Toothache and social and economic conditions among adolescents in Northeastern Brazil

O objetivo deste estudo foi relacionar dor de dente com condição socioeconômica, acesso aos serviços de saúde bucal e estilo de vida em adolescentes do município de Sobral, Ceará, desenvolvido com delineamento transversal analítico, com amostra composta por 688 indivíduos. A prevalência de dor de dente no grupo pesquisado foi de 31,8%. Para avaliar a relação entre as variáveis independentes e a dor de dente, realizou-se teste de associação pelo qui-quadrado, estimando-se a razão de prevalências por meio da regressão de Poisson. Os fatores que mais demonstraram relação com a dor de dente foram severidade da cárie, motivo do atendimento odontológico relacionado com urgência, frequência ao dentista e recebimento de escova na escola. Observou-se que a alta prevalência de dor de dente em adolescentes está diretamente relacionada às condições de acesso, assim como às características das ações desenvolvidas pelos serviços de saúde. Assim como há necessidade da implantação de serviços vinculados à promoção de saúde, pautados pela equidade e integralidade, é necessária a implantação de serviços de urgência que não simplesmente intervenham na dor de forma mutiladora, mas a encarem como mecanismo de estímulo ao desenvolvimento de procedimentos de prevenção das doenças bucais.

Práticas pedagógicas e inclusão escolar: o processo de ensino-aprendizagem de alunas com deficiência intelectual

This research aimed to know and analyze the pedagogical practices that have been developed in the teaching and learning of students with Intellectual Disability (DI), enrolled at common class of elementary school I. The study was conducted in a public school at Natal/RN, involving two students with DI, a multipurpose teacher, a teaching assistant, a teacher of arts and educational coordinator. As for methodological choice, we chose to develop a qualitative study, undertaking a case study. As tools for the construction of the data we use: semi-structured interviews, participant observation, field diary and document analysis. Data analysis reveals that the institution in which the research was undertaken gradually implementing changes in order to develop an inclusive practice, consistent with its assumptions. Regarding the practices developed in the teaching and learning of students with intellectual disabilities, it was possible to realize the fulfillment of certain adjustments in relation to the objectives, activities and some content, involving the use of resources and varied strategies. With regard to educational activities, we found that these had different levels of complexity, covering both basic goals as more complex objectives. From the observations, we realize that the Assistant Professor of mediations during varied activities as challenging tool in intellectual processes. We note, too, a dynamic classroom in which disabled students were under the guidance of Assistant Professor, and other students with all-round teacher who had a fairly traditional teaching methodology. It created thus an isolation situation, since there was no proposition practices to be developed with all students, and interaction among classmates, generally quite restricted. Although were highlighted developments in the social and academic learning of the surveyed students, the teachers said they did not feel prepared to work freight inclusion. The study reveals the need for teachers reviewing some actions undertaken, in order to develop more democratic pedagogical practices of education, stimulating the interactions between students, by proposing challenging activities that promote the formation and concepts. In addition, it points to the need of the education system invest and encourage the qualification of teachers with regard to education in an inclusive perspective, through actions that promote lifelong learning. It needs to be developed on the teacher a reflective attitude, resulting in a view that due diligence must be entered in practice inherent in teaching in order to use to enhance their educational experience.

Práticas pedagógicas e inclusão escolar: o processo de ensino-aprendizagem de alunas com deficiência intelectual

