Smartphone Ownership, Minors' Well-being, and Parental Mediation Strategies. An Analysis in the Context of Social Media Influencers.

Although smartphone ownership among minors has become an important social phenomenon, its impact on children's and adolescents' well-being, as well as the mechanisms by which this might take place are not yet sufficiently well-established. To date, no research has examined the effect of smartphone ownership on the well-being of minors through the consumption of influencer-generated content, nor has it explored the effectiveness of the main prevention strategies employed by parents in this context. To fill those gaps, 800 Spanish minors (50% female) aged from 8 to 16 years old (M = 12.33, SD = 2.38) participated in a correlational study in which the ownership of electronic devices, the consumption of influencer generated content, the parasocial relationship with the influencer, and the most common parental mediation strategies were considered. The results showed a positive association between electronic device ownership and psychological discomfort, problematic usage, and imitation of dangerous behaviors. This association was mediated by the consumption of influencer-generated content and the parasocial relationship established by the minor with the influencer. Regarding preventive strategies, only active mediation was inversely related to poorer well-being indicators, however this positive effect significantly decreased when a smartphone or a similar electronic device was owned by the minor (vs. no owned). These findings contribute to the understanding of how smartphone ownership can affect the well-being of children, emphasizing the need for thoughtful consideration when deciding whether to provide smartphones to minors.

Multiclassifier Radiomics Analysis of Ultrasound for Prediction of Extrathyroidal Extension in Papillary Thyroid Carcinoma in Children.

Objective: To explore extrathyroidal extension (ETE) in children and adolescents with papillary thyroid carcinoma using a multiclassifier ultrasound radiomic model. Methods: In this study, data from 164 pediatric patients with papillary thyroid cancer (PTC) were retrospectively analyzed and patients were randomly divided into a training cohort (115) and a validation cohort (49) in a 7:3 ratio. To extract radiomics features from ultrasound images of the thyroid, areas of interest (ROIs) were delineated layer by layer along the edge of the tumor contour. The feature dimension was then reduced using the correlation coefficient screening method, and 16 features with a nonzero coefficient were chosen using Lasso. Then, in the training cohort, four supervised machine learning radiomics models (k-nearest neighbor, random forest, support vector machine [SVM], and LightGBM) were developed. ROC and decision-making curves were utilized to compare model performance, which was validated using validation cohorts. In addition, the SHapley Additive exPlanations (SHAP) framework was applied to explain the optimal model. Results: In the training cohort, the average area under the curve (AUC) was 0.880 (0.835-0.927), 0.873 (0.829-0.916), 0.999 (0.999-1.000), and 0.926 (0.892-0.926) for the SVM, KNN, random forest, and LightGBM, respectively. In the validation cohort, the AUC for the SVM was 0.784 (0.680-0.889), for the KNN, it was 0.720 (0.615-0.825), for the random forest, it was 0.728 (0.622-0.834), and for the LightGBM, it was 0.832 (0.742-0.921). Generally, the LightGBM model performed well in both the training and validation cohorts. From the SHAP results, original_shape_MinorAxisLength,original_shape_Maximum2DDiameterColumn, and wavelet-HHH_glszm_SmallAreaLowGrayLevelEmphasis have the most significant effect on the model. Conclusions: Our combined model based on machine learning and ultrasonic radiomics demonstrate the excellent predictive ability for extrathyroidal extension (ETE) in pediatric PTC.

Comparative Clinical Study on Periodontal Health Status and Early Diagnosis of Periodontal Diseases Quantified through Clinical Periodontal Indices on a Group of Children and Adolescents with and without Cardiovascular Diseases.

It is well known that bacterial plaque is the main etiological factor that causes the appearance of periodontal diseases and carious disease. Periodontal diseases can affect children and adolescents and are manifested in the form of gingivitis, but also the early form of chronic periodontitis as well as aggressive marginal periodontitis associated with local or general factors. Early periodontitis is frequently undiagnosed by clinicians due to a lack of knowledge of the specific symptoms. Certain systemic diseases, such as cardiovascular diseases, can create favorable conditions for the appearance and progression of severe manifestations of periodontal disease; also, recent research highlights that individuals with periodontal disease present an increased risk of developing cardiovascular diseases. Children with congenital or acquired cardiovascular diseases are at increased risk for complications resulting from the growth of microorganisms in the oral cavity, presenting a risk of infective endocarditis. The specific aim was to highlight the existing differences between the periodontal health of children with cardiovascular diseases and that of children without these diseases. The analyzed group included 124 patients, represented by children and adolescents, aged between 7 and 17 years, who were divided into four subgroups depending on the presence or absence of cardiovascular diseases and periodontal disease. A specialized clinical examination was performed for each patient, and periodontal clinical parameters were quantified (plaque index, gingival bleeding index, gingival index, community periodontal index of treatment needs) and associated with the diagnosis of general condition. Patients diagnosed with periodontal disease underwent specialized treatment and were called to a control visit 3 months after treatment. Statistical analysis showed significant differences between subgroups with much higher values of clinical parameters for patients with cardiovascular disease. Also, the response to the treatment was better in the case of patients in the control subgroup without cardiovascular diseases. The present study highlighted the interaction of three factors in the progression of periodontal diseases: subgingival microbiota, immune system response and environmental factors.

