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.

Infant mortality in Brazil, 1980-2000: A spatial panel data analysis

Background: Infant mortality is an important measure of human development, related to the level of welfare of a society. In order to inform public policy, various studies have tried to identify the factors that influence, at an aggregated level, infant mortality. The objective of this paper is to analyze the regional pattern of infant mortality in Brazil, evaluating the effect of infrastructure, socio-economic, and demographic variables to understand its distribution across the country. Methods: Regressions including socio-economic and living conditions variables are conducted in a structure of panel data. More specifically, a spatial panel data model with fixed effects and a spatial error autocorrelation structure is used to help to solve spatial dependence problems. The use of a spatial modeling approach takes into account the potential presence of spillovers between neighboring spatial units. The spatial units considered are Minimum Comparable Areas, defined to provide a consistent definition across Census years. Data are drawn from the 1980, 1991 and 2000 Census of Brazil, and from data collected by the Ministry of Health (DATASUS). In order to identify the influence of health care infrastructure, variables related to the number of public and private hospitals are included. Results: The results indicate that the panel model with spatial effects provides the best fit to the data. The analysis confirms that the provision of health care infrastructure and social policy measures (e. g. improving education attainment) are linked to reduced rates of infant mortality. An original finding concerns the role of spatial effects in the analysis of IMR. Spillover effects associated with health infrastructure and water and sanitation facilities imply that there are regional benefits beyond the unit of analysis. Conclusions: A spatial modeling approach is important to produce reliable estimates in the analysis of panel IMR data. Substantively, this paper contributes to our understanding of the physical and social factors that influence IMR in the case of a developing country.

Water balance and spatial distribution of an anuran community from Brazil

Terrestrial amphibians may dehydrate when exposed to low humidity, representing an important factor affecting spatial distribution and community composition. In this study we investigated whether rates of dehydration and rehydration are able to explain the spatial distribution of an anuran community in a Restinga environment at the northern coast of the State of Bahia, Brazil, represented by 11 species distributed in 27 sample units. The environmental data set containing 20 variables was reduced to a few synthetic axes by principal component analysis (PCA). Physiological variables measured were rates of dehydration, rehydration from water, and rehydration from a neutral substrate. Multiple regression analyses were used to test the null hypothesis of no association between the environmental data set (synthetic axes of PCA) and each axis representative of a physiological variable, which was rejected (P < 0.001). Of 15 possible partial regressions only rehydration rate from neutral substrate vs. PC1. and PC2, rehydration rate from water vs. PC1, and dehydration rate vs. PC2 were significant. Our analysis was influenced by a gradient between two different groups of sample units: a beach area with high density of bromeliads and an environment without bodies of water with low density of bromeliads. Species of very specific natural history and morphological characters occur in these environments: Phyllodytes melanomystax and Scinax auratus, species frequently occurring in terrestrial bromeliads, and Ischnocnema paulodutrai, common along the northern coast of Bahia and usually found in forest remnants within environments with low number of bodies of water. In dry environments species with lower rates of dehydration were dominant, whereas species showing greater rates of dehydration were found predominantly in microhabitats with greater moisture or abundance of bodies of water.

Job satisfaction and discrepancies between social and biological timing

The discrepancies between social and biological timing are reflected in shift workers' well-being. The aim of this study was to verify the association between job satisfaction and chronotype among day and night nursing personnel. Several variables, including seniority at the hospital and, in the same shift, sleep duration, quality of sleep, sleepiness and willingness to change sleep timing were also analyzed. Chronotype was calculated by using the morningness-eveningness questionnaire. We studied 514 nursing professionals from a public university hospital. Among the day workers, the higher the morningness, the more the workers were satisfied with their job. In contrast, among night workers, job satisfaction was associated with sleep quality and seniority at the hospital but not with chronotype. Our results suggest that an agreement between work schedule and chronotype may help to increase job satisfaction among diurnal workers.

Ethical Cultures in Large Business Organizations in Brazil, Russia, India, and China

This study focuses on comparison of perceptions of ethical business cultures in large business organizations from four largest emerging economies, commonly referred to as the BRICs (Brazil, Russia, India, and China), and from the US. The data were collected from more than 13,000 managers and employees of business organizations in five countries. The study found significant differences among BRIC countries, with respondents from India and Brazil providing more favorable assessments of ethical cultures of their organizations than respondents from China and Russia. Overall, highest mean scores were provided by respondents from India, the US, and Brazil. There were significant similarities in ratings between the US and Brazil.

Neoproterozoic glacial deposits from the Aracuai orogen, Brazil: Age, provenance and correlations with the Sao Francisco craton and West Congo belt

Glacigenic diamictite successions of the Macaubas Group are widespread in the western domain of the Aracuai orogen, east of the Sao Francisco craton (Brazil). Diamictites also occur on this craton and in the African counterpart of the Aracuai orogen, the West Congo belt. Detrital zircon grains from the matrix of diamictites and sandstones from the Macaubas Group were dated by the U-Pb SHRIMP technique. The geochronological study sets the maximum depositional age of the glacial diamictites at 900 Ma, and indicates multiple sources for the Macaubas basin with ages ranging from 900 to 2800 Ma. Sm-Nd T-DM model ages, determined on whole rock samples, range from 1.8 Ga to 2.5 Ga and get older up-section. Comparison of our data with those from the cratonic area suggest that these glacial deposits can be correlated to the Jequitai and Carrancas diamictites in the Sao Francisco craton, and to the Lower Mixtite Formation of the West Congolian Group, exposed in Africa. The 900-1000 Ma source is most probably represented by the Zadinian-Mayumbian volcanic rocks and related granites from the West Congo belt. However, one of the most voluminous sources, with ages in the 1.1-1.3 Ga interval, has not been detected in the Sao Francisco-Congo craton. Possible sources for these grains could occur elsewhere in Africa, or possibly from within the Brasilia Belt in western central Brazil. (C) 2011 International Association for Gondwana Research. Published by Elsevier B.V. All rights reserved.

