Exploring the effects of the withdrawal of the capitation policy on Cesarean rates in public hospitals in Ghana: an interrupted time series analysis

Context and objectives. In Ghana, CS rates have increased by 2% since 2014 even though the World Health Organization has called for the procedure only for medically justifiable cases. Provider payment mechanisms such as capitation have been used to moderate CS rates in some settings. We explored the effects of the withdrawal of the capitation policy on the Cesarean Surgery (CS) rate in public primary care hospitals together with vaginal delivery (VD) and antenatal care for women with 4+ visits (ANC4+) rates. Methods. An interrupted time-series analytical design was used to assess the effects of the withdrawal of capitation on selected variables from the secondary District Health Information Management System (DHIMS 2) of public hospitals between January 2015 and December 2019. Results: The results show that after the policy withdrawal, the trend and level of provision of CS and VD were not significantly altered. Significant declining trends of ANC4+ reversed with significant positive trends after the policy removal. Conclusion. We conclude that the withdrawal of the capitation policy may not have impacted the CS rate significantly in public hospitals. Enhanced capitation payment mechanisms and specific policies aimed at limiting CS are needed to curtail the rise in Ghana.

Association of maternal depression, family composition and poverty with maternal care and physical health of children in the first year of life / Associação da depressão materna, composição da família e pobreza com os cuidados maternos e a saúde física de crianças no primeiro ano de vida

INTRODUCTION: The child's overall health depends on several factors, including the quality of the environment in which it lives and the care it receives. Child well-being early in life has an impact on its future and future generations' health. OBJECTIVE: Analyze the association of maternal depression, family composition, and socioeconomic conditions with the indicator of maternal care and physical health of children. METHODS: Retrospective cohort that analyzed data from 120 children during their first year of life. A Health and Maternal Care Indicator (ISCM) was created, aggregating information on growth, breastfeeding, vaccination, prophylaxis of iron deficiency anemia, illnesses, and accidents. The socioeconomic and health conditions were obtained through a structured interview. The Edinburgh Postnatal Depression Scale assessed maternal depression. Quasipoisson Regression examined the association between the ICSM and the predictors. The initial model considered p<0.25 in the univariate analysis and p<0.05 in the final model. RESULTS: The mothers were adults (83.3%), studied for an average of 10 years, and 36% had depressive symptoms. About 37% of the families were single-parent female, 59% were from Class C1-C2 of ABEP, and 12% received the "Bolsa Família" benefit. ISCM was 8% lower in children whose mothers were depressed (p = 0.04) or had no partner (p = 0.03), and was 14% higher in families receiving Bolsa Família (p = 0.02) in relation to their peers. CONCLUSION: Maternal depression and female single-parent family arrangements negatively impacted child health and care, while the conditional cash transfer program represented a protective factor.

INTRODUÇÃO: A saúde integral da criança depende de vários fatores, entre eles a qualidade do ambiente em que vive e dos cuidados que recebe. O bem-estar da criança no início da vida tem impacto na sua saúde futura e das próximas gerações. OBJETIVO: Analisar a associação da depressão materna, composição da família e condições socioeconômicas com o indicador de cuidados maternos e saúde física de crianças. MÉTODO: Coorte retrospectiva que analisou dados de 120 crianças no primeiro ano de vida. Foi criado um Indicador de Saúde e Cuidados Maternos (ISCM), agregando informações sobre crescimento, aleitamento materno, vacinação, profilaxia de anemia ferropriva, adoecimentos e acidentes. A condição socioeconômica e de saúde foram obtidas por entrevista estruturada. A depressão materna foi avaliada pela Edinburgh Postnatal Depression Scale. A associação entre o ICSM e os preditores foi examinada pela Regressão de Quasipoisson. O modelo inicial foi composto por variáveis com p<0,25 na análise univariada e p<0,05 no modelo final. RESULTADOS: As mães eram adultas (83,3%), estudaram, em média, por 10 anos e 36% delas apresentaram sintomas depressivos. Cerca de 37% das famílias eram do tipo monoparental feminino, 59% eram da Classe C1-C2 da ABEP e 12% recebiam o benefício "Bolsa Família". O ISCM foi 8% menor nas crianças cujas mães eram deprimidas (p=0,04) ou não tinham companheiro (p=0,03), e foi 14% maior nas famílias que recebiam o Bolsa família (p=0,02) em relação aos seus pares. CONCLUSÃO: A depressão materna e o arranjo familiar monoparental feminino impactaram negativamente a saúde e os cuidados com a criança, enquanto o programa de transferência condicionada de renda representou um fator de proteção.

Conceptualized framework for levels of obstetric care

It has been demonstrated that risk-appropriate perinatal and obstetric care can improve perinatal morbidity and mortality. Recently, various studies focus on the importance of evaluation for maternal conditions and allocation of high risk pregnant women to highly qualified facilities. Therefore, it is necessary to develop the conceptualized framework for levels of obstetric care and establish the guidelines for the situations that should be cared in each level of facility. In this review article, we reviewed several classifications of obstetric care in eastern and western countries, and conditions in which transfer should be recommended depending on the risk and capacity of centers.

