Search

In this article, we provide an overview of remote monitoring of pediatric PGHD and family-generated health data, including its current uses, future opportunities, and implementation resources., Competing Interests: FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose., (Copyright © 2022 by the American Academy of Pediatrics.)

Chagas disease, cysticercosis, and toxoplasmosis affect millions of people in the United States and are considered neglected parasitic diseases. Few resources are devoted to their surveillance, prevention, and treatment. Chagas disease, transmitted by kissing bugs, primarily affects people who have lived in Mexico, Central America, and South America, and it can cause heart disease and death if not treated. Chagas disease is diagnosed by detecting the parasite in blood or by serology, depending on the phase of disease. Antiparasitic treatment is indicated for most patients with acute disease. Treatment for chronic disease is recommended for people younger than 18 years and generally recommended for adults younger than 50 years. Treatment decisions should be individualized for all other patients. Cysticercosis can manifest in muscles, the eyes, and most critically in the brain (neurocysticercosis). Neurocysticercosis accounts for 2.1% of all emergency department visits for seizures in the United States. Diagnosing neurocysticercosis involves serology and neuroimaging. Treatment includes symptom control and antiparasitic therapy. Toxoplasmosis is estimated to affect 11% of people older than six years in the United States. It can be acquired by ingesting food or water that has been contaminated by cat feces; it can also be acquired by eating undercooked, contaminated meat. Toxoplasma infection is usually asymptomatic; however, people who are immunosuppressed can develop more severe neurologic symptoms. Congenital infection can result in miscarriage or adverse fetal effects. Diagnosis is made with serologic testing, polymerase chain reaction testing, or parasite detection in tissue or fluid specimens. Treatment is recommended for people who are immunosuppressed, pregnant patients with recently acquired infection, and people who are immunocompetent with visceral disease or severe symptoms.

The COVID-19 pandemic exposed mothers to stress and social isolation during the pre- and post-natal periods. The deleterious effects of stress on both pregnant women and their infants are well documented, with research suggesting that effects are exacerbated by reduced social support. In this brief report, we summarize evidence linking stress and social isolation to negative outcomes for mothers and infants and present a conceptual model featuring inflammation as a driving mechanism. There is strong evidence that the coronavirus pandemic will affect mothers and infants through immune pathways that, in previous research, have been shown to link stress and social isolation during the pre- and post-natal periods with deficits in maternal mental health and infant well-being and development across developmental stages. We close with recommendations for novel research, policy changes, and integrated clinical care that can address these biological threats to infants and mothers while leveraging the anti-inflammatory effects of social support.

