Encarceramento feminino: um debate entre criminologia e perspectivas feministas / Female incarceration: a debate between criminology and feminist perspectives / Encarcelamiento femenino: un debate entre la criminología y las perspectivas feministas

Este ensaio teórico-reflexivo tem como objetivo discutir sobre as contribuições dos estudos da criminologia e sua crítica para as diversas formas de aprisionamento feminino, e mais atualmente para o encarceramento em massa no sistema prisional, além de abrir espaço para o debate sobre as diferentes perspectivas feministas e as relações com os estudos criminológicos, sobretudo com os posicionamentos da chamada criminologia crítica. Reconhecem-se importantes avanços e conquistas feministas no debate sobre a estruturação masculinizada do direito penal e do seu fazer jurídico, mas também a manutenção de diversas formas de violência de gênero que configuram um sistema penal antropocêntrico, seletivo, racista e discriminatório. Indica-se a urgência de estudos interseccionais que considerem as particularidades e reinvindicações das mulheres no cárcere e suas formas de militância, sobretudo diante de população carcerária feminina composta majoritariamente por mulheres negras, pobres e periféricas. Faz-se visível a necessidade de uma análise dos fatores que atravessam o encarceramento feminino por uma ótica feminista plural, adequada às realidades que se estudam e atenta às múltiplas perspectivas que podem existir dentro do feminismo.(AU)

This theoretical-reflexive essay aims to discuss the contributions of criminological studies and their critique of the various forms of imprisonment of women, and more recently of mass incarceration in the prison system, in addition to opening space for the debate on the different feminist perspectives and their relations with criminological studies, especially with the positions of the so-called critical criminology. Important feminist advances and conquests are recognized in the debate about the masculinized structure of penal law and its legal practice, but also the maintenance of diverse forms of gender violence that configure an anthropocentric, selective, racist, and discriminatory penal system. It indicates the urgency of intersectional studies that consider the particularities and claims of women in prison and their forms of militancy, especially in the face of the female prison population composed mostly of black, poor, and peripheral women. The need for an analysis of the factors that cross women's imprisonment from a plural feminist perspective, adequate to the realities under study and attentive to the multiple perspectives that may exist within feminism, becomes visible.(AU)

Este ensayo teórico-reflexivo pretende discutir las aportaciones de los estudios criminológicos y su crítica a las distintas formas de encarcelamiento femenino, y más recientemente de encarcelamiento masivo en el sistema penitenciario, además de generar debate sobre las distintas perspectivas feministas y sus relaciones con los estudios criminológicos, especialmente con las posiciones de la Criminología Crítica. Se reconocen importantes avances y logros feministas en el debate sobre la estructuración masculinizada del derecho penal y su práctica jurídica, además del mantenimiento de diversas formas de violencia de género que configuran un sistema penal antropocéntrico, selectivo, racista y discriminatorio. Se necesitan estudios interseccionales que consideren las particularidades y reivindicaciones de las mujeres en prisión y sus formas de militancia, principalmente ante la población penitenciaria femenina compuesta mayoritariamente por mujeres negras, pobres y periféricas. Se hace evidente la necesidad de analizar los factores que inciden en el encarcelamiento femenino desde una perspectiva feminista plural, adecuada a las realidades que se estudian y atenta a las múltiples perspectivas que pueden existir dentro del feminismo.(AU)

Intimidade conjugal: papel discriminante dos níveis de mindfulness / Conjugal intimacy: discriminating role of levels of mindfulness / Intimidad conyugal: papel discriminatorio de los niveles de mindfulness

Esse estudo parte do pressuposto de que o mindfulness poderia estar relacionado com a intimidade conjugal. Investigou-se o papel discriminante da intimidade em dois grupos de indivíduos com maiores e menores níveis de mindfulness. Partiparam 281 sujeitos, maiores de 18 anos, em relacionamento estável e em coabitação. Os mesmos responderam à Escala Filadélfia de Mindfulness e à Escala de Avaliação Pessoal de Intimidade em Relacionamentos (PAIR). Os resultados indicaram que os fatores da intimidade avaliados (comunicação, validação pessoal e abertura ao exterior) discriminaram o grupo com maiores níveis de mindfulness. O estudo sugere que indivíduos com maiores níveis de mindfulness possuem maior facilidade de desenvolver intimidade em seus relacionamentos, contribuindo para o entendimento do papel considerável dessa habilidade na conjugalidade.

