Äitiys kulttuurisina odotuksina

Tutkimuksen kohteena ovat äitiydelle tuotetut kulttuuriset odotukset, joita tarkastellaan kahdella yhteiskunnallisella keskustelufoorumilla. Tutkimuksessa tarkastellaan yhtäältä lastensuojelun perhetyössä toimivien ammattilaisten ja toisaalta median puhetta äitiydestä. Tutkimuksen tavoitteena on tehdä näkyväksi vaihtoehtoisia tapoja konstruoida äitiyttä hyvänä tai riittämättömänä sekä haastaa pohtimaan erilaisten tulkintojen perusteita ja seurauksia lastensuojelutyössä. Kulttuuriset, äitiyttä koskevat odotukset vaikuttavat myös siihen, miten äitiys henkilökohtaisella tasolla koetaan. Äitiyden kulttuurista määrittelyä analysoidaan kahdesta tekstiaineistosta. Yhtenä aineistona ovat Stakesissa vuonna 1999 toteutetun Perhetyöprojektin yhteydessä kerätyt, lastensuojelussa toimivien perhetyöammattilaisten ryhmäkeskustelut. Toisena aineistona on projektin ajankohtana ilmestyneistä suomalaisista naisten- ja perhelehdistä (Kotiliesi, Anna, Kaksplus) kerätyt äitien haastattelut. Tutkimuksessa kysytään 1) Mihin ammattilaisten äitejä koskeva huolipuhe kiinnittyy ja millaisia kulttuurisia äitiyden odotuksia se konstruoi? 2) Millaisia äitiyden odotuksia median äitihaastattelut konstruoivat? 3) Millaisen äitiyden odotushorisontin nämä puhekäytännöt yhdessä tuottavat? Analyysin teoreettis-metodologisina kulmakivinä ovat sosiaalinen konstruktionismi ja feministinen tietokäsitys. Analyysimenetelmänä on laadullinen, aineistojen ehdoilla etenevä, feministisesti ja kriittisesti sävyttynyt lukutapa, joka hyödyntää teemoittelun, diskurssianalyysin ja feministisen metodologian ideoita ja käsitteitä. Analysoitavana olevissa keskusteluissa äitiyttä konstruoidaan lapsen tarpeiden (ammattilaiset) ja naisen tarpeiden (media) näkökulmista. Ammattilaiset puhuvat tilanteista, joissa äitien toiminta rikkoo kulttuurista hyvän äidin kuvaa, vaarantaa lapsen hyvinvointia ja äitiyteen joudutaan puuttumaan ammatillisesti. Ammattilaisten tulkinnat kuvaavat taitavaa lapsen edun näkökulmasta tehtyä arviointia, jonka kiintopisteenä ovat äidit yksilöllisine ominaisuuksineen ja piirteineen. Ammatillisen huolipuheen keskiössä ovat äidin vuorovaikutussuhteet sekä äidin tunteet, käyttäytyminen ja asenteet. Riittävää äitiyttä konstruoi kodin luominen, kiintymyssuhteen rakentaminen ja lapsen ensisijaiseksi asettaminen. Sen sijaan vaikuttaa siltä, ettei äitiyden arviointia juurikaan tehdä suhteessa äidin muihin identiteetteihin tai äitiyden toteuttamisen kontekstiin. Paikoin ammattilaisten tulkinnat heijastavat myös stereotyyppisiä ja idealistisia odotuksia, joita vasten äitiyttä arvioidaan. Tällaiset piirteet voivat kertoa siitä, että äitien avuntarpeet jäävät lastensuojelutyössä kohtaamatta ja ymmärtämättä. Mediapuhe äitiydestä käydään naiseuden ja äitiyden mallien antamisen kontekstissa. Puheen keskiössä ovat mediajulkisuuteen päässeiden naisten äidiksi tuloon ja äitiyden toteuttamiseen liittyvät valinnat ja käyttäytyminen. Mediapuhe on puhetta kulttuuristen ja ammatillisten äitiyden odotusten rikkomisesta, uudelleen tulkinnasta ja niiden muovaamisesta itselle sopiviksi. Mediapuheessa hyvää äitiyttä konstruoi äidin itsenäisyys ja oma aika, sosiaalisen elämän rikkaus, ammatillinen identiteetti ja persoonalliset valinnat. Aineistojen kautta rakentuu moninaisten ja ristiriitaisten, äitejä eri suuntaan vetävien kulttuuristen odotusten kirjo. Odotukset jäsentyvät neljälle ulottuvuudelle: 1) lapselle omistautuva – itseään toteuttava, 2) emotionaalinen side – rationaalinen tehtävä, 3) odotuksia toteuttava – omaehtoinen, 4) itsenäinen - äitiyttä jakava. Äitiyden toteuttaminen kulttuurisesti ”oikein” on näiden odotusten välissä tasapainoilua. Ulottuvuuksien kautta esille tulevat kaksoisviestit voivat heikentää äitien itsetuntoa, tuottaa riittämättömyyden tunteita tai yllyttää suorittamaan äitiyttä. Myös äitiyden ammatillinen tukeminen edellyttää tasapainoilua, jottei äitejä idealisoida tai syyllistetä kulttuurisia odotuksia vasten.