This research aimed to know and analyze the pedagogical practices that have been developed in the teaching and learning of students with Intellectual Disability (DI), enrolled at common class of elementary school I. The study was conducted in a public school at Natal/RN, involving two students with DI, a multipurpose teacher, a teaching assistant, a teacher of arts and educational coordinator. As for methodological choice, we chose to develop a qualitative study, undertaking a case study. As tools for the construction of the data we use: semi-structured interviews, participant observation, field diary and document analysis. Data analysis reveals that the institution in which the research was undertaken gradually implementing changes in order to develop an inclusive practice, consistent with its assumptions. Regarding the practices developed in the teaching and learning of students with intellectual disabilities, it was possible to realize the fulfillment of certain adjustments in relation to the objectives, activities and some content, involving the use of resources and varied strategies. With regard to educational activities, we found that these had different levels of complexity, covering both basic goals as more complex objectives. From the observations, we realize that the Assistant Professor of mediations during varied activities as challenging tool in intellectual processes. We note, too, a dynamic classroom in which disabled students were under the guidance of Assistant Professor, and other students with all-round teacher who had a fairly traditional teaching methodology. It created thus an isolation situation, since there was no proposition practices to be developed with all students, and interaction among classmates, generally quite restricted. Although were highlighted developments in the social and academic learning of the surveyed students, the teachers said they did not feel prepared to work freight inclusion. The study reveals the need for teachers reviewing some actions undertaken, in order to develop more democratic pedagogical practices of education, stimulating the interactions between students, by proposing challenging activities that promote the formation and concepts. In addition, it points to the need of the education system invest and encourage the qualification of teachers with regard to education in an inclusive perspective, through actions that promote lifelong learning. It needs to be developed on the teacher a reflective attitude, resulting in a view that due diligence must be entered in practice inherent in teaching in order to use to enhance their educational experience.

L'évaluation des allégations d’agression sexuelle chez les enfants

Rapport de stage présenté à la Faculté des sciences de criminologie en vue de l'obtention du grade de Maître ès sciences (M.Sc.) en sciences en criminologie option cheminement avec stage en intervention

L’évaluation des allégations d’agression sexuelle chez les enfants

Rapport de stage présenté à la Faculté des sciences de criminologie en vue de l'obtention du grade de Maître ès sciences (M.Sc.) en sciences en criminologie option cheminement avec stage en intervention

Examining Cognitive Processing in Children with an Arithmetic Disability

Currently there is no consensus as to the specific cognitive impairments that characterize mathematical disabilities (MD) or specific subtypes such as an arithmetic disability (AD). The present study sought to address this concern by examining cognitive processes that might undergird AD in children. The present study utilized archival data to conduct two investigations. The first investigation examined the executive functioning and working memory of children with AD. An age-matched achievement-matched design was employed to explore whether children with AD exhibit developmental lags or deficits in these cognitive domains. While children with AD did not exhibit impairments in verbal working memory or colour word inhibition, they did demonstrate impairments in shifting attention, visual-spatial working memory, and quantity inhibition. As children with AD did not perform more poorly than their younger achievement-matched peers on any of these tasks, impairments in specific areas of executive functioning and working memory appeared to reflect a developmental lag rather than a cognitive deficit. The second study examined the phonological processing performance of children with AD compared to children with comorbid disabilities in arithmetic and word recognition (AD/WRD) and to typically achieving (TA) children. Results indicated that, while children with AD did demonstrate impairments on all isolated naming speed tasks, trail making digits, and memory for digits, they did not demonstrate impairments on measures of phonological awareness, nonword repetition, serial processing speed, or serial naming speed. In contrast, children with AD/WRD demonstrated impairments on measures of phonological awareness, phonological short-term memory, isolated naming speed, serial processing speed, and the alphabet a-z task. Overall, results suggested that phonological processing impairments are more prominent in children with a WRD than children with an AD. Together, these studies further our understanding of the nature of the cognitive processes that underlie AD by focusing upon rarely used methods (i.e., age-matched achievement-matched design) and under-examined cognitive domains (i.e., phonological processing).