This study assumes that mindfulness could be related to conjugal intimacy. The discriminating role of intimacy was investigated in two groups of individuals with higher and lower levels of mindfulness. 281 subjects, over 18 years old, participated in a stable relationship and cohabitation. They responded to the Philadelphia Mindfulness Scale and the Personal Relationship Intimacy Scale in Relationships (PAIR). The results indicated that the factors of intimacy evaluated (communication, personal validation and openness to the outside) discriminated against the group with the highest levels of mindfulness. The study suggests that individuals with higher levels of mindfulness have an easier time developing intimacy in their relationships, contributing to the understanding of the considerable role of this ability in conjugality.

Este estudio asume que la atención plena podría estar relacionada con la intimidad conyugal. El papel discriminador de la intimidad se investigó en dos grupos de individuos con niveles más altos y más bajos de atención plena. 281 sujetos, mayores de 18 años, participaron en una relación estable y en convivencia. Respondieron a la Escala de atención plena de Filadelfia y la Escala de intimidad en las relaciones personales (PAIR). Los resultados indicaron que los factores de intimidad evaluados (comunicación, validación personal y apertura al exterior) discriminaban al grupo con mayores niveles de mindfulness. El estudio sugiere que las personas con niveles más altos de atención plena tienen más facilidad para desarrollar la intimidad en sus relaciones, lo que contribuye a comprender el papel considerable de esta capacidad en la conyugalidad.

Perceived differences on the role of traditional birth attendants in rural Tanzania: a qualitative study.

BACKGROUND: In many low to middle income countries, traditional birth attendants (TBAs) play various roles (e.g., provision of health education, referral to hospitals, and delivery support) that can potentially improve women's access to healthcare. In Tanzania, however, the formal healthcare systems have not acknowleded the role of the TBAs. TBAs' contributions are limited and are not well described in policy documents. This study aimed to examine the perspectives of both TBAs and skilled birth attendants (SBAs) to clarify the role of TBAs and issues impacting their inclusion in rural Tanzania. METHODS: We used a qualitative descriptive design with triangulation of investigators, methods, and data sources. We conducted semi-structured interviews with 15 TBAs and focus group discussions with 21 SBAs in Kiswahili language to ask about TBAs' activities and needs. The data obtained were recorded, transcribed, and translated into English. Two researchers conducted the content analysis. RESULTS: Content analysis of data from both groups revealed TBAs' three primary roles: emergency delivery assistance, health education for the community, and referrals. Both TBAs and SBAs mentioned that one strength that the TBAs had was that they supported women based on the development of a close relationship with them. TBAs mentioned that, while they do not receive substantial remuneration, they experience joy/happiness in their role. SBAs indicated that TBAs sometimes did not refer women to the hospital for their own benefit. TBAs explained that the work issues they faced were mainly due to insufficient resources and unfavorable relationships with hospitals. SBAs were concerned that TBAs' lacked formal medical training and their actions could interfere with SBAs' professional work. Although there were no between-group interactions at the time of this study, both groups expressed willingness to collaborate/communicate to ensure the health and lives of mothers and babies. CONCLUSIONS: TBAs and SBAs have different perceptions of TBAs' knowledge and skills, but agreed that TBAs need further training/inclusion. Such collaboration could help build trust, improve positive birth experiences of mothers in rural Tanzania, and promote nationwide universal access to maternal healthcare.

Being beneficial to self and caregiver: the role of dispositional mindfulness among breast cancer patients.

PURPOSE: Breast cancer (BC) patients report complex negative emotions, including symptoms of anxiety, depression, and posttraumatic stress disorder (PTSD). What's more, being diagnosed with cancer also has a negative impact on the patient's family such as additional financial burden and care needs, leading to higher levels of caregiver burden. This study aimed to explore whether dispositional mindfulness could alleviate multiple negative emotions of BC patients and to investigate the mediating effect of caregiver burden on the relationship between the patients' dispositional mindfulness and negative emotions. METHODS: A sample of 230 Chinese BC patients receiving chemotherapy and their caregivers voluntarily participated in the study by completing a set of questionnaires including the Mindfulness Attention Awareness Scale, the Caregiver Self-assessment Questionnaires, the General Anxiety Symptoms Scale, the Patient Health Questionnaire, and the PTSD Symptom Scale. Structural equation modeling was used to test the relationship between dispositional mindfulness, negative emotions, and caregiver burden. RESULTS: Dispositional mindfulness was significantly and negatively correlated with negative emotions, including anxiety, depression, and PTSD among the BC patients. Structural equation modeling showed that caregiver burden mediated the relation between patients' dispositional mindfulness and negative emotions. CONCLUSION: BC patients with higher levels of dispositional mindfulness showed less negative emotions. The results of the mediation analysis suggested that higher levels of dispositional mindfulness of breast cancer patients could decrease the caregivers' perceived burden and, in turn, relieve patients' negative emotions. Dispositional mindfulness was beneficial to breast cancer patients as well as their caregivers, indicating that mindfulness-based interventions targeting distress in patient-caregiver dyads would be more effective than what interventions for patients alone.

