Influencia del funcionamiento familiar y bienestar psicológico en padres de familia ecuatorianos / Influence of the family functioning and psychological well-being in Ecuadorian patresfamilias

RESUMEN Introducción: la presente investigación surge motivada por el estudio de las variables de funcionamiento familiar y bienestar psicológico en padres de familia. Objetivo: determinar la influencia del funcionamiento familiar en el bienestar psicológico de los padres de familia pertenecientes al Ministerio de Compasión Internacional, de las iglesias del Nazareno en Ecuador. Materiales y métodos: se hizo un estudio observacional, transversal y cuantitativo de 405 padres de familia de las ciudades de Riobamba, Guaranda, Puyo y Montalvo, en Ecuador, entre agosto y octubre de 2020. Se realizó una encuesta mediante Google Forms. Los datos del funcionamiento familiar y bienestar psicológico se procesaron en Microsoft Excel, y el cálculo del coeficiente de correlación de Spearman se realizó mediante el software SPSS 25. Resultados: se evidenció la prevalencia de una familia moderadamente funcional (50,9 %) y de bienestar psicológico bajo (61,5 %). La correlación entre las dos variables de estudio fue de rho = 0,215. Las familias fueron mayormente nucleares y predominó el estado civil casado. Conclusiones: se determinó que los resultados no fueron concluyentes, ya que no existió una correlación entre las variables de estudio: funcionamiento familiar y bienestar psicológico. Se infirió que existieron otras variables intervinientes que merecieron ser analizadas (AU).

ABSTRACT Introduction: the current research arises motivated by the study of the variables of family functioning and psychological well-being in patresfamilias. Objective: to determine the influence of family functioning on the psychological well-being of patresfamilias who belong to the Ministry of International Compassion of the churches of the Nazarene in Ecuador. Materials and method: an observational, cross-sectional and quantitative study was carried out, in 405 patresfamilias from the cities of Riobamba, Guaranda, Puyo and Montalvo, in Ecuador, in the period August-October 2020. An inquiry was applied through Google Forms. Data on family functioning and psychological well-being were processed in Microsoft Excel, and the SPSS 25 software was used for working Spearman correlation out. Results: the prevalence of a moderately functional family (50.9%) and low psychological well-being (61.5%) were evidenced. The correlation between the two study variables was rho=0.215. Families were mostly nuclear and married marital status predominated. Conclusions: it was determined that results were not conclusive, because there was not a correlation between the study variables: family functioning and psychological well-being. The authors inferred that there were other involved variables that need to be analyzed (AU).

Prática alimentar e determinantes sociais na anemia em famílias atendidas pela Estratégia Saúde da Família no estado do Maranhão - estudo de base populacional / Food practice and social determinants of anemia in families attended by Family Health Strategy in the state of Maranhão - a population-based study

Introdução: A anemia é extremamente relevante no contexto da saúde pública. As prevalências em países em desenvolvimento, como o Brasil, são altas e, a despeito de todo o avanço no conhecimento, no diagnóstico e no tratamento, ainda são subestimadas pelo poder público no seu impacto. Objetivo: Avaliar a prática alimentar e determinantes sociais na anemia em mães atendidas pela Estratégia Saúde da Família no estado do Maranhão. Método: Estudo transversal de base populacional que fez parte do projeto \"Prevalência e Determinantes da Anemia em Mulheres e Crianças no Estado do Maranhão\". Foram utilizados dados do questionário socioeconômico e demográfico, do questionário de frequência alimentar (QFA), dados bioquímicos referentes à dosagem de hemoglobina das mulheres e escore de altura para idade das crianças. Para a análise das informações com base no QFA das mulheres (n=779), verificou-se a associação das variáveis com a presença ou ausência de anemia e seus determinantes sociais, a presença de marcadores de alimentação saudável (n=779) e o crescimento linear e anemia com os determinantes sociais (n=966). Resultados: As condições socioeconômicas das famílias não favoreceram o consumo regular de alimentos fonte de ferro e a proteção contra a anemia. A presença frequente de marcadores de alimentação saudável foi destacada pelo consumo de feijão (83,4%), peixe (53,7) e laranja (55,2%). A prevalência de baixa estatura para a idade foi de 9,7% para o estado e entre as variáveis estudadas apenas o Programa Bolsa Família atuou como uma proteção contra a anemia (p<0,003). Conclusão: A elevada demanda de ferro seria facilmente alcançada pela dieta desde que os alimentos considerados fonte fossem consumidos regularmente. Os resultados do estado do Maranhão e os determinantes sociais não mostraram associação direta, pois estão permeados pela pobreza. O Programa Bolsa Família contribuiu para amenizar a vulnerabilidade social da população beneficiária e a inserção na atenção básica, por meio da ESF, como forma de proteção

