Evaluation of the prevalence and nutritional and social determinants of overweight in a population of schoolchildren: a cross-sectional analysis of 5,037 children

Objective: To evaluate the prevalence and nutritional and social determinants of overweight in a population of schoolchildren in Southern Brazil. Methods: Cross-sectional descriptive study of 5,037 children of both genders, between 6 and 10.9 years of age, from public and private schools of Maringa, Parana, Brazil. Evaluation of factors associated with excess weight (overweight and obesity) included gender, age, school type, socioeconomic level, education of the head of the family, eating habits, and means of commuting to school. After univariate analysis (Fisher's exact test), we adjusted a logistic regression model and used Wald's test for decision-making (p < 0.05). Results: The mean age was 8.7 +/- 1.3 years, with 52.8% females; 79.1% of the students attended public school and 54.6% had families of socioeconomic class A or B. Regarding nutritional status, 24% of children were overweight (7% obesity, 17% overweight). Being male, attending a private school, and having a head of the family with over four years of education were significantly associated with excess weight. In relation to food, inadequate intake of,carbohydrates was associated with a 48% greater chance of overweight/obesity (p < 0.001; OR: 1.48; 95% CI: 1.25-1.76), Conclusion: The prevalence of overweight found in this study is approximate to that reported in national studies. Its association with gender and inadequate food intake indicates that these factors should be considered in initiatives aimed at preventive measures in childhood.

Flexible and conservative features of social systems in tufted capuchin monkeys: comparing the socioecology of Sapajus libidinosus and Sapajus nigritus

Socioecological models assume that primates adapt their social behavior to ecological conditions, and predict that food availability and distribution, predation risk and risk of infanticide by males affect patterns of social organization, social structure and mating system of primates. However, adaptability and variation of social behavior may be constrained by conservative adaptations and by phylogenetic inertia. The comparative study of closely related species can help to identify the relative contribution of ecological and of genetic determinants to primate social systems. We compared ecological features and social behavior of two species of the genus Sapajus, S. nigritus in Carlos Botelho State Park, an area of Atlantic Forest in Sao Paulo state, and S. libidinosus in Fazenda Boa Vista, a semi-arid habitat in Piaui state, Brazil. S. libidinosus perceived higher predation risk and fed on clumped, high quality, and usurpable resources (fruits) all year round, whereas S. nigritus perceived lower predation risk and relied on evenly distributed, low-quality food sources (leaves) during periods of fruit shortage. As predicted by socioecology models, S. libidinosus females were philopatric and established linear and stable dominance hierarchies, coalitions, and grooming relationships. S. nigritus females competed less often, and could transfer between groups, which might explain the lack of coalitions and grooming bonds among them. Both populations presented similar group size and composition and the same polygynous mating system. The species differed from each other in accordance with differences in the characteristics of their main food sources, as predicted by socioecological models, suggesting that phylogenetic inertia does not constrain social relationships established among female Sapajus. The similarity in mating systems indicates that this element of the social system is not affected by ecological variables and thus, is a more conservative behavioral feature of the genus Sapajus. Am. J. Primatol. 74:315331, 2012. (c) 2011 Wiley Periodicals, Inc.

Materno-infantilism, feminism and maternal health policy in Brazil

In the last days of 2011, President of Brazil Dilma Rousseff issued a provisional measure (or draft law) entitled "National Surveillance and Monitoring Registration System for the Prevention of Maternal Mortality" (MP 557), as part of a new maternal health programme. It was supposed to address the pressing issue of maternal morbidity and mortality in Brazil, but instead it caused an explosive controversy because it used terms such as nascituro (unborn child) and proposed the compulsory registration of every pregnancy. After intense protests by feminist and human rights groups that this law was unconstitutional, violated women's right to privacy and threatened our already limited reproductive rights, the measure was revised in January 2012, omitting "the unborn child" but not the mandatory registration of pregnancy. Unfortunately, neither version of the draft law addresses the two main problems with maternal health in Brazil: the over-medicalisation of childbirth and its adverse effects, and the need for safe, legal abortion. The content of this measure itself reflects the conflictive nature of public policies on reproductive health in Brazil and how they are shaped by close links between different levels of government and political parties, and religious and professional sectors. (C) 2012 Reproductive Health Matters

