Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal.

Este estudo descreve os desafios para promoção da saúde sexual e reprodutiva entre estudantes do Ensino Médio que residem em comunidades quilombolas, utilizando o quadro de Vulnerabilidade e Direitos Humanos (V&DH) para destacar neste cenário os fatores e a dinâmica sócio-programática que aumentam a suscetibilidade às IST/HIV e gravidezes não planejadas. A partir da triangulação de métodos com base em estudo etnográfico que utilizou entrevistas, questionários, e observação participante de práticas de educação em sexualidade, identificamos que a maior vulnerabilidade dos estudantes quilombolas está relacionada a interação dinâmica de seis aspectos. (1) O território quilombola conformados historicamente pelo racismo resultando no empobrecimento, restrição de acesso aos equipamentos públicos de saúde e educação. (2) Transformações no modo de viver nas relações entre os gêneros, étnico-raciais e geracional - produziram novas tensões para o exercício da sexualidade dos jovens estudantes, embora perdurem as expectativas relacionadas às performances sexuais demarcadas pela heteronormatividade e desigualdade entre os gêneros: os meninos são estimulados à prática sexual e das meninas espera-se a abstinência sexual até o casamento. (3) Os educadores, cujo processo de trabalho dificulta a integração do tema no currículo, se sentem despreparados, faltam materiais e incentivos financeiros para o seu envolvimento e há fragilidade de articulação com os serviços de saúde, assim como menor aceitabilidade dos pais em relação a esses programas, menor ainda para as meninas. (4) A qualidade de serviços de saúde disponíveis - frágeis na resolutividade, faltam médicos, exames, medicamentos, sobram dificuldade de referenciamento. Os serviços de saúde não se adequam à cultura local e contribuem para a negligência aos direitos dos jovens em acessar informações, insumos e os programas preventivos. (5) Pais e responsáveis, profissionais de saúde e de educação não reconhece os direitos sexuais e reprodutivos dos estudantes. (6) os discursos e as práticas dos jovens sobre a sexualidade e cuidados preventivos indicam a sua vulnerabilidade individual associada à insuficiência dos conhecimentos sobre prevenção e baixa percepção de risco. O uso pouco consistente dos preservativos, a dificuldade de acesso aos contraceptivos, indicam desafios para os programas educativos e serviços voltados para os jovens. Ao mesmo tempo, a negligência da promoção e proteção dos direitos à saúde sexual e reprodutiva de jovens estudantes, comum a contextos de pobreza e escassez de infraestrutura, é coproduzida na sua singularidade pelo lugar: o estigma e a discriminação associado à comunidade quilombola se somam à precariedade das estradas e do transporte, do acesso à internet e telefone e o desprezo pelas tradições culturais. Ao final do projeto, a escola mostrou ser um local estratégico para promoção da saúde sexual e reprodutiva desses jovens. Para tanto é preciso que os programas de educação em sexualidade identifiquem e abordem, em cada cenário, a singularidade de cada lugar que potencializará ou que dificultará a efetivação dos direitos sexuais e reprodutivo dos jovens, que demanda sua participação no processo / This study describes the challenges to sexual and reproductive health promotion for high school students that live in quilombola communities. The vulnerability and human rights (V&HR) framework indicate the factors and the social-programmatic dynamic that increase their susceptibility to STI/AIDS and unplanned pregnancies. Through methodological triangulation based in an ethnographic study conducted through interviews, questionnaires, and participant observation of sexuality education practices, we identify that the increase in the vulnerability of the quilombola students is related to six dynamic aspects. (1) The quilombola territory, historically shaped by racism and resulting in impoverishment, lower access to social services as health and education. (2) The recent transformations in their lifestyles - in the generational, gender and racial-ethnic relations - created new tensions to the experience with the sexuality of the young students, while sustaining the anticipated heteronormative and gender inequality; boys are stimulated to have sex and girls should wait for marriage. (3) Teachers feel they are unprepared and do not have a working process that guarantees this themes in the curriculum. They lack resources and