Explicit discrimination and health: development and psychometric properties of an assessment instrument

OBJECTIVE: To develop an instrument to assess discrimination effects on health outcomes and behaviors, capable of distinguishing harmful differential treatment effects from their interpretation as discriminatory events. METHODS: Successive versions of an instrument were developed based on a systematic review of instruments assessing racial discrimination, focus groups and review by a panel comprising seven experts. The instrument was refined using cognitive interviews and pilot-testing. The final version of the instrument was administered to 424 undergraduate college students in the city of Rio de Janeiro, Southeastern Brazil, in 2010. Structural dimensionality, two types of reliability and construct validity were analyzed. RESULTS: Exploratory factor analysis corroborated the hypothesis of the instrument's unidimensionality, and seven experts verified its face and content validity. The internal consistency was 0.8, and test-retest reliability was higher than 0.5 for 14 out of 18 items. The overall score was higher among socially disadvantaged individuals and correlated with adverse health behaviors/conditions, particularly when differential treatments were attributed to discrimination. CONCLUSIONS: These findings indicate the validity and reliability of the instrument developed. The proposed instrument enables the investigation of novel aspects of the relationship between discrimination and health.

Effect of the time-of-day of training on explicit memory

Studies have shown a time-of-day of training effect on long-term explicit memory with a greater effect being shown in the afternoon than in the morning. However, these studies did not control the chronotype variable. Therefore, the purpose of this study was to assess if the time-of-day effect on explicit memory would continue if this variable were controlled, in addition to identifying the occurrence of a possible synchronic effect. A total of 68 undergraduates were classified as morning, intermediate, or afternoon types. The subjects listened to a list of 10 words during the training phase and immediately performed a recognition task, a procedure which they repeated twice. One week later, they underwent an unannounced recognition test. The target list and the distractor words were the same in all series. The subjects were allocated to two groups according to acquisition time: a morning group (N = 32), and an afternoon group (N = 36). One week later, some of the subjects in each of these groups were subjected to a test in the morning (N = 35) or in the afternoon (N = 33). The groups had similar chronotypes. Long-term explicit memory performance was not affected by test time-of-day or by chronotype. However, there was a training time-of-day effect [F (1,56) = 53.667; P = 0.009] with better performance for those who trained in the afternoon. Our data indicated that the advantage of training in the afternoon for long-term memory performance does not depend on chronotype and also that this performance is not affected by the synchronic effect.

Five generations of peace operations: from the "thin blue line" to "painting a country blue"

This article combines both international practice and analytical contributions into a systematic and synthetic presentation of the evolution of peace operations from their modern inception in 1948 to the present. It seeks to serve a didactic purpose in proposing a basic structure for Brazilian scholars' burgeoning debate on peace operations and intervention, rather than a definitive characterization of blue helmet practice. Peace operations' progression is traced through five analytical "generations," each adding a crucial factor distinguishing it from its predecessors. Each generation is placed in relation to changes in the nature of conflict and in the interpretation of the foundational principles of peace operations, and links to broader theoretical issues in International Relations are made explicit at each stage.

China's rising Soft Power: the role of rhetoric in constructing China-Africa relations

As China turns increasingly to the cultivation of soft power in the course of developing its foreign policy, the use of political rhetoric and its explicit and implicit audiences become more and more important, both on a bilateral level and within the international arena at large. Using the case of China's relations with African countries, this article examines key themes within China's diplomatic narrative regarding its role on the African continent and contrasts with Western and African responses.

