Serum Uric Acid Level and Its Influencing Factors in Patients with Diabetes Insipidus / 中国医学科学院学报

Objective To investigate the level of serum uric acid in patients with diabetes insipidus (DI),summarize the clinical characteristics of central diabetes insipidus (CDI) patients with hyperuricemia (HUA),and analyze the factors affecting the level of serum uric acid in the patients with CDI. Methods The clinical data of DI patients admitted to Peking Union Medical College Hospital from 2018 to 2021 were retrospectively analyzed.The patients were assigned into a child and adolescent group (≤ 18 years old) and an adult group (>18 years old) according to their ages.The demographic and biochemical data between two groups of patients with and without HUA were compared.Spearman correlation analysis and multiple linear regression analysis were performed to analyze the correlations between serum uric acid level and other factors. Results Among the 420 DI patients,411 patients had CDI (97.9%),including 189 patients with HUA (46.0%).Thirteen (6.9%) out of the 189 CDI patients with HUA presented the disappearance of thirst.The prevalence of HUA in children and adolescents was higher than that in adults (χ2=4.193,P=0.041).The level of serum uric acid in the CDI patients with HUA and disappearance of thirst was higher than those without disappearance of thirst (U=2.593,P=0.010).The multiple linear regression predicted serum creatinine (β=0.472,95%CI=2.451-4.381,P<0.001) and body mass index (β=0.387,95%CI=6.18-12.874,P<0.001) as the independent risk factors of serum uric acid level increment in children and adolescents,while serum creatinine (β=0.361,95%CI=1.016-1.785,P<0.001),body mass index (β=0.208,95%CI=2.321-6.702,P<0.001),triglyceride (β=0.268,95%CI=12.936-28.840,P<0.001),and total cholesterol (β=0.129,95%CI=2.708-22.250,P=0.013) were the independent risk factors in adults. Conclusions The patients with CDI were more likely to have HUA,and the prevalence of HUA in children and adolescents was higher than that in adults.Body mass index,serum creatinine,triglyceride,total cholesterol,and disappearance of thirst were the risk factors for the increased level of serum uric acid in CDI patients.

Pensando os efeitos subjetivos das medidas socioeducativas: indiferença, crítica e ressignificação / Thinking about the subjective effects of socio-educational measures: indifference, criticism and re-meaning / Pensando en los efectos subjetivos de las medidas socioeducativas: indiferencia, crítica y re-significado

Mais de três décadas do Estatuto da Criança e do Adolescente mostram importantes princípios éticos norteadores de políticas públicas e apontam desafios que abrem novos horizontes de reflexão e aperfeiçoamento. Este trabalho apresenta resultados parciais de uma pesquisa transdisciplinar e tem como objetivo analisar os possíveis efeitos subjetivos do atendimento socioeducativo a adolescentes autores de ato infracional. Foi realizada uma pesquisa documental, a partir de 373 PIAs e, posteriormente, foram localizados 14 desses adolescentes, que compartilharam conosco suas histórias de vida, a partir do método das narrativas memorialísticas, e responderam a um questionário acerca de suas trajetórias. Como resultado, encontramos indiferença, crítica e ressignificação como possíveis efeitos subjetivos das medidas socioeducativas. Concluímos que a trajetória infracional é sobredeterminada, demonstrando que a abertura a elementos contingentes na oferta do serviço socioeducativo pode ter ressonâncias emancipatórias

More than three decades of the Child and Adolescent Statute show important ethical principles guiding public policies and point out challenges that open new horizons for reflection and improvement. This work presents partial results of a transdisciplinary research and aims to analyze the possible subjective effects of socio-educational assistance to adolescents who have committed an infraction. A documentary research was carried out, from 373 PIAs and, subse-quently, 14 of these adolescents were found, who shared their life stories with us, using the Memorialistic Narratives method, and answered a questionnaire about their trajectories. As a result, we find indifference, criticism and reframing as possible subjective effects of socio-educational measures. We conclude that the infraction trajectory is overdetermined, demonstrating that the opening to contingent elements in the provision of the socio-educational service can have emancipatory resonances

Más de tres décadas del Estatuto de la Niñez y la Adolescencia muestran importantes principios éticos que orientan las políticas públicas y señalan desafíos que abren nuevos horizontes para la reflexión y la superación. Este trabajo presenta resultados parciales de una investigación transdisciplinaria y tiene como objetivo analizar los posibles efectos subjetivos de la asistencia socioeducativa a adolescentes autores de una infracción. Se realizó una investigación documental, a partir de 373 PIA y, posteriormente, se encontraron 14 de estos adolescentes, quienes compartieron con nosotros sus historias de vida, utilizando el método de Narrativas Memorialistas, y respondieron un cuestionario sobre sus trayectorias Como resultado, encontramos la indiferencia, la crítica y el replanteamiento como posibles efectos subjetivos de las medidas socioeducativas. Concluimos que la trayectoria de la infracción está sobredeterminada, demostrando que la apertura a elementos contingentes en la prestación del servicio socioeducativo puede tener resonancias emancipatorias

Estratégias para a Escuta Especializada de vítimas de violência sexual em redes intersetoriais* / Strategies for the specialized interview for sexual abuse victims with in intersectoral networks

Resumo: Este artigo se embasa em dados obtidos com pesquisas (documental e de campo), realizadas entre 2018 e 2021, para demonstrar os percursos e os desafios para a definição de estratégias, visando orientar a realização de entrevista de Escuta Especializada para o atendimento de crianças e adolescentes vítimas de violência sexual no âmbito das experiências de duas redes intersetoriais de políticas públicas, organizadas nos municípios de Cascavel (REDE) e Toledo (RIPS), situados na região oeste do Paraná.

