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Parental daily care and adequate stimuli are extremely important for development and safety of premature babies at home. This study aimed to analyze safe home care for babies born under 32 weeks from parents' perspectives, with a view to a longitudinal promotion of baby development. A qualitative study, based on philosophical hermeneutic approach proposed by Hans-Georg Gadamer, in which dialogue as a principle provides understanding and fusion of experiences and knowledge. Semi-structured interviews were conducted with 18 parents of premature babies under 1 year of age. Thematic analysis proposed by Braun and Clarke was applied using an inductive approach. Elements related to safe care were identified: home arrival, safe home care: preserving baby health and development, support for safe home care, and development of parental care to promote baby safety. These elements can provide a basis for safe home care that needs to be reinforced longitudinally to increase particularities of baby protection, avoid accidents and illnesses, and improve appropriate developmental stimuli and positive parenting., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objective: To report the structures of the experience of nurse's home visits to premature and low birth weight newborns., Method: This is a descriptive study of the experience report type, structured on the experience of the nurse authors in the development of 48 home visits in a city in the state of São Paulo and its microregion between August 2020 and 2021 with eight mothers of premature and low weight newborns., Results: The guiding documents "Home visit for families with preterm and low birth weight newborns" and "Strategy of guiding questions for home visits" were created and used to promote open narratives from parental caregivers about caring for at-risk newborns, creating a relational space aimed at joint construction., Conclusion: The documents used have favored home visits, helping nurses to establish professional bonds and build relational space through dialogue when conducting their activities in the home environment.

Objective: To analyze the childbirth experience focusing on the intervening factors and on the delivery method., Method: A sequential and explanatory mixed-methods study guided by the World Health Organization document for positive childbirth experiences. The participants were puerperal women in a maternity teaching hospital from inland São Paulo (Brazil). The first quantitative stage involved descriptive analysis with Poisson regression of 265 answers to the "Termômetro da Iniciativa Hospital Amigo da Mulher e da Criança" ("Women- and Baby-Friendly Hospital Initiative Thermometer") questionnaire. The second stage, qualitative, thematically analyzed the interviews conducted with 44 puerperal women who took part in the first stage. Data integration was by connection., The Results and Discussion: The analysis by connection showed that among the factors that restricted the positive experience, C-section was predominant (61.9%), understood as an option due to fear of pain, the treatment modality and previous traumas. Restrictions referring to the presence of a companion (99.6%), not having privacy (83%), disrespectful situations (69.5%), too many touches (56.9%) and the absence of skin-to-skin contact (55%), among others, potentiated fear, loneliness, concern, shame, the perception of disrespect and insecurity with the assistance provided. The promoting factors were as follows: choosing the companion (95.4%) for collaborating in the safety perception, not having infections (83.9%), having continuous team monitoring (82.2%) and pain relief methods (78.9%), which were valued by the women., Conclusion: The intervening factors that promoted positive experiences were related to clinical and protocol-related issues and to service availability. The restrictive factors were associated with excess interventions, deprivation of rights and of choice, absence of privacy and restriction referring to the presence of a companion. Women with a normal postpartum period felt more insecure and disrespected when compared to those subjected to C-sections, whose choices were considered, although they had lower prevalence of skin-to-skin contact. There is an urgent need to apprehend women's experiences and turn them into actions that guarantee their lives in a safe and respectful way., (© 2024. The Author(s).)

Background: The diagnosis of a life-limiting condition of a child in the perinatal or neonatal period is a threat to parental hopes. Hope is an interactional and multidimensional construct, and in palliative care, it is a determinant of quality of life, survival, acceptance and peaceful death., Objective: To map scientific evidence on parents' hope in perinatal and neonatal palliative care contexts., Method: a scoping review theoretically grounded on Dufault and Martocchio's Framework, following the Joanna Briggs Institute methodological recommendations. Searches were performed until May 2023 in the MEDLINE, CINAHL and PsycINFO databases. The searches returned 1341 studies., Results: Eligible papers included 27 studies, most of which were carried out in the United States under a phenomenological or literature review approach. The centrality of women's perspectives in the context of pregnancy and perinatal palliative care was identified. The parental hope experience is articulated in dealing with the uncertainty of information and diagnosis, an approach to which interaction with health professionals is a determinant and potentially distressful element. Hope was identified as one of the determinants of coping and, consequently, linked to autonomy and parenthood. Cognitive and affiliative dimensions were the hope dimensions that predominated in the results, which corresponded to the parents' ability to formulate realistic goals and meaningful interpersonal relationships, respectively., Conclusion: Hope is a force capable of guiding parents along the path of uncertainties experienced through the diagnosis of a condition that compromises their child's life. Health professionals can manage the family's hope by establishing sensitive therapeutic relationships that focus on the dimension of hope. The need for advanced research and intervention in parental and family hope are some of the points made in this study., Protocol Registration: https://osf.io/u9xr5/ ., (© 2023. The Author(s).)

Objective: to identify factors associated with fear of COVID-19 among women who experienced pregnancy or childbirth during the pandemic., Methods: a cross-sectional study, nested within a prospective cohort, using an online survey, from August 2021 to February 2022, based on descriptive data analysis., Results: of the 431 participants, 52.8% were postpartum women and 20.1% were pregnant women. With regard to fear of COVID-19, a mean score of 20.46 was obtained (moderate fear). The highest fear scores were present in women whose newborns were admitted to hospital in neonatal critical units (p=0.032), and the lowest among those covered by supplementary health (insurance) (p=0.016)., Conclusion: among pregnant and postpartum women, high fear of COVID-19 translated into the possibility of having newborns admitted to hospital in a critical unit. The importance of supporting actions to support pregnant/postpartum women's mental health in relation to COVID-19 or other threats that may influence the neonatal outcome stands out.