O planejamento econômico no Brasil: considerações críticas

In the past thirty years, a series of plans have been developed by successive Brazilian governments in a continuing effort to maximize the nation's resources for economic and social growth. This planning history has been quantitatively rich but qualitatively poor. The disjunction has stimulated Professor Mello e Souza to address himself to the problem of national planning and to offer some criticisms of Brazilian planning experience. Though political instability has obviously been a factor promoting discontinuity, his criticisms are aimed at the attitudes and strategic concepts which have sought to link planning to national goals and administration. He criticizes the fascination with techniques and plans to the exclusion of proper diagnosis of the socio-political reality, developing instruments to coordinate and carry out objectives, and creating an administrative structure centralized enough to make national decisions and decentralized enough to perform on the basis of those decisions. Thus, fixed, quantified objectives abound while the problem of functioning mechanisms for the coordinated, rational use of resources has been left unattended. Although his interest and criticism are focused on the process and experience of national planning, he recognized variation in the level and results of Brazilian planning. National plans have failed due to faulty conception of the function of planning. Sectorial plans, save in the sector of the petroleum industry under government responsibility, ha e not succeeded in overcoming the problems of formulation and execution thereby repeating old technical errors. Planning for the private sector has a somewhat brighter history due to the use of Grupos Executivos which has enabled the planning process to transcend the formalism and tradition-bound attitudes of the regular bureaucracy. Regional planning offers two relatively successful experiences, Sudene and the strategy of the regionally oriented autarchy. Thus, planning history in Brazil is not entirely black but a certain shade of grey. The major part of the article, however, is devoted to a descriptive analysis of the national planning experience. The plans included in this analysis are: The Works and Equipment Plan (POE); The Health, Food, Transportation and Energy Plan (Salte); The Program of Goals; The Trienal Plan of Economic and Social Development; and the Plan of Governmental Economic Action (Paeg). Using these five plans for his historical experience the author sets out a series of errors of formulation and execution by which he analyzes that experience. With respect to formulation, he speaks of a lack of elaboration of programs and projects, of coordination among diverse goals, and of provision of qualified staff and techniques. He mentions the absence of the definition of resources necessary to the financing of the plan and the inadequate quantification of sectorial and national goals due to the lack of reliable statistical information. Finally, he notes the failure to coordinate the annual budget with the multi-year plans. He sees the problems of execution as beginning in the absence of coordination between the various sectors of the public administration, the failure to develop an operative system of decentralization, the absence of any system of financial and fiscal control over execution, the difficulties imposed by the system of public accounting, and the absence of an adequate program of allocation for the liberation of resources. He ends by pointing to the failure to develop and use an integrated system of political economic tools in a mode compatible with the objective of the plans. The body of the article analyzes national planning experience in Brazil using these lists of errors as rough model of criticism. Several conclusions emerge from this analysis with regard to planning in Brazil and in developing countries, in general. Plans have generally been of little avail in Brazil because of the lack of a continuous, bureaucratized (in the Weberian sense) planning organization set in an instrumentally suitable administrative structure and based on thorough diagnoses of socio-economic conditions and problems. Plans have become the justification for planning. Planning has come to be conceived as a rational method of orienting the process of decisions through the establishment of a precise and quantified relation between means and ends. But this conception has led to a planning history rimmed with frustration, and failure, because of its rigidity in the face of flexible and changing reality. Rather, he suggests a conception of planning which understands it "as a rational process of formulating decisions about the policy, economy, and society whose only demand is that of managing the instrumentarium in a harmonious and integrated form in order to reach explicit, but not quantified ends". He calls this "planning without plans": the establishment of broad-scale tendencies through diagnosis whose implementation is carried out through an adjustable, coherent instrumentarium of political-economic tools. Administration according to a plan of multiple, integrated goals is a sound procedure if the nation's administrative machinery contains the technical development needed to control the multiple variables linked to any situation of socio-economic change. Brazil does not possess this level of refinement and any strategy of planning relevant to its problems must recognize this. The reforms which have been attempted fail to make this recognition as is true of the conception of planning informing the Brazilian experience. Therefore, unworkable plans, ill-diagnosed with little or no supportive instrumentarium or flexibility have been Brazil's legacy. This legacy seems likely to continue until the conception of planning comes to live in the reality of Brazil.

Health-related quality of life in patients with Chagas disease: a review of the evidence

Chagas disease (ChD), a neglected tropical disease caused by infection with the parasite Trypanosoma cruzi (T. cruzi), remains a serious public health issue in Latin America and is an emerging disease in several non-endemic countries, where knowledge of the condition and experience with its clinical management are limited. Regionally, the disease is the major cause of disability secondary to tropical diseases in young adults. Health-related quality of life (HRQoL) impairment is common in patients with ChD, especially in those with Chagas dilated cardiomyopathy, the most severe manifestation of the disease, which frequently leads to heart failure. The aim of this review was to conduct a literature search for studies that have evaluated the determining factors of HRQoL in ChD patients. We included cross-sectional, case-control, cohort, and experimental studies, as well as clinical trials that evaluated the HRQoL in ChD patients aged 18 to 60 years and are presenting an explicit description of statistical analysis. Using a combination of keywords based on Descriptors in Health Sciences (DeCS) and Medical Subject Headings (MeSH) for searches in PubMed and the Scientific Electronic Library Online (SciELO), 148 studies were found. After exclusions, 12 studies were selected for analysis. Three main findings were extracted from these studies: 1) cardiac involvement is associated with a worse HRQoL in ChD patients; 2) HRQoL is associated with the patients' functional capacity; and 3) simple and inexpensive therapeutic measures are effective for improving HRQoL in ChD patients. Hence, ChD patients' functional capacity, the effectiveness of non-surgical conservative treatment, and cardiac involvement are important determining factors for the HRQoL in ChD patients.