Prevalence of postpartum depression among Filipino mothers seen at the University of the East Ramon Magsaysay Memorial Medical Center, Inc. (UERMMMCI) from 2012-2013: A descriptive study

@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> This paper sought to describe the prevalence rate of postpartum depression in patients seen for follow-up at the UERMMMCI Obstetrics and Gynecology Services from June 01, 2012 to May 31, 2013.</p><p style="text-align: justify;"><strong>METHODOLOGY:</strong> Participants of the study included mothers who sought consult at the Obstetrics and Gynecology Service of the UERMMMCI  Outpatient Department after giving birth. These participants were recruited via convenience sampling. A survey method was used to determine variables under study, which included age, relational status and length of relationship, occupation, income, presence of feto-maternal complications, and manner of delivery, while the Filipino version of the Edinburgh Postnatal Depression Scale (EPDS) was used to screen depression risk. Ethics approval was secured prior to study initiation. Analysis of data was done using SPSS v.16.0.</p><p style="text-align: justify;"><strong>RESULTS:</strong> A total of fifty-one mothers participated in the study. Of the total sample, the majority were of adult age and were unemployed. It was observed that 20% of the sample had an EPDS of 10 and above, with 6% having an EPDS score of 14 and above. Mothers who presented with higher EPDS scores were noted to have had a caesarean section delivery and feto-maternal complications after delivery.</p><p style="text-align: justify;"><strong>CONCLUSION:</strong> The study showed that the prevalence of post partum depression was clinically significant to warrant routine screening among mothers.</p>

Práticas populares de cura e o uso de plantas medicinais pormães ribeirinhas no cuidado infantil / Prácticas populares de cura y plantas medicinales usados por las madresribereñas en el cuidado infantil / Popular healing practices and medical plants use for riparian mothers in early childhood care

Objetivo: analisar as praticas populares de cura com plantas medicinais pelas mães ribeirinhas durante o cuidado dos filhos. Métodos: Trata-se de uma pesquisa qualitativa, de etnoenfermagem, com coleta de dados por meio de entrevista semiestruturada e observação participante. Participaram do estudo 15 mães da comunidade ribeirinha Vila Nova Maringá, Amazonas. Para análise dos dados foi utilizada a análise temática. Pesquisa aprovada pelo CEP EEAN/HESFA n°54/08. Resultados: Constatou-se que as praticas populares de cura variam de acordo com a etiologia; que 17 problemas físicos de saúde infantis podem ser tratados com 37 plantas medicinais; e que grande parte das plantas utilizadas encontram respaldo no saber científico. Conclusão: Acredita-se que a pesquisa tenha relevância para a enfermagem e comunidade, pois permitiu o intercâmbio de saberes popular e científico, bem como apontou uma necessidade de investimentos que trabalhem com esta temática.

Objectives: to analyze the popular healing practices with the use of medicinal plants by the riverside mothers during child care. Methods: This is a qualitative research, ethnonursing with data collection through semi-structured interview and participant observation.Study participants were 15 mothers of the riverside community Vila Nova Maringa, Amazonas, Brazil. For data analysis it was used the thematic analysis. Research approved by the CEP EEAN/HESFA n°54/08. Results: It was found that the popular healing practices vary according to the etiology; 17 that infant physical health problems can be treated with 37 medicinal plants; and that many of the plants used are supported by the scientific knowledge. Conclusion: It is believed that research has relevance for nursing and community, because it allowed the exchange of popular and scientific knowledge, and pointed to a need for investment into works with this theme.

Objetivo: analizar las practicas de curacion populares con el uso de plantas medicinales por las madres de ribera durante el cuidado del nino. Métodos: Se trata de una investigacion cualitativa, etnoenfermeria con la recopilacion de datos a traves de entrevistas semiestructuradas y observacion participante. Los participantes del estudio fueron 15 madres de la comunidad riberena Vila Nova Maringa, Amazonas. Para el analisis de datos se utilizo el analisis tematico. De investigacion aprobado por el CEP EEAN/HESFA n°54/08. Resultados: Se encontro que las practicas de curacion populares varian de acuerdo a la etiologia; 17 que los problemas de salud fisica para ninos pueden ser tratados con 37 plantas medicinales; y que muchas de las plantas utilizadas estan basadas en el conocimiento cientifico. Conclusión: Se cree que la investigacion tiene relevancia para el mal gema y la comunidad debido a que permitia el intercambio de conocimiento popular y cientifica, y senalo una necesidad de inversion para trabajar con este tema.

