O inventário de avaliação pediátrica de incapacidade e suas contribuições para estudos brasileiros / The pediatric evaluation of disability inventory and its contributions to brazilian studies / El inventario de evaluación pediátrica de discapacidad y sus contribucones a los estudios brasileños

Objective: The study's main purpose has been to analyze the Brazilian scientific productions that used the Pediatric Evaluation of Disability Inventory (PEDI) in investigations focused on children diagnosed with disabilities. Methods: It is an integrative literature review which was carried out from July to August 2017 in the following data sources: MEDLINE (PubMed), Virtual Health Library (VHL) and Web of Science, in English, Portuguese and Spanish languages. Results: The use of PEDI contributed to the identification of individual disabilities and the most impaired functions in children, providing data that allows the planning of interventions for parents, professionals, and caregivers. Furthermore, it has revealed the benefits of physical activities for functional performance, as well as the effects of the guidelines transmitted by health professionals to children with developmental disorders. Conclusion: PEDI has been proved to be relevant as it contributes with evidence to the evolution of the child with disabilities, identifies the commitments and allows the redirection of the actions of professionals and caregivers

Objetivo: Analisar as produções científicas brasileiras que utilizaram o Inventário de Avaliação Pediátrica de Incapacidade (PEDI) em estudos voltados para crianças diagnosticadas com deficiência. Metodologia: Trata-se de revisão integrativa da literatura, realizada entre julho e agosto de 2017 nas seguintes fontes: MEDLINE (PubMed), Biblioteca virtual em saúde (BVS) e Web of sience nos idiomas inglês, português e espanhol. Resultados: A utilização do PEDI contribuiu para identificação de incapacidades individuais e das funções mais comprometidas em crianças, fornece dados que permitem o planejamento de intervenções para pais, profissionais e cuidadores. Além disso, permitiu revelar os benefícios das atividades físicas para o desempenho funcional assim como os efeitos das orientações realizadas por profissionais de saúde para crianças com desvios de desenvolvimento. Conclusão: O PEDI têm-se mostrado relevante por contribuir com evidências sobre a evolução da criança com incapacidades, identificar os comprometimentos e permitir redirecionamento das ações de profissionais e cuidadores

Objetivo: Analizar las producciones científicas brasileñas que utilizaron el Inventario deEvaluación Pediátrica de Discapacidad en estudios centrados en niños diagnosticados con discapacidad. Método: Se trata de una revisión integradora de la literatura, efectuada entre julio y agosto de 2017 en las siguientes fuentes: MEDLINE (PubMed), Biblioteca Virtual en Salud (BVS) y Web of Science enlos idiomas inglés, portugués y español. Resultados: La utilización del PEDI contribuyó a la identificación de discapacidades individuales y de las funciones más comprometidas en niños, suministra datos que permiten la planificación de intervenciones redireccionando las acciones de padres, profesionales y cuidadores, además de haber permitido revelar los beneficios de las actividades físicas para el desempeño funcional, así como los efectos de las orientaciones transmitidas por profesionales de salud para niños con desviaciones de desarrollo. Conclusión: El PEDI se ha mostrado relevante por contribuir con evidencias sobre la evolución del niño con discapacidades, identificar los compromisos y permitir la redirección de las acciones de profesionales y cuidadores

Impact of untreated dental caries on oral health-related quality of life of children with special health care needs

Abstract: The oral health status of children with special health care needs (SHCN) can affect their quality of life wich domains of the Brazilian version of the Early Childohood Oral Health Impact Scale (B-ECOHIS). A cross-sectional study was conducted in children with SHCN (aged 1 to 9 years), who underwent an oral examination for the assessment of dental caries severity. Parents/caregivers answered two questionnaires, one on oral health-related quality of life (OHRQoL) - B-ECOHIS, and one on socioeconomic characteristics. Statistical analyses were performed using the Kolmogorov-Smirnov test, Mann-Whitney U-test, Poisson regression, Point-biserial correlation coefficient, and Cronbach's alpha. A total of 128 children participated in the study and OHRQoL was affected in 68.75% of them. The function domain in the Child Impact Section (CIS) had a higher mean value. Caries severity was associated with worse quality of life (p=0.001). Severe dental caries was associated with a negative impact on the OHRQoL of disabled children and of their families. The impact of untreated dental caries and severity of dental caries was associated with the CIS domains (except for the self-image/social interaction domain).

