The seasonal influenza (flu) vaccine has been shown to prevent flu outbreaks that can cause debilitating effects on the body and even death. Underserved members of Black communities are more likely to refuse the flu vaccine than are persons of other ethnicities. The purpose of the project was to determine from a needs assessment the reasons for flu vaccine refusal in the Black population of an inner city clinic in order to develop tailored communication and nursing actions that promote awareness of the flu vaccine's importance and safety. The health belief model constructs (perceived susceptibility, perceived severity, perceived benefits, and perceived barriers) were used to guide the project. A survey based on the constructs of the health belief model was administered to a convenience sample of 40 adult patients in an inner city clinic who completed the anonymous survey while they waited for the physician. Descriptive statistics showed that adults ages 18 to 36, who were the largest group of respondents (n = 33), agreed to be vaccinated and believed the flu to be a serious disease for their age group. Reported barriers to vaccination included finding time to get vaccinated and the belief that the vaccine causes the flu. The findings supported development of an annual seasonal flu vaccine campaign that included verbal and written education, informational posters, social media messages, and a standing order to offer and administer the injection to all adults served by the practice. Social change implications are expected to include decreased morbidity and mortality from flu among the Black inner city patients and closer alignment of the clinic with the Healthy People 2020 vaccination goals.

Introduction: The continual increase of type 2 diabetes (T2D) prevalence is a global public health concern. The aetiology of T2D has not been fully elucidated and this is hampering the development of effective preventative and curative interventions to curb the T2D burden. Although much has been done to elucidate the environmental risk factors associated with T2D, little is known about the precise genetic risk factors that predispose people to it. There is limited knowledge about the common variants associated with T2D risk in the black South African population. However, evidence of shared common variants associated with T2D among people of different ethnicities has been documented. Nonetheless, the majority of the common variants that have been reported to be associated with T2D in other ethnicities are still yet to be evaluated in the black South African population. Objectives: The aim of this study was to evaluate the association of previously reported common genetic variants with T2D susceptibility, as indicated by impaired glucose tolerance (IGT), in a black South African population of Tswana descent. Methods: This study was a case-control study of 180 cases and 180 controls nested in the Prospective Urban Rural Epidemiology (PURE) study baseline data, which was collected in 2005. The DNA samples of the participants were genotyped for 77 single nucleotide polymorphisms (SNPs), using Illumina® VeraCode technology on the BeadXpress® platform. The gPlink software was used to evaluate the standard genetic models of disease penetrance for the association of the common variants with impaired glucose tolerance (IGT) while adjusting for age, sex and body mass index. Results: Four out of the 66 SNPs that were evaluated through the genetic association tests in this study were noted to be significantly associated with IGT (p< 0.05). Of the four SNPs, only rs1436955 was associated with an increase in T2D risk, while the other three variants, rs831571, rs8050136 and rs7542900, were noted to be associated with a decreased risk of T2D. However, none of the four SNPs was significantly associated with IGT after correcting for multiple testing (p <0.05). Conclusions: Black South Africans of Tswana descent might not share common variants associated with T2D risk, as indicated by IGT in other ethnicities. Wellpowered studies are required to evaluate the association of common variants with T2D risk in this population group. The results from this study emphasise the need for population-specific variants to assess the genetic susceptibility of complex diseases such as T2D in the black South African population. / MSc (Nutrition), North-West University, Potchefstroom Campus, 2014