Abstract: This article is based on data got by researchers (documental and field), realized between 2018 and 2021 to show the way and challenges to the definition of strategies with visits and to guide the realization of Especialized Interview to attendance of sexual violence children in a experiences scope of two intersetorial networks of public polices, organized on counties of Cascavel (REDE) and Toledo (RIPS), located of west of Parana.

Narratives of Photographic Records of the Practices of Social Educators of a Residential Group Home for Children and Adolescents / Narrativas dos Registros Fotográficos das Práticas de Educadores Sociais de uma Instituição de Acolhimento para Crianças e Adolescentes / Narrativas de los Registros Fotográficos de las Prácticas de Educadores Sociales en una Institución de Acogida para Niños y Adolescentes

Abstract The social educator offers a set of practices aimed at children/adolescents in institutional care. This study aimed to analyze the practices of social educators based on narratives of photographic records in a residential group homes for children and adolescents in the Southern Brazil. Ten adults participated. Photographic recording and narrative interview script were used and analyzed based on the acquired data. The care provided surpassed the assistance for basic needs, a relevant aspect for practices carried out in a humanized and comprehensive manner. Favorable conditions were identified for the expression of play through creativity, and recognition of life history and aspects of development. The results indicated involvement in care, and this can strengthen continuing education strategies in line with current public policies.

Resumo O educador social oferece um conjunto de práticas direcionadas para crianças/adolescentes na situação de acolhimento institucional. O presente estudo teve como objetivo analisar as práticas de educadores sociais provenientes das narrativas dos registros fotográficos numa instituição de acolhimento para crianças e adolescentes no Sul do Brasil. Participaram 10 adultos, e utilizou-se a técnica do registro fotográfico e roteiro de entrevista narrativa, que foram analisadas por meio da teoria fundamentada nos dados. O cuidado proporcionado superou a assistência às necessidades básicas, aspecto relevante para práticas realizadas de maneira humanizada e integral. Foram identificadas condições propícias para a expressão do brincar por meio da criatividade, e reconhecimento da história de vida e aspectos do desenvolvimento. Os resultados indicaram envolvimento no cuidado e isto pode fortalecer as estratégias de formação continuada congruentes com as políticas públicas vigentes.

Resumen El educador social cuenta con un conjunto de prácticas dirigidas a niños/adolescentes en acogimiento institucional. El presente estudio tuvo como objetivo analizar las prácticas de los educadores sociales a partir de las narrativas de registros fotográficos en una institución de acogida para niños y adolescentes en el Sur de Brasil. Participaron diez adultos, y se utilizó la técnica de registro fotográfico y guion narrativo de entrevista, la cual fue analizada a partir de la teoría fundamentada en los datos. La atención brindada superó la asistencia a las necesidades básicas, aspecto relevante para las prácticas realizadas de manera humanizada e integral. Se identificaron condiciones favorables para la expresión del juego a través de la creatividad, y el reconocimiento de la historia de vida y aspectos del desarrollo. Los resultados indicaron involucramiento en el cuidado, lo que puede fortalecer estrategias de educación permanente coherentes con las políticas públicas vigentes.

The financial estimation of fluoride application coverage for children and adolescents / 대한구강보건학회지

OBJECTIVES: This study aimed to estimate the financial budget of fluoride application in the National Health Insurance.METHODS: The amount of fluoride application was calculated by using the sealant rate (utilization rate 1), dental examination rate (utilization rate 2), and the average rate of these two (utilization rate 3) in children and adolescents. For the next five years, 100% of the existing fees were applied to estimate the financial budget.RESULTS: The total budget for children and adolescents was estimated to be 22.0 billion won minimum and 83.5 billion won maximum in the first year, and 104.8 billion won minimum and 398.5 billion won maximum up to the next five years. Moreover, in high risk groups, the total budget was estimated to be 4.2 billion won minimum and 16.1 billion won maximum in the first year, and 18.6 billion won minimum and 70.8 billion won maximum up to the next five years.CONCLUSIONS: The financial budget of fluoride application coverage for children and adolescents was similar or lower than that of the current dental sealants. It needs to implement promptly with the reason of financial saving over the long-term point of view. Based on this evidence, it is affordable and necessary to begin to promote oral health for children and adolescents.

