Processos de saúde e doença entre crianças institucionalizadas: uma visão ecológica

Este artigo discute aspectos do processo de saúde e doença entre crianças assistidas em um abrigo infantil de Belém, entre 2004 a 2005. Os dados foram coletados em fontes documentais e por meio de entrevista com técnicos da instituição. De um total de 287 crianças, constatou-se que 49,47% apresentavam doenças, deficiências e lesões corporais quando do seu encaminhamento ao abrigo, que podem ser associadas à situação de pobreza e negligência familiar experimentadas desde o nascimento. Em relação ao período de permanência na instituição, verificou-se que as crianças contraíram doenças infecto-contagiosas (42,5%) e manifestaram problemas de ordem emocional (18,83%), que podem estar relacionados às características ambientais da instituição proporção adulto/criança inadequada (1:8), superlotação do espaço (75/mês). Os resultados permitem concluir que a condição de saúde das crianças traduz as situações de privação material e emocional a que foram submetidas no convívio com a família e ao longo de sua permanência no abrigo. Nesses termos, os processos de saúde e doença são discutidos a partir de uma perspectiva ecológica, que reconhece fatores biológicos, sociais e culturais que constituem a família e o abrigo como contextos de desenvolvimento da criança institucionalizada.

Negoziazioni intergenerazionali dell'autonomia abitativa in contesti di working class

Nell’ambito della riflessione sui processi di riproduzione e trasmissione intergenerazionale delle disuguaglianze sociali, la presente tesi dottorale propone un’analisi in prospettiva intersezionale dei percorsi verso l’indipendenza abitativa dei giovani bolognesi di origine popolare, e il ruolo svolto dalle loro famiglie in questi percorsi. Nell’approfondimento teorico si offre una ricostruzione del dibattito sociologico nazionale e internazionale sul tema delle disuguaglianze sociali e abitative delle giovani generazioni, nonché dello studio della classe sociale e i principali approcci presenti in letteratura. La ricerca sul campo si concentra, in particolare, sui modi in cui le famiglie appartenenti ad una determinata classe sociale, intesa nel senso conferito al termine da Bourdieu, negoziano e sostengono la transizione all’indipendenza abitativa dei loro figli. L’approfondimento empirico consiste in una ricerca qualitativa longitudinale retrospettiva, condotta nel bolognese nel 2013-2014 su un campione di famiglie working class. Ai giovani-adulti coinvolti e ai loro genitori è stato chiesto di ricostruire le loro biografie attraverso lo strumento delle life histories. La ricerca evidenzia il delinearsi di “micro sistemi economici” familiari specifici e creativi. Le molteplici forme di sostegno genitoriale nei percorsi di autonomizzazione dei figli, individuate nel corso dell’analisi del materiale raccolto, si innestano quindi all’interno di un più ampio sistema di supporto intergenerazionale, che continua anche dopo l’uscita dalla famiglia di origine, a conferma dello stretto legame che caratterizza le famiglie italiane. Nello studio una particolare attenzione viene rivolta alle logiche di legittimazione del sostegno genitoriale, adottate dalle famiglie per orientare i propri interventi di aiuto. Infine, mettendo a confronto la concezione di indipendenza dei giovani adulti con quella dei loro genitori, l’indagine rileva l’esistenza di una apparente contraddizione tra le rappresentazioni dell’indipendenza e dell’autonomia abitativa e i comportamenti attuati nella vita quotidiana, contraddizione che trova una risoluzione nella negoziazione, tra le due diverse generazioni, del concetto stesso di indipendenza.

Firing Up the Crucible with Senator Lee Metcalf & Governor Forrest Anderson -- Judge Gordon Bennett in “The Crucible of Change”