Population profiles associated with severe functioning difficulties and disability among two to four years old children in Mexico / Perfiles poblacionales asociados a dificultades severas de funcionamiento y discapacidad en niños de dos a cuatro años de edad en México

Abstract: Objective: To describe the prevalence and factors associated with severe child functioning difficulties and disability (CFD) among two to four year old children in Mexico, and estimates the probability of presenting CFD based on specific population profiles. Materials and methods: The sample consists of 5 104 children who participated in the National Survey of Children and Women 2015 (ENIM). We used post-estimation exploration by computing predicted values of CFD to interpret the logistic models for discrete combinations of the independent variables. Results: CFD prevalence is 2%, which means at least 130 000 two to four year-old children are at risk of experiencing severely limited participation in an unaccommodating environment. The probability of presenting CFD is dramatically higher in specific sub-groups of the population, in particular, male children of women with low education, who live in the poorest households. Conclusions: A significant proportion of Mexican children face important challenges due to functioning difficulties and disability. Public policies must be developed to accommodate the needs of these children and provide a proper environment for their development.

Resumen: Objetivo: Describir la prevalencia y los factores asociados con las dificultades severas de funcionamiento y discapacidad (CFD, por sus siglas en inglés) en niños de dos a cuatro años de edad en México y estimar la probabilidad de presentar CFD basada en perfiles poblacionales específicos. Material y métodos: La muestra fue conformada por 5 104 niños participantes de la Encuesta Nacional de los Niños, Niñas y Mujeres (ENIM) 2015. Se realizó una post-estimación calculando los valores predichos de CFD para interpretar los modelos logísticos a partir de combinaciones discretas de las variables independientes. Resultados: La prevalencia de CFD es de 2%, lo que significa que al menos 130 000 niños de 2 a 4 años de edad están en riesgo de experimentar una participación severamente limitada en un ambiente no adaptado a sus necesidades. La probabilidad de presentar CFD aumenta dramáticamente en subgrupos específicos de la población, en particular los hijos varones de mujeres con baja educación, que viven en los hogares más pobres. Conclusión: Una proporción importante de la población infantil mexicana enfrenta retos importantes derivados de las dificultades de funcionamiento y la discapacidad. Es necesario desarrollar políticas públicas que respondan a las necesidades específicas de este grupo poblacional, proporcionando un entorno apropiado para su desarrollo.

Mismatch between diagnostic reports and special educational needs classification in a public educational system / Descompasso entre os registros diagnósticos e a classificação de necessidade educacional especial em uma rede municipal de educação

ABSTRACT Objective To assess the diagnostic status, the sociodemographic and health profiles for students with special educational needs (SEN) in a public educational system, and to map their use of educational/social services. Methods The sample comprised 1,202 SEN students from a total of 59,344 students. Results Only 792 students of the 1,202 had an established diagnosis. The most prevalent SEN condition was intellectual disability. There was a low percentage (29.4%) of use of specialized educational services or support. It was found that, for some neurodevelopmental disorders, prevalence data suggest an under-reporting in the school system. Conclusion Results suggest that there is a mismatch between the diagnostic reports and the SEN condition legally recognized according to Brazilian law, in addition to the under-reporting and under specialized service use of students with disabilities.

RESUMO Objetivo Avaliar a situação diagnóstica, o perfil sociodemográfico e de saúde dos alunos com necessidades educacionais especiais (NEE) de uma rede municipal de educação, assim como mapear o uso de serviços educacionais e sociais. Métodos A amostra foi composta por 1202 alunos com NEE de um total de 59344 alunos. Resultados Dos 1202 alunos somente 792 tinha diagnóstico estabelecido. A condição de NEE mais prevalente foi a deficiência intelectual. Verificou-se um baixo percentual (29,4%) de uso de serviços educacionais especializados ou de apoio. Foi constatado que, para alguns transtornos do neurodesenvolvimento, os dados de prevalência parecem indicar uma subnotificação. Conclusão Os resultados sugerem um descompasso entre os registros diagnósticos e a condição de necessidade educacional especial segundo a legislação brasileira, além disso verificou-se uma subnotificação diagnóstica e baixo uso de serviços especializados entre estudantes com deficiências.