Biodegradação de uma mistura de corantes têxteis usando o fungo Ganoderma sp: um estudo cinético

The kinetics of biodegradation by the fungus Ganoderma sp of textile dyes Yellow, Blue and Red Procion were studied in effluents using UV-Vis spectroscopy, Partial Least Squares Regression (PLS) and univariate analysis. The kinetic of the reactions were founded intermediate between first and second orders and the rate constants were calculated. The biodegradation after 72 h at 28 ºC were 33.6, 43.5 and 57.7% for the dyes Yellow, Blue and Red Procion, respectively. The quantitative analysis of the effluent by HPLC method can not be used without previous separation.

Determinação de parâmetros cinéticos em fluxo com câmara de gradiente e deteção espectrofotométrica: aplicação à reação entre o violeta de cristal e o ião hidróxido

A didactic experiment is proposed aimed to extend the Flow Injection Analysis (FIA) based methodology to the area of physical chemistry/chemical reactors for undergraduate labs. Our prime objective was to describe the use of a gradient chamber for determination of the rate constant for the reaction between crystal violet and the hydroxide ion. The study was complemented by determining the effect of temperature on the rate constant. The kinetic parameters, activation energy and reaction rate constant are determined based on an assumption of rate orders. The main didactic advantages of the proposed experimental set-up are the use of less reagents, contributing to a more environmental friendly experiment. The experiment illustrates also the reduction of associated errors and time by using automated analysis owing to decreased operator manipulation.

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Enhanced Vegetation Index (EVI) na análise da dinâmica da vegetação da reserva biológica de Sooretama, ES

Técnicas de análises de séries temporais são utilizadas para caracterizar o comportamento de fenômenos naturais no domínio do tempo. Neste artigo, segundo a metodologia proposta por Box et al. (1994), 125 observações do Enhanced Vegetation Index (EVI) foram analisadas. Os valores modelados correspondem às variações temporais ocorridas no dossel florestal da reserva biológica de Sooretama, localizada ao Norte do Estado do Espírito Santo, no Município de Linhares. Os resultados indicaram que a metodologia foi adequada. Os resíduos do modelo ajustado são não correlacionados com distribuição normal, média zero e variância s². Com o menor valor do Critério de Informação de Akaike (AIC) -570,51, o modelo ajustado foi o Sazonal Auto-Regressivo Integrado de Médias Móveis (1,0,1)(1,0,1)12.

Study of carotid disease in patients with peripheral artery disease

Objective: To study the stenosis of the carotid arteries in patients with symptomatic peripheral arterial disease.Methods: we assessed 100 consecutive patients with symptomatic peripheral arterial disease in stages of intermittent claudication, rest pain or ulceration. Carotid stenosis was studied by echo-color-doppler, and considered significant when greater than or equal to 50%. We used univariate analysis to select potential predictors of carotid stenosis, later taken to multivariate analysis.Results: The prevalence of carotid stenosis was 84%, being significant in 40% and severe in 17%. The age range was 43-89 years (mean 69.78). Regarding gender, 61% were male and 39% female. Half of the patients had claudication and half had critical ischemia. Regarding risk factors, 86% of patients had hypertension, 66% exposure to smoke, 47% diabetes, 65% dyslipidemia, 24% coronary artery disease, 16% renal failure and 60% had family history of cardiovascular disease. In seven patients, there was a history of ischemic cerebrovascular symptoms in the carotid territory. The presence of cerebrovascular symptoms was statistically significant in influencing the degree of stenosis in the carotid arteries (p = 0.02 at overall assessment and p = 0.05 in the subgroups of significant and non-significant stenoses).Conclusion: the study of the carotid arteries by duplex scan examination is of paramount importance in the evaluation of patients with symptomatic peripheral arterial disease, and should be systematically conducted in the study of such patients.

