical scaffolding of the thesis is structured alongside two other transgressive case studies: Pussy Riot's occupation in Moscow and my interviews with parkour practitioners. These cases have been investigated in comparison with homelessness in order to highlight aspects concerning occupation of space as a performative action under precarious circumstances (precarity). The literary review is combined with auto-ethnographical studies I conducted with a community of rough sleepers, comprising 20-40 members who inhabit a portico area nearby St Peter's Square in Rome. I also ran focus groups, individual interviews and project presentations to people who either are involved in charitable bodies that deal with homelessness or are part of the general public, such as passers-by in St Peter's Square. This study has revealed a series of aspects concerning the negotiation of public space and the role of agency and mediation. This study has stimulated questions concerning the role design can play in discourses of social innovation and inclusion. The research conducted has also outlined diffculties concerning the range of data and the possible response to the many voices heard. How can design re-imagine the centre ground between alternative practices in space? By highlighting the centre as precarious, is it possible to fnd a way of re-thinking the centre? On the basis of this study, the aim of the research has been to look at the state of the gap between these alternative poles, investigating and exploring the concept of precarity. This suggests the possibility of redefning concepts of mediation, social inclusion and architectural activism, articulated further through a series of speculative projects, concluding with the presentation of a 'precarious' object I designed together with the community of rough sleepers in St Peter's Square and COTRAD onlus (a charitable body based in Rome).

Esta tese teve como objetivo avaliar o Serviço Ação Rua, responsável pela abordagem e acompanhamento a crianças e adolescentes em situação de rua e suas famílias na cidade de Porto Alegre, Brasil. A organização metodológica é qualitativa, através de Estudo de Caso Único, com Unidades de Análise Incorporadas, abarcando o período de 2007 a 2009. Foram realizados cinco estudos: análise documental, que avaliou qualitativamente o processo de implantação e analisou dados quali-quantitativos; e quatro estudos que analisaram, a partir da realização de grupos focais, a percepção de adolescentes e famílias atendidas, trabalhadores sociais e gestores do Serviço. A partir da literatura sobre avaliação de programas e projetos sociais, e sobre intervenções em situação de rua, foram constituídos os referenciais de base que sustentam as análises, destacando-se o apoio social e a Teoria Bioecológica do Desenvolvimento Humano. O conjunto dos resultados originados nas unidades de análise incorporadas foi sintetizado em quatro eixos emergentes na avaliação do Caso Ação Rua: intervenção, relação em rede, modo de gestão e intersetorialidade. Destaca-se a relevância das relações proximais na implementação da intervenção, do estabelecimento de uma rede de apoio, de um modelo consistente de cooperação entre a sociedade civil e governo e da articulação com as políticas públicas do macrossistema. As experiências de transformação do serviço descritas neste estudo podem contribuir para a construção das políticas públicas para a situação de rua e risco social. / This thesis aimed to evaluate the Action Street Program (Serviço Ação Rua), responsible for approaching and monitoring homeless children and adolescents, as well as their families, in the city of Porto Alegre, Brasil. A qualitative methodology, through Single Case Study with Embedded Units of Analysis, covering the period from 2007 to 2009 was used. Five studies were conducted: a document analysis, which evaluated the implantation process qualitatively and analyzed qualitative and quantitative data; and four studies analyzed the perceptions of adolescents, families, social workers and service managers, through focus groups. Theoretical background comes from literature on the evaluation of both social programs and projects and interventions designed for homeless children, in which social support and bioecological theory of human development are highlighted. The overall results were synthesized into four emerging axes in the evaluation of the Street Action Case: intervention, network connection, management and intersectoral cooperation. The following items are emphasized: the relevance of the proximal processes on the intervention level, the establishment of a social support network, a consistent model of cooperation among civil society and the liaison with government and public policies in the macrosystem. The transformation experiences of the service described in this study can contribute to the construction of public policies for homelessness and social risk situation.

In this piece the author takes a journey into the meaning of quests through the philosophical terrain of existential phenomenology and authenticity. Unlike quest narratives in literature and popular culture, our life narratives are not yet finished, but ongoing. Comparing the idea of existential homelessness with its undeniable and constant change to that of autoethnographic writing, he examines narrative and memory and how current life events change our understandings of past narratives and our sense of identity. Our life narratives are made up of fragmented thoughts and ideas, the stories others told before we were born—and will tell about us after we are gone.

As the number of older adults experiencing homelessness continues to increase, understanding the experiences of older homeless adults is necessary. Although housing first initiatives are vital to removing individuals from homelessness, the psychosocial aspects of homelessness are often neglected. The efforts to end and prevent homelessness among older adults require interagency collaboration to include counseling professionals who can assist with the psychosocial aspects of the phenomenon. In an effort to provide a platform for older adults experiencing homelessness to inform researchers and practitioner alike, a phenomenological qualitative study was conducted to explore their lived experiences and their human and social capital. The findings of the study suggest that the experiences older adults participants of this study ranged from maladaptive behaviors (e.g., poor decision making) to positive outlooks for their future. Overall, both their human and their social capital are impaired, and they require interventions that address psychosocial aspects of homelessness, such as loss of social ties and financial insecurity.

Homeless outreach programs vary widely in their approaches to client treatment. At the Grace Café, an organization that serves daily meals to people who are homeless, the concept of dignity is central to guest treatment. According to the café's ideology, the importance of providing food is secondary to serving with dignity. This research explores dignity as an ideal of client treatment at the Grace Café. Based on ethnographic research, this paper explores how dignity is communicated to volunteers, implemented in service, and challenged at the Grace Café.

The UpliftU® program is a long-term residential program for women and families who are homeless or at risk for homelessness. This program is one part of a larger, community-based non-profit organization serving low-income and homeless families in Hillsborough County, Florida for over 35 years. This program is not an emergency shelter program, but rather offers up to 18 months of participation in a self-sufficiency program to single women and families. The goal of the program is to prevent future homelessness for residents by helping them to reach their highest level of self-sufficiency. After volunteering at this organization for nine months, I completed an internship as the Health Specialist Case Manager for the UpliftU® program during the summer of 2008. The internship was conducted using ethnographic research methods to understand counseling team members' and resident mothers' perceptions of access to health care resources and their experiences in utilizing area health care services. This thesis compares the perspectives of the counseling team members with the resident mothers' perspectives, and examines barriers to and gaps in service provision, as reported by both groups. Findings from qualitative data analysis suggest that counseling team members conceptualize the barriers to health care as originating at the individual level with resident mothers' behaviors and actions, while resident mothers' expressed that they experience barriers to health care services at interpersonal and institutional levels. Resident mothers described how health professionals and staff treating them poorly leads to barriers to health care at an interpersonal level, and that at an institutional level the bureaucratic hassles associated with public insurance and public clinics also acted as barriers to care. Such differences in perception of causality of barriers to health care services between counseling team members and resident mothers have significant ramifications for resident mothers' health and ability to access health care services.