Introduction: Nutritional anemia is extremely relevant in the context of public health. Its prevalence in developing countries, such as Brazil, are high and, in spite of all advances in knowledge, diagnosis and treatment, its impact is still underestimated by the public power. Objective: To evaluate the feeding practice and social determinants of anemia in mothers assisted by Family Health Strategy (FHS) in the state of Maranhão. Methods: A population-based cross-sectional study that was part of the project \"Prevalence and Determinants of Anemia in Women and Children in the State of Maranhão\". Data from the socioeconomic and demographic questionnaire, the food frequency questionnaire (FFQ), biochemical data on the hemoglobin dosage of women and height-for-age children´s score were used. For the analysis of information based on women FFQ (n = 779), the association of the variables with the presence or absence of anemia and its social determinants was verified, the presence of healthy food markers (n = 779) and linear growth and anemia with social determinants (n = 966). Results: Socioeconomic conditions of families did not favor the regular consumption of iron source foods and the protection against anemia. The frequent presence of healthy food markers was highlighted by the consumption of beans (83.4%), fish (53.7) and orange (55.2%). The prevalence of short stature for age was 9.7% for the state and among the variables studied only Bolsa Família Program acted as a protection against anemia (p<0.003). Conclusion: High demand for iron would be easily achieved by the diet provided that the foods considered as source were consumed regularly. The results of the state of Maranhão and the social determinants showed no direct association, since they are permeated by poverty. Bolsa Família Program helped to alleviate the beneficiary population social vulnerability and the insertion in primary care, through the ESF, as a form of protection

Risk of Type 2 Diabetes Mellitus following Gestational Diabetes Pregnancy in Women with Polycystic Ovary Syndrome.

BACKGROUND: This study examines gestational diabetes mellitus (GDM) in women with polycystic ovary syndrome (PCOS) and the risk of type 2 diabetes mellitus (DM) following GDM pregnancy. METHODS: A cohort of 988 pregnant women with PCOS who delivered during 2002-2005 was examined to determine the prevalence and predictors of GDM, with follow-up through 2010 among those with GDM to estimate the risk of DM. RESULTS: Of the 988 pregnant women with PCOS, 192 (19%) developed GDM. Multivariable predictors of GDM included older age, Asian race, prepregnancy obesity, family history of DM, preconception metformin use, and multiple gestation. Among women with PCOS and GDM pregnancy, the incidence of DM was 2.8 (95% confidence interval (CI) 1.9-4.2) per 100 person-years and substantially higher for those who received pharmacologic treatment for GDM (6.6 versus 1.5 per 100 person-years, p < 0.01). The multivariable adjusted risk of DM was fourfold higher in women who received pharmacologic treatment for GDM (adjusted hazard ratio 4.1, 95% CI 1.8-9.6). The five-year incidence of DM was 13.1% overall and also higher in the pharmacologic treatment subgroup (27.0% versus 7.1%, p < 0.01). CONCLUSIONS: The strongest predictors of GDM among women with PCOS included Asian race and prepregnancy obesity. Pharmacologic treatment of GDM is associated with fourfold higher risk of subsequent DM.

Dietary Inflammatory Index and Risk of Colorectal Cancer: A Case-Control Study in Korea.

The role of diet-associated inflammation in colorectal cancer is of interest. Accordingly, we aimed to examine whether the dietary inflammatory index (DII) was associated with the risk of colorectal cancer in a case-control study conducted in Korea. The DII was based on dietary intake, which was determined by a 106-item semi-quantitative food frequency questionnaire completed by 923 colorectal cancer cases and 1846 controls. Logistic regression was used to estimate odd ratios (ORs) and 95% confidence intervals (CIs). Subgroup analyses were conducted by the anatomical site of the cancer, sex, and other risk factors. Higher DII scores were associated with an increased incidence of colorectal cancer (OR (95% CI) = 2.16 (1.71, 2.73) for highest vs. lowest tertile). The magnitude differed by anatomical site and sex. This association was slightly weaker in subjects with proximal colon cancer (1.68 (1.08, 2.61)) and was stronger in women (2.50 (1.64, 3.82)). Additionally, stronger associations were observed in subjects who were older than 50 years (p for interaction = 0.004) and engaged in physical activity (p for interaction < 0.001). Results from this study suggest that diet-associated inflammation may increase the risk of colorectal cancer, and this effect may differ by certain factors, such as anatomical site, age, sex, and lifestyle.

