Food choices and practices during pregnancy of immigrant and Aboriginal women in Canada: a study protocol

Abstract Background Facilitating the provision of appropriate health care for immigrant and Aboriginal populations in Canada is critical for maximizing health potential and well-being. Numerous reports describe heightened risks of poor maternal and birth outcomes for immigrant and Aboriginal women. Many of these outcomes may relate to food consumption/practices and thus may be obviated through provision of resources which suit the women's ethnocultural preferences. This project aims to understand ethnocultural food and health practices of Aboriginal and immigrant women, and how these intersect with respect to the legacy of Aboriginal colonialism and to the social contexts of cultural adaptation and adjustment of immigrants. The findings will inform the development of visual tools for health promotion by practitioners. Methods/Design This four-phase study employs a case study design allowing for multiple means of data collection and different units of analysis. Phase 1 consists of a scoping review of the literature. Phases 2 and 3 incorporate pictorial representations of food choices (photovoice in Phase 2) with semi-structured photo-elicited interviews (in Phase 3). The findings from Phases 1-3 and consultations with key stakeholders will generate key understandings for Phase 4, the production of culturally appropriate visual tools. For the scoping review, an emerging methodological framework will be utilized in addition to systematic review guidelines. A research librarian will assist with the search strategy and retrieval of literature. For Phases 2 and 3, recruitment of 20-24 women will be facilitated by team member affiliations at perinatal clinics in one of the city's most diverse neighbourhoods. The interviews will reveal culturally normative practices surrounding maternal food choices and consumption, including how women negotiate these practices within their own worldview and experiences. A structured and comprehensive integrated knowledge translation plan has been formulated. Discussion The findings of this study will provide practitioners with an understanding of the cultural differences that affect women's dietary choices during maternity. We expect that the developed resources will be of immediate use within the women's units and will enhance counseling efforts. Wide dissemination of outputs may have a greater long term impact in the primary and secondary prevention of these high risk conditions.

Cross-cultural adaptation and psychometric properties of the Brazilian version of the scale of oral health outcomes for 5-year-old children (SOHO-5)

Abstract Background Most of the instruments available to measure the oral health-related quality of life (OHRQoL) in paediatric populations focus on older children, whereas parental reports are used for very young children. The scale of oral health outcomes for 5-year-old children (SOHO-5) assesses the OHRQoL of very young children through self-reports and parental proxy reports. We aimed to cross-culturally adapt the SOHO-5 to the Brazilian Portuguese language and to assess its reliability and validity. Findings We tested the quality of the cross-cultural adaptation in 2 pilot studies with 40 children aged 5���6���years and their parents. The measurement was tested for reliability and validity on 193 children that attended the paediatric dental screening program at the University of S��o Paulo. The children were also clinically examined for dental caries. The internal consistency was demonstrated by a Cronbach's alpha coefficient of 0.90 for the children���s self-reports and 0.77 for the parental proxy reports. The test-retest reliability results, which were based on repeated administrations on 159 children, were excellent; the intraclass correlation coefficient was 0.98 for parental and 0.92 for child reports. In general, the construct validity was satisfactory and demonstrated consistent and strong associations between the SOHO-5 and different subjective global ratings of oral health, perceived dental treatment need and overall well-being in both the parental and children���s versions (p���<���0.001). The SOHO-5 was also able to clearly discriminate between children with and without a history of dental caries (mean scores: 5.8 and 1.1, respectively; p���<���0.001). Conclusion The present study demonstrated that the SOHO-5 exhibits satisfactory psychometric properties and is applicable to 5- to 6-year-old children in Brazil.

