This study investigates (1) whether infants cared for by a single caregiver exhibit more attachment behaviors than do infants cared for by multiple caregivers and (2) whether sex differences are found in these behaviors. Twenty-six Black infants, nine to twenty-three months of age, in a day-care center, were observed during one brief low-stress separation from a caregiver. Data were taken using six indices of attachment: maintaining proximity, visual regard, touching, protesting, seeking proximity, and greeting. Where subjected to a two-way analysis of variance, the obtained results showed no significant differences in the effects of the two types of care. However, visual regard and greeting behaviors were observed significantly more frequently in females than in males.

The diploma thesis titled "Foster care" is dedicated to the foster care in the Czech republic. Its main objective is to explore the benefits of legislative changes to the functioning of foster care. The work also provides view of alternative forms of family education and types of foster care. In the theoretical part of the thesis focuses on the history of foster care, its forms, modes of mediation, both for applicants and in children. Furthermore, is the financing of foster care and foster's rights and obligations that are newly included within the framework of foster care. Finally, the work also addresses the difficulties that foster care entails, and which should be equated foster even before the adoption of a child in foster care. There is the thesis research among foster families focusing among other things on the evaluation of changes in foster care from their perspective in the practical part.

Thesis deals with the legislation of institutional care for delinquent youth and the possibilities of saving measures in response to wrongdoing committed by adolescents or otherwise of a criminal offense a child younger than 15 years. The work also includes analysis of the situation and socio-pathological development of young people after leaving the institutional care. The last part deals with implementation of the Early Intervention System and Youth team as an effective tool in combating children and adolescents crime in the Czech Republic.

M.A. (Psychology) / Please refer to full text to view abstract

The general intention of recent Swedish legislation concerning adults with intellectual disabilities has been to provide care and support for this group in small settings in the community. It has been shown that adults with intellectual disabilities are better equipped to exert influence over their own care and support when living in group homes in the community and other forms of independent living as opposed to large institutional settings. Recent research on this group has to a great extent concerned the study of how life is in small group homes for this group and has highlighted obstacles preventing them from participating in society. Previous research has indicated that living in institutional settings makes it difficult for them to exert influence on their lives. A small number of large institutional care settings still exist, however, in Sweden and there is a dearth of research that focuses on how adults with intellectual disabilities experience everyday life in such settings. In addition, little research has been carried out on the role of the care workers who work in such settings. The aim of this research has thus been to describe the experiences of adults with intellectual disabilities and care workers of living and working in an institutional care setting in Sweden.   An ethnographic approach including participant observation and in-depth interviews was used to gain a deeper understanding of how adults with intellectual disabilities and staff experience their everyday life in an institutional care setting. The result showed that the residents experienced;  I) a sense of belonging, which was connected to having access to a private sphere and being part of social togetherness;  II) a feeling of insecurity in relation to other residents and care workers;  III) a longing for independence and a desire to get away. The study of the staff revealed three main themes that represent their approach; I) creating a family-like atmosphere; II) making the everyday life ordered and structured; III) being exposed to stress factors.   