O processo de adoção estrangeira e inter-racial: uma análise sobre a formação vincular / The process of foreign and interracial adoption: an analysis of linking formation

Esse artigo visa discutir as questões de vinculação no processo de adoção estrangeira inter-racial segundo um estudo reflexivo teórico; tomando por base a análise documental de uma notícia veiculada na mídia brasileira a respeito de uma adoção nessa modalidade por um casal de atores. A adoção inter-racial continua necessitando de investigações com o intuito de desmitificar preconceitos e transpor barreiras entre as diferentes etnias, além de possibilitar um lugar de reconhecimento para a família multirracial. A psicanálise vincular mostrou-se de grande contribuição, sobretudo por propor um novo entendimento dos processos interpsíquicos envolvendo sujeito e família, bem como a formação de vínculos entre eles. Conclui-se, nesse caso ilustrativo, apesar das diferenças étnico-culturais, há uma possibilidade de remalhagem dos laços vinculares, uma vez que é outorgado à criança adotada um lugar no desejo daqueles que a adotam. Assim, o pertencimento é construído sobre a primazia afetiva e respeitando a alteridade.(AU)

This article aims discusses the linkage issues arising from interracial foreign adoption process a throughout theoretical study, based on news from the Brazilian media regarding the adoption under said modality by a couple of actors. The interracial adoption still needs further investigation to demystify prejudices and overcome barriers among different ethnicities, as well as to provide a place of recognition for the multiracial family. Linkage psychoanalysis has shown a significant value, especially because it allows a new understanding of the inter-psychic processes that take place between the individual and the family, as well as the formation of links between them. In conclusion, in this illustrative case, there is a possibility of remolding the family bonds, despite the ethnic-cultural differences, once it is given to the adoptive child a place in the desire of the parents. Thus, the belonging is built on affective primacy and respecting the altherity.(AU)

Mexico’s northern border conflict: collateral damage to health and human rights of vulnerable groups / El conflicto en la frontera norte de México: daños colaterales a la salud y los derechos humanos en grupos vulnerables

Objective. To compare distributions of human rights violations and disease risk; to juxtaposethese patterns against demographic and structural environmental variables, and to formulateimplications for structural interventions.Methods. Female sex workers who inject drugs were surveyed in Tijuana and CiudadJuarez, Mexico. Structured interviews and testing for sexually transmitted infections (STIs)were conducted (October 2008 to October 2009). Frequencies of individual and environmentalfactors, including police abuse, risk of HIV infection, and protective behaviors, were comparedbetween sites using univariate logistic regression.Results. Of 624 women, almost half reported police syringe confiscation despite syringesbeing legal; 55.6% reported extortion (past 6 months), with significantly higher proportions inCiudad Juarez (P < 0.001). Reports of recent solicitation of sexual favors (28.5% in Tijuana,36.5% in Ciudad Juarez, P = 0.04) and sexual abuse (15.7% in Tijuana, 18.3% in CiudadJuarez) by police were commonplace. Prevalence of STIs was significantly lower in Tijuanathan in Ciudad Juarez (64.2% and 83.4%, P < 0.001), paralleling the lower prevalence ofsexual risk behaviors there. Ciudad Juarez respondents reported significantly higher mediannumber of monthly clients (6.8 versus 1.5, P < 0.001) and lower median pay per sex act(US$ 10 versus US$ 20, P < 0.001) (in the past month). Relative to Tijuana, security deployment,especially the army’s presence, was perceived to have increased more in Ciudad Juarezin the past year (72.1% versus 59.2%, P = 0.001).Conclusions. Collateral damage from police practices in the context of Mexico’s drug conflictmay affect public health in the Northern Border Region. Itinerant officers may facilitate diseasespread beyond the region. The urgency for mounting structural interventions is discussed.

Objetivo. Comparar las distribuciones de las violaciones a los derechos humanos yel riesgo de enfermedades; yuxtaponer los patrones obtenidos con las variables demográficasy estructurales del entorno, y formular las implicaciones de llevar a cabointervenciones estructurales.Métodos. Se entrevistaron trabajadoras del sexo que consumían drogas inyectablesen Tijuana y Ciudad Juárez, México. Entre octubre del 2008 y octubre del 2009 sellevaron a cabo entrevistas estructuradas y pruebas para detectar infecciones de transmisiónsexual (ITS). Se compararon entre las dos ciudades las frecuencias de factoresindividuales y ambientales, como el abuso policial, el riesgo de infección por el VIH ylas conductas protectoras, usando regresión logística de una sola variable.Resultados. De 624 mujeres, casi la mitad comunicaron la confiscación de jeringaspor la policía a pesar de que es legal poseerlas; 55,6% informaron extorsión (en losúltimos 6 meses), con proporciones significativamente mayores en Ciudad Juárez(P < 0,001). Los informes de solicitación reciente de favores sexuales (28,5% en Tijuana,36,5% en Ciudad Juárez, P = 0,04) y de abuso sexual (15,7% en Tijuana, 18,3%en Ciudad Juárez) por la policía fueron comunes. La prevalencia de ITS fue significativamentemenor en Tijuana que en Ciudad Juárez (64,2% y 83,4%, P < 0,001), en formaanáloga a la menor prevalencia de conductas sexuales de riesgo en la primera ciudad.Las mujeres entrevistadas en Ciudad Juárez informaron una mediana del número declientes mensual significativamente mayor (6,8 frente a 1,5, P < 0,001) y una medianadel pago por acto sexual menor (US$ 10 frente a US$ 20, P < 0,001) en el último mes.En el último año, las mujeres entrevistadas percibieron un mayor aumento del desplieguede seguridad, especialmente la presencia del ejército, en Ciudad Juárez queen Tijuana (72,1% frente a 59,2%, P = 0,001).Conclusiones. Los daños colaterales derivados de las prácticas policiales en el contextodel conflicto de narcotráfico de México pueden afectar a la salud pública enla región de la frontera norte de México. Los oficiales itinerantes pueden facilitar lapropagación de enfermedades más allá de la región. Se analiza la urgencia para establecerintervenciones estructurales.

Pediatric [staff nurses]perspectives on safety practices for medication-use system adoption in critical care units

Medications are a great benefit to patient's lives for relieving pain or curing illness. Medications may be very dangerous if improperly used, moreover medications' safety is one of the highest priorities of nursing practice, a matter of considerable concern for all health team members. Medication errors produce a variety of problems for patients ranging from minor discomfort to substantial morbidity that may prolong hospitalization or lead to death and risk of litigation. Therefore, the aim of this study was to assess the medication safety measures used in every day practice. The study was conducted at the Pediatric Cairo University Hospital. All critical care units of the hospital were included in the study. A convenient sample consisting of all staff nurses [60] who are giving direct care and working three shifts were recruited. The tool used a socio demographic data sheet, and a "Medication Safety Measures Evaluation Tool for Nurses" developed by [American Hospital Association and Institute for safe medication practice 2002] to assess safety of medication in every day practice. It contains 10 domains with a total of [91] items representing safe medication use. The result of the study indicated that there is unsafe use of medication safety measures in majority of dimensions, also there is no significance difference between staff nurses demographic characteristics and unit type from staff nurses perspectives on medication use system safety. The study recommended establishes a clearly defined system and policies for drug ordering, dispensing, and administering. Avoid use of verbal orders whenever possible. Develop an educational program for all medical staff in calculating, prescribing, preparing, and administering medications for children, especially for nurses to develop and maintain pediatric medications knowledge base, and to know how to respond to medication error