Impact of traumatic dental injuries and malocclusions on quality of life of young children

Abstract Background The presence of traumatic dental injuries and malocclusions can have a negative impact on quality of life of young children and their parents, affecting their oral health and well-being. The aim of this study was to assess the impact of traumatic dental injuries and anterior malocclusion traits on the Oral Health-Related Quality of Life (OHRQoL) of children between 2 and 5 years-old. Methods Parents of 260 children answered the six domains of the Early Childhood Oral Health Impact Scale (ECOHIS) on their perception of the OHRQoL (outcome). Two calibrated dentists assessed the types of traumatic dental injuries (Kappa = 0.9) and the presence of anterior malocclusion traits (Kappa = 1.0). OHRQoL was measured using the ECOHIS. Poisson regression was used to associate the type of traumatic dental injury and the presence of anterior malocclusion traits to the outcome. Results The presence of anterior malocclusion traits did not show a negative impact on the overall OHRQoL mean or in each domain. Only complicated traumatic dental injuries showed a negative impact on the symptoms (p = 0.005), psychological (p = 0.029), self image/social interaction (p = 0.004) and family function (p = 0.018) domains and on the overall OHRQoL mean score (p = 0.002). The presence of complicated traumatic dental injuries showed an increased negative impact on the children's quality of life (RR = 1.89; 95% CI = 1.36, 2.63; p < 0.001). Conclusions Complicated traumatic dental injuries have a negative impact on the OHRQoL of preschool children and their parents, but anterior malocclusion traits do not.

Comparison of child self-reports and parent proxy-reports on quality of life of children with attention deficit hyperactivity disorder

Abstract Background Attention deficit hyperactivity disorder (ADHD) is a neurobiological condition that affects 3%���7% of the pediatric population and significantly compromises the quality of life (QoL) of these individuals. The aim of the current study was to compare child self-reports and parent proxy reports on the QoL of children with ADHD. Methods Forty-five children with ADHD, combined type, aged 8���12��years without comorbidities, were compared with 43 typically developing children. PedsQL��� 4.0 (Pediatric QoL Inventory���) Generic Core Scales (physical, emotional, social, and school functioning) were completed by families and children self-reporting their health-related QoL. Results Children with ADHD reported themselves significantly lowered their PedsQL��� scores on all dimensions in comparison to typically developing children. Statistically significant differences were observed in social functioning (p���=���0.010), school functioning (p <0.001), psychosocial health (p <0.001), and total score (p���=���0.002). The physical functioning and emotional functioning dimensions did not differ significantly between groups, with p���=���0.841 and p���=���0.070, respectively. Parents of children with ADHD also reported lower PedsQL��� scores, with statistically significant differences in all dimensions. The relationship between child self-reports and parent proxy reports indicated that there is greater agreement among children with ADHD, except for the school functioning. Conclusions This suggests that children with the disorder and their parents have a perception of the functional limitations the disorder brings. It is therefore important to undertake studies to verify the QoL in children with ADHD that aim to provide and measure the scope of the well-being of these children.

Rapporti fra fattori ambientali e proteine di parete in Bifidobacterium

The normal gut microbiota has several important functions in host physiology and metabolism, and plays a key role in health and disease. Bifidobacteria, which are indigenous components of gastrointestinal microbiota, may play an important role in maintaining the well-being of the host although its precise function is very difficult to study. Its physiological and biochemical activities are controlled by many factors, particularly diet and environment. Adherence and colonization capacity are considered as contributing factors for immune modulation, pathogen exclusion, and enhanced contact with the mucosa. In this way, bifidobacteria would fortify the microbiota that forms an integral part of the mucosal barrier and colonization resistance against pathogens. Bifidobacteria are not only subjected to stressful conditions in industrial processes, but also in nature, where the ability to respond quickly to stress is essential for survival. Bifidobacteria, like other microorganisms, have evolved sensing systems for/and defences against stress that allow them to withstand harsh conditions and sudden environmental changes. Bacterial stress responses rely on the coordinated expression of genes that alter various cellular processes and structures (e.g. DNA metabolism, housekeeping genes, cell-wall proteins, membrane composition) and act in concert to improve bacterial stress tolerance. The integration of these stress responses is accomplished by regulatory networks that allow the cell to react rapidly to various and sometimes complex environmental changes. This work examined the effect of important stressful conditions, such as changing pH and osmolarity, on the biosynthesis of cell wall proteins in B. pseudolongum subsp. globosum. These environmental factors all influence heavily the expression of BIFOP (BIFidobacterial Outer Proteins) in the cell-wall and can have an impact in the interaction with host. Also evidence has been collected linking the low concentration of sugar in the culture medium with the presence or absence of extracromosomal DNA.

