Violencia contra niños, niñas y adolescentes: actuación del odontólogo y nivel de conocimiento para la detección y atención de casos / Violence against children and adolescents: dentist´s performance and knowledge levels for case detection and care

Objetivo: Analizar el nivel de conocimiento del pro-fesional odontólogo sobre la violencia ejercida en niños, niñas y adolescentes, poniendo énfasis en la importancia de su actuación para la detección, aten-ción y derivación de potenciales casos que posibi-liten, dentro de un contexto multidisciplinario, una intervención oportuna y efectiva. Materiales y méto-dos: Se realizó una encuesta a 132 odontólogos, 123 mujeres y 9 hombres, con experiencia profesional de 2 a 43 años, profesores universitarios especialistas en odontopediatría, cursantes de carreras de espe-cialización y posgrados afines o aquellos que desa-rrollan sus actividades laborales en 2 hospitales pú-blicos de la Ciudad Autónoma de Buenos Aires aten-diendo a menores de edad. La encuesta totalizó 15 preguntas distribuidas en 3 categorías cuyos ejes te-máticos ahondaron respecto al conocimiento sobre violencia ejercida contra menores (Categoría 1), sos-pecha de un presunto maltrato infantil en la consulta (Categoría 2) y factores que condicionan la eventual derivación del caso (Categoría 3). Cada pregunta in-cluida en las 3 categorías se direccionó conforme a si el ámbito profesional del sujeto encuestado era es-pecialista/cursante de posgrado (Grupo 1) u hospi-talario (Grupo 2). Resultados: En la primera categoría se observó una significativa carencia de formación específica en la etapa de grado con un 89% para el grupo 1 y 93,75% para el grupo 2, aunque éstos úl-timos han accedido a cursos de perfeccionamiento y actividades tendientes a incrementar destrezas y aptitudes en un 71,87%, contrastando con el 24% del otro grupo. Asimismo, el 29% del grupo 1 y un 50% del grupo 2 conocían los protocolos establecidos en sus entornos profesionales. Ambos consideraron que el odontólogo no está capacitado para detectar conductas orientativas hacia posibles casos (89%, grupo 1; 87,5%, grupo 2). Para la segunda categoría, el grupo 1 respondió positivamente en un 73%, en tanto que el grupo 2 lo hizo en un 84,38%. En la ter-cera categoría se destacó para el grupo 1 un elevado porcentaje en las preguntas relacionadas al temor por parte del odontólogo de agravar las acciones Objetivo: Analizar el nivel de conocimiento del pro-fesional odontólogo sobre la violencia ejercida en niños, niñas y adolescentes, poniendo énfasis en la importancia de su actuación para la detección, aten-ción y derivación de potenciales casos que posibi-liten, dentro de un contexto multidisciplinario, una intervención oportuna y efectiva. Materiales y méto-dos: Se realizó una encuesta a 132 odontólogos, 123 mujeres y 9 hombres, con experiencia profesional de 2 a 43 años, profesores universitarios especialistas en odontopediatría, cursantes de carreras de espe-cialización y posgrados afines o aquellos que desa-rrollan sus actividades laborales en 2 hospitales pú-blicos de la Ciudad Autónoma de Buenos Aires aten-diendo a menores de edad. La encuesta totalizó 15 preguntas distribuidas en 3 categorías cuyos ejes te-máticos ahondaron respecto al conocimiento sobre violencia ejercida contra menores (Categoría 1), sos-pecha de un presunto maltrato infantil en la consulta (Categoría 2) y factores que condicionan la eventual derivación del caso (Categoría 3). Cada pregunta in-cluida en las 3 categorías se direccionó conforme a si el ámbito profesional del sujeto encuestado era es-pecialista/cursante de posgrado (Grupo 1) u hospi-talario (Grupo 2). Resultados: En la primera categoría se observó una significativa carencia de formación específica en la etapa de grado con un 89% para el grupo 1 y 93,75% para el grupo 2, aunque éstos úl-timos han accedido a cursos de perfeccionamiento y actividades tendientes a incrementar destrezas y aptitudes en un 71,87%, contrastando con el 24% del otro grupo. Asimismo, el 29% del grupo 1 y un 50% del grupo 2 conocían los protocolos establecidos en sus entornos profesionales. Ambos consideraron que el odontólogo no está capacitado para detectar conductas orientativas hacia posibles casos (89%, grupo 1; 87,5%, grupo 2). Para la segunda categoría, el grupo 1 respondió positivamente en un 73%, en tanto que el grupo 2 lo hizo en un 84,38%. En la ter-cera categoría se destacó para el grupo 1 un elevado porcentaje en las preguntas relacionadas al temor por parte del odontólogo de agravar las acciones de violencia familiar (64%) o represalias (55%) contra el niño si efectuaran la derivación. En los mismos ítems, el grupo 2 respondió con porcentajes disímiles (28,13% y 31,25%, respectivamente). Finalmente, se diferenciaron claramente los resultados en cuanto al desconocimiento de los procedimientos a seguir si amerita derivar un caso, con un 71% para el grupo 1 y un 34,38% para el grupo 2. Conclusión: Se hace imperioso instruir y capacitar al profesional odontólogo, concientizándolo sobre la necesidad de conocer la legislación vigente y los mecanismos de detección y ulterior derivación. Si bien aquellos que desempeñan su labor a nivel hospitalario aparecen como mejor preparados para actuar, existe un evidente desconocimiento general que conlleva el riesgo de no advertir o proceder inadecuadamente en casos de violencia que atenta contra la seguridad de niños, niñas y adolescentes (AU)

