RESUMO
INTRODUCTION: One reason given by the South African government for establishing a physician training agreement with Cuba is that the ethical, humanistic and solidarity principles promoted in Cuban medical education are difficult to acquire in other settings. However, Cuba's general medical training program does not provide all skills needed by a general practitioner in South Africa: other competencies are required, such as management of general and gynecological or obstetrical surgical emergencies, administration of anesthesia and nursing procedures. As long as the desired humanistic values were assured, South African authorities have preferred to complement these competencies. Thus, since 2003, the Medical University of Villa Clara has applied a curricular strategy of 12 complementary courses to develop the requested additional skills, but results have not met expectations. OBJECTIVE: Determine why the complementary curricular strategy has not been entirely successful and identify possible courses of action for improvement. METHODS: A document review was conducted of the curricular strategy applied and of minutes of meetings between Cuban and South African counterparts to identify correspondence between requested professional skills and actions to develop them. In addition, South African students were surveyed and Cuban professors were interviewed in depth. Senior university administrators and key informants were also interviewed. Variables assessed were course quality and satisfaction of students and professors. RESULTS: Some actions originally included in the curricular strategy were not implemented and there were structural weaknesses in complementary courses, primarily in objectives, teaching strategy and evaluation. Students reported insufficient practical activities and lack of relationship between content and the health situation in South Africa. Professors were dissatisfied with student levels of motivation and ability to manage their own learning. Other influencing factors were insufficient academic management and professors' lack of knowledge about the context where these future professionals would eventually practice. CONCLUSIONS: Curricular strategy deficiencies detected are primarily in academic management; overcoming them could facilitate action in specific directions identified to improve the requested skill levels.
Assuntos
Competência Cultural , Educação Médica/organização & administração , Clínicos Gerais/educação , Estudantes de Medicina/psicologia , Educação Baseada em Competências/métodos , Educação Baseada em Competências/organização & administração , Cuba , Currículo , Educação Médica/métodos , Docentes de Medicina , Humanos , Intercâmbio Educacional Internacional , Entrevistas como Assunto , Avaliação das Necessidades , Avaliação de Programas e Projetos de Saúde , Pesquisa Qualitativa , África do Sul/etnologiaRESUMO
The authors use examples of youth civic engagement from Chile, South Africa, Central/Eastern Europe, and the United States--and also emphasize diversities among youth from different subgroups within countries--to illustrate common elements of the civic domain of youth development. These include the primacy of collective activity for forming political identities and ideas and the greater heterogeneity of civic compared to other discretionary activities, the groupways or accumulated opportunities for acting due to the groups (social class, gender, ethnic, caste, etc.) to which a young person belongs, and the role of mediating institutions (schools, community-based organizations, etc.) as spaces where youths' actions contribute to political stability and change.
Assuntos
Desenvolvimento Infantil , Relações Comunidade-Instituição , Comportamento Cooperativo , Diversidade Cultural , Democracia , Mudança Social , Criança , Chile/etnologia , Europa (Continente)/etnologia , Humanos , Modelos Organizacionais , Grupo Associado , África do Sul/etnologia , Estados Unidos/etnologiaRESUMO
The significance of social movements for pro-poor political and social change is widely acknowledged. Poverty reduction has assumed increasing significance within development debates, discourses and programmes - how do social movement leaders and activists respond? This paper explores this question through the mapping of social movement organisations in Peru and South Africa. We conclude that for movement activists 'poverty' is rarely a central concern. Instead, they represent their actions as challenging injustice, inequality and/or development models with which they disagree, and reject the simplifying and sectoral orientation of poverty reduction interventions. In today's engagement with the poverty-reducing state, their challenge is to secure resources and influence without becoming themselves subject to, or even the subjects of, the practices of government.
Assuntos
Programas Governamentais , Pobreza , Política Pública , Mudança Social , Justiça Social , Seguridade Social , Programas Governamentais/economia , Programas Governamentais/educação , Programas Governamentais/história , Programas Governamentais/legislação & jurisprudência , História do Século XX , História do Século XXI , Peru/etnologia , Pobreza/economia , Pobreza/etnologia , Pobreza/história , Pobreza/legislação & jurisprudência , Pobreza/psicologia , Áreas de Pobreza , Assistência Pública/economia , Assistência Pública/história , Assistência Pública/legislação & jurisprudência , Política Pública/economia , Política Pública/história , Política Pública/legislação & jurisprudência , Mudança Social/história , Justiça Social/economia , Justiça Social/educação , Justiça Social/história , Justiça Social/legislação & jurisprudência , Justiça Social/psicologia , Responsabilidade Social , Seguridade Social/economia , Seguridade Social/etnologia , Seguridade Social/história , Seguridade Social/legislação & jurisprudência , Seguridade Social/psicologia , África do Sul/etnologiaRESUMO
It has been difficult to explain why all HTLV-1 sequences in Salvador, a city in the northeast of Brazil, belong to the Transcontinental (A) subgroup of the Cosmopolitan (a) subtype, since according to historical data the vast majority of slaves brought to Brazil (through Salvador) came from west Africa, where only the western African subgroup (C) has been found. To shed more light on this subject we conducted a phylogenetic analysis of 23 isolates from blood donors of Salvador. DNA was extracted and submitted to a nested PCR for amplification of the entire LTR region. The PCR products were purified and sequenced on an automated sequencer. Neighbor-joining and maximum likelihood phylogenetic analyses were performed. None of the new sequences from Salvador clustered within the West-African subgroup C. Confirming previous results, all sequences belonged to the Transcontinental subgroup (A) of the Cosmopolitan subtype, and clustered in two Latin American clusters. In addition we showed sequences from southern Africa clustering in both Latin American clusters. One of the new sequences is ancestral to the larger Latin American cluster beta due to a duplication of a 12-bp long fragment, a finding that has not been previously described. These findings support the hypothesis that HTLV-1 isolates circulating in Latin America have a closer relationship to South African compared to West-African HTLV-1 strains. The 12-bp-long duplications in one of the sequences has no obvious clinical or biological implications yet.