Objective: to compare the effectiveness of different diagnostic methods to estimate postpartum blood volume loss., Methods: a systematic review of effectiveness according to PRISMA and JBI Protocol. Searches in PubMed/MEDLINE, LILACS, Scopus, Embase, Web of Science and CINAHL, with descriptor "Postpartum Hemorrhage" associated with keyword "Quantification of Blood Loss". Tabulated extracted data, presented in metasynthesis and meta-analysis was applied to quantitative data. To assess risk of bias, JBI Appraisal Tools were applied., Results: fourteen studies were included, published between 2006 and 2021. Quantification of loss by any method was superior to visual estimation and is highly recommended, however the studies' high heterogeneity did not allow estimating this association., Conclusion: the studies' high heterogeneity, with a probable margin of error given the uncontrolled factors, indicates the need for further studies, however quantification proved to be effective in relation to visual estimate. PROSPERO registration CRD 42021234486.

Objectives: to compare exclusive breastfeeding prevalence versus artificial feeding in newborns of mothers with COVID-19., Methods: a systematic review of prevalence, according to JBI. Searches in PubMed®, Embase, CINAHL, LILACS and Web of Science™ databases in August 2021. Cross-sectional, longitudinal or cohort studies were selected, without language and time limitations that showed breastfeeding prevalence or that allowed calculation., Results: fifteen articles published in 2020 and 2021, cohort (60%) or cross-sectional (40%) were analyzed. The average of exclusive breastfeeding in mothers with COVID-19 was 56.76% (CI=39.90-72.88), and artificial breastfeeding, 43.23% (CI = 30.99 - 55.88), without statistically significant differences., Conclusions: despite the recommendations for maintaining breastfeeding, there was a reduction worldwide, when compared to periods prior to the pandemic. With advances in science, these rates have improved, showing the impact of evidence on practices. As limitations, study sources are cited. It is recommended to carry out new studies. PROSPERO registration CRD42021234486.

Background: Despite the benefits of breastfeeding, early weaning is a reality, so less than 50% of children worldwide and in Brazil are on exclusive breastfeeding in the sixth month of life. A strategy to counteract this scenario is breastfeeding counseling. This study aims to verify the effectiveness of individualized counseling by nurses trained in breastfeeding counseling, on the duration of exclusive breastfeeding, compared to standard care., Methods: Multicenter, randomized, parallel, and open clinical trial, with primiparous women aged over 18 years, hospitalized in rooming-in wards at participating centers and hemodynamically stable, aware, and oriented, who had a single-fetus pregnancy and gave birth, regardless of the type of delivery, with live child, gestational age of 37 to 42 weeks and birth weight greater than 2500 g. The women will be initially approached in rooming-in wards and, upon consent to participate in the study, will be allocated through randomization by blocks composed of eight participants in two groups: intervention and control. The randomization lists will be organized by a central without involvement with the study, which will manage the allocation groups and be prepared in the Randon® program. Women allocated to the intervention group will receive breastfeeding counseling by trained nurses, and those in the control group will receive standard care at the center participating in the study., Discussion: The results can contribute to breastfeeding by evidencing possible exclusivity and duration of the counseling trained nurses provide., Trial Registration: REBEC RBR-4w9v5rq (UTN: U1111-1284-3559) ( https://ensaiosclinicos.gov.br/rg/RBR-4w9v5rq ). Posted on March 20, 2023., (© 2023. The Author(s).)

Objectives: to present a theoretical model for the interactional context of health professionals and families of children and adolescents under palliative care., Methods: qualitative study based on the theoretical frameworks of Grounded Theory and Symbolic Interactionism. Ten palliative care professionals took part in this study through semi-structured interviews employing snowball technique from 2020 to 2021., Results: the comparative data analysis resulted in the theoretical model "Searching for human connection to transcend symbolisms in pediatric palliative care". It reveals symbolic elements that substantiate the construction of a collaborative context integrating two phenomena: "Overcoming boundaries and intertwining paths" and "Embracing suffering to weave meaningful experiences". Symbolisms in palliative care guide the behavior of families and professionals, which makes them the key factor to be managed., Final Considerations: symbolisms and suffering continually integrate the interactional experience of professionals. Empathy and compassion are fundamental elements to enable their connection with families.

Objective: To report and discuss the experience of the Circle of Culture in a school space, with attention to the social identity of adolescents., Method: Action research, conducted under the assumptions of the Circle of Culture, from August to December 2019. Participants were 16 adolescents, enrolled in Elementary School, in a state public school, in the rural district of a city of São Paulo. Data collection took place through photographic records, participant observation and field diary., Results: The relations of friendship were the central agenda of the Circles of Culture when dialogues about their structuring and influence on the identity construction were developed., Conclusion: Circles of Culture mediated by health professionals in the school setting have the power to problematize the reality of each adolescent's life and, simultaneously, dialogue about the common, an aspect that empowers identity projects.