Background: Autism Spectrum Disorder (ASD) is a life-long condition which affects the individual and their family system. Little research understands the impact of an ASD upon families, how this may change over time and how COVID-19 has impacted these dynamics., Aims: To explore the impact of an ASD on the lived experiences of parents and neurotypical adult siblings, including during the UK COVID-19 lockdown., Methods: Eight parent-sibling dyads (16 individuals) completed semi-structured interviews discussing their family before, during and after receiving the ASD diagnosis, and in relation to the first UK lockdown. Interview transcripts were analysed using Interpretative Phenomenological Analysis., Results: Three super-ordinate themes were identified: Dominated by ASD; Family Cohesion; and the Need for Support., Conclusions: The data suggested a closeness within the families and an adoration towards the individual with ASD (IWA). Dyads were, to an extent, consumed by the diagnosis both presently and in the future, implicating the need for a stretch in services to support parents and neurotypical siblings. In terms of the first UK lockdown, the IWA added an extra layer of difficulty to the dyads work-life balance yet there was an essence of family cohesion. Future research should consider longitudinal methods and explore the impact of ASD co-morbidities upon family dynamics., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Introduction: Short message service (SMS) is a widely accepted telecommunications approach used to support health informatics, including behavioral interventions, data collection, and patient-provider communication. However, SMS delivery platforms are not standardized and platforms are typically commercial "off-the-shelf" or developed "in-house." As a consequence of platform variability, implementing SMS-based interventions may be challenging for both providers and patients. Off-the-shelf SMS delivery platforms may require minimal development or technical resources from providers, but users are often limited in their functionality. Conversely, platforms that are developed in-house are often specified for individual projects, requiring specialized development and technical expertise. Patients are on the receiving end of programming and technical specification challenges; message delays or lagged data affect quality of SMS communications. To date, little work has been done to develop a generalizable SMS platform that can be scaled across health initiatives., Objective: We propose the Configurable Assessment Messaging Platform for Interventions (CAMPI) to mitigate challenges associated with SMS intervention implementation (e.g., programming, data collection, message delivery)., Method: CAMPI aims to optimize health data captured from a multitude of sources and enhance patient-provider communication through a technology that is simple and familiar to patients. Using representative examples from three behavioral intervention case studies implemented among diverse populations (pregnant women, young sexual minority men, and parents with young children), we describe CAMPI capabilities and feasibility., Conclusion: As a generalizable SMS platform, CAMPI can be scaled to meet the priorities of various health initiatives, while reducing unnecessary resource utilization and burden on providers and patients. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The COVID-19 pandemic imposed dramatic changes to everyone's daily routines, but especially to children with developmental disabilities. The Robert Hollman Foundation decided not to interrupt its service to all the visually impaired children and initiated a Distance Support Project. It was an online process covering all aspects of support for the children and involving audio-video calls, videos and tailored-made multisensory material created specifically for each child. A questionnaire, carried out after the 5-month project duration, was created to collect feedback from parents and professionals to understand the impact this project had on everyone involved. Overall both parents and professionals indicated high levels of satisfaction, but in a significant number of questions parents reported consistently higher levels of satisfaction (p-value <0.001). It was shown that parents felt reassured at this otherwise very difficult time because their children were able to continue their treatment, even if in a very different way. This fact encourages us to consider enriching our existing programmes of support and care, integrating this online approach when necessary. At the same time, it seems clear that the responses of the professionals indicate their belief that the benefits of the traditional ways of working remain of unquestionable importance for children with sight deprivation., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Introduction: Diabetes self-management education (DSME) programs that engage the families of patients with diabetes have shown to be effective in improving diabetes-related outcomes of the patients. The health effects of these "family models" of DSME on participating family members are rarely studied. Opportunity exists for the participating family members to benefit from the healthy lifestyle recommendations offered through such programs., Method: Using data from a randomized controlled trial to assess the effect of family DSME compared to standard DSME among Marshallese adults with Type 2 diabetes, this study examined baseline to 12-month changes in A1c, body mass index (BMI), food consumption, and physical activity among participating family members, comparing outcomes of family members based on attended at least 1 (n = 98) versus attended no (n = 44) DSME sessions., Results: Overall, family member attendance was low. There were no differences in the level of change from baseline to 12 months for A1c, BMI, food consumption, and physical activity between groups. After controlling for attendance and sociodemographic measures, lowering of BMI was the only significant predictor of not having an A1c level indicative of diabetes at 12 months., Discussion: Future research on family DSME should consider ways to improve family member attendance; have them set their own health improvement goals; and integrate healthy lifestyle education, such as healthy eating and being physically active, along with the DSME core content to create an added benefit of diabetes prevention for participating family members. The limitations of this study and recommendations for future research are provided. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Objective: This article reports on the conceptual development and subsequent implementation of a targeted and attractive general practice teaching program in a rural area for students of human medicine at the medical faculty of Goethe University, Frankfurt am Main. Project description: Since the 2016/2017 winter semester, usually up to 15 interested students a year have had the opportunity to participate in the longitudinal priority program "Landpartie 2.0". The program runs for six semesters during the clinical stage of medical studies and consists of regular internships during which the students receive one-to-one support in a family practice, and participate in a series of seminars and an annual one-day excursion. The aim is to enable students, early on in their studies and without any obligations, to gain uninterrupted experience of providing patient care, and to find out what it means to pursue a career in family medicine. Results: Since the beginning of the annual program, 62 students have been included in it. The initial results show that the different elements of the program fulfil the expectations and requirements of participants and that their overall level of satisfaction is high. Almost 95% of students reported that they felt their knowledge had increased as a result of the internships, and they rated them as a useful part of their medical education. Despite the rural focus of the program, around half of the participants were of urban origin. Conclusion: The "Landpartie 2.0" provides students with the opportunity to familiarize themselves with family health care in a rural area. Further studies should investigate to what extent the program encourages students to continue their training with a view to pursuing a career in family medicine., Competing Interests: The authors declare that they have no competing interests., (Copyright © 2020 Seeger et al.)

