Conceptualizing pathways linking women's empowerment and prematurity in developing countries.

BackgroundGlobally, prematurity is the leading cause of death in children under the age of 5. Many efforts have focused on clinical approaches to improve the survival of premature babies. There is a need, however, to explore psychosocial, sociocultural, economic, and other factors as potential mechanisms to reduce the burden of prematurity. Women's empowerment may be a catalyst for moving the needle in this direction. The goal of this paper is to examine links between women's empowerment and prematurity in developing settings. We propose a conceptual model that shows pathways by which women's empowerment can affect prematurity and review and summarize the literature supporting the relationships we posit. We also suggest future directions for research on women's empowerment and prematurity.MethodsThe key words we used for empowerment in the search were "empowerment," "women's status," "autonomy," and "decision-making," and for prematurity we used "preterm," "premature," and "prematurity." We did not use date, language, and regional restrictions. The search was done in PubMed, Population Information Online (POPLINE), and Web of Science. We selected intervening factors-factors that could potentially mediate the relationship between empowerment and prematurity-based on reviews of the risk factors and interventions to address prematurity and the determinants of those factors.ResultsThere is limited evidence supporting a direct link between women's empowerment and prematurity. However, there is evidence linking several dimensions of empowerment to factors known to be associated with prematurity and outcomes for premature babies. Our review of the literature shows that women's empowerment may reduce prematurity by (1) preventing early marriage and promoting family planning, which will delay age at first pregnancy and increase interpregnancy intervals; (2) improving women's nutritional status; (3) reducing domestic violence and other stressors to improve psychological health; and (4) improving access to and receipt of recommended health services during pregnancy and delivery to help prevent prematurity and improve survival of premature babies.ConclusionsWomen's empowerment is an important distal factor that affects prematurity through several intervening factors. Improving women's empowerment will help prevent prematurity and improve survival of preterm babies. Research to empirically show the links between women's empowerment and prematurity is however needed

Vías y escenarios de la transformación laboral: aproximaciones teóricas y nuevos problemas

Los procesos de globalización y de reestructuración empresarial apuntan a transformaciones en las formas de trabajo, en las relaciones laborales, en las identidades de los trabajadores y en las profesiones. Investigar y reflexionar sobre estos campos del saber se hace más acuciante hoy en día debido a que dichos cambios no apuntan necesariamente a mejoras en la calidad de vida de los trabajadores ni a la institucionalización de la negociación de las relaciones laborales en el espacio empresarial.Reconstruir el mundo del trabajo desde diversos puntos de vista teóricos y desde abordajes empíricos, tanto nacionales como internacionales, es el esfuerzo del libro. Problemáticas como la construcción social del trabajo en categoría de empleo; las relaciones laborales en España, Venezuela, México y Colombia; la transformación productiva vinculada a la introducción de tecnologías de la información y la comunicación (TIC´s) y la configuración de redes empresariales; la informalidad; las identidades profesionales y la educación como mecanismo de movilidad social, hacen parte del complejo y cambiante mundo del trabaja, expuestos en este libro

Nurses' perceptions of aids and obstacles to the provision of optimal end of life care in ICU

Contains fulltext : 172380.pdf (publisher's version ) (Open Access

Community-based diabetes prevention randomized controlled trial in refugees with depression: effects on metabolic outcomes and depression

Abstract Depression and antidepressant medications increase risk for type 2 diabetes. Cambodian-Americans have exceedingly high rates of both depression and diabetes. This paper reports outcomes of a diabetes prevention trial for Cambodian-Americans with depression. Primary outcomes were HbA1c, insulin resistance and depressive symptoms. Participants were aged 35–75, Khmer speaking, at risk for diabetes, and met study criteria for likely depression by either (a) antidepressant medication and/or (b) prolonged elevated depressive symptoms. Participants were randomized to one of three community health worker (CHW) interventions: (1) lifestyle intervention called Eat, Walk, Sleep (EWS), (2) EWS plus medication therapy management sessions with a pharmacist/CHW team to resolve drug therapy problems (EWS + MTM), or, (3) social services (SS; control). Assessments were at baseline, post-treatment (12 months), and follow-up (15 months). The n = 188 participants were 78% female, average age of 55 years, half had a household income < $20,000, and modal educational attainment was 7.0 years. Compared to the other arms, EWS + MTM showed a significant decrease in HbA1c and a trend for reduced inflammation and stress hormones. Depressive symptoms improved for EWS and EWS + MTM relative to SS. There was no change in insulin resistance. Cardiometabolic and mental health can be improved in tandem among immigrant and refugee groups

Secondary analysis of a randomized trial testing community health educator interventions for diabetes prevention among refugees with depression: effects on nutrition, physical activity and sleep

Abstract Background Refugees have high levels of psychological distress that hamper lifestyle change efforts. We previously reported that community health educator (CHE) diabetes prevention interventions decreased HbA1c and depressive symptoms among Cambodian-American refugees with depression; this paper reports health behavior outcomes of those interventions. Methods Participants were aged 35–75, Khmer speaking, at risk for diabetes, and met study criteria for likely depression by either a) antidepressant medication and/or b) prolonged elevated depressive symptoms. Participants were randomized to one of three CHE interventions: 1) lifestyle intervention called Eat, Walk, Sleep (EWS), 2) EWS plus medication therapy management with a pharmacist/CHE team (EWS + MTM), or, 3) social services (SS; control). Physical activity and sleep were measured with 7 days of actigraphy. Nutrition was measured as carbohydrates as reported in a culturally tailored food frequency questionnaire. Assessments were at baseline, end point (12 months), and follow-up (15 months). Results The n = 188 participants were 78% female, average age of 55 years, half had a household income < $20,000, and modal education was 7.0 years. Individuals in the two treatment groups that received the EWS intervention significantly increased their brown rice consumption (p < .001, Cohen’s d = 0.76) and their moderate-to-vigorous activity (p = .039, d = 0.32). No intervention changed sleep duration, timing, efficiency or wake after sleep onset. Across groups, individuals who increased brown rice consumption, increased vigorous activity and decreased total sleep time variability showed decreased HbA1c, with small effect sizes. Conclusions CHEs may improve nutrition and physical activity in refugees with depression but more intensive interventions may be required to impact sleep. Improvements in all three behaviors appear to be associated with HbA1c lowering Trial registration ClinicalTrials.gov identifier NCT02502929

Maestros que hacen historia / tejedores de sentidos : entre voces, silencios y memorias

La intención del presente proyecto-libro es generar procesos colectivos que permitan reflexionar, a buscar formas de nombrar metodológica y epistemáticamente los trazos de las acciones de las memorias en movimiento, cuyos puntos de articulación son los territorios -tejidos y huecos- de los silencios, de los olvidos; de la emergencia de las narrativas que transitan por otras formas y modos de hacer historia a través de la oralidad, en sus múltiples temporalidades y rostros. Por tanto, Maestros que hacen historia, reúne a docentes-investigadores que desarrollan la práctica creativa, tanto que la formación pedagógica a través de la tensión reflexiva sobre los relatos/testimonios, como de la creación de colectivos pedagógicos, en particular sobre historia oral en nuestro continente