Disparities in female breast cancer mortality rates in Brazil between 1980 and 2009

OBJECTIVE: To describe the temporal trends in female breast cancer mortality rates in Brazil in its macro-regions and states between 1980 and 2009. METHODS: This was an ecological time-series study using data on breast cancer deaths registered in the Mortality Data System (SIM/WHO) and census data on the resident population collected by the Brazilian Institute of Geography and Statistics (IBGE/WHO). Joinpoint regression analyses were used to identify the significant changes in trends and to estimate the annual percentage change (APC) in mortality rates. RESULTS: Female breast cancer mortality rates in Brazil tended to stabilize from 1994 onward (APC = 0.4%). Considering the Brazilian macro-regions, the annual mortality rates decreased in the Southeast, stabilized in the South and increased in the Northeast, North, and Midwest. Only the states of Sao Paulo (APC = -1.9%), Rio Grande do Sul (APC = -0.8%) and Rio de Janeiro (APC = -0.6%) presented a significant decline in mortality rates. The greatest increases were found in Maranhao (APC = 12%), Paraiba (APC = 11.9%), and Piaui (APC = 10.9%). CONCLUSION: Although there has been a trend toward stabilization in female breast cancer mortality rates in Brazil, when the mortality rate of each macro-region and state is analyzed individually, considerable inequalities are found, with rate decline or stabilization in states with higher socioeconomic levels and a substantial increase in those with lower socioeconomic levels.

Mini-Mental State Examination sentence writing among community-dwelling elderly adults in Brazil: text fluency and grammar complexity

Background: In normal aging, the decrease in the syntactic complexity of written production is usually associated with cognitive deficits. This study was aimed to analyze the quality of older adults' textual production indicated by verbal fluency (number of words) and grammatical complexity (number of ideas) in relation to gender, age, schooling, and cognitive status. Methods: From a probabilistic sample of community-dwelling people aged 65 years and above (n = 900), 577 were selected on basis of their responses to the Mini-Mental State Examination (MMSE) sentence writing, which were submitted to content analysis; 323 were excluded as they left the item blank or performed illegible or not meaningful responses. Education adjusted cut-off scores for the MMSE were used to classify the participants as cognitively impaired or unimpaired. Total and subdomain MMSE scores were computed. Results: 40.56% of participants whose answers to the MMSE sentence were excluded from the analyses had cognitive impairment compared to 13.86% among those whose answers were included. The excluded participants were older and less educated. Women and those older than 80 years had the lowest scores in the MMSE. There was no statistically significant relationship between gender, age, schooling, and textual performance. There was a modest but significant correlation between number of words written and the scores in the Language subdomain. Conclusions: Results suggest the strong influence of schooling and age over MMSE sentence performance. Failing to write a sentence may suggest cognitive impairment, yet, instructions for the MMSE sentence, i.e. to produce a simple sentence, may limit its clinical interpretation.

Peer and group relationships in preschoolers: the role of social and linguistic skills

Being able to positively interact and build relationships with playmates in preschool years is crucial to achieve positive adjustment. An update review and two studies on such topics were provided. Study 1 is observational; it investigates the type of social experience in groups (N = 443) of children (N = 120) at preschool age in child-led vs. teacher-led contexts. The results revealed that in child-led contexts children were more likely to be alone, in dyads, and in small peer groups; groups were mostly characterized by same-gender playmates who engaged in joint interactions, with few social interactions with teachers. In teacher-led contexts, on the other hand, children were more likely to be involved in small, medium and large groups; groups were mostly characterized by other-gender playmates, involved in parallel interactions, with teachers playing a more active role. The purpose of Study 2 was to describe the development of socio-emotional competence, temperamental traits and linguistic skill. It examined the role of children’s reciprocated nominations (=RNs) with peers, assessed via sociometric interview, in relation to socio-emotional competence, temperamental traits and linguistic skill. Finally, the similarity-homophily tendency was investigated. Socio-emotional competence and temperamental traits were assessed via teacher ratings, linguistic skill via test administration. Eighty-four preschool children (M age = 62.53) were recruited within 4 preschool settings. Those children were quite representative of preschool population. The results revealed that children with higher RNs showed higher social competence (tendency), social orientation, positive emotionality, motor activity and linguistic skill. They exhibited lower anxiety-withdrawal. The results also showed that children prefer playmates with similar features: social competence, anger-aggression (tendency), social orientation, positive emotionality, inhibition to innovation, attention, motor activity (tendency) and linguistic skill. Implications for future research were suggested.

Money is not enough: exploring the impact of social and cultural resources on youth health

Findings on socioeconomic health differentials in youth remain fragmented with the role of cumulative and interaction effects of different forms of health resources not well understood.