Clinical analysis of differentiated thyroid carcinoma in children and adolescent: 75 cases / 中华内分泌外科杂志

Objective To investigate the clinical characters and treatment strategies of differentiated thyroid carcinoma in children and adolescent.Methods The clinical data of 75 cases of thyroid carcinoma in children and adolescents(≤ 18 years old)from Jan.2004 to Mar.2017 in the First Hospital of China Medical University were retrospectively analyzed.Clinical pathology characters and prognosis between patients ＜13 years old (group A) and those ≥ 13 years old (group B) were compared.Results There were 74 cases with papillary carcinoma and 1 with follicular carcinoma.The rate of lateral neck lymph node metastasis(100％ vs 54.5％,x2=6.818,P=0.025) and bilateral location (55.6％ vs 18.2％,x2=6.311,P=0.037) in group A were higher than in group B.There were no significant differences in central lymph nodes metastasis (88.9％ vs 69.7％,x2=1.758,P=0.420),gender composition ratio (22.2％ vs 31.8％,x2=0.343,P=0.841),extra-thyroid extension (33.3％ vs 18.2％,x2=1.136,P=0.534),distant metastasis(11.1％ vs 1.5％,x2=2.810,P=0.566) and recurrent disease(25％ vs 7.8％,x2=1.141,P=0.183) between the two groups.Conclusions Papillary carcinoma is the most common pathology type in children and adolescent thyroid carcinoma.Patients＜13 years old are more likely to present lateral neck lymph node metastasis and bilateral location.

Ultrasonographic characteristics of the follicular variant of papillary thyroid cancer in children and adolescents / 中华内分泌外科杂志

Objective To compare the sonographic features as well as clinical histopathological features of follicular variant papillary thyroid carcinoma(FVPTC) and conventional papillary thyroid carcinoma (CPTC) in pediatric patients.Methods From Jan.2006 to Dec.2017,26 FVPTC patients and 82 CPTC patients were enrolled in this study.The clinical histopathological findings and the sonographic features were compared between the two groups.FVPTCs and CPTCs were divided into PTC-like and follicular neoplasm(FN)-like based on sonographic characteristics.Results The mean nodule size of FVPTCs was larger than that of conventional PTCs.Extrathyroid invasion and cervical lymph node metastasis did not have significant difference between CPTC and FVPTC patients(53.8％ vs 62.2％ and 76.9％ vs 82.9％,respectively).Multiple nodules(P=0.000)and distant pulmonary metastases(P=0.024) were more frequent in CPTCs than in FVPTCs(P＜0.05).The rate of an ill-defined margin (P=0.000) and calcification (P=0.003)in terms of sonographic features were lower in FVPTCs than conventional PTCs(P＜0.05).A Ⅴ+Ⅵ diagnosis of PTC on FNAC of FVPTCs was less common than that of conventional PTCs (P=0.014).Multifocality(P=0.000),extrathyroidal invasion (P=0.000),and lymph node metastasis (P=0.000) were significantly different between PTC-like FVPTCs and FN-like FVPTCs.Conclusion FVPTC in children and adolescents shows a relatively larger size,more benign sonographic features,and a lower diagnostic rate of PTC by FNAC compared with conventional PTCs in pediatric patients.

A criança em Instituições de Acolhimento: o que dizem as pesquisas científicas / he child in Foster Institutions: what scientific research says / El niño en instituciones de acogida: lo que dicen las investigaciones científicas

Este artigo é um estudo exploratório que tem como principal objetivo refletir sobre as pesquisas com crianças em Instituições de Acolhimento. Para isso, realizou-se um levantamento da produção científica brasileira sobre infância e instituições de abrigo cadastrada no banco de dados do Scielo, a partir dos descritores "infância", "criança", "instituição de acolhimento" e "abrigo", publicada no Brasil no período de 2010 a 2015. Com referência nos estudos da sociologia da infância, de autores como Corsaro, Qvortrup e Sarmento, buscou-se fazer uma análise crítica acerca de produções a respeito do tema instituição de acolhimento compreendendo a importância de uma discussão e reflexão acerca da institucionalização da criança (AU).

The child in Foster Institutions: What scientific research says. This article is an exploraty study that has as main objective to reflect about researches with children who live in institutional shelter. For such, a survey of Brazilian scientific production on childhood and foster institution was carried out in the Scielo database, using the descriptors "childhood", "child", "foster institution" and "shelter", published in Brazil in the period from 2010 to 2015. With reference in the studies of the sociology of childhood, authors such as Corsaro, Qvortrup and Sarmento, it was sought to make a critical analysis about productions on the topic of shelters, understanding the importance of a discussion and reflection about the practice of sheltering children (AU).

El niño en instituciones de acogida: Lo que dicen las investigaciones científicas. Este artículo es un estudio exploratorio que tiene como principal objetivo reflexionar sobre las investigaciones con niños en Instituciones de Acogida. Para eso, se realizó un levantamiento de la producción científica brasileña sobre infancia e instituciones de abrigo registrada en el Banco de Datos del Scielo, a partir de los descriptores "infancia", "niño", "institución de acohida" y "abrigo", publicada en Brasil En el período de 2010 a 2015. Con referencia en los estudios de la sociología de la infancia, de autores como Corsaro, Qvortrup y Sarmento, se buscó hacer un análisis crítico acerca de producciones acerca del tema abrigos, comprendiendo la importancia de una discusión y reflexión acerca de la institucionalización del niño (AU).

