Educação à distãncia como ferramenta de promoção das atividades de alimentação e nutrição na Atenção Primária à Saúde: um estudo de caso

Pós-graduação em Enfermagem (mestrado profissional) - FMB

Midwifery Training in Brazil: Context, Challenges and Perspectives

This article describes the creation process of the first direct-entry Midwifery Course in Brazil, at the School of Arts, Sciences and Humanities of the University of Sao Paulo, Brazil. It presents the course's political-educational project and the theoretical references that support it; the movements or resistances that are opposed to the training and registration of midwives; the challenges that need to be overcome. Finally, the paper presents the foreseen perspectives of contribution of these professionals towards the improvement of healthcare quality, the decrease in maternal and perinatal morbidity and mortality rates, as well as of unnecessary cesarean sections in the country.

Contexto, desafios e perspectivas na formação de obstetrizes no Brasil

O artigo descreve o processo de criação do Curso de Obstetrícia da Escola de Artes, Ciências e Humanidades da Universidade de São Paulo. Ele apresenta o projeto político pedagógico e os referenciais teóricos que suportam a formação de obstetrizes, a resistência ou os movimentos que se opõem à formação e ao registro desses profissionais, os desafios que precisam ser superados e, finalmente, as perspectivas nas quais as obstetrizes podem contribuir não só para melhorar a qualidade dos cuidados em saúde, como também para diminuir as taxas de morbidade e mortalidade materna e perinatal e de cesarianas desnecessárias no país.

Die psychologische Kampfführung

Nach dem Ende des Zweiten Weltkriegs wurden auf dem Gebiet der Bundesrepublik Deutschland zahlreiche Organisationen gegründet, die es sich zur Aufgabe machten, auf die Meinungsbildung im Osten und Westen Einfluss zu nehmen. Dazu zählte von 1957 bis 1990 die Psychologische Kampfführung / Psychologische Verteidigung der Bundeswehr (PSK/PSV). Ihr primäres Ziel war es, das Staats- und Gesellschaftssystem der Bundesrepublik nach innen und außen zu konsolidieren. Der Dissertationsschrift liegt ein interdisziplinärer Ansatz zugrunde: Zum einen wird die PSK/PSV im Kontext der Propagandageschichte und -theorie dargestellt und untersucht – von diesem Standpunkt aus betrachtet handelt es sich um eine publizistikwissenschaftliche Untersuchung. Zum anderen wird die Wirklichkeit der PSK/PSV mit erziehungswissenschaftlichen Begriffen beschrieben, analysiert und unter pädagogischen Gesichtspunkten diskutiert – aus dieser Sichtweise liegt hier eine erziehungswissenschaftliche Untersuchung vor. Die PSK/PSV stand historisch betrachtet keineswegs im wertfreien Raum. Vor allem die Ausprägungen von Propaganda im Dritten Reich – aber auch in der Deutschen Demokratischen Republik – spielten für die PSK/PSV eine bedeutende Rolle. Sie waren gewissermaßen stets zu meidende (politische) rechte und linke Grenze in dem Unterfangen, eine eigene Form von Propaganda zu entwickeln und zu betreiben. Die PSK/PSV wirkte unter politischer Zielsetzung auf Einstellungen und Verhalten von Personen beiderseits des Eisernen Vorhangs ein. Ihre Aktivitäten weisen in auffälliger Weise Schnittmengen zu Feldern der Erziehung auf. Die unterschiedlichen pädagogischen Programme und Strategien der vier PSK/PSV-Bereiche – (1) Lehr- und Forschungsstätten, (2) PSK/PSV-Truppe, (3) Deutsche Gesellschaft für Sozialbeziehungen e.V. und (4) Studiengesellschaft für Zeitprobleme e.V. – werden in der Dissertationsschrift dargestellt, analysiert und bewertet. In den Schlussbetrachtungen wird unter pädagogischen Gesichtspunkten diskutiert, ob der in Presse und Politik geäußerte Vorwurf einer Nähe der PSK/PSV zur Propaganda und Erziehung im Dritten Reich haltbar ist.