Objective: To analyze the level of knowledge of the dental professional about violence committed in children and adolescents, emphasizing the importance of their actions for the detection, care and referral of potential cases that allow, within a multidisciplinary context, an intervention timely and effective. Materials and methods: A survey was carried out with 132 dentists, 123 women and 9 men, with professional experience of 2 to 43 years, university professors in the specialty of pediatric dentistry, students of specialization course and related postgraduate courses or those who carry out their work activities in 2 public hospitals in the Autonomous City of Buenos Aires that care for minors. The survey included 15 questions distributed in 3 categories whose thematic axes delved into knowledge about violence committed against minors (Category 1), suspicion of alleged child abuses in the consultation (Category 2) and factors that condition the eventual referral of the case (Category 3). Each question included in the 3 categories is addressed according to whether the professional field of the surveyed subject was a specialist/graduate student (Group 1) or a hospitalist (Group 2). Results: In the first category, a significant lack of specific training is observed in the undergraduate stage with 89% for group 1 and 93.75% for group 2, although the latter have accessed courses and improvement activities aimed at to increase skills and abilities by 71.87%, in contrast to 24% in the other group. Likewise, 29% of group 1 and 50% of group 2 knew the protocols established in their professional environments. Both considered that the dentist is not trained to detect guiding behaviors towards possible cases (89%, group 1; 87.5%, group 2). For the second category, group 1 responded positively by 73%, while group 2 did so by 84.38%. In the third category, a high percentage stood out for group 1 in the questions related to the dentist's fear of aggravating the actions of family violence (64%) or retaliation (55%) against the child if he made the referral. In the same items, group 2 responded with dissimilar percentages (28.13% and 31.25%, respectively). Finally, the results were clearly differentiated in terms of lack of knowledge of the procedures to follow if a case warrants referral, with 71% for group 1 and 34.38% for group 2. Conclusion: It is imperative to instruct and train the professional dentist, raising awareness about the need to know current legislation and the detection and subsequent referral mechanisms. Although those who carry out their work at the hospital level seem to be better prepared to act, there is an evident widespread lack of knowledge that entails the risk of not announcing or acting inappropriately in cases of violence that threaten the safety of children and adolescents (AU)

Tracking demands for seeking psychological help before and during the COVID-19 pandemic: a quanti-qualitative study

Abstract The COVID-19 pandemic has placed unprecedented burdens on individuals and communities around the world. The isolation, fear, and uncertainty caused by the virus has led to increased rates of anxiety, depression, and other mental health issues. The pandemic has also had a disproportionate impact on individuals and communities with low income and socioeconomic status. Objective To shed light on the consequences of the pandemic on individuals from minorities and low-income areas, we investigate the main reasons that led patients who were referred to a social clinic of a private university in Rio de Janeiro to seek psychological treatment before (2019) and during the pandemic (2020 and 2021). Methods We conducted a quanti-qualitative study with a lexical analysis that evaluated 549 complaint forms of patients seeking treatment in these two distinct periods. Our analyses included descending hierarchical analysis (DHA) and correspondence factor analysis (CFA). Results Family dynamics and communication factors play a dominant role in the reason for seeking therapy and psychological treatment. Additionally, our study suggested an increase in anxiety and panic attacks among other mental health issues associated with griefand losses during the pandemic years. Conclusion Based on these analyses, we can begin to identify a few changes in the main demand and redirection of complaints of patients during the period of COVID-19.

Resignificando la queja escolar: contribuciones del PARQUÉ a la no medicalización de la Educación / Ressignificando a queixa escolar: contribuições do parque para a desmedicalização da educação / Resignifying the school complaint: parque's contributions to the demedicalization of education

Esta pesquisa teve como objetivo avaliar um programa de atenção e ressignificação da queixa escolar e suas contribuições para o enfrentamento da patologização e medicalização dos fenômenos escolares. O referencial teórico norteador de toda a pesquisa foi fundamentado na perspectiva histórico-cultural da Psicologia e na Psicologia Escolar Crítica. As informações foram obtidas através de entrevistas semiestruturadas individuais, realizadas com quatro professoras do Ensino Fundamental de uma escola de Educação Básica da rede federal de ensino, e analisadas por meio de análise de conteúdo temática de cunho qualitativo. Os resultados apontaram que o Programa estudado contribuiu para as participantes ampliarem a compreensão da queixa escolar, passando a reconhecer a atividade docente e as relações institucionais como constituintes dela. Os espaços coletivos de escuta e troca dialógica acerca dos desafios presentes no processo de escolarização oportunizados pelo Programa foram fundamentais para o enfrentamento da patologização e medicalização dos fenômenos escolares.

En esta investigación se tuvo por objetivo evaluar un programa de atención y resignificación de la queja escolar y sus contribuciones para el enfrentamiento de la patologización y medicalización de los fenómenos escolares. El referencial teórico orientador de toda la investigación se fundamentó en la perspectiva histórico-cultural de la Psicología y en la Psicología Escolar Crítica. Las informaciones se obtuvieron por intermedio de entrevistas semiestructuradas individuales, realizadas a cuatro profesoras de la Enseñanza Básica de una escuela de educación básica de la red federal de enseñanza, y analizadas por intermedio de análisis de contenido temático, de cuño cualitativo. Los resultados apuntaron que el Programa estudiado contribuyó para las participantes ampliar la comprensión de la queja escolar, pasando a reconocer la actividad docente y las relaciones institucionales como constituyentes de ella. Los espacios colectivos de escucha y cambio dialógico acerca de los desafíos presentes en el proceso de escolarización ofrecidos por el Programa fueron fundamentales para el enfrentamiento de la patologización y medicalización de los fenómenos escolares.

This research aimed to evaluate a program of attention and resignification of school complaints and its contributions to the confrontation of pathologization and medicalization of school phenomena. The theoretical framework guiding the entire research was based on the historical-cultural perspective of Psychology and Critical School Psychology. The information was obtained through individual semi-structured interviews, carried out with four elementary school teachers from a Basic Education school in the federal education network, and analyzed through qualitative thematic content analysis. The results showed that the Program studied contributed to the participants' broadening their understanding of school complaints, starting to recognize the teaching activity and institutional relationships as constituents of it. The collective spaces of listening and dialogic exchange about the challenges present in the schooling process provided by the Program were fundamental to face the pathologization and medicalization of school phenomena.