Introduction: Literature supports numerous benefits of skin-to-skin contact for neonatal adaptation to extrauterine life and bonding/attachment, but few studies explore the effects of skin-to-skin contact on maternal outcomes. This review aims to map the evidence on skin-to-skin contact in the third stage of labor for postpartum hemorrhage prevention., Methods: Scoping review, which covered stages recommended by the Institute Joanna Briggs, including studies from the PubMed, EMBASE, CINAHL, LILACS, Web of Science, and Scopus databases, using the descriptors "Postpartum hemorrhage", "Labor stages, third", "Prevention" and "Kangaroo care/Skin-to-skin"., Results: 100 publications on the subject found, 13 articles met the inclusion criteria, with 10,169 dyads were assessed in all studies. Publications from 2008 to 2021 were mostly written in English and designed as a randomized controlled trial. Skin-to-skin contact was effective and significant in: reducing the duration of the third stage of labor; placenta delivery; uterine contractility and physiological involution; absence of atony, decreasing blood loss with lower rates of erythrocyte and hemoglobin drop; reducing the need for synthetic oxytocin and/or ergometrine to control bleeding; and reducing changing pads per period and length of stay., Discussion: Skin-to-skin contact was considered an effective, low-cost, and safe strategy, with positive effects already established in the literature for infants and extremely favorable results in postpartum hemorrhage prevention cases, being highly recommended in assistance for the dyad. Open Science Framework Registry ( https://osf.io/n3685 )., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Objective: to analyze nurses' statements about health care for gay adolescents., Method: qualitative study, anchored on the Thematic Analysis of Clarke and Braun, with adoption of Symbolic Interactionism as a theoretical framework, since it favors the understanding of the relationship between behaviors, interactions, and social meanings. Twelve nurses recruited using the snowball sampling technique were remotely interviewed via the Google Meet® video-conferencing app., Results: four themes were elaborated throughout the comprehensive-interpretative process: "Gay adolescents, agendas, and relation with health;" "The gay adolescent's family and care;" "Relationship with gay adolescents in care," and "Limits to nursing care for gay adolescents.", Conclusion: the statements denounce stigmas and symbols derived from cisheteronormativity as intervening in the relationship and indicate the urgency of investing in the intersubjective encounter with gay adolescents and their families in a horizontal, affective, and empathic relationship, with chances of favoring public defense of the right to health. There are comments on the nurses' attitude and qualification of care for this population., Keypoints: (1) Tendency towards "de-subjectifying" objectification in health practices. (2) Hegemony of cisheteronormative logic as a limitation to care. (3) Sex and sexually transmitted infections (STIs) as stigmas attached to gay adolescents. (4) Family and health care for homosexual adolescents: opportunities and obstacles. (5) The limits and powers of nursing to enable equity in care for gay adolescents.

Objective: to determine the profile of pregnancies and prevalence of adherence to puerperal consultation among adolescent puerperal women compared to non-adolescent puerperal women served in an outpatient clinic of a teaching hospital in the rural area of Minas Gerais., Method: cross-sectional study nested in a cohort of puerperal women; non-probabilistic sample, by convenience; adolescent pregnancy - dependent variable; sociodemographic, clinical and obstetric - independent variables. It employed its own instrument, tested by means of a pilot test. Prevalence ratios and confidence intervals were calculated; chi-square and Fisher's exact tests were applied, considering a significance level of 5%, and Poisson regression with robust variance., Results: we interviewed 121 puerperal women, of which 18.2% (22) were adolescents, and observed among them low educational level (p<0.001); fewer pregnancies with pathologies (p=0.016); predominance of primiparous women (p<0.001), and higher rates of normal delivery (p=0.032). The prevalence of adherence to puerperal consultation was 34.7% and 31.8% for adolescents. There were no differences regarding adherence and age of puerperal women., Conclusion: adolescents did not present negative obstetric and neonatal outcomes, although a lower educational level was observed. Association was found between early age and absence of diseases during pregnancy and higher rates of normal vaginal deliveries. Adherence to puerperal return visit was slightly lower, but without statistical significance., (1) Adolescent puerperal women had low educational level. (2) Association between early age and absence of diseases during pregnancy. (3) There were higher rates of normal vaginal deliveries among adolescents. (4) Adolescents did not present negative obstetric and neonatal outcomes. (5) There were no differences regarding adherence and age of puerperal women.

Background: Antenatal care is an important tool to prevent complications and decrease the incidence of maternal and antenatal morbidity and mortality. In Brazil, quality, access, and coverage of antenatal care are described as insufficient. Consequently, high rates of caesarean section, congenital morbidities such as syphilis, maternal and early neonatal mortality occur, as well as obstetric violence and dissatisfaction with healthcare. It is important to reflect on health disparities in antenatal care. This study aimed to carry out a critical analysis of antenatal care in one city of São Paulo state in Brazil., Methods: A case study was performed, structured in a descriptive cross-sectional epidemiological study and two qualitative studies. Data for the epidemiological study was obtained from the Informatics Department of the Unified Health System (DATASUS) of Brazil, which was processed in the Epi-info v software 7.2. and treated descriptively and by the Mantel-Haenszel or Fisher's exact tests. Qualitative data was collected through semi-structured interviews with 30 pregnant women and 8 nurses in the primary healthcare service of one city in São Paulo. The qualitative data analysis was based on thematic content analysis., Results: The data revealed a limited quality of antenatal care. More than six antenatal visits increased the probability of a caesarean section by 47% and babies born vaginally had a lower Apgar score. There was little participation of nurses in antenatal care and women described it as "a quick medical appointment", limited by protocols, based on procedures and insufficient in dialogue. Antenatal care appeared to be fragmented and permeated by challenges that involve the need for change in management, performance, and ongoing training of professionals, as well as in the guarantee of women's rights., Conclusions: Caesarean section was statistically related to the number of antenatal care visits. Interactions between professionals and pregnant women were poor and resulted in dissatisfaction. There is an urgent need to connect health indicators with the findings from professionals and women's experiences to improve the quality of antenatal care., (© 2022. The Author(s).)