O jogo como estratégia para melhor convivência entre crianças e adolescentes acolhidos / The game as an strategy to better relationships between sheltered children and teenagers

Este artigo relata a experiência de um estágio desenvolvido com crianças e adolescentes em acolhimento institucional na cidade de Joinville - SC. O objetivo do trabalho realizado foi estimular relações e vínculos socioafetivos nas crianças e adolescentes em acolhimento institucional, por meio de jogos. Participaram do grupo oito crianças e adolescentes entre 10 e 17 anos. Foram realizados três encontros, entre julho e agosto de 2019, sendo os dois primeiros para apresentação e reconhecimento do campo, e o terceiro para intervenção. A prática psicopedagógica institucional, dialética e coletiva, apresenta-se como um momento de troca entre o psicopedagogo e os sujeitos, um momento construído do coletivo, para o coletivo. Por meio de jogos, atividades lúdicas e coletivas, assim como a atribuição de papéis e responsabilidades, além de construir regras e combinados em conjunto, foi possível perceber algumas mudanças na relação entre os acolhidos.

This article reports the experience of an internship developed with children and teenagers sheltered in an institutional care in the city of Joinville - SC. The objective of the work was to stimulate relationships and social-affective bonds in children and teenagers in institutional care, through games. Eight children and teenagers between 10 and 17 years old participated in the group. Three meetings were held, between July and August 2019, the first two for presentation and recognition of the field, and the third for intervention. The institutional, dialectical and collective psychopedagogical practice presents itself as a moment of exchange between the psychopedagogue and the subjects, a moment constructed from the collective to the collective. Through games, recreational and collective activities, as well as the attribution of roles and responsibilities, in addition to building rules and add arrangements, it was possible to see some changes in the relationship between the hosted.

Single-vision spectacle use and myopia progression in children with low myopia, a propensity score matching study.

PURPOSE: To investigate the impact of single-vision spectacle use on myopia progression in children with low myopia. METHODS: MYOSOTIS is a prospective myopia screening survey including all 46 primary and junior high schools in two districts of Hangzhou, China. After 1-to-1 propensity score matching (PSM), 1,685 pairs of students with low myopia were included. Group 1 was composed of 1,685 non-spectacle users at baseline, and group 2 consisted of 1,685 spectacle wearers at both survey rounds. Refraction was examined by noncycloplegic autorefraction and mean spherical equivalent refraction (SER) of both eyes was analyzed. Myopia progression was measured by average rate of change in SER (r∆SER) between two survey rounds and compared between the two groups. RESULTS: After PSM, no significant difference in age, sex ratio, SER, and uncorrected visual acuity (VA) between the two groups was found at baseline. For myopic progression, r∆SER showed no significant difference between the two groups (- 0.67 ± 0.97 versus - 0.69 ± 0.81 diopter/year, P = 0.448). After adjusting for age, sex, SER, and VA, the difference in r∆SER between the two groups was not significant (- 0.031, 95% CI - 0.089 ~ 0.028 diopter/year, P = 0.302). In the subgroup analyses stratified by age and SER, and in the sensitivity analyses by eye side, there was still no significant difference in myopia progression between the two groups. CONCLUSIONS: Our study indicates that single-vision spectacle use has no impact on myopia progression in children with low myopia. Spectacles are recommended in children with low myopia if their visual acuity has interfered with the daily life.

Intersetorialidade e políticas sociais no contexto brasileiro: desafios para a proteção integral infantojuvenil

Resumo: O artigo em questão tem como objetivo discutir sobre como tem se efetivado a intersetorialidade no atendimento à crianças e adolescentes em situação de violência intrafamiliar no Brasil, tendo como recorte um município na região noroeste do Paraná. Por meio de uma pesquisa de caráter documental, analisamos as atas das reuniões da rede de serviços públicos do município em pauta ocorridas entre os anos de 2013 a 2017. As atas revelaram que apesar da roupagem intersetorial, as ações na rede se dão de modo fragmentado por meio da divisão de tarefas ou competências, responsabilizando ainda, alguns serviços específicos pelo êxito ou não dos encaminhamentos previamente dados nas reuniões. Por ora, vemos que as práticas intersetoriais tem se efetivado, via políticas sociais, distantes daquilo que é proposto e que apesar das contradições estruturais da lógica dos direitos sociais, o desenvolvimento de um trabalho que cumpra o previsto pelas diretrizes, princípios e objetivos dessas políticas deve ser o foco do Estado.