The differential impact of oxytocin receptor (OXTR) genotypes on the risk of autism spectrum disorder (ASD) and resulting social communication deficits

Background: Autism spectrum disorder (ASD) is multifactorial and is likely the result of complex interactions between multiple environmental and genetic factors. Recently, it has been suggested that each symptom cluster of the disorder, such as poor social communication, may be mediated by different genetic influences. Genes in the oxytocin pathway, which mediates social behaviours in humans, have been studied with single nucleotide polymorphisms (SNPs) in the oxytocin receptor gene (OXTR) being implicated in ASD. This thesis examines the presence of different oxytocin receptor genotypes, and their associations with ASD and resulting social communication deficits. Methods: The relationship between four OXTR variants and ASD was evaluated in 607 ASD simplex (SPX) families. Cases were compared to their unaffected siblings using a conditional logistic approach. Odds ratios and associated 95 percent confidence intervals were obtained. A second sample of 235 individuals with a diagnosis of ASD was examined to evaluate whether these four OXTR variants were associated with social communication scores on the Autism Diagnostic Interview – Revised (ADI-R). Parameter estimates and associated 95 percent confidence intervals were generated using a linear regression approach. Multiple testing issues were addressed using false discovery adjustments. Results: The rs53576 AG genotype was significantly associated with a lower risk of ASD (OR = 0.707, 95% CI: 0.512-0.975). A single genotype (AG) provided by the rs2254298 marker was found to be significantly associated with higher social communication scores (Parameter estimate = 1.833, SE = 0.762, p = 0.0171). This association was also seen in a Caucasian only and mothers as the respondent samples. No association was significant following false discovery rate adjustments. Conclusion: The findings from these studies provide limited support for the role of OXTR SNPs in ASD, especially in social communication skills. The clinical significance of these associations remains unknown, however, it is likely that these associations do not play a role in the severity of symptoms associated with ASD. Rather, they may be important in the appearance of social deficits due to the rs2254298 markers association with enlarged amygdalas.

Linking the ecosystem service approach to social preferences and needs in integrated coastal land use management - a planning approach

Coastal zones with their natural and societal subsystems are exposed to rapid changes and pressures on resources. Scarcity of space and impacts of climate change are prominent drivers of land use and adaptation management today. Necessary modifications to present land use management strategies and schemes influence both the structures of coastal communities and the ecosystems involved. Approaches to identify the impacts and account for (i) the linkages between social references and needs and (ii) ecosystem services in coastal zones have been largely absent. The presented method focuses on improving the inclusion of ecosystem services in planning processes and clarifies the linkages with social impacts. In this study, fourteen stakeholders in decisionmaking on land use planning in the region of Krummhörn (northwestern Germany, southern North Sea coastal region) conducted a regional participative and informal process for local planning capable to adapt to climate driven changes. It is argued that scientific and practical implications of this integrated assessment focus on multifunctional options and contribute to more sustainable practices in future land use planning. The method operationalizes the ecosystem service approach and social impact analysis and demonstrates that social demands and provision of ecosystem services are inherently connected.

Contar la crisis: materiales narrativos en la semántica social de la crisis

Basado en la evidencia proporcionada por 9 grupos de discusión, este trabajo aborda la semántica social de la crisis en el marco de la hipótesis propuesta por Janet Roitman. En consecuencia propone retratar distintas estrategias narrativas que permiten dar cuenta de la experiencia de la crisis según cuatro ejes de contraposiciones: agencia/paciencia, moralización/poder, coyuntura/cronicidad, destrucción/creación. En su parte final, propone fijar los rasgos fundamentales de los sujetos que aparecen en seno de las tramas narrativas propuestas.

Palliative Medicine:Scoping the level and extent of service provision to people with intellectual disability at end of life Poster Presentation