Introduction: The continual increase of type 2 diabetes (T2D) prevalence is a global public health concern. The aetiology of T2D has not been fully elucidated and this is hampering the development of effective preventative and curative interventions to curb the T2D burden. Although much has been done to elucidate the environmental risk factors associated with T2D, little is known about the precise genetic risk factors that predispose people to it. There is limited knowledge about the common variants associated with T2D risk in the black South African population. However, evidence of shared common variants associated with T2D among people of different ethnicities has been documented. Nonetheless, the majority of the common variants that have been reported to be associated with T2D in other ethnicities are still yet to be evaluated in the black South African population. Objectives: The aim of this study was to evaluate the association of previously reported common genetic variants with T2D susceptibility, as indicated by impaired glucose tolerance (IGT), in a black South African population of Tswana descent. Methods: This study was a case-control study of 180 cases and 180 controls nested in the Prospective Urban Rural Epidemiology (PURE) study baseline data, which was collected in 2005. The DNA samples of the participants were genotyped for 77 single nucleotide polymorphisms (SNPs), using Illumina® VeraCode technology on the BeadXpress® platform. The gPlink software was used to evaluate the standard genetic models of disease penetrance for the association of the common variants with impaired glucose tolerance (IGT) while adjusting for age, sex and body mass index. Results: Four out of the 66 SNPs that were evaluated through the genetic association tests in this study were noted to be significantly associated with IGT (p< 0.05). Of the four SNPs, only rs1436955 was associated with an increase in T2D risk, while the other three variants, rs831571, rs8050136 and rs7542900, were noted to be associated with a decreased risk of T2D. However, none of the four SNPs was significantly associated with IGT after correcting for multiple testing (p <0.05). Conclusions: Black South Africans of Tswana descent might not share common variants associated with T2D risk, as indicated by IGT in other ethnicities. Wellpowered studies are required to evaluate the association of common variants with T2D risk in this population group. The results from this study emphasise the need for population-specific variants to assess the genetic susceptibility of complex diseases such as T2D in the black South African population. / MSc (Nutrition), North-West University, Potchefstroom Campus, 2014

[pt] Este trabalho busca conhecer a trajetória de vida dos universitários provenientes dos pré-vestibulares comunitários e populares em rede, que foram beneficiados com as ações afirmativas da PUC-Rio desde 1993, após a sua formatura na graduação, com especial ênfase nos indivíduos da população negra. Para tanto, procurou-se conhecer a atual realidade profissional desses indivíduos e o impacto da sua formação universitária sobre sua vida material e sobre suas relações com a família e com a comunidade de onde são provenientes. Ao empreender esta análise, que é política e simbolicamente relevante, procura-se descrever aspectos ainda desconhecidos, tanto no que diz respeito à estes novos profissionais e sua entrada no mercado de trabalho, quanto ao acesso a bens culturais recentemente aberto para os indivíduos da população negra. Assim, para além de mapear a trajetória dos 14 indivíduos entrevistados, procurou-se entender as questões colocadas a partir de sua formação, para saber se o acesso ao ensino superior e a passagem pela universidade tem de fato ampliado os seus direitos de cidadania. A intenção é a de contribuir com informações que permitam avaliar se as perspectivas integradoras da população negra, muito presentes nos discursos sobre ações afirmativas, tanto nas universidades, como na esfera do trabalho, têm sido capazes de transformar os conteúdos subjacentes às relações raciais no contexto sociocultural brasileiro. / [en] This work deals with life histories of college students from PUC-Rio, after their graduation, who were included in the university s affirmative action program since 1993, with special emphasis on the black population. Those students belong to social networks called community pré-vestibulares. The aim of this work is to know the present professional reality of those individuals and to measure the impact of their college education upon their material lives and their social relations within family and community. This analysis is political and symbolically relevant because will enable to describe unknown aspects of the present professional life of the black population. Those aspects relate to day-to-day experiences of their entrance to the job market, as well as to the recently open access to a new cultural reality to the black population. The research is based on the interview of 14 individuals, whose life histories were described and analyzed with the purpose of understanding the impact of their professional training upon their rights as citizens of Brazilian society. The goal is to contribute information which will enable an evaluation of the impact of the affirmative actions of higher education institutions, as well as in the job market, concerning the remaining contents of racial relations in Brazilian cultural and social life.