A violência familiar e a criança e o adolescente com deficiências / Family violence in a sample of children and adolescents with disabilities / La violencia familiar y el niño y/o adolescente con discapacidad

Resumo: O trabalho objetivou identificar e analisar a prevalência da violência familiar física e psicológica entre crianças e adolescentes com diferentes categorias de deficiência em um hospital no Rio de Janeiro, Brasil. Estudo observacional, transversal realizado com aplicação do instrumento Parent-Child Conflicts Tatics Scales numa amostra de 270 responsáveis. Mostrou-se a prevalência de 83,7% para agressão psicológica e 84,4% para maus-tratos físicos, e 96,5% das crianças e dos adolescentes com deficiência que sofreram punição corporal, também foram vítimas de agressão psicológica (p < 0,01), e todos os que sofreram maus-tratos físicos graves sofreram agressão psicológica (p = 0,01). Crianças e adolescentes com deficiência apresentam maior risco de sofrer violência intrafamiliar do que aquelas sem deficiência. Conclui-se haver necessidade de maior conscientização e capacitação das equipes de saúde em relação à detecção e notificação dos casos de maus-tratos da população estudada e para as medidas de proteção, e esforços devem ser feitos para apoiar essas famílias.

Abstract: This study aimed to identify and analyze the prevalence of physical and psychological family violence in a sample of children and adolescents with different categories of disabilities in a hospital in Rio de Janeiro, Brazil. This was a cross-sectional observational study based on application of the Parent-Child Conflict Tactics Scale in a sample of 270 parents or guardians. Prevalence was 83.7% for psychological aggression and 84.4% for physical maltreatment, while 96.5% of the children and adolescents with disabilities that suffered physical punishment were also victims of psychological aggression (p < 0.01) and 100% of those who suffered severe physical maltreatment also suffered psychological aggression (p = 0.01). Children and adolescents with disabilities showed increased risk of suffering family violence compared to those without disabilities. In conclusion, there is a need for greater awareness-raising and training of health teams for detection and notification of child abuse, and efforts should be made to support these families.

Resumen: El trabajo tuvo como objetivo identificar y analizar la prevalencia de la violencia familiar física y psicológica entre niños y adolescentes con diferentes categorías de discapacidad en un hospital de Río de Janeiro, Brasil. Se trata de un estudio observacional, transversal, realizado a partir de la aplicación de la herramienta Parent-Child Conflict Tactics Scale en una muestra de 270 responsables. Se mostró una prevalencia de un 83,7% en el caso de la agresión psicológica y un 84,4% en el de malos tratos físicos, siendo que un 96,5% de los niños y de los adolescentes con discapacidad que sufrieron castigo corporal, también fueron víctimas de agresión psicológica (p < 0,01) y todos los que sufrieron malos tratos físicos graves sufrieron agresión psicológica (p = 0,01). Niños y adolescentes con discapacidad presentan un mayor riesgo de sufrir violencia intrafamiliar que aquellos sin discapacidad. Se concluye que existe necesidad de una mayor concienciación y capacitación de los equipos de salud, en relación con la detección y notificación de los casos de malos tratos de la población estudiada y desarrollo de medidas de protección y esfuerzos en apoyo a estas familias.

Crianças com necessidades especiais de saúde: impacto no cotidiano familiar / Niños con necesidades médicas especiales: impacto en la rutina diaria familiar / Children with special health care needs: impact on familiar daily routine

Objetivo: Descrever através da literatura científica o impacto que as crianças com necessidades especiais de saúde causam em suas famílias. Método: Revisão integrativa, realizada nas bases de dados MEDLINE, BDENF, LILACS e IBECS. Foram selecionados 67 artigos publicados entre 2003 e 2013, os quais constituíram a amostra do estudo. Resultados: Apontaram que esta temática tem sido investigada prioritariamente em estudos internacionais e o impacto ocorre na transmissão do diagnóstico e acarreta em repercussões financeiras sobre a saúde e no cotidiano social dos membros da família. Conclusão: A enfermagem deve ser facilitadora e instrumentalizar a família para o cuidado às crianças com necessidades especiais de saúde.