Cause-specific mortality and income inequality in Sao Paulo, Brazil

OBJECTIVE: To analyze cause-specifi c mortality rates according to the relative income hypothesis. METHODS: All 96 administrative areas of the city of Sao Paulo, southeastern Brazil, were divided into two groups based on the Gini coefficient of income inequality: high (>= 0.25) and low (<0.25). The propensity score matching method was applied to control for confounders associated with socioeconomic differences among areas. RESULTS: The difference between high and low income inequality areas was statistically significant for homicide (8.57 per 10,000; 95% CI: 2.60; 14.53); ischemic heart disease (5.47 per 10,000 [95% CI 0.76; 10.17]); HIV/AIDS (3.58 per 10,000 [95% CI 0.58; 6.57]); and respiratory diseases (3.56 per 10,000 [95% CI 0.18; 6.94]). The ten most common causes of death accounted for 72.30% of the mortality difference. Infant mortality also had signifi cantly higher age-adjusted rates in high inequality areas (2.80 per 10,000 [95% CI 0.86; 4.74]), as well as among males (27.37 per 10,000 [95% CI 6.19; 48.55]) and females (15.07 per 10,000 [95% CI 3.65; 26.48]). CONCLUSIONS: The study results support the relative income hypothesis. After propensity score matching cause-specifi c mortality rates was higher in more unequal areas. Studies on income inequality in smaller areas should take proper accounting of heterogeneity of social and demographic characteristics.

Household income, sex and respiratory mortality in Sao Paulo, Brazil, 1996-2010

SETTING: Respiratory mortality rates are declining in several countries, including Brazil; however, the effect of socio-economic indicators and sex is unclear. OBJECTIVE: To identify differences in mortality trends according to income and sex in the city of Sao Paulo, Brazil. DESIGN: We performed a time-trend analysis of all respiratory diseases, including chronic obstructive pulmonary disease (COPD), lung cancer and tuberculosis, using Joinpoint regression comparing high, middle and low household income levels from 1996 to 2010. RESULTS: The annual per cent change (APC) and 95% confidence intervals (95%CIs) for death rates from all respiratory disease in men in high-income areas was -1.1 (95%CI -2.7 to 0.5) in 1996-2002 and -4.3 (95%CI -5.9 to -2.8) in 2003-2009. In middle- and low-income areas, the decline was respectively -1.5 (95%CI -2.2 to -0.7) and -1.4 (95%CI -1.9 to -0.8). For women, the APC declined in high-income (-1.0, 95%CI -1.9 to -0.2) and low-income areas (0.8, 95%CI -1.3 to -0.2), but not in middle-income areas (-0.5, 95%CI -1.4 to 0.3) from 1996 to 2010. CONCLUSION: Death rates due to COPD and all respiratory disease declined more consistently in men from high-income areas. Mortality due to lung cancer decreased in men, but increased in women in middle- and low-income areas.

'Beheading', Rule Manipulation and Fraud: The Approval of Election Results in Brazil, 1894-1930

Studies of electoral fraud tend to focus their analyses only on the pre-electoral or electoral phases. By examining the Brazilian First Republic (1889-1930), this article shifts the focus to a later phase, discussing a particular type of electoral fraud that has been little explored by the literature, namely, that perpetrated by the legislatures themselves during the process of giving final approval to election results. The Brazilian case is interesting because of a practice known as degola ('beheading') whereby electoral results were altered when Congress decided on which deputies to certify as duly elected. This has come to be seen as a widespread and standard practice in this period. However, this article shows that this final phase of rubber-stamping or overturning election results was important not because of the number of degolas, which was actually much lower than the literature would have us believe, but chiefly because of their strategic use during moments of political uncertainty. It argues that the congressional certification of electoral results was deployed as a key tool in ensuring the political stability of the Republican regime in the absence of an electoral court.