Signaling of two-component systems by phosphoryl transfer requires interaction of the sensor kinase with the response regulator. Interaction of the C4-dicarboxylate-responsive and membrane-integral sensor kinase DcuS with the response regulator DcuR was studied. In vitro , the cytoplasmic part of DcuS (PAS C -Kin) was employed. Stable complexes were formed, when either DcuS or DcuR were phosphorylated ( K d 22 ± 11 and 28 ± 7 nM, respectively). The unphosphorylated proteins produced a more labile complex ( K d 1380 ± 395 nM). Bacterial two-hybrid studies confirm interaction of DcuR with DcuS (and PAS C -Kin) in vivo . The absolute contents of DcuR (197-979 pmol mg -1 protein) in the bacteria exceeded those of DcuS by more than 1 order of magnitude. According to the K d values, DcuS exists in complex, with phosphorylated but also unphosphorylated DcuR. In live cell imaging, the predominantly freely diffusing DcuR becomes markedly less mobile after phosphorylation and activation of DcuS by fumarate. Portions of the low mobility fraction accumulated at the cell poles, the preferred location of DcuS, and other portions within the cell, representing phosphorylated DcuR bound to promoters. In the model, acitvation of DcuS increases the affinity toward DcuR, leading to DcuS-P × DcuR formation and phosphorylation of DcuR. The complex is stable enough for phosphate-transfer, but labile enough to allow exchange between DcuR from the cytosol and DcuR-P of the complex. Released DcuR-P diffuses to target promoters and binds. Uncomplexed DcuR-P in the cytosol binds to nonactivated DcuS and becomes dephosphorylated. The lower affinity between DcuR and DcuS avoids blocking of DcuS and allows rapid exchange of DcuR. IMPORTANCE Complex formation of membrane-bound sensor kinases with the response regulators represents an inherent step of signaling from the membrane to the promoters on the DNA. In the C4-dicarboxylate-sensing DcuS-DcuR two-component system, complex formation is strengthened by activation (phosphorylation) in vitro and in vivo , with trapping of the response regulator DcuR at the membrane. Single-molecule tracking of DcuR in the bacterial cell demonstrates two populations of DcuR with decreased mobility in the bacteria after activation: one at the membrane, but a second in the cytosol, likely representing DNA-bound DcuR. The data suggest a model with binding of DcuR to DcuS-P for phosphorylation, and of DcuR-P to DcuS for dephosphorylation, allowing rapid adaptation of the DcuR phosphorylation state. DcuR-P is released and transferred to DNA by 3D diffusion.

Objective: To understand the childbirth experience of women assisted in a maternity hospital signatory of the Adequate Childbirth Project., Methodology: Mixed study, carried out in 2018. Applied the Free Word Association Test in 62 pregnant women and then conducted an open interview with 18 of them, then puerperal women, and, for analysis, the Central Nucleus Theory, Word Cloud, and thematic Categories, respectively., Results: The predominant words revealed in the quantitative stage were: pain, wonderful, recovery, anxiety, and desires. The qualitative analysis is presented by thematic categories "Women's insecurities in the PPA model" and "New perspectives from experience in the PPA model"., Conclusions: The women's experiences demonstrated that the model favored the remodeling of childbirth care. However, they still experience pain, dissatisfaction, and lack of autonomy. The impossibility of choosing a trusted professional was a source of insecurity, and nurses had no voice in decisions and actions in care.

Aim: The study aim was to map clinical characteristics and the evolution of pregnancies in pregnant women with confirmed diagnosis of SARS-CoV-2 infection., Methods: Searching four databases, studies were investigated that described the evolution of pregnancies in women diagnosed with SARS-CoV-2 infection through laboratory tests. A scoping review was undertaken, including 35 articles published in English. Two pairs of independent researchers synthesized the data., Results: Most studies were case studies or case series and had a low risk of bias. A predominance of cases was found in women over the age of 30 years who got infected in the third term of pregnancy and who had comorbidities. The prematurity index varied with the heterogeneity of the samples, and the cases of abortion occurred in combination with severe forms of infection. Caesarean section deliveries predominated, indicated mainly by respiratory decompensation caused by infection. Most women were discharged., Conclusion: Based on the reviewed studies, the profile and evolution of pregnant women infected with COVID-19 could be evaluated., (© 2021 John Wiley & Sons Australia, Ltd.)

Objective: Analyze available evidence related to SARS-CoV-2 infection and vertical transmission., Methods: Scoping review, according to the Joanna Briggs Institute and PRISMA-ScR. Searches were conducted in five electronic databases to find publications about coronavirus infection and vertical transmission. Data were extracted, analyzed and synthesized by three independent researchers using a descriptive approach., Results: The search resulted in 76 publications. After selective steps, 15 articles - retrospective descriptive or case studies - were analyzed, all in English. In order to track the infection, specimens were collected from neonates through nasal swabs and C-reactive protein from breast milk, cord blood, amniotic fluid, placenta and vaginal secretion was analyzed. A small percentage of neonates tested positive for COVID-19, but these cases were not attributed to vertical transmission., Conclusion: Vertical transmission could not be demonstrated. Research protocol registered with the Open Science Framework (https://osf.io/fawmv).

Objective: To analyze online information available on the internet about COVID-19 and childhood cancer and discuss its reach potential with regard to supporting family functioning., Method: Documentary research supported by thematic analysis and the concept of family functioning and support. A total of 27 publications available on the websites of reference institutions in pediatric oncology, from March 1 to May 31, 2020, were analyzed., Results: Two themes guided the presentation of results with emphasis on language and sustainability assumptions to content, and to conveyed meanings and intentionality. The publications prospect families/people with basic knowledge about COVID-19 and have little information specific to the relationship with childhood cancer., Final Considerations: Threatening circumstances require informational support. This study revealed incipient of specificity and a prescriptive tone in the online information available in early times of the pandemic, questioning the scope of support for family functioning.

