Prevalence of Anemia among Adolescent Girls in Rural Area of a District of Maharashtra

Introduction: Nutritional anemia is one of India’s major public health problems. Adolescence is a vulnerable period in the human life cycle for the development of nutritional anemia. Anemia in adolescent girls contributes to maternal and foetal mortality and morbidity in future. Aim and Objectives: To estimate the prevalence of anemia among adolescent girls and to study the sociodemographic factors associated with anemia. Method: It was a community based cross sectional study in 10 villages of a district. 420 adolescent girls were interviewed using a predesigned, pretested questionnaire, and their anemic status was assessed by hemoglobin estimation. Results were analyzed by using percentage, proportion and Chi-square test, with the help of Microsoft Excel 2007 and SPSS version 20.0 statistical software. Result: Mean age of the study sample was 14.01 ± 2.57 years. The majority (64.8%) of the girls were Hindu by religion and belonged to a nuclear family (53.6%). 45.2 % were educated up to high school level. Most of the girls belonged to socioeconomic class IV (46.0%). The prevalence of anemia in this study was found to be 65.7%. The prevalence of mild and moderate anemia among study participants was 32.6 and 29.8%, respectively. A statistically significant association was found between the prevalence of anemia with age group, educational status of both father and mother, and status of attainment of menarche (p<0.05). Conclusion and Recommendation: The prevalence of anemia among adolescent girls was very high; therefore, attempts must be made to sensitize adolescents and their parents through health and nutrition education, information, education, and communication (IEC), and appropriate behavioral change communication (BCC) activities.

Comunicación de orígenes en familias formadas por donación de gametos: del anonimato a la apertura como posibilidad / Comunicating origins in families formed by gamete donation: from anonymity to openness as a possibility

La reproducción asistida con donación ha venido a interrogar y a ampliar la noción de parentesco. La hegemonía del modelo biogenético dificulta que los padres de estas familias incorporen con tranquilidad la donación en su gestación. Desde los inicios de la técnica los padres han optado por no contar a su decendencia la historia de su concepción, muchas veces por miedo a que se deslegitimara su relación filial. Con el tiempo, se ha observado una apertura hacia la comunicación. Este cambio va de la mano con el desarrollo de la investigación en el área, que comenzó preguntándose por el bienestar psicológico de los nacidos por donación, por los aspectos relacionales de las familias concebidas de este modo e interrogando los beneficios de la comunicación de orígenes. Luego, investigando las percepciones en relación con su origen de las personas nacidas por donación. Finalmente, se ha publicado acerca la imposibilidad del anonimato en la era de los exámenes genéticos directos al consumidor. El modo de entender la reproducción con donante ha evolucionado, de un modelo médico en el que el foco es el lograr un embarazo saludable, a un modelo de formación de familia, en el que la motivación es contribuir a formar familias de buen funcionamiento. Esto tiene implicancias en la consejería a quienes participan del proceso, y también en los lineamientos que las sociedades científicas y comités de ética sugieren a los programas de reproducción con donante.

Gamete donation has come to question and broaden the notion of kinship. The hegemony of an biogenetic model has been an obstacle for parents of these families to incorporate donation into their history. From the beginning of the technique the parents chose not to tell their descent the history of their conception, often for fear that their filial relationship would be delegitimized. Over time, an openness to disclosure has been observed. This change goes hand in hand with the development of research in the area, which began by asking about the psychological well-being of those born by donation. Then investigating the relational aspects of families conceived in this way and questioning the benefits of disclosure. Subsequently, it was possible to study the perceptions regarding their origin of people born by donation. Finally, the impossibility of anonymity in the era of direct consumer genetic testing has been published. The way of understanding donor reproduction has evolved, from a medical model in focus is to achieve a healthy pregnancy, a family formation model, in which the motivation is to contribute to forming well-functioning families. This has implications in counseling to those who participate in the process, and in the guidelines that scientific societies and ethics committees affect donor reproduction programs.