The Role of Yoga in the Management of Bladder Pain Syndrome: A Single-Arm Pilot Study.

BACKGROUND: Bladder pain syndrome (BPS) is a devastating urologic condition characterized by irritative bladder symptoms, pelvic pain, and dyspareunia. First-line treatment includes dietary, self-care and behavioral modifications. The ancient practice of yoga is well suited to treat BPS, but evidence is lacking on its use. AIMS: To investigate the feasibility and efficacy of an integrated yoga module on BPS outcomes as measured by self-reported questionnaires from baseline to 3 months after therapy. METHODS AND MATERIALS: This was a prospective single-arm study of 8 patients who underwent 3 months of integrated yoga therapy. The treatment module was performed 3 to 4 times weekly at home with 1 session performed weekly in-office during the first month to ensure proper performance of postures. Patients completed questionnaires (Pelvic Pain and Urgency/Frequency Patient Symptom Scale [PUF], Pelvic Floor Impact Questionnaire - short form 7 [PFIQ-7], Short Form 36 questionnaire [SF-36], Pittsburgh Sleep Quality Index [PSQI]) at baseline and 3 months, including Patient Global Impression of Improvement (PGI-I) at the 3-month follow-up visit. Voiding diaries were also requested at baseline and at the 3-month assessment. RESULTS: There was a trend toward improvement regarding patients' responses to all questionnaires 3 months after yoga therapy, with the only statistically significant improvements noted in social function and pain components of the SF-36. There were no significant changes noted on the voiding diaries except a non-statistically significant trend toward increased voided volumes. Patients rated their experiences with yoga therapy positively. CONCLUSIONS: Yoga therapy for BPS showed evidence of benefit for improving bothersome bladder symptoms, pain and voiding. A randomized controlled trial will follow to investigate the efficacy of this yoga module against a control group.

School-Based Meditation and Interoceptive Awareness Program for Preventing Somatic Symptoms: The Role of Emotional Awareness.

Although meditation has been used to alleviate somatic symptoms in adults, there is little literature on this issue in children. School-based meditation programs are mainly used to increase attention control and self-awareness in children. Here, however, we evaluate the effects of a three-month school-based psychoeducational meditation and interoceptive awareness program (EETB) on somatic symptoms in 281 children (126 females and 155 males) aged 6-9 years. Outcome measures were scores on the Children's Somatisation Inventory (CSI) and KidScreen-10 for quality of life (QoL), administered at baseline and over the three-month program. ANOVA repeated measures showed a reduction in somatic symptoms (F = 46.43; P < .0001; η = .14; Cohen's d effect size: 0.538) while there was little effect on QoL (F = 4.63, P = .003; η = 0.016; Cohen's d effect size: 0.010). Emotional awareness (EA) influenced QoL, but not CSI outcome. The EETB program is effective at reducing somatic symptoms, even one month after baseline. As EA cognitive abilities increase after age 8, the application of this project in even younger children indicates that a state of general well-being requires enough emotional awareness to be perceived.

Let food be the medicine, but not for coronavirus: Nutrition and food science, telling myths from facts.

The entire globe is facing a dangerous pandemic due to the coronavirus disease (COVID-19). The medical and scientific community is trying to figure out and adopt effective strategies that can lead to (i) preventing virus expansion; (ii) identifying medications for the management of critical care and reducing rates of mortality; and (iii) finally discovering the highly anticipated vaccine. Nutritional interventions have attained considerable scientific evidence in disease prevention and treatment. The main question, "What is the role of nutrition and food science in this scenario?" requires urgent answer as many theories suggesting that specific food or dietary supplements can fight coronavirus infection have received extensive coverage in most popular social media platforms. In this editorial, we focus on some frequent statements on the role of nutrition and food science in the battle against COVID-19, distinguishing between myths and facts. We highlight that social distancing and hygiene precautions are the best practices for reducing the risk of COVID-19 transmission. We further underline the importance of nutrition in its wholistic concept, pointing out the risk of unproven dietary options that could lead individuals to weaken effective precautionary measures.