Small mammal distributional patterns in Northwestern Argentina

ABSTRACT Quantitative evaluations of species distributional congruence allow evaluating previously proposed biogeographic regionalization and even identify undetected areas of endemism. The geographic scenery of Northwestern Argentina offers ideal conditions for the study of distributional patterns of species since the boundaries of a diverse group of biomes converge in a relatively small region, which also includes a diverse fauna of mammals. In this paper we applied a grid-based explicit method in order to recognize Patterns of Distributional Congruence (PDCs) and Areas of Endemism (AEs), and the species (native but non-endemic and endemic, respectively) that determine them. Also, we relate these distributional patterns to traditional biogeographic divisions of the study region and with a very recent phytogeographic study and we reconsider what previously rejected as 'spurious' areas. Finally, we assessed the generality of the patterns found. The analysis resulted in 165 consensus areas, characterized by seven species of marsupials, 28 species of bats, and 63 species of rodents, which represents a large percentage of the total species (10, 41, and 73, respectively). Twenty-five percent of the species that characterize consensus areas are endemic to the study region and define six AEs in strict sense while 12 PDCs are mainly defined by widely distributed species. While detailed quantitative analyses of plant species distribution data made by other authors does not result in units that correspond to Cabrera's phytogeographic divisions at this spatial scale, analyses of animal species distribution data does. We were able to identify previously unknown meaningful faunal patterns and more accurately define those already identified. We identify PDCs and AEs that conform Eastern Andean Slopes Patterns, Western High Andes Patterns, and Merged Eastern and Western Andean Slopes Patterns, some of which are re-interpreted at the light of known patterns of the endemic vascular flora. Endemism do not declines towards the south, but do declines towards the west of the study region. Peaks of endemism are found in the eastern Andean slopes in Jujuy and Tucumán/Catamarca, and in the western Andean biomes in Tucumán/Catamarca. The principal habitat types for endemic small mammal species are the eastern humid Andean slopes. Notwithstanding, arid/semi-arid biomes and humid landscapes are represented by the same number of AEs. Rodent species define 15 of the 18 General Patterns, and only in one they have no participation at all. Clearly, at this spatial scale, non-flying mammals, particularly rodents, are biogeographically more valuable species than flying mammals (bat species).

Large-scale patterns in morphological diversity and species assemblages in Neotropical Triatominae (Heteroptera: Reduviidae)

We analysed the spatial variation in morphological diversity (MDiv) and species richness (SR) for 91 species of Neotropical Triatominae to determine the ecological relationships between SR and MDiv and to explore the roles that climate, productivity, environmental heterogeneity and the presence of biomes and rivers may play in the structuring of species assemblages. For each 110 km x 110 km-cell on a grid map of America, we determined the number of species (SR) and estimated the mean Gower index (MDiv) based on 12 morphological attributes. We performed bootstrapping analyses of species assemblages to identify whether those assemblages were more similar or dissimilar in their morphology than expected by chance. We applied a multi-model selection procedure and spatial explicit analyses to account for the association of diversity-environment relationships. MDiv and SR both showed a latitudinal gradient, although each peaked at different locations and were thus not strictly spatially congruent. SR decreased with temperature variability and MDiv increased with mean temperature, suggesting a predominant role for ambient energy in determining Triatominae diversity. Species that were more similar than expected by chance co-occurred near the limits of the Triatominae distribution in association with changes in environmental variables. Environmental filtering may underlie the structuring of species assemblages near their distributional limits.

The Strategic Impact of Clinical Practice Guidelines in Nursing on the Managerial Function of Supervision

Clinical practice guidelines in nursing (CPG-N) are tools that allow the necessary knowledge that frequently remains specialist-internalised to be made explicit. These tools are a complement to risk adjustment systems (RAS), reinforcing their effectiveness and permitting a rationalisation of healthcare costs. This theoretical study defends the importance of building and using CPG-Ns as instruments to support the figure of the nursing supervisor in order to optimise the implementation of R&D and hospital quality strategies, enabling clinical excellence in nursing processes and cost-efficient reallocation of economic resources through their linear integration with SARs.