Asynchronous Hatching and Extended Parental Care in Aegla schmitti (Decapoda, Anomura)

ABSTRACT The aim of this study was to describe the behavior of newly-hatched juveniles and maternal care in Aegla schmitti. The experiment was conducted using seven ovigerous females with eggs at different stages of embryonic development and 12 eggs that had been placed in a separate aquarium. We observed asynchronous hatching in all females, with a mean of 66 hatched juveniles per female. The females also exhibited extended maternal care, allowing the juveniles to remain inside their abdominal chamber or on other parts of their body in the first few days after hatching. The juveniles that hatched in a separate aquarium fed on the remaining eggs, despite food being available. The incubation period and number of hatched eggs are highly variable between species with direct development, with no clear pattern being evident. However, asynchrony in hatching time is apparently common among freshwater anomurans, most likely due to the environmental conditions in which they live. Parental care is an important trait for crustaceans that live in osmotically unfavorable environments, such as freshwater, increasing the survival rate of juveniles.

Epigenética, cuidados maternais e vulnerabilidade ao estresse: conceitos básicos e aplicabilidade / Epigenetics, maternal care and stress vulnerability: basic concepts and applicability

Cuidados maternais são experiências do início da vida que têm sido consistentemente relacionados com alterações na expressão gênica por meio de mecanismos epigenéticos como a metilação do DNA ou a modificação de suas histonas. O objetivo deste trabalho é apresentar uma investigação teórica sobre cuidados maternais enquanto evento ambiental que pode produzir alterações epigenéticas atuantes na composição da vulnerabilidade ao estresse. A investigação teve por base estudos empíricos e de revisão de literatura com animais não humanos sobre Epigenética, estresse e cuidados maternais. Apresenta também alguns estudos com humanos que mostram tais efeitos, destacando-se aqueles que influenciam ou são influenciados pelo comportamento operante. A partir da investigação realizada encontrou-se que cuidados maternais pós-parto são uma condição ambiental que produz efeitos no eixo hipotálamo-pituitária-adrenal (HPA), participando da composição da vulnerabilidade ao estresse. Seus possíveis efeitos fisiológicos no condicionamento operante sinalizam alternativas para intervenções baseadas na plasticidade da formação do epigenoma. Este conhecimento, além de promover a aproximação entre a Epigenética e a Análise do Comportamento em nível básico por meio de estudos com animais não humanos, poderá contribuir em nível aplicado para um melhor entendimento do neurodesenvolvimento infantil e adequado planejamento de intervenções efetivas com mães e filhos. (AU)

Maternal care is an early life experience that has been consistently related to alterations in the genetic expression through epigenetic mechanisms such as DNA methylation or DNA histone modification. The present study aims to present a theoretical investigation about maternal care as an environmental event that may produce epigenetic alterations related to the biological bases of stress vulnerability. The research was based on empirical studies as well as literature review on non-human animals concerning epigenetics, stress and maternal care. It also presents some studies on humans that show such effects, particularly the ones that influence or are influenced by the operant behavior. Post-natal maternal care is found to cause effects on the hypothalamic-pituitary-adrenal (HPA) axis activity participating in the building of stress vulnerability. Its possible physiological effects on the operant conditioning point out to alternatives to intervention based on the plasticity of the epigenome formation. This knowledge enhances the proximity between Epigenetics and Behavior Analysis at a basic level through studies with non-human animals and at an applied level through a better understanding of child neurodevelopment and proper planning of effective intervention with mothers and children. (AU)

Foraging, oviposition sites and notes on the natural history of the harvestman Heteromitobates discolor (Opiliones, Gonyleptidae) / Forrageamento, sítios de oviposição e notas sobre a história natural do opilião Heteromitobates discolor (Opiliones, Gonyleptidae)

The lack of data on the natural history often hampers phylogenetic studies on the evolution of behavior. Herein we provide quantitative field data on foraging and oviposition sites of a Neotropical harvestman belonging to a subfamily with a published phylogeny, Goniosomatinae. Heteromitobates discolor rests during the day on granitic boulders on rivers, laying eggs in sheltered and darker areas. The female guard the eggs and aggressively respond to approaching conspecific females. In the absence of the female, ants, conspecifics and reduviids may predate the eggs. Egg-guarding females are known not to leave the clutch, but males and non-guarding females may leave the granitic boulders and forage on the vegetation at night, close to the river margins and with no difference in the sites explored between males and females. The general features described in H. discolor are similar to what has been reported for other species in this subfamily, suggesting an evolutionary conservatism within the group.

A falta de dados de história natural por vezes dificulta estudos filogenéticos sobre a evolução do comportamento. Nesse estudo nós fornecemos dados quantitativos de campo sobre forrageamento e sítios de oviposição de um opilião Neotropical pertencente a uma subfamília com uma filogenia publicada, Goniosomatinae. Heteromitobates discolor passa o dia em rochedos graníticos em rios, onde deposita os ovos em áreas abrigadas e escuras. A fêmea cuida dos ovos e responde agressivamente a fêmeas co-específicas que se aproximam. Na ausência de fêmeas, formigas, co-específicos e percevejos reduvídeos podem predar os ovos. Fêmeas que guardam ovos não deixam as desovas, mas machos e fêmeas sem ovos deixam os rochedos graníticos e forrageiam sobre a vegetação è noite, próximos è margem do rio e sem diferença nos sítios explorados entre os machos e as fêmeas. As características gerais descritas em H. discolor são similares ao que tem sido reportado para outras espécies nesta subfamília, sugerindo um conservadorismo evolutivo dentro do grupo.