During the lead-up to Montana second progressive era, Lee Metcalf and Forrest Anderson, along with others, kept the progressive flame lit in Montana. Metcalf’s political history is replete with close electoral wins because of his commitment to progressive ideals when the times were not always politically favorable for that. As State Legislator, MT Supreme Court Justice, Congressman and eventually as US Senator, Lee won races by as little as 55 votes because he stuck to his guns as a progressive. In Forrest Anderson’s career as a County Attorney, State Legislator, MT Supreme Court Justice and 12 years as MT Attorney General he was respected as a pragmatic practitioner of politics. But during that entire career leading up to his election as Governor, Forrest Anderson was also a stalwart supporter of the progressive agenda exemplified by FDR and the New Deal, which brought folks out of the Great Depression that was brought on by the bad policies of the GOP and big business. As MT’s second progressive period began in 1965, the first important election was Senator Metcalf’s successful re-election battle in 1966 with the sitting MT Governor, Tim Babcock. And the progressive express was really ignited by the election of Forrest Anderson as Governor in 1968 after 16 years of Republican Governors in MT. Gordon Bennett played a rather unique role, being a confidant of Metcalf and Anderson, both who respected his wide and varied experience, his intellect, and his roots in progressivism beginning with his formative years in the Red Corner of NE Montana. Working with Senator Metcalf and his team, including Brit Englund, Vic Reinemer, Peggy McLaughlin, Betty Davis and Jack Condon among others, Bennett helped shape the progressive message both in Washington DC and MT. Progressive labor and farm organizations, part of the progressive coalition, benefitted from Bennett’s advice and counsel and aided the Senator in his career including the huge challenge of having a sitting popular governor run against him for the Senate in 1966. Metcalf’s noted intern program produced a cadre of progressive leaders in Montana over the years. Most notably, Ron Richards transitioned from Metcalf Intern to Executive Secretary of the Montana Democratic Party (MDP) and assisted, along with Bennett, in the 1966 Metcalf-Babcock race in a big way. As Executive Secretary Richards was critical to the success of the MDP as a platform for Forrest Anderson’s general election run and win in 1968. After Forrest’s gubernatorial election, Richards became Executive Assistant (now called Chief of Staff) for Governor Anderson and also for Governor Thomas Judge. The Metcalf progressive strain, exemplified by many including Richards and Bennett, permeated Democratic politics during the second progressive era. So, too, did the coalition that supported Metcalf and his policies. The progressivism of the period of “In the Crucible of Change” was fired up by Lee Metcalf, Forrest Anderson and their supporters and coalitions, and Gordon Bennett was in the center of all of that, helping fire up the crucible, setting the stage for many policy advancements in both Washington DC and Montana. Gordon Bennett’s important role in the 1966 re-election of Senator Lee Metcalf and the 1968 election of Governor Forrest Anderson, as well as his wide experience in government and politics of that time allows him to provide us with an insider’s personal perspective of those races and other events at the beginning of the period of progressive change being documented “In the Crucible of Change,” as well as his personal insights into the larger political/policy picture of Montana. Gordon Bennett, a major and formative player “In the Crucible of Change,” was born in the far northeast town of Scobey, MT in 1922. He attended school in Scobey through the eighth grade and graduated from Helena High School. After attending Carroll College for two years, he received his BA in economics from Carleton College in Northfield, MN. During a brief stint on the east coast, his daily reading of the New York Times (“best newspaper in the world at that time … and now”) inspired him to pursue a career in journalism. He received his MA in Journalism from the University of Missouri and entered the field. As a reporter for the Great Falls Tribune under the ownership and management of the Warden Family, he observed and competed with the rigid control of Montana’s press by the Anaconda Company (the Great Falls Tribune was the only large newspaper in Montana NOT owned by ACM). Following his intellectual curiosity and his philosophical bend, he attended a number of Farm-Labor Institutes which he credits with motivating him to pursue solutions to economic and social woes through the law. In 1956, at the age of 34, he received his Juris Doctorate degree from the Georgetown University Law Center in Washington, DC. Bennett’s varied career included eighteen years as a farmer, four years in the US Army during WWII (1942-46), two years as Assistant MT Attorney General (1957-59) with Forrest Anderson, three years in private practice in Glasgow (1959-61), two years as Associate Solicitor in the Department of Interior in Washington, DC (1961-62), and private law practice in Helena from 1962 to 1969. While in Helena he was an unsuccessful candidate for the Montana Supreme Court (1962) and cemented his previous relationships with Attorney General Forrest Anderson and US Senator Lee Metcalf. Bennett modestly refuses to accept the title of Campaign Manager for either Lee Metcalf (1966 re-election over the challenger, MT Republican Governor Tim Babcock) or Forrest Anderson (his 1968 election as Governor), saying that “they ran their campaigns … we were only there to help.” But he has been generally recognized as having filled that critical role in both of those critical elections. After Governor Anderson’s election in 1968, Bennett was appointed Director of the MT Unemployment Compensation Commission, a position from where he could be a close advisor and confidant of the new Governor. In 1971, Governor Anderson appointed him Judge in the most important jurisdiction in Montana, the 1st Judicial District in Helena, a position he held for seventeen years (1971-88). Upon stepping down from his judgeship, for twenty years (1988-2008) he was a law instructor, mediator and arbitrator. He currently resides in Helena with his wife, Norma Tirrell, former newspaper reporter and researcher/writer. Bennett has two adult children and four grandchildren.

