Comportamentos de saúde e doença numa comunidade Cabo-Verdiana em Lisboa

This study aims at analysing, through personal reports, the way individuals behave in terms of health and illness. A comparative analysis of the collected data was performed, with the purpose of highlighting divergences in the health and illness practices. The study was undertaken with a sample of 40 «first generation» Cape Verdeans living in the Metropolitan area of Lisbon, divided into distinct groups: social (popular and elite), generation (younger and older) and gender (men and women). A qualitative methodology was employed, by conducting semi-structured interviews for the collection of information. The health and illness practices were grouped into preventive and health care practices, practices used in episodes of illness, resources used for prevention and treatment, use of home remedies, and other alternative resources. Individuals who are part of our study experimented, at the level of practices, with the three health systems that existed in Cape Verde, namely, the official, popular and traditional, and recourse to religion. The discourse analysis concerning health and disease practices showed there are differences, in some respects, between social groups. There were also slight differences between genders and generations. These immigrants’ health practices are identical to those of the Portuguese who are in similar socioeconomic contexts, with no significant effects of immigration itself on these practices. The analysis of the results confirms the existence of differences between social groups concerning the health and illness practices. They were more determined by the socioeconomic factors than by the cultural and ethnic aspects. Those differences also highlighted the existence of a unifying aspect, resulting from their cultural heritage. Although belonging to different social groups, the existence of a common culture and ethnic identity originates a shared feeling of cultural belonging, but not identical behaviours and practices.

Lidar com a doença mental : a pluralidade de sistemas de cuidados e de itinerários terapêuticos : análise comparativa de dois estudos efectuados junto de duas populações residentes em Portugal

Several studies point to the plurality of care systems to deal with illness. They can be organized into professional, popular and alternative systems (the latter includes the complementary and the traditional ones). What the particular setup is in each cultural system is the core question of both the empirical studies we report. The purpose of this article is to understand how lay people deal with mental illness, examining the therapeutic itineraries that are constructed between plural care systems, featuring in particular the use of traditional medicine. The analysis of the two studies (one carried out in the north region and the other in Lisbon) allowed us to interpret these practices and discuss the social and cultural factors that determine and explain the settings that were found. Both researches fit into a qualitative methodology. In-depth, semi-structured interviews were performed and were analyzed using discourse analysis to describe and interpret data. The results point to a plurality of therapeutic itineraries, built around public and private speeches, where the explanatory systems underlying the use of official medicine and/or traditional practices found plural meanings. People may use these systems in several forms, using one or combining more than one, simultaneously or sequentially, depending on the context and on the needs they feel to face both illness and mental suffering. It is in between the space of the impotence and ‘incompetence’ of the ‘wise’ medicine that other therapeutic systems develop. It is important to understand those systems because of their achievements and their heuristic power to explain society and culture.

Análise de Dados de Desemprego em Cabo Verde

Este trabalho baseia-se na análise de dados do desemprego em Cabo Verde nos anos de 2006 e 2008, usando informação da base de dados do INE e IEFP. Partindo da análise dos dados em estudo vai-se procurar descrever e perspectivar metodologias que contemplam as variáveis qualitativas e quantitativas com significado social positivo para a sociedade deste país. Após a introdução no capítulo 1, fez-se, no capítulo 2, a análise exploratória dos dados do desemprego em Cabo Verde referente aos anos 2006 e 2008. No capítulo 3 estudam-se associações entre variáveis, usando a metodologia de tabelas contingência, através da realização de testes de independência e testes de homogeneidade, e análise de medidas de associação. As variáveis usadas, vão ser essencialmente, o escalão etário, o género e o ano. O capítulo 4 é dedicado ao estudo de modelos Log - lineares em tabela de contingência, finalizando-se o trabalho com a apresentação das principais conclusões.

