Childbearing in adolescence: intergenerational dejà-vu? Evidence from a Brazilian birth cohort

Abstract Background Pregnancy in adolescence tends to repeat over generations. This event has been little studied in middle and low-income societies undergoing a rapid epidemiological transition. To assess this association it is important to adjust for socioeconomic conditions at different points in lifetime. Therefore, the aim of this study is to analyze the independent effect of adolescent childbearing in a generation on its recurrence in the subsequent generation, after adjusting for socioeconomic status at different points in life. Methods The study was conducted on a prospective cohort of singleton liveborn females from the city of Ribeirão Preto, Brazil, evaluated in 1978/79, and their daughters assessed in 2002/04. A total of 1059 mother-daughter pairs were evaluated. The women who had their first childbirth before 20 years of age were considered to be adolescent mothers. The risk of childbearing in adolescence for the daughter was modeled as a function of the occurrence of teenage childbearing in her mother, after adjustment for socio-demographic variables in a Poisson regression model. Results The rate of childbearing during adolescence was 31.4% in 1978/79 and 17.1% in 2002/04. Among the daughters of the 1st generation adolescent mothers, this rate was 26.7%, as opposed to 12.7% among the daughters of non adolescent mothers. After adjustments the risk of adolescent childbearing for the 2nd generation was 35% higher for women whose mothers had been pregnant during adolescence – RR = 1.35 (95% CI 1.04-1.74). Conclusion Adolescent childbearing in the 1st generation was a predictor of adolescent childbearing in the 2nd, regardless of socioeconomic factors determined at different points in lifetime.

Risk factors for inadequate prenatal care use in the metropolitan area of Aracaju, Northeast Brazil

Abstract Background The aim of prenatal care is to promote good maternal and foetal health and to identify risk factors for adverse pregnancy outcomes in an attempt to promptly manage and solve them. Although high prenatal care attendance is reported in most areas in Brazil, perinatal and neonatal mortalities are disproportionally high, raising doubts about the quality and performance of the care provided. The objective of the present study was to evaluate the adequacy of prenatal care use and the risk factors involved in inadequate prenatal care utilization in the metropolitan area of Aracaju, Northeast Brazil. Methods A survey was carried out with puerperal women who delivered singleton liveborns in all four maternity hospitals of Aracaju. A total of 4552 singleton liveborns were studied. The Adequacy of Prenatal Care Utilization Index, modified according to the guidelines of the Prenatal Care and Birth Humanization Programme, was applied. Socioeconomic, demographic, biological, life style and health service factors were evaluated by multiple logistic regression. Results: Prenatal care coverage in Aracaju was high (98.3%), with a mean number of 6.24 visits. Prenatal care was considered to be adequate or intensive in 66.1% of cases, while 33.9% were considered to have inadequate usage. Age < 18 to 34 years at delivery, low maternal schooling, low family income, two or more previous deliveries, maternal smoking during pregnancy, having no partner and prenatal care obtained outside Aracaju were associated with inadequate prenatal care use. In contrast, private service attendance protected from inadequate prenatal care use. Conclusion Prenatal care coverage was high. However, a significant number of women still had inadequate prenatal care use. Socioeconomic inequalities, demographic factors and behavioural risk factors are still important factors associated with inadequate prenatal care use.

Cesarean section and increased body mass index in school children: two cohort studies from distinct socioeconomic background areas in Brazil

Abstract Background Recent studies have raised controversy regarding the association between cesarean section and later obesity in the offspring. The purpose of this study was to assess the association of cesarean section with increased body mass index (BMI) and obesity in school children from two Brazilian cities with distinct socioeconomic backgrounds. Methods Two birth cohorts respectively born in 1994 in Ribeirao Preto, a wealthy city in Southeast, and in 1997/98 in Sao Luis, a less wealthy city in Northeast of Brasil, were evaluated. After birth, 2,846 pairs of mothers-newborns were evaluated in Ribeirao Preto and 2,542 in Sao Luis. In 2004/05, 790 children aged 10/11 years were randomly reassessed in Ribeirao Preto and 673 at 7/9 years in Sao Luis. Information on type of delivery, maternal and child characteristics, socioeconomic position and anthropometric measurements were collected after birth and at school age. Obesity was defined as BMI ≥ 95th percentile at school age. Results Obesity rate was 13.0% in Ribeirao Preto and 2.1% in Sao Luis. Cesarean section was associated with obesity and remained significant after adjustment only in Ribeirao Preto [OR = 1.74 (95% CI: 1.04; 2.92)]. The association between cesarean section and BMI remained significant after adjustment for maternal schooling, maternal smoking during pregnancy, duration of breastfeeding, gender, birth weight and gestational age, type of school and, only in Sao Luis, pre-pregnancy maternal weight. In Ribeirao Preto children born by cesarean section had BMI 0.31 kg/m2 (95%CI: 0.11; 0.51) higher than those born by vaginal delivery. In Sao Luis BMI of children born by cesarean section was 0.28 kg/m2 higher (95%CI: 0.08; 0.49) than those born by vaginal delivery. Conclusion A positive association between cesarean section and increased BMI z-score was demonstrated in areas with different socioeconomic status in a middle-income country.