Violência Juvenil e Medidas Socioeducativas: Revisão de Literatura / Juvenile Crime and Socio-educational Measures: A Literature Review

RESUMO Neste artigo, partindo do objetivo de compreender a relação entre violência juvenil e a resposta do Estado através das medidas socioeducativas, buscamos explicitar o pano de fundo das pesquisas científicas atuais. Realizamos uma meta-análise dos artigos publicados sobre adolescência e medidas socioeducativas, no campo da psicologia, entre os anos de 2000 e 2012. Concluímos que essa produção nacional pode ser reunida em três grandes categorias: (a) prático-experiencial, que apresenta relatos analíticos da prática na aplicação das medidas socioeducativas, privilegiando a experiência concreta; (b) político-institucional, que discute criticamente a dimensão política da lógica socioeducativa, detendo-se na análise estrutural de sua legislação e de suas instituições; (c) sociocultural, que analisa os determinantes sociais e psíquicos do fenômeno da violência juvenil.

ABSTRACT In this article, which assumes as its main goal to contribute to the understanding of the relationship between juvenile crime and the response of the state through socio-educational measures, we tried to explain the background of current scientific research. We performed a meta-analysis of Brazilian articles on juvenile crime and socio-educational measures in the field of psychology published between 2000 and 2012. We concluded that articles can be divided in three broad categories: (a) practical-experiential, presenting experience reports or technical difficulties in implementing measures, emphasizing concrete experience; (b) political-institutional, discussing critically the political dimension of the logic behind social-educational measures, focusing on a structural analysis of their laws and institutions; (c) sociocultural, analyzing the social and psychological determinants of the phenomenon of juvenile violence.

Cutoff Waist?to?height and Waist?to?hip Ratios for Metabolic Syndrome in Chinese Children and Adolescents / 中国医科大学学报

Objective This study aimed to identify high?risk groups for metabolic syndrome(MS)among Chinese children and adolescents by calculating the cutoff values of adiposity measures and insulin resistance(IR). Methods From December 2010 to January 2011,data from 933 Chinese subjects(492 boys and 436 girls,aged 11?16 years)from Liaoyang City,China,were included. Questionnaires were administered,and da?ta such as anthropometric parameters(height,waist circumference,and hip circumference),blood pressure,fasting blood glucose level,blood lip?id level,serum uric acid level,and fasting insulin level were collected. Receiver?operating characteristic(ROC)curve analysis was used to deter?mine the optimal cutoff waist?to?height ratio(WHtR),waist?to?hip ratio(WHR),homeostasis model assessment?insulin resistance(HOMA?IR) index,triglyceride level,glucose index(TyG index),and serum uric acid(SUA)level for identification of children and adolescents with MS. Results The AUC of WHtR,WHR,TyG index,HOMA?IR index,and SUA level were larger than 0.5,with P values of<0.01. The optimal cutoff WHtR and WHR derived from the ROC analysis were respectively 0.48(87.0%,84.1%)and 0.84(83.3%,70.3%)for boys and 0.46(95.1%, 81.8%)and 0.80(90.5%,71.8%)for girls. Conclusion This study demonstrated that WHtR and WHR are useful predictive markers of MS , while HOMA?IR,TyG index,and SUA level are not. The usefulness of these criteria needs to be verified by further evaluation.

Association of hypertriglyceridemic-waist phenotype with liver enzymes and cardiometabolic risk factors in adolescents: the CASPIAN-III study / Associação do fenótipo de cintura hipertrigliceridêmica com enzimas hepáticas e fatores de risco cardiometabólico em adolescentes: o estudo CASPIAN-III

Abstract Objective This study aims to investigate the role of metabolic syndrome (MetS) and the hypertriglyceridemic-waist (HW) phenotype in determining cardiometabolic risk factors and elevated liver enzymes in a national sample of Iranian pediatric population. Method This nationwide study was conducted in the framework of the third survey of a surveillance program. Students, aged 10-18 years, were recruited from 27 provinces in Iran. The prevalence of cardiometabolic risk factors was compared in students with and without HW and MetS. The association of HW with different cardiometabolic risk factors was determined. Results The mean age of studied population was 14.73 ± 2.41 years. Prevalence of HW and MetS was 3.3% and 4%, respectively. Sixty-nine (71.1%) participants with HW had MetS. The prevalence of obesity, elevated systolic blood pressure, hypercholesterolemia, and elevated alanine aminotransaminase (ALT) was significantly higher in subjects with HW phenotype and MetS than in their peers (p < 0.05). A significant association was observed between HW and elevated levels of cholesterol and ALT, as well as between obesity and low HDL-C (p < 0.05). Conclusions The current findings serve as complementary evidence to previous studies, which have been mainly conducted among adults, suggesting that the HW phenotype is associated with cardiometabolic risk factors, especially with elevated cholesterol and ALT. The authors propose that, in primary care settings and in large epidemiological studies, the measurement of all MetS components can be replaced by studying HW as a screening tool for identifying children at high risk for cardiometabolic disorders.