Guidelines and training for maternal and newborn care post-Haiyan

In any disaster-affected population, it is estimated that 3% of the total population will be pregnant, 3.5% will be lactating women and 15% will be adolescents. After Typhoon Haiyan in the Philippines in November 2013 it was estimated that there would be 95 270 pregnant women within the affected areas and 480 000 pregnancies in the year following. The disruption of access to reproductive health care after Haiyan meant that prenatal care, birth attendance, postpartum care and family planning services were urgently required as part of the response.

Para uma clínica psicanalítica do cuidado / For a psychoanalytic clinic of care

O objetivo do artigo é analisar os elementos fundamentais e as condições necessárias para uma clínica psicanalítica do cuidado. Para tanto, na primeira parte, o autor resume o que Heidegger diz sobre o cuidado (Sorge) como a condição ontológica das manifestações do ser do Dasein; na segunda parte, tendo como referencial teórico a metapsicologia freudiana e a teoria winnicottiana do desenvolvimento afetivo, o autor mostra a função estruturante do cuidado na constituição da subjetividade e no desenvolvimento afetivo da criança; finalmente, na última parte e à guisa de uma conclusão, são apresentadas as condições que o autor considera indispensáveis para que a clínica psicanalítica possa ser considerada como uma clínica do cuidado.

The author proposes to analyze the fundamental elements and the necessary conditions for a psychoanalytic clinic of care. To do so, in the first part of the article, he summarizes what Heidegger said about care (Sorge) as the ontological status of the manifestations of Dasein's being; in the second part, with the theoretical reference to Freudian metapsychology and affective development in winnicottian theory, the author shows the structuring role of care in the constitution of subjectivity and affective development of the child; finally, in the last part and by way of a conclusion, the conditions that the author considers indispensable so that the psychoanalytical clinic can be considered as a clinic of care are presented.

De madres y expertos: la psicología de posguerra y el disciplinamiento de los cuidados maternos / Of mothers and experts: the psichology of pos war period and the disciplining of maternal care

El artículo reflexiona acerca de la construcción discursiva de los cuidados maternos en la psicología. Se discute la emergencia de estos saberes y su relación con las transformaciones políticas y económicas ocurridas durante el periodo de posguerra y el inicio de la guerra fría. La hipótesis general que guía la reflexión desde una perspectiva foucaultina, señala que los cuidados son prácticas individuales y espontáneas de las madres, más que efectos de relaciones de poder/saber históricamente situadas , siendo tales cuidados una práctica social través de la cual, la Psicología se erigió como ciencia y dispositivo de la normalidad y la subjetividad.

The article reflects on the discursive construction of maternal care in Psychology: We discuss the emergence of this knowledge and its connections to the political and economic transformations occurred during the postwar period and the beginning of the Cold War. From a Foucauldian perspective, the general hypothesis guiding this reflection states that motherly care practices, rather than having an individual and spontaneous character, represent a product of power relationships and knowledge relationships both historically situated and a social practice trough which, Psychology emerged as science and device of normality and subjectivity.

Significados de las prácticas de cuidado que las madres con experiencia de VIH positivo brindan a sus hijos recién nacidos / Meanings of the care practices that mothers with HIV positive experience provide to their newborn children

Tipo de estudio: estudio de tipo etnográfico y enfoque cualitativo, aplicando el método del enfoque transcultural de Madeleine Leininger. Objetivo: Describir el significado que tienen las prácticas de cuidado ofrecido a su recién nacido para la madre con experiencia de VIH positivo dentro del contexto cultural de una ciudad de la Costa Caribe. Metodología: se utilizaron los parámetros éticos para la investigación con seres humanos, las opiniones de las diez madres entrevistadas fueron grabadas y transcritas para su posterior sistematización. Resultados: se identificaron 177 unidades de significado, 26 descriptores emicos, los cuales se consolidaron en siete patrones y tres temas a saber: el cuidado del recién nacido mantiene fuerte y retroalimenta los vínculos materno-filiales, la experiencia de seropositividad para VIH afecta los actos de cuidado al promover sobreprotección para proteger al recién nacido y el conocimiento formal recibido y el conocimiento etno-cultural se relacionan en el cuidado de los recién nacidos. En el contexto de las madres entrevistadas, se interpreta el "cuidado" en el sentido de actividades de prevención y también se le interpreta en el sentido de protección entendida como alejarlo de cualquier situación que le implique riesgo para la salud; tienen temor a la censura y estigmatización social, que acompaña a las personas que conviven con la enfermedad; situaciones de miedo al rechazo se hicieron evidentes para sí mismas y las extienden al acto de cuidado con clara orientación sobreprotectora, la supresión de la lactancia materna así como la asistencia a los controles no fueron reconocidas como una forma eficiente de cuidados en la situación de convivencia con el virus; para las madres entrevistadas el cuidado que ofrecen a sus recién nacidos es un acto de amor, en el cual disponen de los espacios y momentos para expresar a sus hijos su amor, estrechar su relación con ellos y simultáneamente cuidarlos las hace sentir vivas. Existe un componente etnocultural propio de la región que se transmite por tradición oral, al respecto se pudo reconocer que las creencias populares, influyen en la práctica de cuidados que las madres bajo la situación del VIH brindan a sus hijos recién nacidos.