Abstract: The present article aim to discuss about how intersectoriality has been implemented in the care of children and adolescents in situations of interfamily violence in Brazil, focused in a municipality in the northwest of Parana. Through a documental research, we analyzed the minutes of the municipality's public service network meetings that occurred between 2013 and 2017. The minutes showed that despite the intersectoral outlook, the network actions are fragmented through the division of tasks or skills, also holding responsible some specific services for the success or not of the referrals previously given in the meetings. For now, we see that intersectoral practices has been effected, through social policies, distant from what is proposed by them, and, despite the structural contradictions of the social rights logic, the development of a work that achieves what is predicted by guidelines, principles and objectives of these policies must be the focus of the State.

Resumen: El articulo presentado tiene como objetivo plantear una discusión sobre como se ha efectivado la intersectorialidad hacia la asistencia a niños, niñas y adolescentes en situación de violencia intrafamiliar en Brasil, centrándose en una ciudad del noroeste del estado de Paraná. Bajo una investigación documental, analizamos las actas de las reuniones de la red de servicios públicos que se desarrollaron entre los años 2013 hasta 2017. El análisis de las actas ha demostrado que, aunque exista una perspectiva intersectorial, las acciones en la red se desarrollan de una manera fragmentada por medio de la división de tareas o competencias y se otorgan determinados servicios específicos según el éxito, o no, de las referencias dadas previamente en las reuniones. Mientras tanto, vemos que se han implementado prácticas intersectoriales, por medio de políticas sociales, lejanas de lo que se propone. Reconocemos que - aunque haya contradicciones estructurales en la lógica de los derechos sociales - el desarrollo de un trabajo que cumpla con los lineamientos, principios y objetivos de estas políticas debe ser el foco del Estado.

Long-term joint outcomes of regular low-dose prophylaxis in Chinese children with severe haemophilia A.

OBJECTIVES: To explore the long-term joint outcomes of low-dose prophylaxis in Chinese children with severe haemophilia A and to analyse their related factors. METHODS: We retrospectively analysed follow-up data from 21 severe haemophilia A children on regular low-dose prophylaxis for 6-10 years. We used International Prophylaxis Study Group magnetic resonance imaging score (IPSG MRI score), Hemophilia Joint Health Score (HJHS), number of target joints, and Hemophilia-Specific Quality of Life Index (Haemo-QoL) to evaluate joint outcomes. Factors associated with these outcomes were evaluated by statistical analysis. RESULTS: (1) The children were 1.75 to 17 years age at prophylaxis initiation. Median prophylactic factor VIII dose was 22.9 IU/kg per week. (2) At the end of follow-up: (a) The total IPSG MRI scores were 2-24 with 90.5% children exhibiting moderate to severe joint involvement (score 7-24); (b) The HJHS ranged 2-27, with 0-10 for 46.7% children and >10 for 53.3% children. There was a positive correlation between the MRI score and HJHS (p < .05); (c) Compared to their on-demand treatment period before prophylaxis, target joints numbers decreased, and no child needed auxiliary devices to walk; (d) Joint outcomes were positively correlated with the age at initiation of low-dose prophylaxis (p < .05) and negatively correlated with the treatment dose. CONCLUSION: Long-term low-dose prophylaxis had positive effect on joint outcomes compared with on-demand treatment. However, a certain degree of joint damage remained in all children indicating the need for improving the current strategy of low-dose prophylaxis.

Explotación Sexual de Niños y Adolescentes: reflexión acerca el papel de la escuela / Exploração sexual de crianças e adolescentes: reflexão sobre o papel da escola / Sexual exploitation of children and adolescents: a reflection of the role played by schools

Este artigo analisa o papel da escola no enfrentamento da Exploração Sexual de Crianças e Adolescentes, com base em um estudo realizado em unidades de ensino da rede pública estadual de Porto Velho-RO, município que nos últimos anos convive com as consequências sociais da construção de usinas hidrelétricas no Rio Madeira. A investigação foi desenvolvida por meio de entrevistas semiestruturadas, da qual participaram 20 agentes escolares, vinculados a quatro instituições de ensino. A análise das informações foi realizada à luz de referenciais críticos sobre direitos humanos, educação e psicologia, por meio da construção de categorias e subcategorias. Os resultados revelam que a maioria dos agentes escolares desconhece a problemática e que nenhuma das escolas pesquisadas desenvolve ações de enfrentamento. A educação sexual não é trabalhada como um tema transversal e a sexualidade é reduzida ao enfoque do risco e vitimização, não entendida sob a perspectiva dos direitos humanos.

