Determinants of mother-baby relationship evaluated during pregnancy

ABSTRACT Background Mental health promotion is supported by a strong body of knowledge and is a matter of public health with the potential of a large impact on society. Mental health promotion programs should be implemented as soon as possible in life, preferably starting during pregnancy. Programs should focus on malleable determinants, introducing strategies to reduce risk factors or their impact on mother and child, and also on strengthening protective factors to increase resilience. The ambition of early detecting risk situations requires the development and use of tools to assess risk, and the creation of a responsive network of services based in primary health care, especially maternal consultation during pregnancy and the first months of the born child. The number of risk factors and the way they interact and are buffered by protective factors are relevant for the final impact. Maternal-fetal attachment (MFA) is not yet a totally understood and well operationalized concept. Methodological problems limit the comparison of data as many studies used small size samples, had an exploratory character or used different selection criteria and different measures. There is still a lack of studies in high risk populations evaluating the consequences of a weak MFA. Instead, the available studies are not very conclusive, but suggest that social support, anxiety and depression, self-esteem and self-control and sense of coherence are correlated with MFA. MFA is also correlated with health practices during pregnancy, that influence pregnancy and baby outcomes. MFA seems a relevant concept for the future mother baby interaction, but more studies are needed to clarify the concept and its operationalization. Attachment is a strong scientific concept with multiple implications for future child development, personality and relationship with others. Secure attachment is considered an essential basis of good mental health, and promoting mother-baby interaction offers an excellent opportunity to intervention programmes targeted at enhancing mental health and well-being. Understanding the process of attachment and intervening to improve attachment requires a comprehension of more proximal factors, but also a broader approach that assesses the impact of more distal social conditions on attachment and how this social impact is mediated by family functioning and mother-baby interaction. Finally, it is essential to understand how this knowledge could be translated in effective mental health promoting interventions and measures that could reach large populations of pregnant mothers and families. Strengthening emotional availability (EA) seems to be a relevant approach to improve the mother-baby relationship. In this review we have offered evidence suggesting a range of determinants of mother-infant relationship, including age, marital relationship, social disadvantages, migration, parental psychiatric disorders and the situations of abuse or neglect. Based on this theoretical background we constructed a theoretical model that included proximal and distal factors, risk and protective factors, including variables related to the mother, the father, their social support and mother baby interaction from early pregnancy until six months after birth. We selected the Antenatal Psychosocial Health Assessment (ALPHA) for use as an instrument to detect psychosocial risk during pregnancy. Method Ninety two pregnant women were recruited from the Maternal Health Consultation in Primary Health Care (PHC) at Amadora. They had three moments of assessment: at T1 (until 12 weeks of pregnancy) they filed out a questionnaire that included socio-demographic data, ALPHA, Edinburgh post-natal Depression Scale (EDPS), General Health Questionnaire (GHQ) and Sense of Coherence (SOC); at T2 (after the 20th weeks of pregnancy) they answered EDPS, SOC and MFA Scale (MFAS), and finally at T3 (6 months after birth), they repeated EDPS and SOC, and their interaction with their babies was videotaped and later evaluated using EA Scales. A statistical analysis has been done using descriptive statistics, correlation analysis, univariate logistic regression and multiple linear regression. Results The study has increased our knowledge on this particular population living in a multicultural, suburb community. It allow us to identify specific groups with a higher level of psychosocial risk, such as single or divorced women, young couples, mothers with a low level of education and those who are depressed or have a low SOC. The hypothesis that psychosocial risk is directly correlated with MFAS and that MFA is directly correlated with EA was not confirmed, neither the correlation between prenatal psychosocial risk and mother-baby EA. The study identified depression as a relevant risk factor in pregnancy and its higher prevalence in single or divorced women, immigrants and in those who have a higher global psychosocial risk. Depressed women have a poor MFA, and a lower structuring capacity and a higher hostility to their babies. In average, depression seems to reduce among pregnant women in the second part of their pregnancy. The children of immigrant mothers show a lower level of responsiveness to their mothers what could be transmitted through depression, as immigrant mothers have a higher risk of depression in the beginning of pregnancy and six months after birth. Young mothers have a low MFA and are more intrusive. Women who have a higher level of education are more sensitive and their babies showed to be more responsive. Women who are or have been submitted to abuse were found to have a higher level of MFA but their babies are less responsive to them. The study highlights the relevance of SOC as a potential protective factor while it is strongly and negatively related with a wide range of risk factors and mental health outcomes especially depression before, during and after pregnancy. Conclusions ALPHA proved to be a valid, feasible and reliable instrument to Primary Health Care (PHC) that can be used as a total sum score. We could not prove the association between psychosocial risk factors and MFA, neither between MFA and EA, or between psychosocial risk and EA. Depression and SOC seems to have a clear and opposite relevance on this process. Pregnancy can be considered as a maturational process and an opportunity to change, where adaptation processes occur, buffering risk, decreasing depression and increasing SOC. Further research is necessary to better understand interactions between variables and also to clarify a better operationalization of MFA. We recommend the use of ALPHA, SOC and EDPS in early pregnancy as a way of identifying more vulnerable women that will require additional interventions and support in order to decrease risk. At political level we recommend the reinforcement of Immigrant integration and the increment of education in women. We recommend more focus in health care and public health in mental health condition and psychosocial risk of specific groups at high risk. In PHC special attention should be paid to pregnant women who are single or divorced, very young, low educated and to immigrant mothers. This study provides the basis for an intervention programme for this population, that aims to reduce broad spectrum risk factors and to promote Mental Health in women who become pregnant. Health and mental health policies should facilitate the implementation of the suggested measures.