Analysis and discussion on the subject complaint in clinical drug trials / 中华医学科研管理杂志

Objective:By exploring the management of subject complaints by the ethics committee, to identify and correct the problems that damage the rights of subjects in clinical drug trials, in order to improve the ability of the ethics committee of protecting the rights and interests of the subjects.Methods:We conducted a retrospective analysis of 13 cases of subject complaints accepted by the Ethics Committee of Peking University People′s Hospital from January to December 2021, analyzed the causes of complaints, and proposed countermeasures and suggestions.Results:Problems exist in the subject complaints regarding the payment of compensation, investigators′ communication attitude and skills, subjects′ understanding bias, etc.Conclusions:The ethics committee should attach great importance to subject complaints, adopt a closed-loop management process, carry out hierarchical management, strict ethical review, improve the ability of continuous supervision, conduct targeted training for investigators, and provide counseling services for subjects, to improve the communication between investigators and subjects, effectively reduce and avoid the occurrence of complaints. Relevant functional departments of medical and health institutions should work together to protect the rights and interests of the subjects.

Significações de crianças sobre o futuro de educandos com queixas escolares / Meanings of children about the future of students with school complaints / Significados de los niños sobre el futuro de los alumnos con quejas escolares

Este artigo propõe-se a discutir as significações de crianças sobre o futuro de educandos com queixas escolares. Adota-se como referencial teórico-metodológico os fundamentos da Psicologia histórico-cultural edificada no materialismo histórico-dialético. Foram analisadas as enunciações de crianças de uma escola municipal, situada em Cuiabá-MT. Os procedimentos investigativos se alicerçaram no estudo do tipo etnográfico, utilizando-se da observação participante do cotidiano escolar, combinada com a realização de entrevistas, embasada no pressuposto de promoção de pesquisa com crianças e não sobre elas. Os dados revelaram uma presença significativa da dicotomia bom/mau orientando as significações de educandos(as) nas relações interperssoais estabelecidas com os pares identificados com queixas escolares, que foram objetivadas, simultaneamente, em possibilidades deles virem a ser policiais ou criminosos. Ao mesmo tempo, também sinalizaram a existência, em menor grau, de aspectos que tendem a promover rupturas em antinomias que engendram visões individualizantes dos fenômenos escolares, na medida em que práticas educativas imbuídas por valores humano-genéricos dirigidos ao processo de humanização também foram elementos incorporados em suas explicações sobre as perspectivas de futuro da "criança difícil". (AU)

This article proposes to discuss the meanings of children about the future of students with school complaints. The fundamentals of cultural-historical psychology built on historical-dialectical materialism are adopted as a theoreticalmethodological framework. The utterances of children from a public school located in Cuiabá-MT were analyzed. The investigative procedures were based on an ethnographic study, using participant observation of everyday school life, combined with interviews, based on the assumption of promoting research with children and not about them. The data revealed a significant presence of the good/bad dichotomy guiding the students' meanings in the interpersonal relationships established with peers identified with school complaints, which were objectified, simultaneously, in possibilities for them to become police officers or criminals. At the same time, they also signaled the existence, to a lesser extent, of aspects that tend to promote ruptures in antinomies that engender individualizing visions of school phenomena, insofar as educational practices embedded by human-generic values aimed at the humanization process were also incorporated elements in his explanations about the prospects for the future of the "difficult child". (AU)

Este artículo se propone discutir los significados de los niños sobre el futuro de los estudiantes con quejas escolares. Se adoptan como marco teórico-metodológico los fundamentos de la psicología histórico-cultural construida sobre el materialismo histórico-dialéctico. Se analizaron los enunciados de niños de una escuela pública ubicada en Cuiabá-MT. Los procedimientos investigativos se basan en estudios etnográficos, utilizando la observación participante del cotidiano escolar, combinado con entrevistas, partiendo del supuesto de promover la investigación con niños y no sobre ellos. Los datos revelaron una presencia significativa de la dicotomía bueno/malo que orienta los significados de los niños en las relaciones interpersonales establecidas con pares identificados con denuncias escolares, que se objetivaban, simultáneamente, en posibilidades de que se conviertan en policías o delincuentes. Al mismo tiempo, también señalan la existencia, en menor medida, de aspectos que tienden a promover rupturas de antinomias que engendran visiones individualizadoras de los fenómenos escolares, en tanto prácticas educativas inmersas en valores humano-genéricos tendientes al proceso de humanización. También se incorporaron elementos en sus explicaciones sobre las perspectivas de futuro del "niño difícil". (AU)

Analysis of complaint characteristics of the government hotline during the COVID-19 pandemic / 中华医院管理杂志

Objective:To analyze the number of appeals volume and causes for complaints received by the government hotline against a hospital in Yangzhou during the pandemic of novel coronavirus pneumonia(hereinafter referred to as COVID-19), so as to provide reference for handling such hotline complaints during pandemics.Methods:Retrospective comparative analysis was made on the " 12345" government hotline work orders received from July 28, 2020 to August 28, 2020(routine prevention and control period) and July 28, 2021 to August 28, 2021(pandemic closure and control period). A descriptive analysis was made on the cause types of complaints and the distribution of departments in question, along with an analysis of the correlation between the cumulative number of cases of pandemic development and the number of complaints using Spearman rank correlation method.Results:The number of work orders for a hospital in Yangzhou during the pandemic control period(659 cases) was 7.7 times higher than that in the routine control period(76 cases). Management problems accounted for 96.7%(637 cases) in the level-1 type of the causes of complaints during the closure and control period of the pandemic, and workflow problems accounted for 90.9%(599 cases) in the level-2 type, which increased by 28.3 and 27.7 percentage points respectively compared with the routine prevention and control period; The highest proportion in the level-3 type of causes for complaints during the closure and control period of the pandemic was administrative management, accounting for 87.9%(579 cases). The departments being complained the most during the pandemic incubation period, outbreak period and recovery period of the pandemic were the fever clinic, oncology department and discharge center respectively. The cumulative number of cases of pandemic development was positively correlated with the number of complaints.Conclusions:During the COVID-19, the handling of the government hotline should be analyzed along with the causes of complaints, focusing on patients′ demands, providing timely feedback, developing collaborative management measures, and achieving accurate policy implementation.