The results revealed the importance of paying close attention to what adults with intellectual disabilities and their care workers have to say about their everyday lives when living and working in an institutional care setting. It may be concluded that adults living in an institutional care setting experience their everyday lives in existential terms such as belonging, insecurity and longing. For caring science and in caring practices of people with intellectual disabilities, it is not satisfactory that residents experience such an insecure existence in a care setting. In order to provide individual care and support, staff need to be more open and vigilant as to the residents’ vulnerability and be able to guide them in matters  concerning emotional aspects. It was seen that care workers in their everyday work with residents in an institutional care setting used experiences from their personal lives in situations where they lacked formal care training. Such experiences may have helped to create meaningfulness but at the same time risked preserving inequality and gender stereotyping. In order to avoid these risks care workers should receive clear directives from the management about the care objectives, and guidelines about how best to care for adults with intellectual disabilities and offer them individualized care. Furthermore, it also became evident that care workers need additional support, training and opportunities for reflection to cope with their complex work situation. The results of this research can contribute to a greater insight and deeper knowledge of what adults with intellectual disabilities experience in an institutional care setting in the 2000’s , enabling the staff and management to further enhance the well-being for this group of individuals. The findings can provide feedback to staff, managers and researchers working in the intellectual disabilities field.   Keywords: adults with intellectual disabilities, care, care workers, ethnography, institutional care setting, Sweden

Os conhecimentos produzidos acerca das interações de bebês em contextos coletivos têm priorizado suas interações com os adultos. Em contextos de acolhimento institucional de crianças em situação de vulnerabilidade, isso se repete, o estudo de bebês nesse contexto estando imerso em invisibilidade. Entendendo que o ser humano é relação, tal característica estando presente mesmo no bebê, hipótese do trabalho é de que suas interações ali poderiam ser mais efetivadas com outras crianças acolhidas já que, nesse contexto, funcionárias são orientadas a não se apegar aos bebês e/ou dispensam pouca presença pela sobrecarga de trabalho. Assim, o objetivo foi investigar as ocorrências de práticas de cuidado na interação de crianças e bebês em situação de acolhimento institucional. A pesquisa teve fundamentação na perspectiva da Rede de Significações, de referencial histórico-cultural. O estudo foi realizado em instituição de acolhimento do interior do Mato Grosso do Sul, de onde se selecionou dois bebês focais Caio e Ana (de sete e dez meses) -, sem parentesco entre eles. Além deles, foram participantes as crianças também acolhidas naquele período e a própria pesquisadora. Foram realizadas 47 videogravações, de trinta minutos cada, por seis meses, sendo três meses com cada bebê focal. Também foram realizadas entrevistas semiestruturadas com funcionários da instituição e, ainda, construiu-se diário de campo. A noção de cuidado foi baseada nos conceitos de Heidegger - Cuidado por Ocupação (baseado em tarefas) e Cuidado por Preocupação (baseado no Ser Com). O cuidado por preocupação teve tonalidades diversas: Atenção, como ir em direção ao bebê, quando o percebia sozinho; Solicitude, como ir em direção ao bebê, em decorrência de expressividades diversas; e, Preocupação/tensão, ir em direção ao bebê, para protegê-lo/ socorrê-lo em situações de perigo. À análise, verificou-se muitas interações das crianças, a maioria concentrada em brincadeiras. Com relação às práticas de cuidado, verificou-se grande ocorrência nas interações das crianças com os bebês e mesmo na interação de bebês, envolvendo as três tonalidades acima. Os cuidados eram, em grande parte, de interações recíprocas, diádicas e comumente viabilizadas por crianças mais velhas (multietárias). Os parceiros que ofertaram cuidados diferenciados eram os mais afetivos e buscados pelos bebês. Embora os cuidados fossem mais ofertados por meninas, este estudo demonstrou que meninos também cuidaram dos bebês. No caso de Ana, as interações não envolviam crianças com grau de parentesco, diferentemente do caso de Caio, que foi bastante cuidado pela irmã. Discute-se a importância do estabelecimento de relações naquele contexto, particularmente nos grupos de irmãos, de forma que possam preservar identidade familiar e manutenção dos vínculos afetivos. As interações permeadas por trocas afetivas foram vistas, como tendo indícios de empatia pelas crianças, mesmo as bem novas, sendo uma questão conceitual a ser explorada em futuros estudos. Pontua-se que tais interações e práticas de cuidados não devem substituir os cuidados dos adultos. A mediação pelo adulto é fundamental e deve ser implementada, inclusive considerando a