The art and learning patterns of knowing in nursing

Objective To identify the perception of the students about the use of art as a pedagogical strategy in learning the patterns of knowing in nursing; to identify the dimensions of each pattern valued in the analysis of pieces of art. Method Descriptive mixed study. Data collection used a questionnaire applied to 31 nursing students. Results In the analysis of the students’ discourse, it was explicit that empirical knowledge includes scientific knowledge, tradition and nature of care. The aesthetic knowledge implies expressiveness, subjectivity and sensitivity. Self-knowledge, experience, reflective attitude and relationships with others are the subcategories of personal knowledge and the moral and ethics support ethical knowledge. Conclusion It is possible to learn patterns of knowledge through art, especially the aesthetic, ethical and personal. It is necessary to investigate further pedagogical strategies that contribute to the learning patterns of nursing knowledge.

Nursing Supervision: Studying the “Case” of the phenomenon of interorganizational articulation Nursing School and Hospital

The history of this research found a suitable ethos not only by the route of the researcher, but also by the current public policies of modernization and reform that are capable of regulating and transforming the educational and health systems, as well as their professional groups. The reflection meantime developed had raised a clear perception of the organizational change processes by which they interfered with the interorganizational coordination between School of Nursing and Hospital, where internship supervision would be the main protagonist, supported by the meanings that intervening actors have assigned to them. In this context, the search for explicit epistemological and methodological choices leads to look more attentively at the problem, ascertaining it, taking into account the organizational dimensions. In this regard, the choice of a case study was related to the fact that the method allowed to answer the purpose of knowing and understanding the interorganizational coordination phenomenon between School of Nursing and Hospital, namely through the supervision of internships.

Creche e família: uma parceria necessária

Estudo de caso em uma creche pública, que tem como objetivo analisar relações entre famílias e profissionais que se desenvolvem no cuidado compartilhado das crianças. Apesar de esforços de profissionais para interagir com as famílias, há evidentes dificuldades na interação, devido a distintos pontos de vista. Considerando que conflitos são inerentes à vida psíquica e social e que é necessário explicitá-los e negociá-los para alcançar objetivos comuns, o artigo buscou apreender o ponto de vista dos sujeitos envolvidos no cuidado infantil. Depreendeu-se da análise que a confiança é construída com "o tempo", no processo de compartilhar o cuidado, ajustando expectativas e negociando diferentes concepções, valores e conhecimentos. Como mostraram dados da observação, conflitos não explicitados nem refletidos podem comprometer o cuidado da criança, que vivencia e percebe quando as diferenças entre a creche e a família são focos de tensão.

Reflexões sobre a contribuição da Carnot à primeira lei da termodinâmica

The classical interpretations of Nicolas Léonard Sadi Carnot on some physical principles involved in the operation of heat engines were fundamental to the development and formulation of the Second Law of Thermodynamics. Moreover, an accurate historical survey clearly reveals that Carnot was, by that time, also well aware about some new concepts, which were further worked out by other scientists to lead to what was, some time later, known as the mechanical equivalent of heat and the conservation of energy. Benoit Paul Émile Clapeyron recognized these original concepts in the first of Carnot´s monographs, published in 1824, but no explicit citation is found in any post-Carnot classical texts dealing with the First Law of Thermodynamics, including those by Julius Robert Mayer, James Prescott Joule and Hermann Ludwig Ferdinand von Helmholtz. The main objective of the present work is to point out some historical evidences of the pioneering contribution of Carnot to the modern concept of the First Law of Thermodynamics.

Um panorama sobre a abordagem ambiental no currículo de cursos de formação inicial de professores de química da região sudeste

This work analysed the contents of 701 disciplines from 22 chemistry courses that prepare chemistry teachers in 16 public Universities in Southeastern Brazil. Only a small number (23) of disciplines showed an explicit relationship between human activities and the environment. A total of 11 theoretical and 193 experimental disciplines explored to some extent scientific and technological aspects related to the environment, but did not include their relationship with society. As the experimental disciplines supposedly include some kind of waste treatment, this may explain why secondary school chemistry teachers work mainly on recycling programs and waste issues at their schools. The aim of this work is to provide information on which to base a much needed discussion about how to better prepare our chemistry teachers to act as Environmental Educators at school, as the Brazilian Education Legislation requires.

The dawn of paraconsistency: Russia's logical thought in the turn of XX century

The paper deals with the factors which enabled N. A. Vasiliev to put forward in 1910 - 12 the idea of logics free of the laws of contradiction and excluded middle, the idea of metalogic and to construct his imaginary logic as novel non-classical system. It is shown that background of Vasiliev's ideas lies deeply in Russia's culture and particular approach to logical discourse. Several Russian scholars expressed ideas similar to Vasiliev's though not in such explicit form. This period might be called the prehistory of paraconsistency. Real history of paraconsistency starts with N.C.A. da Costa's works.