MICROFINANCE AND CLIMATE CHANGE IMPACTS: THE CASE OF AGROAMIGO IN BRAZIL

ABSTRACTThis paper reports an empirical case study on the interface between microfinance and climate change actions. Climate change, which until recently seemed a luxury for the microfinance sector, now appears to be crucial for its future. For their low adaptive capacity, the millions of microfinance clients worldwide happen to be the most vulnerable to a changing climate. However, such an arena is still blurred from an academic viewpoint, and inexistent among Brazilian academia. Therefore, by investigating Brazil’s largest rural MFI, Agroamigo, we aim at providing an empirical contribution to green microfinance. The main conclusion is that, albeit Agroamigo offers important links to climate change initiatives, it will need to take better account of specific vulnerabilities and risks to protect its portfolio and clients better from climate change impacts.

Intergenerational interaction in health promotion: a qualitative study in Brazil

OBJECTIVE: In 1994 a pilot intergenerational project was started in the city of Taguatinga, Brazil, to promote the well-being of both elderly and adolescent populations using reminiscence processes as a means of interaction. The purpose of the study is to evaluate the project from the participants' viewpoint and to improve the contribution of those age groups in building up social capital. METHODS: From November 1999 to April 2000 a qualitative study using focus groups technique was conducted. Using a discussion guide, 9 groups of students, ranging in age from 13 to 19 years old, and 3 groups of elderly aged 60 years and over were interviewed to collect data regarding their interaction before and after an intergenerational program. RESULTS: The main findings suggested a change in attitude of young people toward old age and elderly people. Participating elderly people reported improvement in their health status. For both age groups the findings suggested a better understanding between generations. CONCLUSIONS: It seems that reminiscence intergenerational activity contributes to building up mutual trust and reciprocity. These results seem to indicate this is an alternative for investing in social capital and improving participants' well-being. However, further work is needed to support these findings.

Knowledge, attitude and practice of mammography among women users of public health services

OBJECTIVE: To evaluate knowledge, attitude and practice related to mammography among women users of local health services, identifying barriers to its performance. METHODS: A total of 663 women were interviewed at 13 local health centers in a city of Southeastern Brazil, in 2001. Interviewees were randomly selected at each center and they were representative from different socioeconomic conditions. The number of interviewees at each center was proportional to monthly mean appointments. For data analysis, answers were described as knowledge, attitude, practice and their respective adequacies and then they were correlated with control variables through the chi-square test. RESULTS: Only 7.4% of the interviewees had adequate knowledge on mammography, while 97.1% of women had an adequate attitude. The same was seen for the practice of mammography that was adequate in 35.7% of the cases. The main barrier to mammography was lack of referral by physicians working at the health center (81.8%). There was an association between adequacy of attitude and five years or more of education and being married. There was also an association between adequacy of mammography practice and being employed and family income up to four minimum wages. CONCLUSIONS: Women users of local health services had no adequate knowledge and practice related to mammography despite having an adequate attitude about this exam.

Oral health in the family health strategy: a change of practices or semantics diversionism

OBJECTIVE:To evaluate public health dentistry practices of two different family health models. METHODS: Qualitative study conducted with data obtained from focus groups consisting of 58 dentists working in the Family Health Strategy for at least three years between August-October, 2006. The Paideia Family Health Approach was used in the city of Campinas and the Oral Health Initiative as part of the Family Health Strategy was implemented in the city of Curitiba, Southeastern and Southern Brazil, respectively. Data was analyzed using the hermeneutic-dialectic method. Analysis indicators were employed to indicate backwardness, stagnation or progress in oral health practices effective from the implementation of the strategies referred. The indicators used were: work process; interdisciplinary approach; territorialization; capacity building of human resources; health promotion practices; and responsiveness to users' demands. RESULTS: There was progress in user access to services, humanization of health care, patient welcoming and patient-provider relationship. The results related to health promotion practices, territorialization, interdisciplinary approach and resource capacity building indicated a need for technical and operational enhancements in both cities. CONCLUSIONS: Both models have brought about important advances in terms of increased access to services and humanization of health care. Universal access to oral health at all levels of complexity was not achieved in both cities studied. Local health managers and oral health program coordinators must bring more weight to bear in the arena that defines public policy priorities.