Comparative study of the different degrees of risk of gastrointestinal stromal tumor

OBJECTIVE: To evaluate the applicability of the main categories of risk and morphological factors in the prognosis of gastrointestinal stromal tumors. METHODS: we retrospectively studied fifty-four cases of GIST, assessing the main prognostic factors of this neoplasis: risk levels, topography, size, mitotic index, necrosis, histological subtype and immunophenotype. We also verified their association and the reduction of overall survival. RESULTS: Univariate analysis showed that tumors with mitoses number greater than 5 per 50CGA (high-power fields), the presence of necrosis and a high risk for both the systems proposed by Fletcher and Miettinen had a significant association with reduced survival (p = 0.00001, 0.0056, 0.03 and 0.009, respectively). The remaining analyzed factors (size, histological subtype, topography and immunophenotype) had no such association. Multivariate analysis (Jacard index) showed that the Miettinen degree of risk was the one that best correlated with prognosis. CONCLUSION: the risk criteria of Fletcher and Miettinen are important in assessing the prognosis of patients with gastrointestinal stromal tumors, especially the latter, which adds to the mitotic index and the presence of tumor necrosis.

Risk factors associated with Toxoplasma gondii infection in dairy cattle, state of Rio de Janeiro

Toxoplasmosis is one of the most common parasitic zoonoses throughout the world. Infection in man and animals varies in different geographical areas influenced by many environmental conditions. Seroprevalence of Toxoplasma gondii infection in cattle in Brazil ranges from 1.03 to 71%. A cross-sectional survey was carried out in 58 out of 453 farms in the South Fluminense Paraiba Valley, State of Rio de Janeiro, Brazil. Over 3-year-old cattle (n=589) from dairy herds were selected for blood collection and detection of anti-T. gondii antibodies by indirect immunofluorescence reaction (IFA) with initial titration of 1:16; titers > 64 were considered positive. Univariate analysis of risk factors showed that cats in contact with cattle, cats in contact with drinking water, and number of cats were associated with T. gondii seroprevalence. Logistic regression revealed a two-fold increased risk for infection of cattle (p=0.0138) through larger number of cats (>3) compared with low numbers of cats (1-2) on the farm. In contrast, the presence of chickens was considered a protective factor (p=0.025).

Occurrence and risk factors assessment associated with Mycoplasma gallisepticum (MG) infection in chickens in the semiarid region of Pernambuco, Brazil

Abstract: The aim of the present study was to assess the occurrence of Mycoplasma gallisepticum (MG) infection and risk factors of this disease in three hundred serum samples from on 23 familiar agricultural properties in the semiarid region of the state of Pernambuco, Brazil. ELISA was used to study antibodies anti-Mycoplasma gallisepticum. The univariate analysis (chi-squared test or Fischer's exact test) followed by multivariate analysis (logistic regression) were used to assess the risk factors with two variables: management and sanity of the poultry. It was detected a frequence of 53.33% (157/300) of the birds were positive for MG, with 100% foci. The risk factors confirmed by multivariate analysis, in the present study, were the presence of other poultry species on the property, including Numida meleagris (OR=2.22; p=0.005), parrots (OR=1.72; p=0.027), and of passerines (OR=1.88; p=0.007). These results showed that Mycoplasma gallisepticum infection is endemic among backyard poultry in the semiarid region of the state of Pernambuco. These birds could be a source of infection for other wild or domestic poultry. . This is the first report of the occurrence of avian mycoplasmosis in backyard poultry in the state of Pernambuco in northeastern Brazil. The risk factors identified should serve as a parameter for the health authorities to seek solutions related to controlling the disease.

Factors associated with the development of renal complications of diabetes mellitus in São Paulo city

The incidence of diabetic end-stage renal failure (ESRF) varies worldwide and risk factors have been demonstrated in several populations. The objective of the present study was to identify possible factors associated with the risk of development of ESRF in patients with diabetes mellitus (DM). Two groups of diabetic subjects were included in a case-control study: 1) one group was submitted to renal replacement therapies, attending dialysis centers in São Paulo city and 2) the same number of controls without clinical nephropathy (two negative dipstick tests for urine protein), matched for duration of DM, were obtained from an outpatient clinic. A standardized questionnaire was used by a single investigator and additional data were obtained from the medical records of the patients. A total of 290 diabetic patients from 33 dialysis centers were identified, and 266 questionnaires were considered to contain reliable information. Male/female ratios were 1.13 for ESRF and 0.49 for the control group. A higher frequency of men was observed in the ESRF group when compared with controls (53 vs 33%, P<0.00001), although logistic regression analysis did not confirm an association of gender and diabetic nephropathy (DN). Similar proportions of non-white individuals were found for both groups. Patients with insulin-dependent diabetes mellitus (IDDM) were less common than patients with non-insulin-dependent diabetes mellitus (NIDDM), particularly in the control group (3.4 vs 26.3%, P<0.00001, for controls and ESRF patients, respectively); this type of DM was associated with a higher risk of ESRF than NIDDM, as determined by univariate analysis or logistic regression (OR = 4.1). Hypertension by the time of the DM diagnosis conferred a 1.4-fold higher risk of ESRF (P = 0.04), but no difference was observed concerning the presence of a family history. Association between smoking and alcohol habits and increased risk was observed (OR = 4.5 and 5.9, respectively, P<0.001). A 2.4-fold higher risk of ESRF was demonstrated in patients with multiple hospitalizations due to DM decompensation, which suggested poor metabolic control. Photocoagulation and neuropathy were found to be strongly associated with ESRF but not with macrovascular disease. Data collected in our country reinforce the higher risk attributable to IDDM and the association between hypertension and the progression of DN. Indirect evidence for an association with metabolic control is also suggested