Construindo Diferenças: Representações, discriminações e identidades múltiplas de imigrantes LGBT

O objectivo principal desta dissertação é analisar as experiências e percepções de discriminação no quotidiano de imigrantes LGBT* residentes na Área Metropolitana de Lisboa. Através da realização de entrevistas semi-estruturadas focando nas experiências e percepções subjectivas, procura-se entender até que ponto estas conduzem ao desenvolvimento de práticas específicas de gestão da discriminação usadas para evitar tais experiências, e qual o seu impacto no quotidiano, na vida social e na formação identitária. Por um lado, a análise centra-se no papel do corpo como marcador de diferença em práticas e discursos discriminatórios, sublinhando a importância de práticas de invisibilização de diferenças, i.e. “passing” (Goffman, 1968). Por outro lado, pretende-se explorar de que forma a discriminação é experienciada e percepcionada de forma múltipla, quer dizer, baseada em mais do que uma categoria social. Num plano mais vasto, procura-se analisar as inter-relações e intersecções entre diferentes relações de poder que se estabelecem em práticas e discursos discriminatórios, utilizando categorias de género, sexualidade, origem, nacionalidade, etnicidade e raça, e além disso, a sua influência na formação identitária de indivíduos que se encontram marginalizados.

Assessing the role of social networks on migrant labor market outcomes: Evidence from a representative immigrant survey

What role do social networks play in determining migrant labor market outcomes? We examine this question using data from a random sample of 1500 immigrants living in Ireland. We propose a theoretical model formally predicting that immigrants with more contacts have additional access to job offers, and are therefore better able to become employed and choose higher paid jobs. Our empirical analysis confirms these findings, while focusing more generally on the relationship between migrants’ social networks and a variety of labor market outcomes (namely wages, employment, occupational choice and job security), contrary to the literature. We find evidence that having one more contact in the network is associated with an increase of 11pp in the probability of being employed and with an increase of about 100 euros in the average salary. However, our data is not suggestive of a network size effect on occupational choice and job security. Our findings are robust to sample selection and other endogeneity concerns.

A importância dos média e da língua de acolhimento na integração de imigrantes. Estudos de caso : a comunidade nepalesa de Portugal e a comunidade portuguesa em Macau