Locus of control and contraceptive knowledge, attitude and practice among university students

OBJECTIVE: To assess the relationship between locus of control and knowledge, attitude and practice regarding pill and condom use among university students. METHODS: The inquiry was developed in Campinas, a city in Southeastern Brazil, in 2006. A total of 295 adolescent newcomers to a public university answered a structured questionnaire and Levenson's multidimensional locus of control scale. The scores of the dimensions of locus of control were calculated and Spearman's correlation coefficient was used to assess their correlation with knowledge and practice concerning pill and condom use. In order to assess the relationship between the dimensions of locus of control and sociodemographic variables and variables related to the individuals' sex life, Kruskal-Wallis and Mann-Whitney tests were used. RESULTS: Male adolescents had higher scores of powerful others externality when compared to female adolescents (p=0.01). Students living alone had lower internality (p=0.01). When locus of control was compared to condom use in the first intercourse, considering only the 102 students who informed the age of the beginning of sexual activity, greater internality was found among male adolescents who did not use condoms (p<0.05). When the locus of control scores were correlated with contraceptive knowledge and practice, it was found that the higher the powerful others externality locus, the lower the adequate use of contraceptive methods (r = -0.22, p=0.03). CONCLUSIONS: The powerful others externality locus influences the practice of contraceptive use in this group of adolescents.

Hospitalization due to drug use did not change after a decade of the Psychiatric Reform

ABSTRACT OBJECTIVE To investigate whether the psychiatric hospitalization rates due to use of psychoactive substances and average time of hospitalization suffered any changes after the first decade of effective implementation of the psychiatric reform in Brazil. METHODS This article examines the evolution of hospitalizations due to disorders arising from the use of alcohol or other substances in the state of Santa Catarina, Southern Brazil, from 2000 to 2012. This is an ecological, time-series study, which uses data from admissions obtained by the Informatics Service of the Brazilian Unified Health System. Hospitalization rates by 100,000 inhabitants and average time of occupancy of beds were estimated. Coefficients of variation of these rates were estimated by Poisson Regression. RESULTS The total and male hospitalization rates did not vary (p = 0.056 and p = 0.244, respectively). We observed an increase of 3.0% for the female sex (p = 0.049). We did not observe any significant variation for occupancy time of beds. CONCLUSIONS The deployment of services triggered by the Brazilian psychiatric reform was not accompanied by a reduction of hospitalization rates or mean occupancy time of hospitalized patients during this first decade of implementation of the reform.

Color change using HSB color system of dental resin composites immersed in different common Amazon region beverages

The purpose of this study is to evaluate in vitro the color stability of composite resins when exposed to beverages with high coloring contents from the Amazon region. 240 samples from four different composite brands (Natural Look, Z350, 4Seasons and Opallis) of hue A3 were fabricated using an acrylic matrix. The samples were stored in distilled water at 37ºC for 24 hours. The initial color (T0) was registered using a Canon EOS Rebel XTi 10 mp camera, and then the samples were divided into four groups (n=15): G1 (coffee), G2 (açaí juice), G3 (energetic guaraná) and G4 (control - distilled water). The samples were exposed to solutions of DES (6hs) and RE (18hs) and placed in a double boiler under constant agitation, at 37ºC for 30 days. The samples were immersed in the coloring solutions for 15 minutes daily. After 7, 15 and 30 days, new photographic registers were made (T1, T2 and T3). The images were analyzed using Corel PHOTO-PAINT 12 software to identify the colors through the HSB system. The Kruskal-Wallis and t tests (p<0.05) demonstrated significant differences in color (hue, saturation and brightness). The results revealed that none of the tested composites showed color stability when exposed to coloring solutions, and that the Amazon region beverages (açaí juice and energetic guaraná) showed to be less coloring than coffee.