Hot spot analysis of outpatient complaints on medical quality and safety in a hospital / 中华医院管理杂志

Objective:To analyze the hot spots complained by outpatients in a tertiary hospital, so as to provide a basis for improving patients′ medical experience and the quality of medical service and medical safety.Methods:The data were selected from the outpatient complaint information severity of a tertiary hospital from November 1, 2020 to April 30, 2021. Complaints were classified and graded with severity. The hot spots of erious plaints and high-risk hidden events were analyzed. The database was established by double entry method. The data were analyzed with descriptive statistic, and the correlation among variants was tested by chi-square.Results:A total of 4 160 valid complaints involving 6 340 questions were included. In terms of the complaint departments and problems, clinical departments(3 682, 88.51%) and environment problems(2 451, 38.66%) accounted for the highest proportions respectively. There was a correlation between the severity of complaint and medical treatment( P<0.001). The distributions of severe complaints in each type of problems were significantly different( P<0.001). In terms of severe complaints, listening and communication(62, 26.38%)accounted for the highest proportions. A total of 161 complaints were in line with definitions of " high-risk hidden incidents" , of which environment-related problems topped the rest, accounting for 45.24%. Conclusions:Outpatient complaints of the tertiary hospital mainly focused on the admission and diagnosis sectors of clinical departments, mostly on environment, listening and communication. In the future, the hospital should focus on optimizing the outpatient environment and establish an effective doctor-patient communication mechanism for better doctor-patient relationship, to avoid occurrence of high-risk hidden events, and improve both medical service quality and safety.

CHINA PH ARMACY Volume 33，Number 4，February 28，2022 Semimonthly Table of Contents Empirical study on the influential factors of the drug complaint and reportin g system in China / 中国药房

OBJECTIVE To improve the drug complaint and reporting system in China ，and to provide reference for improving the social multi-component governance level of the drug safety. METHODS Taking Guangdong province as an example ， literature review ，questionnaire survey ，structural equation model and other methods were used to analyze influential factors of the drug complaint and reporting system ，such as “Internet+”approach，drug quality ，specialized drug knowledge ，complaint and reporting procedures ，complaint and reporting methods ，complaint and reporting motivation ，governmental reward ，administrative review or litigation. RESULTS & CONCLUSIONS A total of 3 375 questionnaires were received ，all of which were valid ；the vast majority of respondents lived in Guangdong province. The results of the empirical analysis of the influential factors of drug complaint and reporting system showed that the path coefficients of “Internet + ”approach and specialized drug knowledge ， complaint and reporting procedures ，complaint and reporting methods were all greater than 0.9，indicating“Internet+”promoted the transformation of the way and behavior of complaint and reporting. It is suggested that the design of the drug complaint and reporting system should not only attract the public to participate in drug complaint and reporting ，but also cultivate the public ’s management capacity through the approach of internet ， standardize professional anti-counterfeiting behavior ， promote the institutional reform of “digital government ”，and appropriately adjust the work responsibilities of drug regulatory department ，so as to reduce the number of drug complaint and reporting in China ，and optimize the drug safety governance system.

Memory complaints, clinical aspects, and self-esteem in adult people with epilepsy / Queixa de memória, aspectos clínicos e a autoestima em pessoas adultas com epilepsia

ABSTRACT Memory complaints are common in adult people with epilepsy (PWEs). However, the associated clinical aspects are not yet fully understood. Objective: This study aims to relate the occurrence of memory complaints in PWEs with clinical aspects and self-esteem. Methods: To relate the data obtained from the Memory Complaint Questionnaire (MAC-Q) with clinical aspects, 71 PWEs were assessed using the Rosenberg Self-Esteem Scale (SES), the Mini Mental State Examination (MMSE), and the Brief Cognitive Battery-Edu. These data were compared with 55 individuals in a control group (CG). Results: Memory complaints (MAC-Q≥25) were significantly higher in PWEs, when compared with individuals in the CG [35 (49.3%) vs. 15 (27.2%); Student's t-test; p=0.012]. Objective cognitive performance was lower in PWEs. Memory complaints were associated with a lower educational level, the presence of depression, SES, MMSE, incidental memory, and the clock-drawing test scores in PWEs. Conclusions: Memory complaints were more frequent in PWEs than in individuals in the CG, and there was a relationship with cognitive deficit, educational level, depression, and low self-esteem.

RESUMO Queixas de memória são frequentes em pessoas adultas com epilepsia (PCEs). Entretanto, os aspectos clínicos associados ainda não são totalmente compreendidos. Objetivo: Relacionar a ocorrência de queixas de memória em PCEs com aspectos clínicos e a autoestima. Métodos: Relacionar os dados do Memory Complaint Questionnaire (MAC-Q) com aspectos clínicos, a Roserberg Self-esteem Scale (SES), o MEEM e a BCB-Edu de 71 PCEs. Os dados foram comparados aos de 55 indivíduos normais (GC). Resultados: Queixa de memória (MAC-Q≥25) foi significativamente maior nos PCEs quando comparada a do GC [35 (49,3%) vs. 15 (27,2%); teste t de Student; p=0,012]. O desempenho cognitivo objetivo foi inferior nas PWEs. As queixas de memória foram associadas à menor escolaridade, presença de depressão e à SES, o MEEM, à memória incidental e o clock-drawing test nas PCEs. Conclusões: As queixas de memória foi mais frequente nas PCEs do que no GC, e houve relação com o déficit cognitivo, a escolaridade, a depressão e a baixa autoestima.

Repercussões do encaminhamento/atendimento psicológico na vida de jovens estudantes / Repercussions of referral/psychological care in the lives of young students / Repercusiones de la remisión/atención psicológica en la vida de jóvenes estudiantes

O texto tem por objetivo apresentar e discutir resultados de pesquisa que investigou as repercussões dos encaminhamentos/atendimentos psicológicos decorrentes de queixas escolares a que foram submetidos jovens residentes em Porto Velho-RO. Fundamentada em referenciais da psicologia escolar crítica, a pesquisa utilizou um roteiro de entrevista para ouvir quatro jovens com idades entre 22 e 29 anos e suas mães, transcorridos mais de 10 anos dos encaminhamentos. A análise buscou compreender a história de cada sujeito e, em seguida, os aspectos comuns a todas elas. Os resultados evidenciam o sofrimento gerado pela condição de não aprender na escola e indicam que os atendimentos recebidos foram no viés clínico, sem considerar os processos de escolarização que deram origem às queixas; demonstram, ainda, que os encaminhamentos para profissionais da saúde produziram efeitos subjetivos que não resultaram em melhorias no processo de escolarização. Ao contrário, reforçaram e contribuíram para que os sujeitos criassem visões de si mesmos piores do que aquelas que geraram os encaminhamentos. Conclui-se que compreensões mais amplas sobre os processos de não aprender na escola, incluindo a produção da escola na sociedade capitalista são imprescindíveis para a atuação crítica da psicologia nas questões escolares.