En este artículo se analiza el papel de la escuela en el enfrentamiento de la Explotación Sexual de Niños y Adolescentes, con base en un estudio realizado en unidades de enseñanza de la red pública estatal de Porto Velho-RO, municipio que en los últimos años convive con las consecuencias sociales de la construcción de usinas hidroeléctricas en el río Madeira. Se desarrolló la investigación por intermedio de entrevistas semiestructuradas, de la cual participaron 20 agentes escolares, ligados a cuatro instituciones de enseñanza. El análisis de las informaciones se realizó a la luz de referenciales críticos sobre derechos humanos, educación y psicología, por intermedio de la construcción de categorías y subcategorías. Los resultados mostraron que la mayor parte de los agentes escolares desconoce la problemática y que ninguna de las escuelas investigadas desarrolla acciones de enfrentamiento. La educación sexual no es trabajada como un tema transversal y la sexualidad es reducida al enfoque del riesgo y victimización, no entendida bajo la perspectiva de los derechos humanos.

This article analyzes the school's role on tackling the sexual exploitation of children and adolescents, based on a study carried out in state schools of Porto Velho - RO , a municipality that in recent years has been suffering from the social consequences of the construction of two hydroelectric power plants on the Madeira River. The research was carried out by means of semi-structured interviews, with the participation of 20 school agents linked to four educational institutions. The analysis of information was carried out in the light of critical references on human rights, education, and psychology, and through the definition of categories and subcategories. The results show that most of the school agents are unaware of the problem and that none of the surveyed schools are actively taking action. Sex education is not seen as a cross-sectional issue and discussions on sexuality are reduced to a focus on risk and victimization, not being understood from a human rights perspective.

[Assessment of caffeine intake in children and adolescents aged 6-17 years in Beijing City].

OBJECTIVE: To assess the intake of caffeine from snacks among children and adolescents aged 6-17 years in Beijing City. METHODS: A multi-stage stratified cluster random sampling method was adopted to obtain the consumption status of caffeine-containing snacks among 881 school-age children and adolescents in Chaoyang, Changping and Yanqing Districts through a 3 d 24 h continuous questionnaire survey between October 2016 and February 2017, and the caffeine content in snacks was obtained through literature retrieval and laboratory detection. RESULTS: The proportion of caffeinated snacks consumers among children and adolescents aged 6-17 years in Beijing was 42. 45%(374/881). The average daily caffeine intake of the whole population was 9. 19 mg, with a median of 0 and a P95 of 41. 38 mg. The average daily caffeine intake of consumers was 21. 66 mg, with a median of 11. 03 mg and 76. 99 mg of P95. About 1. 60%(6/374) of individuals exceeded the daily safe intake level and there were statistically significant differences in caffeine intake between different ages, genders, grades and groups with and without tea drinking habits after weight was taken into account. Among the top three contributors, 12. 13 mg of caffeine was derived from tea, milk tea and tea beverages(including solid drinks), with a contribution rate which reached 56. 01%, 4. 35 mg of caffeine was derived from coffee, with a contribution rate of 20. 09%, and 3. 31 mg of caffeine was derived from cola and energy drinks, with a contribution rate of 15. 30%, and there existed slightly difference of the top three contribution foods among 6-11 and 12-17 years old children and adolescents. CONCLUSION: Children and adolescents aged 6-17 years in Beijing City had low caffeine intake levels from snacks and there was little risk of overconsumption. Tea, milk tea and tea beverages(including solid drinks) was the major contributor to its caffeine exposure.

Actividad física recreativa en niños y adolescentes: situación actual, indicaciones y beneficios / Recreational physical activity in children and adolescents: current situation, indications and benefits

Actividad física se considera a cualquier movimiento corporal producido por los músculos esqueléticos, con el consiguiente consumo de energía. Los niños que hacen actividad física logran beneficios en diversos aspectos: condición física, psicológica, social, desarrollo de hábitos saludables, mejora en la calidad de vida adulta. Esta actividad física debe ser voluntaria, desarrollada en los tiempos libres, y generar placer y alegría, lo que contribuirá a la salud física y psicológica. Favorece la creatividad y las relaciones sociales y de comunicación. Promueve la educación en hábitos saludables para la vida adulta. Según la Organización Mundial de la Salud la actividad física es un pilar para combatir el flagelo de la obesidad y el sobrepeso, y una herramienta para disminuir el sedentarismo mundial de aquí al 2030. (AU)

Physical activity is considered as any body movement produced by skeletal muscles, which consumes energy. Children who do physical activity achieve benefits in various aspects: physical, psychological, social condition, develop of healthy habits, improvement of quality in adult life. Physical activity must be voluntary, developed in leisure time, and shall generate pleasure and joy. This way physical activity contributes with physical and psychological health. It also promotes creativity as much as sociable and communicational relationships. At the same time, physical activity encourages, promotes the education in healthy habits for adult life. According to the World Health Organization, physical activity is a pillar to combat the scourge of obesity and the overweight. It is a tool to reduce world sedentary lifestyle by 2030. (AU)

A Measurement Scale to Assess Children's Satisfaction with Hospitalization in the Andalusian Population.