Os manuais de língua portuguesa e o desenvolvimento da expressão oral no ensino secundário de Cabo Verde

Na elaboração do presente trabalho, que tem como tema “Os manuais de língua portuguesa e o desenvolvimento da expressão oral no ensino secundário de Cabo Verde”, procurou-se investigar, a partir da perspectiva dos manuais de Língua Portuguesa, até que ponto os mesmos podem servir ou não para o desenvolvimento da competência comunicativa dos alunos do ensino secundário, na modalidade de expressão oral. Para isso foi adoptada uma metodologia situada no campo da investigação educacional, sem pôr de lado os métodos da pesquisa qualitativa e quantitativa, o que permitiu abordar as questões relacionadas com as constantes situações de insucesso na aprendizagem da Língua Portuguesa, cujas causas têm sido atribuídas, quase sempre, aos factores como as metodológicas, aos problemas linguísticos, decorrentes da forte presença da língua materna no quotidiano dos aprendentes e ao uso de materiais desajustados da realidade nacional. Assim, para o cumprimento dos objectivos propostos, foi possível trabalhar sobre dois corpora; por um lado analisaram-se os manuais do ensino secundário, por outro, foi examinado o inquérito aplicado tanto aos professores como aos alunos, e cujo tratamento dos dados permitiu confirmar a aceitação entusiástica dos manuais escolares no contexto pedagógico, apesar da descrença na potencialidade dos exercícios propostos em desenvolver a capacidade de expressão oral dos alunos. Outro aspecto digno de registo foi o desejo manifestado pelos informantes em ter outros materiais capazes de melhorar o ensino do Português como língua segunda. Em termos do ensino da citada disciplina, foram apresentadas algumas sugestões para que a sua melhoria reverta a favor do sucesso de aprendizagem de todos os alunos

Comportamentos de saúde e doença numa comunidade Cabo-Verdiana em Lisboa

O objetivo foi compreender como os indivíduos se comportam em termos de saúde e o que fazem em caso de doença. Análise comparativa realçou semelhanças e divergências de práticas de saúde ou em caso de doença. O estudo foi efetuado numa amostra de 40 cabo-verdianos da primeira geração residentes na região de Lisboa, dividida em subgrupos: grupo social, geração e genero. Baseou-se em metodologia qualitativa com entrevistas semi-estruturadas. As práticas analisadas foram agrupadas em preventivas e de saúde, práticas utilizadas em episódios de doença, recursos para prevenção e tratamento, utilização de remédios caseiros e outros recursos ou terapeutas. Indivíduos experimentaram, ao nível das práticas, três sistemas de saúde que coexistiam em Cabo Verde, oficial, popular e tradicional e o recurso à religião. O discurso acerca das práticas de saúde e de doença demonstrou existirem diferenças, em alguns aspectos, entre grupos sociais e entre generos e gerações. Práticas de saúde destes imigrantes são idênticas às dos portugueses em contextos socioeconomicos semelhantes. Resultados sugerem existência de diferenças entre grupos sociais relativamente às práticas, na esfera da saúde e da doença. Mais que cultura e etnicidade, que se moldam às condições materiais de existência, neste estudo, o nível socioeconomico determinou as maiores diferenças a interferir nas práticas de saúde e doença, de grupo com cultura de base comum. Em geral, os indivíduos sobrevalorizaram sua identidade étnica e cultura de origem. Pertencimento a grupos sociais diferentes dá origem a partilha do sentimento de pertença cultural, mas não a comportamentos e práticas idênticos.

Understanding death in custody: a case for a comprehensive definition.

Prisoners sometimes die in prison, either due to natural illness, violence, suicide, or a result of imprisonment. The purpose of this study is to understand deaths in custody using qualitative methodology and to argue for a comprehensive definition of death in custody that acknowledges deaths related to the prison environment. Interviews were conducted with 33 experts, who primarily work as lawyers or forensic doctors with national and/or international organisations. Responses were coded and analysed qualitatively. Defining deaths in custody according to the place of death was deemed problematic. Experts favoured a dynamic approach emphasising the link between the detention environment and occurrence of death rather than the actual place of death. Causes of deaths and different patterns of deaths were discussed, indicating that many of these deaths are preventable. Lack of an internationally recognised standard definition of death in custody is a major concern. Key aspects such as place, time, and causes of death as well as relation to the prison environment should be debated and incorporated into the definition. Systematic identification of violence within prison institutions is critical and efforts are needed to prevent unnecessary deaths in prison and to protect vulnerable prisoners.