Type of study: ethnographic study and qualitative approach, applying the method of the Madeleine Leininger transcultural approach. Objective: describe their meaning care practices offered to her newborn to the mother with HIV positive experience within the cultural context of a city on the Caribbean coast. Methodology: used ethical standards for research involving human subjects, the views of the ten mothers interviewed were recorded and transcribed for later systematization. Results: We identified 177 units of meaning, 26 descriptors emic, which were consolidated into seven patterns and three issues namely: newborn care and feedback remains strong mother-child ties, seropositivity experience acts of care affects to promote overprotection to protect the newborn and received formal knowledge and ethno-cultural knowledge related to the care of newborn. In the context of the mothers interviewed have means the "care" in the sense of prevention activities and is also interpreted to mean protection understood as away from any situation that involves a risk to health, have fear of censorship and social stigma that accompanies people living with the disease of fear of rejection situations were evident for themselves and care extend to act with clear guidance overprotective, suppression of breastfeeding as well as assistance to controls were not recognized as an efficient way to care for the situation of living with the virus, the mothers interviewed for the care they provide to their newborn is an act of love, which have the space and time to express their children their love, strengthen your relationship with them and look after them simultaneously makes them feel alive. There is an ethnocultural component of the region itself is transmitted by oral tradition, the matter could recognize that popular beliefs influence the practice of care that mothers in providing HIV status to their newborn children.

Cultural Factors Affecting the Decision-making to Seek Maternal Care: Ethnography in a Nigerien Rural Village / 国際保健医療

<B>Introduction:</B> This study elucidates the cultural factors affecting decision-making to seek maternal care in rural Niger, which records one of the highest MMR.<BR><B>Methods:</B> Ethnographic fieldwork (participant observation, ethnographic interview and documentation) was conducted in a Nigerien rural village and data were analyzed qualitatively.<BR><B>Results:</B> The decision-making was affected by a value system holding that "to mention sexuality in public is regarded shamefulness", "delivery is part of daily life", "clinic should be used only when there are problems during delivery", "<I>Albeeri </I>(great adult) never make mistakes". The value of shame resulted in pregnant women tending to conceal their pregnancy and an absence of opportunity for public reproductive health education. The notion that a woman who cannot endure pain is not an <I>Albeeri </I>encourages pregnant women to rely on folk medicine without complaining about any abnormal symptoms and to continue working until shortly before delivery. The exclusion of any person, even a doula, from the scene of delivery in order to avoid witchcraft contributes to unassisted home delivery. These interacting factors cause delayed care. On the other hand, when complications are foreseen during pregnancy, the family’s elder women assess the pregnant woman’s condition and evacuate her to a clinic without her appeal. In case of first delivery, women go back their fathers’ houses to deliver and receive their mothers’ support and women rest for 40 days postpartum.<BR><B>Conclusion:</B> The decision-making is influenced by culturally-defined values related to sex, perceptions of the scene of delivery and abnormalities, and a social structure esteeming elders, and these factors cause a delayed care. However, cultural values also lead to mutual help complementing maternal care. Therefore, it is important for the betterment of maternal health to improve the quality of existing health services and also to link it to the culturally-based childbirth support system.

Maternal mental disease, parental styles and social support: study of the conceptions of the mothers and adolescents in the countryside of São Paulo state

A observação de mulheres nos serviços de saúde mental motivou o interesse em pesquisar como tais mães cuidam de seus filhos e como esses percebem os cuidados. Este estudo objetivou identificar associações entre práticas parentais de mães doentes mentais, suporte social e condições socioeconômicas; e verificar possíveis diferenças entre práticas parentais de mães doentes e mães saudáveis. Estudo de casos e controles, quantitativo. Participaram 41 mulheres doentes mentais e seus filhos adolescentes e 41 díades mãe-filho saudáveis. Observou-se maior insatisfação com o suporte social recebido pelas mães doentes, que nessas famílias os pais são menos responsivos do que os pais do grupo comparado; mães do grupo de comparação são mais exigentes e responsivas do que as do grupo de estudo; a situação econômica familiar também influencia no cuidado materno. Conclui-se que os transtornos de humor, em especial os transtornos depressivos e ansiosos, o suporte social recebido e condições financeiras influenciam nas ações de cuidado materno.