Heritability of cognitive functions in nuclear families with bipolar I disorder / 中国神经精神疾病杂志

Objective To examine the heritability of neurocognitive functions in bipolar I disorder(BD-I)families and BD-associated cognitive endophenotypes. Methods Seventy-nine nuclear families consisting of euthymic BD-I probands and their healthy parents were recruited. Cognitive functions including attention, working memory, processing speed and executive function were evaluated by 7 classic neurocognitive tests, and the heritability of neuroconitive functions in these families was estimated using parent-offspring regression indexes of quantitative traits.Furthermore,the heritable cognitions were compared between 79 BD probands and 140 normal controls. Results After adjusted by age and education,mistake numbers of Trail Making Test A(TMT-A),total score and completed mission numbers of Tower of Hanoi (TOH) were significantly heritable (P<0.05). The comparison of these heritable cognitions between patients and normal controls showed that TOH total score and TOH completed mission numbers were significantly impaired in the patient group (P<0.05). Conclusion Processing speed and executive function are probably heritable in BD nuclear families. Executive function impairments may be disease-related which could be candidate endophenotypes for bipolar disorder.

The prevalence characteristic of Kashin-Beck disease in nuclear families / 中华地方病学杂志

Objective To analyze the occurrence characteristic of Kashin-Beck disease (KBD) in nuclear families,and to provide a scientific basis for KBD prevention.Methods KBD patients in 15 villages of Linyou County,Shaanxi Province were investigated using clinical and questionnaire survey.According to the prevalence of KBD,the nuclear families were divided into 4 different types:parents did not suffer from KBD (A,n =3 657),mother suffered from KBD and father did not (B,n =674),father suffered from KBD and mother did not (C,n =907),and both patients suffered from KBD (D,n =748).The relationship between prevalence of nuclear families and prevalence of population was analyzed using correlation analysis,and the changes of prevalence in different age groups of family members were analyzed.Results ①The prevalence of nuclear families (38.91％,2 329/5 986) and the prevalence of popttlation (14.42％,3 700/25 656) were significantly correlated (r =0.77,P ＜ 0.05);②The proportions of parental generation men and women with KBD were 9.91％ (118/1 191) vs 11.30％ (105/929) in 0-10 years old group,62.80％ (748/1 191) vs 58.45％ (543/929) in 11-20 years old group,15.70％ (187/1 191) vs 18.51％ (172/929) in 21-30 years old group,7.30％ (87/1 191) vs 7.64％ (71/929) in 31-40 years old group,2.77％ (33/1 191) vs 2.37％ (22/929) in 41-50 years old group,1.34％ (16/1 191) vs 1.51％ (14/929) in 51-60 years old group,and 0.17％ (2/1 191) vs 0.22％ (2/929) in 61-70 years old group,respectively.③Among the three nuclear families (B,C,D),the age of offspring with KBD was less than 13 years old when the age of their parents with KBD was less than 13 years old(83.33％,20/24);The age of the offspring with KBD was mainly distributed between the ages of 13 and 25 years old when the age of their parents with KBD was 13-25 years old (69.86％,51/73);When the age of parents with KBD was order than 25 years old,the age of their offspring with KBD was mainly less than 25 years old (84.85％,56/66);④Among the four nuclear families,the prevalence rates of male and female in the first filial generation were 1.41％ (52/3 683) vs 0.47％ (12/2 538) in A family (x2 =0.47,P ＞ 0.05),5.73％ (31/541) vs 0.53％ (2/378) in B family (x2 =4.32,P ＜ 0.05),6.48％ (44/679) vs 0.95％ (5/528) in C family (x2 =4.10,P ＜ 0.05),and 9.46％ (66/698) vs 3.31％ (15/453) in D family (x2 =2.96,P＞ 0.05),respectively.Conclusions ①The prevalence of the nuclear family with KBD is related to the population prevalence;②the prevalence of male and female with KBD is related to age,and KBD mainly occurs between the age of 11 and 20;③the age of offspring with KBD is partly influenced by the age of their parents;④the prevalence rate of male in the first filial generation is higher than that of female in the first filial generation.

Variables associated with family breakdown in healthy and obese/ overweigh adolescents / Investigacion de factores de desagregacion familiar en adolescentes eutroficos y adolescentes con sobrepeso/obesidad / Fatores de desagregacao familiar em adolescentes eutroficos e nos portadores de sobrepeso/obesidade

Objective: To evaluate the presence of family breakdown factors among eutrophic and overweight/obese adolescents. Methods: Cross-sectional study of 242 students aged between 14 and 19 years old, from a public school. Each student was weighed, measured and answered a questionnaire with closed questions addressing the presence of family breakdown factors. The adolescents were divided in two groups: euthophic and overweight/obese. The answers of both groups were compared by Fisher's exact and Mann-Whitney tests. Results: There was no statistically significant difference in the prevalence of the studied factors between the two groups. Comparing the number of positive answers (presence of family breakdown factors) and negative ones (absence of family breakdown factors), no difference was observed between the groups. Conclusions: The inclusion of a control group showed that factors of family breakdown, usually identified as associated with obesity in adolescents, may also be present in eutrophic adolescents. .