Exploring the implementation of a medication adherence programme by community pharmacists : a qualitative study

Background Medication adherence has been identified as an important factor for clinical success. Twenty-four Swiss community pharmacists participated in the implementation of an adherence support programme for patients with hypertension, diabetes mellitus and/or dyslipidemia. The programme combined tailored consultations with patients about medication taking (expected at an average of one intervention per month) and the delivery of each drug in an electronic monitoring system (MEMS6?). Objective To explore pharmacists' perceptions and experiences with implementation of the medication adherence programme and to clarify why only seven patients were enrolled in total. Setting Community pharmacies in French-speaking Switzerland. Method Individual in-depth interviews were audio-recorded, with 20 of the pharmacists who participated in the adherence programme. These were transcribed verbatim, coded and thematically analysed. Process quality was ensured by using an audit trail detailing the development of codes and themes; furthermore, each step in the coding and analysis was verified by a second, experienced qualitative researcher. Main outcome measure Community pharmacists' experiences and perceptions of the determining factors influencing the implementation of the adherence programme. Results Four major barriers were identified: (1) poor communication with patients resulting in insufficient promotion of the programme; (2) insufficient collaboration with physicians; (3) difficulty in integrating the programme into pharmacy organisation; and (4) insufficient pharmacist motivation. This was related to the remuneration perceived as insufficient and to the absence of clear strategic thinking about the pharmacist position in the health care system. One major facilitator of the programme's implementation was pre-existing collaboration with physicians. Conclusion A wide range of barriers was identified. The implementation of medication adherence programmes in Swiss community pharmacies would benefit from an extended training aimed at developing communication and change management skills. Individualised onsite support addressing relevant barriers would also be necessary throughout the implementation process.

Long term global evaluation of a national AIDS prevention strategy: the case of Switzerland.

OBJECTIVES: The Swiss Aids prevention strategy has been subject to a continuous process of evaluation for the past 12 years. This paper describes the conceptual approach, methodology, results obtained and contribution to policy-making of that evaluation.¦DESIGN: The evaluation is on-going, global with respect to all components of the strategy, and utilization-focused. Each successive phase of the evaluation has included 10-20 studies centred either on aspects of process, of outcome or of environmental context. Findings are synthesized at the end of each phase. METHODS: Both quantitative and qualitative methods are used. Studies generally have one of three functions within the overall evaluation: assessment of trends through surveys or other types of repeated studies; evaluation of specific areas through a series of studies from different viewpoints; in-depth investigation or rapid assessment through one-off studies. Various methods of triangulation are used to validate findings. RESULTS: The evaluation has allowed for: the observation of behavioural change in different populations; the availability of scientific data in controversial fields such as drug-use policy; an understanding of the diversity of public appropriation of prevention messages. Recommendations are regularly formulated and have been used by policy-makers and field workers for strategy development. CONCLUSIONS: The global approach adopted corresponds well to the evaluation requirements of an integrated long-term prevention strategy. Cost is low relative to the extent of information provided. Such an evaluation cannot however address the question of causal relationship between the strategy and observed changes. The evaluation has contributed to the development of a culture of evaluation in Swiss AIDS prevention more generally.

Mastectomy, body deconstruction, and impact on identity: a qualitative study.

Objectives This qualitative study aims at understanding the consequences of body deconstruction through mastectomy on corporality and identity in women with breast cancer. Design Nineteen women were contacted through the hospital. All had to undergo mastectomy. Some were offered immediate breast reconstruction, others, because of cancer treatments, had no planned reconstruction. A qualitative reflexive methodological background was chosen. Method Women were invited to participate in three semi-structured interviews, one shortly before or after mastectomy, and the other interviews later in their illness courses, after surgery. All interviews were transcribed verbatim. Thematic analysis was performed. The analysis of the first interview of each woman is presented in this article. Results Mastectomy provokes a painful experience of body deconstruction. Even when immediate reconstruction is proposed, contrasted feelings and dissonance are expressed when comparing the former healthy body to the present challenged body entity. Body transformations are accompanied with experiences of mutilation, strangeness, and modify the physical, emotional social, symbolic and relational dimensions of the woman's gendered identity. Although the opportunity of breast reconstruction is seen as a possible recovery of a lost physical symmetry and body integrity, grieving the past body and integrating a new corporality leads to a painful identity crisis. Conclusion With mastectomy, the roots of the woman's identity are challenged, leading to a re-evaluation of her existential values. The consequences of mastectomy transform the woman's corporality and embodiment, and question her identity. Psychological support is discussed in the perspective of our results.