Background: Concerns exist about the end of life care
that people with intellectual disabilities receive. This population
are seldom referred to palliative care services and
inadequate data sets exist about their place of death.
Aim: To scope the extent of service provision to people
with intellectual disabilities at the end of life by specialist
palliative care and intellectual disability services in one
region of the United Kingdom.
Methods: As part of a larger doctoral study a regional survey
took place of a total sample (n=66) of specialist palliative
care and intellectual disability services using a postal
questionnaire containing forty items. The questionnaire
was informed by the literature and consultation with an
expert reference group. Data were analysed using SPSS to
obtain descriptive statistics.
Results: A total response rate from services of 71.2%
(n=47) was generated. Findings showed a range of experience
among services in providing end of life care to people
with intellectual disabilities in the previous five years, but
general hospitals were reported the most common place of
death. A lack of accessible information on end of life care
for people with learning disabilities was apparent. A few
services (n=14) had a policy to support this population to
make decisions about their care or had used adapted Breaking
Bad News guidelines (n=5) to meet their additional
needs. Both services recognised the value of partnership
working in assessing and meeting the holistic needs of
people with intellectual disabilities at end of life.
Conclusions: A range of experience in caring for people
with intellectual disabilities was present across services,
but more emphasis is required on adapting communication
for this population to facilitate them to participate in their
care. These findings could have international significance
given that studies in other countries have highlighted a
need to widen access to palliative care for this group of
people.

Influência do Suporte Social e dos Estilos de Coping na Percepção de Bem-estar Subjectivo em Doentes Mentais Crónicos

O objectivo do presente estudo consistiu em verificar a influência do suporte social e dos estilos de coping sobre a percepção de bem-estar subjectivo e de estados emocionais negativos numa amostra de 41 indivíduos (27 homens e 14 mulheres) portadores de doença mental crónica, com idades compreendidas entre os 18 e 61 anos. Foram, ainda, identificados os principais estilos de coping utilizados por esses indivíduos, bem como um estudo de comparação entre doentes institucionalizados e não-institucionalizados. Foram utilizados os seguintes instrumentos: Escala de Satisfação com o Suporte Social, constituída por quatro subescalas (satisfação com amizades, intimidade, satisfação com a família e actividades sociais); Questionário dos Estilos de Coping, formado igualmente por quatro subescalas (Coping Racional, Coping Emocional, Coping Evitante e Coping Distanciado/Desligado); Escala de Satisfação com a Vida e, por último, a Escala de Depressão, Ansiedade e Stress. Os resultados demonstram que o valor global de suporte social e as suas dimensões “satisfação com amizades”, “intimidade”, “satisfação com a família” e “actividades sociais” se correlacionam positivamente, a nível estatisticamente significativo com o bem-estar subjectivo. Relativamente ao estilo de coping racional, verifica-se que este se relaciona negativamente com a sintomatologia depressiva, ao contrário do coping emocional que apresenta uma correlação positiva com os estados emocionais negativos (depressão, ansiedade e stress) e uma relação inversa com o bem-estar. Os doentes institucionalizados, comparativamente aos não-institucionalizados, apresentam o uso mais frequente de coping desadaptativo (emocional) e níveis mais elevados de ansiedade. O suporte social, os estilos de coping e a percepção de bem-estar subjectivo demonstram estar associados de modo teoricamente esperado, mostrando a importância dos factores psicossociais na adaptação à doença mental crónica. / The aims of this study was to verify the influence of social support and coping styles on the perception of subjective well-being and negative emotional states in a sample of 41 subjects (27 men and 14 woman) with chronic mental illness (aged between 18 and 61 years). We also identified the main coping styles used by these subjects, as well as a comparative study of institutionalized patients and non-institutionalized. Instruments used include the Satisfaction with Social Support (with four dimensions: satisfaction with friendships, intimacy, satisfaction with family and social activities); Coping Styles Questionnaire (with four coping dimensions: rational, emotional, avoidant and distance); Scale of Satisfaction with Life and, finnaly, the Scale for Depression, Anxiety and Stress. Results shows that the global social support and its dimensions “satisfaction with friendships”, “intimacy”, “satisfaction with family” and “social activities” have a statistically significant positive correlation with subjective well-being.and It appears that the rational coping styles is negatively related to depressive symptoms, unlike the emotional coping has a positive correlation with negative emotional states (depression, anxiety and stress) and an inverse relationship with well-being. The institutionalized patients, compared to non-institutionalized, have more frequent use of maladaptative coping (emotional) and higher levels of anxiety. Social support, coping styles and perception of subjective well-being are associated according to the theoretical models, showing the role of psychosocial factors in adaptation to chronic mental illness.