Hepatitis C virus infection among Brazilian hemophiliacs: a virological, clinical and epidemiological study

We determined and analyzed risk factors of hepatitis C virus (HCV)-infected Brazilian hemophiliacs according to their virological, clinical and epidemiological characteristics. A cross-sectional and retrospective study of 469 hemophiliacs was carried out at a Brazilian blood center starting in October 1997. The prevalence of HCV infection, HCV genotypes and factors associated with HCV RNA detection was determined. The seroprevalence of anti-HCV antibodies (ELISA-3.0) was 44.6% (209/469). Virological, clinical and epidemiological assessments were completed for 162 positive patients. There were seven (4.3%) anti-HCV seroconversions between October 1992 and October 1997. During the same period, 40.8% of the positive anti-HCV hemophiliacs had abnormal alanine transaminase (ALT) levels. Plasma HCV RNA was detected by nested-RT-PCR in 116 patients (71.6%). RFLP analysis showed the following genotype distribution: HCV-1 in 98 hemophiliacs (84.5%), HCV-3 in ten (8.6%), HCV-4 in three (2.6%), HCV-2 in one (0.9%), and not typeable in four cases (3.4%). Univariate analysis indicated that older age (P = 0.017) and abnormal ALT levels (P = 0.010) were associated with HCV viremia, while the presence of inhibitor antibodies (P = 0.024) and HBsAg (P = 0.007) represented a protective factor against the presence of HCV RNA. These findings may contribute to a better understanding of the relationship between HCV infection and hemophilia.

Factors associated with adherence to antiretroviral therapy in HIV/AIDS patients: a cross-sectional study in Southern Brazil

A cross-sectional study was conducted on HIV-infected adults being treated with antiretroviral drugs at a reference service in Southern Brazil. Participants answered a sociodemographic questionnaire and were tested by scales assessing sociocognitive variables. Adherence to treatment was assessed by a self-report inventory developed for the study. Clinical information was obtained from the patients' records. Significance tests were conducted using univariate logistic regressions followed by multivariate logistic regression analysis. A total of 195 patients participated in the study and 56.9% of them reported > or = 95% adherence on the previous two days. In univariate analysis, the odds of adherence increased with self-efficacy (a person's conviction that he/she can successfully execute the behavior required to produce a certain desired outcome) in taking medications as prescribed (OR = 3.50, 95% CI 1.90-6.55), and decreased with perception of negative affect and physical concerns (OR = 0.71, 95% CI 0.53-0.95). The odds were lower for taking antiretroviral medications >4 times a day (OR = 0.44, 95% CI 0.20-0.94) and higher for patients with 8 years of schooling (OR = 2.28, 95% CI 1.12-4.66). In the multivariate analysis, self-efficacy (OR = 3.33, 95% CI 1.69-6.56) and taking medication >4 times a day (OR = 0.34, 95% CI 0.14-0.80) were independently associated with adherence. Self-efficacy was the most important predictor of adherence, followed by number of times antiretroviral medication was taken per day. Among sociodemographic and clinical variables, only the number of years of schooling was associated with adherence. Motivational interventions based on self-efficacy may be useful for increasing treatment adherence.