Temporal and spatial resource use by female three-toed sloths and their young in an agricultural landscape in Costa Rica

The information on ecological behavior of wild sloths is very scarce. In this study we determined the home ranges and resources used by three adult female three-toed sloths (Bradypus variegatus) and their four young in an agricultural matrix of cacao (Theobroma cacao), pasture, riparian forests and living fencerows in Costa Rica. Births occurred during November-December and the young became independent at five to seven months of age. Initially, mothers remained fixed in one or a few trees, but expanded their use of resources as young sloths became independent from them. Mothers initially guided the young to preferred food and cover resources, but they gradually left their young in small nucleus areas and colonized new areas for themselves. Home range sizes for young sloths (up to seven months of age) varied between 0.04-0.6 hectares, while home range sizes for mothers varied from 0.04-25.0 hectares. During the maternal care period, 22 tree species were used, with the most common being Cecropia obtusifolia (30.9%), Coussapoa villosa (25.6%), Nectandra salicifolia (12.1%), Pterocarpus officinalis (5.8%) and Samanea saman (5.4%). However, young sloths used only 20 tree species, with the most common being C. villosa (18.4%), S. saman (18.5 %) and N. salicifolia (16.7%). The cacao agroforest was used only by mother sloths and never by their young following separation. However, in the riparian forest, both mother sloths and young used the tree species. A total of 28 tree species were used by the mother sloth; including the food species: C. obtusifolia, C. villosa, N. salicifolia and P. officinalis. However, the young used 18 trees species in this habitat with N. salicifolia and S. saman most commonly used, although they rested and fed during the day in C. obtusifolia, C. villosa and O. sinnuata. The cacao agroforest with adjacent riparian forests and fencerows provides an important habitat type that links the smaller secondary forests and other patches. Rev. Biol. Trop. 59 (4): 1743-1755. Epub 2011 December 01.

La información sobre el comportamiento ecológico de los perezosos silvestre es muy escasa. Determinamos los ámbitos de acción y uso de recursos para hembras adultas de perezosos de tres dedos (Bradypus variegatus) y sus crías en una matriz agroforestal compuesta de cacao (Theobroma cacao), potreros, bosques ribereños y cercas vivas en Costa Rica. Los nacimientos de las crías se presentan frecuentemente de noviembre a diciembre y entre 5 a 7 meses las crías se vuelven independientes. Inicialmente las madres utilizan pocos árboles y van expandiendo el uso de recursos conforme las crías se van haciendo independientes de la madre. Las madres en los primeros meses guían a sus crías para seleccionar recursos y coberturas de bosque preferidos, y gradualmente se van separando de la cría hasta dejarlos en lo que fue su área núcleo. Ámbitos de acción de las crías (de hasta 7 meses o más de edad) varían entre 0.04-0.6ha, mientras que los ámbitos de acción de las madres varían 0.04-25.0ha. Durante el cuido maternal, 22 especies de árboles fueron utilizadas entre las más comunes se encuentran: Cecropia obtusifolia (30.9%), Coussapoa villosa (25.6%), Nectandra salicifolia (12.1%), Pterocarpus officinalis (5.8%) y Samanea saman (5.4%). Los jóvenes utilizaron solo 20 especies entre las más comunes C. villosa (18.4%), S. saman (18.5 %) y N. salicifolia (16.7%). El sistema agroforestal del cacao fue únicamente utilizado por la madre y no por la cría después del periodo de separación. Sin embargo, en los bosques ribereños tanto la madre como la cría utilizaron árboles como recursos. Un total de 28 especies de árboles fueron utilizados por la madre incluyendo especies para su alimentación tales como: C. obtusifolia, C. villosa, N. salicifolia y P. officinalis. Los jóvenes solo utilizaron 18 especies de árboles como N. salicifolia and S. saman entre las más frecuentes; inclusive los árboles utilizados para descanso y alimentación durante el día fueron C. obtusifolia, C. villosa y O. sinnuata. Los sistemas agroforestales de cacao adyacentes a bosques ribereños y cercas vivas proveen un importante hábitat que une pequeños parches de bosques secundarios.

Diferenças no investimento materno em função de variáveis socioambientais / Differences in maternal investment as a function of socio-environmental variables

A partir da Teoria do Investimento Parental prevê-se diminuição no investimento com a diminuição da relação benefício/custos. Investigou-se a variação no investimento materno em função de variáveis socioambientais que podem apresentar impacto na relação benefício/custo do investimento materno. Os fatores investigados apresentaram, de forma geral, efeito sobre o investimento materno no sentido esperado de acordo com a teoria: quanto maiores os custos representados pela ausência de coabitação com pai, pouca disponibilidade de renda e início precoce da vida reprodutiva, menor o investimento materno. Conclui-se que os fatores socioambientais podem promover ou inibir o investimento materno indicando a importância de políticas públicas no sentido da promoção da estabilidade destes fatores.