Use of NIR spectroscopy and multivariate process spectra calibration methodology for pharmaceutical solid samples analysis

Accomplish high quality of final products in pharmaceutical industry is a challenge that requires the control and supervision of all the manufacturing steps. This request created the necessity of developing fast and accurate analytical methods. Near infrared spectroscopy together with chemometrics, fulfill this growing demand. The high speed providing relevant information and the versatility of its application to different types of samples lead these combined techniques as one of the most appropriated. This study is focused on the development of a calibration model able to determine amounts of API from industrial granulates using NIR, chemometrics and process spectra methodology.

When nightclub security agents assault clients more insight through a qualitative approach.

Between 2007 and 2009, aggressions by security agents of nightclubs on clients increased from 6% to 10% among community violence situations encountered at the Violence Medical Unit (VMU) at the Lausanne University Hospital in Switzerland. Most victims were young men who had been drinking alcohol before the assault. About one quarter (25.7%) presented with one or several fractures, all of them in the head area. (For more details, refer to the previous article "When nightclub security agents assault clients" published in 2012(1).) Following this first study, we performed a second qualitative study in order to bring more information about the context and highlight victims' behaviors and experiences. Four themes emerged: how the assault began; the assault itself; third-party involvement; and the psychological state of victims when they consulted the VMU. The findings of this second study complemented the statistical results of the first study by showing under what circumstances security agents of nightclubs respond with physical violence to situations they consider a threat to security. Furthermore, the study described consequences for the victims that could be quite serious. Our findings support the need for nightclubs to improve selection and training of security staff.

Processus et fonctions psychiques de l'écriture : de la création littéraire au groupe à médiation

Ce travail porte sur l'étude des processus et fonctions psychiques de la création littéraire et de l'écriture dans une perspective psychanalytique, à partir d'une méthodologie de recherche qualitative exploratoire. Un premier volet de la recherche s'attache à étudier les processus et fonctions psychiques dans la création littéraire à partir de six entretiens semi-structurés avec des écrivains romands publiés. Les entretiens sont analysés en profondeur à partir de la méthodologie qualitative Interpretative Phenomenological Analysis (Smith, Flowers & Larkin, 2009). Un second volet de la recherche étudie les processus et fonctions psychiques de l'écriture dans un atelier de groupe à médiation écriture prenant place dans un Centre de Jour pour adultes, à partir de l'élaboration de deux cas. L'articulation des analyses de ces expériences d'écriture dans les deux contextes étudiés permet de mettre en évidence des enjeux de continuité/discontinuité dans le passage du premier mouvement créateur de l'écriture - le « miroir-papier » - vers le mouvement de la publication/lecture - le « miroir-lecteur ». Ces enjeux de partage invitent à penser le travail créateur de l'écriture à partir de la notion de « Moi- peau » (Anzieu, 1995) et à préciser cinq fonctions psychiques de l'écriture : transformation ; protection ; échange ; réassurance narcissique ; partage. Un accent particulier est porté sur la fonction de protection, dans la tension qu'elle entretient avec celle de transformation, au travers de la mise en évidence de six formes d'enveloppes d'écriture protectrice. Finalement, les analyses mettent en évidence la manière dont cette tension entre un investissement défensif de l'écriture et un investissement de transformation se déploie par des voies singulières en vue d'une tentative de résolution du conflit subjectif interne entre les exigences du « public intérieur » (De M'Uzan, 1964) et la rencontre avec l'objet réel. Ces pistes d'analyses permettent de préciser les modalités de contribution de l'écriture aux processus de symbolisation et d'enrichir la pratique du champ des médiations thérapeutiques de repères d'appréciation clinique. - Based on an exploratory qualitative research methodology, this work focuses on the psychical processes and functions of literary creation and writing from a psychoanalytic perspective. The first part of the research investigates psychical processes and functions in creative writing through the analysis of six semi-structured interviews with published Swiss writers. The interviews are analyzed according to the exploratory qualitative methodology Interpretative Phenomenological Analysis (Smith, Flowers & Larkin, 2009). The second area of research examines the processes of writing in the context of an art-therapy writing group that took place in an adult day center. The observations lead to the elaboration of two case studies. The joint analysis of these writing experiences highlights issues of continuity/discontinuity in passing from the first creative writing movement - the « mirror-paper » - to the final publication/reading of the work - the «mirror-reader». These issues enable us to understand the creative writing processes from the concept of the « skin-ego » (Anzieu, 1995). Five functions of writing are proposed: transformation, protection, exchange, narcissistic reassurance, and sharing. An emphasis on the tension between the protection and the transformation functions is highlighted through the identification of six forms of protective writing psychical envelopes. Finally, the analysis shows how this tension between a defensive and a transformative investment in writing takes place in an attempt to resolve the internal conflict between the « inner audience » (De M'Uzan, 1964) and the encounter with the real object. This study clarifies the way creative writing can contribute to symbolization and can enrich clinical assessment in the field of art-therapy.