Este trabalho tem como objetivo demonstrar que o uso das ações coletivas para a defesa de direitos transindividuais da população negra, mostra-se assertivo na promoção da igualdade racial, pois este instrumento processual de tutela coletiva reúne elementos adequados a promover igualdade material com medidas inclusivas, compensatórias, reparatórias, punitivas e educativas. Por outro lado, as ações coletivas enfrentam problemas no que diz respeito às medidas contra o racismo institucional e à discriminação indireta. Para tanto, realizou-se pesquisa bibliográfica sobre o tratamento jurídico recebido pelo indivíduo negro no Brasil e sobre aspectos das relações raciais, focalizando em subsídios a interpretação judicial das demandas de promoção da igualdade racial, como conceitos de racismo, preconceito e discriminação racial. Em seguida, complementou-se este estudo com a análise da proteção de direitos transindividuais da população negra, com base na Lei de Ação Civil Pública. Destacou-se nesta pesquisa as funções assumidas pelo poder judiciário, jurisdição e processo para se cumprir com os fins sociais do Estado democrático de direito sempre que provocados a cumprir com os direitos fundamentais envolvidos na promoção da igualdade racial. Tanto a Constituição Federal quanto normas infraconstitucionais expressam os princípios protetivos contra a discriminação e o racismo. É preciso se considerar o problema racial no plano coletivo e não apenas individual, buscando-se uma proteção mais efetiva da política antirracismo. A pesquisa foi desenvolvida por meio de uma investigação bibliográfica quanto ao racismo sob a perspectiva jurídica nacional, e da análise dialético-expositiva dos institutos do microssistema de processo coletivo nacional e ação civil pública. / This study aimed to demonstrate that the use of class action for the defense of transindividual rights of black people, it is shown assertive in promoting racial equality, for this procedural instrument of collective protection meets all relevant factors to promote the material equality with inclusive measures, compensatory, remedial, punitive and educational. On the other hand, collective action facing problems with regard to measures against institutional racism and indirect discrimination. Held documental research on the legal treatment of black individuals in Brazil and on aspects of race relations, focusing on subsidies judicial interpretation of the demands of promoting racial equality, as concepts of racism, prejudice and racial discrimination. Then added up this study with analysis of trans-rights protection of the black population, based on the Public Civil Action Law. It is noteworthy in this research the functions assumed by the judiciary, jurisdiction and process to meet the social purposes of the democratic rule of law whenever caused to comply with the fundamental rights involved in promoting racial equality. Both the Federal Constitution and infra-constitutional norms express the protective principles against discrimination and racism. It has to consider the racial problem at the collective level, not just individual, seeking a more effective protection of anti-racism policy. This research was developed through a literature search as racism under the national legal perspective, and dialecticalexpository analysis of microsystem institutes of national class action and public civil action.

Introdução: A metade da população brasileira feminina é constituída por negras. Muitas mulheres pertencentes a este grupo racial jamais fizeram a mamografia, e a taxa de mortalidade materna é maior entre as negras. Muitas desigualdades ainda persistem em diversos setores da sociedade, inclusive no âmbito da saúde, mesmo após a implementação do Sistema Único de Saúde, que disponibiliza assistência gratuita a todas as pessoas. Objetivos: Explorar as crenças, valores e práticas das mulheres negras relativas ao cuidado com a saúde no domicílio, no contexto da própria comunidade e a sua interface com a busca por assistência nas instituições de saúde. Metodologia: A pesquisa foi desenvolvida mediante abordagem qualitativa, utilizando-se do método etnográfico. O estudo foi desenvolvido na Cidade de São Paulo, no bairro Cidade Ipava (CI), uma região do Jardim Ângela constituída por uma grande proporção de negros, apresentando altos índices de vulnerabilidade à pobreza. Os dados foram coletados mediante o processo de observação participante e entrevistas etnográficas com 17 informantes gerais e três