The Theory of Parental Investment predicts a decrement in parental investment as the benefit/cost ratio decreases. Differences in maternal investment were investigated in relation to socio-environmental variables that may have an impact on the benefit/cost ratio. The factors investigated showed, in general, effects on maternal investment in the expected direction according to the theory: as costs increased, represented by the absence of cohabitation with the father, diminished income and early reproductive age, lower levels of investment were observed. It is concluded that socio-environmental factors may promote or inhibit maternal investment, indicating the importance of public policies in promoting the stability of these variables.

Significados do cuidado materno em mães de crianças pequenas / Meanings of maternal care in mothers of toddlers

Uma relação mãe-bebê saudável é considerada fundamental para a constituição do psiquismo da criança e também para o desenvolvimento da maternagem. O objetivo deste estudo qualitativo foi compreender os significados do cuidado materno e da experiência da maternagem produzidos e negociados por mães de crianças pequenas. Foram realizadas cinco entrevistas semi-estruturadas com mães, entre 22 e 45 anos de idade, com filhos de zero a cinco anos. A análise de conteúdo temática teve a psicanálise como referencial teórico, especialmente na vertente winnicottiana. Foram identificados cinco temas principais nas entrevistas: o holding profissional; a preocupação materna primária; a amamentação e os momentos com o bebê; as angústias e transformações no amor materno; e os sentimentos ambivalentes sobre a gravidez. A atitude do profissional no cuidado dessas mães foi importante para que elas se sentissem seguras para terem seus filhos. A ambivalência dessas mães foi expressa no conflito entre o desejo de ter filhos e as preocupações com as mudanças que ocorreram com a chegada do bebê. Concluiu-se que as mães que encontraram o holding necessário no ambiente foram capazes de sentir as necessidades dos filhos e de compreender a melhor forma de responder a elas, promovendo o desenvolvimento saudável da díade mãe bebê.

A health infant-mother relationship is considered essential to the constitution of the child psyche and also to the development of the motherhood. This qualitative research aimed to comprehend the meanings of maternal care and the experience of motherhood produced and negotiated by mothers of babies, toddlers and young children. Five semi-structuredi nterviews with mothers, aged from 22 to 45 years, with children aged from zero to five years, were undertaken. The thematic content analysis used psychoanalysis as theoretical framework, especially Winnicott’s work. Five main themes were identified in the interviews: professional holding; primary maternal preoccupation; breastfeeding and moments with thebaby; anguish and maternal love transformations; and ambivalent feelings toward the pregnancy. Professional’s attitudes in the care of these mothers were important so they could feel secure to take care of their children. The ambivalence of these mothers was expressed in the conflict between the desire of being a mother and the changes involved in that. It was possible to conclude that the mothers who experienced the necessary holding in the environment were able to feel the needs of their children and understand the best way to respond to them, promoting the health development of infant-mother relationship.

Educar para el Cuidado Materno Perinatal: Una propuesta para reflexionar / Educating for perinatal maternal care: a proposal for reflection

El propósito del cuidado materno perinatal es la salud y la calidad de vida de la madre y el niño, lo cual se puede lograr mediante una interacción que se ejerce entre la madre, la familia y el cuidador; es allí donde se comparten conocimientos, experiencias y percepciones acerca del cuidado, y a su vez se generan responsabilidades para que se alcance este fin. Para lograrlo, es preciso reconocer que la práctica del cuidado materno perinatal difiere de un lugar a otro y de un tiempo a otro, porque el cuidar como toda actividad humana se ejecuta siempre en el seno de una determinada cultura y una sociedad, es decir, se articula con la cultura en el marco de un contexto histórico. Así el cuidado materno perinatal es vía de transmisión, conservación y actualización de la cultura de una generación a otra. El reflexionar sobre las relaciones entre cuidado y cultura me llevó a plantear una propuesta educativa que parte de una visión más integradora de la realidad utilizando como estrategia la educación participante a través de la cual se desarrolla la capacidad de las personas para investigar, reflexionar, participar y cuidar asumiendo responsabilidad por su propio proceso de desarrollo. / The purpose of the perinatal maternal care is the mother’s and child’s health and life quality, which can be achieved through the interaction between the mother, family and caretaker. It is within this relationship where knowledge, experiences and perceptions about care are shared, generating responsibilities to achieve this goal. However, to obtain this, it is necessary to realize that the perinatal maternal care practice differs from one place to another and from time to time, since care taking, like every human activity, is always set in a particular culture and society, that is to say, it is articulated with culture in within a historical context. This way, the perinatal maternal care is a transmission, conservation, and culture upgrade channel, from one generation to the nex...