This study aims to present and discuss the results of research that investigated the repercussions of psychological referrals resulting from school complaints reported by young residents in Porto Velho, Rondônia. Based on the school psychology scientific frame, the study used an interview script to listen to four young students between the ages of 22 and 29, with more than 10 years of refer-rals, and their mothers. The analysis sought to understand each person's story and, subsequently, the common aspects to all of them. The results demonstrated the suffering generated by the non-learning condition in the school and shows that the services that were offered were clinical biased, and did not consider the schooling processes that gave rise to the complaints. The analysis also shows that referrals to health professionals produced subjective effects that did not result in improvements to the schooling process. On the contrary, they actually reinforced and contributed to the students creating worse perspectives about themselves than what the referral originally had been based on. It was concluded that broader understandings of the non-learning processes in school, including school production in a capitalist society, are indispensable for the critical action of psychology in school issues.

El texto tiene por objetivo presentar y discutir resultados de la investigación que indago las repercusiones de las remisiones/atención psicológica resultantes de quejas escolares a las que se sometieron jóvenes residentes en Porto Velho-RO. Basado en referencias de la psicología escolar crítica, la investigación utilizó un guion de entrevista para escuchar a cuatro jóvenes entre 22 y 29 años y sus madres, más de 10 años después de haber sido remitidos. El análisis buscó comprender la historia de cada sujeto y, posteriormente, los aspectos comunes entre ellas. Los resultados demuestran el sufrimiento generado por la condición de no aprender en la escuela e indican que la atención recibida fue desde el sesgo clínico, sin considerar los procesos de escolarización que dieron origen a las quejas; demostrando, además, que las remisiones para profesionales de la salud produjeron efectos subjetivos que no resultaron en mejoras en el proceso de escolarización. Al contrario, reforzaron y contribuyeron para que los sujetos crearan visiones de sí mismos peores que aquellas que generaron las remisiones. Se concluye que las comprensiones más amplias sobre los procesos de no aprender en la escuela, incluyendo la producción de la escuela en la sociedad capitalista, son imprescindibles para la actuación crítica de la psicología en las cuestiones escolares.

O discurso meritocrático nas explicações parentais de crianças com queixa escolar / Meritocratic discourse in explanations provided by parents of children with school complaints / El discurso meritocrático en las explicaciones parentales de niños con queja escolar

Resumo O artigo discute a leitura meritocrática do fracasso escolar e mapeia sua emergência no discurso de participantes de um programa de extensão universitária que atende crianças com queixa escolar. Indaga-se a dimensão social do discurso sobre dificuldades de aprendizagem explorando e comparando de que modo esta ressoa nas tramas significantes de crianças e adultos. Foram analisadas 128 fichas de inscrição onde os sujeitos assinalaram o motivo da demanda de atendimento. Com base em análise qualitativa e quantitativa (não estatística) das produções discursivas, reflete-se acerca da coconstrução dos sentidos da queixa escolar. Os resultados mostram que, diferentemente dos motivos infantis, o discurso causal dos adultos tende a ser individualizante, o que se expressa na responsabilização da criança pelo "não aprender" justificada, predominantemente, por problemas de concentração e atenção. Concluiu-se que esses dados são coerentes com a atual lógica fragmentadora oriunda do crescente fenômeno da medicalização da infância, que desloca o conflito escolar para o âmbito da saúde mental.

Abstract This paper discusses the meritocratic interpretation of school failure and maps its emergence in the discourse of participants in a university extension program that serves children with school complaints. The social dimension of the discourse about learning difficulties is explored by comparing how this resonates in the significant narratives of children and adults. A total of 128 registration forms recorded their reason for the demand of a clinical care and were subsequently analyzed. Based on a qualitative/quantitative (non-statistical) analysis of discursive expression, this paper reflects on the co-construction of meanings present in school complaints. The results show that, unlike children's motives, the causal discourse of adults tends to be individualizing, which is expressed in the child's accountability for "not learning" being justified, predominantly, by problems of concentration and attention. These data are consistent with the current fragmented logic stemming from the growing phenomenon of childhood medicalization that shifts the school conflict to the mental health field.

Resumen El artículo discute la lectura meritocrática del fracaso escolar y traza su emergencia en el discurso de participantes de un programa de extensión universitario que atiende a niños con queja escolar. Se indaga la dimensión social del discurso sobre dificultades de aprendizaje explorando y comparando de qué modo resuena en las tramas significantes de niños y adultos. Se analizaron 128 fichas de inscripción en las cuales los sujetos indicaron la razón de la demanda de atención. Con base en el análisis cualitativo y cuantitativo (no estadístico) de las producciones discursivas, se reflexiona acerca de la coconstrucción de los sentidos de la queja escolar. Los resultados muestran que, diferentemente de razones infantiles, el discurso causal de los adultos tiende a ser individualizante, lo que se expresa en la responsabilización del niño por su "no aprendizaje" justificada predominantemente por problemas de concentración y atención. Se concluye que esos datos son coherentes con la actual lógica fragmentaria que proviene del creciente fenómeno de medicalización de la infancia, que traslada el conflicto escolar para el ámbito de la salud mental.

"A s professoras falam que eu sou lenta": o autoconceito na interface educação e saúde / "The teachers say that I am slow": the self-concept in the education and health interface / "Las professoras dicen que soy lenta": el autoconcepto en la interfase educación y salud

Durante a infância a escola constitui o principal espaço social onde as habilidades e limitações individuais ficam publicamente expostas. O estigma do "déficit escolar" leva a sentimentos de fracasso, incapacidade, e a um autoconceito empobrecido. Considerando a importância dos colegas e dos educadores nesse processo de co-construção, o estudo visou indagar o papel dessas relações interpessoais em crianças com queixa escolar no contexto de um atendimento clínico. Foram analisados, qualitativamente, registros de rodas de conversa e questionários de anamnese. Os resultados evidenciaram que para as crianças resultam significativas as provocações e zoações dos pares referentes a características físicas ou da personalidade. O olhar dos educadores expressou-se em atributos e elogios sobre o desempenho acadêmico. Ambos os olhares apresentaram tonalizações de gênero. Verificou-se, ademais, a fecundidade das rodas de conversa como um dispositivo metodológico e de intervenção favorável à tomada de consciência do autoconceito e dos sentimentos atrelados à autopercepção (AU).