Social Mobilization in Health and Sanitation in an Action Research Process in an Indigenous Community in Northwestern Amazon

The living conditions of the inhabitants of Iauarete, an indigenous area in the municipality of Sao Gabriel da Cachoeira, State of Amazonas (Northern Brazil), have been negatively affected by population density, poor sanitation and maintenance of sanitation practices that are incompatible with that reality. To improve the population's quality of life, sanitation systems that are adequate to the local socio-cultural characteristics should be implemented, as well as educational processes with emphasis on social mobilization and community empowerment. The aim of this paper is to report and discuss a training course on health and sanitation using action research, directed to the mobilization of the Iauarete indigenous people, with the objective of assisting other studies of this nature. In the meetings, issues related to environmental health were discussed, a Community Newspaper was constructed, the course participants made interviews and drew up claims documents. This experience has enhanced the participants' understanding of local problems and of the importance of social mobilization for the dialogue with governmental institutions that are responsible for providing sanitation services and for seeking better living conditions. The researchers and teachers of the training course benefitted from the construction of collective knowledge resulting from interaction with subjects of the investigated situation and from the recognition and redefinition of their representations, fulfilling the fundamental premise of action research.

Spiritist Psychiatric Hospitals in Brazil: Integration of Conventional Psychiatric Treatment and Spiritual Complementary Therapy

In Brazil, during the XX century, dozens of Spiritist psychiatric hospitals emerged seeking to integrate conventional medical treatment with complementary spiritual therapy. This combined inpatient treatment is largely found in Brazil, where many psychiatric hospitals stem from the Spiritist movement. The present report describes the use of these spiritual practices, their operating structure, health professionals involved, modalities of care, and institutional difficulties in integrating spiritual practices with conventional treatment in six leading Brazilian Spiritist psychiatric hospitals. These hospitals combine conventional psychiatric treatment with voluntary-based spiritual approaches such as laying on of hands ("fluidotherapy"), lectures regarding spiritual and ethical issues, intercessory prayer, spirit release therapy ("disobsession") and "fraternal dialogue". The non-indoctrination and optional nature of these spiritual complementary therapies seem to increase acceptance among patients and their family members. In conclusion, the Spiritist psychiatric hospitals in Brazil have, for more than half a century, provided an integrative approach in the treatment of psychiatric disorders, associating conventional and spiritual treatments, more specifically Spiritist therapy. The lack of standardized treatment protocols and scientific studies remain a barrier to assessing the impact of this integrative approach on patients' mental health, quality of life, adherence, and perceived quality of treatment.

Inequalities in mortality of men by oral and pharyngeal cancer in Barcelona, Spain and São Paulo, Brazil, 1995–2003

Abstract Background Large inequalities of mortality by most cancers in general, by mouth and pharynx cancer in particular, have been associated to behaviour and geopolitical factors. The assessment of socioeconomic covariates of cancer mortality may be relevant to a full comprehension of distal determinants of the disease, and to appraise opportune interventions. The objective of this study was to compare socioeconomic inequalities in male mortality by oral and pharyngeal cancer in two major cities of Europe and South America. Methods The official system of information on mortality provided data on deaths in each city; general censuses informed population data. Age-adjusted death rates by oral and pharyngeal cancer for men were independently assessed for neighbourhoods of Barcelona, Spain, and São Paulo, Brazil, from 1995 to 2003. Uniform methodological criteria instructed the comparative assessment of magnitude, trends and spatial distribution of mortality. General linear models assessed ecologic correlations between death rates and socioeconomic indices (unemployment, schooling levels and the human development index) at the inner-city area level. Results obtained for each city were subsequently compared. Results Mortality of men by oral and pharyngeal cancer ranked higher in Barcelona (9.45 yearly deaths per 100,000 male inhabitants) than in Spain and Europe as a whole; rates were on decrease. São Paulo presented a poorer profile, with higher magnitude (11.86) and stationary trend. The appraisal of ecologic correlations indicated an unequal and inequitably distributed burden of disease in both cities, with poorer areas tending to present higher mortality. Barcelona had a larger gradient of mortality than São Paulo, indicating a higher inequality of cancer deaths across its neighbourhoods. Conclusion The quantitative monitoring of inequalities in health may contribute to the formulation of redistributive policies aimed at the concurrent promotion of wellbeing and social justice. The assessment of groups experiencing a higher burden of disease can instruct health services to provide additional resources for expanding preventive actions and facilities aimed at early diagnosis, standardized treatments and rehabilitation.