Esta pesquisa foca-se na comunidade imigrante portuguesa em Macau e na comunidade imigrante nepalesa em Portugal. Analisa os usos dos média – étnicos, mainstream e transnacionais - por imigrantes durante o processo de integração: na manutenção de laços com o país de origem e na adaptação à sociedade de acolhimento, em que a língua de acolhimento assume um papel crucial. A investigação enquadra-se nos estudos de audiências e baseia-se na teoria dos Usos e Gratificações dos Média (Katz, Blumler, & Gurevitch, 1974). No que respeita à integração assenta no modelo de estratégias de aculturação de Berry & Sam (2001, 2006). Quanto à língua, assenta na teoria do poder e da prática de Bourdieu (1991), especificamente na parte relativa ao poder simbólico da língua. Quanto à metodologia, foram realizadas oito entrevistas em profundidade na comunidade nepalesa e 29 entrevistas na comunidade portuguesa. A amostra foi de conveniência e teoricamente sustentada. A seguir às entrevistas, foi feita uma análise de conteúdo individual e transversal. Esta tese pretende contribuir para o enriquecimento de linhas de investigação sobre audiências activas dos média. Poderá servir de fonte de informação para políticas relacionadas com a integração de imigrantes, nomeadamente, para reformulação de políticas relacionadas com os média e com a língua de acolhimento. No caso de empresas de comunicação, a informação obtida poderá ser útil para adaptarem melhor os seus conteúdos a este público específico.

Assessing the role of social networks on migrant labor market outcomes: Evidence from a representative immigrant survey

What role do social networks play in determining migrant labor market outcomes? We examine this question using data from a random sample of 1500 immigrants living in Ireland. We propose a theoretical model formally predicting that immigrants with more contacts have additional access to job offers, and are therefore better able to become employed and choose higher paid jobs. Our empirical analysis confirms these findings, while focusing more generally on the relationship between migrants’ social networks and a variety of labor market outcomes (namely wages, employment, occupational choice and job security), contrary to the literature. We find evidence that having one more contact in the network is associated with an increase of 11pp in the probability of being employed and with an increase of about 100 euros in the average salary. However, our data is not suggestive of a network size effect on occupational choice and job security. Our findings are robust to sample selection and other endogeneity concerns.

Morfo-anatomia de sementes de Dipteryx odorata (Aubl.) Will. (Fabaceae) como contribuição ao estudo Farmacognóstico de plantas da região Amazônica

Dipteryx odorata (Aubl.) Willd. (Fabaceae) é popularmente conhecida como cumaru. Suas sementes são utilizadas pela população, por seus efeitos terapêuticos, dados pela cumarina, hoje comercializada para distúrbios vasculares e linfáticos e pela produção de óleo. Realizou-se um estudo morfo-anatômico de sementes de seis indivíduos desta espécie através da caracterização morfológica, determinação do peso da matéria fresca e das dimensões de 100 sementes, além de cortes histológicos transversais e longitudinais, considerando-se o tegumento e o embrião. A semente é oblonga, levemente comprimida na região do hilo. O tegumento seminal apresenta cutícula delgada e lisa, macroesclereídeos, osteoesclereídeos, mesofilo interno e membrana basal. O embrião constitui-se de dois cotilédones e o eixo embrionário retilíneo, formado por plúmula, epicótilo e radícula.

Cidadania, imigração e nacionalidade na União Europeia

Projeto de mestrado em Políticas Comunitárias e Cooperação Territorial

A rádio na vida dos cidadãos: estudo do papel das rádios locais

Relatório de estágio de mestrado em Ciências da Comunicação

Modelos de regressão multinível no estudo do desempenho escolar

Dissertação de mestrado em Estatística

O filme “A Gaiola Dourada”: reflexões sobre o regresso em força da emigração portuguesa e a ‘portugalidade’ de uma gaiola (cada vez menos) dourada

A história de um casal de emigrantes portugueses em França bateu, no verão de 2013, recordes de audiência nas salas de cinema. O filme “A Gaiola Dourada”, de Ruben Alves, recuperou a temática da emigração portuguesa, numa altura em que esta atingiu o boom registado nos anos 1960. Recorrendo ao seu percurso, o realizador refere-se à ‘portugalidade’ como alegada ‘pertença a Portugal’, que assume como um cliché, e utiliza de forma humorística vários estereótipos associados aos emigrantes portugueses, através dos quais é mostrada alguma vergonha que os filhos dos emigrantes sentem em relação ao comportamento dos pais, trazendo ao de cima os contrastes com a sociedade onde vivem. A grande ficção reside no regresso ao país de origem, concretizando o sonho da grande maioria dos emigrantes, mas subvertendo a lógica: no filme, não são os pais que voltam a Portugal, mas os filhos, que aparentemente pouco se identificam com o país dos progenitores. “A Gaiola Dourada” reintroduziu o debate sobre a emigração em Portugal, aproveitando a crise económica para refletir sobre o seu regresso em força, bem como traçar o perfil dos novos emigrantes. Será que os portugueses na ‘diáspora’ ainda reavivam a chama ‘lusitana’ (Gonçalves, 2009)? E será que a partilha do nome ‘Portugal’ basta para sublinhar uma alegada identidade nacional (Sobral, 2012)?