Objectives: To analyze the motivation of neonatal intensive care nurses and the meanings attributed to the continuity of professional training., Methods: qualitative study, developed between August and December 2018, based on interviews with 16 nurses working in Neonatal Intensive Care in cities in seven Health Regions in the State of São Paulo. The theory of self-determination and narrative analysis supported this study., Results: the search for specialization and qualification of care is the plot, with the motivation for training initially based on the specialization and qualification of care. Over time, they revisit understandings carried out about care, making considerations about training, factors that influence motivation., Final Considerations: the motivation expressed by the nurse in the search for training is shown through movements marked by the limitations apprehended in practice on the care of the risk neonate and the acquisition of knowledge to act with quality in this specific health scenario.

Objective: to unveil the interrelation of childhood colic management by mothers and Family Health Strategy professional., Methods: a qualitative, exploratory and descriptive research carried out with 4 Family Health Strategy teams and 31 mothers who experienced childhood colic. Data collection included, respectively, focus group and individual unstructured interview. Symbolic Interactionism was adopted as the theoretical framework, and Narrative Research as methodological., Results: two themes emerged: "Colic approach" and "Social support and care". Professional childhood colic management is based on diagnosis and drug interventions. For mothers, the child's suffering and impotence in the face of the disease stand out., Final Considerations: childhood colic is socially widespread because it is a physiological and self-limiting event. Mothers felt helpless in the face of childhood colic. Professionals felt the need to expand their care, with a view to achieving maternal suffering and alleviating it.

The genome versus experience dichotomy has dominated understanding of behavioral individuality. By contrast, the role of nonheritable noise during brain development in behavioral variation is understudied. Using Drosophila melanogaster , we demonstrate a link between stochastic variation in brain wiring and behavioral individuality. A visual system circuit called the dorsal cluster neurons (DCN) shows nonheritable, interindividual variation in right/left wiring asymmetry and controls object orientation in freely walking flies. We show that DCN wiring asymmetry instructs an individual's object responses: The greater the asymmetry, the better the individual orients toward a visual object. Silencing DCNs abolishes correlations between anatomy and behavior, whereas inducing DCN asymmetry suffices to improve object responses., (Copyright © 2020 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.)

Objectives: to know the meaning attributed by family members to the health safety of pediatric patients, with attention to the possibilities of their collaboration., Methods: this qualitative study was conducted with eighteen family members of children hospitalized in a pediatric unit, from January to July 2018. Symbolic Interactionism was used as a theoretical framework, and Inductive Content Analysis as method., Results: child hospitalization poses risks to possible incidents and adverse events. Participants and professionals are responsible for patient safety. Thus, their actions focus on error prevention. Therefore, they seek information and observe in a vigil way professional care in classic aspects of safety. They conceive essential and favoring safety the approach centered on children and family members. Final Considerations: family members recognized the chances of errors and care damage, identified themselves as support in minimizing damage and were in partnership with the professional, increasing chances of effecting safety.

Objectives: to characterize and analyze the experiences of families involved in domestic violence against children and adolescents, based on the Paradigm of Complexity., Methods: qualitative research, in which data of 15 families was collected through documentary research, open interviews and field diary. The data were analyzed through thematic analysis., Results: two categories "I don't have it" and "I didn't have it" emerged, revealing the historicity that marks the violence experienced in the present. They include social vulnerability, maternal burden, associated with urban violence to which families are exposed. At the same time, stories of violence by the intimate partner, as well as intergenerational violence and drug abuse have impacted the current moment. Final Considerations: nursing can contribute to attribute new meaning to violent stories woven by families, as well as to the interdisciplinary construction of perspectives and interventions that consider the multiple violence and adversities to which such a population is exposed.

Objective: To analyze the interactions between nursing and hospitalized high-risk pregnant women regarding the possibilities and limits of providing care guided by the principle of comprehensiveness., Method: A qualitative study based on the conceptual framework of comprehensiveness and developed from the precepts of thematic content analysis. Data were collected through open interviews and observation of the care scenario of twelve nursing professionals with hospitalized high-risk pregnant women., Results: Twelve (12) nursing professionals participated in the study. Nursing practices are portrayed from two thematic categories: "Embracement: emotional and informational support" and "Assessing and monitoring gestational risk". The findings revealed intentions to embrace women, providing informal and emotional support, but under weaknesses in intersubjective relationships. There is an emphasis on "technical success", not always sufficiently articulated with "practical success" in care actions, with harm to achieving comprehensiveness., Conclusion: The findings revealed that an emphasis on the biomedical management of obstetric risk and structural and organizational limitations of work end up hindering incorporating into daily care the concerns and knowledge necessary for constructing its comprehensiveness.

Objective: To analyze maternal care for siblings of preterm babies hospitalized in the neonatal intensive care unit., Method: Qualitative research using symbolic interactionism as a theoretical reference and narrative research as a methodological reference. Ten mothers were surveyed through semi-structured interviews., Results: Three thematic units emerged from the analysis of data: "social support in the sharing of child care"; "promotion of adaptation to the arrival of a sibling" and "maternal feelings and coping"., Final Considerations: Care for the premature child's sibling is developed under mothers' physical distance from him/her, justified by the need to remain close to the premature child due to risks and fragility related to the condition.

Objective: to understand the experience of families about school experiences of children and adolescents with visual impairment., Method: a qualitative study developed through the Symbolic Interactionism and narrative research. Data were collected through a semi-structured recorded interview, with eleven families of children/adolescents with visual impairment, totaling 40 participants., Results: two phenomena emerged: "exclusion context" and "impaired school performance". Prejudice experienced at school brings devastating consequences to the life of the visually impaired child/adolescent and his family. Isolation occurs, difficulty adapting to the support resource and deficits in school performance., Final Considerations: production contributes to awakening professionals involved with the assistance of these people. Effective participation of health professionals in this area is required to develop actions with students, teachers and families, aimed at meeting the needs of learning and health promotion, inclusion, and respect for differences.