A Institucionalização no Feminino: que repercussões na reintegração: trajectórias de vida e dimensão dos factores de (des) protecção

A presente dissertação – A Institucionalização no Feminino: que repercussões na Reintegração (Trajectórias de vida e dimensão dos factores de (des) protecção na transmissão intergeracional das jovens que saíram da CIJE de Castelo Branco no período de 1995-2000) – foi realizada no âmbito do VI Curso de Mestrado em Serviço Social. O objecto desta dissertação centrou-se na análise das trajectórias de vida de mulheres adultas que durante a sua infância estiveram internadas na Instituição Casa de Infância e Juventude de Castelo Branco e cuja desinstitucionalização ocorreu no período de 1995 a 2000, considerando como critério a residência das jovens no Distrito de Castelo Branco. Para a prossecução desta investigação, adoptou-se uma metodologia qualitativa. Recorreu-se à análise documental e a entrevistas semi-directivas efectuadas a nove jovens. Com esta investigação pretendeu-se estudar as trajectórias para a obtenção de dados sobre a experiência de vida, o seu processo de autonomização e de que forma a medida de institucionalização se reproduziu nos descendentes, e se estes constam igualmente das crianças e jovens com medida de protecção, nomeadamente de acolhimento institucional. Relativamente aos objectivos, pretendemos: analisar o percurso de vida das jovens com medida de acolhimento institucional; identificar a avaliação das jovens sobre o seu processo de internamento e a experiência de vida; identificar a forma como estas jovens se relacionam com a percepção do conceito formal da lei de “Perigo”; analisar a autonomia de vida face à família, à inserção profissional e eventual ligação face aos sistemas de protecção social; e analisar a situação e as expectativas face às jovens sem filhos. Dos resultados obtidos na presente investigação, podemos concluir que, após a medida de internamento, a maioria das jovens integrou a família de origem. Algumas valorizam este regresso, ressalvando as dificuldades de adaptação à sua família, e à própria comunidade. A maioria das jovens constituíram agregado próprio, revelando capacidades parentais na educação dos seus filhos, e proporcionando-lhes uma infância segura e feliz, assegurando de forma responsável as suas necessidades tendo em vista a sua segurança, saúde, formação, educação e desenvolvimento.

Social Theory and Nursing

Despite noteworthy exceptions, nursing’s literature largely disregards the ways in which social and sociological theory permeates, guides and shapes research, education, and practice. Likewise, social theory’s ability to position nursing within wider structures of healthcare and educational provision is similarly and puzzlingly downplayed. The questions nurses ask and the problems they face cannot however, adequately be addressed without engaging with social and sociological theory and, to progress this engagement, contributors to this book explore how social theories are used by and might apply to nursing and nursing practice. This work brings together leading international nursing and non-nursing scholars to stimulate thought and debate around a fascinating and enduring topic.