Objetivo: Investigar la existencia de factores de desagregación familiar entre adolescentes eutróficos y portadores de sobrepeso/obesidad. Métodos: Estudio transversal, implicando a 242 alumnos de una escuela pública, de 14 a 19 años, que fueron pesados, medidos y contestaron a un cuestionario con cuestiones cerradas, el que investigó la presencia de factores de desagregación familiar. Enseguida, los adolescentes fueron divididos en dos grupos, eutróficos y portadores de sobrepeso/obesidad, y las respuestas fueron confrontadas y analizadas mediante las pruebas exacto de Fisher y de Mann-Whitney. Resultados: No hubo diferencia significante para la prevalencia de los factores estudiados entre los dos grupos cuando vistos en separado e incluso cuando las variables fueron analizadas en conjunto. Comparándose el número de respuestas positivas (presencia del factor de desagregación familiar) y negativas (ausencia del factor de desagregación familiar), no se observó diferencia entre los dos grupos. Conclusiones: El análisis con la inclusión de un grupo control mostró que factores relacionados a la desagregación familiar, habitualmente señalados como asociados a la obesidad en adolescentes, pueden estar presentes también en adolescentes eutróficos. .

Objetivo: Investigar a existência de fatores de desagregação familiar em adolescentes eutróficos e nos portadores de sobrepeso/obesidade. Métodos: Estudo transversal de 242 alunos de uma escola pública, de 14 a 19 anos, que foram pesados, medidos e responderam a um questionário com questões fechadas, o qual investigou a presença de fatores de desagregação familiar. Em seguida, os adolescentes foram divididos em dois grupos, eutróficos e portadores de sobrepeso/obesidade, e as respostas foram confrontadas e analisadas por meio dos testes exato de Fisher e de Mann-Whitney. Resultados: Não houve diferença significante para a prevalência dos fatores estudados entre os dois grupos. Comparando-se o número de respostas positivas (presença do fator de desagregação familiar) e negativas (ausência do fator de desagregação familiar), não se observou diferença entre os dois grupos. Conclusões: A análise com a inclusão de um grupo controle mostrou que fatores ligados à desagregação familiar, habitualmente apontados como associados à obesidade em adolescentes, podem estar presentes também em adolescentes eutróficos. .

Estrés materno y configuración familiar: estudio comparativo en familias chilenas monoparentales y nucleares de bajos ingresos / Maternal Stress and Family Constitution: Comparative Study on Chilean, Single-Mother and Nuclear, Low-Income Families

Los estudios sobre estrés materno durante la crianza infantil han considerado variables contextuales para explicarlo. El nivel socioeconómico (NSE) así como la configuración familiar han sido variables relevantes, asociándose monoparentalidad en familias de bajos ingresos a mayores niveles de estrés materno. Se estudian los niveles de estrés materno en familias chilenas nucleares y monoparentales de NSE bajo, considerando el estrés en distintas dimensiones, asociado al rol materno, a la interacción madre-hijo y a la percepción de dificultades en el niño percibidas por la madre. Se estudia un total de 169 diadas, 80 pertenecientes a familias monoparentales y 89 pertenecientes a familias nucleares con niños entre los 4 y 15 meses de edad. Se evaluaron los niveles de estrés materno con el Parental Stress Index, versión abreviada, desarrollado por R. Abidin (1995). Los resultados muestran niveles de estrés significativamente más altos en las madres pertenecientes a familias monoparentales en el estrés asociado al rol materno, a la percepción del niño como difícil y en el estrés total.

Studies on maternal stress during child raising have taken into consideration contextual variables to explain it. The socioeconomic level, as well as the family constitution have been relevant variables, associating single-parenting in low-income families with greater levels of maternal stress. Maternal stress levels in Chilean, nuclear and single-mother low income families are studied, considering stress in various dimensions, associated to the maternal role, to the mother-child interaction and to the difficulties the mother perceives in the child. 169 Dyads are studied, 80 of them of single-mother families and the other 89 of nuclear families, with children between the ages of 4 to 15 months. Maternal stress levels were measured with the Parental Stress Index, abbreviated version, developed by R. Abidin (1995). The results show significantly higher stress levels in mothers of single-parent families on stress associated to the maternal role, to the perception of a difficult child, and to total stress.