Patient-reported flare frequency is associated with diminished quality of life and family role functioning in systemic lupus erythematosus.

PURPOSE: To understand the influence of the systemic lupus erythematosus (SLE)-related flares on patient's health-related quality of life (HRQoL). METHODS: An online survey included individuals with self-reported physician's diagnosis of SLE or lupus nephritis (LN). Lupus impact tracker (LIT) assessed lupus symptoms and HRQoL, SLE-Family questionnaire measured family role functioning, and Healthy Days Core Module (HDCM) measured overall mental and physical health. Chi-square and analysis of variance evaluated differences by flare frequency. Multivariable linear regression and generalized linear models evaluated the independent relationships of flare frequency to HRQoL. RESULTS: 1066 respondents with SLE or LN completed the survey. Mean (SD) duration of illness was 12.4 (10.1) years. 93.4% (n = 996) were women, 82.3% (n = 830) were White, and 49.7% (n = 530) were employed or students. More frequent flares were associated with significantly worse scores on all HRQoL measures: LIT (adjusted means: 0 flares, 31.8; 1-3 flares, 47.0; 4-6 flares, 56.1; ≥ 7 flares, 63.6; P < 0.001); SLE-Family (adjusted means: 0 flares, 3.1; 1-3 flares 3.8; 4-6 flares, 4.3; ≥ 7 flares, 4.6, P < 0.001); HDCM unhealthy days (0 flares, 8.7; 1-3 flares, 17.4; 4-6 flares, 21.5; ≥ 7 flares, 26.2 days, P < 0.001). CONCLUSION: Lupus flares contributed to impaired functional and psychological well-being, family functioning, and number of monthly healthy days. Better understanding of the burden of flare activity from the patient's perspective will support a holistic approach to lupus management.

The role of spirituality in the COVID-19 pandemic: a spiritual hotline project.

Recent correspondence letters to the editor of this journal pointed out to the need of implementing psychological support during the pandemic and post-pandemic period to both general and frontline workers. Especially, they highlighted the importance of religious/spiritual interventions in order to provide an integral and holistic care. In this perspective, an important consequence of the social isolation is the closure of churches and the suspension of religious meetings in order to avoid agglomeration and contagion. However, although this is a very important approach in terms of public health, a question is raised: how to promote spiritual care and help spiritual/religious individuals to cope with their problems while maintaining compliance with social isolation? To address this question, we report the Spiritual Hotline Project, a project designed by many Brazilian healthcare workers intended to give spiritual and religious assistance to people with different cultural background. So far, the hotline was able to assist people from different parts of the world, including Brazil and Portugal as well as with different religious affiliation, in order to provide a spiritual comfort and care during this public health crisis.

Volunteer responsibilities, motivations and challenges in implementation of the community-based health planning and services (CHPS) initiative in Ghana: qualitative evidence from two systems learning districts of the CHPS+ project.

BACKGROUND: Community volunteerism is essential in the implementation of the Community-based Health Planning and Services (CHPS) in Ghana. We explored the responsibilities, motivations and challenges of community health management committees (CHMCs) in two CHPS+ Project districts in Ghana. METHODS: We used a qualitative approach to collect data through 4 focus group discussions among a purposive sample of community health volunteers in December 2018 and analysed them thematically. RESULTS: Community health management committees (CHMCs) were found to provide support in running the CHPS programme through resource mobilisation, monitoring of logistics, assisting the Community Health Officers (CHO) in the planning of CHPS activities, and the resolution of conflicts between CHOs and community members. The value, understanding and protective functions were the key motivations for serving on CHMCs. Financial, logistical and telecommunication challenges, lack of recognition and cooperation from community members, lack of motivation and lack of regular skill development training programmes for CHMC members who serve as traditional birth attendants (TBAs) were major challenges in CHMC volunteerism. CONCLUSION: Community health volunteerism needs to be prioritised by the Ghana Health Service and other health sector stakeholders to make it attractive for members to give off their best in the discharge of their responsibilities.

A role for traditional doctors in health promotion: experience from a trial of HIV prevention in Botswana.