La partecipazione popolare nell'esperienza dei referendum comunali

I Comuni incarnano idealmente delle piazze in cui il dibattito politico può svilupparsi in assenza di particolari filtri ed intermediazioni, con un rapporto diretto tra cittadini ed istituzioni. Essi costituiscono uno snodo di centrale importanza nell'esercizio della sovranità popolare e, al contempo, sono terreno fertile per la sperimentazione di modelli di partecipazione democratica. Prendendo come punto di vista l'esperienza dei Comuni italiani, si è scelto di focalizzare l'attenzione su uno degli strumenti “istituzionali” – nonché uno tra i più tradizionali – di partecipazione popolare, ovvero il referendum, nelle diverse forme ed accezioni che rientrano nel campo semantico di tale espressione. Questa è generalmente impiegata per indicare tutte quelle votazioni popolari non elettive su questioni politicamente rilevanti, formulate attraverso un quesito con due o più risposte alternative tra loro. L'analisi della disciplina legislativa degli istituti di partecipazione negli enti locali e lo studio delle disposizioni statutarie e regolamentari previste dai singoli Comuni, nonché le informazioni raccolte da alcuni casi di studio, rappresentano, in questo contesto, l'occasione per indagare le caratteristiche peculiari dell'istituto referendario, la sua effettività ed il suo impatto sulla forma di governo. In particolare, si è verificata positivamente la compatibilità del referendum, classificato dalla prevalente dottrina come istituto di democrazia diretta, con le forme attuali di democrazia rappresentativa. Si è tentato, altresì, un accostamento ai concetti di democrazia partecipativa e deliberativa, evidenziando come manchi del tutto, nel procedimento referendario (che pure è dotato di massima inclusività) un momento di confronto “deliberativo”. Il raffronto tra le esperienze riscontrate nei diversi Comuni ha consentito, inoltre, di ricercare le cause di alcuni aspetti critici (scarsa affluenza, mancata trasformazione del voto in decisioni politiche, aumento del conflitto) e, al contempo, di individuarne possibili soluzioni, tracciate sulla scorta delle migliori pratiche rilevate.

The Making of a Shiite Bourgeoisie in Lebanon Political Mobilisation, Economic Resources and Formation of a Social Group

The thesis analyses the making of the Shiite middle- and upper/entrepreneurial-class in Lebanon from the 1960s till the present day. The trajectory explores the historical, political and social (internal and external) factors that brought a sub-proletariat to mobilise and become an entrepreneurial bourgeoisie in the span of less than three generations. This work proposes the main theoretical hypothesis to unpack and reveal the trajectory of a very recent social class that through education, diaspora, political and social mobilisation evolved in a few years into a very peculiar bourgeoisie: whereas Christian-Maronite middle class practically produced political formations and benefited from them and from Maronite’s state supremacy (National Pact, 1943) reinforcing the community’s status quo, Shiites built their own bourgeoisie from within, and mobilised their “cadres” (Boltanski) not just to benefit from their renovated presence at the state level, but to oppose to it. The general Social Movement Theory (SMT), as well as a vast amount of the literature on (middle) class formation are therefore largely contradicted, opening up new territories for discussion on how to build a bourgeoisie without the state’s support (Social Mobilisation Theory, Resource Mobilisation Theory) and if, eventually, the middle class always produces democratic movements (the emergence of a social group out of backwardness and isolation into near dominance of a political order). The middle/upper class described here is at once an economic class related to the control of multiple forms of capital, and produced by local, national, and transnational networks related to flows of services, money, and education, and a culturally constructed social location and identity structured by economic as well as other forms of capital in relation to other groups in Lebanon.