Aims and Objectives: To develop a profile of registered nurses working in Child and Family Health services across the Northern Sydney Local Health District to inform workforce strategic planning., Background: Child and family health nurses (CFHNs) are registered nurses holding recognized qualifications in child and family health. To date, information regarding Child and family health nurses has been very limited., Methods: The survey was conducted using a self-administrated online questionnaire between March-June 2017., Results: Just over 75% of the respondents were aged over 50 years. Job satisfaction and feeling valued are enablers for remaining in current positions and not feeling valued can contribute to leaving employment. Nearly, one-third of respondents are currently a carer., Conclusion: This study provides an insight into the demographics of Child and family health nurses in Northern Sydney Local Health District, including roles as carers. It also examines factors influencing Child and family health nurses to remain or leave current positions., Implication for Nursing Management: This survey has drawn attention to the need for managers to urgently develop strategies, for example succession planning, to ensure that shortages of these experienced Child and family health nurses do not occur. The inability to staff Child and Family Health could potentially impact on the ability to provide services and meet key performance indicators., (© 2020 John Wiley & Sons Ltd.)

This paper analyzes recent policies in the field of Primary Health Care (PHC) and their possible implications for the care model in the Unified Health System (SUS). Initially, some of the concepts that influenced the models of care in the Brazilian public system are revived, and we argue that the Family Health Strategy (ESF) bases for reorienting care practices in primary care are consistent with the principles of the SUS. Below, we analyze the central elements of new federal policies for PHC. We show that changes in the PHC care model threaten the teams' multidisciplinarity, prioritize acute illness care, focus in individual care, weaken the community territorial approach and establish coverage by registration, which evidence redirection of the health policy, harming the principles of universality, integrality, and equity in the SUS.

Objectives: to perform a systematic review and meta-synthesis of qualitative studies about the work-related quality of life of Family Health Strategy professionals., Methods: this systematic review was developed to answer the following PVO question: "Which factors (variables) are associated with the work-related quality of life (outcome) of Family Health Strategy professionals (population)?" The PubMed, Scopus, Embase, SciELO, Web of Science, LILACS, Science Direct, OpenThesis, OpenGrey, and OATD databases were selected. The meta-synthesis analyzed the main codes and secondary codes of all included studies., Results: the database search resulted in 1,744 reports; six were considered eligible for the meta-synthesis. Four factors were considered for the quality of work life: working conditions; work processes; interpersonal relationships; and personal aspects., Conclusions: although this study confirms the adequacy of aspects commonly related to the quality of work life, other factors are important in the case of FHS professionals, especially work context.

Objectives: to analyze the conicity index in people with hypertension followed in the Brazil's Family Health Strategy., Methods: cross-sectional study conducted in a medium-sized municipality located in the state of Paraná. Data collection took place in the first semester of 2016. using an adapted and validated instrument. which addresses attributes of Primary Health Care. Sociodemographic and anthropometric variables and blood pressure were used in the study. The analysis of variance and linear regression was used to analyze the variables., Results: a total of 417 people participated in the study. most were women. elderly. married. with less than eight years of education and retired. Conicity index was prevalent in most of the study population. being significantly associated with the group of people with inadequate blood pressure control and high anthropometric parameters., Conclusions: most of the study participants had altered conicity index. especially those with inadequate blood pressure control.