Cause-specific mortality and income inequality in São Paulo, Brazil

OBJECTIVE: To analyze cause-specific mortality rates according to the relative income hypothesis. METHODS: All 96 administrative areas of the city of São Paulo, southeastern Brazil, were divided into two groups based on the Gini coefficient of income inequality: high (>0.25) and low (<0.25). The propensity score matching method was applied to control for confounders associated with socioeconomic differences among areas. RESULTS: The difference between high and low income inequality areas was statistically significant for homicide (8.57 per 10,000; 95%CI: 2.60;14.53); ischemic heart disease (5.47 per 10,000 [95%CI 0.76;10.17]); HIV/AIDS (3.58 per 10,000 [95%CI 0.58;6.57]); and respiratory diseases (3.56 per 10,000 [95%CI 0.18;6.94]). The ten most common causes of death accounted for 72.30% of the mortality difference. Infant mortality also had significantly higher age-adjusted rates in high inequality areas (2.80 per 10,000 [95%CI 0.86;4.74]), as well as among males (27.37 per 10,000 [95%CI 6.19;48.55]) and females (15.07 per 10,000 [95%CI 3.65;26.48]). CONCLUSIONS: The study results support the relative income hypothesis. After propensity score matching cause-specific mortality rates was higher in more unequal areas. Studies on income inequality in smaller areas should take proper accounting of heterogeneity of social and demographic characteristics.

A mixed methods inquiry into the political economy of agriculture and rural areas in Lebanon

The present work, then, is concerned with the forgotten elements of the Lebanese economy, agriculture and rural development. It investigates the main problematic which arose from these forgotten components, in particular the structure of the agricultural sector, production technology, income distribution, poverty, food security, territorial development and local livelihood strategies. It will do so using quantitative Computable General Equilibrium (CGE) modeling and a qualitative phenomenological case study analysis, both embedded in a critical review of the historical development of the political economy of Lebanon, and a structural analysis of its economy. The research shows that under-development in Lebanese rural areas is not due to lack of resources, but rather is the consequence of political choices. It further suggests that agriculture – in both its mainstream conventional and its innovative locally initiated forms of production – still represents important potential for inducing economic growth and development. In order to do so, Lebanon has to take full advantage of its human and territorial capital, by developing a rural development strategy based on two parallel sets of actions: one directed toward the support of local rural development initiatives, and the other directed toward intensive form of production. In addition to its economic returns, such a strategy would promote social and political stability.

Social Context and Economic Biases in Representation

This article explores the role of political context in shaping economic biases in representation-the degree to which wealthy citizens' views are more strongly represented than poorer citizens' views in the choices of policymakers. I develop a general model that explains why poorer citizens will be better represented relative to the rich in certain political contexts than others, arguing that the relative representation of the poor will be stronger in contexts that make the views of the poor relevant and accessible to policymakers. I then derive several specific hypotheses that flow from this model and test these hypotheses through a study of the dyadic relationships between citizens and their representatives in the U.S. Congress. The results show that poorer citizens are better represented relative to the rich in Congressional districts that are electorally competitive, have low median incomes, have relatively equal distributions of incomes, have a significant organized labor presence, and are represented by Democrats.