Knowledge Management and Decision Support for Sustainable Land Management

Much research has focused on desertification and land degradation assessments without putting sufficient emphasis on prevention and mitigation, although the concept of sustainable land management (SLM) is increasingly being acknowledged. A variety of SLM measures have already been applied at the local level, but they are rarely adequately recognised, evaluated, shared or used for decision support. WOCAT (World Overview of Technologies and Approaches) has developed an internationally recognised, standardised methodology to document and evaluate SLM technologies and approaches, including spatial distribution, allowing the sharing of SLM knowledge worldwide. The recent methodological integration into a participatory process allows now analysing and using this knowledge for decision support at the local and national level. The use of the WOCAT tools stimulates evaluation (self-evaluation as well as learning from comparing experiences) within SLM initiatives where all too often there is not only insufficient monitoring but also a lack of critical analysis. The comprehensive questionnaires and database system facilitate to document, evaluate and disseminate local experiences of SLM technologies and their implementation approaches. This evaluation process - in a team of experts and together with land users - greatly enhances understanding of the reasons behind successful (or failed) local practices. It has now been integrated into a new methodology for appraising and selecting SLM options. The methodology combines a local collective learning and decision approach with the use of the evaluated global best practices from WOCAT in a concise three step process: i) identifying land degradation and locally applied solutions in a stakeholder learning workshop; ii) assessing local solutions with the standardised WOCAT tool; iii) jointly selecting promising strategies for implementation with the help of a decision support tool. The methodology has been implemented in various countries and study sites around the world mainly within the FAO LADA (Land Degradation Assessment Project) and the EU-funded DESIRE project. Investments in SLM must be carefully assessed and planned on the basis of properly documented experiences and evaluated impacts and benefits: concerted efforts are needed and sufficient resources must be mobilised to tap the wealth of knowledge and learn from SLM successes.

Tracking the implicit self using event-related potentials

Negative biases in implicit self-evaluation are thought to be detrimental to subjective well-being and have been linked to various psychological disorders, including depression. An understanding of the neural processes underlying implicit self-evaluation in healthy subjects could provide a basis for the investigation of negative biases in depressed patients, the development of differential psychotherapeutic interventions, and the estimation of relapse risk in remitted patients. We thus studied the brain processes linked to implicit self-evaluation in 25 healthy subjects using event-related potential (ERP) recording during a self-relevant Implicit Association Test (sIAT). Consistent with a positive implicit self-evaluation in healthy subjects, they responded significantly faster to the congruent (self-positive mapping) than to the incongruent sIAT condition (self-negative mapping). Our main finding was a topographical ERP difference in a time window between 600 and 700 ms, whereas no significant differences between congruent and incongruent conditions were observed in earlier time windows. This suggests that biases in implicit self-evaluation are reflected only indirectly, in the additional recruitment of control processes needed to override the positive implicit self-evaluation of healthy subjects in the incongruent sIAT condition. Brain activations linked to these control processes can thus serve as an indirect measure for estimating biases in implicit self-evaluation. The sIAT paradigm, combined with ERP, could therefore permit the tracking of the neural processes underlying implicit self-evaluation in depressed patients during psychotherapy.

Die Erziehung zu einer aktiven Bürgerschaft

Trying to give a definition of Citizenship Education is a challenging operation: it is characterized by a variety of meanings flowing from Civic Education (related to knowledge and practice about the system of laws, rules, conventions referring to a particular civil community) to Socio-political education (related to the awareness of being part of the system of cultural elements, values, traditions historically produced by the community itself). It would be not be correct identifying Citizenship Education only with elements of Civic Education, as it would restrict its range to formal level of rules and laws, rights and duties. Otherwise, limiting its understanding only on elements of Sociopolitical Education, would offer the risk of investing in cultural similarities, common roots, values homogeneity, that are strong in giving hold on identity, membership, participation, but so exposed to acts of fanaticism, exclusion of diversity, hostility towards minorities. Therefore, it is necessary to assume that Citizenship Education has to be established on problematic integration of the two presented perspectives, thus founding knowledge and practice about the rules of civil society on the system of values and cultural aspects that every single micro-community (and every single individual) recognizes to be source of the rules: a complex system of various elements made of homogeneity and inhomogeneity, similarities and differences in constant modification an dynamic intercommunication.