Background: This study assessed the trend of minimum acceptable dietary practices among children aged 6 to 23 months in India in the past decade., Methods: Data collected in the National Family Health Survey during 2005 to 2006 (NFHS-3) and 2015 to 2016 (NFHS-4) were used. The sample size for this study was 11 727 children for NFHS-3 and 61 158 children for NFHS-4. Bivariate and multivariate analyses were done to identify the predictors of feeding practices. We analyzed data of last-born singleton children aged 6 to 23 months who were living with their mother (ever-married women aged 15-49 years)., Results: In India, a low proportion (10%) of children aged 6 to 23 months received a minimum acceptable diet, and its estimate remained the same in the past 10 years. Older mothers, educated mothers, antenatal care, high economic status, and place of residence were the most consistent predictors of minimum acceptable dietary intake. Over the past decade, however, the minimum acceptable dietary intake has declined among older children (odds ratio [OR] = 0.57, 95% confidence interval [CI], 0.47-0.70; P < .001), children with overweight mothers (OR = 0.40, 95% CI, 0.31-0·50; P <.001), and children of well-off families (OR = 0.29, 95% CI, 0.23-0.37; P < .001). The odds for minimum acceptable dietary intake were significantly higher among children of high (4+) birth order (OR = 1.74, 95% CI, 1.41-2.15; P < .001), rural areas, and children living in the central, eastern, and north-eastern region., Conclusion: Results indicate the need for further investigations of poor dietary intake among children living in well-off families and in the northern region. This study suggests policymakers and program managers to address contextual barriers against minimum acceptable dietary intake among children and to reconsider existing strategies in India.

Objective: to analyze the daily work of rural Family Health Strategy (FHS) nurses., Method: a qualitative, descriptive and exploratory research. The data were collected with eleven rural nurses of the city of Campina Grande, Paraíba State, through semi-structured interviews, between January and March of 2017, using Content Analysis., Results: rural nurses have a strong relationship with the population. However, they reveal a daily work with various organizational barriers that range from the team displacement to the workplace to the operationalization of health actions, which are mediated by the characteristics of rurality. Some of these barriers can be remedied by a more proactive action from the management., Final Considerations: conditioned by the characteristics of rurality, the differentiated dynamics work reveal weaknesses in the quality of nursing care and lower effectiveness of the FHS.

Objective: to measure the organizational climate in the work of professionals from Family Health Strategy (FHS) teams., Method: a cross-sectional study carried out with 458 professionals belonging to 72 FHS teams in a municipality in Southern Brazil. Data collection occurred between March and July of 2016 with self-application of the Team Climate Inventory (TCI). Data were analyzed by means of a non-parametric ANOVA., Results: "Team Participation" was the best-rated domain (8.11), while "Task orientation" was the worst (7.51). Nurses obtained the highest mean in TCI (8.05), and dentists, the lowest (7.45)., Conclusion: TCI is an appropriate and innovative tool for assessing the teamwork climate at the FHS. Identifying fragilities such as "task orientation" and relationships among professional categories of the team supports the planning of actions for organizational climate improvements and teamwork at the FHS.

Article provides the nomination of John S. Rolland, MD, MPH for the 2018 CFHA Don Bloch Award. John Rolland is the author of 70 journal articles and book chapters, and three books, translated into multiple languages, all focused on understanding the intersection of family function, illness, and health care. Google Scholar shows that his publications have been cited several thousand times, placing his intellectual contributions above 95% of all academic health care authors. John brought us an understanding of the psychosocial aspects of various diseases, their developmental course, and the potential for skew in relationships because of illness. He is a strong theoretician who brings his ideas to life through sharing his clinical experience as well as his own profound family experience to illustrate his points. John has supported service, training, and research through participation in grants focused on support for victims of ethnic cleansing, families and substance abuse, genetic testing and family involvement, and the impact of chronic and terminal illness on families. He is on the editorial board of three journals, all focused on families and health, and reviews submissions for many other journals. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Objective: To verify how socialization of nurses in the Family Health Strategy (FHS) influences their professional identity., Method: Exploratory, descriptive research, whose theoretical-methodological framework was dialectical hermeneutics, anchored in the premises of the Sociology of Professions. Data were collected through semi-structured interviews with 27 nurses from the FHS of the city of São Paulo. The resulting empirical material was subjected to Discourse Analysis., Results: The choice for Nursing was influenced by previous knowledge of the profession and by the affinity with care. Socialization was not limited to what was absorbed, including the search for an individual professional identity and collective sharing., Final Considerations: Nursing care is built in daily practice, mobilizing the nurse for an action that includes herself, the relationship with the other and the conditions in which the work is performed, opening the opportunity for identity reconstruction, consistent with the concreteness of the work.