Background: Patient satisfaction is a principal indicator in the evaluation of the stay of pediatric patients in hospitals, since its consequences can emotionally interfere with health treatment. The aim of this study was to obtain a valid scale to assess children's satisfaction with their time spent as a patient in an Andalusian hospital. Method: The Children's Satisfaction with Hospitalization Questionnaire (CSHQ) was applied to 623 pediatric patients hospitalized in Andalusia. An exploratory factor analysis (EFA) showed one dimension underlying the children's satisfaction with their hospitalization. After that, we developed a depuration analysis process to achieve a valid and unidimensional scale to assess children's satisfaction. Results: The eleven-item one-dimension solution showed suitable consistency and goodness-of-fit indices. The final scale addresses hosting aspects as the main dimension of a minor's satisfaction in Andalusian hospitals. Conclusion: A unidimensional scale has been determined for the assessment of children's satisfaction with their stay in Andalusian hospitals based on hosting aspects. Nonetheless, other dimensions underlying the satisfaction of patients should also be considered.

[Outpatient Psychotherapy for Children and Adolescents with Intellectual Disability]. / Ambulante Psychotherapie für Kinder und Jugendliche mit geistiger Behinderung.

Outpatient Psychotherapy for Children and Adolescents with Intellectual Disability The psychiatric morbidity risk for people with intellectual disability is considerably increased. Psychotherapy is considered as one possible treatment. Among experts the caresituation is described as substantial insufficient. This study investigated the perspective of psychotherapists for children and adolescents in the German state North Rhine-Westphalia regarding the care situation of outpatient psychotherapy for children and adolescents with intellectual disability. The participants received a questionnaire (a) about the care situation, (b) how they consider their training to treat these patients and (c) the possibility for free answers. In this cross-section study 185 licensed psychotherapists for children and adolescents filled out a semi-standardized online-questionnaire. The data were analyzed descriptively; free answers were categorized according to Mayring. Additionally, group differences were tested. (a) The psychotherapeutic supply situation for children and adolescents with intellectual disability was rated as insufficient. Clients with learning disability or minor intellectual disability are mainly treated. This group of people benefits from psychotherapy. (b) The training for treating these clients was rated as inadequate. (c) Qualitative analysis refers that request for psychotherapy is seen as difficult; cognitive orientated treatments need modification. The psychotherapeutic care situation for children and adolescents with intellectual disability appears insufficient. This topic should be part of the training curriculum for psychotherapists.

[Stabilizing effectiveness of orthokeratology and long-term minute-concentration atropine therapy in myopia (draft report)]. / Otsenka stabiliziruiushchego éffekta ortokeratologicheskoi korrektsii i dlitel'nykh instilliatsii atropina sverkhmalykh kontsentratsii pri miopii (predvaritel'noe soobshchenie).

The rational for the study was the high prevalence of myopia in the world. According to the World Health Organization (WHO), myopia is one of the five leading causes of blindness and low vision. Of recent reports on conservative measures for the stabilization of myopia, two areas of investigation deserve attention: methods of optical correction that affect peripheral refraction, orthokeratology lenses (OKL) in particular, and pharmacotherapy. The aim of the study was to evaluate the effectiveness and safety of myopia control in pediatric patients by combining two methods - OKL wearing and instillation of extra low doses of atropine (0.01%). MATERIAL AND METHODS: Within a prospective cohort study, 31 patients (62 eyes) aged 8 to 14 years with acquired myopia of low 14 (28), medium 11 (22), or high 6 (12) degree, were examined before and 6 months after adding 0.01% atropine instillations to OKL wearing. Refraction (Huvitz MRK 3100P), axial eye length (IOL-Master, 'CarlZeiss', Germany), absolute accommodation (Grand Seiko WRK-5100K), accommodative reserves, and pseudoaccommodation were assessed. RESULTS: The most significant effect on reducing the rate of disease progression was observed in patients with low and moderate myopia (1.5 and 1.7 times, correspondingly, p<0.05). In high myopia no reliable changes were noticed. Obviously, the inhibitory effect of OKL, which is conditioned by optical factors (peripheral myopic defocus in particular), even in combination with atropine, is not able to stop the progression of high myopia, which is based on structural and biomechanical changes of the sclera. CONCLUSION: Judging from these preliminary results, one should not claim 100% effectiveness of prolonged minute-concentration atropine use, however, the positive effect exists and the study continues.