financial incentives to be involved or to involve health services, and face lower parents acceptability related to these programs, even lower to girls. (4) The quality of existing health services, that lack medical doctors, exams, medication, and cant perform good reference to other services. They are not culturally sensitive and sum up to the negligence of the young people rights to access information, prevention tools, and programs. (5) The low recognition of their sexual and reproductive health by their parents and adults responsible for their health and education. Still, students do not see themselves as sujeitos de direitos (rights holders). (6) Sexuality discourses and practices of young people and their self-care indicate an individual vulnerability associated with the lack of prevention knowledge and low-risk perception. The inconsistent condom use and the lack of access to contraceptives indicate challenges for the health and educational programs to young people. Also, the negligence in the promotion and protection of the young students common to disenfranchised contexts is co-produced by the local singularities: stigma and discrimination associated to the quilombola community enhance the effects of precarious roads and transportation, lack of access to telephone and internet, and no respect for their cultural traditions. Ultimately, the school proved to be a strategic place (Lugar) to the sexual and reproductive health of these students. But also showed the requirement for sexuality education programs to identify the singularities of each place, which will enhance or complicate young peoples sexual and reproductive rights, and of their participation in the process

Made available in DSpace on 2015-04-22T22:14:17Z (GMT). No. of bitstreams: 1 Evelyn Costa Lira.pdf: 1005417 bytes, checksum: 3bedf4425cb61a6cb9ef7da53b2dd67f (MD5) Previous issue date: 2010-12-10 / Fundação de Amparo à Pesquisa do Estado do Amazonas / The cervical cancer is the second most common type of cancer between women worldwide. In Brazil, 18.430 new cases of the disease are expected through 2010. Its incidence is greater in the North region. One of the most crucial factors to the spawning of this kind of cancer is the presence of an infection caused by the HPV (Human Papillomavirus). By itself, this virus can t lead to carcinogenesis. Some studies suggest the presence of Chlamydia trachomatis as a co-factor in its development. This study s goal was to investigate the co-infection of HPV and C. trachomatis in cervical samples with normal and altered cell biologies. Its consisted of a transversal study, where two groups were applied: GROUP I, made of 152 women who showed pre-malignant and malignant cervical injuries, and GROUP II, of 164 women who showed inflammatory cell biology. The HPV/C. trachomatis co-infection was detected through PCR and the two HPV types were detected by sequencing. Co-infection was found in 27,1% (41/152) of women in GROUP I and 3,75% in GROUP II s. The connection between the co-infection and the environmental, socio-economic and clinical factors was observed only to the variable HPV type (p=0,0424) which associates HPV 16 to 64,1% of co-infected women. / O câncer de colo do útero é o segundo tipo de câncer mais comum entre as mulheres no mundo inteiro. Para o Brasil, o número de novos casos esperados, em 2010, é de 18.430. Na região Norte é o mais incidente. Um dos fatores mais importantes para o surgimento deste tipo de câncer é a presença da infecção pelo Papilomavírus Humano (HPV). Sozinho, este vírus não pode levar à carcinogênese. Alguns estudos sugerem a presença da Chlamydia trachomatis como co-fator em seu desenvolvimento. Este estudo teve como objetivo investigar a co-infecção de HPV e C. trachomatis em amostras cervicais com citologia normal e alterada. Trata-se de um estudo transversal, onde foram utilizados dois grupos: o GRUPO I, constituído de 152 mulheres que apresentaram lesões pré-malignas e malignas do colo do útero e o GRUPO II, constituído de 164 mulheres que apresentaram citologia inflamatória. A co-infecção HPV/C. trachomatis foi detectada através da PCR e os tipos de HPV foram identificados via seqüenciamento. Foi encontrada co-infecção em 27,1% (41/152) das mulheres do GRUPO I e em 3,75% das mulheres do GRUPO II. A associação entre a co-infecção e os fatores sócio-econômicos-ambientais e clínicos foi observada apenas para a variável Tipo de HPV (p=0,0424) que associa o HPV 16 a 64,1% das mulheres co-infectadas.