Objective: To evaluate the quality of life and to analyze the epidemiological profile of people with diabetes treated in Family Health Strategies., Method: A cross-sectional study carried out with 350 people with diabetes., Results: Most people with diabetes are women, elderly, married, white, with low educational level, retired/pensioners, family income of up to two minimum wages. As the time of people with the disease increases, their quality of life decreases. People with complications from diabetes have a lower quality of life, with a statistically significant difference., Conclusion: Knowledge of the sociodemographic characteristics, clinical evaluation and quality of life of people with diabetes can improve the care process provided to this population.

Objective: to analyze the Family Health Strategy (FHS) coverage time trend in Brazil, its Regions and Federative Units (FUs) in 2006-2016., Methods: this was an ecological study with time series analysis of Ministry of Health Primary Care Department data; Prais-Winsten regression was used., Results: FHS coverage in Brazil in 2006 and 2016 was 45.3% and 64.0%, respectively, with an increasing trend of coverage (annual variation = 8.4%: 95%CI 7.4;9.3); all five regions showed an increasing trend in coverage, as did the majority of FUs, with the exception of Roraima, Amapá, Piauí, Rio Grande do Norte and Paraíba, which showed stability; in 2016, 14 FUs had coverage of between 75 and 100%, and 11 had coverage of between 50 and 74,9%; coverage in São Paulo and Federal District was below 50%., Conclusion: although, overall, FHS coverage increased, 13 FUs presented coverages below 75% in 2016; therefore, more efforts are needed to universalize coverage.

This study examined the recent level, trends and determinants of consanguineous marriage in Jordan using time-series data from the Jordan Population and Family Health Surveys (JPFHSs). According to the 2012 JPFHS, 35% of all marriages were consanguineous in Jordan in 2012. There has been a declining trend in consanguinity in the country, with the rate decreasing from a level of 57% in 1990. Most consanguineous marriage in 2012 were first cousin marriages, constituting 23% of all marriages and 66% of all consanguineous marriages. The data show that women with a lower age at marriage, older marriage cohort, larger family size, less than secondary level of education, rural place of residence, no employment, no exposure to mass media, a monogamous marriage, a husband with less than higher level of education and lower economic status, and those from the Badia region, were more likely to have a consanguineous marriage. Increasing age at marriage, level of education, urbanization and knowledge about the health consequences of consanguinity, and the ongoing socioeconomic and demographic transition in the country, will be the driving forces for further decline in consanguinity in Jordan.

Maternal depression symptoms (MDS) are a robust risk factor for internalising problems (IP) in the offspring. However, the relative importance of MDS and other factors associated with it (i.e. other types of maternal psychopathology, maternal parenting practices, family characteristics) is not well understood. To (a) identify a group of children with high levels of IP between 6 and 12 years using combined maternal and teacher assessments and (b) to quantify the associations between trajectories of MDS during early childhood and children's IP trajectories before and after controlling for family factors associated with MDS. MDS and family factors were assessed in a population-based sample in Canada (n = 1537) between 5 months and 5 years. The outcome variable was membership in trajectories of teacher- and mother-rated IP between ages 6 and 12 years. Family factors were included as covariates in a multinomial logistic regression model. There was a strong association between MDS and children's atypically high levels of IP in unadjusted analyses [OR 4.14 (95% CI 2.60; 6.61)]. The association was reduced, but remained strong [2.60 (1.55; 4.36)] when maternal psychopathology, maternal parenting, and family socioeconomic status were entered in the model. MDS, maternal anxiety, and low parental self-efficacy were associated with offspring's high IP trajectories. MDS is associated with high levels of children's IP independently of other maternal and family characteristics. Intervention targeting maternal psychopathology and parenting self-efficacy and testing the impact on children's IP would provide information on the putative causal pathways between maternal and offspring's symptomatology.

This article comments on the article in the current issue by J. E. Patterson et al (see record 2018-27937-001) regarding families' role in global mental health. In the world's low- and middle-income countries, a person's identity is often located more within the family, clan, or tribe than the individual. The authors add to the discussion and call for family-centered stepped delivery of health care. The family should move to the forefront of global mental health clinical research, mental health policy, and human rights advocacy. (PsycINFO Database Record, ((c) 2018 APA, all rights reserved).)