Assuntos
Doadores de Sangue , Infecções por HTLV-I/etnologia , Infecções por HTLV-I/epidemiologia , Vírus Linfotrópico T Tipo 1 Humano/classificação , Brasil/epidemiologia , Estudos de Coortes , Infecções por HTLV-I/genética , Vírus Linfotrópico T Tipo 1 Humano/genética , Humanos , Oriente Médio/epidemiologia , Dados de Sequência Molecular , Filogenia , Reação em Cadeia da Polimerase , África do Sul/epidemiologia , África do Sul/etnologiaRESUMO
BACKGROUND: RH genotyping assays are mainly based on research in whites. These assays may not be reliable in a multiracial society because of the genetic variation in RH among ethnic groups. STUDY DESIGN AND METHODS: Five groups from different ethnic backgrounds were serologically typed for C and c and were genotyped on nucleotide C48 and intron 2 for RHC and RHc on nucleotides C178 and C307. RESULTS: RHc genotyping with both methods proved to be reliable. RHC genotyping on C48 is not reliable because of a 48G>C mutation in the RHce allele (false-positive prediction of C). This mutation was found in every ethnic group and does not affect c or e expression. RHC genotyping on intron 2 is unreliable because of r's (Cdes) alleles (a false-negative prediction of C). This allele was found in whites and blacks from Curaçao and South Africa. Reactions of r's cells with anti-C are weaker, but no negative reactions with various MoAbs were found. A new method (RHC/c/hex3-intron 4/exon 7 multiplex PCRs) was developed based on intron 2 and r's hybrid exon 3 characteristics (RHC) and C307 (RHc). CONCLUSIONS: Reliable RHC and RHc genotyping is possible in different ethnic groups with the RHC/c/hex3-intron 4/exon 7 multiplex PCR approach.
Assuntos
Etnicidade/genética , Glicoproteínas/genética , Sistema do Grupo Sanguíneo Rh-Hr/genética , Alelos , Ásia/etnologia , Povo Asiático/genética , População Negra/genética , Tipagem e Reações Cruzadas Sanguíneas , Análise Mutacional de DNA , Desoxirribonucleases de Sítio Específico do Tipo II , Etiópia , Éxons/genética , Frequência do Gene , Genótipo , Humanos , Íntrons/genética , Países Baixos/etnologia , Antilhas Holandesas , Fenótipo , Reação em Cadeia da Polimerase , Polimorfismo de Fragmento de Restrição , África do Sul/etnologia , População Branca/genéticaRESUMO
Investigators have reported variable findings regarding the role of race in diurnal blood pressure patterns. We performed a review and meta-analysis of this literature to identify the overall effect of race on circadian blood pressure patterns. Eighteen studies involving 2852 participants were reviewed. Meta-analyses were conducted using effect sizes calculated from the data provided directly in the study reports. Separate meta-analyses were conducted on effect sizes for differences between blacks and whites in daytime and nighttime systolic and diastolic blood pressure and nocturnal dip in systolic and diastolic blood pressure. To evaluate discrepancies in findings from studies involving American versus non-American blacks, overall meta-analyses as well as within-subset meta-analyses of black/white differences were conducted for comparisons involving American and non-American blacks. Results of overall meta-analyses indicate that blacks experience higher levels of systolic and diastolic blood pressure, both at night and during the day. These differences were significantly greater at night than during the day (P<0.05). Results of within-subset analyses involving American blacks mirrored those for all black/white comparisons, except that the effect of race on nocturnal dip, ie, that American blacks experienced less of a dip in both systolic and diastolic blood pressure at night, was significant (P<0.05). In contrast, the effect of race on nocturnal dip was not significant for comparisons involving non-American blacks. These results suggest a consistent difference in the chronobiology of blood pressure, particularly in American blacks.