questão da organização das crianças e sua localização dentro do ambiente de acolhimento / Interactions of babies with adults in collective contexts have been prioritized by most research literature. In institutional care of vulnerable babies, researches are immersed in invisibility. The relationship that features the human being is present even in the baby. Our work hypothesis is that babies interactions could be great effective when occur with children. In that context, employees are oriented not to attach to the babies and pay little attention due to work overload. The objective was to investigate the occurrences of care actions within the interaction of children and babies in an institutional host situation. The research was based on the Network of Meanings, historical, and cultural perspectives. The study was carried out in a care institution in the interior of Mato Grosso do Sul, from which two focal babies - Caio and Ana (seven and ten months old) - were selected, without any relationship between them. In addition, children who were also welcomed in the care institution and the researcher herself participated. For six months, thirty minutes of each 47 video were recorded, three months with each of two focal babies. Also, semi-structured interviews were conducted with employees of the institution, and a kind of logbook was also written to better understanding institutional dynamics. The notion of care was based on the Heidegger concepts - Care for Occupation (based on tasks) and Care for Concern (based on Being With). Care for worry had several tones: Attention, Solicitude, Worry, that is how heading towards the baby, when it was alone or crying, and protect or help it in dangerous situations. At the analysis, many interactions of the children were verified, most concentrated in jokes. With regard to the care practices, there was a great occurrence in the interactions of the children with the babies and even in the babies interaction involving the three shades above. Care was largely of reciprocal interactions, dyadic and commonly made feasible by older children (multistage). Partners who offered differentiated care were the most affectionate and sought after by baby. Although the care was more offered by girls, this study showed that boys also care. In Ana\'s case, interactions did not involve children with a degree of kinship, unlike the case of Caio, who was taken care of by her sister. It is discussed the importance of establishing relationships in that context, particularly in sibling groups, so that they can preserve family identity and maintain affective bonds. Interactions permeated by affective exchanges were seen as having signs of empathy for children, even the new ones, being a conceptual issue to be explored in future studies. It is pointed out that such interactions and caring practices should not replace the care of adults. Mediation by the adult is fundamental and should be implemented, including considering the issue of the organization of children and their location within the care environment

This study seeks the views of care workers working with older people about what impact social support resources has on the living conditions of older people. Social support was conceptualised in the study as support received from family members or close friends of the older people. Care workers were asked to share their views about social support for older people receiving care support in institutional setting or receiving home-based support services. This qualitative investigation involved eight care workers working with older people in Sweden. It has been argued in the study that care workers proving support for older people could have useful information about the social support of older people because they would have witnessed interactions between older people and their immediate network members. Qualitative interviews were conducted with eight care workers providing care support in institutions and home-based to explore their perspectives on the impact of social support on older people. Data from the interviews were analysed using thematic analysis. It was revealed from the views of care workers that both family and friends were engaged in different ways to provide support for older people, although not at all times. Managing loneliness, satisfaction with life and feeling better about themselves emerged as the ways social support impacted on the living conditions of older people. The care workers highlighted certain activities or areas that could ensure continuity of social support for older people. These included family members having regular contact with older people, older people acknowledging the need for support. Implications of the study for the practice of care for older people were highlighted.