Getting Old Here and There: Opportunities and Pitfalls of Transnational Care Arrangements

This article focuses on challenges of transnational aging and family care among „guest-workers‟ from Italy and Spain. It is based on two qualitative studies on aging in migration and experiences of family care. These migrants‟ situations tend to be socioeconomically underprivileged, yet they have the option to either stay in Switzerland or return to Italy or Spain. Our results show that an additional option is available by combining elements of both national systems of reference. However, these options are often costly and have short-comings which are particularly relevant when ill health conditions demand intensified care. By then, decisions taken within the context of transnational ways of living have far-reaching consequences that affect not only the elderly migrants but also their adult children. The empirical data presented in this article illustrate how specific constellations of caring options emerge from the Swiss „guest-worker‟ migration regime and from transnational practices and choices made in earlier years.

Adolescents’ willingness for intergenerational support: Relations to maternal expectations and mothers’ life satisfaction in 14 cultures

How is adolescents’ willingness for intergenerational support affected by parents’ expectations and parenting behavior? Does youths’ willingness for intergenerational support in turn affect parents’ well-being? The current study addresses these questions from a cross-cultural perspective, using data from connected samples of mother-adolescent dyads (N = 4162) from 14 diverse cultural contexts as part of the “Value of Children and Intergenerational Relations Study” (Trommsdorff & Nauck, 2005). The results are based on mixed model analyses (with culture as a random factor). Associations were investigated between family norms (expectations of support by adult children), parenting goals (obedience, independence) and parenting behavior (acceptance, control) reported by mothers and adolescents’ reports on willingness to support (help in household tasks, willingness to tolerate burdens in order to help their parents in case of accident, emotional support given to mothers and fathers). Across cultures, maternal expectations of adult children were positively related to adolescents’ reported household help and their current emotional support to mothers and fathers. Obedience, and control were positively related to the amount of adolescent help in the household, while independence and acceptance were related to a higher willingness to tolerate burdens as well as to higher emotional support given to the mother. Regarding associations between adolescents’ actual and intended intergenerational support with mothers’ life satisfaction, adolescents’ willingness to tolerate burdens was related to a higher maternal life satisfaction while adolescents’ reported household help was not. Adolescents’ current emotional support to fathers (but not to mothers) was also related to higher maternal life satisfaction. While most of the effects were stable across cultures (no significant random slope variance across cultural groups), some effects did significantly vary across cultures. Traditional-vs.-secular values as culture-level characteristics will be discussed as explanation for these culture-specific relations among mothers’ expectations, adolescents’ intergenerational support, and mothers’ life satisfaction.

Moderating Variables Impacting Adherence to the Reducing Disability in Alzheimer's Disease (RDAD) Intervention

Thesis (Ph.D.)--University of Washington, 2016-06

A családi fészekben élő fiatal felnőttek és fogyasztói döntéseik (In the family nest living young adults and their consumer decisions)

Fiatal felnőttek nagyarányú jelenléte a szülői háztartásokban nemcsak Magyarországon és Európában jellemző, de a fejlett ipari országokban általánosan megfigyelhető jelenség. Az Európai Unióban élő 18–34 év közötti fiatalok 46%-a él együtt legalább egyik szülőjével, a magyar fiatalok esetében hasonló az arány. A fiatalok kitolódó felnőtté válása azt is jelenti, hogy a szülők egyre későbbi időponttól kezdve rendelkeznek szabadabban idejükkel és anyagi forrásaikkal, a fiatal felnőttek döntései pedig részben szüleik részvételével történik. Jelen cikk arra keresi a választ, hogy a szülői fészekben élő vagy a szüleiktől részben függő fiatalok milyen döntési mintákkal rendelkeznek, illetve vásárlási döntéseikben mennyire önállóak. A kérdés vizsgálatát a szülői háztól függő egyetemista fiatalok körében végzett kérdőíves megkérdezés segítségével a szerzők elemezték, és arra is lehetőségük volt, hogy a családtagok által írt rövid esszék segítségével a kérdést több oldalról vizsgálják meg. Eredményeik szerint a szülői háztól függő fiatal felnőttek önálló döntésre képes, sok esetben szakértő fogyasztók, döntéseik önállóságát azonban a termékkategória, a családdal való kapcsolattartás gyakorisága, a családforma és a nemi szerepek is befolyásolják. ____ High ratio of adult children is still living in their parents’ home. This is a significant phenomenon that can be observed in Hungary and throughout Europe, while influences living trends globally. In the EU, 46% of youth between 18-34 years live with at least one of their parents and this same statistic holds true in the case of Hungary. This postponement of adulthood allows parents to enjoy more free time and have higher disposable income from later in life. The young adults, however, in the household make their consumer decisions under parental control. The purpose of this study is to explore the decisionmaking styles of young adults and their independence from their parents in shopping-related decision-making through a literature review and primary study. The survey focused on university students who are dependent on their parental home and short essays were also collected from family members of the target group in order to gain a more complex view on this phenomenon. According to the results the following conclusion can be made: young adults living in their parents’ home are competent consumers with individual decisions, in addition, they are consumer experts within the family in many cases. However, their independent shopping-related decision-making is influenced by product category, frequency of connection to the family home, family form and also sex role orientations.