Objective: To describe through the scientific literature, the impact that children with special health care needs cause on their families. Method: Integrative review, performed in MEDLINE, BDENF, LILACS e IBECS database. There were 67 articles published between 2003 and 2013 selected, which constituted the study sample. Results: This issue has been investigated with priority in international studies and the impact occurs in the transmission of the diagnosis and results in financial repercussions, on health and everyday social life of family members. Conclusion: Nursing should be facilitate and mediate the family for children's care with special health needs.

Objetivo: Describir a través de la literatura científica, el impacto que los niños con necesidades especiales de salud causan en sus familias. Método: Revisión integradora, realizada en base de datos MEDLINE, BDENF, LILACS y IBECS. Se seleccionaron 67 artículos publicados entre 2003 y 2013, los que constituyen la muestra del estudio. Resultados: Los resultados revelaron que este tema se ha investigado, con prioridad en estudios internacionales, y que el impacto ocurre en la transmisión del diagnóstico y resulta en consecuencias financieras, sobre la salud y sobre la vida social cotidiana de los miembros de la familia. Conclusión: La enfermería debe ser facilitadora e instrumentalizar la familia para cuidar a niños con necesidades especiales de salud.

Primera infancia y discapacidad en Chile: revisión y enfoque actual a los programas de gobierno / Early childhood and disability in Chile: review and current approach to government programs

En el presente artículo se realiza una revisión acerca de la Primera Infancia en situación de discapacidad en Chile, se abordarán los programas de gobierno que existen, su actual enfoque y se analizará si las soluciones que ofrecen son pertinentes y eficientes para este importante grupo de niños y niñas. El trabajo toma como marco de referencia la Convención sobre los Derechos del Niño y la Convención sobre los Derechos de las Personas en Situación de Discapacidad, con el fin de evaluar el estado de los derechos de estos niños y si los programas de gobierno garantizan lo convenido en ambas convenciones.

In this article we review the current Chilean government programs about early childhood with disability. The current focus of these programs will be addressed in order to analyze whether the solutions they provide are relevant and efficient for this significant group of children. This article takes as a reference the Convention on the Rights of the Child and the Convention on the Rights of Persons with disability, to assess the state of the rights of these children and whether government programs guarantee what is enshrined in both conventions.

Caracterización de heridas en pacientes infantiles y juveniles con discapacidad neuro-músculo-esquelética / Characterization of wounds in children and young patients with neuro-musculoskeletal disabilities at Telethon Institute

Introducción: En la literatura existen escasas referencias a heridas en pacientes pediátricos con discapacidad, éstas son principalmente en población adulta. Para implementar medidas de prevención en pacientes infantiles y juveniles con discapacidad, es fundamental conocer sus características y factores asociados. Objetivo: Describir las características socio-demográficas y clínicas de los niños y jóvenes con discapacidad neuro-músculo-esquelética y de sus heridas, atendidos en policlínico de heridas del Instituto Teletón (IT)-Santiago. Método: Evaluación y descripción clínica de las heridas; aplicación de encuesta a pacientes/cuidadores atendidos en el policlínico, desde mayo a noviembre de 2013. Resultados: De los 34 evaluados, 55,9 por ciento son de sexo masculino, con edades entre 4,5 y 27,2 años. El diagnóstico principal corresponde a lesión medular adquirida o congénita en 79,4 por ciento de los casos. Son totalmente dependientes en transferencias y aseo genital el 50 por ciento. Se identificaron 44 heridas en total, 90,9 por ciento corresponden a úlceras por presión; grado II de profundidad en el 45 por ciento. La localización más frecuente fue tobillo-pie con 52,2 por ciento. Un 61,4 por ciento de ellas corresponde a una recidiva de episodio de herida. El 43,2 por ciento se desarrolla en el curso de una hospitalización. 29,5 por ciento de las heridas tiene contacto con elementos ortésicos o calzado no terapéutico. Se obtuvo asociación significativa entre localización y diámetro de la herida (p < 0,036). Conclusiones: En el grupo de pacientes evaluados, que en un 80 por ciento presentan lesiones medulares congénitas o adquiridas, las úlceras de mayor tamaño se concentran significativamente más en zona pelviana, y la localización de las heridas se presenta en forma casi exclusiva, en zona pelviana y tobillo-pie.