Métodos de agrupamento em estudo de divergência genética de pimentas

O objetivo deste trabalho foi comparar três métodos para determinação do número de grupos em estudos com aplicação de métodos hierárquicos de agrupamentos, baseando-se em dados obtidos a partir da caracterização de acessos de Capsicum, de modo a identificar aquele com maior poder de discriminação. Os métodos de Mojena, de Tocher e o método RMSSTD foram aplicados com a finalidade de determinar o número ideal de grupos formados na fase final do procedimento de agrupamento com o método UPGMA. Foram analisados 49 acessos da espécie Capsicum chinense do Banco de Germoplasma de Hortaliças da Universidade Federal de Viçosa, em relação a dez características morfológicas com o intuito de identificar e agrupar os acessos mais similares, tornando possível a seleção de genótipos superiores, ou seja, com as características comerciais de interesse. Os resultados mostraram que o método RMSSTD permitiu concluir sobre a existência de sete grupos, evidenciando um maior poder de discriminação para este método, em relação ao método de otimização de Tocher e ao método de Mojena, que formaram respectivamente, quatro e três grupos.

A DOCÊNCIA EM ADMINISTRAÇÃO E ALGUMAS CONTRIBUIÇÕES DE PROJETOS EDUCATIVOS

Esta dissertação apresenta dois projetos que apontam possibilidades de se construir novos conhecimentos com práticas viáveis e significativas para os alunos de Administração de Empresas do ensino superior. O objetivo é fomentar a discussão sobre o papel do docente e a formação dos professores no ensino superior com qualidade, através dos estudos em uma Faculdade da Zona Leste da cidade de São Paulo. Este trabalho aponta que o bacharelado em Administração pode ir para além de meros conteúdos técnicos a serem humanizados a partir da utilização de recursos didáticos inovadores. A análise dos projetos permite concluir que ações educativas diferenciadas, inspiradas na teoria freiriana, apresentaram-se como forma de enfrentamento às dificuldades nas relações entre ensino e aprendizagem. Com a aplicação dos referidos projetos, as possíveis dificuldades de aprendizagem foram transformadas em oportunidades, e hoje são contribuições à qualidade educativa.

A casa amarela

Resumo da dissertação

Primazia serafica na regiam da America : novo descobrimento de santos, e veneraveis religiosos da Ordem Serafica, que ennobrecem o Novo Mundo com suas virtudes, e acçoens... /

Sabin,

O homem medico de si mesmo, ou sciencia, e arte nova de conservar cada hum a si proprio a saude, e destruir a sua doença ... /

Mode of access: Internet.

Pharmacopea tubalense chimico-galenica : parte primeira [-segunda] ... /

Mode of access: Internet.

Grammatica portugueza.

Mode of access: Internet.

“Somos quem podemos ser”: os homens (trans) brasileiros e o discurso pela (des)patologização da transexualidade

This research analyzed the discourse of Brazilian transmen in relation to (un) pathologizing of identity (trans). Therefore, it seeks to analyze the perception of the meanings attributed by Brazilian transmen to their experiences within the context in which their experience is considered a psychiatric disorder, which can be (or not) be diagnosed by doctors and psychologists. Whereby, obtaining such permissions becomes a necessity to perform bodily changes, as well as referrals for modifications of civil documentation. The methodology used was discourse analysis and research techniques were semi-structured interviews and systematic observation of the meetings of Cartografias Trans group, psychotherapeutic care group of transpeople to the Centro de pesquisa e atendimento à travestis e transexuais - CPATT in Curitiba , Paraná. The theoretical framework of the research suppoted mainly, but not only, in the studies proposed by queer theory. In this sense the research found by entering the field and analyzing the data brought, among other things, the existence of a strategic discourse by Brazilian transmen toward depathologization of their identities, manifested mainly on the notion of to have the identity (trans) pathologized does not make them sick.