Objective: to evaluate the adherence and associate it to blood pressure control and to follow-up observation of people with hypertension in the Brazil's Family Health Strategy., Method: cross-sectional study, conducted with 417 people in treatment of hypertension, living in a municipality located in the Northwest region of the state of Paraná, Brazil. The data were collected in the first 2016 semester, using an instrument adapted and validated for the evaluation of satisfaction with the services offered by Primary Health Care. Analysis of variance and the logistic regression model were used for the treatment of variables., Results: it was evidenced that people with inadequate follow-up observation evaluate the relations between professional/user and the guidance to the medications used as unsatisfactory., Conclusion: weak guidelines and ineffective dialogue between health professionals and users might result in an inadequate follow-up observation of blood pressure control and of people with hypertension.

Universal Health Coverage (UHC) is one of the United Nations Sustainable Development Goals (SDGs). Achieving UHC will require strong health systems to promote and deliver equitable and integrated healthcare services through primary healthcare (PHC). In Brazil, the Family Health Strategy (FHS) delivers PHC through the public health system. Created in 1994, the FHS covered almost 123 million individuals (63% of the Brazilian population) by 2015. The FHS has been associated with many health improvements, but gaps in coverage still remain. This article examines factors associated with the implementation and expansion of the FHS across 5419 Brazilian municipalities from 1998 to 2012. The proportion of the municipal population covered by the FHS over time was assessed using a longitudinal multilevel model for change that accounted for variables covering eight domains: economic development, healthcare supply, healthcare needs/access, availability of other sources of healthcare, political context, geographical isolation, regional characteristics and population size. Data were obtained from multiple publicly available sources. During the 15-year study period, national coverage of the FHS increased from 4.4% to 54%, with 58% of the municipalities having population coverage of 95% or more, and municipalities that had not adopted the programme decreased from 86.4% to 4.9%. The increase in FHS uptake and coverage was not homogenous across municipalities, and was positively associated with small population size, low population density, low coverage of private health insurance, low level of economic development, alignment of the political party of the Mayor and the state Governor, and availability of healthcare supply. Efforts to expand the FHS coverage will need to focus on increasing the availability of health personnel, devising financial incentives for municipalities to uptake/expand the FHS and devising new policies that encompass both private and public sectors.

Congenital Zika virus infection has obvious implications for infants, and considerable research has addressed the nature and consequences of congenital Zika syndrome (CZS). Children with classic CZS meet the criteria for "children with medical complexity," and ongoing research is required to understand the range of needs and optimal treatment options. Far less attention has been given to the consequences of CZS for families, which are both immediate and lifelong. Although families of children with CZS have much in common with families of other children with disabilities, at least 4 features of CZS have special family implications: (1) the severity of the impact on children with obvious abnormalities at birth, coupled with the anticipation of a lifetime of caregiving and economic burdens; (2) uncertainty about the unfolding consequences, both for obviously affected children and for exposed children with no symptoms at birth; (3) a lack of specialized professional knowledge about the course of the disease or treatment options; and (4) social isolation, a lack of social or community supports, and potential stigma. Supporting families will require a family-centered approach to services, extensive care coordination, access to evolving new information, ongoing surveillance, formal and informal supports, and individualized child and family services., Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose., (Copyright © 2018 by the American Academy of Pediatrics.)

Objective: to identify the functional capacity of older people based on their performance on basic activities of daily living., Method: a cross-sectional study, carried out through the record of the Family Health teams working in the urban area of a city in northern Minas Gerais, in 2015. To assess the functional capacity of 373 older people, the Katz Scale was applied, which includes dimensions on the performance of daily living activities. The interviews took place in the participants' households., Results: of the total participants, 6.9% had some degree of dependence. Those aged over 80 years old and were living without a partner had about three times more chances of presenting higher levels of functional dependence., Conclusion: most older people enrolled in a Family Health Strategy had their functional capacity preserved.