Objective: To understand the satisfaction women experience during the normal delivery., Methodology: Qualitative, exploratory and descriptive study, developed during January and February of 2017, from interviewing twenty women that were satisfied with their natural delivery, residing on the countryside of Sao Paulo. The Symbolic Interactionism and the Thematic Content Analysis support this study., Results: The main theme "Normal delivery as a means to find oneself" developed through three thematic units that report the satisfaction in the normal delivery: "Decision for normal delivery", "Childbirth with welcoming support", "Violence: it is not all roses". The satisfaction has been correlated to the accomplishment of the dream of giving birth, welcoming support of Doulas/health professionals and the presence of a companion/family members during the process, but it also reveals labors marked by invasive, imposing and unwelcoming experiences., Conclusions: The empowerment granted and felt by the woman during the normal delivery experience reinforces the urgency of investments to promote sociocultural transformations that concern childbirth in Brazil.

The recently published purely metallo-organic Ni I salt [Ni(cod) 2 ][Al(OR F ) 4 ] (1, cod=1,5-cyclooctadiene, R F =C(CF 3 ) 3 ) provides a starting point for a new synthesis strategy leading to Ni I phosphine complexes, replacing cod ligands by phosphines. Clearly visible colour changes indicate reactions within minutes, while quantum chemical calculations (PBE0-D3(BJ)/def2-TZVPP) approve exergonic reaction enthalpies in all performed ligand exchange reactions. Hence, [Ni(dppp) 2 ][Al(OR F ) 4 ] (2, dppp=1,3-bis(diphenylphosphino)propane), [Ni(dppe) 2 ][Al(OR F ) 4 ] (3, dppe=1,3-bis(diphenyl-phosphino)ethane), three-coordinate [Ni(PPh 3 ) 3 ][Al(OR F ) 4 ] (4) and a remarkable two-coordinate Ni I phosphine complex [Ni(PtBu 3 ) 2 ][Al(OR F ) 4 ] (5) were characterised by single crystal X-ray structure analysis. EPR studies were performed, confirming a nickel d 9 -configuration in complexes 2, 4 and 5. This result is supported by additional magnetization measurements of 4 and 5. Further investigations by cyclic voltammetry indicate relatively high oxidation potentials for these Ni I compounds between 0.7 and 1.7 V versus Fc/Fc + . Screening reactions with O 2 and CO gave first insights on the reaction behaviour of the Ni I phosphine complexes towards small molecules with formation of mixed phosphine-CO-Ni I complexes and oxidation processes yielding new Ni I and/or Ni II derivatives. Moreover, 4 reacted with CH 2 Cl 2 at RT to give a dimeric Ni II ylide complex (4 c). As CH 2 Cl 2 is a rather stable alkyl halide with relatively high C-Cl bond energies, 4 appears to be a suitable reagent for more general C-Cl bond activation reactions., (© 2018 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.)

Objective: to analyze the Developmental Care in nursing care for Newborns in critical Neonatal Intensive Care Units., Method: a qualitative study with 11 nurses from Neonatal Intensive Care Units of a city in the State of São Paulo countryside, based on the Developmental Care. Data collection was based on non-participant observation, documentary research in medical records and semi-structured interviews. The Symbolic Interactionism was adopted as theoretical framework, and the Bardin Content Analysis, as method of analysis., Results: nurses have knowledge about Developmental Care; however, there are dissonances with doing them. The analysis is presented from two thematic categories: "Nurses' performance in the Developmental Care" and "Nurse, Family and Developmental Care"., Final Considerations: it is necessary to encourage reflections on the care of nurses regarding Developmental Care, and to foster sensitivity and perception in relation to the executed and registered.

Objective: to understand the elements composing intersubjective recognition that are relevant for nursing care in early childhood in favor of comprehensive child development., Method: reflexive study based on the Honnethian concept of intersubjective recognition in the dimensions of affection, defense of rights, and social esteem., Results: nursing knowledge and practices, permeated by the intersubjective recognition in the mentioned dimensions, contribute to the dynamism of interpersonal relations, the production of co-responsibility, and shared construction of health care in early childhood, with benefits to comprehensive development., Conclusion: a successful coordination of the three intersubjective dimensions enables the expansion of the understanding on childhood and nursing care in child health in the field of human development promotion, covering affection, defense of rights, and social esteem in the established relationships with future positive individual and social possibilities.

Objective: To analyze the influence of health professionals' receptiveness on parental care of children with retinopathy of prematurity (ROP)., Method: A qualitative study developed under the theoretical framework of Symbolic Interactionism and using a narrative research methodology. Six women and three men, being parents of children with retinopathy of prematurity were individually interviewed in depth., Results: From the scope of information, emotions and their rights, the parents experienced receptiveness from some professionals and unreceptiveness from others. The predominance of unreceptive attitudes in the parental narratives originated the following analysis themes: Informational (un)receptiveness, Emotional (un)receptiveness, and (Un)receptiveness of rights., Conclusion: The study supports human and comprehensive healthcare in the context of retinopathy of prematurity by pointing out the interactive process with health professionals as a potential stressor of parental care. The results signal a nuclear of attitudinal changes and reinforce challenges to the child and family-centered approach., Objetivo: Analisar a influência do acolhimento do profissional de saúde no cuidado parental junto ao filho com retinopatia da prematuridade., Método: Estudo qualitativo desenvolvido sob o referencial teórico do Interacionismo Simbólico e metodológico da pesquisa de narrativas. Foram entrevistados em profundidade e individualmente seis mulheres e três homens, pais de crianças com retinopatia da prematuridade., Resultados: Os pais vivenciam, nos âmbitos informacional, emocional e de direitos, acolhimento com alguns profissionais e destrato com outros. A predominância da postura de desacolhimento nas narrativas parentais deu origem aos temas de análise: (Des)acolhimento informacional, (Des)acolhimento emocional, e (Des)acolhimento de direitos., Conclusão: O estudo oferece subsídios ao cuidado humano e integral em saúde no contexto da retinopatia da prematuridade ao apontar o processo interativo com os profissionais de saúde enquanto potencial estressor do cuidado parental. Os resultados sinalizam núcleos de mudanças atitudinais e reforçam desafios à abordagem centrada na criança e família.

