Violência contra a mulher: uma análise do trabalho do centro de referência da assistência social-CREAS/Parnamirim

This work demonstrates the results obtained from research on violence against women: an analysis of the work from reference center of the Social Assistance-CREAS, held in the city of Parnamirim/RN from September 2008 extending through the february of 2009. Having as goal to investigate and examine in a longitudinal cut, which specifically covers the period from 2006 to 2007, find out extent the actions taken by the Reference Center Specialized Social Assistance-CREAS, contributed to the change of women who were there, by checking if there was any change in their positions ahead of the violence and if they began to realize how social subjects, able to control their living conditions and interfere in the orientation of social dynamics Have a particular emphasis on the presence of work and schooling or lack of them is also a factor to be allied to the barriers and rules imposed on women in contemporary society. In this study it was found through a qualitative research guided by dialectical and implemented through the use of documentary research, observation, semi-structured interview and an extensive theoretical background on the subject in question that the woman victim of violence is in a complex and contradictory context where there is both the construction and deconstruction of rights, a view that there are strong influences of patriarchal culture and the consequences of social issues that specifically searched for the public, focuses on social, economic , political, social and cultural. In this sense, the National Policy to Combat Violence against Women, operated by CREASE Parnamirim, is also reflected in its early stages in the life of these women are to nurture a real chance for these victims of violence, to perceive themselves as social subjects can control their lives and interfere in their own destinies. We want this study to add more knowledge to help and most appropriate intervention in this reality, but without the intention of reaching exhaustion, but to subsidize future studies on the topic of women victims of violence

Metabolic Profile of Offspring from Diabetic Wistar Rats Treated with Mentha piperita (Peppermint)

This study aimed at evaluating glycemia and lipid profile of offspring from diabetic Wistar rats treated with Mentha piperita (peppermint) juice. Male offspring from nondiabetic dams (control group: 10 animals treated with water and 10 treated with peppermint juice) and from dams with streptozotocin-induced severe diabetes (diabetic group: 10 animals treated with water and 10 treated with peppermint juice) were used. They were treated during 30 days, and, after the treatment period, levels of glycemia, triglycerides, total cholesterol, and fractions were analyzed in the adult phase. The offspring from diabetic dams treated with peppermint showed significantly reduced levels of glucose, cholesterol, LDL-c, and triglycerides and significant increase in HDL-c levels. The use of the M. piperita juice has potential as culturally appropriate strategy to aid in the prevention of DM, dyslipidemia, and its complications.

Um novo jogo para o estudo do raciocínio combinatório e do cálculo de probabilidade

We present an educational proposal for the study of combinatorial reasoning and calculation of probabilities based on a game and problem solving methodology, aiming to support the teaching of mathematical content. A review of the literature related to the teaching and learning of the concepts of combinatorial reasoning and probability is presented. The game is original, using a board game similar to Tic-tac-toe, and the movements of its parts have some similarities, in particular those made with the rook and pawn pieces of the game of chess. We formulate various activities (problems) involving the game which, in the process of solving them, using the problem solving methodology and with the appropriate intervention of the teacher, encourage students to develop strategies for counting, an indispensable tool in the initial study of Combinatorial Analysis and Calculation of Probabilities.

Treinamento auditivo-fonológico: uma proposta de intevenção para escolares com dificuldades de aprendizagem

Pós-graduação em Educação - FFC

Development of an interview version of the Native American Cultural Involvement and Detachment Anxiety Questionnaire