Process Evaluation of the Project SHINE Intervention for African American Families: An Integrated Positive Parenting and Peer Monitoring Approach to Health Promotion.

This study describes the process evaluation of Project SHINE, a randomized family-based health promotion intervention that integrated parenting and peer monitoring for improving sedentary behavior, physical activity, and diet in African American families. Adolescent-parent dyads (n = 89) were randomized to a 6-week behavioral, positive parenting, and peer monitoring skills intervention or a general health education comparison condition. Process evaluation included observational ratings of fidelity, attendance records, psychosocial measures, and qualitative interviews. Results indicated that the intervention was delivered with high fidelity based on facilitator adherence (>98% of content delivered) and competent use of theoretically based behavior change and positive parenting skills (100% of ratings >3 on a 1-4 scale). Although only 43% of peers attended the "bring a friend" session, overall attendance was high (4.39 ± 1.51 sessions) as was the retention rate (88%). Parents in the intervention condition reported significant improvements in communication related to adolescents' engagement in health behaviors both on their own and with peers. These findings were supported by qualitative themes related to improvements in family communication and connectedness. This study provides an innovative example of how future family-based health promotion trials can expand their process evaluation approaches by assessing theoretically relevant positive parenting variables as part of ongoing monitoring.

Ethnic differences in types of social support from multiple sources after breast cancer surgery.

OBJECTIVES: Diagnosis of and treatment for breast cancer (BCa) may require psychological adaptation and often involve heightened distress. Several types of social support positively relate to psychological adaptation to BCa, and negative support is associated with poorer adaptation. Although Hispanic women report greater distress than non-Hispanic White (NHW) women after diagnosis of BCa, no studies have examined ethnic differences in types of social support received from varying sources after surgery for BCa. DESIGN: Hispanic (N = 61) and NHW (N = 150) women diagnosed with early-stage BCa self-reported emotional, informational, instrumental, and negative support from five sources. Ethnic differences in levels of social support were compared using multiple regression analysis. RESULTS: When controlling for age, income, days since surgery, and stage of disease in multivariable models there were no ethnic differences in levels of emotional support from any source. Hispanic women reported greater informational support from adult women family members and children and male adult family members than did NHW women. Instrumental support from adult women family members was also greater among Hispanic than NHW women. Hispanic women reported higher negative support from husbands/partners and from children and male adult family members. When the number of years in the USA was controlled, Hispanic women showed greater informational support from adult women family members, children and male adult family members, and friends. Instrumental support from adult women family members remained greater in Hispanic women, but negative support no longer differed. CONCLUSION: Family is a greater source of informational and instrumental support for Hispanic than NHW women. Hispanic women reported higher negative support from male sources than did NHW women. Level of support from different sources may also depend on time spent in the USA. Longitudinal studies are needed to determine whether patterns and sources of social support shift over the course of BCa treatment.

Associations between dietary intakes of first-time fathers and their 20-month-old children are moderated by fathers' BMI, education and age.

Children's learning about food is considerable during their formative years, with parental influence being pivotal. Research has focused predominantly on maternal influences, with little known about the relationships between fathers' and children's diets. Greater understanding of this relationship is necessary for the design of appropriate interventions. The aim of this study was to investigate the associations between the diets of fathers and their children and the moderating effects of fathers' BMI, education and age on these associations. The diets of fathers and their first-born children (n 317) in the Melbourne Infant Feeding Activity and Nutrition Trial (InFANT) Program were assessed using an FFQ and 3 × 24-h recalls, respectively. The InFANT Program is a cluster-randomised controlled trial in the setting of first-time parents groups in Victoria, Australia. Associations between father and child fruit, vegetable, non-core food and non-core drink intakes were assessed using linear regression. The extent to which these associations were mediated by maternal intake was tested. Moderation of associations by paternal BMI, education and age was assessed. Positive associations were found between fathers' and children's intake of fruit, sweet snacks and take-away foods. Paternal BMI, education and age moderated the relationships found for the intakes of fruit (BMI), vegetables (age), savoury snacks (BMI and education) and take-away foods (BMI and education). Our findings suggest that associations exist at a young age and are moderated by paternal BMI, education and age. This study highlights the importance of fathers in modelling healthy diets for their children.