informantes chave. Resultados: Três descritores e um tema cultural expressam as crenças, valores e práticas das mulheres negras relativas ao cuidado com a saúde: 1) Faço o máximo para não ir ao médico - cuido da saúde do jeito que posso para evitar ficar doente: 2) A experiência com a assistência à saúde que recebo nas instituições não é boa: 3) Sofro racismo velado por ser negra. O tema cultural foi: Sem outra saída somos obrigadas a enfrentar obstáculos e buscar assistência médica porque os remédios caseiros não deram certo e o problema de saúde é grave. Conclusões: As mulheres se deparam com muralhas (in)visíveis ao acessar as instituições de saúde. Os resultados desta pesquisa reiteraram a premissa de que os determinantes sociais que marcam as desigualdades em saúde, tais como, as relações de gênero, classe social, idade, território, religião, raça/cor, entre outros aspectos, não se manifestam de forma isolada nas relações sociais. No tempo atual pós-moderno, as desigualdades sociais persistem, sobretudo entre as mulheres negras moradoras das regiões periféricas de grandes metrópoles. Estas requerem suporte para o empoderamento, essencial para reivindicar, acessar e usufruir de uma assistência à saúde de qualidade. / Introduction: Half of the female Brazilian population is black. Many women in this racial group never did mammography, and the maternal mortality rates are higher among them. Many inequalities still persist in many society sectors, including health, even after the implementation of the National Health System, which provides free health care for all people. Objectives: To explore the beliefs, values and practices of black women regarding health care at home, in the community context, and it is the interface with the process of seeking for health care facilities. Methodology: The research was conducted through qualitative approach and the ethnographic method was done. It was carried out in the city of São Paulo, at a neighborhood district called Cidade Ipava, located in Jardim Angela, where is there a large proportion of blacks, which suffer high levels of vulnerability to poverty. Data were collected through the participant observation process and ethnographic interviews were done with 17 general informants and three key informants. Results: Three descriptors and a cultural theme express the beliefs, values and practices of black women regarding health care: 1) I do my best to not have to go to the doctor I take care of the health as I can to avoid getting sick: 2) The experience with the health care that I have received in health care facilities is not good: 3) I suffer hidden prejudice for being black. The cultural theme was: Do not having another way - we are forced to face obstacles and must seek for medical care because the home medicines did not showed effects and the health problem is serious. Conclusions: Women are faced with (in)visible obstacles when they to access the health care facilities. These results reiterated that the social determinants which characterize the health inequalities, such as gender relations, social class, age, territory, religion, race, among others, do not manifest themselves alone in the social relations. At the current post-modern environment, the social inequalities persist, especially among black women residents of outlying areas of large cities. These require support for empowerment, essential to claim, to access and to enjoy a high quality health care.

Submitted by Marcos Anselmo (marcos.anselmo@unipampa.edu.br) on 2016-09-22T12:57:22Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) PatriciaMaurer.pdf: 1214978 bytes, checksum: 59751fb7a14586f406187c0afea9a8ef (MD5) / Approved for entry into archive by Marcos Anselmo (marcos.anselmo@unipampa.edu.br) on 2016-09-22T12:58:09Z (GMT) No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) PatriciaMaurer.pdf: 1214978 bytes, checksum: 59751fb7a14586f406187c0afea9a8ef (MD5) / Made available in DSpace on 2016-09-22T12:58:09Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) PatriciaMaurer.pdf: 1214978 bytes, checksum: 59751fb7a14586f406187c0afea9a8ef (MD5) Previous issue date: 2015-07-24 / A população negra apresenta elevado risco cardiometabólico, contudo em estudos populacionais a incidência de síndrome metabólica (SM) nesta população é baixa. Neste contexto, parece existir um paradoxo relacionado aos critérios diagnósticos da SM, o que faz com que a presença da mesma seja subestimada em negros. Esta condição traz consigo a necessidade