Parental influence on children's answers to an oral-health-related quality of life questionnaire

Abstract The aim of the study was to evaluate parental influence on children's answers to an oral health-related quality of life (OHRQoL) questionnaire. A cross-sectional study was conducted with a non-probabilistic sample of 84 pairs of 5-year-olds and parents/guardians. The participants were selected from a primary family healthcare center in Campina Grande, Brazil. First, the children and parents answered respective versions of the Scale of Oral Health Outcomes for Five-Year-Old Children (SOHO-5). Seven days later, the children answered their version of the SOHO-5, without the presence of their parents/guardians, and underwent a clinical exam of dental caries, traumatic dental injury and malocclusion, by a previously calibrated researcher. Statistical analysis involved a comparison of mean scores and the calculation of the intraclass correlation coefficient (ICC). Poisson regression models were used to associate the variables (α = 5%). No significant differences were found between the mean SOHO-5 scores of the children when alone or accompanied by parents/guardians (p > 0.05). The ICC between the answers of the children alone or accompanied was 0.84. White spot (PR = 6.32; 95%CI: 1.36 - 29.40) and cavitated lesions (PR = 9.81; 95%CI: 3.22 - 29.85) had an impact on OHRQoL, according to the children's self-report, whereas cavitated lesions (PR = 90.52; 95%CI: 13.26 - 617.74) and anterior open bite (PR = 1.95; 95%IC: 1.07 - 3.53) remained on the final model, according to the parents' version of the SOHO-5. In conclusion, parents did not influence the children's responses, and dental caries are the oral health problem exerting the greatest impact on the children's OHRQoL.

Percepção e orientação de condutas de conselheiros tutelares sobre práticas sexuais de menores de 18 anos / Perception and conduct's guidance of the guardianship board's members on sexual practices of the under 18 years old

A abertura política do Brasil à democracia promoveu uma série de mudanças legislativas e de organização do Estado. Na área da infância e adolescência, após a promulgação do Estatuto da Criança e do Adolescente (ECA), foram criados conselhos de nível federal, estadual e municipal, com o objetivo de promover e defender os direitos dessa população específica. Também foram formados os Conselhos Tutelares compostos por membros da sociedade civil, diretamente eleitos pela população, com a função de informar e promover esses direitos localmente. Utilizando a metodologia qualitativa-quantitativa do Discurso do Sujeito Coletivo, a pesquisa analisou a percepção e opinião dos conselheiros tutelares a respeito de situações que envolvem a prática sexual voluntária heterossexual e homossexual de adolescentes da faixa etária de 12 a 17 anos. Os dados foram colhidos com o uso de questionários semiestruturados para autopreenchimento, apresentados em visita técnica aos membros dos 44 Conselhos Tutelares do município de São Paulo. Além do perfil social e familiar, foram coletadas opiniões dos conselheiros quanto à autonomia dos adolescentes e suas noções de desrespeito legal, além de sugestões de orientação de condutas frente a três casos hipotéticos de prática sexual realizada por adolescentes. Responderam à pesquisa 80 (36,4 por cento ) conselheiros de um total de 220, de 29 (65,9 por cento ) dos 44 Conselhos Tutelares da cidade. Observou-se que apresentaram tendência a reproduzir os modelos tradicionais negativos da sociedade brasileira no julgamento da prática sexual de adolescentes, avaliando sua ocorrência pela ótica moral e de opinião de familiares e outros adultos

The political opening to democracy in Brazil promoted a series of changes of legislation and state organization. Concerning to the childhood and adolescence, after the promulgation of the Estatuto da Criança e do Adolescente (Statute for Children and Adolescents), councils were created at federal, state and municipal level, to promote and defend the rights of this specific group. The Conselhos Tutelares (Tutelary Councils) were also created, composed by civil society members, directly elected by the population, to inform and promote these rights locally. Using qualitative and qualitative-quantitative methodologies of the Discurso do Sujeito Coletivo (Discourse of the Collective Subject), the research analyzed the perception and the opinion of councilors regarding to situations involving heterosexual and homosexual voluntary sexual practices, among teenagers from 12 to 17 years old. Data were collected with semi-structured questionnaires for self-fulfillment, presented in technical visits to members of the 44 Tutelary Councils in São Paulo city. Beyond the social and family profile, opinions on the autonomy of adolescents and their notions of legal disrespect were collected and also the suggestions to orientation of conducts, facing three hypothetical cases of sexual practice performed by adolescents. The research was answered by 80 (36,4 per cent ) counselors from a total of 220, of 29 (65,9 per cent ) Tutelary Councils from the 44 placed in the city