The influence of perception of forgetting and gender, ethnicity, and closeness on likelihood of caregiving

As life expectancy increases, the population of older adults is increasing rapidly. The caregiving of older parents by adult children has become a normative experience. Much of the gerontological literature has examined the caregiving experience, particularly in terms of the stresses involved. However, research is only beginning to examine the factors which motivate adult children to begin caregiving. The research described here examined how an elderly parent's memory behavior might influence caregiving decisions. In addition, gender, ethnicity, and parent-adult child closeness were examined to explore how these individual difference variables might influence those caregiving decisions.^ Participants read one of two vignettes describing a social visit with an elderly widow (target). In the vignette, the elderly target experiences several instances of forgetting. The vignettes depicted forgetting behavior established in pilot work as normal or serious. The normal forgetting vignette did not arouse concern and the serious forgetting vignette did arouse concern when the middle-aged participants imagined their mothers in the role of the vignette target. Participants rated their likelihood of engaging in eight caregiving behaviors if their mothers behaved like the vignette target. They also rated their closeness with their own mothers.^ Multivariate analyses of variance indicated main effects for vignette type, gender, ethnicity, and attachment. The likelihood of caregiving was higher when forgetting was more serious and when participants were female, Hispanic, and were highly attached to their mothers. Interaction effects showed that gender differences decreased with increased seriousness of forgetting, and ethnic differences were only significant for the normal forgetting condition.^ Multiple regression analyses indicated that attachment was the most significant predictor of likelihood of caregiving. Gender and ethnicity predicted specific caregiving behaviors. Females were more likely to engage in phoning and cooking, and Hispanics were more likely to engage in visiting and suggesting mother move in. ^

Coping with a diagnosis of Alzheimer's disease: A client and caregiver perspective

The purpose of this study was to examine how individuals and their caregivers cope with a diagnosis of Alzheimer's disease. The sample size consisted of six patients with Alzheimer's disease and seven caregivers. The caregivers included spouses and adult children. The study was conducted at an academic medical center in the South Florida area. Using a phenomenological approach, data were collected by audiotaped interviews. Data were analyzed following the seven steps of Colaizzi (1978).^ The results of the study indicated that clients experienced fear, social withdrawal, decreased self-esteem and a need for love and support. Caregivers experienced psychological strain, burden, lifestyle adjustments and sacrifice. Both clients and caregivers identified numerous strategies for coping with Alzheimer's disease. The findings reflect the need for a holistic approach to promoting the quality of life for patients and caregivers. ^

Interação individualizada educador-criança e desenvolvimento da linguagem

Relatório de estágio apresentado para a obtenção do grau de mestre na especialidade profissional de Educação pré-Escolar e ensino do 1º ciclo do ensino básico

Identical Origins, Divergent Paths: Filial Responsibility Laws in Canada and the United States

This dissertation examines the origins of filial responsibility laws in Canada and the United States, laws which prescribe that adult children have an obligation of support which is owed to their parents. Filial responsibility laws enable an indigent parent, or an institution providing medical treatment and care to an indigent parent, to seek financial support from that parent’s adult children through the use of litigation. While those who favour these rarely-used laws claim that they bring many benefits to both the family and the state, there is little evidence to suggest that such benefits are actualized. The development and use of the laws in Canada and the United States make it clear that the limitation of the expenditure of government funds was the primary motive for these laws and the support of families a distant secondary motive.