Introdution: In the literature there are few references to wounds in pediatric patients with disabilities. For prevention of wounds in pediatric population with disabilities, it is essential to know its characteristics and associated factors. Objective: Describe the socio-demographic and clinical characteristics of wounds in children and young patients with neuro-musculoskeletal disabilities in Santiago Telethon Institute. Method: Assessment and clinical description of injuries; survey application to patients/caregivers attended at Telethon Institute from May to November 2013. Results: Out of 34 patients, 55.9 percent were male, the age ranged between 4.5 and 27.2 years. The main diagnose corresponds to acquired or congenital spinal cord injury (79.4 percent). 50 percent are totally dependent on transfers and genital toilet. Overall 44 wound were identified, 90 percent of which were pressure ulcers; 45 percent classified as grade II. The most common site of injury was ankle-foot area (52.2 percent). 61.4 percent are a recurrence of pressure ulcer; 43.2 percent develops during hospitalization, 29.5 percent of wounds have contact with orthotics or footwear. Significant association was found between location and diameter of the wound (p < 0.036). Conclusions: In the group of patients evaluated, 80 percent have congenital or acquired spinal cord injuries; the greater ulcer sizes are located in the pelvic area, and the location of the wound occurs almost exclusively in the pelvic and ankle-foot area.

Antecedentes epidemiológicos y demográficos: escolares chilenos entre 6-14 años / Epidemiological and demographic background: chilean students between 6-14 years

Entre 1992 y 2002 Chile cambió. Las variables epidemiológicas y demográficas más significativas que afecta a la población escolar entre 6-14 años, son analizados desde la salud pública en forma sistémica y relacionadas con los procesos salud-enfermedad. Las variables revisadas son familia, pertenencia asociativa, uso del tiempo libre, antecedentes demográficos, antecedentes epidemiológicos, discapacidad y maltrato infantil. El artículo propone potenciar el rol del kinesiólogo en educación, así como de los educadores del nivel básico en promoción de salud para construir una sociedad más saludable, siendo la actividad física una herramienta poderosa de inclusión, participación, tolerancia y de intervención eficiente y directa sobre los escolares chilenos.

Audit of paediatric surgical intensive care unit admissions in north Jordan

An audit was carried out over a 12-month period at a district general hospital in the north of Jordan. The study aimed to establish the reasons for and outcome of paediatric intensive care unit admissions. Of the 854 admissions, 107 were paediatric surgical cases. The causes of trauma were: road traffic accident [42 cases], burns [35] and falls [18]. The remaining 12 cases were either post-operative admissions [7 cases] or acute admissions [5 cases]. A total of 31 patients died and 8 children were left with significant disability or brain death. We conclude that trauma is a significant cause of disability, morbidity and mortality in children in our area. Society as a whole needs to look at the causes of childhood trauma and identify ways of reducing it

Caries prevalence amongst handicapped children of South Canara district, Karnataka.

This epidemiological investigation was carried out among 524 handicapped children in the age group of 3-30 years, attending 8 different non-residential special schools in South Canara district, Karnataka. The examination procedure and criteria were those recommended by W.H.O. in 1997. The total caries prevalence was found to be 71.56%. The mean deft in the primary dentition was found to be 3.06 +/- 3.14. The mean deft and DMFT in the mixed dentition were 3.32 +/- 2.82 and 1.14 +/- 1.08 respectively. The mean DMFT in the permanent dentition was 4.51 +/- 3.17. The prevalence of dental caries was higher in the mentally subnormal and handicapped children. The decayed component constituted the majority of the dental caries index. Lack of conservative approach to the treatment had been confirmed in the study.