Traditional doctors have been largely ignored in HIV prevention, particularly primary prevention. As part of a structural intervention programme to reduce HIV risk among young women in Botswana, we trained 147 traditional doctors in four districts as well as government health education assistants (HEAs) and teachers to run discussion groups in the community and schools, using an evidence-based eight-episode audio-drama, covering gender roles, gender violence, and how these are related to HIV risk. One year later, we contacted 43 of the 87 trained traditional doctors in two districts. Most (32) were running discussion groups with men and women, with links to the local HEAs and teachers. They were adept at recruiting men to their groups, often a challenge with community interventions, and reported positive changes in attitudes and behaviour of group participants. Traditional doctors can play an important role in primary prevention of gender violence and HIV.

Cuidado espiritual al adulto mayor, elemento del conocimiento y práctica de enfermería / Elder spiritual care, as part of nursing knowledge and practice / Cuidado Espiritual do idoso, elemento do conhecimento e prática de enfermagem

La espiritualidad es un concepto que ha permeado el mundo académico, especialmente en los contextos de los cuidados en salud y particularmente en enfermería. Esta se ha asociado a situaciones tales como el afrontamiento de la muerte, al cuidado paliativo, a la vivencia de la cronicidad y a la adultez mayor. El presente texto aborda una reflexión a la luz de la literatura y la experiencia clínica acerca de la relación entre cuidado espiritual y el rol de la enfermería en la práctica en donde se brinda cuidado a las personas a través del ciclo vital. Se hace una aproximación al estado del arte y a los referentes relacionados con la delimitación del constructo cuidado espiritual, proporcionando un marco de referencia útil para la consulta académica y su inclusión en la práctica de la enfermería.

Spirituality is a concept which has permeated the academic world, especially in the contexts of health care, and particularly, nursing. This has been associated to situations such as facing death, palliative care, and living chronicity and adulthood. This text addresses a reflection, to the light of literature and clinical experience, relating to the relationship between spiritual care and the role of nursing in the practice, where care is provided for people throughout their life cycle. An approximation about the state of the art and the referring related to the delimitations of the spiritual care construct is made, providing a frame of reference that is useful for academic review and its inclusion in the nursing practice.

A espiritualidade é um conceito que tem permeado o mundo acadêmico, especialmente nos contextos dos cuidados na saúde e particularmente, na enfermagem. Têm se associado a situações como o afrontamento da morte, o cuidado paliativo, a viven cia da cronicidade e o envelhecimento. O presente texto faz uma abordagem reflexiva à luz da literatura e a experiência clínica, ao redor da relação entre o cuidado espiritual e o rol de enfermagem na prática, onde se presta cuidados as pessoas através do curso de vida. Faz uma aproximação ao existente e os referentes relacionados com a delimitação do constructo cuidado espiritual, proporcionando um marco de referencia útil para a consulta acadêmica e a inclusão da prática enfermeira.

Communities as 'renewable energy' for healthcare services? a multimethods study into the form, scale and role of voluntary support for community hospitals in England.

OBJECTIVE: To examine the forms, scale and role of community and voluntary support for community hospitals in England. DESIGN: A multimethods study. Quantitative analysis of Charity Commission data on levels of volunteering and voluntary income for charities supporting community hospitals. Nine qualitative case studies of community hospitals and their surrounding communities, including interviews and focus groups. SETTING: Community hospitals in England and their surrounding communities. PARTICIPANTS: Charity Commission data for 245 community hospital Leagues of Friends. Interviews with staff (89), patients (60), carers (28), volunteers (35), community representatives (20), managers and commissioners (9). Focus groups with multidisciplinary teams (8 groups across nine sites, involving 43 respondents), volunteers (6 groups, 33 respondents) and community stakeholders (8 groups, 54 respondents). RESULTS: Communities support community hospitals through: human resources (average=24 volunteers a year per hospital); financial resources (median voluntary income = £15 632); practical resources through services and activities provided by voluntary and community groups; and intellectual resources (eg, consultation and coproduction). Communities provide valuable supplementary resources to the National Health Service, enhancing community hospital services, patient experience, staff morale and volunteer well-being. Such resources, however, vary in level and form from hospital to hospital and over time: voluntary income is on the decline, as is membership of League of Friends, and it can be hard to recruit regular, active volunteers. CONCLUSIONS: Communities can be a significant resource for healthcare services, in ways which can enhance patient experience and service quality. Harnessing that resource, however, is not straight forward and there is a perception that it might be becoming more difficult questioning the extent to which it can be considered sustainable or 'renewable'.