A ótica dos conselheiros tutelares sobre a ação da rede para a garantia da proteção integral a crianças e adolescentes em situação de violência sexual / Guardianship Councilors’ views on the effectiveness of the existing network in providing full protection to children and teenagers in situations of sexual violence

Resumo O artigo objetivou conhecer a ótica dos conselheiros tutelares sobre as principais dificuldades de atuação e mobilização da rede para garantir a proteção integral de crianças e adolescentes em situação de abuso e exploração sexual no município do Rio de Janeiro. O estudo qualitativo, a partir da análise temática de 12 entrevistas (individuais e grupos focais), reconstituiu o cenário desenhado pelos conselheiros e os limites percebidos de sua atuação. Os resultados apontam como problemas percebidos a insuficiência de instituições para atendimento especializado, profissionais despreparados, morosidade, falta de comunicação e de articulação interinstitucionais para garantir as medidas de proteção necessárias aos casos.

Abstract This article aimed to ascertain the point of view of Guardianship Councilors about the main difficulties of operation and mobilization faced by the Guardianship Councils network in ensuring full protection to children and teenagers in a situation of sexual abuse and exploitation in the municipality of Rio de Janeiro. The qualitative study, based on thematic analysis of 12 interviews (with individuals and as focus groups), reconstituted the scenario reported by the Councilors and the limitations that they experienced on their sphere of activity. The results indicate the following problems perceived: (i) insufficiency of institutions for specialized care; (ii) professionals without the necessary training/experience; (iii) delays; and (iv) lack of communication and coordination between institutions able to ensure the necessary protection measures for the cases concerned.

Abuso sexual na infância e adolescência: perfil social e médico-assistencial no centro de referência de Belém / Sexual abuse in the childhood and adolescence: social profile and medical welfare charts in the centre of reference of Belém

Objetivo: descrever características dos casos de crime sexual, atendidos no PROPAZ de Belémdo Pará, ano de 2010, envolvendo crianças e adolescentes na faixa etária até 14 anos, visandoidentificar dados epidemiológicos do agressor, assim como reconhecer dados do crime,descrever os achados do exame físico, avaliar os principais agravos decorrentes deste abuso,além de identificar o tempo entre a agressão alegada e a procura pelo serviço de saúde. Método:estudo prospectivo, transversal, em que foram utilizados os prontuários sociais e médicoassistenciaisdo PROPAZ, perfazendo um total de 1076 crianças e adolescentes em situação deviolência sexual. Foi realizada uma análise estatística adequada para avaliar a significância dosvalores encontrados. Resultados: na amostra estudada, a cidade de Belém é a que apresentamaior prevalência de casos (52,6%). As meninas lideraram as estatísticas de atendimento nacategoria de abuso sexual (78,8%) e com maior índice a faixa etária dos 12 aos 14 anos com31,4%. Os resultados evidenciaram que a violência intra-familiar é bastante significativa, umavez que entre os principais agressores estão o pai, outros parentes e o padrasto. Observou-se quea maioria das vítimas não recebeu a profilaxia necessária (75,0%), e somente em 34 (3,2%)casos esta foi devidamente realizada. 45 (5,3%) dos atos de violência sexual apresentaramresultado confirmado de gravidez. Conclusão: O gênero feminino é o que sofre este tipo deagressão com maior freqüência, demonstrando também que é categoria dominada e sujeita aopoder exercido pelo mais velho sobre o mais novo e do masculino sobre o feminino

Objective: to describe the characteristics of cases of sexual assault, seen at PROPAZ of Belém,Pará, in 2010, involving children and teenagers aged up to 14 years, a total of 1076 victims insituations of sexual violence, in order to identidy epidemiological data of the perpetrator, crimedata, describe the findings of physical examination, assess the main hazards arising from thisabuse, and identify the time between the alleged assault and demand for health services.Method: this is a prospective, descriptive, cross-sectional study that utilized social and medicalwelfare charts of the PROPAZ. A statistical analysis was performed to adequate assess thesignificance of the values found. Results when assessing the background of minors treated atPROPAZ, one can observe that the city of Bethlehem is the onde with the higher prevalence ofcases (52.6%). The girls led the service statistics in the category of sexual abuse (78.8%) andhighest incidence rate age group was from 12 to 14 years with 31.4%. The results showed thatdomestic violence is very significant, since among the main perpetrators are the father, otherrelatives and stepfather. It was observed that most victims did not receive the requiredprophylaxis 807 (75.0%), and only 34 (3.2%) cases it was properly done. 45 (5.3%) of the actsof sexual violence had positive pregnancy tests. Conclusion: it is the feminine type that suffersthis type of aggression with bigger frequency, demonstrating also what is a category dominatedand subject to the power practised by the oldest thing on the newest thing and of the masculineon the feminine thing.

