The use of the Family Management Style Framework to evaluate the family management of liver transplantation in adolescence

Objective: To understand the family management experience of liver transplantation during adolescence based on the Family Management Style Framework(FMSF). Method: This is a case study that used the FMSF as theoretical framework and the hybrid model of thematic analysis as methodological reference. The case presented is from an adolescent’s family that lives in Salvador, Bahia. The data were collected through interviews with the mother and the patient charts analysis. Results: The results shows that the family defines the transplantation as threatening and there are divergence between mother and daughter related to the teen’s capabilities perception. Facing those discrepancies, the family assumes a protective posture by believing that the teen cannot take care of herself alone. The perceived consequences reflect how much the uncertainty permeates the family environment. Conclusion: It is concluded that the use of a model to evaluate the management can help professionals to direct and plan specific interventions.



Starting a Family at Your Parent's House: Multigenerational Households and Below Replacement Fertility in urban Bulgaria

In societies with strong multigenerational links, economic uncertainty results in choosing to stay with one child, sometimes in association with postponement of first births (i.e. Italy) and sometimes in early childbearing (i.e. Bulgaria). The interaction between intergenerational family practices in lowest-low fertility contexts is likely to play a role on differences timing to parenthood. In this paper, we focus on the phenomenon of women who have one child in their early twenties in Bulgaria and do not intend to have a second child. We argue that the key to this process is the persistence of extended multigenerational households in the Bulgarian context and their effect on young couples' fertility decision making. We use semi-structured interview data from the project Fertility Choices in Central and Eastern Europe and ethnographic fieldnotes. The interviews were collected from a sample of 22 couples resident in Sofia and representing different permutations of educational level, marital status and number of children (0 or 1). The four-year ethnographic fieldwork was conducted in both rural and urban Bulgaria between 1997 and 2009. Results suggest that as long as the economic situation remains dire, and young Bulgarians hopes for the future remain cynical, multigenerational households represent the accepted practice of entering into parenthood for young families.

A-1 Monthly Public Assistance Statistical Report Family Investment Program, October 2006

A-1 Monthly Public Assistance Statistical Report Family Investment Program, October 2006

A-1 Monthly Public Assistance Statistical Report Family Investment Program, November 2006

A-1 Monthly Public Assistance Statistical Report Family Investment Program, November 2006

Family functioning of elderly with depressive symptoms

Objective: To classify families of elderly with depressive symptoms regarding their functioning and to ascertain the presence of an association between these symptoms, family functioning and the characteristics of the elderly. Method: This was an observational, analytical, cross-sectional study performed with 33 teams of the Family Health Strategy in Dourados, MS. The sample consisted of 374 elderly divided into two groups (with and without depressive symptoms). The instruments for data collection were a sociodemographic instrument, the GeriatricDepression Scale (15 items) and the Family Apgar. Results: An association was observed between depressive symptoms and family dysfunction, female gender, four or more people living together, and physical inactivity. Conclusion: The functional family may represent effective support for the elderly with depressive symptoms, because it offers a comfortable environment that ensures the well-being of its members. The dysfunctional family can barely provide necessary care for the elderly, which can exacerbate depressive symptoms.


Secreted subtilisin gene family in Trichophyton rubrum.

Secreted proteases constitute potential virulence factors of dermatophytes. A total of seven genes encoding putative serine proteases of the subtilisin family (SUB) were isolated in Trichophyton rubrum. Based on sequence data and intron-exon structure, a phylogenetic analysis of subtilisins from T. rubrum and other fungi revealed a presumed ancestral lineage comprising T. rubrum SUB2 and Aspergillus SUBs. All other SUBs (SUB1, SUB3-7) are dermatophyte-specific and have apparently emerged more recently, through successive gene duplication events. We showed that two subtilisins, Sub3 and Sub4, were detected in culture supernatants of T. rubrum grown in a medium containing soy protein as a sole nitrogen source. Both recombinant enzymes produced in Pichia pastoris are highly active on keratin azure suggesting that these proteases play an important role in invasion of keratinised tissues by the fungus. The set of deduced amino acid sequences of T. rubrum SUB ORFs allowed the identification of orthologous Subs secreted by other dermatophyte species using proteolysis and mass spectrometry.

Child hearing health: practice of the Family Health Strategy nurses

Objective Evaluating the practice of nurses of the Family Health Strategy (FHS) in child hearing health care. Method A normative assessment of structure and process, with 37 nurses in the Family Health Units, in the city of Recife, Pernambuco. The data collection instrument originated from the logical model of child hearing health care provided by nurses of the Family Health Strategy, and the matrix of indicators for evaluation of nursing practice. Results All the nurses identified the hearing developmental milestones. At least two risk factors were identified by 94.5% of the nurses, and 21.6% of them carried out educational activities. Conclusion The normative assessment was considered adequate despite existing limitations in the structure and process.


Supervision of Community Health Agents in the Family Health Strategy: the perspective of nurses

Objective Analyzing the conceptions of supervision of nurses in the Family Health Strategy (ESF - Estratégia Saúde da Família) in relation to community health workers (ACS – Agente Comunitário de Saúde), taking for reference the work process and the power relations. Method A qualitative study, in which 18 interviews were carried out with nurses from the ESF in the countryside of the state of Goiás. Following transcription, the data were subjected to thematic content analysis and the following categories were identified: Supervision with that sees it all and Supervision is participating and working together. Results Among the findings, it is clear the character of control and monitoring that is carried out primarily through printed instruments and home visits, which constitute vertical and impositive relations, and suffer influence of the local health management. Another finding is the supervision as acting together and with the educational perspective. Conclusion The supervision carried out does not provide the changes intended by the ESF.

A-1 Monthly Public Assistance Statistical Report Family Investment Program, December 2006

A-1 Monthly Public Assistance Statistical Report Family Investment Program.