Resumo Objetivo Investigar o desempenho da síndrome metabólica (SM) e do fenótipo de cintura hipertrigliceridêmica (CH) na determinação de fatores de risco cardiometabólico e enzimas hepáticas elevadas em uma amostra nacional da população pediátrica iraniana. Método Estudo nacional feito na estrutura da terceira pesquisa de um programa de vigilância. Foram recrutados alunos de 10-18 anos de 27 províncias do Irã. A prevalência de fatores de risco cardiometabólico foi comparada em alunos com e sem CH e SM. Foi determinada a associação da CH com diferentes fatores de risco cardiometabólico. Resultados A média de idade da população estudada foi de 14,73 ± 2,41 anos. A prevalência de CH e SM foi de 3,3% e 4%, respectivamente; 69 (71,1%) dos participantes com CH apresentaram SM. A prevalência de obesidade, pressão arterial sistólica elevada, hipercolesterolemia e alanina aminotransferase (ALT) elevada foi significativamente maior em meninos e meninas com fenótipo CH e SM do que em seus outros pares (p < 0,05). A associação de CH foi significativa com elevados níveis de colesterol e ALT, bem como obesidade e HDL-C baixo (p < 0,05). Conclusões Os achados atuais servem de evidência complementar de estudos anteriores, conduzidos principalmente com adultos, e sugerem que o fenótipo CH está associado a fatores de risco cardiometabólico, principalmente com colesterol e ALT altos. Propomos que, em ambientes de cuidados básicos e em grandes estudos epidemiológicas, a medição de todos os componentes de SM possa ser substituída pelo estudo da CH como ferramenta de triagem para identificar crianças com alto risco de apresentarem distúrbios cardiometabólicos.

Relationship between perceived parenting style with anxiety levels and loneliness in visually impaired children and adolescents

Abstract Background Visual impairment is a risk factor for psychiatric disorders in the affected children and adolescents, but there are only a limited number of studies concerning the mental health characteristics of visually impaired children and adolescents. Objective The aim of this study was to determine levels of loneliness and anxiety in visually impaired children and adolescents, to analyze parenting style perceived by visually impaired children and adolescents, to compare those with typically controls. Methods The study included 40 children and adolescents with visually impairment and 34 control group without visual impairment. Sociodemographic data form, the UCLA loneliness scale, and the State-Trait Anxiety Inventory for Children were used in both groups. The parenting Style Scale was used to determine perceived parental attitudes. Results This study found more loneliness and trait anxiety levels in visually impaired children and adolescents compared to the control group. Authoritative parenting style was the most frequent type of parental attitude in the visually impaired group. In visual impairment group, loneliness level was higher in subgroups of authoritative and permissive-indulgent parenting style. However, level of trait anxiety was higher in authoritative parenting style subgroup compared to the control group. Discussion The results of this study showed higher loneliness and anxiety levels in visually impaired children and adolescents. Further studies are needed to determine psychopathological risks in this population.

Direitos da criança e do adolescente e maus-tratos: epidemiologia e notificação / Children's and adolescents' rights and abuse: epidemiology and notification / Derechos de los niños y del adolescente y malos tratos: epidemiología y notificación

O objetivo deste estudo é discutir criticamente estudos brasileiros sobre a temática dos maus-tratos, buscando-se melhor compreender as características da violência perpetrada contra crianças e adolescentes, assim como os desafios para sua notificação. Embora a legislação estabeleça a obrigatoriedade da proteção e garantia de direitos dessa população, dados epidemiológicos indicam altos índices de maus-tratos contra crianças e adolescentes brasileiros, especialmente relacionados à negligência e agressões físicas. Quanto às dificuldades para a notificação, os resultados evidenciam o despreparo de profissionais, receios de retaliação e desconhecimento do processo de notificação. Destaca-se a importância de investimentos em ações de prevenção à violência e de capacitação de profissionais, bem como a necessidade de uma maior articulação da rede de proteção.

The aim of this paper is to critically discuss Brazilian studies on child and adolescent maltreatment to better understand the characteristics of this violence and the challenges involved in its notification. Although legislation establishes the obligation of protection and guarantee of rights of this population, epidemiological data indicate high levels of maltreatment against Brazilian children and adolescents, especially related to neglect and physical abuse. Regarding difficulties in notification, results show professionals' unpreparedness, fears of reprisal and unawareness of notification process. The importance of investments in violence prevention and professional qualification is highlighted, as well as the need of better articulation of the protection network.

El objetivo de este trabajo es discutir críticamente estudios brasileños sobre el tema de los malos tratos, buscando mejor entender las característica de la violencia contra niños y adolescentes, así como los retos a su notificación. Aunque la ley establece la obligación de la protección y garantía de los derechos de esta población, los datos epidemiológicos indican altos niveles de malos tratos contra niños y adolescentes brasileños, sobre todo relacionados con la negligencia y el maltrato físico. Acerca de las dificultades en la notificación, los resultados muestran la falta de preparación de los profesionales, el temor a las represalias y el desconocimiento del proceso de notificación. Se destaca la importancia de inverciones en acciones de prevención de la violencia y la formación de profesionales, así como la necesidad de una mayor coordinación de la red de protección.

The Major Elements of Psychological Assessment and Intervention for Children and Adolescents after a Disaster: A Professional Delphi Preliminary Survey

OBJECTIVES: This study attempted to evaluate the usefulness and direction of development of post-traumatic assessment and interventions based on the opinions of psychiatrics and disaster and trauma-related experts using the Delphi survey technique. METHODS: In-depth individual interviews served as the pre-survey and were followed by Delphi primary and secondary surveys. Specialists in child and adolescent mental health, psychological support professionals specialized in disasters and related practitioners with experience of disasters in Korea completed a set of questionnaires and participated in focus group interviews and in-depth individual interviews on post-traumatic assessment and intervention. RESULTS: We found that the following issues have a significant impact on the interventions after disasters: the proper time of the initial interview in the event of a disaster, assessment notices, aged assessment services, mandatory enforcement measures, scale screening and treatment intervention elements, symptoms degree classification, intervention standardization, the use of a levelled program, care unit environment, and operation plan. CONCLUSION: This study proposed effective mental health intervention measures and has implications for the development of evaluation treatment protocols after disasters.