Hepatitis C virus infection in a Brazilian population with sickle-cell anemia

Patients with sickle-cell anemia submitted to frequent blood transfusions are at risk of contamination with hepatitis C virus (HCV). Determination of HCV RNA and genotype characterization are parameters that are relevant for the treatment of the viral infection. The objective of the present study was to determine the frequency of HCV infection and the positivity for HCV RNA and to identify the HCV genotype in patients with sickle-cell anemia with a history of blood transfusion who had been treated at the Hospital of the HEMOPE Foundation. Sera from 291 patients were tested for anti-HCV antibodies by ELISA 3.0 and RIBA 3.0 Chiron and for the presence of HCV RNA by RT-PCR. HCV genotyping was performed in 19 serum samples. Forty-one of 291 patients (14.1%) were anti-HCV positive by ELISA and RIBA. Both univariate and multivariate analysis showed a greater risk of anti-HCV positivity in those who had started a transfusion regime before 1992 and received more than 10 units of blood. Thirty-four of the anti-HCV-positive patients (34/41, 82.9%) were also HCV RNA positive. Univariate analysis, used to compare HCV RNA-negative and -positive patients, did not indicate a higher risk of HCV RNA positivity for any of the variables evaluated. The genotypes identified were 1b (63%), 1a (21%) and 3a (16%). A high prevalence of HCV infection was observed in our patients with sickle-cell anemia (14.1%) compared to the population in general (3%). In the literature, the frequency of HCV infection in sickle-cell anemia ranges from 2 to 30%. The serological screening for anti-HCV at blood banks after 1992 has contributed to a better control of the dissemination of HCV infection. Because of the predominance of genotype 1, these patients belong to a group requiring special treatment, with a probable indication of new therapeutic options against HCV.

Prevalence of serological markers of hepatitis B virus in pregnant women from Paraná State, Brazil

The prevalence of hepatitis B virus (HBV) in Brazil increases from South to North but moderate to elevated prevalence has been detected in the Southwest of Paraná State. The prevalence of serological markers of HBV was evaluated in 3188 pregnant women from different counties in Paraná State and relevant epidemiological features were described. The prevalence of HBV markers in pregnant women for the state as a whole was 18.5% (95% CI = 17.2-19.9), ranging from 7.2% in Curitiba to 38.5% in Francisco Beltrão. The endemicity of HBV marker prevalence in pregnant women was intermediate in Cascavel, Foz do Iguaçu, and Francisco Beltrão, and low in Curitiba, Londrina, Maringá, and Paranaguá. Multiple logistic regression showed that HBV marker prevalence increased with age, was higher among black women, among women of Italian and German descent, and among women who had family members in neighboring Rio Grande do Sul State. Univariate analysis showed that HBV marker prevalence was also higher among women with no education or only primary education, with a lower family income and whose families originated from the South Region of Brazil. Pregnant women not having positive HBV markers (anti-HBc, HBsAg or anti-HBs detected by ELISA) corresponded to 73.7% of the population studied, implying that HBV vaccination needs to be reinforced in Paraná State. The highest prevalence was found in three counties that received the largest number of families from Santa Catarina and Rio Grande do Sul, where most immigrants were of German or Italian ascendance. This finding probably indicates that immigrants that came to this area brought HBV infection to Southwestern Paraná State.

Incidence, risk factors and prognostic factors of acute renal failure in patients admitted to an intensive care unit

The objective of the present study was to assess the incidence, risk factors and outcome of patients who develop acute renal failure (ARF) in intensive care units. In this prospective observational study, 221 patients with a 48-h minimum stay, 18-year-old minimum age and absence of overt acute or chronic renal failure were included. Exclusion criteria were organ donors and renal transplantation patients. ARF was defined as a creatinine level above 1.5 mg/dL. Statistics were performed using Pearsons' chi2 test, Student t-test, and Wilcoxon test. Multivariate analysis was run using all variables with P < 0.1 in the univariate analysis. ARF developed in 19.0% of the patients, with 76.19% resulting in death. Main risk factors (univariate analysis) were: higher intra-operative hydration and bleeding, higher death risk by APACHE II score, logist organ dysfunction system on the first day, mechanical ventilation, shock due to systemic inflammatory response syndrome (SIRS)/sepsis, noradrenaline use, and plasma creatinine and urea levels on admission. Heart rate on admission (OR = 1.023 (1.002-1.044)), male gender (OR = 4.275 (1.340-13642)), shock due to SIRS/sepsis (OR = 8.590 (2.710-27.229)), higher intra-operative hydration (OR = 1.002 (1.000-1004)), and plasma urea on admission (OR = 1.012 (0.980-1044)) remained significant (multivariate analysis). The mortality risk factors (univariate analysis) were shock due to SIRS/sepsis, mechanical ventilation, blood stream infection, potassium and bicarbonate levels. Only potassium levels remained significant (P = 0.037). In conclusion, ARF has a high incidence, morbidity and mortality when it occurs in intensive care unit. There is a very close association with hemodynamic status and multiple organ dysfunction.