Tutela dei minori e recupero della genitorialit��: il caso dell'accoglienza in comunit��

La tesi di Matteo Allodi intende analizzare alcune pratiche socio-assistenziali rivolte a minori e famiglie in difficolt�� relative a progetti di accoglienza presso alcune strutture residenziali. In particolare, Matteo Allodi si sofferma su progetti di accoglienza elaborati presso alcune Comunit�� familiari la cui metodologia d���intervento si caratterizza per un orientamento verso un modello di lavoro sociale di tipo sussidiario nell���ottica del recupero dei legami e delle competenze genitoriali. La tesi affronta nella prima parte la dimensione teorica relativa a un approccio progettuale di intervento sociale che, mettendo al centro le relazioni dei soggetti in gioco, possa promuovere la loro attivazione in funzione della realizzazione dell���obiettivo del recupero della genitorialit��. Allodi si concentra dal punto di vista teorico sulle modalit�� di realizzazione di un servizio alla persona guidato dal principio di sussidiariet��, ovvero orientato alla valorizzazione delle capacit�� riflessive degli attori. Nella seconda, parte Allodi presenta l���indagine condotta in alcune Comunit�� di tipo familiare di Parma. La strategia iniziale d���indagine �� quella del case study. Allodi sceglie di indagare il fenomeno partendo da un���osservazione partecipata di orientamento etnometodologico integrata con interviste agli attori privilegiati. In questa fase si �� proceduto a una prima ricerca qualitativa, attraverso la metodologia dello studio di caso, che ha permesso di entrare in contatto con alcune tipologie di strutture residenziali per minori al fine di completare il quadro generale del fenomeno delle Comunit�� familiari e impostare una prima mappatura esplorativa. La ricerca prosegue con uno studio longitudinale prospettico volto a monitorare e valutare il lavoro di rete della comunit�� e dei servizi, osservando principalmente la mobilitazione verso l���autonomia e l���empowerment dei soggetti (minori) e delle reti ancorate al soggetto (single case study). Si �� voluto comprendere quali modalit�� relazionali gli attori della rete di coping mettono in gioco in funzione del ���cambiamento sociale���.

Inserimento eterofamigliare supportato di adulti sofferenti di disturbi psichici: Valutazione degli esiti

L���Inserimento Eterofamigliare Supportato di Adulti (IESA) sofferenti di disturbi psichici consiste nell���accogliere persone in cura presso i servizi psichiatrici territoriali, nel proprio domicilio, integrandole nelle proprie relazioni famigliari. Obiettivo �� migliorare la qualit�� di vita dell���utente e favorirne l���integrazione nella comunit��. Obiettivo. Valutare gli esiti dello IESA, con un disegno di ricerca longitudinale, considerando: psicopatologia, benessere psicologico, funzionamento sociale e familiare. Metodologia. 40 soggetti: 20 pazienti e 20 ospitanti. La valutazione clinica �� stata effettuata all���inizio della convivenza e al follow-up di 1, 3, 6 e 12 mesi. Strumenti utilizzati: BPRS, VGF, PWB, SQ, FAD. Analisi statistica: Modello Lineare Generale (GLM) con l���Analisi della Varianza per prove ripetute e calcolo dell���effect-size. Risultati. 15 pazienti maschi e 5 femmine, 17 italiani. 11 soddisfano i criteri diagnostici (DSM-IV-TR) per schizofrenia e disturbi psicotici, 5 per i disturbi dell���umore e 4 per i disturbi di personalit��. Dopo l���inserimento 3 sono stati i ricoveri e 4 le visite psichiatriche urgenti. 8 pazienti modificano/diminuiscono la terapia e 3 la sospendono. Aumenta il benessere psicologico (PWB); diminuiscono i sintomi psicopatologici (BPRS ed SQ) e migliora il funzionamento globale (VFG). Il gruppo dei famigliari composto da 11 uomini e 9 donne, 19 di nazionalit�� italiana; con et�� media di 55 anni. 8 sono coniugati, 6 celibi/nubili, 4 divorziati e 2 vedovi. 9 hanno figli, 11 lavorano e 8 sono pensionati. Nei famigliari aumenta il benessere psicologico (PWB), migliora il funzionamento famigliare (FAD) e la valutazione del funzionamento globale (VGF) rimane costante nel tempo. Discussioni e conclusioni. Il progetto IESA sembra migliorare la psicopatologia, con una diminuzione dei comportamenti maladattativi e un aumento delle capacit�� relazionali dell���ospite favorendone l���integrazione. Inoltre, lo IESA sembra diminuire i costi della cronicit�� psichiatrica: diminuzione degli accessi al Pronto Soccorso, delle visite psichiatriche urgenti e delle giornate di ricovero.