Father's roles and perspectives on healthcare seeking for children with pneumonia: findings of a qualitative study in a rural community of the Philippines.

OBJECTIVES: Pneumonia remains a primary cause of death for under-five children. It is possible to reduce the mortality impact from childhood pneumonia if caregivers recognise the danger signs of pneumonia and obtain appropriate healthcare. Among caregivers, research on fathers' healthcare-seeking behaviours and perceptions are limited, whereas research on mothers is available. This study aims to reveal fathers' roles and perspectives with respect to the selection of care and treatment for children with pneumonia in a remote island of the Philippines. DESIGN: A qualitative research was carried out using semistructured interviews. SETTING AND PARTICIPANTS: The interviews were conducted with 12 fathers whose children had pneumonia-like episodes in the 6 months prior to the interview. Data analysis was performed using the concept analysis method to identify codes which were merged into subcategories and categories. Finally, the themes were identified. RESULTS: Three themes were identified as part of fathers' roles, and two were identified as fathers' perspectives on various treatment options. Fathers took care of their sick children by not entrusting care only to mothers because they considered this as part of their role. Notably, fathers considered that arranging money for the child's treatment was a matter of prime importance. They selected a particular treatment based on their experiences and beliefs, including herbal medicine, home treatment, and visiting traditional healers and health facilities. Their decision was influenced by not only their perception of the severity of illness but also cultural beliefs on the cause of illness. Visiting health facilities, particularly during hospital admissions, causes significant financial burden for the family which was the main concern of fathers. CONCLUSION: It is crucial to consider the cultural background and also imperative to address issues related to medical cost and the credibility of health facilities to improve fathers' healthcare-seeking behaviour.

Psychoeducational assessment of students with intellectual disability: professional-action framework analysis.

BACKGROUND: The right to educational inclusion for students with intellectual disability (SWID) requires the development of good assessment and intervention practices from holistic perspectives not exclusively focused on the academic limitations that SWID may present. These practices are settled in Spain, via regulations drawn up by each Autonomous Community (AC). The variety of existing regulations demands a critical review of the decisions taken to promote the inclusion of those students. METHOD: current regulations-in-force in each AC that regulate attention to diversity (AD) have been were analyzed by using a checklist that includes the variables that defining each stage of the AD process and the ways of providing supports that favor the development, learning and participation of SWID. RESULTS: attention to diversity measures in each AC emphasize organizational and curricular issues, with no AC following holistic approaches in both assessment and intervention, but rather neglecting self-determination and the promotion of quality of life for SWID. CONCLUSIONS: guidelines for the development of new legal frameworks and professional practices based on the latest evidence-based models of attention to SWID and on the results are discussed.

School reintegration of pediatric burn survivors: An integrative literature review.

BACKGROUND: The school is an essential context for children's social interaction with peers and to develop academic skills. Therefore, a fast reintegration can help children with burns to normalize their life. Thus, school reintegration is an important outcome after burns. The aim of this review was to systematically synthesize the literature addressing school reintegration programs of pediatric burns survivors. METHODS: Five electronic databases were searched independently by two reviewers. The search yielded 13 eligible publications. A qualitative content analysis was conducted. RESULTS: The two themes identified centered around (1) the roles, obstacles, and support for the different stakeholders (i.e., the child, parents and teacher) and (2) the contents of the school reintegration programs in which subthemes such as purpose, planning, essential elements, team, and effect were distinguished. The results show that return to school should start as soon as the child is admitted to the hospital and the program should acknowledge the different stakeholders' needs and tailor the program to these needs. CONCLUSION: The review emphasizes the necessity of an integrated school reintegration program empowering both the child, the parents and the teachers and tailored to the child's specific situation. Furthermore, it offers recommendations for further improvement of the field.