During childhood the school is the main social space where individual skills and limitations are publicly exposed. The stigma of "school deficit" leads to feelings of failure, incapacity, and impoverished self-concept. Considering the importance of colleagues and educators in this process of co-construction, the study aimed to investigate the role of these interpersonal relationships in children with a school complaint in the context of clinical care. Records of conversation circles and anamnesis questionnaires were qualitatively analyzed. The results showed that for children, the provocations and motions of the pairs regarding physical or personality characteristics are significant. The gaze of educators expressed themselves in attributes and praises about academic performance. Both regards presented gender shades. The fertility of the conversation circles was also verified as a methodological and intervention device favorable to the awareness of selfconcept and feelings linked to self-perception (AU)

Durante la infancia la escuela constituye el principal espacio social donde las habilidades y limitaciones individuales quedan públicamente expuestas. El estigma del "déficit escolar" lleva a sentimientos de fracaso, incapacidad, y a un autoconcepto empobrecido. Considerando la importancia de los colegas y de los educadores en ese proceso de co-construcción, el estudio indaga el papel de esas relaciones interpersonales en niños con queja escolar en el contexto de una atención clínica. Se analizaron, cualitativamente, registros de ruedas de conversación y cuestionarios de anamnesis. Los resultados evidenciaron que para los niños resultan significativas las provocaciones y burlas de los pares referentes a características físicas o de la personalidad. La mirada de los educadores se expresó en atributos y elogios sobre el desempeño académico. Ambas perspectivas presentaron tonalizaciones de género. Se verificó, además, la fecundidad de las ruedas de conversación como un dispositivo metodológico y de intervención favorable a la toma de conciencia del autoconcepto y de los sentimientos ligados a la autopercepción (AU).

Motivações e expectativas de mulheres em situação de violência no momento da denúncia em uma delegacia especializada em atendimento à mulher / Motivations and expectations of women in situations of violence when filing a complaint at a police station specialized in assistance to women / Motivaciones y expectativas de mujeres en situación de violencia en el momento de la denuncia en una comisaría especializada en atención a la mujer

O estudo busca compreender os motivos que levam as mulheres em situação de violência a buscar ajuda em uma Delegacia de Polícia Especializada de Atendimento à Mulher (DEAM) e suas expectativas após a denúncia. A coleta de dados foi realizada durante o plantão psicológico na DEAM, em uma cidade no Sul do Brasil, por meio de uma entrevista semiestruturada. Os dados de 24 acolhimentos a mulheres com idade entre 19 e 84 anos (M = 36,86; dp = 15,90) foram submetidos à análise qualitativa. O excompanheiro foi o principal agressor; e a violência psicológica e física, os principais motivos para as mulheres procurarem a delegacia. Todas buscaram a polícia na expectativa de resolutividade do serviço jurídico, principalmente com medidas de segurança. O estudo evidencia a necessidade do fortalecimento da rede de atenção social, de saúde e de justiça, auxiliando na revelação da violência e no desenvolvimento de novas perspectivas futuras após o ocorrido.

The study aims to understand the reasons that drive women in situations of violence into looking for help from a Police Station Specialized in the Assistance to Women (DEAM – in Portuguese) and the women’s expectations after filing a complaint. Data collection was carried out through a semi-structured interview during a psychological emergency attendance duty at one of these specialized police stations in a city in the South of Brazil. The data collected in 24 cases with women from 19 to 84 years (Avg = 36.86; sd = 15.90) were subjected to qualitative analysis. The former partner was appointed as the main aggressor; and psychological and physical violence were the main reasons leading the women into looking for help from a Police Station. All women looked for the DEAM with the expectation that the legal system could solve their problems, mainly through security measures. This study shows that there is a need to empower the social care, health and justice network, helping to unveil violence and develop new perspectives after the event.

El estudio busca comprender las razones que llevan a las mujeres en situación de violencia a buscar ayuda en una Comisaría Especializada en Atención a la Mujer (DEAM) y sus expectativas después de la denuncia. Los datos fueron obtenidos durante el servicio psicológico en la DEAM en una ciudad del sur de Brasil, a través de una entrevista. Las 24 mujeres del estudio, de 19 a 84 años (M = 36.86, SD = 15.90), fueron sometidas a un análisis cualitativo. El ex compañero fue nombrado como el agresor principal y la violencia psicológica y física fueron los principales motivos que llevaron a las mujeres a la DEAM. Todas las mujeres buscaron a la DEAM con la esperanza de resolver el problema, principalmente con medidas de seguridad. El estudio demuestra la necesidad de fortalecimiento de la red de atención social, salud y justicia, ayudando en la exposición de la violencia y en el desarrollo de nuevas perspectivas futuras.

Factors predicting screen time related to physical and behavioural complaints in primary school children

@#problems from extended usage of electronic devices areissues among primary school children. This study is aimedto investigate the prevalence of physical and behaviouralcomplaints arising from the electronic device usage and toidentify the potential factors that predicted the complaints.Methods: This was a primary school-based cross-sectionalstudy using multistage cluster sampling, conducted at Baudistrict in Sarawak, Malaysia in 40 primary schools. Aquestionnaire was used to collect information of usagepattern in insufficient lighting, timing and position. Thephysical and behavioural complaints were traced. Dataanalysis was performed using SPSS version 22. A p-value <0.05 with 95% CI was considered as statistically significant. Results: About 52.8% of the 569 students used digitaldevices in a bright room, 69.8% in the day time and 54.4% insitting position. The physical complaints were headache(32.9%), neck, shoulder and back pain (32.9%) followed by byeye strain (31.8%). Regarding behavioural problems, 25.7% ofthe students had loss of interest in study and outdooractivities (20.7%), skipped meals (19.0%) andarguments/disagreements with parents (17.9%). After logisticregression analysis, the lying position (OR=1.71, 95% CI:1.096, 2.688) and darkroom lighting (OR=2.323 95% CI: 1.138,4.744) appeared to be potential predictors of the complaint.Conclusion: One-quarter of the students studiedexperienced physical complaints, and one-fifth hadbehavioural problems associated with the use of electronicdevices. Lying position and darkroom lighting are thepotential predictors of complaints. Therefore, we suggestthat the children should use electronic devices in the sittingposition with adequate room lighting.