Objective: To reflect on technologies for the peace culture that can be used in family nursing., Method: Theoretical essay, based on the premises of non-violence and peace culture., Results: Four light technologies are singled out for the peace culture within families: nonviolent communication, qualified listening, conflict mediation, and restorative circles., Conclusion: The technologies proposed can be used by nurses to promote care and policies aiming at a peace culture and non-violence in families, with the objective of assisting in the obtainment of the well-being for family systems and their correlations.

Objective: To analyze the practices of nurses working in the Family Health Strategy (FHS) in a city of Rio de Janeiro (RJ) and the theoretical foundations that guide them., Method: Qualitative research through semi-structured interviews with twelve nurses working in eleven FHS units between August and December 2014. Data were organized by hermeneutic-dialectical analysis., Results: The nurse is inserted in the municipal FHS as care coordinator and political agent; has practices aimed at welcoming, mobilizing social groups, making technical and monitoring of users through health programs. The practices remain in the confrontation of problems and are guided by technical manuals and coordination of health programs., Final Considerations: Studies are needed to recognize the nurse's therapeutic objective at the FHS and to propose theoretical foundations, specific to Nursing or Collective Health that will instrumentalize their daily practice.

Mentorship has been repeatedly shown to be a necessary component of successful professional development. However, effective mentorship can be elusive to define insofar as "you know it when you have it," but it is hard to match the objective qualities of mentorship with the subjective experience of effective and helpful mentoring. This article explores the Collaborative Family Healthcare Association's mentorship program from the perspective of one mentor and two mentees over the course of a yearlong formal relationship. During the year, both mentees had to navigate significant transitions, including changing jobs and having a baby; these experiences are relevant for many new career professionals. (PsycINFO Database Record, ((c) 2017 APA, all rights reserved).)

Purpose: The purpose of this study was to explore rural families' functioning following a parental cancer diagnosis., Method: Ten families in which a parent of dependent children had received a cancer diagnosis were purposively sampled using two questionnaires based upon the Resiliency Model of Family Adjustment and Adaptation (RMFAA): the Family Crisis Oriented Personal Evaluation Scales (F-COPES) and the Family Attachment Changeability Index 8 (FACI8). The total participant number was 34, which comprised the involvement of 17 parents and 17 children. The use of questionnaires ensured representation from both high and low functioning families. Qualitative data were gathered via semi-structured family interviews, and thematic analysis was used., Results: Families identified three key challenges that are not accounted for by the RMFAA and may be unique to the rural cancer patient experience: frequent travel, increased work/financial demands and family separation. Families also described a number of protective factors that enabled them to cope with the demands of the cancer diagnosis, some of which were specific to rural families, while others may apply to Australian families more broadly. Many of these protective factors aligned with the RMFAA framework., Conclusion: The findings suggest that rural families' ability and willingness to access external resources, including informal community support and formal support services, are influenced by the strength of their internal protective factors. This result has practical implications for the development of interventions that accommodate the specific supportive care needs of rural families affected by cancer.

Introduction: Research examining the implementation and effectiveness of integrated behavioral health (BH) care in family medicine/primary care is growing. However, research identifying ways to consistently use integrated BH in busy family medicine/primary care settings with underserved populations is limited. This study describes 1 family medicine clinic's transformation into a fully integrated BH care clinic through the development of an Integrated Care Clinic (ICC) and enhanced clinical pathways to promote regular use of behavioral health clinicians (BHCs)., Method: We implemented the ICC at the Broadway Family Medicine Clinic serving a low-income (<$25,000 annual income/year) and minority population (>70% African American) in Minnesota. We conducted a pre- and postevaluation of the ICC during regular clinic activity., Results: Pilot findings indicated that the creation of ICC and the use of enhanced clinical pathways (e.g., 5-2-1-0 obesity prevention messages, Transitional Care Management, postpartum depression screening visits, warm hand-offs) to facilitate regular use of integrated BH care resulted in 6 integrated care visits per BHC per clinic half-day. In addition, changes in the behavioral/mental health therapy appointment time slot (from 60 to 30 min) reduced therapy no-show rates. Transitional Care Management (TCM) visits also showed improved pre- and postchanges in patient and clinician satisfaction and reductions in patient hospital readmission rates., Discussion: The transformation into a fully integrated BH family medicine clinic through the creation of ICC and enhanced clinical pathways to facilitate regular integrated BH care showed promising pilot results. Future research is needed to examine associations between ICC and patient outcomes (e.g., weight, depressive symptoms). (PsycINFO Database Record, ((c) 2017 APA, all rights reserved).)