本研究旨於探討政策研究社群(STI policy research communities)在政策實務中所扮演的角色、與政策實務間的關係及互動，以及該社群隨著不同政策情境其所累積的知識結構。本文以英國科技政策研究社群SPRU及MIoIR為例，首先以Top-down的方式從整體制度及機構面進行探討，第二部份則進一步描述及探討SPRU及MIoIR這兩個研究社群在英國政策實務中所扮演的角色及定位。第三部份旨於探討在英國的政策研究及決策支援制度情境下，政策研究社群與政策實務間的互動關係，以及影響兩者關係的關鍵因素。第四部份則進一步探討如何橋接政策與研究之間的缺口，以及研究社群如何透過不同的研究成果擴散模式，進而政策產生影響與效益。第五部份，本文綜合英國科技政策社群所處之制度及機構情境、政策研究社群之知識產出、政策與研究之間的缺口、以及兩者間的互動關係，從Bottom-Up的角度提出一全面性的理論架構，填補過去文獻在探討政策與研究兩者間關係時，僅探討部份、或分析特定議題之理論缺口。 / The importance of scientific research which positively motivates economic growth has been widely recognised by governments of most countries in the world. A government needs to formulate policies for sustaining national developments, but a sound policy usually has to be evident by academic findings provided by academic researcher. On the opposite, an academic researcher can conduct research needed by the government only if they can be funded by the government. The mutual reliance on each other for academic researchers and the government as well as the relationship between them have been investigated previously in literature. The complex relationship between the government and researcher is modelled as “principal-agent relationship” (Pratt & Zeckhauser, 1985). The interdisciplinary STI (Science, Technology and Innovation) policy research, which seeks to solve socioeconomic problem at national level, creates knowledge much closer to what the government needs and can be used directly to inform policy formulation. The relationship between the government and STI policy research community is therefore much stronger and more sensitive than that between the government and other research communities. In the process of delivering research to policymakers, the agenda and concern underlying different interacting scenarios between actors are varied from academia, funding agency, governmental organisation and policy makers. Therefore, changing the way of communication is becoming important for academic researchers to make the whole process more smoothly or effectively. However, in this interacting process research actors not only need to turn around the language, but also change the perspective they view from different scenarios especially when there is conflicting interest or view exited between academia and politics. The purpose of this study aims to investigate in what way can STI policy research community influence policy as well as interaction between STI policy research community and the government by bottom-up approach, i.e. from STI policy researcher to the government and three different perspectives proposed by Allison (1971), i.e. 1) Bounded Rational Perspective, 2) Organisational Behaviour Perspective, and 3) Governmental Politics Perspective. This study selects the two prestigious research organisations in the UK- SPRU and MIoIR (formerly PREST) as the case study and a total of sixteen renown interviewees are interviewed, since the UK is the leading country in STI policy research and the most outstanding research organisations in the UK STI policy research community are SPRU and MIoIR which have contributed to STI policymaking since 1970s, interaction between the UK government and this research community are analysed. Further, the UK Technology Foresight programme undertaken jointly by SPRU and MIoIR is used as a representative event to demonstrate the responding strategy of STI policy research community to the UK government. It is found in this study that a successful contribution from STI policy research community to the government critically relies on appropriate responding strategies which are dependent on whom (on the government side) exactly the researcher is interacting with. A successfully interaction between researcher and the government takes a sound strategy which eventually lead to contribution of research to policy practice. Finally, this study develops several propositions for suggesting how to sustain effective policy contribution from STI policy researcher and sound interaction between STI policy research community and the government.