The present study sought to develop and validate an interview version of the Native American Cultural Involvement and Detachment Anxiety Questionnaire (CIDAQ; McNeil, Porter, Zvolensky, Chaney, & Kee, 2000) in an effort to construct a more culturally appropriate means of obtaining anxiety-related information from a tribally homogenous sample of Native Americans. Five pilot subjects (60% women; M age = 35.8 years) and 50 Native American participants (46% women; M age = 40.32 years) residing on a Northern Plains reservation were administered the CIDAQ - Interview, designed specifically for this study, the Worry Domains Questionnaire (WDQ; Tallis, Eysenck, & Mathews, 1992), a measure of non-pathological worry, the CIDAQ (McNeil et al., 2000), a self-report measure of culturally-related anxiety, and a demographics form. Using a mixed design method of analysis, interviews were audio taped and data was both qualitatively and quantitatively compared for convergence and discrepancies across measures. As hypothesized, CIDAQ-Interview subscales corresponded with subscales from the CIDAQ self-report and included worries and anxiety in three content areas: (1) social involvement with Native Americans and cultural knowledge, (2) economic issues, and (3) social involvement with the majority culture. Results further revealed similarities between CIDAQ-Interview items and those on the CIDAQ self-report, indicating reliability for the Interview. Findings also confirmed the Interview's validity (r 's range = .349-.754), as well as a high level of internal consistency for the CIDAQ self-report (Cronbach alpha = .931). Data suggest the CIDAQ-Interview is a more culturally appropriate method of assessment and may be capable of assessing anxiety at a higher level of specificity then the self-report version. Results of the study are discussed in relation to the assessment of anxiety for homogenous reservation Native Americans, study limitations and directions for future research with the CIDAQ-Interview are also discussed.

Promoting Higher Education: The Latino Achievement Mentoring Program (LAMP)

Statistics suggest that Latino youths are at risk for academic underachievement and withdrawal. Culturally sensitive approaches to supporting school achievement based on the needs of Latino youth and their families must be developed. In response to these needs, the Latino Research Initiative (LRI), a collaborative group with members from the University of Nebraska-Lincoln (UNL) and the Hispanic Community Center (HCC) created the Latino Achievement Mentoring Program (LAMP). LAMP is a culturally appropriate mentoring program designed to promote school success and post-secondary opportunities for Latino youths. This program provides Latino youths with positive role models and information and guidance about academic life and future school success. Finally, because of the cultural significance of family members among many Latinos, LAMP activities are developed and implemented such that the mentees' family members are involved. This presentation will report the first-year activities of the initial mentor and men tee pairs, with particular emphasis on educational outreach and academic development of the program. Evaluation data will be presented for the first cohort of mentees, including academic information, teacher reports and self-measure findings. LAMP activities aimed at promoting academic success will also be presented. Finally, the experiences of the mentors will briefly be reported.

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.

Assessment of depression in medical patients: a systematic review of the utility of the beck depression inventory-II

To perform a systematic review of the utility of the Beck Depression Inventory for detecting depression in medical settings, this article focuses on the revised version of the scale (Beck Depression Inventory-II), which was reformulated according to the DSM-IV criteria for major depression. We examined relevant investigations with the Beck Depression Inventory-II for measuring depression in medical settings to provide guidelines for practicing clinicians. Considering the inclusion and exclusion criteria seventy articles were retained. Validation studies of the Beck Depression Inventory-II, in both primary care and hospital settings, were found for clinics of cardiology, neurology, obstetrics, brain injury, nephrology, chronic pain, chronic fatigue, oncology, and infectious disease. The Beck Depression Inventory-II showed high reliability and good correlation with measures of depression and anxiety. Its threshold for detecting depression varied according to the type of patients, suggesting the need for adjusted cut-off points. The somatic and cognitive-affective dimension described the latent structure of the instrument. The Beck Depression Inventory-II can be easily adapted in most clinical conditions for detecting major depression and recommending an appropriate intervention. Although this scale represents a sound path for detecting depression in patients with medical conditions, the clinician should seek evidence for how to interpret the score before using the Beck Depression Inventory-II to make clinical decisions

Recipients' Satisfaction with Locally Procured Food Aid Rations: Comparative Evidence from a Three Country Matched Survey

Using survey data from natural experiments in three countries that simultaneously received food aid sourced locally and from the United States, we test the hypothesis that locally-sourced commodities are more culturally appropriate and thus preferred over traditional food aid commodities sourced from the donor country. We use a semi-nonparametric regression method to estimate recipients' satisfaction with these commodities across a range of criteria. We establish that recipients of locally procured rations are generally more satisfied with the commodities they receive than are recipients of US-sourced foods. This pattern is especially pronounced among less-well-off recipients. (C) 2013 Elsevier Ltd. All rights reserved.