The context of collecting family health history: examining definitions of family and family communication about health among African American women.

Public health initiatives encourage the public to discuss and record family health history information, which can inform prevention and screening for a variety of conditions. Most research on family health history discussion and collection, however, has predominantly involved White participants and has not considered lay definitions of family or family communication patterns about health. This qualitative study of 32 African American women-16 with a history of cancer-analyzed participants' definitions of family, family communication about health, and collection of family health history information. Family was defined by biological relatedness, social ties, interactions, and proximity. Several participants noted using different definitions of family for different purposes (e.g., biomedical vs. social). Health discussions took place between and within generations and were influenced by structural relationships (e.g., sister) and characteristics of family members (e.g., trustworthiness). Participants described managing tensions between sharing health information and protecting privacy, especially related to generational differences in sharing information, fear of familial conflict or gossip, and denial (sometimes described as refusal to "own" or "claim" a disease). Few participants reported that anyone in their family kept formal family health history records. Results suggest family health history initiatives should address family tensions and communication patterns that affect discussion and collection of family health history information.

Literature research of the Nutrition Improvement Programme for Rural Compulsory Education Students in China.

OBJECTIVE: To describe the Nutrition Improvement Programme for Rural Compulsory Education Students (NIPRCES) in China and to share the experiences of developing and implementing nationwide school meal programmes with other countries. DESIGN: The article is based on a literature review of technical documents and reports of NIPRCES and relevant national legislation, technical reports and studies on school nutrition, minutes of meetings and national conferences, and official documents of the National Office of Student Nutrition and the Chinese Center for Disease Control and Prevention. SETTING: People's Republic of China. SUBJECTS: Published papers, national policies, legislation and unpublished official documents. RESULTS: A total of 23 million rural compulsory education students were covered by NIPRCES. In the development and implementation process of NIPRCES, fifteen ministries and national committees were involved and an efficient collaborative mechanism was established. All NIPRCES-covered schools were required to serve meals on a daily basis. By the end of June 2012, the proportions of students choosing 'school feeding', 'food package' and 'family feeding' modes were respectively 64.0 %, 32.0 % and 4.0 %. The central government subsidized school meals annually by more than $US 2.5 billion and invested $US 4.8 billion on school kitchens to support this programme. CONCLUSIONS: The NIPRCES is a significant movement of governmental nutritional intervention in China. Food safety, financial security, decentralization and other potential concerns should be considered and lessons can be learned from other countries. Further relevant research and a nationwide monitoring and evaluation programme are needed.

A qualitative study of family healthy lifestyle behaviors of Mexican-American and Mexican immigrant fathers and mothers.

This study qualitatively examines contrasting parental decision-making styles about family food choices and physical activities as well as willingness to change behaviors among Mexican-American and Mexican immigrant mothers and fathers of school-aged children. Twelve sex-specific focus groups were held in English or Spanish in 2012. Qualitative analysis informed by grounded theory examined parenting styles (ie, authoritative, authoritarian, or permissive), barriers to healthy lifestyle, and parents' stage of change about healthy lifestyles. One third of the 33 participating couples were born in Mexico. The majority of mothers and fathers described being permissive and allowing unhealthy food choices, and a minority of mothers reported more authoritarian approaches to promoting a healthier diet for their children. Mothers were more permissive than fathers about family physical activities and less engaged in these activities. Most mothers and fathers described only contemplating a healthier diet and more physical activity, while wanting their children to have a healthier lifestyle. These data suggest that clinicians need to assess and address differential parental roles when promoting a healthy lifestyle for children. Clinicians should also adopt culturally competent approaches to overcome barriers to parental engagement in diverse aspects of a healthy family lifestyle.

The development and implementation of an interdisciplinary on-line academic course using a life course perspective.