Is low self-esteem a risk factor for depression? Findings from a longitudinal study of Mexican-origin youth

We examined the relation between low self-esteem and depression using longitudinal data from a sample of 674 Mexican-origin early adolescents who were assessed at age 10 and 12 years. Results supported the vulnerability model, which states that low self-esteem is a prospective risk factor for depression. Moreover, results suggested that the vulnerability effect of low self-esteem is driven, for the most part, by general evaluations of worth (i.e., global self-esteem), rather than by domain-specific evaluations of academic competence, physical appearance, and competence in peer relationships. The only domain-specific self-evaluation that showed a prospective effect on depression was honesty-trustworthiness. The vulnerability effect of low self-esteem held for male and female adolescents, for adolescents born in the United States versus Mexico, and across different levels of pubertal status. Finally, the vulnerability effect held when we controlled for several theoretically relevant 3rd variables (i.e., social support, maternal depression, stressful events, and relational victimization) and for interactive effects between self-esteem and the 3rd variables. The present study contributes to an emerging understanding of the link between self-esteem and depression and provides much needed data on the antecedents of depression in ethnic minority populations

Equine parasite control under prescription-only conditions in Denmark - Awareness, knowledge, perception, and strategies applied.

Due to widespread development of anthelmintic resistance in equine parasites, recommendations for their control are currently undergoing marked changes with a shift of emphasis toward more coprological surveillance and reduced treatment intensity. Denmark was the first nation to introduce prescription-only restrictions of anthelmintic drugs in 1999, but other European countries have implemented similar legislations over recent years. A questionnaire survey was performed in 2008 among Danish horse owners to provide a current status of practices and perceptions with relation to parasite control. Questions aimed at describing the current use of coprological surveillance and resulting anthelmintic treatment intensities, evaluating knowledge and perceptions about the importance of various attributes of parasite control, and assessing respondents' willingness to pay for advice and parasite surveillance services from their veterinarians. A total of 1060 respondents completed the questionnaire. A large majority of respondents (71.9%) were familiar with the concept of selective therapy. Results illustrated that the respondents' self-evaluation of their knowledge about parasites and their control associated significantly with their level of interest in the topic and their type of education (P<0.0001). The large majority of respondents either dewormed their horses twice a year and/or performed two fecal egg counts per horse per year. This approach was almost equally pronounced in foals, horses aged 1-3 years old, and adult horses. The respondents rated prevention of parasitic disease and prevention of drug resistance as the most important attributes, while cost and frequent fecal testing were rated least important. Respondents' actual spending on parasite control per horse in the previous year correlated significantly with the amount they declared themselves willing to spend (P<0.0001). However, 44.4% declared themselves willing to pay more than what they were spending. Altogether, results indicate that respondents were generally familiar with equine parasites and the concept of selective therapy, although there was some confusion over the terms small and large strongyles. They used a large degree of fecal surveillance in all age groups, with a majority of respondents sampling and/or treating around twice a year. Finally, respondents appeared willing to spend money on parasite control for their horses. It is of concern that the survey suggested that foals and young horses are treated in a manner very similar to adult horses, which is against current recommendations. Thus, the survey illustrates the importance of clear communication of guidelines for equine parasite control.

This Was Not on the Syllabus!: An Examination of First-Year Urban Teachers' Self-Efficacy

Many first-year teachers find it difficult to reach the needs of all their students in part, because they feel their college coursework left them ill-prepared for the complexity they face in the classroom. This is particularly true among urban teachers who often face crowded classrooms of diverse students with a wide range of instructional needs. This study is a comparative case study of two University of Connecticut graduates during their first year teaching in urban schools. Using mixed-methods, the study draws on interviews, questionnaires, and videotape data shared as a part of a monthly teacher study group of similar graduates. I also draw on group conversations in which teachers discussed their ability to reach the needs of all of their students as this was related to their preservice coursework. My findings suggest that many first-year teachers feel university coursework failed to help them. One teacher felt it did not help her at all, while the other felt it helped her but she still could not meet all of her students' needs. Many first-year, urban teachers do not feel confident in the classroom as a result of their preparation from coursework. With this lack in confidence, the teachers may be more likely to leave their urban position, and this may contribute to the high turnover of teachers in urban placements.