This study aimed to understand the interactions established between social support networks and families that have children and adolescents with visual impairment, in two different cities in the state of Sao Paulo, Brazil. This was a qualitative, descriptive study with symbolic interactionism as a theoretical framework. A genogram, ecomap and semi-structured interviews with 18 families were used. The method adopted for data analysis was narrative analysis. Two themes were found: potentials derived from the relationship with the support network, and, counterpoints in the support network. The family members accessed other members of their own family, friends, spiritual and cultural activities, health services, government institutions, and philanthropic organizations as support networks. The weakness in health services support is an obstacle to comprehensive healthcare for children and adolescents living in city A. In city B, other possibilities exist because it has a reference service. Despite the weaknesses in the support network in both cities, the family articulates and develops a foundation so that they can provide the best situation possible for their child or adolescent. It is up to health professionals to provide support to families and empower them to care for their members.

Objective: analyze the maternal experience in a neonatal intensive care unit, focusing on relations of recognition., Method: a qualitative study, built on the perspective of Gadamer's hermeneutics, based on Honneth's concept of recognition. In-depth interviews were conducted with 10 mothers of children admitted to a neonatal intensive care unit., Results: failures were reported in the process of mother recognition in the unit, with consequent feelings of insecurity and obligation to child care, resulting in fragility of self-esteem., Conclusion: interactions with health professionals in the NICU and its standards and protocols cause vulnerabilities and affect maternal recognition and autonomy.

During and after pregnancy, mothers with HIV can undergo treatment that is capable of preventing vertical transmission (VT) to their babies. The purpose of this study was to analyze the experience of family members that provide care for children whose mothers have HIV, to reduce the risk ofVT, with emphasis on the beginning of this trajectory. This study was based on the qualitative approach and Symbolic Interactionism was adopted as a theoretical framework. A total of 36 family members participated in the study, all of whom were carers of children aged up to 18 months and waiting for confirmation of the HIV diagnosis. Data were collected in a hospital in north-eastern Brazil, between December 2012 and February 2013, and examined by means of content analysis. Child care began during pregnancy, when the possibility of the child having HIV was expected. Some had previous experience in providing care for exposed children. Understanding the early trajectory of care will help find ways to provide better support for carers during the trajectory of diagnosis confirmation.

The objective of this study is to characterize how the Family Health Strategy teams in Brazil perceive their role to provide continued care to families of children with chronic diseases. This was a qualitative study that used symbolic interactionism as its theoretical framework, with content analysis for thematic categorical analysis. Focus groups with three Family Health Strategy teams were used for data collection, with a total of 32 study participants. The results were organized into three thematic categories: 1) singularities of families that live with children with chronic diseases; 2) team, family and Family Health Strategy; and 3) limitations of care . The teams' perception is that the design of the Family Health Strategy encourages access to the family experience, allowing the recognition of its specificities. Further, the data reveal team limitations regarding their capacity to provide care, and the need for investments in articulation with different social services, sectors, and equipment.

The purpose of this study was to learn the perception that families of children with a chronic disease make of their relationships with the Family Health Unit (FHU). This qualitative study was performed using symbolic interactionism as the theoretical ground and narrative inquiry as the method. Data were collected through semi-structured interviews with seven families of children with chronic disease, enrolled in the FHU of a region with high social vulnerability, in Sdo Paulo state, Brazil. Results showed that the family's relationship with the FHU is influenced by elements from their experience and trajectory, and that their experience as a family of a child with a chronic disease is strongly marked by their relationship with the health care services. This has great influence on the responses of the family, thus requiring a systematic and committed engagement of the health system in relieving their suffering, beyond merely treating the disease.

The prevalence of chronic disease in childhood has increased, placing families in constant contact with health professionals. In such situations the relationship with health professionals has an important role. Few scientific studies address this theme, in spite of its being highlighted as fundamental for effective interaction. The aim of this study was to characterize how the family of a child with a chronic disease perceives its relationship with health professionals. Twenty caregivers for children with chronic diseases were interviewed. The theoretical and methodological frameworks were, respectively, symbolic interactionism and thematic content analysis. The analytical process revealed four themes: role of the caregiver, stressful relationships, services and professionals, and seeking welcoming relationships. The outcomes of this interactional process, which show an incongruity of expectations and behaviors between professionals and families, are poor and generate feelings of abandonment. These can be eased through listening and understanding by other families in similar situations.

Identifying the need to comprehend how nurses 'move' to the family, with the intention of caring for them, the present study obtained twelve biographical narratives of pediatric nurses. The theoretical approach adopted was the Symbolic Interactionism and the methodological one was the Interpretative Interactionism. The analysis of the data allowed the reconstruction of a story which showed that through modifying the concept of caring and family is the process that approximate the pediatric nurses progressively to the family, to a being with them, reaching the freedom to act.