da busca de marcadores mais fidedignos das condições patológicas e do risco cardiometabólico destes indivíduos. Um possível biomarcador é o óxido nítrico (NO), cuja dosagem de metabólitos como nitrito/nitrato (NOx) tem se mostrado associada a alguns critérios da SM, como obesidade e diabetes, entretanto a literatura carece de trabalhos mais específicos para avaliar se níveis alterados de óxido nítrico estão associados com alterações metabólicas e doenças cardiovasculares na população negra. O objetivo deste estudo foi analisar os níveis de NOx como marcador de alterações cardiometabólicas em afrodescendentes, bem como sua relação com parâmetros laboratoriais na população negra. Participaram do estudo 202 indivíduos autodeclarados negros, a maioria mulheres, com idade média de 45 anos. A avaliação antropométrica demonstrou que a maioria da população estudada estava com IMC médio classificado como obesidade grau 1 e com cintura abdominal alterada. A SM foi verificada em 61% da amostra. Os níveis de nitrito/nitrato foram distribuídos em percentis, o percentil 50%=122,3μmol/L foi escolhido como ponto de corte. Valores de NOx<122,3 μmol/L foram associados com maiores Índices de Massa Corporal (p=0,015), circunferência abdominal (p=0,037) e circunferência de quadril (p=0,040). Quanto aos critérios bioquímicos, o NOx associou-se significativamente aos níveis de glicose (p=0049), triglicerídeos (p=0,046), albumina (p=0,034), ácido úrico (p=0,019) e uréia (p=0,052). Na avaliação inflamatória e de estresse oxidativo, apenas a carbonilação de proteínas (p=0,002) foi associada ao NOx, em que o dano foi maior nos indivíduos que tinham valores de NOx menor do que o percentil 50%. Não houve nenhuma associação entre o NOx e o perfil hematológico. Por estar relacionado principalmente com obesidade, dislipidemias, glicose e triglicerídeos, o NOx foi considerado um bom preditor de risco cardiometabólico na população negra, principalmente de progressão de doença, além de ser um teste adaptado facilmente à rotina laboratorial e possível de ser programado em analisadores automáticos e semi-automáticos, necessitando de pouca preparação da amostra. / The black population has a high cardiometabolic risk, however low incidence of metabolic syndrome (MetS). In this context, there seems to be a paradox related to the diagnostic criteria of MetS, which makes the presence of the same is underestimated in blacks. This condition shows the need to look for a more reliable markers of actual pathological conditions and cardiometabolic risk of these individuals. A possible marker is nitric oxide (NO). The dosage metabolic nitrite/nitrate (NOx) have been shown to be associated with certain criteria of the metabolic syndrome, such as obesity and diabetes, however the literature lacks more specific studies to assess whether altered levels of nitric oxide are associated with metabolic and cardiovascular disease among blacks. The aim of this study was to analyze the NOx levels as a marker of cardiometabolic alterations in Brazilian blacks, as well as its relationship with anthropometric, biochemical, inflammatory and oxidative stress in the black population. The study included 202 self-declared black people, mostly women, average age 45 years. Anthropometric assessment showed that most of the study population had an average BMI classified as grade 1 obesity and altered waist circumference. The metabolic syndrome was found in 61% of the sample. NOx levels were distributed in percentiles, the 50% percentile = 122,3μmol / L was chosen as the cutoff point. NOx values <122.3 μmol/L were associated with higher body mass index (p=0.01), waist circumference (p=0.03) and hip circumference (p=0.04). As to biochemical criteria, the NOx was significantly correlated to blood glucose levels (p=0.04), triglycerides (p=0.04), albumin (p=0.03), uric acid (p=0.01) and urea (p=0.05). In inflammatory and oxidative stress assessment, only protein carbonylation (p<0.01) was associated with the NOx, in which the damage was greater in subjects who had NOx values lower than the 50% percentile. There was no association between NOx and the blood profile. To be mainly related to obesity, dyslipidemia, glucose and triglycerides, the NOx was considered a good predictor of cardiometabolic risk in black population, mainly of disease progression as well as being an adapted easily to laboratory test routine and can be programmed in analyzers automatic and semi-automatic, requiring little sample preparation.