Predictors of HIV/AIDS confirmation and differences by guardian status in HIV+ adolescents in Jamaica / Predictores de la confirmación del VIH/SIDA y diferencias con respecto al estatus de tutoría de adolescentes con VIH+

BACKGROUND: Approximately 25% of the cumulative AIDS cases in Jamaica involve adolescents and young adults. However, the lives of adolescents living with HIV within Jamaica and the Caribbean have been understudied. OBJECTIVES: (1) To describe the sociodemographic characteristics of HIV+ Jamaican adolescents who have ever been a part of the Kingston Paediatric/Perinatal HIV Programme (KPAIDS) from September 1, 2002 to August 31, 2006 (2). To identify predictors of HIV/AIDS confirmation as well as factors associated or uniquely present in these adolescents by their guardian status. METHODS: Seventy-two HIV+ adolescents, ages 10-19 years, were included. Factors studied included demographics as well as time to and time between HIV and AIDS confirmation. Data were analyzed by bivariate and multivariate statistics. RESULTS: The mean age of the adolescents was 12.6 ± 2.8 years with slightly more males (52.8%) in the programme. There were equal proportions of adolescents living with HIV as with AIDS (43.1%). There were equal proportions who were lost to follow-up or deceased (8.3%). Twenty-two of them lived with parents, 25 with guardians and 18 in residential institutions. The primary mode of transmission was perinatal infection (68.1%), followed by sexual (20.8%), blood transfusion (2.9%) and unknown (8.3%). The mean time from HIV exposure to HIV confirmation and AIDS confirmation in mother-to-child transmission (MTCT) cases were 8.0 ± 2.9 years and 9.6 ± 3.3 years, respectively. In the multivariate analysis model, age and gender were significant in predicting time from HIV exposure to HIV confirmation. CONCLUSION: The majority of HIV-positive adolescents reside with parents and guardians and this might indicate support in spite of stigma and discrimination. However, the mean time to HIV confirmation in MTCT cases is quite long and must be reduced.

ANTECEDENTES: Aproximadamente el 25% de los casos cumulativos de SIDA en Jamaica comprenden adolescentes y adultos jóvenes. Sin embargo, las vidas de los adolescentes que viven con VIH en Jamaica y el Caribe no ha recibido suficiente estudio. OBJETIVOS: (1) Describir las características socio-demográficas de los adolescentes jamaicanos VIH+ que hayan sido alguna vez parte del Programa Pediátrico/Prenatal de Kingston contra el SIDA (KPAIDS) desde septiembre 1 de 2002 a agosto 31 de 2006. (2). Identificar los predictores de la confirmación del VIH/SIDA así como los factores asociados o presentes de forma única en estos adolescentes con respecto a su estatus de tutoría. MÉTODOS: Se incluyeron setenta y dos adolescentes VIH+, con edades de 10 a 19 años. Los factores estudiados comprendieron los datos demográficos así como el tiempo hasta la confirmación de VIH y el SIDA, así como el tiempo entre la confirmación de ambos. Los datos fueron analizados mediante estadísticas divariadas y multivariadas. RESULTADOS: La edad promedio de los adolescentes fue 12.6 ± 2.8 años siendo el número de varones ligeramente mayor (52.8%) en el programa. Las proporciones de adolescentes viviendo con VIH fueron iguales a las de los adolescentes viviendo con SIDA (43.1%). Hubo iguales proporciones perdidas al seguimiento o fallecidas (8.3%). Veintidós de ellos vivían con sus padres, 25 con tutores, y 18 en instituciones residenciales. El modo primario de transmisión fue la infección perinatal (68.1%), seguida por la sexual (20.8%), la transfusión de sangre (2.9%), y otros desconocidos (8.3%). Los tiempos medios desde la exposición al VIH hasta la confirmación de VIH y la confirmación del SIDA en los casos de transmisión madre a hijo (TMAH) fueron 8.0 ± 2.9 años y 9.6 ± 3.3 años, respectivamente. En el modelo de análisis multivariado, la edad y el género fueron significativos a la hora de predecir el tiempo desde la exposición al VIH hasta la confirmación del VIH. CONCLUSIÓN: La mayor parte de los adolescentes VIH positivos residen con sus padres y tutores y esto podría ser un índice de apoyo a pesar del estigma y la discriminación. Sin embargo, el tiempo medio hasta la confirmación del VIH en los casos de TMAH es bien largo y tiene que ser reducido.