The inaudible noise: adolescence, boredom and withdrawal / O barulho inaudível: adolescência, tédio e retraimento

RESUMO: Este artigo tem como objetivo refletir acerca da não comunicação reativa - conceito desenvolvido por D. W. Winnicott, que corresponde a uma reclusão patológica. Para tanto, traz o relato do atendimento psicanalítico a um adolescente que apresentava um estado de isolamento. O artigo se reporta ao modo de funcionamento psicopatológico apresentado segundo a matriz ferencziana de adoecimento psíquico, caracterizada por Luís Claudio Figueiredo. As estratégias técnicas assinaladas baseiam-se, fundamentalmente, nos conceitos de reclamação/reivindicação da psicanalista Anne Alvarez, que postula uma abordagem mais ativa no sentido de o analista ir ao alcance do paciente, configurando, assim, uma clínica revitalizadora.

Abstract: This article aims to reflect on non-reactive communication - concept developed by D. W. Winnicott that corresponds to a pathological reclusion. For that, it brings the report of psychoanalytic care to a teenager who was in a state of isolation. The article refers to the understanding the mode of psychopathological functioning presented according to the Ferenczian matrix of psychic illness, characterized by Luís Claudio Figueiredo. The technical strategies pointed out are fundamentally based on the concepts of complaint/claim of psychoanalyst Anne Alvarez, who postulates a more active approach in the sense of the analyst reaching the patient, thus configuring a revitalizing clinic.

Escuta histórico-cultural de dificuldades de aprendizagem: multiplicidade da experiência habitada no discurso / Historical-cultural listening of learning difficulties: multiplicity of experience inhabited in discourse / Escuchar dificuldades de aprendizaje hitórico-culturales: multiplicidad de la experiência habitado em el habla

Esse artigo visa compartilhar ações realizadas frente à demanda de dificuldades de não aprendizagem escolar no aspecto de escuta e intervenção à queixa escolar, em crianças atendidas em um Serviço de Psicologia Aplicada - SPA de uma IES de Porto Velho/RO. Foram acompanhadas experimentalmente cinco crianças, ao longo do segundo semestre de 2017. O trabalho avançou ao tentar romper com o olhar de análise clínico institucionalizado e na desconstrução da queixa escolar com o sujeito, família e escola. Evidenciou-se que no discurso da queixa escolar muitos significados das tensões não possuem sentido individual e a que a consciência sobre essa relação emergiu sem laço e com desencontros no discurso anunciado.

This article aims to share actions in response to the demand for school non - learning difficulties in the aspect of listening and intervention to the school complaint, with attended children at Applied Psychology Service - SPA in Porto Velho/RO. Five children were experimentally monitored during the second half of 2017. The work progressed in trying to break with the institutionalized clinical analysis look and in the desconstruction of the school complaint with the subject, family and school. It was evidenced that in the speech of the scool complaint many meanings of the tensions do not have individual sense and that the consciousness about this relation emerged without tie and with disagreements in the proclaimed speech.

Este artículo tiene como objetivo compartir las acciones adoptadas para cumplir con la demanda de las dificultades de aprendizaje no escolar em la escucha aspecto y la intervención a la angustia de la escuela em niños atendidos en un Servicio de Psicología Aplicada - SPA de Porto Velho/RO. Experimentalmente fueron acompañados por cinco niños, durante la segunda mitad de 2017. El trabajo há avanzado para tratar de romper com el aspecto de análisis clínicos institucionalizada y la deconstrucción de la queja escolar con el sujeto, la familia y la escuela. Era evidente que en el discurso de las quejas de la escuela muchos significados de las tensiones no tienen sentido individual y la conciencia de esta relación surgido sin derecho a fianza y los desacuerdos en el discurso anunciado.

Subjective memory complaint and its relationship with cognitive changes and physical vulnerability of community-dwelling older adults / Queixa subjetiva de memória e relação com alterações cognitivas e vulnerabilidade física de idosos da comunidade

ABSTRACT. Memory complaint (MC) is common in older adults and can be confirmed by people close to them, such as family members and caregivers. Studies show an association between MC and cognitive impairment and, hence, physical vulnerability may exacerbate MC. However, the relationship between MC and physical vulnerability is not yet clear in the literature.\ Objective: to investigate the association between MC, cognitive impairment, and physical vulnerability. Methods: this is a cross-sectional study. We evaluated 100 older adults with a mean age of 65 years or over. The Memory Complaint Scale (MCS), Addenbrooke's Cognitive Examination-Revised (ACE-R), Mini-Mental State Examination (MMSE), Vulnerable Elderly Research-13 (VES-13), Geriatric Depression Scale and a sociodemographic questionnaire were applied. Results: participants were divided into two groups according to results on the MCS-A (elderly) and MCS-B (informant). Correlations were found between the MCS-A and the MMSE (p=.045/ρ=.201), ACE-R/Visual-Spatial (p=.048/ρ=.199), and ACE-R/Attention-Orientation (p=.026/ρ=.223). For the MCS-B, correlations were found with total score on the ACE-R (p=.044/ρ=-.202) and the ACE-R/Visual-Spatial (p=0.003/ρ=-.291). Conclusion: MC reported by the informant indicate the need to assess, in more depth, the cognition of the older adult. Thus, for clinical practice, screening of MC through an informant is advised.