Reconstructing historical forest cover change in the Lower Amazon floodplains using the LandTrendr algorithm

ABSTRACTThe Amazon várzeas are an important component of the Amazon biome, but anthropic and climatic impacts have been leading to forest loss and interruption of essential ecosystem functions and services. The objectives of this study were to evaluate the capability of the Landsat-based Detection of Trends in Disturbance and Recovery (LandTrendr) algorithm to characterize changes in várzeaforest cover in the Lower Amazon, and to analyze the potential of spectral and temporal attributes to classify forest loss as either natural or anthropogenic. We used a time series of 37 Landsat TM and ETM+ images acquired between 1984 and 2009. We used the LandTrendr algorithm to detect forest cover change and the attributes of "start year", "magnitude", and "duration" of the changes, as well as "NDVI at the end of series". Detection was restricted to areas identified as having forest cover at the start and/or end of the time series. We used the Support Vector Machine (SVM) algorithm to classify the extracted attributes, differentiating between anthropogenic and natural forest loss. Detection reliability was consistently high for change events along the Amazon River channel, but variable for changes within the floodplain. Spectral-temporal trajectories faithfully represented the nature of changes in floodplain forest cover, corroborating field observations. We estimated anthropogenic forest losses to be larger (1.071 ha) than natural losses (884 ha), with a global classification accuracy of 94%. We conclude that the LandTrendr algorithm is a reliable tool for studies of forest dynamics throughout the floodplain.

Sensitivity of the Amazon biome to high resolution climate change projections

ABSTRACT: Despite the reduction in deforestation rate in recent years, the impact of global warming by itself can cause changes in vegetation cover. The objective of this work was to investigate the possible changes on the major Brazilian biome, the Amazon Rainforest, under different climate change scenarios. The dynamic vegetation models may simulate changes in vegetation distribution and the biogeochemical processes due to climate change. Initially, the Inland dynamic vegetation model was forced with initial and boundary conditions provided by CFSR and the Eta regional climate model driven by the historical simulation of HadGEM2-ES. These simulations were validated using the Santarém tower data. In the second part, we assess the impact of a future climate change on the Amazon biome by applying the Inland model forced with regional climate change projections. The projections show that some areas of rainforest in the Amazon region are replaced by deciduous forest type and grassland in RCP4.5 scenario and only by grassland in RCP8.5 scenario at the end of this century. The model indicates a reduction of approximately 9% in the area of tropical forest in RCP4.5 scenario and a further reduction in the RCP8.5 scenario of about 50% in the eastern region of Amazon. Although the increase of CO2 atmospheric concentration may favour the growth of trees, the projections of Eta-HadGEM2-ES show increase of temperature and reduction of rainfall in the Amazon region, which caused the forest degradation in these simulations.

Validation of the Disordered Eating Attitude Scale for adolescents

ABSTRACT Objective To perform the psychometric evaluation of the Disordered Eating Attitude Scale (DEAS) for adolescents. Methods Sample consisted of 1,119 Brazilian adolescents (12-18 years old; 59.6% female) studying at technical schools in São Paulo state-Brazil, who answered an online survey with the DEAS, the Eating Attitude Test (EAT-26), and the Restraint Scale (RS). The internal consistency of the DEAS was assessed using Cronbach’s alpha. The convergent validity of DEAS was evaluated by means of Pearson’s coefficient correlation with EAT-26 and RS. The test-retest reliability was evaluated using a sub-sample of 61 adolescents. Known-groups validity was determined by comparing female student mean scores with scores of 33 female adolescents with eating disorders. Results The reliability of the DEAS was 0.79. EAT-26 and RS scores were positively correlated with DEAS scores (EAT: 0.78 for females and 0.59 for males, p < 0.001; RS: 0.63 for females and 0.48 for males, p < 0.001). The DEAS total and subscale scores differentiated students and patients with eating disorders (p < 0.001). The intra-class correlation coefficient for test-retest reliability was 0.87. Conclusion Results indicate that the DEAS adolescent version showed good internal consistency, convergent validity, known-groups validity, and test-retest reliability, suggesting its potential in identifying disordered eating attitudes among adolescents. It could also be helpful in identifying adolescents at risk from eating disorders, assisting in prevention programs.

