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(1) Background: Brazil has a universal public healthcare system, but individuals can still opt to buy private health insurance and/or pay out-of-pocket for healthcare. Past research suggests that Brazilians make combined use of public and private services, possibly causing double costs. This study aims to describe this dual use and assess its relationship with socioeconomic status (SES). (2) Methods: We calculated survey-weighted population estimates and descriptive statistics, and built a survey-weighted logistic regression model to explore the effect of SES on dual use of healthcare, including demographic characteristics and other variables related to healthcare need and use as additional explanatory variables using data from the 2019 Brazilian National Health Survey. (3) Results: An estimated 39,039,016 (n = 46,914; 18.6%) persons sought care in the two weeks before the survey, of which 5,576,216 were dual users (n = 6484; 14.7%). Dual use happened both in the direction of public to private (n = 4628; 67.3%), and of private to public (n = 1855; 32.7%). Higher income had a significant effect on dual use (p < 0.0001), suggesting a dose-response relationship, even after controlling for confounders. Significant effects were also found for region (p < 0.0001) and usual source of care (USC) (p < 0.0001). (4) Conclusion: A large number of Brazilians are seeking care from a source different than their regular system. Higher SES, region, and USC are associated factors, possibly leading to more health inequity. Due to its high prevalence and important implications, more research is warranted to illuminate the main causes of dual use.

We study (fe)male adolescents' interest in watching sports as a spectator using logistic multilevel analyses based on a representative sample of 5837 Flemish (Belgian) pupils in the first year of secondary education. To uncover the mechanisms behind the 'gendering' of passive sports consumption, this study evaluates how the gender gap (characterized by higher male involvement) relates to the gender identity, experienced pressures for gender-conforming behavior and gender role attitudes of the students. Results indicate that the gender gap in interest is to a large extent related to the studied mechanisms. The findings have implications for research on the feminization of sports fandom and call for further analysis of the processes behind the gender gap in consumption of different sports with masculine or feminine connotations and of on-site and TV spectatorship. [ABSTRACT FROM AUTHOR]

This paper studies the gender gap in sport event attendance -- characterized by higher male and lower female participation -- using a macro-sociological and cross-national comparative approach. We argue that because gender is produced and justified in the realm of sport, gender gaps in sport event attendance may be more pronounced in some societies than others, depending on the position women and men have in the particular context in which someone 'does' his/her gender. So, in addition to individual attributes, one has to consider the societal, macro-level gender equality in order to understand the individual-level gender inequalities in sport event attendance. Using multilevel analyses on Eurobarometer data (2007), we evaluate whether the size of the gender gap in sport event attendance varies across European Union (EU) countries and how this variation relates to societal gender equality, as measured by the Gender Equality Index of the European Institute for Gender Equality. We find higher male than female attendance in all EU countries, but also conclude that higher levels of macro-level gender equality are associated with smaller gender gaps in sport event attendance. [ABSTRACT FROM AUTHOR]

In this paper we explore whether and how ‘sport’ can be an adequate and valid sociological concept considering the multitude of contested meanings and definitions attached to ‘sport’ by different stakeholders in the sports field. Firstly, we argue that essentialist definitions of ‘sport’ too often one-sidedly focus on physical exertion and neglect the socially distinguishing nature of sportive practices as part of a lifestyle. Secondly, survey questions reflect this physical definition of ‘sport’ and assume that ‘sport’ has an obviously similar meaning to respondents. However, reflecting the struggle to define ‘sport’ in the sports field, people with different socio-demographic backgrounds differ in their understanding of the concept. Because current measurement of ‘sport’ does not adequately deal with the open and contested nature of the concept, suggestions on how to collect survey data on sport participation are presented. [ABSTRACT FROM AUTHOR]

AbstractPurposeMethodsResultsConclusions\nIMPLICATIONS FOR REHABILITATIONSeveral high-income countries install Cash-for-Care Schemes (CCSs) by granting budgets to care users. However, little quantitative evidence exist on empowerment and client-centered care levels, due to a lack of validated scales. This research aimed to validate the Psychological Empowerment Scale (PE scale) and Client-Centered Care Questionnaire (CCCQ) in budget holders with disabilities.A survey was developed based on a literature review and experts and budget holders input. Principal Axis Factoring with direct oblimin rotation, Cronbach’s Alpha, and hypotheses testing with socio-demographic and budget characteristics as independent variables, and PE scale and CCCQ as dependent, were undertaken to assess both scales’ internal consistency and validity.A convenience sample of 224 Flemish (proxy) budget holders completed the survey. Our analysis showed a two-factor solution for both scales; for the PE scale consisting of “meaning” and “competence,” and “self-determination” and “impact,” for CCCQ consisting of items 1–7 (conduct by caregiver) and items 8–15 (autonomy). Cronbach’s Alpha of both scales was 0.94. The majority of our hypotheses were confirmed.The findings show that both scales are valid and internally consistent, meaning that they can be further tested in a respondent sample of people with disabilities and in other care contexts.In light of the current trends in the (health)care sector to stimulate empowerment and client-centered care in care users, the monitoring of this experience is important.The Psychological Empowerment Scale (PE scale) measures empowerment by means of four cognitions (meaning, competence, impact, and self-determination), while the Client-Centered Care Questionnaire (CCCQ) measures the level of client-centered care.The PE scale and CCCQ are valid and internally consistent in our sample of (proxy) budget holders with disabilities.In light of the current trends in the (health)care sector to stimulate empowerment and client-centered care in care users, the monitoring of this experience is important.The Psychological Empowerment Scale (PE scale) measures empowerment by means of four cognitions (meaning, competence, impact, and self-determination), while the Client-Centered Care Questionnaire (CCCQ) measures the level of client-centered care.The PE scale and CCCQ are valid and internally consistent in our sample of (proxy) budget holders with disabilities. [ABSTRACT FROM AUTHOR]