Riesgo familiar total en salud y grado de salud familiar en las familias de los pacientes con diagnostico de síndrome coronario agudo / Total health familial risk and degree of family health in families of patients diagnosed with acute coronary syndrome / Risco para a saúde total familiar e grau de saúde da família em famílias de pacientes com diagnóstico de síndrome coronariana aguda

Objetivo: identificar el riesgo familiar total en salud y grado de salud familiar en las familias de los pacientes con diagnóstico de síndrome coronario agudo de la Clínica San José de Cúcuta. Materiales y Métodos: Estudio cuantitativo, de tipo descriptivo transversal; en el que se calculó una muestra de 165 familias por muestreo no probabilístico. La recolección de la información se realizo por medio de los instrumentos RFT: 5-33 y ISF GEN-21 donde se clasifico el riesgo familiar total y se percibió el grado de salud familiar. Resultados: se evidencia que las familias están conformes con el modelo habitual de organización familiar en función de cada uno de los integrantes y del grupo como tal. Lo cual nos indica que toda la familia del paciente coronario lo ayuda a sobrellevar el proceso de salud-enfermedad y tiene claro el papel que juega dentro de ella permitiendo así la funcionalidad y la unidad que requiere este tipo de pacientes para su rehabilitación. Conclusiones: los factores de riesgo biológicos, sociales y del medio ambiente que clasifican a la población estudiada dentro de riesgo familiar bajo. Se evidenció un alto grado de organización y satisfacción asegurando en gran medida la adaptación y el éxito de las familias frente al proceso de salud- enfermedad por la que atraviesan algunos de los miembros especialmente si es un paciente coronario.

Objective: To identify the total health familial risk and degree of family health in families of patients with acute coronary syndrome Clinic San Jose de Cucuta. Materials and Methods: A quantitative, descriptive transversal which calculated a sample of 165 families by non-probability sampling. The data collection was performed using instruments RFT: 5-33 and ISF GEN-21 where you rate the overall familial risk and the degree of perceived family health. Results: We found that families conform to the usual pattern of family organization in terms of each of the members and the group as such. This indicates that the whole family of coronary patients helps them cope with the health-disease process and is clear about the role played in it allowing the functionality and unit requiring such patients for rehabilitation. Conclusions: biological risk factors, social and environment that classify the study population within low familial risk. It showed a high degree of organization and ensuring satisfaction largely successful adaptation and families facing the health-disease process being experienced by some members especially a coronary patient.

Objetivo: Identificar o risco total da saúde familiar e grau de saúde da família de famílias de pacientes com síndrome coronária aguda Clínica San José de Cúcuta. Materiais e Métodos: Estudo quantitativo, descritivo transversal que calculou uma amostra de 165 famílias por amostragem não-probabilística. A coleta de dados foi realizada por meio de instrumentos RFT: 5-33 e ISF GEN-21, onde você classificaria o risco global familiar e do grau de saúde da família percebida. Resultados: Encontramos que as famílias estão em conformidade com o padrão habitual de organização familiar, em termos de cada um dos membros e do grupo como tal. O que indica que toda a família de pacientes coronarianos ajuda a lidar com o processo saúde-doença e é claro sobre o papel desempenhado no mesmo permitindo a funcionalidade e unidade de exigir tais pacientes para a reabilitação. Conclusões: fatores de risco biológicos, sociais e ambientais que classificam a população do estudo dentro de risco familiar baixa. Ele mostrou um alto grau de organização e garantir a satisfação de adaptação muito bem sucedida e famílias que enfrentam o processo saúde-doença está sendo experimentado por alguns membros especialmente um paciente coronariano.

Discursos normativos sobre o desejo de ter filhos / Discursos normativos sobre el deseo de tener hijos / Normative discourses on the desire to have children

São apresentadas reflexões acerca dos discursos normativos sobre sexualidade, família e reprodução difundidos pelos saberes médico e jurídico na sociedade contemporânea. Partiu-se do pressuposto de que nos atuais discursos acerca do desejo de filhos coexistem transformações e permanências de valores e práticas, traduzidas em reivindicações no plano dos direitos sexuais e reprodutivos, com novas demandas no âmbito das políticas públicas e de saúde. O atual valor atribuído à família tem por base o modelo de família conjugal moderna, o que pode ser observado em meio às transformações ocorridas nas relações familiares e das identidades sexuais. A partir de uma nova configuração de valores, a expectativa de paternidade e de maternidade tornou-se, em parte, um valor da relação homossexual. No entanto, a despeito das transformações no âmbito das relações familiares e das identidades sociais, a centralidade do casal heterossexual prevalece no discurso médico e jurídico acerca do desejo de filhos.