Cultural beliefs and hypertension in rural Philippines

Hypertension (HTN), the major risk factor for cardiovascular disease (CVD), is emerging as a major public health problem in the Philippines. CVD has been the leading cause of mortality in the Philippines since 1990. ^ Although research has shown that certain populations have a greater propensity for HTN, and that culture may be a factor, empirical investigations of the influence of cultural beliefs on HTN are lacking. ^ The operational aims of this study were to: (a) develop and examine the reliability (test-retest, internal consistency) and validity (content) of a questionnaire which measures factors related to HTN; (b) administer the questionnaire; and (c) measure blood pressure, height, and weight of the ≥ 30 year old residents of San Antonio, Nueva Ecija, Philippines. ^ The analytic aims were to determine the: (a) cultural beliefs relating to HTN; (b) associations between cultural beliefs and HTN; and (c) extent to which cultural beliefs versus biological, behavioral, socioeconomic, and access factors are associated with HTN. ^ A cluster survey was conducted among 336 residents ≥ 30 years old in May, 1998. Sixty clusters of households were derived using probability proportionate to size sampling technique. Seven households per cluster were visited and one respondent per household was randomly chosen for interview and measurement of blood pressure, height and weight. A response rate of 84% (336/400) was achieved. ^ Results showed that the test-retest reliability of cultural belief items was 0.69–0.96. Internal consistency reliability was 0.74. ^ HTN (SBP ≥ 140; or DBP ≥ 90 mmHg; or currently taking anti-hypertensive medication) prevalence was 23/100. Univariate logistic regression showed cultural beliefs to be significantly associated (p < 0.037) with HTN. However, multivariate analysis showed that only age ≥ 50 (p = 0.000), family history of HTN (p = 0.004) and body mass index ≥ 25 (p = 0.003) were significant predictors. ^ In the absence of fully implemented programs to prevent and control HTN, the current prevalence is only expected to increase, leading to substantial increases in morbidity and mortality and health care cost. It is recommended that research which focuses on designing, implementing, and evaluating culturally appropriate community-wide programs on HTN prevention and control be undertaken in this community. ^

Identification of cryptic Anopheles mosquito species by molecular protein profiling.

Vector control is the mainstay of malaria control programmes. Successful vector control profoundly relies on accurate information on the target mosquito populations in order to choose the most appropriate intervention for a given mosquito species and to monitor its impact. An impediment to identify mosquito species is the existence of morphologically identical sibling species that play different roles in the transmission of pathogens and parasites. Currently PCR diagnostics are used to distinguish between sibling species. PCR based methods are, however, expensive, time-consuming and their development requires a priori DNA sequence information. Here, we evaluated an inexpensive molecular proteomics approach for Anopheles species: matrix assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). MALDI-TOF MS is a well developed protein profiling tool for the identification of microorganisms but so far has received little attention as a diagnostic tool in entomology. We measured MS spectra from specimens of 32 laboratory colonies and 2 field populations representing 12 Anopheles species including the A. gambiae species complex. An important step in the study was the advancement and implementation of a bioinformatics approach improving the resolution over previously applied cluster analysis. Borrowing tools for linear discriminant analysis from genomics, MALDI-TOF MS accurately identified taxonomically closely related mosquito species, including the separation between the M and S molecular forms of A. gambiae sensu stricto. The approach also classifies specimens from different laboratory colonies; hence proving also very promising for its use in colony authentication as part of quality assurance in laboratory studies. While being exceptionally accurate and robust, MALDI-TOF MS has several advantages over other typing methods, including simple sample preparation and short processing time. As the method does not require DNA sequence information, data can also be reviewed at any later stage for diagnostic or functional patterns without the need for re-designing and re-processing biological material.