Giardini per rivivere: orticoltura e giardinaggio a fini terapeutici in contesti sanitari

Questa tesi riassume il lavoro di ricerca da me effettuato per studiare i meccanismi della relazione uomo - pianta su cui si basa l���orticoltura terapeutica, le sue modalit�� di attuazione e le risposte dei pazienti al lavoro in giardino. La ricerca si �� svolta in due diversi giardini terapeutici con pazienti adulti con varie tipologie di disabilit�� fisica o psichica. Partendo dalla analisi delle basi teoriche su cui si fonda l���ortoterapia, l���obiettivo era di capire come creare le condizioni migliori per ottenere i massimi benefici dall���uso dell���orticoltura e del giardinaggio per il benessere delle persone. Due elementi sono apparsi fondamentali per il raggiungimento degli obiettivi terapeutici: il primo �� lo stretto legame esistente tra la forma del giardino e delle piante e la sua funzione terapeutica; il secondo sta nella necessit�� di creare nel paziente una connessione profonda con il giardino e il lavoro con le piante �� risultato essere un fattore determinante per farlo. Utilizzando questionari e osservazioni degli utenti, sono stati raccolti ed elaborati dati relativi al benessere dei pazienti durante e dopo le attivit�� in giardino e si �� cercato di trovare un indice, individuato poi nella variazione di percezione del pollice verde, che potesse essere utilizzato per esprimere la soddisfazione del paziente. Infine si �� cercato di capire come potesse variare la capacit�� ristorativa del giardino, in funzione della frequenza di visita e dell���attivit�� che vi si svolgeva, attraverso la somministrazione della versione italiana della scala PRS a chi era impegnato nelle attivit�� di orticoltura e giardinaggio, a chi passeggiava nel parco e a chi invece non lo frequentava regolarmente ma lo conosceva bene: �� risultato che le tre modalit�� di fruizione del giardino davano ai fruitori un potenziale rigenerativo diverso e significativamente pi�� alto per chi metteva le mani nella terra.

Dal Bes ad Urbes: I piani di performance e di trasparenza nelle citta'

Obiettivo del lavoro �� quello di legare tra di loro due aspetti che storicamente sono sempre stati scollegati. Il primo �� il lungo dibattito sul tema ���oltre il PIL���, che prosegue ininterrottamente da circa mezzo secolo. Il secondo riguarda l���utilizzo dei sistemi di misurazione e valutazione della performance nel settore pubblico italiano. Si illustra l���evoluzione del dibattito sul PIL facendo un excursus storico del pensiero critico che si �� sviluppato nel corso di circa cinquanta anni analizzando le ragioni assunte dagli studiosi per confutare l���utilizzo del PIL quale misura universale del benessere. Cogliendo questa suggestione l���Istat, in collaborazione con il CNEL, ha avviato un progetto per individuare nuovi indicatori da affiancare al PIL, in grado di misurare il livello non solo della crescita economica, ma anche del benessere sociale e sostenibile, con l���analisi degli indicatori riferiti a 12 domini di benessere individuati. Al progetto Istat-CNEL si �� affiancato il progetto UrBES, promosso dall���Istat e dal Coordinamento dei sindaci metropolitani dell���ANCI, che hanno costituito una rete di citt�� metropolitane per sperimentare la misurazione e il confronto sulla base di indicatori di benessere urbano equo e sostenibile, facendo proprio un progetto del Comune di Bologna e di Laboratorio Urbano (Centro di documentazione, ricerca e proposta sulle citt��), che ha sottoposto a differenti target un questionario on line, i cui risultati, con riferimento alle risposte fornite alle domande aperte, sono stati elaborati attraverso l���utilizzo di Taltac, un software per l���analisi dei testi, al fine di individuare i ���profili��� dei rispondenti, associando i risultati dell���elaborazione alle variabili strutturali del questionario. Nell���ultima parte i servizi e progetti erogati dal comune di Bologna sono stati associati alle dimensioni UrBES, per valutare l���impatto delle politiche pubbliche sulla qualit�� della vita e sul benessere dei cittadini, indicando le criticit�� legate alla mancanza di dati adeguati.