Solvability of mental health care in the Family Health Strategy: social representation of professionals and users

Objective To aprehend the social representations about the solvability in mental health care with users of the Family Health Strategy and professionals of family health teams and of the Center for Psychosocial Care. Method A qualitative study using semi-structured interviews for data collection, and the Alceste software for analysis. This software uses the Hierarchical Descending Classification based on the examination of lexical roots, considering the words as units and providing context in the corpus. Results The representations emerge in two opposing poles: the users require satisfaction with care and the professionals realize the need for improvement of health actions. Although the matricial support in mental health and the home visits are developed, the barriers related to investment in health, continuing education and organization of care persist. Conclusion The different representations enable improvements in customer service, solvability of care and aggregate knowledge and practices in the expanded perspective of health needs in the family, social and therapeutic context.


Evaluation of prenatal care in unit with family health strategy

We analyzed prenatal care (PN) provided at a unit of the Family Health Strategy Service in São Paulo, according to the indicators of the Program for the Humanization of Prenatal and Birth (PHPB). We compared adequacy of PN in terms of sociodemographic variables, procedures, examinations and maternal and perinatal outcomes. Cross-sectional study with data from records of 308 pregnant women enrolled in 2011. We observed early initiation of PN (82.1%), conducting of a minimum of six consultations (84.1%), puerperal consultation (89.0%); to the extent that there is a sum of the actions, there is a significant drop in the proportion of adequacy. Prenatal care was adequate for 67.9%, with a significant difference between adequacy groups in relation to gestational age and birth weight. Prenatal care deficiencies exist, especially in regards to registration of procedures, exams and immunization. The difference between adequacy groups with respect to perinatal outcomes reinforces the importance of prenatal care that adheres to the parameters of the PHPB.


A-1 Monthly Public Assistance Statistical Report Family Investment Program, January 2007

A-1 Monthly Public Assistance Statistical Report Family Investment Program for January 2007

Caring for family caregivers: An analysis of a family-centered intervention

Objective To assess the effectiveness of Problem-Solving Therapy (PST) on family caregivers through the use of scales to measure anxiety, depression and emotional distress; and to explore facilitating factors and obstacles for its use based on the narrative of nurses. Method A clinical trial and an exploratory focus group with the use of mixed analysis methodology. The study was conducted in a primary health care center in Tarragona, Spain, and the sample consisted of 122 family caregivers who were included in the home care service, and 10 nurses who participated in the intervention group. Family caregivers with evident symptoms of anxiety, depression and emotional distress received PST in the intervention group. The intervention group also consisted of a discussion with eight nurses, which was transcribed and submitted to content analysis. Conclusion Problem-Solving Therapy proved to be effective in reducing perceived anxiety, depression and emotional distress. We identified its strong points and obstacles as described by nurses.



Social network of family caregivers of disabled and dependent patients

Cross-sectional study that used the Social Network Index and the genogram to assess the social network of 110 family caregivers of dependent patients attended by a Home Care Service in São Paulo, Brazil. Data were analyzed using the test U of Mann-Whitney, Kruskal-Wallis and Spearman correlation. Results were considered statistically significant when p<0,05. Few caregivers participated in activities outside the home and the average number of people they had a bond was 4,4 relatives and 3,6 friends. Caregivers who reported pain and those who had a partner had higher average number of relatives who to trust. The average number of friends was higher in the group that reported use of medication for depression. Total and per capita incomes correlated with the social network. It was found that family members are the primary caregiver’s social network.





Identification and characterization of the members of the pho1 gene family in moss and rice

Inorganic phosphate (Pi) is one of the main nutrients limiting plant growth anddevelopment in many agro-ecosystems. In plants, phosphate is acquired from the soil by theroots, and is then transferred to the shoot via the xylem. In the model plant Arabidopsisthaliana, PHO1 was previously identified as being involved in loading Pi into the xylem ofroots. AtPHO1, belongs to a multigenic family composed of 10 additional members, namelyAtPHO1;H1 to AtPHO1;10. In this study, we aimed at further investigating the role of thePHO1 gene family in Pi homeostasis in plants, and to this end we isolated and characterizedthe PHO1 members of two main model plants, the moss Physcomitrella patens and the riceOryza sativa.In the bryophyte P. patens, bioinformatic analyses revealed the presence of seven AtPHO1homologues, highly similar to AtPHO1. The seven moss PHO1 genes, namely PpPHO1;1 toPpPHO1;7 appeared to be differentially regulated, both at the tissue level and in response toPi status. However only PpPHO1;1 and PpPHO1;7 were specifically up-regulated upon Pistarvation, suggesting a potential role in Pi homeostasis. We also characterized the responseof P. patens to Pi starvation, showing that higher and lower plants share some commonstrategies to adapt to Pi-deficiency.In the second part, focusing on the monocotyledon rice, we showed the existence of threePHO1 homologues OsPHO1;1 to OsPHO1;3, with the unique particularity of each havingNatural Antisense Transcripts (NATs). Molecular analyses revealed that both the sense andthe antisense OsPHO1;2 transcripts were by far the most abundantly expressed transcripts ofthe family, preferentially expressed in the roots. The stable expression of OsPHO1;2 in allconditions tested, in opposition with the highly induced antisense transcript upon Pistarvation, suggest a putative role for the antisense in regulating the sense transcript.Moreover, mutant analyses revealed that OsPHO1;2 plays a key role in Pi homeostasis, intransferring Pi from the root to the shoot. Finally, complementing the pho1 mutant inArabidopsis, characterized by low Pi in the shoot and reduced growth, with the riceOsPHO1;2 gene revealed a new role for PHO1 in Pi signaling. Indeed, the complementedplants showed normal growth, with however low Pi content.