Acolhimento institucional de crianças e adolescentes em Aracaju / Shelter for children and adolescents in Aracaju - Brazil / Instituciones que albergan niños y adolescentes en Aracaju - Brasil

Este trabalho tem como objetivo apresentar e discutir pesquisas realizadas sobre a execução do acolhimento institucional de crianças e adolescentes em Aracaju, capital do estado de Sergipe (Brasil). Nas investigações analisadas foi observado que as instituições de acolhimento do município ainda não cumprem todas as diretrizes propostas pelo Estatuto da Criança e do Adolescente para esse tipo de medida protetiva, o que acarreta violação de certos direitos das crianças e adolescentes. A análise desses trabalhos revela importantes problemas na execução do acolhimento institucional, tais como: desmembramento de grupo de irmãos no momento do acolhimento, instituições que restringem o atendimento a crianças de determinada faixa etária, desarticulação da rede de proteção à infância e adolescência, significativo número de crianças e adolescentes do interior acolhidos na capital, ausência de trabalho com a família e dificuldades para efetivação do direito à convivência familiar e comunitária. Conclui-se pela necessidade de se oferecer modalidades de proteção à infância e à juventude que valorizem a família e evitem a aplicação da medida de acolhimento institucional.

This paper aims to present and discuss researches conducted on the implementation of shelters for children and adolescent in Aracaju, capital of Sergipe (Brazil). It was observed on the analyzed surveys that Aracaju's shelters still do not carry out all of the guidelines proposed by the Statute of Children and Adolescents for this type of protective measure, which results in the violation of certain rights of children and adolescents. The analysis of these studies indicates problems in the implementation of shelters, such as: dismembering of siblings' group, shelters with age restrictions, communication problems of the network who protects childhood and adolescence, a significant number of children and adolescents born in the country side but sheltered in the capital, absence of work with children and adolescence's family, difficulties in ensuring the right to live among family members and community. We concluded that it is necessary to offer other ways of protecting children and adolescents in order to value the family and avoid the adoption of protective measure of sheltering.

Este trabajo tiene como objetivo presentar y discutir investigaciones sobre instituciones que albergan niños y adolescentes en Aracaju, capital del estado de Sergipe (Brasil). En las investigaciones analizadas se observó que las instituciones de ese condado aún no cumplen con todas las directrices propuestas por el Estatuto del Niño y del Adolescente para esto tipo de medida de protección, lo que resulta en la violación de determinados derechos de los niños y adolescentes. El análisis de estos estudios revela problemas importantes en la aplicación de la atención institucional como: desmembramiento de los hermanos en el momento de alberga miento; instituciones que restringen la asistencia a los niños de un determinado grupo de edad, la desarticulación de la red de seguridad para los niños y adolescentes, un número importante de niños y adolescentes de lo interior albergados en la capital, la falta de trabajo con la familia y las dificultades para garantizar el derecho a la vida familiar y comunitaria. Se concluye la necesidad de desarrollar otras formas de protección de los niños y jóvenes que valoran la familia y evitar la aplicación de la medida de alberga miento.

Aspectos legales de la transfusión de hemoderivados en el paciente crítico pediátrico hijo de padres Testigos de Jehová, a propósito de un caso mediáticamente relevante / Legal aspects of blood-derived transfusion in a pediatric critical patient whose parents are Jehova Witness: with regard to a medically relevant case

Caso: en el mes de agosto del año 2013, se dio lugar un caso en la ciudad de Guayaquil, que llamó la atención a los medios de comunicación. Una jueza, dictaminó una orden judicial (medida cautelar) para la administración de sangre a un neonato ingresado en Unidad de Cuidados Intensivos Neonatales, que requería transfusión sanguínea urgente y que era hijo de padres que negaban la transfusión al menor de edad aduciendo motivos religiosos. Este artículo tiene como objetivos verificar fuentes sobre el caso y realizar una revisión bibliográfica sobre los fundamentos religiosos, bioéticos y legales que sustenten el evento. Para el desarrollo del mismo se realizó entrevistas tanto a la Jueza involucrada, como al procurador jurídico de la Congregación de los Testigos de Jehová del Ecuador, al Asesor Jurídico de la Jefatura de la DINAPEN (Dirección Nacional de la Policía especializada en Niños, Niñas y Adolescentes), y al Director Nacional Tutelar de la Defensoría del Pueblo del Ecuador. Este reporte de caso, además cuenta con una revisión actualizada del tema con el fin de esclarecer las condiciones en las que se debe recurrir a instancias judiciales ante la negativa de los padres de transfusión a menores de edad en condiciones críticas.