The University of Wisconsin-Madison Pediatric Pulmonary Center (UW PPC) provides interdisciplinary leadership training for graduate students and postgraduate professionals. The training includes a three-credit on-line course entitled Interdisciplinary Care of Children with Special Health Care Needs. This paper describes the course, the content and organization of which was guided by the life course perspective (LCP). The UW PPC team used the LCP to guide course organization, content development, and evaluation approaches. UW PPC trainees took responsibility for content areas, performed literature reviews and reviews of resources, and suggested student activities. Course content was focused on the child with special health care needs (CSHCN) embedded in contextual environments of family, community, culture, and larger social and public policy arenas. The content included three case-study videos that followed a child with cystic fibrosis from birth to age 18. Key concepts of the LCP were woven in throughout the videos and other course materials. Emphasis was on representing development of the individual during critical/sensitive periods and on social determinants of health. At semester's end, qualitative and quantitative student evaluation results were very positive for all areas of the course. The final course paper, organized similarly to course modules, synthesized all aspects of the course. A successful paper included LCP concepts woven throughout to show integration of course content. The LCP provided a useful framework for course organization and content, and served as a lens through which students came to understand the care needs of CSHCN and their families. A course such as this can serve the important goal of educating future maternal child health professionals in using the LCP to understand how multiple determinants of health interact across the life span to produce health outcomes in this population.

Novel and recurrent mutations in the EXT1 and EXT2 genes in Chinese kindreds with multiple osteochondromas.

Multiple osteochondromas (MO) is an autosomal dominant hereditary disorder caused by heterozygous germline mutations in the exostonsin-1 (EXT1) or exostosin-2 (EXT2) genes. In this study, we screened mutations in the EXT1/EXT2 genes in four Chinese MO kindreds by direct sequencing. Three point mutations were detected, including a nonsense mutation in the EXT2 gene (c.544C > T) and two splice site mutations in the EXT1 and EXT2 genes, respectively (EXT1: c.1883 + 1G > A and EXT2: c.1173 + 1G > T). Although splice site mutations constitute at least 10% of all mutations that cause MO, there has been limited research on their pathogenic effect on RNA processing due to poor availability of patient RNA samples. In this study, ex vivo and in vivo splicing assays were used to investigate the effect of EXT1 and EXT2 mutations on aberrant splicing at the mRNA level. Our results indicate that identified splice site mutations can cause either cryptic splice site usage or exon skipping.

Obesity in adolescence is associated with perinatal risk factors, parental BMI and sociodemographic characteristics.

BACKGROUND/OBJECTIVE: To record the prevalence of overweight and obesity in primary-school children in relation to perinatal risk factors, parental body mass index and sociodemographics. SUBJECTS/METHODS: A sample of 2294 schoolchildren aged 9-13 years was examined in municipalities from four Greek counties. Weight and height were measured using standard procedures, whereas international thresholds were used for the definition of overweight and obesity. Perinatal and parental data were also recorded via standardized questionnaires. RESULTS: The prevalence of overweight and obesity was 30.5% and 11.6%, respectively, with a higher prevalence of obesity in boys compared with girls (13.7% vs 9.5%, P<0.02). Maternal smoking at pregnancy (odds ratio (OR) 1.37; 95% confidence interval (CI) 1.05-1.98), rapid infant weight gain (OR 1.69; 95% CI 1.20-2.38), paternal and maternal obesity (OR 2.25; 95% CI 1.45-3.48 and OR 2.14; 95% CI 1.28-3.60) were found to significantly increase the odds of children's obesity (apart from overweight), whereas Greek nationality (OR 1.06; 95% CI 1.01-1.39) was found to significantly increase only the odds of children's overweight. Maternal pre-pregnancy obesity (OR 2.15; 95% CI 1.27-3.70) and introduction of solid foods at weaning later than 5 months of life (OR 1.60; 95% CI 1.02-2.51) were also found to increase the likelihood of childhood obesity. On the contrary, children having older fathers (OR 0.55; 95% CI 0.37-0.80) or more educated mothers (OR 0.57; 95% CI 0.36-0.90) were less likely to be obese. CONCLUSIONS: The current study identified certain perinatal factors (that is, maternal pre-pregnancy obesity, maternal smoking at pregnancy, rapid infant weight gain and late introduction of solid foods at weaning) and parental characteristics (that is, younger fathers, Greek nationality, less educated and overweight parents) as important risk factors for children's overweight and obesity, indicating the multifactorial nature of their etiology and the need to extend our understanding beyond positive energy equilibrium.

Talking (or not) about family health history in families of Latino young adults.