The Ideology, Politics and Autonomous Art of Richard Weiner: (An Event in Discourse)"

The first aim of the project was to compile documentation on the life and work of Richard Weiner, a Czech journalist, writer and poet who spent the best part of his life as Paris correspondent for Lidove noviny. Langerova looked at the contexts and the growing independence of certain parts of his work, the distribution of thematic compositional elements into different parts of discourse and their position in the autonomous space of a work of art. Looking at the features of minority literature and the contemporary contexts of Weiner's life and work Langerova focuses on the situation of the Jewish community (Wiener came from an assimilated Jewish family). For this minorities, the function of language as a medium of communication which is able to create an autonomous world became increasingly important. Literature, which is based on this function of language, is a political matter par excellence before it begins forming as an autonomous, independent and divergent place. This means that everything private and intimate is closely connected to political and social responsibility, while supposedly objective genres contain subjective features. Another important characteristic is "nomadism", which asks the question of "Where do I belong". This was very important in Czechoslovakia after World War I , as in the issue of Zionism. Although Weiner rejected Zionism, he asks this question in his writing and it is reflected at a symbolic level in his work, which shows a fundamental thematic and compositional plan of a journey, cross-roads and wandering. These theses were reflected in Weiner's life, which was a series of continuous transfers and unplanned moves, often when he thought he had found his place. As well as tracing the course of his life, and his relations with and views of other writers, Langerova looks at his writings in various areas. Her major focus is the divergence of trivial and great events into different types of discourse in Richard Weiner's work, their transfer (small into great, trivial into mythical) and their historical context.

Social Work, Political Violence and Historical Change:

In this paper the author outlines the background to the history of the conflict in Northern Ireland which led to the current ‘Troubles’. In this discussion a range of key ideas are highlighted, including the nature of sectarianism and patterns of violence which have profoundly affected the society. The second part of the paper reviews a number of issues which face social workers when they try to deal with the effects of such violence as well as highlighting new challenges which have emerged as the society moves towards the resolution of conflict. It concludes with the argument that, wherever there is such conflict in the world, social workers need critically to understand the way in which political and social structures impinge upon their everyday practice.

Policy Contexts of Social Work in Britain: the wider implications of 'New' Labour and the 'New Legal Regime'

Several commentators have expressed disappointment with New Labour's apparent adherence to the policy frameworks of the previous Conservative administrations. The employment orientation of its welfare programmes, the contradictory nature of the social exclusion initiatives, and the continuing obsession with public sector marketisation, inspections, audits, standards and so on, have all come under critical scrutiny (c.f., Blyth 2001; Jordan 2001; Orme 2001). This paper suggests that in order to understand the socio-economic and political contexts affecting social work we need to examine the relationship between New Labour's modernisation project and its insertion within an architecture of global governance. In particular, membership of the European Union (EU), International Monetary Fund (IMF) and World Trade Organisation (WTO) set the parameters for domestic policy in important ways. Whilst much has been written about the economic dimensions of 'globalisation' in relation to social work rather less has been noted about the ways in which domestic policy agenda are driven by multilateral governance objectives. This policy dimension is important in trying to respond to various changes affecting social work as a professional activity. What is possible, what is encouraged, how things might be done, is tightly bounded by the policy frameworks governing practice and affected by those governing the lives of service users. It is unhelpful to see policy formulation in purely national terms as the UK is inserted into a network governance structure, a regulatory framework where decisions are made by many countries and organisations and agencies. Together, they are producing a 'new legal regime', characterised by a marked neo-liberal policy agenda. This paper aims to demonstrate the relationship of New Labour's modernisation programme to these new forms of legality by examining two main policy areas and the welfare implications they are enmeshed in. The first is privatisation, and the second is social policy in the European Union. Examining these areas allows a demonstration of how much of the New Labour programme can be understood as a local implementation of a transnational strategy, how parts of that strategy produce much of the social exclusion it purports to address, and how social welfare, and particularly social work, are noticeable by their absence within policy discourses of the strategy. The paper details how the privatisation programme is considered to be a crucial vehicle for the further development of a transnational political-economy, where capital accumulation has been redefined as 'welfare'. In this development, frameworks, codes and standards are central, and the final section of the paper examines how the modernisation strategy of the European Union depends upon social policy marked by an employment orientation and risk rationality, aimed at reconfiguring citizen identities.The strategy is governed through an 'open mode of coordination', in which codes, standards, benchmarks and so on play an important role. The paper considers the modernisation strategy and new legality within which it is embedded as dependent upon social policy as a technology of liberal governance, one demonstrating a new rationality in comparison to that governing post-Second World War welfare, and which aims to reconfigure institutional infrastructure and citizen identity.