The influence of patient's consciousness regarding high blood pressure and patient's attitude in face of disease controlling medicine intake

OBJECTIVE: To assess the relation between blood pressure control and the following: the Morisky-Green test, the patient's consciousness regarding high blood pressure, the patient's attitude in face of medicine intake, the patient's attendance at medical consultations, and the subjective physician's judgment. METHODS: We studied 130 hypertensive patients with the following characteristics: 73% females, 60±11 years, 58% married, 70% white, 45% retired, 45% with incomplete elementary schooling, 64% had a familial income of 1 to 3 minimum wages, body mass index of 30±7 kg/m², consciousness regarding the disease for a mean period of 11±9.5 years, and mean treatment duration of 8 ±7 years. RESULTS: Only 35% of the hypertensive individuals had blood pressure under control and a longer duration of treatment (10±7 vs 7±6.5 years; P<0.05). The retiree predominated. The result of the Morisky-Green test did not relate to blood pressure control. In evaluating the attitude in face of medicine intake, the controlled patients achieved significantly higher scores than did the noncontrolled patients (8±1.9 vs 7 ±2, P<0.05). The hypertensive patients had higher levels of consciousness regarding their disease and its treatment, and most (70%) patients attended 3 or 4 medical consultations, which did not influence blood pressure control. The physicians attributed significantly higher scores regarding adherence to treatment to controlled patients (6±0.8 vs 5±1.2; P<0.05). CONCLUSION: Consciousness regarding the disease, the Morisky-Green test, and attendance to medical consultations did not influence blood pressure control.

A change in the treatment of abdominal aortic aneurysms

OBJECTIVE: One of the most exciting potential applications of percutaneous therapy is the treatment of abdominal aneurysms. METHODS: Of 230 patients treated with a self-expanding polyester-lined stent-graft for different aortic pathologies at our institution, we selected 80 abdominal aneurysm cases undergoing treatment (from May 1997 to December 2002). The stent was introduced through the femoral artery, in the hemodynamic laboratory, with the patient under general anesthesia, with systemic heparinization, and induced hypotension. RESULTS: The procedure was successful in 70 (92.9%) cases; 10 patients with exclusion of abdominal aortic aneurysms were documented immediately within the hemodynamic room and 5 patients persisted with a residual leak. Two surgical conversions were necessary. Additional stent-grafts had to be inserted in 3 (3.7%) cases. In the follow-up, 91.4% of patients were alive at a mean follow-up of 15.8 months. CONCLUSION: We believe that stent-grafts are an important tool in improving the treatment of abdominal aneurysms, and this new policy may change the conventional medical management of these patients.

The change of behavior of two strains of Leishmania after cultivation in a defined medium

Attempts have been made to characterize two strains of Leishmania that became infective to golden hamsters only after they had been maintained for several years in a chemically defined culture medium. Observations were made on the growth rates of promastigotes in vitro, course of infection in hamsters, morphology of amastigotes, and electrophoretic mobility patterns of eight isoenzymes. Information was obtained about the buoyant densities of n-DNA and k-DNA, and one strain was tested against monoclonal antibodies. The identity of both strains remains obscure.

Climatic change in northeastern Brazil: paleoparasitological data

Trichuris eggs were observed in Kerodon rupestris coprolites dated 9,000 years before present, collected in archeological sites of São Raimundo Nonato, northeastern Brazil. However, present day local rodents seem not to be infected by the parasite, suggesting its disappearence due to climatic changes.