Objective:: This article aims to identify the relational technologies used by Family Health Strategy nurses in their daily work when treating patients., Method:: Descriptive and cross-sectional study with qualitative approach; conducted between May and July 2015, in three Basic Health Units of the Southern Region of the Municipality of São Paulo, with 19 nurses of the Family Health Strategy. Data were collected through a semi-structured interview, and the speeches were fully transcribed and analyzed according to the technique of content analysis., Results:: From the speeches of the participants, three categories emerged, showing the unawareness of the concept, but the valorization of its use; which are the relational technologies used by the participating nurses (communication, listening, empathy and welcoming reception), as well as the report of barriers to the use of relational technologies., Final Consideration:: Although the nurses value the use of relational technologies, the participants denoted unawareness of the nomenclature and its associated concepts, suggesting superficiality in the understanding and use of these instruments in the context of care in the Family Health Strategy., Objetivo:: Identificar as tecnologias relacionais utilizadas por enfermeiros de Estratégia Saúde da Família em seu cotidiano de trabalho no atendimento aos usuários., Método:: Estudo descritivo, transversal, com abordagem qualitativa; desenvolvido entre maio e julho de 2015, em três Unidades Básicas de Saúde da Região Sul do Município de São Paulo, com 19 enfermeiros da Estratégia Saúde da Família. Os dados foram coletados por meio de entrevista semiestruturada, e os discursos foram transcritos na íntegra, analisados segundo a técnica de análise de conteúdo., Resultados:: Das falas dos participantes, surgiram três categorias, que evidenciam o desconhecimento do conceito, mas valorização do uso; quais são as tecnologias relacionais utilizadas pelos enfermeiros participantes (comunicação, escuta, empatia e acolhimento), além do relato de barreiras para a utilização de tecnologias relacionais., Considerações Finais:: Embora valorizem a utilização de tecnologias relacionais, os participantes denotaram desconhecer a nomenclatura e os conceitos associados, sugerindo superficialidade na compreensão e utilização dessas ferramentas no contexto de atendimento na Estratégia Saúde da Família.

The present study examined the race/ethnicity-specific trend of parent-reported health among children aged 17 years and under in the U.S. between 2003 and 2007, and its relationship with family background, neighbourhood support and neighbourhood safety. Data from the 2003 and 2007 National Survey of Children's Health (NSCH) were merged and analysed after taking into account the weighting and the complex sampling design of the data. Trends in children's health and racial/ethnic disparities were identified for this time period. Multivariate models were analysed to examine the association between children's health and their family background variables, neighbourhood support and safety, and other socio-demographic variables. Race/ethnicity-specific stratified models were also performed. Our findings indicated an adverse trend in the parent-reported health among children in the U.S. from 2003 to 2007, and little progress has been made towards reducing the health disparities by race/ethnicity. Racial/ethnic disparities also existed in children's family background and neighbourhood support and safety. Further, the health effects of family background and neighbourhood characteristics differed in magnitudes and directions by race/ethnicity. These findings suggest that different intervention/prevention strategies should be employed in improving childhood health for different racial/ethnic groups.

Objective: to analyze the power relations that permeate the work of the family health team, and to discuss perspectives of emancipation of these subjects, focusing on nursing and community health agents., Method: a qualitative study with a family health team from a municipality in the countryside of the state of São Paulo. Data were collected through systematic observation and interview with workers. A thematic content analysis was performed., Results: three categories were identified: the work of the family health team and power relations; power relations between the nurse and the healthcare team; and the relations among the nursing team and between community agents and the nurse. The team produces relations of power moved by hierarchical knowledge that move in the search for the reordering of powers., Final Considerations: it is necessary to review the contradictions present in the performance scenario of the family health teams, with a view toward making power relations more flexible.