Effects of acute temperature increase on performance and survival of Caribbean echinoids

Climate change is occurring at a faster rate than in the past, with an expected increase of mean sea surface temperatures up to 4.8��C by the end of this century. The actual capabilities of marine invertebrates to adapt to these rapid changes has still to be understood. Adult echinoids play a crucial role in the tropical ecosystems where they live. Despite their role, few studies about the effect of temperature increase on their viability have been reported in literature. This thesis work reports a first systematic study on several Caribbean echinoids about their tolerance to temperature rise in the context of global warming. The research - carried out at the Bocas del Toro Station of the Smithsonian Tropical Research Institute, in Panama - focalized on the 6 sea urchins Lytechinus variegatus, L. williamsi, Echinometra lucunter, E. viridis, Tripneustes ventricosus and Eucidaris tribuloides, and the 2 sand dollars Clypeaster rosaceus and C. subdepressus. Mortality and neuromuscular well-being indicators - such as righting response, covering behaviour, adhesion to the substrate, spine and tube feet movements - have been analysed in the temperature range 28-38��C. The righting time RT (i.e., the time necessary for the animal to right itself completely after inversion) measured in the 6 sea urchin species, demonstrated a clearly dependence on the water temperature. The experiments allowed to determine the ���thermal safety margin��� (TSM) of each species. Echinometra lucunter and E. viridis resulted the most tolerant species to high temperatures with a TSM of 5.5��C, while T. ventricosus was the most vulnerable with a TSM of only 3��C. The study assessed that all the species already live at temperatures close to their upper thermal limit. Their TSMs are comparable to the predicted temperature increase by 2100. In absence of acclimatization to such temperature change, these species could experience severe die-offs, with important consequences for tropical marine ecosystems.

Role Stress and Job Outcomes in Public Accounting: Have the Gender Experiences Converged?

Using data collected from professionals in a large U.S. national public accounting firm, we explored gender differences in perceived levels of role stress and job outcomes as well as the effects of a healthy lifestyle as a coping mechanism for role stress, burnout and related job outcomes. Our large sample size (1,681) and equal participation by women (49.7%) and men (50.3%) allowed us to analyze the causal relationships of these variables using a previously tested multi-disciplinary research model (Jones, Norman, & Wier, 2010). We found that women and men perceive similar levels of role stress as defined by role ambiguity and role overload, and that women perceive less role conflict. Men and women perceive similar levels of job satisfaction and job performance. Contrary to earlier studies, women do not report higher levels of turnover intentions. Results show that efforts of the public accounting firms over the past decade may be somewhat successful in reducing the levels of role stress and turnover intentions among women. Another plausible explanation could be that an expansionist theory of gender, work and family (Barnett & Hyde, 2001) may now be responsible for improved well-being of females to the point where the genders have converged in their experience of role stress and job outcomes in public accounting.

Comparative Study of Informal Health Care Networks and Elderly Health Status in Argentina and Cuba