"Foi normal, não foi forçado!" versus "Fui abusada sexualmente": uma interpretação dos discursos de agressores sexuais, das suas vítimas e de testemunhas / "It was normal, it was not forced!" versus "I was sexually abused": an interpretation of the discourses of sex offenders, their victims and witnesses

Os crimes sexuais contra crianças e adolescentes são uma forma de violência física que constitui uma preocupação no campo da Saúde Pública. Compreender estes crimes torna-se crucial para se poder intervir na sua prevenção e fundamentar o seu conhecimento para as políticas de saúde. Oartigo analisa as versões do crime sexual, comparando o discurso dos agressores com os depoimentos das vítimas e dos familiares registados em documento judicial. Estudo de natureza qualitativa, utilizando como técnicas de formação do corpus da pesquisa a entrevista individual com réus condenados ao regime de perda de liberdade e a análise documental das sentenças dos agressores sexuais de crianças e adolescentes. A reconstrução do delito sexual por parte dos reclusos, das vítimas e das testemunhas difere muito. Alguns dos agressores admitem o ato sexual criminoso, mas suas justificativas vão no sentido de eximir-se da responsabilidade alegando o consentimento da vítima; outros consideram seu crime uma acusação mentirosa elaborada por terceiros com o propósito de prejudicá-lo. As crenças partilhadas entre eles fazem com que minimizem seus comportamentos delituosos, declarando que o abuso sexual não tenha sido forçado, ou realizado mediante ameaças, nem traga sequelas físicas e psicológicas às vítimas. Os argumentos apresentados frequentemente pelos agressores expõem uma troca de papéis, passando do lugar de agressor ao da vítima. Esses agressores igualmente não reconhecem o fato de as vítimas ficarem com sequelas resultantes da violência sexual que poderão colocar seu futuro em causa.

Sexual crimes against children are a form of physical violence that is a concern in the field of Public Health. Understanding these crimes becomes crucial to be able to intervene in their prevention and foster knowledge on which to ground health policies. The article analyzes versions of sexual crime, comparing the speech of the attackers with the testimonies of victims and family members recorded in court document. It is a qualitative study, using techniques such as individual interviews with defendants sentenced to prison, as well as court documents pertaining to the sex crime against children and adolescents. The reconstruction of the sexual offense on the part of inmates, victims and witnesses differ much. Some of the attackers admit the sex offense, but their justifications go towards shirk responsibility by claiming the victim's consent; others consider his crime an elaborated lie concocted by third parties in order to cause harm. The shared beliefs between them make them minimize their criminal conduct, declaring that sexual abuse has not been forced under threats or that it brought physical and psychological effects on victims. The arguments presented by the sexual offenders often expose an exchange of roles; the attacker becomes the victim. These sexual offenders also do not recognize the fact that the victims are left with injuries resulting from sexual violence that may put their future in question.

Crianças e adolescentes em situação de rua e seus macro determinantes / Street children and their macro determinants

Este trabalho está baseado nos resultados de uma pesquisa realizada simultaneamente em 20 cidades do Estado de Minas Gerais, no ano de 2007, que teve como objeto de análise todas as crianças e adolescentes com idade até 18 anos incompletos que morassem ou estivessem exercendo qualquer tipo de trabalho nas ruas, nos diversos períodos do dia (manhã, tarde ou noite), durante uma semana de referência. O artigo tem como objetivo analisar o impacto de algumas características agregadas de cada município ao respectivo número de crianças identificadas. Através de regressões lineares multivariadas foram correlacionadas a proporção de crianças e adolescentes em situação de rua em relação aos diferentes Índices de Desenvolvimento Humano Municipal (IDH-M) e seus diversos componentes. Os resultados foram significativos, em especial no que se refere às variáveis "escolaridade dos adultos" e "longevidade". Entre as principais conclusões tem-se que parecem existir fatores ou características de caráter comunitário que propiciam ou não a maior ocorrência de crianças trabalhando nas ruas.

Percepções de crianças e adolescentes sobre seu trabalho informal / Las percepciones de niños y adolescentes sobre su trabajo informal es el tema de estetrabajo / The perceptions of children and adolescents over their informal work

A pesquisa foi realizada em uma cidade do interior de São Paulo, cuja principal atividade econômica é a produção de calçados masculinos. Teve como objetivo investigar a realidade e o sentido do trabalho para crianças e adolescentes que trabalham no setor informal com a costura manual do sapato, e a relação trabalho-escola. Participaram da pesquisa dez sujeitos com idade entre 6 e 16 anos, moradores de um bairro periférico. Para a investigação e compreensão dos dados, foram utilizadas, numa abordagem etnográfica, a observação participante e entrevista semiestruturada. Na análise dos dados, foi utilizada a análise temática de conteúdo. No contexto pesquisado, as crianças e adolescentes dizem trabalhar para ajudar os pais e adquirir bens materiais. E que o trabalho que executam não gera prejuízos no rendimento escolar. O estilo de relação parental parece ser um componente fundamental quanto aos possíveis prejuízos causados pelo trabalho infantil no contexto doméstico.