Orientador: Carlos Magno Castelo Branco Fortaleza / Banca: Antônio Carlos Campos Pignatari / Banca: Rosely Moralez de Figueiredo / Resumo: O aumento recente da incidência e gravidade de Staphylococcus aureus tem suscitado diversos estudos abordando sua epidemiologia em instituições fechadas. Isolados de S. aureus resistentes à meticilina (methicillin resistant S. aureus, MRSA) são agentes comuns de infecção em hospitais. Nos últimos anos, a atenção dos epidemiologistas e clínicos tem se voltado aos MRSA de origem comunitária, associados a infecções graves de pele e trato respiratório. Nesse contexto, as Casas de repouso representam espaços de especial interesse, já que são instituições intermediárias entre a comunidade e os serviços de saúde. Não há dados sobre prevalência de S. aureus e MRSA em Casas de repouso no Brasil, um país onde somente 0,8% da população idosa são institucionalizadas. O presente estudo teve delineamento transversal e objetivou identificar a prevalência e fatores de risco para colonização por S. aureus como um todo e MRSA em particular. Foram incluídos 300 idosos vivendo em Casas de repouso no município de Bauru (SP). A colonização foi analisada através de coleta de swabs nasais dos sujeitos da pesquisa. Estes foram cultivados, e nos casos de isolamento de S. aureus, foi realizada a caracterização molecular da resistência à meticilina. Adicionalmente, os isolados de MRSA foram submetidos à genotipagem por Pulsed-Field Gel Electrophoresis (PFGE). Para análises de fatores de risco, foram levantados os prontuários dos sujeitos de pesquisa. Dados demográficos, internações, procedimentos e uso de antimicrobianos foram identificados. Análises univariadas e multivariadas (regressão logística) foram aplicadas. As prevalências identificadas para S. aureus e MRSA foram 17,7% e 3,7%, respectivamente. A idade avançada e a internação recente em hospitais foram preditores independentes para colonização por S. aureus como um todo. Os fatores associados à colonização por MRSA foram à residência em instituições de ... / Abstract: The recent increase in the incidence and severity of Staphylococcus aureus gave rise to many studies on its epidemiology in closed institutions. Isolates of methicillin-resistant Staphylococcus aureus (MRSA) are usual agents of infection in hospitals. In recent years, the attention of epidemiologists and clinicians has turned to MRSA of community origin, associated with severe infections of skin and respiratory tract. In this context, nursing homes represent areas of special interest, since they are intermediary institutions between the community and health services. No data on the prevalence of S. aureus and MRSA in nursing homes in Brazil, a country where only 0.8% of the elderly population is institutionalized. This cross-sectional study aimed to identify the prevalence and risk factors for colonization by S. aureus as a whole and MRSA in particular. We enrolled 300 elderly living in nursing homes in the city of Bauru, São Paulo State, Brazil. Colonization was analyzed by collecting nasal swabs of research subjects. Whenever S. aureus was isolated, we performed molecular characterization of methicillin resistance. Additionally, MRSA isolates underwent genotyping by pulsed-field gel electrophoresis (PFGE). For analysis of risk factors, we reviewed the charts of research subjects. Demographics, hospitalizations, procedures and uses of antimicrobials were identified. Univariate and multivariate (logistic regression) were applied. The prevalence identified for S. aureus and MRSA were 17.7% and 3.7%, respectively. Old age and recent hospitalization in hospitals were independent predictors of colonization with S. aureus as a whole, while small or medium-sized facilities and recent hospital admission were associated with carriage of MRSA. In the molecular analysis of 11 MRSA isolates, six were identified as carriers of chromosome cassette SCCmec type II (typically hospital), and two as carriers of SCCmec IV (associated with the community). ... / Mestre

Orientador: Regina Célia Popim / Banca: Silvia Cristina Mangini Bocchi / Banca: Stael Silvana Bano Eleutério da Silva / Resumo: O envelhecimento da população tem se tornando um dos maiores desafios das últimas décadas, principalmente no que diz respeito à saúde pública, em países em desenvolvimento, como o Brasil. Objetivou se avaliar a qualidade de vida, saúde mental, autonomia funcional, risco de quedas de idosos que frequentam as Unidades Saúde da Família na cidade de Nova Campina. Trata-se de um estudo transversal descritivo, no qual foram aplicados instrumentos de avaliação geriátrica, validados para a população idosa, em 250 indivíduos cadastrados nos serviços de saúde do município. A análise revelou que as mulheres foram a maioria e com maior fragilidade. Mesmo os idosos referindo uma ou mais doenças consideram seu estado de saúde bom. O impedimento físico não alterou suas atividades