Case: in august 2013, a particular medical case called the attention of the Media in the city of Guayaquil. A Judge granted a judicial order (interim measure) for blood transfusion to a newborn child who was an inpatient in the Newborn Intensive Care Unit and needed the treatment urgently. The parents of the Child refused the blood transfusion due to their religious beliefs. The objectives of the present article are to share the interviews of the sources of the case and confirm the event. In addition, a review of the religious, bioethical and legal issues behind the event has been portrayed. Interviews to the Judge involved, the Jehovah's Witness of Ecuador Attorney, the Legal Adviser of DINAPEN (Police Specialized in Children National Management Office), and the National Tutelary Attorney of the Public Defense Office of Ecuador were performed. Furthermore, the article will set the procedure in which legal action shall be sought for the administration of blood transfusions in critical situations when parents deny a blood transfusion in children.

The defense of socio-educational internment: feature of the hygienist principles / Defesa da internação socioeducativa: aspecto do ideário higienista / La Defensa de la Internación Socio Educativa: Aspecto del Ideario Higienista

Youth violence and interventions to affront it are the focus of our scientific research. The aim of this study is evaluate the existence of the aspects contained in the justifications of hygienism judgments of teenagers who meet admission youth work. In this sense, we 21 sentences that determined the internment and its supporting materials which makes up the judicial process of teenagers that have entered the year 2010 in the Center of Socio-education II in Cascavel Paraná State. The results led us to conclude that nowadays, notwithstanding the Children and Adolescent, we are still, by judicial determination, removing the Teen Delinquency situation and closed the judicial term returning it to the same context from which it was withdrawn. Enshrined due differences in shape and time note this routing aspects of the ideology of mental hygiene and the minor doctrine.

O objetivo deste estudo foi avaliar a existência de aspectos do higienismo nas justificativas das sentenças judiciais de adolescentes que cumprem a internação socioeducativa. Foram analisadas 21 sentenças que determinaram a internação e os respectivos materiais de apoio que compõem o processo judicial de adolescentes que deram entrada no ano de 2010 no Centro de Socioeducação II de Cascavel, no Estado do Paraná. Os resultados indicaram que, na atualidade, não obstante o Estatuto da Criança e do Adolescente, continuamos, por determinação judicial, retirando o adolescente da situação de delinquência e encerrado o prazo judicial devolvendo-o para o mesmo contexto de onde foi retirado. Resguardadas as devidas diferenças de forma e de tempo, nota-se nesse encaminhamento aspectos do ideário da higiene mental e da doutrina menorista.

La violencia juvenil y las intervenciones para enfrentarla son el enfoque de esta investigación científica. El objetivo del este estudio fue evaluar la existencia de aspectos del higienismo contenidos en las justificativas de las sentencias judiciales de los adolescentes que cumplen la internación socioeducativa. Analizamos 21 sentencias que determinan la internación y los respectivos materiales de apoyo que componen los procesos judiciales de adolescentes que ingresaron en el año de 2010 en el Centro de Socioeducação II de Cascavel en el Estado de Paraná. Concluimos con los resultados alcanzados que, actualmente, pese al Estatuto del Niño y del Adolescente, seguimos por determinación judicial, retirándoles de la situación de delincuencia y, pasados los plazos judiciales, devolviéndoles para el mismo contexto de donde fueron sacados. Salvaguardadas las diferencias de forma y tiempo, notamos en estos encaminamientos aspectos del ideario de la higiene mental y de la doctrina menorista.

Acolhimento institucional na assistência à infância: o cotidiano em questão / Acogida institucional en la asistencia de la infancia: el cotidiano en cuestión / Institutional care in the assistance to childhood: the everyday in question

Tendo como referência o trabalho desenvolvido em uma instituição de acolhimento para crianças e adolescentes, este artigo reflete sobre o cotidiano desses serviços a partir da discussão sobre o lugar no discurso social em que são colocadas as crianças e suas famílias, bem como a instituição e seus agentes. A hipótese trabalhada é de que os diversos momentos cotidianos são constituídos por modelos de práticas sociais que formaram a assistência à infância - a caritativa, a filantrópica e a do Estado de bem-estar social - , cada uma atribuindo, em seu discurso, posições específicas aos envolvidos. São retomados esses modelos de assistência, de forma a evidenciar os eixos centrais pelos quais se constituem. Em seguida, é discutida essa hipótese a partir de cenas desse dia a dia, de modo a pensar como a problematização dessas posições pode permitir um outro lugar na escuta e nas práticas de psicólogos nas instituições de acolhimento institucional.

En relación con el trabajo en un centro de acogida para niños y adolescentes, este artículo reflexiona sobre la vida cotidiana de estos servicios a partir de la discusión sobre el lugar en el discurso social en el que se colocan los niños y sus familias, así como a la institución y sus agentes. La hipótesis es que los diversos momentos cotidianos son elaborados por los modelos de prácticas sociales que formaban la asistencia del infancia -caritativo, filantrópico y Estado de Bienestar Social -, asignando a cada uno, en su discurso, a los puestos específicos involucrados. Son recogido estos modelos, destacando los ejes centrales por los cuales se constituyen. A continuación, estas hipótesis son discutidas desde escenas de ese día a día, por lo que pensar lo problemático de estas posiciones puede permitir otro lugar de la escucha y la práctica de los psicólogos en las instituciones de acohida institucional.