The research was carried through in a city of São Paulo's countryside which main economic activity is the production of male footwear. It aimed at investigating the reality and meaning of job for children and teenagers who work in the informal sector and also the relationship between work and school. Ten people participated in the research aged from six to sixteen years old, all residents of the city suburb. For the inquiry and understanding of the data an ethnographic approach was used, observing participant and semi-structured interview. The thematic analysis of content was used in the data analysis. In the research context, the participants told that they work to help their parents and acquire material goods. They also said that work doesn't damage their school routine; however, the style of parental relationship seems to be a key component for potential losses caused by child labor in the domestic context.

La investigación fue realizada en la ciudad de Franca, interior del Estado de São Paulo, que tiene la producción de calzado masculino como su principal actividad económica. El estudio tuvo la finalidad de investigar la realidad y el sentido del trabajo para los niños y adolescentes que trabajan en el sector informal, cosiendo manualmente el calzado, y la relación trabajo y escuela. Fueron entrevistados diez personas con edad de seis a dieciséis años, que viven en el suburbio. Para la investigación y comprensión de los datos se utilizó, en un abordaje etnográfico, la observación participante y la entrevista semi-estructurada. El análisis de los datos fue realizado a través del Análisis Temático de Contenido. En el contexto pesquisado, los entrevistados dijeron trabajar para ayudar a sus padres y adquirir bienes materiales. Los entrevistados dijeran que el trabajo no genera perjuicios a la vida escolar. La forma de relacionarse con los parientes parece ser un componente fundamental en relación a los posibles daños causados por el trabajo infantil en el contexto doméstico.

Percepções de crianças e adolescentes sobre seu trabalho informal / Las percepciones de niños y adolescentes sobre su trabajo informal es el tema de estetrabajo / The perceptions of children and adolescents over their informal work

A pesquisa foi realizada em uma cidade do interior de São Paulo, cuja principal atividade econômica é a produção de calçados masculinos. Teve como objetivo investigar a realidade e o sentido do trabalho para crianças e adolescentes que trabalham no setor informal com a costura manual do sapato, e a relação trabalho-escola. Participaram da pesquisa dez sujeitos com idade entre 6 e 16 anos, moradores de um bairro periférico. Para a investigação e compreensão dos dados, foram utilizadas, numa abordagem etnográfica, a observação participante e entrevista semiestruturada. Na análise dos dados, foi utilizada a análise temática de conteúdo. No contexto pesquisado, as crianças e adolescentes dizem trabalhar para ajudar os pais e adquirir bens materiais. E que o trabalho que executam não gera prejuízos no rendimento escolar. O estilo de relação parental parece ser um componente fundamental quanto aos possíveis prejuízos causados pelo trabalho infantil no contexto doméstico.(AU)

The research was carried through in a city of São Paulo's countryside which main economic activity is the production of male footwear. It aimed at investigating the reality and meaning of job for children and teenagers who work in the informal sector and also the relationship between work and school. Ten people participated in the research aged from six to sixteen years old, all residents of the city suburb. For the inquiry and understanding of the data an ethnographic approach was used, observing participant and semi-structured interview. The thematic analysis of content was used in the data analysis. In the research context, the participants told that they work to help their parents and acquire material goods. They also said that work doesn't damage their school routine; however, the style of parental relationship seems to be a key component for potential losses caused by child labor in the domestic context.(AU)

La investigación fue realizada en la ciudad de Franca, interior del Estado de São Paulo, que tiene la producción de calzado masculino como su principal actividad económica. El estudio tuvo la finalidad de investigar la realidad y el sentido del trabajo para los niños y adolescentes que trabajan en el sector informal, cosiendo manualmente el calzado, y la relación trabajo y escuela. Fueron entrevistados diez personas con edad de seis a dieciséis años, que viven en el suburbio. Para la investigación y comprensión de los datos se utilizó, en un abordaje etnográfico, la observación participante y la entrevista semi-estructurada. El análisis de los datos fue realizado a través del Análisis Temático de Contenido. En el contexto pesquisado, los entrevistados dijeron trabajar para ayudar a sus padres y adquirir bienes materiales. Los entrevistados dijeran que el trabajo no genera perjuicios a la vida escolar. La forma de relacionarse con los parientes parece ser un componente fundamental en relación a los posibles daños causados por el trabajo infantil en el contexto doméstico.(AU)