Reflections on normative discourses on sexuality, family and reproduction are shown, promoted by medical and juridical knowledge in modern society. This study was based on the assumption that changes and maintenance of values and practices coexist in the current discourses on the desire to have children, expressed as claims in the dimension of sexual and reproductive rights, with new demands in the sphere of public and health policies. The current value attributed to family is founded on the model of modern conjugal family, which can be observed in the changes that have occurred in family relations and sexual identities. Based on a new configuration of values, the expectation of paternity and maternity has partly become a value of the homosexual relationship. However, despite changes in the sphere of family relations and social identities, the centrality of the heterosexual couple prevails in the medical and juridical discourse on the desire to have children.

Son presentadas reflexiones acerca de los discursos normativos sobre sexualidad, familia y reproducción difundidos por los conocimientos médico y jurídico en la sociedad contemporánea. Se partió del supuesto de que en los actuales discursos acerca del deseo de hijos coexisten transformaciones y permanencias de valores y prácticas, traducidas en reivindicaciones en el plano de los derechos sexuales y reproductivos, con nuevas demandas en el ámbito de las políticas públicas y de salud. El actual valor atribuido a la familia tiene por base el modelo de familia conyugal moderna, lo que puede ser observado en medio de las transformaciones ocurridas en las relaciones familiares y de las identidades sexuales. A partir de una nueva configuración de valores, la expectativa de paternidad y de maternidad se tornó, en parte, un valor de la relación homosexual. Sin embargo, ignorando las transformaciones en el ámbito de las relaciones familiares y de las identidades sociales, la centralidad de la pareja heterosexual prevalece en el discurso médico y jurídico acerca del deseo de hijos.

Estado Nutricional y su Relación con la Estructura-Función Familiar en Menores de 5 Años de Pediatría, Caja Nacional de Salud 2009 / Nutritional Condition and its Relation with the Relative Structure-Function in Minors Gives 5 Years of Pediatrics, National Box Health 2009

El presente trabajo es de tipo transversal y descriptivo donde se describirá como objetivo general los factores y características de la estructura y función familiar que influyen en el estado nutricional en menores de 5 años hospitalizados en el servicio de pediatría Hospital Obrero N° 2 de la Caja Nacional de Salud en 2009. A su vez entre los objetivos específicos nos encontramos con describir la función familiar, estructura familiar y relacionar con el estado nutricional, y evaluar el estado nutricional de la población en estudio según peso y talla. Relacionar el estado nutricional con la lactancia materna. Nuestros resultados muestran que un 54% de los niños en su totalidad presentan un estado nutricional adecuado, de los cuales el 61% provienen de familias normo-funcionales y el restante 39% provienen de familias disfuncionales. En relación a la estructura familiar el 50% pertenecen a familias nucleares integras de la misma manera el restante 50% pertenecen a familias nucleares desintegradas; Pero también se pudo observar que un 24% de niños presentan bajo peso y el 22% presentan sobrepeso teniendo un restante 54% con normo-peso. Por lo tanto concluimos que un alto porcentaje de niños presentan familias normo funcionales, y provienen de familias nucleares integras. Según el estado nutricional más de 50% son niños eutróficos pero aun existen niños con peso bajo cuyas cifras se igualan a los con niños con sobrepeso. Relacionando el estado nutricional la mayoría de niños eutróficos pertenecen a familias normo funcionales al igual que los niños con sobrepeso.