Rede Social Pessoal de Jovens Acolhidos em Lares de Infância e Juventude

A rede social dos sujeitos tem sido considerada fundamental para lidar com a adversidade. O objetivo central deste estudo foi caracterizar as redes sociais pessoais de jovens em regime de acolhimento institucional prolongado, na perspetiva dos próprios e dos técnicos das instituições e perceber se estas relacionam com o projeto de vida. Participaram 84 jovens, com idades compreendidas entre os 12 e os 20 anos de idade, acolhidos em 6 lares de infância e juventude do distrito de Santarém. Os participantes são na sua maioria do sexo feminino, com uma idade média de 15 anos. Para avaliação das variáveis em estudo utilizou-se a versão revista sumária do Instrumento de Avaliação de Redes Sociais Pessoais (IARSP-RS) e um questionário de autorresposta de caracterização da instituição de acolhimento. Os resultados desta investigação permitiram verificar que as redes dos jovens em situação de acolhimento institucional são fragmentadas, constituídas, em média, por 12 elementos e predominantemente compostas por familiares, amigos e profissionais das instituições, destacando-se as relações familiares. O nível de apoio social percebido é elevado na função emocional e informativa. Verificou-se uma maior reciprocidade do apoio por parte das jovens do sexo feminino, a institucionalização pode potenciar a expansão da rede social de suporte e a frequência de contactos associa-se à distância geográfica. A satisfação dos jovens com o suporte social é elevada. Metade dos jovens perspetivam a saída da instituição pela via da autonomização. A perceção dos profissionais das redes de suporte social é mais limitada, no tamanho, reciprocidade, satisfação com o suporte social e nas relações estabelecidas com a família, amigos da comunidade envolvente e relações de trabalho/estudo. Por outro lado, os técnicos identificam um nível mais elevado de densidade e de vínculos com os técnicos e educadores da instituição. Não se verificaram diferenças significativas nas características da rede social em função do projeto de vida, porém perceberam-se diferenças no projeto de vida em função da idade e da duração do acolhimento. A rede social apresenta um potencial protetor que vale a pena conhecer, fomentar e valorizar, destacando-se que é importante conhecer a perspetiva do próprio sujeito, já que esta tem um carácter muito pessoal. / The social network has been considered fundamental to deal with the adversities. The main objective of this study was to characterize the social network of the youngesters in prolonged institutional care, from the perspective of themselves and professionals of the institutions and to observe if their social network fits with their life project. 84 youngsters with ages between 12 and 20 years old living in 6 institutions of childhood and juvenile care from de district of Santarém participated in this study. The participants are mainly female, with an average age of 15 years old. To evaluate the variables in study, it was applied a version of the summary review of the Instrument of Evaluation of Personal Social Networks (IARSP-RS) and a survey of self-response to characterize the institutional care. The results of this investigation allowed to conclude that the social network of youngsters in a situation of institutional care are fragmented, composed by an average of 12 elements and primarily composed by family members, friends and professionals, but the most significant were the family relationships. It was observed that social support is high in terms of emotional and informative functions. It was observed an higher mutual support from the young ladies, institutionalization may foster the expansion of the social support network and that the frequency of connections is related with geographic distance. The satisfaction of the youngsters with social support is high. Half of the youngsters previews getting out of the institution by becoming autonomous. The understanding of the professionals of the social support network is more limited, about size, mutuality, satisfaction with the social support, family, friends of involving community and relationship of work/study. On the other side, the professionals identify an higher level of density and bonds with the technicals and educators of the institutions. Significative differences in the characteristics social network in terms of the life project weren’t found, however there were diferences in the life project in terms of the age and the duration of institutionalization. The social network has a protector potential that is worth of studying, promote and valorize, highlighting that it is important to know the perspective of the individual, because of its personal nature.

Una experiencia de investigación inclusiva. Personas con discapacidad intelectual como asesoras en una investigación sobre transición a la edad adulta

A pesar del creciente reconocimiento de la inclusión social de las personas con discapacidad, su participación en las investigaciones sobre temas que las preocupan aún es un tema pendiente. El objetivo de este artículo es presentar una investigación desarrollada de forma inclusiva a través de la participación de personas con discapacidad intelectual en un Comité Asesor. Se contextualizan los planteamientos de la Investigación Inclusiva, para presentar seguidamente el proceso llevado a cabo para la constitución, puesta en marcha y desarrollo del Consejo Asesor que participa en una investigación sobre transición a la vida adulta. A partir de esta experiencia, se aportan diversas reflexiones sobre las aportaciones de la incorporación de las personas con discapacidad en la investigación y se valora la necesidad de su inclusión para mejorar las investigaciones sobre discapacidad. Con este trabajo se pretende contribuir a difundir información sobre las acciones a emprender para facilitar la participación de las personas con discapacidad intelectual en los procesos de investigación sobre temas que las afectan.