Existential values transformation in all organ transplantation : a qualitative prospective study

The aim of this qualitative study was to analyze psychological concerns in wait-listed patients T1 and six months after transplantation T2. Semi-structured interviews were conducted and qualitative analysis performed. T1 Kidney patients maintained apparent normality, building emotional protection, and a fatalist attitude. Liver patients set physical limits, reevaluation of life values was reported. Lung patients developed physical and psychological self-protection. Modified life values, fatalism and spirituality were mentioned. Heart patients husbanded ressources and self-protection. Modified life values, fatalist attitude were reported. T2 Kidney patients described new life perspectives and increase of empathy. Liver patients underlined positive identity and life values modifications. Lack of respect of life values generated anger. Heart and lung patients set their existential priorities and underlined increase in spirituality, greater openness and more closeness to significant ones. Lack of respect of human values induced negative feelings. TX comes with physical benefits, but also with positive existential values transformations and a humanistic, altruistic attitude.

Estratègies de cura i presa de decisions en persones grans amb dependència ingressades en una unitat geriàtrica d'atenció intermèdia : estudi descriptiu

Aquest estudi té com objectiu observar les relacions entre les estratègies de cura (formal, informal, mixta) que fan servir els cuidadors de persones grans dependents, la seva situació social i les seves motivacions per la decisió respecte a com fan la cura. L’estat del tema destaca el predomini de les cures informals sobre les formals en els models de benestar mediterranis i la rellevància de la interacció entre factors personals socioculturals i les polítiques socials en la presa de decisions individuals sobre la cura de la dependència. La llei de la dependència, de recent implementació a l’Estat espanyol, ha universalitzat l’accés als recursos formals, creant un nou paradigma d’interacció cuidadors-recursos. Es tracta d’un estudi observacional, transversal, descriptiu de tipus mixt quantitatiu/qualitatiu realitzat a partir d’entrevistes individuals als cuidadors de dependents ingressats en una unitat geriàtrica d’atenció intermèdia. Es recullen dades sobre el context sociofamiliar, l’estratègia de cura, l’autopercepció i les motivacions. Els resultats mostren que els cuidadors combinen prestacions econòmiques i serveis (públics i privats) per adaptar al màxim l’estratègia a les condicions del dependent i a les seves pròpies. Tenen la convicció generalitzada que l’atenció cal fer-la al domicili per motius de reciprocitat i respecte a la persona cuidada. El pas a l’atenció residencial és una decisió molt difícil pels cuidadors. La implantació de la llei de la dependència ha normalitzat la relació entre cuidadors i recursos formals, però la burocratització i la insuficiència de l’oferta de serveis no afavoreixen canvis substancials en la provisió de l’ajut, que continua essent majoritàriament informal. La millora en la percepció de continuïtat d’atenció entre el domicili i la residència, i també en la gestió i l’oferta de serveis formals públics es presenten com a reptes de treball importants al nostre país.