The present work is a transverse and descriptive type where there will be described as general aim the factors and characteristics of the structure and familiar function that influence in the nutritional condition in 5-year-old minors hospitalized in the service of pediatrics Working Hospital (H.O.) N ° 2. National Box of Health (C.N.S.). 2009. In turn between the specific aims we find ourselves Describing the familiar function and familiar structure and relating with the nutritional condition, and To evaluate the nutritional condition of the population in study according to weight and height. Our results show that 54 % of the children in its entirety presents a nutritional suitable condition, of which 61 % comes from normo-functional families and the remaining one 39 % comes from dysfunctional families. In relation to the familiar structure 50 % belongs to complete nuclear families of the same way the remaining 50 % belongs to nuclear disintegrated families; but also it was possible to observe that 24 % of children have under weight and 22 % have overweight with a remaining of 54 % with normo-peso. Therefore we conclude that a high percentage of children have normo-functional families, and they come from complete nuclear families. According to the nutritional condition more than 50 % is eutrofic children but even children exist with un-derweight whose numbers are equal to them with children that have overweight. Relating the nutritional condition the majority of eutrofic children belong to normo-functional families as the children with overweight.

Pacto perverso e biopolítica / Perverse pact and biopolitics

A intenção deste artigo é a de delinear a construção teórica do campo da perversão, nos registros teórico e clínico, desde o começo do século XIX, nas suas relações com a constituição da família nuclear e o discurso da biopolítica. Para isso, pretende inscrever a emergência da experiência da perversão na articulação entre o novo poder social materno e o lugar privilegiado ocupado então pela figura da criança no imaginário social da modernidade.

The aim of this paper is to outline the historical constitution of the perversion field, in both theoretical and clinics levels, since the beginning of the XIX century, and its relationship with the constitution of a biopolitical speech and the nuclear family. In order to achieve this, the paper intends to inscribe the historical emergency of the perverse experience in the juncture between the new social power attributed to motherhood and the prominent place taken by children in modern society's social imaginary field.

Perfil organizativo-funcional de la familia nuclear psicosomática con un hijo asmático / Organizational and functional profile of the nuclear psychosomatic family with one asthmatic son

Introduction Asthma is a current problem worldwide. By one hand the prevalence of the disease has been increasing in México during the last decades; on the other hand there is a considerable number of patients in whose the disease can not be controlled. The analysis of familiar function is a convenient weapon to approach in a more integrated manner such problem. In this systematic focus, the family becomes the protagonist in the symptoms of the indicated patient. It is within the family where the study proposes to find characteristics that instigate the development of the psychosomatic disease. The psychosomatic family basically suffers problems with boundaries. As with most family problems, the psychosomatic illness pertains to this dynamic group of families where the family roles are intermixed. The desire for a unified family creates a difficult home environment for individual spaces. This difficulty interpreted by Minuchin (1990) as the absence of psychological distance and defined it as the moment where one, or various family members begin to function as a family subsystem to which they do not pertain. According to Onnis (1990), there are four main characteristics of the psychosomatic family: Agglutination This refers to the reciprocal over-involvement of the family members. Each member is prone to intrusive actions, thoughts, feelings and communication with the other members. Reciprocal over-protection The members of the family demonstrate a high grade of diligence and reciprocal interest, encouraging and supplying answers that are of a protective type. As a result, the illness of the patient has a protective function towards the family. Rigidity This is the principal characteristic of the psychosomatic family. The family is resistant to change, and show itself as a unified and harmonious one, where the only problem is the illness of the patient. Outside relationships are scarce and the family remains stuck in the attempt to maintain it's own homeostasis. Avoidance of conflict There is a very low capacity for tolerating conflicts by the family and applies all possible methods to avoid it, which in the end the family only manages to hide the problem. In such a pattern, the patient plays a central and vital role by interfering every time the tension between the parents raises to a threat and the appearance of a symptom blocks the conflict by attracting the attention of the family members towards him/herself. The present study was done to characterize the organizational and functional profile of the nuclear family with one asthmatic child. Methods This is a descriptive semi-quantitative, non-experimental study to understand the family behavior and function of twenty nuclear families with one asthmatic child. The family function was evaluated in nine different areas with Emma Espejel Acco's the Scale of Family Function. This instrument was chosen because they could attain the desired objective and they were standardized for the Mexican population with a sensibility of 0.91 to discriminate between dysfunctional and functional families. Emma Espejel Acco's Scale of Family Function include the following areas: support, affect, disruptive conduct, communication, resources, authority, supervision, negative affect and control and final evaluation of each areas were reported in four categories: functional, fairly functional, poor functional and dysfunctional, attending Espejel Acco's recommendations. The study population was taken from a pool containing 102 psychosomatics families, whose participated in a previous study to characterize clinical patterns of asthma in children, also their relation with social and environmental factors leaded by Rodríguez-Orozco at the University of San Nicolás de Hidalgo, Morelia, México. Those nuclear families with an asthmatic children, within the ages six and twelve years, were included. There were only twenty families that fit the nuclear typology also, requirements for the study and those twenty were the ones included in this study; 95% was considered statistically significant and Pearson's Correlation was applied to study the relations between explored areas of the Scale of Family Function. The written consent was previously received for participant families and this study was run during 2005 at the University of San Nicolás de Hidalgo, Morelia, México. Results The 80% of the families were poorly functional in the area of affect. The communication was poorly functional in 60% of the families, in the area of resources 50 % of the families were fairly functional. Attending authority (75%), supervision(95%) and control (50%) of the families were fairly functional. 70 % of the families were fairly functional in support, and 65% were fairly functional when disruptive conducts were analized. In the area of negative affect almost 50% of the families were fairly functional. Within the obtained results, there was a positive correlation with a significance P <0.05 between the following areas authority and disruptive conduct r= .545 between the areas of authority and communication r=.518, and between disruptive conduct and resources r=.524 Discussion The principal characteristics found in the studied nuclear psychosomatic families with one son with asthma were agglutination, overprotection, rigidity and avoidance of conflict according to the four main characteristics referred in psychosomatic families. The familiar dinamics was really complex, even when all areas of the familiar function are compromised there is a predominance of poor efficacy to demonstrate affect and to communicate their feelings; it is associated with persistence of negative feelings which can not be treat adecuately due to a limited number of resources to solve conflicts. There was a positive correlation between authority and communication; authority and disruptive conduct and disruptive conduct and resources. This means that when authority resides in a parental subsystem, feelings are good expressed within the family; the emerging situations such as addictions and innapropiate social behaviour are well-discussed, despite of the major part of this innapropiate conducts remain unsolved because the family can not recognize the instruments to solve this problems. Conclusions The nuclear psychosomatics families with an asthmatic son, are rigid ones, and all areas of familiar functioning according. Espejel's Scale are affected, in agreement to other authors rigidity, as the crucial characteristics accompanied of avoidance of conflict, reciprocal-overprotection and agglutination. All evaluated areas of family function were affected in nuclear psychosomatic families with an asthmatic son. That is the way to stop the psychosomatic system. The psychological assistance is necessary to integrate to the medical treatment.