básicas da vida diária, mas houve interferência significativa nas atividades instrumentais. A saúde mental apresentou-se preservada, o escore diminuído deveu-se ao fato da baixa escolaridade, não caracterizando distúrbio. Sentem-se felizes com a vida que vivem. Sinalizo que foi fator protetor para saúde mental, morar com algum familiar e viver em sua própria casa. Em relação marcha e equilíbrio observou-se que os idosos conseguem se movimentar livremente, chamando atenção para as mulheres que apresentaram maior lentidão na execução dos testes, em especial Time Up and Go, não apresentando riscos acentuados para quedas. A maioria referiu ter sofrido queda no ultimo ano e 14,94% sofreu fratura, em especial as mulheres. Os dados analisados possibilitaram identificar a condição real de saúde desses indivíduos inseridos na comunidade. Chama atenção para a importância de se implantar políticas municipais que garanta o acesso aos serviços de saúde, bem como ações de cuidados integrais, de acordo com as demandas de cada indivíduo, nas suas necessidades comprometidas. Atenção especial deve se dar ... / Abstract: The aging of the population is becoming one of the biggest challenges in decades, particularly with regard to public health in developing countries like Brazil. Aimed to evaluate the quality of life, mental health, functional autonomy , risk of falls in patients attending Family Health Units in the City of New Campina. This is a descriptive cross-sectional study in which geriatric assessment instruments validated for the elderly population , in 250 enrolled in health services in the municipality individuals were applied. The analysis revealed that women were the majority and more fragile. Even the elderly referring to one or more diseases consider their health good. The physical impairment did not alter their basic activities of daily life, but there was significant interference in instrumental activities. Mental health was preserved, the score decreased was due to the fact of low education level, featuring disorder. Are happy with the life you live. I signal that was a protective factor for mental health, living with a family and live in your own home. In relation gait and balance it was observed that the elderly can move freely, calling attention to the women who had greater slowdown in the execution of tests, in particular Time Up and Go, showing no pronounced risks for falls. The majority reported having been dropped in the past year and 14.94 % suffered fractures, particularly women. The data analyzed possible to identify the actual health status of these individuals within the community. Calls attention to the importance of implementing municipal policies that ensure access to health services as well as comprehensive care actions, according to the demands of each individual in their needs compromised. Special attention should be given to professional training, on the topic aging and quality of life of persons assisted, especially the elderly. Also draws attention to the trainers of health bodies to this issue of elder ... / Mestre

As práticas de assistência às crianças e aos adolescentes alijados do convívio familiar de origem, resultantes de diferentes processos históricos e sociais, culminaram nos atuais programas sociais de proteção integral, dentre eles, os serviços de acolhimento institucional (abrigos). Partindo de perspectiva que entende o desenvolvimento humano como se dando nas inerentes relações estabelecidas com o outro e ambiente, aquelas sendo mediadas pela linguagem e engendradas num determinado contexto histórico-cultural, questionamos: como o bebê se relaciona com e nesse ambiente? Há especificidades no acolhimento e na construção de relações dessa faixa etária? Assim, a presente pesquisa propôs-se investigar como se dão as relações entre bebês, adultos e outras crianças. A meta é apreender a existência (ou não) do (re)conhecimento de pessoas e parceiros preferenciais; e, se ocorrem interações que envolvam trocas afetivas, com indícios de vínculos afetivos. O estudo foi realizado em cidade de médio porte do interior de São Paulo. Foram realizadas videogravações, por três meses, tendo como foco dois bebês, cujos nomes (fictícios) são Lucas (3 meses) e Luis/Guilherme (10 meses). Para apreensão das relações, foram utilizados dois métodos: uma observação sistemática, de caráter quantitativo, buscando avaliar, por meio do uso de recursos comunicativos e emocionais específicos, a ocorrência de \"orientação da atenção\", \"busca/manutenção de proximidade\" e \"trocas sociais\" com os diferentes interlocutores deste contexto; e, utilizando método de cunho qualitativo, também foram realizadas seleções e descrições de oito episódios interativos envolvendo trocas afetivas. A Rede de Significações, enquanto perspectiva teóricometodólogico, amparou o olhar para a complexidade e apreensão dos entrelaçados e múltiplos sentidos que se apresentam nas