<p>The aims of this thesis were to expand the knowledge about sexual and reproductive health among urban Ugandan youths, living in a slum, and to evaluate the national flow-chart for management of the abnormal vaginal discharge (AVD) syndrome in adolescent girls. Data collection included individual interviews, focus-group discussions and clinical investigations with tests for chlamydia trachomatis (CT), neisseria gonorrhoea (NG), trichomonas vaginalis (TV), syphilis, and HIV infection. Poverty, peer pressure and gender power imbalance were obstacles to safe sexual practices: to abstain from sex, be faithful or to use condoms. Prevalence among the 199 female and 107 male adolescents for CT, NG, TV, syphilis and HIV was 4.5%, 9.0%, 8.0%, 4.0% and 15.2% for females and 4.7%, 5.7%, 0%, 2.8% and 5.8% for males. The national AVD flow-chart had a sensitivity of 61%, a specificity of 38.5% and a positive predictive value (PPV) of 11.6%. A flow-chart using risk factors, rather than symptoms, implicated a sensitivity/specificity and PPV of 82.6%/47% and 17.3% respectively. Socially disadvantaged females had a high risk to be HIV infected and HIV infection was associated to other STIs. Females were more likely than males to have any of the infections studied. Voluntary counselling and testing (VCT) for HIV was considered as helpful in preventing the spread of HIV. Obstacles for testing were: lack of time and money, fear of stigmatisation and fear that the knowledge of HIV positive status could shorten someone's life. An alternative flow-chart for management of AVD among adolescent girls should be evaluated. Girl's opportunities for education and income generating work should be a priority. VCT services for young people should be made accessible in terms of cost, time and quality of counselling.</p>

The aims of this thesis were to expand the knowledge about sexual and reproductive health among urban Ugandan youths, living in a slum, and to evaluate the national flow-chart for management of the abnormal vaginal discharge (AVD) syndrome in adolescent girls. Data collection included individual interviews, focus-group discussions and clinical investigations with tests for chlamydia trachomatis (CT), neisseria gonorrhoea (NG), trichomonas vaginalis (TV), syphilis, and HIV infection. Poverty, peer pressure and gender power imbalance were obstacles to safe sexual practices: to abstain from sex, be faithful or to use condoms. Prevalence among the 199 female and 107 male adolescents for CT, NG, TV, syphilis and HIV was 4.5%, 9.0%, 8.0%, 4.0% and 15.2% for females and 4.7%, 5.7%, 0%, 2.8% and 5.8% for males. The national AVD flow-chart had a sensitivity of 61%, a specificity of 38.5% and a positive predictive value (PPV) of 11.6%. A flow-chart using risk factors, rather than symptoms, implicated a sensitivity/specificity and PPV of 82.6%/47% and 17.3% respectively. Socially disadvantaged females had a high risk to be HIV infected and HIV infection was associated to other STIs. Females were more likely than males to have any of the infections studied. Voluntary counselling and testing (VCT) for HIV was considered as helpful in preventing the spread of HIV. Obstacles for testing were: lack of time and money, fear of stigmatisation and fear that the knowledge of HIV positive status could shorten someone's life. An alternative flow-chart for management of AVD among adolescent girls should be evaluated. Girl's opportunities for education and income generating work should be a priority. VCT services for young people should be made accessible in terms of cost, time and quality of counselling.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal

This dissertation has two overall aims; to explore and develop the use of SNA in sociology, and to demonstrate that sociology has much to give to other sciences. Interdisciplinary collaboration is necessary because we do not live in a world in which subject areas are strictly isolated. Human beings are social animals, and a sociological understanding is crucial in all human-related science. The examination in this thesis of different kinds of social networks and how they affect the lives of individuals (and vice versa) will provide knowledge both in the development of methods for analyzing social networks, and in their areas specific scientific areas. Paper I-III investigates sexual networks and how the number of sexual encounters involving intercourse in combination with the number of sexual partners affects the dynamics of sexually transmitted infections (STIs). The results show that this relationship is non-linear, indicating that it may not be the individuals with the largest number of partners who have the most impact on the spread of STIs. One might also have to focus interventions on individuals who have a large number of sexual encounters involving intercourse per partner, and who have several (but not necessarily a very large number of) partners. In the fourth paper, we apply the theoretical concept of so-called small worlds to a sexual network. The spread of epidemics can be difficult to stop in such networks, and we show that the sexual network of individuals infected with chlamydia can be characterized as such. The fifth and last paper differs from the four first. In this paper, we focus on how individuals who committed suicide in Stockholm during the 1990s where connected to each other. The social-interaction exposure effect is larger for the individual within the family than at the workplace; yet work-domain exposure is more important for the overall suicide rate because individuals are more often exposed to suicides of co-workers than family members.