A terapia comunitária e a vivência de estudantes de medicina: uma estratégia de ensino aprendizagem do cuidado humanizado na ESF?

Before the scenario full of criticism about a medical model that gives privilege to the diseases and not to the diseased, there are many arguments that defend the need of redeem the humanized relationship between doctor and patient. It became indispensable to mold during the medical graduation a professional capable of perform a special care, less instrumental and more humanized; however, even though the advances of the pedagogical program of the medical graduation, we still face numerous challenges in the process of molding. This study has as general goal to understand if the students medicine experience with the Integrative Community Therapy (TCI) at the Primary Attention – APS/Family Healthy Strategy-ESF, presents potential to configure itself while strategy of teaching-learning to the integral and humanized care. It was held a qualitative research with the students of the medical graduation from the tenth to the twelfth semester that had experience with the TCI, as part of the Boarding of Family and Community Medicine – MFC. We used interviews with script and we resorted to analyze the narratives to Gadamerian Hermeneutics. It was possible to find that before join the boarding of MFC, the students were unaware the TCI and their preconceptions lined up with depreciated character. The experience with the TCI enabled the reframing of the prejudices and the build of new concepts. Internship in ESF and participate of TCI revealed potential to learning of the humanized care by the practical exercise with experiences that privilege the built of ties; the autonomy of the patient; the fulfillment of the longitudinality at the care of the patient; the acknowledgment of the power of resilience of the patients, at the strength of the collective, at the pain sharing, at the strength of a good communication, at the gains of qualified listening exercise. The absence of models of what to do was replaced by experiences of pains and joys at the learning of becoming a doctor. The pains spoke of the structural difficulties (inputs), at the get along with the socials vulnerabilities of the users and the difficult of perform a good communication with the patients. The joys were experienced at the finding of the humanized care exercise. Questions as structural difficulties, low number of people with TCI degree, a shortly experience of with TCI, show up as limitations to its utilization as pedagogical tool. In turn, the reflective potential is capable of cause resignifications about the know-how before the pain of the other being very much present at the narratives, signaling the potential of the learning of TCI. Therefore, this study advocate that the participation of the students at the TCI, beyond the power of offering the students a teaching-learning strategy to the humanized care, represents the possibility of enlarge the horizons of those future doctors at a glance much more conscious of the difficulties and potential of a professional at the ESF, contributing to the graduation of more sensitized professionals and prepared to perform an integral and humanized approach of the person and his/her community, contributing to an APS/ESF more resolute and rewarding to everyone.

Escola: lugar político da diversidade sexual e de gênero

This work aims to understand how the public school system has become a failing institution with regards to sexual and gender diversity. I start from the principle that the school system performs a social sorting operation, leaving out of its halls almost all people who don‘t fit into the established heteronormative social order. First, I explore the experiences of primary school (Educação do Ensino Fundamental) professionals from the public network (Rede Pública Municipal) of the city of Natal-RN. I consider their narratives a result of daily practices which denounce the rules that govern and produce them in a broader context. Then I aim to establish a dialogue with the students who are victims of name-calling, teasing and abuse for not aligning with the ―normal‖ gender standards. At this stage of the research, I conducted fieldwork at the State Secondary School of Rio Grande do Norte (Escola Estadual de Ensino Médio). This investigation is guided by the following questions: What challenges need to be addressed in order to recognize the students who have been excluded from the school environment on account of sexual and/or gender differences; additionally, how can their classroom attendance and positive learning experience be ensured? To what degree is the school community concerned with building education practices which value and acknowledge sexual and gender diversity? The research goals were: to analyze how the school and its professionals deal with sexual and gender diversity, investigating which pedagogical practices silence, freeze and obstruct the diversity of student identities; examine how the school and its subjects work toward building new pathways for learning, for coexistence, and for facing the challenges of ―new‖ social demands such as homoaffection; observe the spaces that are cracked open by the presence and the voices of students who demand recognition of their existence.