Interação individualizada educador-criança e desenvolvimento da linguagem

Relatório de estágio apresentado para a obtenção do grau de mestre na especialidade profissional de Educação pré-Escolar e ensino do 1º ciclo do ensino básico

INTERGENERATIONAL SUPPORT AND WELL-BEING OF OLDER ADULTS IN CHANGING FAMILY CONTEXTS

This dissertation consists of three papers that examine the complexities in upward intergenerational support and adult children’s influence on older adults’ health in changing family contexts of America and China. The prevalence of “gray divorce/repartnering ” in later life after age 55 is on the rise in the United States, yet little is known about its effect on intergenerational support. The first paper uses the life course perspective to examine whether gray divorce and repartnering affect support from biological and stepchildren differently than early divorce and repartnering, and how patterns differ by parents’ gender. Massive internal migration in China has led to increased geographic distance between adult children and aging parents, which may have consequences for old age support received by parents. This topic has yet to be thoroughly explored in China, as most studies of intergenerational support to older parents have focused on the role of coresident children or have not considered the interdependence of multiple parent-child dyads in the family. The second paper adopts the within-family differences approach to assess the influence of non-coresident children’s relative living proximity to parents compared to that of their siblings on their provision of support to parents in rural and urban Chinese families. The study also examines how patterns of the impact are moderated by parents’ living arrangement, non-coresident children’s gender, and parents’ provision of support to children. Taking a multigenerational network perspective, the third paper questions if and how adult children’s socioeconomic status (SES) influences older parents’ health in China. It further examines whether health benefits brought by adult children’s socioeconomic attainment are larger for older adults with lower SES and whether one of the mechanisms through which adult children’s SES affects older parents’ health is by changing their health behaviors. These questions are highly relevant in contemporary China, where adult children have experienced substantial gains in SES and play a central role in old age support for parents. In sum, these three papers take the life course, the within-family differences, and the multigenerational network perspective to address the complexities in intergenerational support and older adults’ health in diverse family contexts.

Distinct resistance mutation and polymorphism acquisition in HIV-1 protease of subtypes B and F1 from children and adult patients under virological failure

The goal of this work was to compare the differences between human immunodeficiency Virus type 1 (HIV-1) of B and F1 Subtypes in the acquisition of major and rninot- protease inhibitor (P1)-associated resistance mutations and of other polymorphisms at the protease (PR) gene, through a cross sectional Study. PR sequences from subtypes B and F1 isolates matched according to P1 exposure time from Brazilian patients were included in this study. Sequences were separated in four groups: 24 and 90 from children and 141 and 99 from adults infected with isolates of subtypes F1 and B, respectively. For comparison, 211 subype B and 79 subtype F1 PR sequences from drug-naive individuals Were included. Demographic and clinical data were similar among B- and F1-infected patients. In untreated patients, Mutations L1OV, K20R, and M361 were more frequent in subtype F1, while L63P, A7IT, and V771 were more prevalent in Subtype B. In treated patients, K20M, D30N, G73S, 184V, and L90M, were More prevalent in subtype B, and K20T and N88S Were more prevalent in Subtype F1. A higher proportion of subtype F1 than Of subtype B Strains Containing other polymorphisms was observed. V82L mutation was Present With increased frequency in isolates from children compared to isolates from adults infected with both subtypes. We could observe a faster resistance emergence in children than in adults, during treatment with protease inhibitors. This data provided evidence that, although rates of overall drug resistance do not differ between subtypes B and F1, the former accumulates resistance at higher proportion in specific amino acid positions of protease when compared to the latter. (c) 2008 Elsevier B.V. All rights reserved.

Assessment of adult formulas for glomerular filtration rate estimation in children.

BACKGROUND: Estimated glomerular filtration rate (eGFR) is an important diagnostic instrument in clinical practice. The National Kidney Foundation-Kidney Disease Quality Initiative (NKF-KDOQI) guidelines do not recommend using formulas developed for adults to estimate GFR in children; however, studies confirming these recommendations are scarce. The aim of our study was to evaluate the accuracy of the new Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula, the Modification of Diet in Renal Disease (MDRD) formula, and the Cockcroft-Gault formula in children with various stages of chronic kidney disease (CKD). METHODS: A total of 550 inulin clearance (iGFR) measurements for 391 children were analyzed. The cohort was divided into three groups: group 1, with iGFR >90 ml/min/1.73 m(2); group 2, with iGFR between 60 and 90 ml/min/1.73 m(2); group 3, with iGFR of <60 ml/min/1.73 m(2). RESULTS: All formulas overestimate iGFR with a significant bias (p < 0.001), present poor accuracies, and have poor Spearman correlations. For an accuracy of 10 %, only 11, 6, and 27 % of the eGFRs are accurate when using the MDRD, CKD-EPI, and Cockcroft-Gault formulas, respectively. For an accuracy of 30 %, these formulas do not reach the NKF-KDOQI guidelines for validation, with only 25, 20, and 70 % of the eGFRs, respectively, being accurate. CONCLUSIONS: Based on our results, the performances of all of these formulas are unreliable for eGFR in children across all CKD stages and cannot therefore be applied in the pediatric population group.