situações. A análise das relações bebê-adulto e bebê-bebê evidenciaram trocas afetivas, com carícias, brincadeiras, vocalizações e um padrão diferencial de interação. Os indícios de preferência (seletividade) e de compartilhamento sugeriram a manifestação de vínculos afetivos nesse contexto. Por outro lado, os dados também mostraram que são diversos os modos de relações estabelecidos no contexto de acolhimento institucional, dependendo tanto do perfil dos funcionários quanto das características de cada criança. Ainda que os bebês tenham demonstrado preferências e busca de proximidade, predominantemente, com funcionários, na maioria das vezes, esses não eram muito responsivos. Além dos funcionários, os próprios bebês/crianças foram outros importantes parceiros de interação e de trocas sociais, sendo, inclusive, mais responsivos aos comportamentos direcionados a eles. No entanto, no geral, devido à organização do ambiente e às conceções/normas, tais relações eram dificultadas, fragmentadas ou com ausência de objetos que mediassem suas atividades. Concluindo, os dados revelaram a ocorrência das relações envolvendo trocas afetivas, com indícios de vínculo, apesar dessas interações não serem freqüentes. Novos estudos devem aprofundar a questão, de modo a se considerar intervenções junto a essas instituições, que potencializem a qualidade das interações e a construção de vínculos, mesmo que a criança ali permaneça de forma temporária. / The assistance practices aimed to children and adolescents jettisoned from their biological family, resulted from different historical and social processes and culminated in the current diverse social programs of custody, one of which is the institutional care service. Based on a perspective that understands human development as unfolding from the inherent relationships established both with the other and the environment, the process being mediated by language and engendered in a particular historical and cultural context, we argued: how does the baby relates him/herself to and in that environment? Are there specificities of greeting, care and relationships construction regarding this age group? Considering this questions, this research aimed to investigate the forms of relationship construction between babies, adults and other children, seeking to apprehend the presence (or the absence) of the babies\' recognition of people around as well as presence (or the absence) of preferred partners, in the institutional care context. Specifically, the goal is to investigate if affective bonds are established in that context; and, in an affirmative case, investigate how they are established. The study has been carried out in a city of São Paulo. Video records were made during three months, focusing on two babies with the following ages and fictional names: Lucas (3 months); Luis/Guilherme (10 months). To grasp the relationships, we used two methods: a systematic observation (quantitative) seeking to evaluate, through the infant\'s use of specific emotional and communicative means, the occurrence of \"orientation of attention\", \"search/maintenance of proximity\" and \"social exchanges\" with different interlocutors in this context; and, by using a qualitative method, it was also performed selections and descriptions of eight interactive episodes involving emotional exchanges. The Network of meanings was the theoreticalmethodological support, which helped at analyzing the interwoven multiple meanings and at their complexity on the situation. Analysis of the infant-adult and infant-infant/children relations revealed the presence of emotional exchanges, constituted by caresses, games, vocalizations and a differential pattern of interaction. Evidence of preference (selectivity) and of sharing activities made unmistakable the manifestations of affective ties in this context. Moreover, data also showed that there are several modes of relationships established within the institutional care context, depending on the profile of both employees and the characteristics of each child. Although babies have shown preferences and proximity search, predominantly with employees, in most cases, adults were not highly responsive. In addition to employees, the other babies / toddlers were other important partners of interaction and social exchange, even being the most responsive to behaviors directed at them. However, in general, due to the organization\'s environment and conceptions, such relationships were hindered, fragmented or unfolding with the absence of objects that could mediate their activities. Finally, the data revealed the occurrence of relations involving emotional exchanges with evidence of linkage, although these interactions did not happen frequently. Further studies should examine the issue in order to consider interventions with these institutions to leverage the quality of interactions and bond constructions, even if the child stays there temporarily.