O jogo de papéis e a criança com autismo na perspectiva histórico-cultural / The role play and the child with autism in the historical-cultural perspective / El juego de roles y el niño con autismo en la perspectiva histórico-cultural

O presente artigo busca analisar o brincar de faz de conta da criança com autismo, com foco nos recursos simbólicos que ela utiliza na assunção de papéis. Este artigo se fundamenta nos aportes teóricos da perspectiva histórico-cultural, tendo Vigotski como seu principal expoente. A pesquisa foi realizada em uma escola pública de educação infantil, em Brasília. Partindo de uma análise microgenética, a investigação contou com a participação de seis crianças com diagnóstico de autismo, com idades entre quatro e seis anos, de uma classe especial. As situações de brincadeira foram videogravadas e posteriormente transcritas em formato de episódios. Na análise dos dados, identificamos dois eixos, a saber: 1) A construção do jogo de papéis e; 2) A assunção de papéis pela criança com autismo: a cenografia e os recursos imagéticos. Os resultados revelam o papel do outro (a participação intencional) na constituição da atividade lúdica, em especial o papel do adulto. Ademais, demonstram que a mediação pedagógica,incluindo a criação de 'cenários', é fundamental para o alargamento da experiência simbólica da criança com o autismo.

This article aims to analyze the play of make-believe for children with autism, focusing on the symbolic resources it uses in asserting roles. It is based on the theoretical contributions of the historical-cultural perspective, with Vygotsky as its main exponent. The research was carried out in a public school of Early Childhood Education, in Brasília. From the microgenetic analysis, the research had six children diagnosed with autism, at the ages of 4 and 6 years, included in Special Class, as participants. The play situations were videotaped and later transcribed in episode format. In the data analysis, we identified two axes, namely: 1) The construction of the role play and; 2) Assumption of roles by the child with autism: set design and imagery resources. The results reveal the role of the other (intentional participation) in the constitution of play activity, especially the role of the adult. In addition, they demonstrate that pedagogical mediation, including the creation of 'scenarios', is fundamental for the extension of the symbolic experience of the child with autism.

En este artículo se pretende analizar el juego de hace de cuenta en niño con autismo, centrándose en los recursos simbólicos que utilizan para la asunción de roles. Este artículo se basa en los aportes teóricos de la perspectiva histórico-cultural, con su máximo exponente Vygotsky. La investigación fue realizada en una escuela pública de Educación Infantil, de Brasilia. A partir de un análisis micro genético, la investigación contó con la participación de seis niños diagnosticados con autismo, de 4 y 6 años, de una clase especial. Las situaciones lúdicas fueron grabadas y transcritas en formato de episodios. El análisis de los datos identificó dos ejes, a saber: 1) La construcción del juego de rol y; 2) la asunción de roles para el niño con autismo: la escenografía y los recursos pictóricos. Los resultados ponen de manifiesto el papel de la otra (la participación intencional) en la creación de la actividad de juego, especialmente el papel del adulto. Además, muestran que la mediación, incluyendo la creación de 'escenarios', es esencial para la ampliación de la experiencia simbólica del niño con autismo.

The role of traditional health practitioners in Rural KwaZulu-Natal, South Africa: generic or mode specific?

BACKGROUND: Traditional health practitioners (THPs) play a vital role in the health care of the majority of the South African population and elsewhere on the African continent. However, many studies have challenged the role of THPs in health care. Concerns raised in the literature include the rationale, safety and effectiveness of traditional health practices and methods, as well as what informs them. This paper explores the processes followed in becoming a traditional healer and how these processes are related to THP roles. METHODS: A qualitative research design was adopted, using four repeat group discussions with nine THPs, as part of a larger qualitative study conducted within the HIV Treatment as Prevention trial in rural South Africa. THPs were sampled through the local THP association and snowballing techniques. Data collection approaches included photo-voice and community walks. The role identity theory and content analysis were used to explore the data following transcription and translation. RESULTS: In the context of rural Northern KwaZulu-Natal, three types of THPs were identified: 1) Isangoma (diviner); 2) Inyanga (one who focuses on traditional medical remedies) and 3) Umthandazi (faith healer). Findings revealed that THPs are called by ancestors to become healers and/or go through an intensive process of learning about traditional medicines including plant, animal or mineral substances to provide health care. Some THPs identified themselves primarily as one type of healer, while most occupied multiple healing categories, that is, they practiced across different healing types. Our study also demonstrates that THPs fulfil roles that are not specific to the type of healer they are, these include services that go beyond the uses of herbs for physical illnesses or divination. CONCLUSIONS: THPs serve roles which include, but are not limited to, being custodians of traditional African religion and customs, educators about culture, counsellors, mediators and spiritual protectors. THPs' mode specific roles are influenced by the processes by which they become healers. However, whichever type of healer they identified as, most THPs used similar, generic methods and practices to focus on the physical, spiritual, cultural, psychological, emotional and social elements of illness.