The purpose of the perinatal maternal care is the mother'sand child's health and life quality, which can be achievedthrough the interaction between the mother, family andcaretaker. It is within this relationship where knowledge,experiences and perceptions about care are shared, generating responsibilities to achieve this goal. However,to obtain this, it is necessary to realize that the perinatalmaternal care practice differs from one place to anotherand from time to time, since care taking, like every humanactivity, is always set in a particular culture and society,that is to say, it is articulated with culture in within ahistorical context. This way, the perinatal maternal care isa transmission, conservation, and culture upgradechannel, from one generation to the next. Meditating onthe relationship between care and culture, led to theoutline of an educational proposal based on a moreintegrative vision of reality, using as participant educationas a strategy, though which it is possible to developpeople's capacity to research, meditate, participate andcare assuming the responsibility for their owndevelopment process

A experiência de gestação e amamentação sob a ótica de mulheres vítimas de violência conjugal / The experience of gestation and breast-feeding under the optics of women victims of conjugal violence

O presente estudo tem como objetivo analisar os significados que mulheres vítimas de violência conjugal atribuem à experiência de gestação e cuidados maternos, enfatizando a questão da amamentação.O método utilizado situa-se no âmbito da pesquisa qualitativa de natureza exploratória. Foram entrevistadas 11 mulheres que sofreram violência conjugal durante a gravidez e tinham o filho mais novo com até 2 anos de idade.As entrevistas seguiram um roteiro de perguntas abertas e a técnica utilizada foi a historia de vida tópica. Os relatos foram analisados através da técnica de análise de conteúdo orientada por adaptações visando também a análise de representações sociais.Como resultados, observamos que mulheres que sofrem violência conjugal durante a gestação avaliaram que não encontraram em seus companheiros cuidados que julgavam merecer. Na concepção desse grupo de mulheres faltou apoio financeiro e afetivo por parte do companheiro. Durante a gravidez surgiram sentimentos de medo,tristeza, solidão e depressão.Também percebemos que a gravidez se mostrou um forte detonador da violência ou aumento da mesma.Já em relação aos cuidados maternos e amamentação consideram a experiência solitária, apesar de terem vivido momentos de "alegria", demonstrando que essa experiência foi cercada de sentimentos ambíguos. Para as mulheres pesquisadas, o desmame ocorreu precocemente para a grande maioria.A necessidade de trabalhar fora, a falta de informação e a própria experiência de violência foram algumas das razões expostas para não prosseguirem com a amamentação.A pesquisa também revelou que a família e, principalmente a mãe dessas mulheres, funcionou como um importante suporte social no apoio a essas vítimas, porém não suprindo todas as carências. também observamos que o serviço de saúde mostrou falhas na detecção e atuação nesse grupo de mulheres estudadas.

The purpose of this study is to analyze the motherly conceptions about the domestic/matrimonial violence consequences during the pregnancy, emphasizing the breast-feeding issue. A qualitative methodology was utilized in this study. During the research, eleven women were interviewed. All of them suffered domestic violence during pregnancy and their youngest child was up to two years old. The interviews were based on open questions and the technique applied was life history. The interviews were analyzed through content analysis. The interviewers’ speech was also analyzed through social representations. The findings showed that those women who suffered domestic violence during pregnancy did not consider their partners as supportive as they think they should be. These women stated that they lacked of emotional and financial support from their partners’ side. During the pregnancy, the women expressed feelings of fear, sadness, and solitude. Furthermore, it was perceived that the pregnancy showed as a strong detonator of the violence. Sometimes the pregnancy caused an increased of the violence suffered by these women. They considered this kind of experience as a good experience if associated to the aspects of maternal care and breast feeding. However, they considered it as a lonely experience. According to the interviews, those women stopped breast feeding early than it was supposed. The reasons for stopping the breast feeding earlier than it was supposed includes: the need of coming back to work, lack of information and the violence experienced by those women. The findings also revealed that the family, especially those women’s mothers, plays an important role as an efficient social support to these victims. On the other hand, the public health system demonstrated failures detecting and acting against this kind of violence.

Paternidade em famílias de camadas médias / Paternity in middle class families

Estudos sobre a relação entre pais e filhos mostram a relevância da mãe nos cuidados com a prole e com sua socialização, enquanto a presença do genitor no exercício dessas tarefas tem sido pouco discutida. Este trabalho toma como referência dados etnográficos, para analisar a construção culturalda paternidade e investigar alguns aspectos das relações entre o pai e os filhos do sexo masculino em dez famílias de camadas médias de Ribeirão Preto-SP. Os dados coletados mediante a realização de 38 entrevistas, com dez pais, dez mães e 18 filhos indicam que tanto o pai e a mãe quanto os filhosapontam certas mudanças no relacionamento destes com o genitor. Entre elas, registra-se a maior proximidade do pai em relação à prole, embora ele continue a ser fonte de autoridade doméstica e incentive a construção de identidade de gênero diversa para filhos e filhas.

Studies on parent-children relationships have shown the relevance of the mother in terms of child care and socialization, while the presence of the father in the performance of these tasks has been little discussed. In the present study, ethnographic data were used as reference to discuss the socialconstruction of paternity and to investigate some aspects of the relations between fathers and sons inten middle class families of Ribeirão Preto-SP. The data collected indicate the fathers and mothers as well as sons point out certain alterations in the relationship between sons and fathers. Among such alterations, a greater proximity of the fathers in relation to their offspring is observed, although they still remain as the source of authority at home and encourage the construction of different genderidentities for sons and daughters.