The Barcelonnettes: an example of network-entrepreneurs in XIX century Mexico. An explanation based on a theory of bounded rational choice with social embeddedness

A theory of network-entrepreneurs or "spin-off system" is presented in this paper for the creation of firms based on the community’s social governance. It is argued that firm’s capacity for accumulation depends on the presence of employees belonging to the same social/ethnic group with expectations of "inheriting" the firm and becoming entrepreneurs once they have been selected for their merits and loyalty towards their patrons. Such accumulation is possible because of the credibility of the patrons’ promises of supporting newcomers due to high social cohesion and specific social norms prevailing in the community. This theory is exemplified through the case of the Barcelonnettes, a group of immigrants from the Alps in the South of France (Provence) who came to Mexico in the XIX Century.

Estratègies d'intervenció i avaluació de l'hàbit tabàquic

Objectiu: Donar informació sobre els riscos del tabac, avaluar l’hàbit tabàquic i el compliment de la normativa vigent per part de la comunitat universitària a través d’una campanya de sensibilització. Metodologia: Prèviament a l’inici de les activitats es van dissenyar i passar unes enquestes per avaluar l’hàbit tabàquic als estudiants (a l’aula) i treballadors de l’Escola de Ciències de la Salut. Durant la setmana d’activitats, que coincidia amb el Dia Internacional de LLuita Antitabàquica, es va crear una taula informativa a càrrec dels estudiants de l’assignatura Atencions d’Infermeria a Addiccions i Toxicomanies, per tal d’informar de forma àmplia sobre el tabaquisme, conseqüències i tractaments. Al mateix temps i de forma passiva en uns monitors de TV es donava més informació, amb una material creat per aquesta campanya. Resultats: Els mitjans de comunicació van demostrar, des de l’inici de la campanya, un gran interès. Respecte a la participació per part de la comunitat universitària podem dir que va ser acceptable, al voltant de 1000 persones van passar per la taula informativa. El perfil dels estudiants que van contestar l’enquesta va ser dona (66.4%), alumne de fisioteràpia (49%), fumadors (regulars i ocasionals 52%). Dintre del grup de fumadors regulars per gèneres les dones fumen més 37%, front als homes 27.7%. Consum setmanal de cigarretes (regulars i ocasionals), presenta una mitjana de 59 (D.E=49). La majoria ha fet algun intent de deixar de fumar, 61%. Respecte al temps d’ abstinència un 69.9% no ha passat de 3 mesos i un 96% pensa que fumar en un espai tancat és perjudicial pels altres. Per últim, de tots el entrevistats la gran majoria (97.8%), declaren que fumen davant seu i a un 41.4 % els molesta. Conclusions: La Comissió fa una valoració positiva general, de com es van desenvolupar les diferents activitats. No obstant s’observa poca sensibilització per una part de la comunitat universitària respecte a la llibertat de viure.

Les Polítiques de gènere als ajuntaments catalans: un procés en construcció

El paper tracta de l’evolució de les polítiques de gènere i la seva implementació en les ciutats catalanes més grans de 20.000 habitants. L’article mostra l’interès en tractar la qüestió com a política pública i la importància que totes les localitats catalanes majors de 20.000 habitants li han atorgat. A través d’un ampli seguit d’entrevistes l’autora mostra que no totes les polítiques poden ser qualificades de polítiques de gènere, i tot i que les ajuntaments estan interessats en aplicar polítiques de gender mainstreaming, no totes les actuacions públiques poden ser-ne considerades com a tals. Hi ha encara molt per a prendre i, tot i que els govern locals hi estan interessats, el camí encara pot ser llarg.