RESUMO. A queixa de memória (QM) é comum em idosos e pode ser confirmada por pessoas próximas a ele, como familiares e cuidadores. Estudos apontam associação entre QM e alterações cognitivas e, nesse sentido, a vulnerabilidade física poderia exacerbá-la. Porém, a relação entre QM e vulnerabilidade física ainda não está clara na literatura. Objetivo: investigar a relação entre QM, alterações cognitivas e vulnerabilidade física. Métodos: trata-se de um estudo transversal. Foram avaliados 100 idosos com idade igual ou superior a 65 anos. Utilizou-se a Escala de Queixa de Memória (EQM), Exame Cognitivo de Addenbrooke - Revisado (ACE-R), Mini Exame do Estado Mental (MEEM), Vulnerable Elders Survey-13 (VES-13), Escala de Depressão Geriátrica e questionário sociodemográfico. Resultados: os participantes foram divididos em dois grupos de acordo com os resultados da EQM formas A (idoso) e B (informante). Encontrou-se correlação entre a EQM-A e MEEM (p=.045/ρ=.201), ACE-R Atenção e Orientação (p=.026/ρ=.223) e ACE-R/Visual-Espacial (p=.048/ρ=.199). Na EQM-B encontrou-se correlação entre pontuação total do ACE-R (p=.044/ρ=-.202) e ACE-R/Visual-Espacial. (p=.003/ρ=-.291). Conclusão: o relato de QM a partir do informante aponta a necessidade de avaliação mais aprofundada da cognição dos idosos. Assim, para a prática clínica, o rastreio de QM do informante é aconselhado.

Subjective cognitive impairment, cognitive disorders and self-perceived health: The importance of the informant / Comprometimento cognitivo subjetivo, alterações cognitivas e autopercepção de saúde: a importância do informante

ABSTRACT There is great divergence of results in the literature regarding the clinical relevance and etiology of subjective cognitive impairment (SCI). Currently, SCI is studied as a pre-clinical symptom of Alzheimer's disease, before establishing a possible diagnosis of mild cognitive impairment (MCI). The hypothesis was that SCI is associated with low cognitive performance and poor self-perceived health. Objective: to investigate the relationship of SCI with objective cognitive impairment and self-perceived health in older individuals and to compare SCI reported by the elderly subjects and by their respective informants. Methods: 83 subjects participated in the study, divided between the forms of the Memory Complaint Scale (MCS). Cognition was evaluated by the Addenbrooke's Cognitive Examination - Revised and self-perceived health by the Short Form Health Survey-8. Results: there was no association between SCI and self-perceived health. SCI reported by the older adults was associated with executive functions. SCI reported by the informant was associated with overall cognitive performance, memory, verbal fluency and visuospatial functions. Conclusion: we found more robust results between SCI reported by the informant and cognitive impairment in the elderly assessed. There is a need to include and value the perception of someone who knows the older individual well enough to evaluate SCI globally.

RESUMO Há grande divergência de resultados na literatura em relação à relevância clínica e à etiologia do comprometimento cognitivo subjetivo (CCS). Atualmente, o CCS é estudado como um sintoma pré-clínico da doença de Alzheimer, antes de se estabelecer um possível diagnóstico de CCL. A hipótese é que o CCS pode estar associado a um desempenho inferior em testes cognitivos ou a uma autopercepção de saúde ruim. Objetivo: O objetivo do estudo foi investigar a relação do CCS com o comprometimento cognitivo objetivo e a autopercepção de saúde em idosos e comparar o CCS relatado pelos idosos e o CCS relatado pelo informante. Métodos: 83 sujeitos participaram do estudo, divididos entre as formas da Escala de Queixa de Memória para as análises. A cognição foi avaliada pelo Exame Cognitivo de Addenbrooke - Revisado e autopercepção da saúde pelo Short Form Health Survey-8. Resultados: não houve associação entre CCS e autopercepção de saúde. O CCS relatado pelos idosos foi associado com funções executivas. O CCS reportado pelo informante esteve associado ao desempenho cognitivo global, memória, fluência verbal e função visual espacial. Conclusão: neste estudo encontramos resultados mais robustos entre CCS relatado pelo informante e o comprometimento cognitivo objetivo dos idosos, evidenciando a necessidade de incluir e valorizar a percepção de um indivíduo que conheça o idoso bem o suficiente para avaliar o CCS de maneira integrada.

Prediction of Alzheimer's Pathological Changes in Subjective Cognitive Decline Using the Self-report Questionnaire and Neuroimaging Biomarkers

BACKGROUND AND PURPOSE: Subjective cognitive decline (SCD) may be the first symptomatic stage of Alzheimer's disease (AD). Hence, a screening tool to characterize the patients' complaints and assess the risk of AD is required. We investigated the SCD neuroimaging biomarker distributions and the relevance between the self-report questionnaire and Alzheimer's pathologic changes. METHODS: Individuals aged 50 and above with consistent cognitive complaints without any objective cognitive impairments were eligible for the study. The newly developed questionnaire consisted of 2 parts; 10 questions translated from the ‘SCD-plus criteria’ and a Korean version of the cognitive failure questionnaire by Broadbent. All the subjects underwent physical examinations such as blood work, detailed neuropsychological tests, the self-report questionnaire, brain magnetic resonance imagings, and florbetaben positron emission tomography (PET) scans. Amyloid PET findings were interpreted using both visual rating and quantitative analysis. Group comparisons and association analysis were performed using SPSS (version 18.0). RESULTS: A total of 31 participants with SCD completed the study and 25.8% showed positive amyloid depositions. The degree of periventricular white matter hyperintensities (WMH) and hippocampal atrophy were more severe in amyloid-positive SCDs compared to the amyloid-negative group. In the self-reported questionnaire, the ‘informant's report a decline’ and ‘symptom's onset after 65 years of age’ were associated with more Alzheimer's pathologic changes. CONCLUSIONS: Amyloid-positive SCDs differed from amyloid-negative SCDs on WMH, hippocampal atrophy, and a few self-reported clinical features, which gave clues on the prediction of AD pathology.

Practice and experience of preoperative conversation as involved by the office of doctor-patient relationship / 中华医院管理杂志

Effective communication between doctors and patients can reduce the occurrence of medical complaints and disputes. The office of doctor-patient relationship acts as the complaints management department of the medical institution and undertakes the management of medical complaints. Since 2017, our hospital has introduced the staff of the doctor-patient relationship office to participate in major preoperative conversations. The mode establishes a communication bridge between clinicians and surgical patients and their families, so that patients′ informed consent is more complete and more realistic, and the sufficiency and effectiveness of doctor-patient communication is enhanced. It has a positive effect on medical complaints and dispute risk prevention.