Este estudo descreve os desafios para promoção da saúde sexual e reprodutiva entre estudantes do Ensino Médio que residem em comunidades quilombolas, utilizando o quadro de Vulnerabilidade e Direitos Humanos (V&DH) para destacar neste cenário os fatores e a dinâmica sócio-programática que aumentam a suscetibilidade às IST/HIV e gravidezes não planejadas. A partir da triangulação de métodos com base em estudo etnográfico que utilizou entrevistas, questionários, e observação participante de práticas de educação em sexualidade, identificamos que a maior vulnerabilidade dos estudantes quilombolas está relacionada a interação dinâmica de seis aspectos. (1) O território quilombola conformados historicamente pelo racismo resultando no empobrecimento, restrição de acesso aos equipamentos públicos de saúde e educação. (2) Transformações no modo de viver nas relações entre os gêneros, étnico-raciais e geracional - produziram novas tensões para o exercício da sexualidade dos jovens estudantes, embora perdurem as expectativas relacionadas às performances sexuais demarcadas pela heteronormatividade e desigualdade entre os gêneros: os meninos são estimulados à prática sexual e das meninas espera-se a abstinência sexual até o casamento. (3) Os educadores, cujo processo de trabalho dificulta a integração do tema no currículo, se sentem despreparados, faltam materiais e incentivos financeiros para o seu envolvimento e há fragilidade de articulação com os serviços de saúde, assim como menor aceitabilidade dos pais em relação a esses programas, menor ainda para as meninas. (4) A qualidade de serviços de saúde disponíveis - frágeis na resolutividade, faltam médicos, exames, medicamentos, sobram dificuldade de referenciamento. Os serviços de saúde não se adequam à cultura local e contribuem para a negligência aos direitos dos jovens em acessar informações, insumos e os programas preventivos. (5) Pais e responsáveis, profissionais de saúde e de educação não reconhece os direitos sexuais e reprodutivos dos estudantes. (6) os discursos e as práticas dos jovens sobre a sexualidade e cuidados preventivos indicam a sua vulnerabilidade individual associada à insuficiência dos conhecimentos sobre prevenção e baixa percepção de risco. O uso pouco consistente dos preservativos, a dificuldade de acesso aos contraceptivos, indicam desafios para os programas educativos e serviços voltados para os jovens. Ao mesmo tempo, a negligência da promoção e proteção dos direitos à saúde sexual e reprodutiva de jovens estudantes, comum a contextos de pobreza e escassez de infraestrutura, é coproduzida na sua singularidade pelo lugar: o estigma e a discriminação associado à comunidade quilombola se somam à precariedade das estradas e do transporte, do acesso à internet e telefone e o desprezo pelas tradições culturais. Ao final do projeto, a escola mostrou ser um local estratégico para promoção da saúde sexual e reprodutiva desses jovens. Para tanto é preciso que os programas de educação em sexualidade identifiquem e abordem, em cada cenário, a singularidade de cada lugar que potencializará ou que dificultará a efetivação dos direitos sexuais e reprodutivo dos jovens, que demanda sua participação no processo / This study describes the challenges to sexual and reproductive health promotion for high school students that live in quilombola communities. The vulnerability and human rights (V&HR) framework indicate the factors and the social-programmatic dynamic that increase their susceptibility to STI/AIDS and unplanned pregnancies. Through methodological triangulation based in an ethnographic study conducted through interviews, questionnaires, and participant observation of sexuality education practices, we identify that the increase in the vulnerability of the quilombola students is related to six dynamic aspects. (1) The quilombola territory, historically shaped by racism and resulting in impoverishment, lower access to social services as health and education. (2) The recent transformations in their lifestyles - in the generational, gender and racial-ethnic relations - created new tensions to the experience with the sexuality of the young students, while sustaining the anticipated heteronormative and gender inequality; boys are stimulated to have sex and girls should wait for marriage. (3) Teachers feel they are unprepared and do not have a working process that guarantees this themes in the curriculum. They lack resources and financial incentives to be involved or to involve health services, and face lower parents acceptability related to these programs, even lower to girls. (4) The quality of existing health services, that lack medical doctors, exams, medication, and cant perform good reference to other services. They are not culturally sensitive and sum up to the negligence of the young people rights to access information, prevention tools, and programs. (5) The low recognition of their sexual and reproductive