This research brings a reflexion on daily children and adolescents care based on the work developed in an institution (shelter). It is based on the emplacement of children and their family, as well as the institution and their agents, into the social discourse. The hypothesis adopted here is that several social practices in these institutions consist on practice models that framed childhood assistance - the charitable, the philanthropic and the State of social welfare -, each one assigning specific positions to families and institutional agents. These models are recapitulated, in order to highlight the central axes for which constitute. Then, this hypothesis is discussed using information from these day-to-day events in order to consider how the questioning of these positions may allow another positioning in listening and in the practices of psychologists in institutional care institutions.

Característica de la composición corporal de agresores y víctimas de bullying / Characteristics of the body composition of aggressors and victims of bullying

El objetivo fue verificar la composición corporal de escolares agresores y víctimas de bullying. Participaron en el estudio 184 alumnos de sexo masculino con media etaria de 12,77 años pertenecientes a una escuela de enseñanza pública de la ciudad de Florianópolis, Brasil. Fueron utilizados el Cuestionario para el Estudio de Violencia entre Pares, un examen socio-métrico, observación y el somatotipo. El análisis estadístico fue realizado a través del programa SPSS versión 14.0, con nivel de significancia fijado en p<0,05. La incidencia de alumnos partícipes en bullying fue 28,3 por ciento, donde 14,1 por ciento, 4,3 por ciento y 9,8 por ciento eran víctimas, agresores/víctimas y agresores, respectivamente. En relación a la clasificación del somatotipo, las víctimas obtuvieron clasificación endomórfica mesomorfo; los agresores/víctimas como mesomorfo equilibrado; y los agresores como endomórfico mesomorfo. Se encontraron evidencias, en términos antropométricos, de que los alumnos agresores presentaron mayores índices de IMC con predominio de masa corporal magra.

The study objective was to verify the school corporal composition of bullying victims and aggressors. A total of 184 boys with an average age of 12.77 years from a public school in the city of Florianópolis took part in this study. We used the Questionnaire for the Study of the Violence among Equal, a sociometric exam, observation and the somatotype. The statistical analysis was accomplished through the program SPSS, version 14.0, with significance level of p<0.05. The incidence was 28.3 percent of students involved in bullying, being 14.1, 4.3 and 9.8 percent were victims, aggressors/victims and aggressors, respectively. In relation to classification of the somatotype the victims obtained classification as endomorphic/mesomorphic; the aggressors/victims as balanced mesomorphic; and the aggressors as endomorphic/mesomorphic. We found evidences in anthropometric terms that the aggressor boys present larger indexes of IMC with prevalence of thin corporal mass.

Aspectos institucionais na execução da medida socioeducativa de internação / Cuestiones institucionales en la aplicación de la medida socioeducativa de internamiento / Institutional aspects in the implementation of the socio-educative measure of internment

O presente estudo objetiva apresentar alguns aspectos institucionais na execução da medida socioeducativa de internação. A partir de uma abordagem qualitativa, foi realizada observação participante no Centro de Integração de Adolescentes de Planaltina (CIAP), com três jovens entre 17 e 19 anos, durante atividades da oficina de arte. Os resultados foram analisados pela análise de conteúdo construtivainterpretativa. A observação da instituição pesquisada nos permitiu concluir que apesar dos avanços ainda nos deparamos com um Estado penal-policial no que tange às políticas públicas destinadas aos adolescentes em conflito com a lei, em especial os que estão na medida socioeducativa de internação. Apesar da implantação do SINASE, o desafio maior permanece, que é garantir a proteção integral a crianças e adolescentes em risco pessoal e social e a adolescentes em conflito com a lei, e implementar o projeto de sociedade que o Estatuto da Criança e do Adolescente preconiza.

The present study aims at presenting some institutional aspects in the implementation of the socio-educative measure of internment. As from a qualitative approach, participant observation was made at the Center for Integration of Adolescents at Planaltina with three youngsters between 17 and 19 years old, during the activities of the art workshop. The results were analised by the constructive-interpretative content analysis. The observation of the researched institution allowed us to conclude that in spite of the advancements, we still face a penal-police State as far as the public policies for adolescents in conflict wih the law are concerned, specially those who are under the socio-educative measure of internment. In spite of the implementation ot the SINASE, the biggest challenge remains, i.e. to guarantee total protection for children and adolescents in social and personal risk and for adolescents in conflict with the law, and to implement the project for society that the Children and Adolescent By-Law calls for.

El presente estudio tiene por objetivo presentar algunos aspectos institucionales en la aplicación de la medida socioeducativa de internación. Desde un enfoque cualitativo se realizó la observación participante en El Centro de Integración de Adolescentes de Planaltina (CIAP). Para el análisis y la interpretación de los datos se utilizó el análisis de contenido. Los resultados señalan que pese a los avances realizados en la institución estudiada, en general, aún nos encontramos en un Estado penal-policial con respecto a las políticas públicas destinadas a los adolescentes en conflicto con la ley, especialmente a los adolescentes en medida socioeducativa de internación. Pese a la implantación del SINASE, permanece el mayor desafío de garantizar la protección integral a los niños y adolescentes en situación de riesgo social y a los adolescentes en conflicto con la ley, e implementar el proyecto de sociedad que el Estatuto del Niño y del Adolescente preconiza.