Although individuals recognize the importance of knowing their family's health history for their own health, relatively few people (e.g., less than a third in one national survey) collect this type of information. This study examines the rates of family communication about family health history of cancer, and predictors of communication in a sample of English-speaking Latino young adults. A total of 224 Latino young adults completed a survey that included measures on family communication, cultural factors, religious commitment, and cancer worry. We found that few Latino young adults reported collecting information from their families for the purposes of creating a family health history (18%) or sharing information about hereditary cancer risk with family members (16%). In contrast, slightly more than half of the participants reported generally "talking with their mothers about their family's health history of cancer." Logistic regression results indicated that cancer worry (odds ratio [OR] = 2.31; 95% confidence interval [CI] = 1.08-4.93), being female (OR = 3.12; 95% CI = 1.02-8.08), and being older (OR = 1.33; 95% CI = 1.01-1.76) were associated with increased rates of collecting information from family members. In contrast, orientation to the Latino culture (OR = 2.81; 95% CI = 1.33-5.94) and religious commitment (OR = 1.54; 95% CI = 1.02-2.32) were associated with increased rates of giving cancer information. Results highlight the need for prevention programs to help further general discussions about a family's history of cancer to more specific information related to family health history.

A novel TNFRSF1 gene mutation in a Turkish family: a report of three cases.

Tumor necrosis factor (TNF) receptor-associated periodic syndrome (TRAPS) is an autosomal dominantly inherited rare autoinflammatory disease. It is caused by mutations in exons 2-3 and 4-5 of the tumor necrosing factor receptor superfamily 1A (TNFRSF1A) gene on chromosome 12p13.2. TNFRSF1A gene encodes the 55-kDa receptor for tumor necrosis factor. Attacks are associated with abdominal pain, myalgia, erythematous skin rash, conjunctivitis, and periorbital edema. Until now, more than 80 mutations have been identified. We herein report three patients with TRAPS of Turkish origin. The patients were followed up in our outpatient clinic in Kocaeli University Division of Rheumatology. Because of their TRAPS associated clinical features, we isolated genomic DNA from whole blood and sequenced the exon 2-3 and 4-5 third exon of TNFRSF1A gene after amplification with appropriate primers. One of the patients with TRAPS was 47-year-old female, who described recurrent attacks of fever, urticarial rash, conjunctivitis, arthralgia, myalgia, abdominal pain, thoracic pain, headache, fatigue, and elevated acute phase response since her childhood. With the sequencing of the TNFRSF1A gene, we identified heterozygous C29R mutation, which has not been reported before in any TRAPS patient. The other patients are her sons with similar findings and age 29 and 26. They were heterozygous for C29R mutation in TNFRSF1A gene too. We report novel C29R mutation in three TRAPS patients of Turkish origin, in which the main clinical features are recurrent fever attacks, erythematous skin rash, conjunctivitis, myalgia, and arthralgia. Treatment with steroids resolved the symptoms and lesions.

Identifying gaps in asthma education, health promotion, and social support for Mi'kmaq families in Unama'ki (Cape Breton), Nova Scotia, Canada.

INTRODUCTION: Asthma is the most common chronic condition affecting Aboriginal youth aged 8 to 12 years in Canada. Research investigating psychosocial challenges associated with asthma is limited. This study examines support resources, support-seeking strategies, support and education needs, and intervention preferences of Aboriginal youth with asthma and their caregivers in an effort to encourage community-wide, health-promoting behaviors. METHODS: We employed a community-based participatory research design to conduct interviews with 21 youths aged 8 to 12 years and 17 caregivers from 5 Mi'kmaq communities in Unama'ki (Cape Breton) Nova Scotia, Canada. After conducting interviews that explored existing and desired social, educational, and health support in participating communities, we held a 2-day asthma camp to engage participants in asthma education, social support networking, and cultural activities. At the camp, we collected data through participant observation, sharing circles, focus groups, and youth drawings of their experiences living with asthma. RESULTS: Our study yielded 4 key findings: 1) asthma triggers included household mold, indoor smoking, pets, season change, strenuous exercise, extreme cold, and humidity; 2) social and educational support is lacking in Mi'kmaq communities despite a strong desire for these services; 3) cultural, linguistic, and geographic barriers to accessing support exist; and 4) family members are primary support resources. CONCLUSION: Improved support and educational resources are needed to foster effective Mi'kmaq asthma support networks. Future asthma interventions for marginalized populations must be culturally meaningful and linguistically accessible to those using and providing asthma support.