Trata-se de uma pesquisa histórica sobre a educação da população negra na Parahyba do Norte. A partir dos aportes teóricos da história social e da micro-história, e da contribuição de pesquisas em história da escravidão e da população negra, e de investigações sobre a história da educação, foram consultadas fontes primárias como imprensa, relatórios e documentos da instrução pública, literatura memorialística e arquivos eclesiásticos, a fim de acompanhar a relação entre negros e educação ao longo do século XIX. Partiu-se do expressivo percentual de população negra que compunha a província e da ausência de pesquisas sobre a temática para acompanhar as experiências e iniciativas voltadas para a população negra e as oriundas dessa camada da população no contato com a escola e o conhecimento da leitura e escrita numa sociedade que transitava do domínio da oralidade para o da escrita. Analisaram-se leis e regulamentos da instrução com interdições a não brancos a fim de perceber como a administração provincial lidou com a presença negra e comparou-se esse conjunto com os de outras províncias, inserindo-se a Parahyba do Norte no Brasil Império. Discutiram-se sentidos e significados de ser negro na província, observando-se cores, qualidades e condições jurídicas dos sujeitos da tese, denominados em conjunto como negros e destacou-se a instabilidade entre escravidão e liberdade para esses. Foram enfatizadas, também, outras experiências possíveis para homens negros no período a partir de um conjunto de personagens que se sobressaíram por seu pertencimento à elite educacional da região. Para isso, o fio condutor da análise foi a vida e trajetória de um desses sujeitos, o professor, político e coronel Graciliano Fontino Lordão. Entende-se que para que estes tenham logrado esse destaque na sociedade local, inúmeros outros sujeitos de origem negra se relacionavam com o universo letrado. Acompanhou-se o contato com a leitura e escrita na escola e em outros espaços de aprendizado de pessoas escravas, filhos de homens e de mulheres de cor livres, filhos de escravas, pretos, pardos e mestiços, alunos de instituições para pobres e desvalidos desde o início do período imperial até a abolição da escravidão e proclamação da República. A análise dos rastros que sobreviveram nas fontes primárias permitiu observar a heterogeneidade das experiências negras na Parahyba do Norte e as possibilidades de inserção desse grupo no universo letrado. / This is a historical research on education of black population in Parahyba do Norte. Based on theoretical contributions of social history and microhistory, of research on the history of slavery and the black population, as well as investigations into the history of education, primary sources were consulted, such as the press, reports and documents related to the public instruction, memorial literature and ecclesiastical archives, in order to follow the relation between blacks and education throughout the nineteenth century. Considering the expressive percentage of the black population that constituted the province and the lack of research on this topic, we followed the experiences and initiatives towards the black population and those coming from this layer of the population in contact with the school and the knowledge of reading and writing in a society that moved from the domain of orality to writing. We analyzed laws and regulations of the public instruction with prohibitions to non-whites in order to understand how the provincial administration dealt with the black presence. We also compared this legislation with those of other provinces, circumscribing Parahyba do Norte within the Brazil Empire. We discussed the senses and meanings of being black in the province, observing the colors, qualities and legal conditions of the subjects analyzed in this thesis, jointly denominated as blacks, emphasizing the instability among slavery and freedom. We also highlighted other possible experiences for black men in the period from a group of characters who stood out for their membership in the region\'s educational elite. To do this, the guiding thread of the analysis was the life and trajectory of one of these subjects, teacher, politician and colonel Graciliano Fontino Lordão. It is understood that these subjects achieved this prominence in local society since numerous other subjects of black origin had contact with the literacy. We took into account the contact with reading and writing in school and in other learning spaces of slave people, children of free colored men and women, children born to slave women, blacks, mulattos and mestizos, students of institutions for the poor and helpless since the beginning of the imperial period until the abolition of slavery and proclamation of the Republic. The analysis of the traces that remained in the primary sources allowed us to observe the heterogeneity of the black experiences in Parahyba do Norte and the possibilities of insertion of this group in the literacy.

Thesis (M.A. (Human Movement Science))--North-West University, Potchefstroom Campus, 2009.

Thesis (M.A. (Human Movement Science))--North-West University, Potchefstroom Campus, 2009.