Visual pigments (rhodopsins) are composed of a chromophore (vitamin A derivative) bound to a protein moiety embedded in the retinal membranes. Animals cannot synthesize the visual chromophore de novo but rely on the uptake of carotenoids, from which vitamin A is formed enzymatically by oxidative cleavage. Despite its importance, the enzyme catalyzing the key step in vitamin A formation resisted molecular analyses until recently, when the successful cloning of a cDNA encoding an enzyme with beta,beta-carotene-15,15'-dioxygenase activity from Drosophila was reported. To prove its identity with the key enzyme for vitamin A formation in vivo, we analyzed the blind Drosophila mutant ninaB. In two independent ninaB alleles, we found mutations in the gene encoding the beta,beta-carotene-15,15'-dioxygenase. These mutations lead to a defect in vitamin A formation and are responsible for blindness of these flies.

Background and Aim of the Study: Our previous studies of bileaflet mechanical heart valves (MHV) explanted from sheep revealed patterns of localized platelet aggregation on valve surfaces, which may have clinical relevance. Since flow phenomena may promote localized platelet aggregation, an evaluation of flow within a valve lumen was conducted., Methods: Phase-locked particle image velocimetry (PIV) measurements were obtained within the lumen of a 'mitral' model bileaflet MHV with transparent acrylic leaflets and housing, in a pulsatile flow loop. Instantaneous, two-dimensional flow maps of a central plane, perpendicular to the flow and leaflet pivot axes, were obtained at discrete times during the simulated cardiac cycle. Flow conditions were cardiac output, 3.5 l/min; rate, 72 beats/min; and systolic duration, 300 ms, using blood analog fluid refractive index-matched to acrylic. Leaflet closing velocities and angles were found using double-exposure imagery, and maximum leaflet closing velocity was extrapolated from regression analysis., Results: During full opening, flow within the three lumenal orifices formed a three-peak axial velocity profile. Vorticity was concentrated in shear layers adjacent to downstream leaflet surfaces and in downstream wakes. Forward flow peak velocity was 90 cm/s, with a steep velocity gradient in the central orifice. During closing, the central-gap regurgitant flow formed a jet (peak velocity, 144 cm/s). High vorticity occurred near leaflet leading and trailing edges. During full closure, first a transient (<3 ms) 'stopping vortex' developed near the leaflet trailing edge, followed by a wall jet which formed at the leaflet-housing junction. Maximum leaflet closing velocity was 1.4 m/s., Conclusion: Localized jets, steep velocity gradients, high vorticity and vortex recirculation have been observed in vitro near model MHV surfaces. In vivo, each of these flow phenomena, when occurring near valve surfaces, may promote localized platelet aggregation. For the acrylic leaflets, maximum velocity was comparable with results reported for pyrolytic carbon leaflets. PIV of fully transparent models is a promising method for evaluating lumenal flows.

The Drosophila ommatidia contain two classes of photoreceptor cells (PR's), the outer and the inner PR's. We performed an enhancer trap screen in order to target genes specifically expressed in PR's. Using the UAS/GAL4 method with enhanced green fluorescent protein (eGFP) as a vital marker, we screened 180000 flies. Out of 2730 lines exhibiting new eGFP patterns, we focused on 16 lines expressing eGFP in particular subsets of PR's. In particular, we describe three lines inserted near the spalt major, m-spondin and furrowed genes, whose respective expression patterns resemble those genes. These genes had not been reported to be expressed in the adult eye. These examples clearly show the ability of our screen to target genes expressed in the adult Drosophila eye.

A new particle imaging velocimetry data acquisition and analysis system, which is an order of magnitude faster than any previously proposed system, has been constructed and tested. The new particle displacement tracking (PDT) system is an all electronic technique employing a video camera and a large memory buffer frame-grabber board. Using a simple encoding scheme, a time sequence of single exposure images is time coded into a single image and then processed to track particle displacements and determine 2-D velocity vectors. Use of the PDT technique in a counterrotating vortex flow produced over 1100 velocity vectors in 110 s when processed on an 80386 PC.

Current pulsed laser velocimetry data processing techniques offer high precision (1%) velocity estimates, but can require several hours of processing time on specialized array processors. Under some circumstances, a simple, fast, less accurate (~5%), data reduction technique, which also gives unambiguous velocity vector information is acceptable. In this work, we examine a direct space domain processing technique. The direct space domain processing technique was found to be far superior to any other techniques known, in achieving the objectives listed above. It employs a new data coding and reduction technique, where the particle time history information is used directly. Further, it has no 180 degrees directional ambiguity. A complex convection vortex flow was recorded and completely processed in under 2 min on an 80386 based PC, producing a 2-D map of the flow field containing over 300 velocity vectors.

Polyclonal and monoclonal antibodies (MoAbs) were raised against human platelet thromboxane (Tx) synthase. Neither the antiserum nor the MoAbs inhibited the enzyme activity significantly. Three MoAbs, Tü 300, Kon 6, and Kon 7, were purified and further characterized. They are monospecific as shown by activity precipitation or Western blot analysis, and recognized different epitopes on Tx-synthase. Tü 300 could precipitate the enzyme and recognized conformational epitopes, whereas Kon 6 and Kon 7 only reacted in Western blots. Antibody Tü 300 can be used in immunohistology but shows no crossreactivity with Tx-synthase from other species. In human lung tissue staining with peroxidase, coupled Tü 300 was only found in alveolar macrophages.

A new time-of-flight (TOF) laser anemometer system utilizing a spatial lead-lag filter for bipolar pulse generation has been constructed and tested. This new TOF has been modified to enable measurements in turbulent flows near walls. Good results have been obtained as close as 100 microm from a surface, with a 140-mm focal length final lens. Lading's theory for the behavior of the measurement variance has been confirmed for this configuration.