Introducción El asma es un problema de salud mundial, su incidencia continúa aumentando en nuestro medio y para su control en muchos casos no resulta suficiente el tratamiento farmacológico; por ello una perspectiva más integradora para su atención debe incluir el manejo de las circunstancias que detonan las crisis y las apuntan hacia la cronicidad de la enfermedad en la familia, la escuela y el trabajo. Bajo este enfoque sistemático, en la familia se encuentran las características que instigan el desarrollo de la enfermedad psicosomática y deviene en protagonista de los síntomas que el paciente exhibe. La familia psicosomática sufre básicamente problemas con las fronteras y los papeles que sus miembros tienden a entremezclar en una complicada madeja; en consecuencia, los deseos de unidad familiar están ligados a las dificultades para mantener los espacios individuales. Según Onnis (1990), existen cuatro características principales que caracterizan a la familia psicosomática: la aglutinación, la hiperprotección recíproca, la rigidez y la evitación de conflicto. La aglutinación se refiere al hecho de que los miembros de la familia se sobreinvolucran recíprocamente; cada uno mantiene tendencias intrusivas en los pensamientos, acciones, sentimientos y comunicaciones de los demás; los límites generacionales e interindividuales son frágiles, y se confunden papeles y funciones. La hiperprotección recíproca se establece cuando miembros de una familia muestran entre sí un alto grado de solicitud e interés recíproco; se estimulan y aportan respuestas de protección, en especial cuando el paciente asume el comportamiento sintomático todos se movilizan para protegerlo. La rigidez es una de las características más importantes del entorno psicosomático, una familia rígida es resistente al cambio aunque con frecuencia se presente unida y armónica, con escasas relaciones externas por lo que, aparentemente, el problema único es la enfermedad del paciente. La evitación del conflicto es otro de los rasgos típicos de la familia psicosomática, se aplican varios mecanismos para evitar el conflicto y ocultar el problema. Existe en la familia un bajo umbral de tolerancia al conflicto, por lo que es frecuente encontrar un niño en quien la aparición del síntoma consigue el bloque de las tensiones entre los padres y atrae hacia él la atención de la familia. Métodos La presente investigación se realizó en la ciudad de Morelia, Michoacán, durante el año de 2005; es una investigación de tipo cuantitativo, no experimental, transversal y descriptiva; se estudiaron 20 familias nucleares con un hijo asmático con edades entre seis y 12 años; el objetivo del estudio fue caracterizar el funcionamiento y la organización de la familia por su relación con la detonación y persistencia de los síntomas asmáticos en el miembro de la familia que experimenta la enfermedad. Para obtener las mediciones se aceptó un rango con 95% de confiabilidad y se usó la Correlación de Pearson para estimar la relación entre las áreas de función familiar evaluadas. Para estimar el funcionamiento de la familia se usó la Escala de Funcionamiento Familiar de Emma Espejel que permite evaluar nueve áreas: apoyo, recursos, afecto, conducta disruptiva, afecto negativo, comunicación, autoridad, supervisión y control, ésta última está validada para la población mexicana y puede discriminar familias funcionales de familias disfuncionales con una sensibilidad de 0.91. Resultados De las familias estudiadas 80% se mostraron poco funcionales en el área de afecto; 60% fueron poco funcionales en la comunicación; y 50% moderadamente funcionales en recursos. En las áreas de supervisión, autoridad y control fueron moderadamente funcionales 95%, 75% y 50% respectivamente. Fueron moderadamente funcionales en el area de apoyo, 70%. El 65% de las familias fueron moderadamente funcionales en el área que explora conductas disruptivas. En el área afecto negativo 50% de las familias fueron moderadamente funcionales. Las correlaciones positivas que más llamaron la atención entre las áreas de función familiar estudiadas fueron: entre autoridad y conducta disruptiva, r=.545, P<0.05; entre autoridad y comunicación, r=.518, P<0.05, y entre conducta disruptiva y recursos r=.524, P<0.05. Discusión El perfil organizativo-funcional encontrado en estas familias correspondió con las principales características reportadas por otros autores en las familias psicosomáticas: rigidez, sobreprotección, evitación de conflicto y aglutinación. Esta dinámica causa poca eficacia en cuanto a la demostración del afecto y para sustentar la comunicación, lo anterior se traduce en una permanencia de sentimientos negativos que repercute en la pobre utilización de recursos para salir adelante y, en ocasiones, se desconoce la existencia de éstos. La existencia de correlaciones positivas entre autoridad y comunicación, entre autoridad y conducta disruptiva y entre conducta disruptiva y recursos, significa que cuando la autoridad radica en el sistema parental los sentimientos son mejor expresados por la familia, se favorece el intercambio de puntos de vista y las situaciones emergentes como las adicciones y los comportamientos inapropiados son mejor discutidos. De igual forma los problemas en el comportamiento de la familia y las conductas inadecuadas tienden a no quedar resueltos debido a la limitación en el reconocimiento y manejo de las herramientas adecuadas para salir adelante.