The objective of this study is to evaluate the impact of informal care support networks on the health status, life satisfaction, happiness and anxiety of elderly individuals in Argentina and Cuba. Recent economic changes, demographic changes, the structure of families and changes in women?s labor participation have affected the availability of informal care. Additionally, the growing number of elderly as a percentage of total population has significant implications for both formal and informal care in Argentina and Cuba. Methods: The SABE - Survey on Health, Well-Being, and Aging in Latin America and the Caribbean, 2000 was used as the data source. The survey has a sample of 10,656 individuals aged 60 years and older residing in private households occupied by permanent dwellers in 7 cities in the Latin American and Caribbean region. My study will focus on the Buenos Aires and Havana samples in which there were 1043 individuals and 1905 individuals respectively. General sampling design was used to establish comparability between countries. Individuals requiring assistance are surveyed on their source of help and the relative impact of informal versus paid help is measured for this group. Other measures of social support (number of living children, companionship and number of individuals living in the same dwelling) are used to measure networks for the full sample. Multivariate probit regression analyses were run separately for Cuba and for Argentina to evaluate the marginal impacts of the types of social support on health status, life satisfaction, happiness and anxiety. Results: For Argentina, almost all of the family help variables positively impact good health. Getting help from most other members of the family negatively impacts satisfaction with life. Happiness is affected differently by each of the family help variables but community support increases the likelihood of being happy. Although none of the family or community help variables show statistical significance, most negatively affect anxiety levels. In Cuba, all of the social support variables have a positive marginal impact on the health status of the elderly. In this case, some of the family and community help variables have a negative marginal impact on life satisfaction; however, it appears that having those closest to the elderly, children, spouse, or other family, positively impacts life satisfaction. Most of the support variables negatively impact happiness. Receiving help from a child, spouse or parent is associated with a marginal increase in anxiety, whereas receiving help from a grandchild, another family member or a friend actually reduces anxiety. Discussion: The study highlights the necessity for enhancing the coordination of various care networks in order to provide adequate care and reduce the burdens of old age on the individual, family and society and the need for consistent support for the caregivers. More qualitative work should be done to identify how support is given and what comprises the support. The constant change and advancement of the world, and the growth of the Latin American and Caribbean region, suggests that more updates studies need to be done.

COMPARATIVE STUDY OF INFORMAL HEALTH CARE NETWORKS AND ELDERLY HEALTH STATUS IN ARGENTINA AND CUBA

This study will explore familial and friend support networks and living arrangements among elderly individuals in Latin America and the impact that this type of support has on the health of the elderly individuals in the countries of interest. Using data from the Survey on Health and Well-Being of Elders (SABE) from 1999-2000, I will explore which type of support has a larger impact on overall health. I will also measure differences in unmet needs for certain health services. This topic is particularly interesting because it will help to uncover what policies are best for aiding in the healthcare of the elderly in aging population. Lastly, the investigation of this topic will allow me to draw conclusions about the most effective means of social and public policy for the elderly community and provide me with information about the role of both informal provisions of support from family and friends, and formal provisions of support from the government. My primary focus will be on Argentina, using Buenos Aires as the sample city, and Cuba, using Havana as the sample city. These two countries have increasingly aging populations, poorer resources and vast inequalities, but, extremely different political, economic and cultural situations. Comparing the two countries will further allow me to determine correlations between health and the existence of support networks, as well as provide me with information to make more general claims that may be of use in the United States. Argentina is particularly interesting to me because of my abroad experience and homestay experience with an older Argentine woman who lived alone but depended upon her family for many healthcare needs, doctors��� visits and general well-being. In Argentina, I experienced a different form of living than I am used to in the United States, where many older individuals or couples live in nursing homes or assisted living facilities rather than alone or with family. The changing economic climate of the two countries coupled with labor patterns of women returning to work at rapid rates indicates that policies cannot just rely on either the formal or informal sector but require a combination of the two sectors working together.This paper will first give background on the difference in the economies and the health care systems in Argentina and Cuba and will show why it interesting to study and compare these two countries. I will then discuss the health status of the elderly in each population as well as discuss the informal care networks and the role of family in each country. This section will then be followed by a description of the data and methods used. I will end by drawing conclusions about the study and the outcomes, and then I will attempt to make suggestions about effective health care policies for the elderly.

The Resilience of Self-Esteem in Late Adulthood

OBJECTIVE: The authors examined the resilience of self-esteem after loss in the lives of older adults. Specifically, the authors investigated the relationship between loss and change in self-esteem during a 3-year period. METHOD: A subsample of older adults (n = 1,278) from the Americans' Changing Lives Study was used to examine loss in the domains of health, financial security, or work and career and self-esteem before and after the loss. RESULTS: There was a small but significant decrease in self-esteem between Wave I and Wave II of the study. Loss in one of the domains explained less than 1% of the variance in self-esteem change. DISCUSSION: The low incidence of loss and small change in high levels of self-esteem are further evidence of resilience in older adults' psychological well-being. The implications for older adults' use of cognitive strategies to manage losses and promote gains are discussed.