A comparison of healthcare access, healthcare utilization and asthma self-management for Hispanic children in border and non-border regions of Texas

The purpose of this culminating experience was to investigate the relationships between healthcare utilization, insurance coverage, and socioeconomic characteristics of children with asthma along the Texas-Mexico Border. A secondary data analysis was conducted on cross-sectional data from the Texas Child Asthma Call-back Survey, a follow-up survey to the random digit dialed Behavior Risk Factor Surveillance Study (BRFSS) conducted between 2006-2009 ( n = 556 adults living in households with a child with asthma).^ The proportion of Hispanic children with asthma in Border areas of Texas was more than twice that of non-Border areas (84.8% vs. 28.8%). Parents in Border areas were less likely to have their own health insurance (OR = 0.251, 95% C.I. = 0.117-0.540) and less likely to complete the survey in English than Spanish (OR = 0.251 95% C.I. = 0.117-0.540) than parents in non-Border areas. No significant socio-economic or health care utilization differences were noted between Hispanic children living in Border areas compared to Hispanic children living in non-Border areas. Children with asthma along the Texas-Mexico Border, regardless of ethnicity and language, have insurance coverage rates, reported cost barriers to care, symptom management, and medication usage patterns similar to those in non-Border areas. When compared to English-speakers, Spanish-speaking parents in Texas as a whole are far less likely to be taught what to do during an asthma attack (50.2% vs. 78.6%).^ Language preference, rather than ethnicity or geographical residence, played a larger role on childhood asthma-related health disparities for children in Texas. Spanish-speaking parents in are less likely to receive adequate asthma self-management education. Investigating the effects of Hispanic acculturation rates and incongruent parent-child health insurance coverage may provide better insight into the health disparities of children along the Texas-Mexico Border.^

The effects of ethnicity and ethnic composition of schools on physical activity and nutrition behaviors of 8th and 11th graders in Texas

With rates of obesity and overweight continuing to increase in the US, the attention of public health researchers has focused on nutrition and physical activity behaviors. However, attempts to explain the disparate rates of obesity and overweight between whites and Hispanics have often proven inadequate. Indeed, the nebulous term ‘ethnicity’ provides little important detail in addressing potential biological, behavioral, and environmental factors that may affect rates of obesity and overweight. In response to this, the present research seeks to test the explanatory powers of ethnicity by situating the nutrition and physical activity behaviors of whites and Hispanic into their broader social contexts. It is hypothesized that a student's gender and grade level, as well as the socioeconomic status and ethnic composition of their school, will have more predictive power for these behaviors than will self-reported ethnicity. ^ Analyses revealed that while ethnicity did not seem to impact nutrition behaviors among the wealthier schools and those with fewer Hispanics, ethnicity was relevant in explaining these behaviors in the poorest tertile of schools and those with the highest number of Hispanics. With respect to physical activity behaviors, the results were mixed. The variables representing regular physical activity, participation in extracurricular physical activities, and performance of strengthening and toning exercises were more likely to be determined by SES and ethnic composition than ethnicity, especially among 8th grade males. However, school sports team and physical education participation continued to vary by ethnicity, even after controlling for SES and ethnic composition of schools. In conclusion then, it is important to understand the intersecting demographic and social variables that define and surround the individual in order to understand nutrition and physical activity behaviors and thus overweight and obesity.^

The development of professor's professional knowledge in Psychology

This work belongs to the Project "Teaching and learning Psychology: a study of the educational practice in professors and beginners". It is part of an investigation program developed in the context of the subject "Didactic and Practical Planning of Psychology teaching" in which we have been working since 1998. This subject is also considered as the final stage of the formative itinerary for Psychology s professors. The reached results show the incidence that the beliefs and professors' representations have in the teaching processes. By getting into the studies centered in the educational knowledge we guide the inquiry around the development of the professor's professional knowledge and particularly the development of their formation. Our proposal contemplates a formation device which incorporates the observation, reflection, evaluation and self-evaluation of the practice in order to facilitate the reconstruction, significance and re-significance of the teaching and learning processes by giving relevance to the development of the teacher professional knowledge. The analysis of teaching practices process reveals that the mediations that cross the knowledge in the being taught instances are constituted in reflections axes. This involves the future professor's relationship with the knowledge and their projection in the construction of the professional identity.