Condições de trabalho na estratégia de saúde da família: relato de experiência de extensão universitária com agentes comunitários de saúde / Work conditions in the family health strategy: report of an experience of university extension with community health agents

É sabida a importância de novos cenários de aprendizagem para a formação do profissional de saúde. A partir da interação da universidade com regiões de vulnerabilidade de Santos-SP, e seus serviços, foi criado o projeto de extensão universitária "A potencialização da capacidade de ação dos agentes comunitários de saúde" como um espaço de escuta e elaboração de vivências para os agentes comunitários de saúde (ACS) de uma dessas regiões. O objetivo deste artigo é dar visibilidade a condições de trabalho dos ACS por meio dos diários de campo produzidos durante o projeto de extensão universitária. Trata-se de uma análise dos registros feitos pelos estudantes na perspectiva de dar voz à experiência e à percepção dos ACS sobre seu trabalho em uma unidade da Estratégia de Saúde da Família (ESF), a partir da qual se construíram seis analisadores. Por fim, a partir das condições de trabalho dos ACS, verificou-se a importância da construção de outro lugar para esses profissionais na equipe, da promoção de uma maior interação dentro da própria equipe e de dedicar um olhar mais cuidadoso à capacitação desses profissionais, para a construção e o fortalecimento da ESF.

The importance of new learning scenarios for the health professional's training is well-known. Through the university's interaction with vulnerable regions of Santos, Sao Paulo, Brazil, and their services, the university extension project named "Potentiation of the community health agents' action capacity" was created as a space for listening and preparing experiences for the community health agents (CHAs) from one of these areas. This paper aims to provide visibility to the work conditions of CHAs by means of the field diaries produced during the university extension project. This is an analysis of records made by the students under the perspective of giving voice to the experience and perception of CHAs on their work in a Family Health Strategy (FHS) unit, through which six analyzers were developed. Finally, through the CHAs work conditions, it was possible to determine the importance of creating a new place for these professionals in the team, promoting a greater interaction within the team itself, and dedicating a more careful look at these professionals' training, for the development and strengthening of FHS.

Cenário de implantação do Núcleo de Apoio a Saúde da Família e a inserção do profissional de educação física / Deployment scenario the Support Nucleus Familys?s Healthy and the insertion of professional physical education

Objetivou-se caracterizar a implantação do Núcleo de Apoio á Saúde da Família (NASF) e analisar a inserção do Profissional de Educação Física, no Brasil. Trata-se de um estudo descritivo com dados secundários do Departamento de Informática do Sistema Único de Saúde e do cadastro das equipes de NASF, disponibilizado pelo Departamento da Atenção Básica. As variáveis selecionadas foram população do Brasil em 2010, população coberta pela saúde da família (SF), número de profissionais, equipes de SF e NASF. Foram adaptados indicadores de Teto de Implantação e Potencial de Expansão (PE) para verificar a implantação do NASF. A inserção do profissional de Educação Física, foi analisada pela proporção de profissionais de Educação Física em relação ao NASF e o número de Profissionais de Educação Física por população coberta pela SF, multiplicado pela constante 100.000. O teste Anova one way, com Post-Hoc de Tukey foi aplicado, pelo programa SPSS, versão 15.0, adotando significância de 5%. Os resultados apontam baixa adesão e elevado PE do NASF nos municípios, a maioria destes implantaram uma equipe de NASF. As cinco categorias mais recrutadas foram Fisioterapia, Psicologia, Nutrição, Serviço Social e Educação Física. Houve diferença na média de profissionais, sobretudo nas regiões Norte e Sudeste. A Educação Física está inserida em 49,2% das equipes de NASF, contudo o coeficiente de profissional por população coberta pela SF foi aproximadamente 1 para 100.000 pessoas. Nota-se a necessidade de investimento político e acadêmico para definição de estratégias coletivas que contribuam para a consolidação do NASF e integração do profissional de Educação Física na rede de assistência pública em saúde.