health by their parents and adults responsible for their health and education. Still, students do not see themselves as sujeitos de direitos (rights holders). (6) Sexuality discourses and practices of young people and their self-care indicate an individual vulnerability associated with the lack of prevention knowledge and low-risk perception. The inconsistent condom use and the lack of access to contraceptives indicate challenges for the health and educational programs to young people. Also, the negligence in the promotion and protection of the young students common to disenfranchised contexts is co-produced by the local singularities: stigma and discrimination associated to the quilombola community enhance the effects of precarious roads and transportation, lack of access to telephone and internet, and no respect for their cultural traditions. Ultimately, the school proved to be a strategic place (Lugar) to the sexual and reproductive health of these students. But also showed the requirement for sexuality education programs to identify the singularities of each place, which will enhance or complicate young peoples sexual and reproductive rights, and of their participation in the process

Made available in DSpace on 2016-03-15T19:37:32Z (GMT). No. of bitstreams: 1 Samuel Fontes Lima.pdf: 2071921 bytes, checksum: 2d66276b3ab526cbf68f0f727c2e1f3d (MD5) Previous issue date: 2010-08-18 / Nowadays, object oriented languages are among the most used ones. Recent studies with beginners have shown that the object oriented programming language (OOP) concepts are not so easy to learn. Students have difficulties not only in understanding those OOP concepts, but also in applying them to solving problems. Therefore, an Intelligent Tutoring System (ITS) is suggested in order to help in the learning process of these concepts. One of the most important challenge for ITS development is the individual treatment of student, which is mainly obtained by system adaptativity to the characteristics of each student. This adaptativity to student is a complex issue and the focus of several researches. It encloses several areas of personality such as: learning style, intelligence, previous knowledge, student background and emotions. Thus, the student model is extremely important because all individual information of student is in it. It is here where Artificial Intelligence (AI) techniques have been employed. This paper approaches the adaptativity issue of tutoring system to student knowledge through a student model based on Bayesian Network (BN). Taking into consideration that the student knowledge level is an inaccurate information, and even professors deal with this uncertainty, the Bayesian Networks (BNs), also known as Belief Network, have been chosen. They are considered proper for uncertain spheres for employing the probabilistic reasoning, which allows to identify a certain belief degree of student knowledge level. Therefore, the BNs have been employed in ITS in the inferences concerning student behavior as well as in the decision-making process concerning tutor actions. / Atualmente as linguagens orientadas a objeto encontram-se entre as mais utilizadas. Estudos recentes com alunos iniciantes demonstram que os conceitos de programação orientada a objetos (POO) não são tão fáceis de assimilar. Os estudantes encontram dificuldades não somente no entendimento dos conceitos de POO, mas também na aplicação deles na resolução de problemas. Diante disso, propõe-se o emprego de um Sistema Tutor Inteligente (STI) para auxiliar no processo de aprendizagem desses conceitos. Um dos principais desafios para o desenvolvimento de um STI é o tratamento individualizado do estudante, que é obtido principalmente por meio da adaptatividade do sistema às características de cada aprendiz. A adaptatividade ao aprendiz é uma questão complexa, foco de várias pesquisas, abrange várias características da personalidade: estilo de aprendizagem, inteligência, conhecimento anterior, histórico do aprendiz e as emoções. Dessa forma, o modelo do estudante é de fundamental importância, pois contém as informações individuais do aprendiz. É nesse ponto que as técnicas de Inteligência Artificial (IA) têm sido empregadas. Este trabalho aborda a questão da adaptatividade do sistema tutor ao conhecimento do estudante por meio de um modelo de aprendiz baseado em Rede Bayesiana. Considerando-se que o nível de conhecimento do aprendiz é uma informação imprecisa, e que até mesmo professores lidam com essa incerteza, optou-se pela utilização de Redes Bayesianas (RBs), também chamadas de Redes de Crença, que são consideradas adequadas para ambientes sob incerteza pois empregam o raciocínio probabilístico, o qual permite identicar um certo grau de crença sobre o nível de conhecimento do aprendiz. Devido a isso, RBs têm sido empregadas em STIs nas inferências sobre o comportamento do aprendiz e nas tomadas de decisões sobre as ações do tutor.