The effect of African Americans' ethnographic paradigms and cultural explanatory model of breast cancer in framing the male partner's attitudes and behaviors about the woman's breast cancer diagnosis

The disparate burden of breast cancer-related morbidity and mortality experienced by African American women compared with women of other races is a topic of intense debate in the medical and public health arenas. The anomaly is consistently attributed to the fact that at diagnosis, a large proportion of African American women have advanced-stage disease. Extensive research has documented the impacts of cultural factors and of socioeconomic factors in shaping African American women's breast-health practices; however, there is another factor of a more subtle influence that might have some role in establishing these women's vulnerability to this disease: the lack of or perceived lack of partner support. Themes expressed in the research literature reflect that many African American breast cancer patients and survivors consider their male partners as being apathetic and nonsupportive. ^ The purpose of this study was to learn how African American couples' ethnographic paradigms and cultural explanatory model of breast cancer frame the male partners' responses to the women's diagnosis and to assess his ability to cope and willingness to adapt to the subsequent challenges. The goal of the study was to determine whether these men's coping and adaptation skills positively or negatively affect the women's self-care attitudes and behaviors. ^ This study involved 4 African American couples in which the woman was a breast cancer survivor. Participants were recruited through a community-based cancer support group and a church-based cancer support group. Recruitment sessions were held at regular meetings of these organizations. Accrual took 2 months. In separate sessions, each male partner and each survivor completed a demographic survey and a questionnaire and were interviewed. Additionally, the couples were asked to participate in a communications activity (Adinkra). This activity was not done to fulfill any part of the study purpose and was not included in the data analysis; rather, it was done to assess its potential use as an intervention to promote dialogue between African American partners about the experience of breast cancer. ^ The questionnaire was analyzed on the basis of a coding schema and the interview responses were analyzed on the principles of hermeneutic phenomenology. In both cases, the instruments were used to determine whether the partner's coping skills reflected a compassionate attitude (positive response) versus an apathetic attitude (negative response) and whether his adaptation skills reflected supportive behaviors (the positive response) versus nonsupportive behaviors (the negative response). Overall, the women's responses showed that they perceived of their partners as being compassionate, yet nonsupportive, and the partner's perceived of themselves likewise. Only half of the women said that their partners' coping and adaptation abilities enabled them to relinquish traditional concepts of control and focus on their own well-being. ^ The themes that emerged indicate that African American men's attitudes and behaviors regarding his female partner's diagnosis of breast cancer and his ability to cope and willingness to adapt are influenced by their ritualistic mantras, folk beliefs, religious teachings/spiritual values, existential ideologies, socioeconomic status, and environmental factors and by their established perceptions of what causes breast cancer, what the treatments and outcomes are, and how the disease affects the entire family, particularly him. These findings imply that a culturally specific intervention might be useful in educating African American men about breast cancer and their roles in supporting their female partners, physically and psychologically, during diagnosis, treatment, and recovery. ^

Social cognitive theory and factors associated with Mexican-American parents' beliefs, attitudes and practices regarding communication with their adolescent children about sex

Latinos have the highest teen birth rate nationally. Cameron County, Texas is primarily Latino (Mexican-American). This mixed-method study (n=43) examines Mexican-American parents of adolescents' beliefs, attitudes and practices regarding communication with their adolescent children about sex. Social Cognitive Theory (SCT) constructs self-efficacy, behavioral determinism, environment, outcome expectations and reciprocal determinism can be influences on frequency and quality of parent-adolescent sex communication.^ This study describes Mexican-American parents' of adolescents recollections of their own experiences associated with learning about sexuality. It also examines the attitudes and practices regarding communication about sex and the self-efficacy and behavioral capability of participants to teach their adolescent children about sex and sexually transmitted infections. ^ Negative childhood experiences (shame, lies and trauma) of the parents in this study played a key role in terms of their desire to communicate more comprehensively about sexuality with their own children than did their parents. While participants' reported low self-efficacy and behavioral capability to communicate with their adolescent children about sex, they reported relatively high frequency and quality of communication, with 75% of participants receiving a high quality score and over 44% reporting frequent communication with their adolescent children about sex. A Chi square analysis and Fisher's Exact Score revealed no association between acculturation status, gender or having a child who has mothered/fathered a baby and the frequency or quality of communication about sex with adolescent children. Study participants also gave specific recommendations for method, content and setting of sex education for their children and themselves. Promotora delivery of information and education in a comfortable, culturally appropriate neighborhood setting, as well as parent –child learning sessions were identified as possible approaches to address improve self-efficacy and behavioral capability of parents communicating with their adolescent children about sex.^ The results of this analysis provide public health practitioners and interested community entities data to identify and develop interventions that use a theoretical, evidence-based framework for culturally appropriate interventions to encourage and equip Mexican-American parents to effectively communicate with their adolescent children about sexuality, and ultimately to address the high rates of teen pregnancy in this U.S.-Mexico border community. ^