Família nuclear e terapia de família: conexões entre duas histórias / Nuclear family and family therapy: conections between two histories

Desenvolver uma história da Terapia de família é minha proposta. Inicio contextualizando o nascimento da família moderna, a partir da história. Assim, considero a estreita relação entre o modelo de família nuclear e a idéia de intervenção terapêutica, própria da modernidade. Esta história é narrada a partir da idéia de família e da intervenção terapêutica, desenvolvendo os questionamentos elaborados, posteriormente, pela Terapia de Família Feminista, pelo Construtivismo e pelo Construcionismo Social. Minuchin (1990a, 1990b; 1991, 1995a, 1995b, 1998) e Andolfi (1980, 1989a, 1989b, 1996, 1998) são citados para discutir o modelo de família nuclear na terapia. Outros autores, como Rampage e Avis (1998) e Anderson e Goolishian (1988), exemplificam a crítica feminista e o movimento pósmoderno na Terapia de família.

My proposal in the present study is to develop a history of Family Therapy. I begin by presenting the origins of the modern family in a historical context, thus taking into account the close relationship between a nuclear family model and the idea of contemporary therapeutic intervention, typical ofmodern times. I begin narrating its history starting from the idea of the family and expert (therapist) interventions, developing questions that were later elaborated by Feminist Family Therapy, by Constructivism and by Social Constructionism. Minuchin and Andolfi are mentioned in the discussion nuclear family model in therapy. Others authors, Rampage, Anderson; Goolishian and Fruggeri, exemplify the feminist criticism and the post modern movement in the history of Family Therapy.