The purpose was to characterize the implementation of the Support Nucleus Familys?s Healthy (NASF) and analyze the insertion of Physical Education Professional in Brazil. This is a descriptive study based on secondary data from the Departament of Health System and NASF teams registration, provided by the Department of Primary Care. The variables selected were: population from Brazil in 2010, the population covered by the Family Health Program (FH), number of professional teams of FH and NASF. Indicators were adapted of maximum implantation and expansion potential (EP) to verify the implantation of NASF. Inclusion of Physical Education Professional in NASF was assessed by the proportion of Physical Education Professional in relation to NASF and to the number of Physical Education Professional per population covered by the FH. Was applied the ANOVA one way whit Tukey post-hoc test, using SPSS, version 15.0, adopting a 5% significance. Results showed low adherence and high EP in the counties of NASF, most of these have deployed one NASF team. The five professions more recruited were: Physiotherary, Psychology, Nutrition, Social Service and Physical Education. Differences were observed in average number of professional, especially in North and South regions. Physical Education is inserted in 49.2% of NASF teams, however the coefficient of population covered by professional for FH was approximately 1 per 100.000 people. It can be pointed the need for investiment to political and academic definition of collective strategies to help to strengthen NASF.

African Americans with a family history of colorectal cancer: barriers and facilitators to screening.

PURPOSE/OBJECTIVES: To explore barriers and facilitators of screening for colorectal cancer (CRC), as well as suggestions for improving screening among African Americans with first-degree relatives with CRC. RESEARCH APPROACH: A qualitative, descriptive approach involving focus groups. SETTING: A community healthcare clinic in Baltimore, MD. PARTICIPANTS: 14 African American men and women aged 40 or older with at least one first-degree family member affected by CRC. METHODOLOGIC APPROACH: In-depth focus groups were conducted until thematic saturation was achieved. Thematic analysis and data reduction were conducted using ATLAS.ti, version 5.0. MAIN RESEARCH VARIABLES: CRC screening barriers and facilitators. FINDINGS: The participants were mostly male, insured, and had a parent with CRC. Commonly reported barriers to CRC screening included fear of serious illness, mistrust of the medical establishment, potential screening discomfort, lack of information on CRC risk factors, lack of healthcare access, absence of symptoms, no knowledge of CRC screening benefits, community reticence about cancer, and CRC myths. Facilitating factors for CRC screening included a belief of personal risk for CRC, physician recommendations, and acknowledgment of age as a risk factor. Suggestions to increase screening rates included distribution of culturally appropriate and community-based efforts (e.g., mobile units, church-based interventions). Participants also suggested ways to increase motivation and provide social support for screening patients. CONCLUSIONS: Additional research is needed to identify and test effective screening approaches for this underserved group at increased risk for CRC. Study results suggest that cancer risk and screening education, coupled with screening opportunities in the community, may yield increased screening rates. INTERPRETATION: Lack of knowledge about CRC and CRC screening exists in the study population. Promoting screening across generations, developing and disseminating culturally appropriate educational materials within the community, and encouraging older individuals to screen to take care of their family may be appropriate interventions.

A educação física no programa de educação pelo trabalho para a saúde de Cuiabá-MT / The physical education program in education by working for the health of Cuiaba-MT

O presente trabalho buscou descrever a atuação da Educação Física (EF) no Programa de Educação pelo Trabalho para Saúde (PET-SAÚDE) em Cuiabá-MT, destacando as contribuições e o desafio dessa área de conhecimento no âmbito da atenção primária. Até o momento a EF desenvolveu diagnóstico das condições de saúde e atividade física da comunidade, educação em saúde, intervenção por meio de grupos de exercícios físicos, além da pesquisa e disseminação do conhecimento científico, contribuindo com a articulação ensino-serviço-comunidade e a aproximação da pesquisa, com o ensino e extensão. As ações foram pautadas nos princípios da interdisciplinaridade. A EF, inserida na equipe de saúde da família por meio do PET-SAÚDE, pode contribuir para ações de promoção da saúde e prevenção de doenças, intervindo positivamente na saúde da população. O PET-SAÚDE tem se mostrado importante na formação de profissionais de EF que atendam o perfil para o trabalho na estratégia de saúde da família.

The current work searched for describing the physical education acting (EF) in the Education Program for the Work to the Health in Cuiabá-MT (PET-SAÚDE), detaching the contribuition and challenges of this knowledge area in the range of primary attention. Until now the EF developed diagnostic of the health condition and community physical activity, education in health, intercession through physical exercises groups, furthermore research and dissemination of the scientific knowledge, contributing with the articulation service-education-community and the approach of searching with the education and extension. The actions were guided by the principles of interdisciplinarity. The PE included in the family health team via PET-SAÚDE, can contribuite for the actions of family´s health promotion and prevention of diseases by intervening positively in the population?s health. PET-SAÚDE has shown it important in the formation of professionals from the PE that attend the profile for the work in the strategy of family´s health.