Outcomes associated with chemotherapy in elderly patients with early stage operable breast cancer

Background. Various clinical trials have proved the efficacy of adjuvant chemotherapy in women with breast cancer. Chemotherapy efficacy and guidelines for its use differ by stage of tumor and age of the patient with no clear recommendations for patients aged 70 and above. Objective. To examine the clinical and economic outcomes associated with chemotherapy use in and to examine the disparities in treatment and survival in elderly patients with early stage operable breast cancer by age and axillary node status. Methods. We studied a cohort of 23,110 node positive and 31,572 node negative women aged 65 and over diagnosed with incident American Joint Committee on Cancer (AJCC) stage I, II or IIIa breast cancer between January 1, 1991 and December 31, 2002 using SEER-Medicare data. Total patient costs were estimated using the phase of care approach and adjusted cost estimates were obtained from regression analysis using a 3% discount rate. Cox proportional hazard ratio of mortality was used to determine the effectiveness of chemotherapy. Propensity score approach was also used to minimize the bias associated with receipt of chemotherapy. To assess disparity in treatment, multivariate logistic regression analyses were performed to assess the relative odds of receiving surgery, chemotherapy and radiation after BCS for African Americans compared to Whites. Results. Regression adjusted cost estimates for all node positive patients receiving chemotherapy was approximately $2,300 and was significantly higher (p<0.05) than for patients not receiving chemotherapy. Mortality was significantly lower in node positive and node negative women aged 65-74 years receiving chemotherapy. There was a significant difference between African American and White women in receiving BCS and radiation after BCS; however this difference was explained by patient demographics, tumor characteristics and socioeconomic status (SES). African American node positive women were 21% less likely to receive chemotherapy than White women (OR, 0.79; CI, 0.68-0.92) in multivariate analysis. Conclusion. Chemotherapy is associated with increased survival in patients aged 65-74 and total costs attributable to chemotherapy differ by phase and age of the patient. Underutilization of systemic adjuvant chemotherapy in African American women requires attention and may serve as potential areas for appropriate intervention.^

Ethnographic and epidemiologic approaches for the programming of prenatal and birth services in Mesa los Hornos, Mexico

The investigator conducted an action-oriented investigation of pregnancy and birth among the women of Mesa los Hornos, an urban squatter slum in Mexico City. Three aims guided the project: (1) To obtain information for improving prenatal and maternity service utilization; (2) To examine the utility of rapid ethnographic and epidemiologic assessment methodologies; (3) To cultivate community involvement in health development.^ Viewing service utilization as a culturally-bound decision, the study included a qualitative phase to explore women's cognition of pregnancy and birth, their perceived needs during pregnancy, and their criteria of service acceptability. A probability-based community survey delineated parameters of service utilization and pregnancy health events, and probed reasons for decisions to use medical services, lay midwives, or other sources of prenatal and labor and delivery assistance. Qualitative survey of service providers at relevant clinics, hospitals, and practices contributed information on service availability and access, and on coordination among private, social security, and public assistance health service sectors. The ethnographic approach to exploring the rationale for use or non-use of services provided a necessary complement to conventional barrier-based assessment, to inform planning of culturally appropriate interventions.^ Information collection and interpretation was conducted under the aegis of an advisory committee of community residents and service agency representatives; the residents' committee formulated recommendations for action based on findings, and forwarded the mandate to governmental social and urban development offices. Recommendations were designed to inform and develop community participation in health care decision-making.^ Rapid research methods are powerful tools for achieving community-based empowerment toward investigation and resolution of local health problems. But while ethnography works well in synergy with quantitative assessment approaches to strengthen the validity and richness of short-term field work, the author strongly urges caution in application of Rapid Ethnographic Assessments. An ethnographic sensibility is essential to the research enterprise for the development of an active and cooperative community base, the design and use of quantitative instruments, the appropriate use of qualitative techniques, and the interpretation of culturally-oriented information. However, prescribed and standardized Rapid Ethnographic Assessment techniques are counter-productive if used as research short-cuts before locale- and subject-specific cultural understanding is achieved. ^