Mood disorders among adolescents in conflict with the law and in custody.

The high prevalence of psychiatric symptoms among juvenile delinquents is a well-replicated international finding. This study aimed to find the prevalence of mood disorders and their relationship with serious criminal acts in a population of adolescents in conflict with the law and in custody. A total of 123 male inmates aged 14 to 17 years were interviewed and assessed. Mood disorders were diagnosed in 15% of the sample for current episode and 31% for lifetime, making them third most prevalent after dependence disorders and disruptive disorders. The psychopathological profile of the adolescents who had committed violent crimes corroborates other studies reporting a high prevalence of mood disorders in this population. Several factors have been found to influence the formation of juvenile delinquency, including absence of family structure, social inequality, lack of quality school education, alcohol and drug abuse/addiction and disruptive disorders. The present results confirm mood disorders as another such factor.

El orden de nacimiento como factor de riesgo para ser víctima de trata sexual en el triángulo norte de Centroamérica / Birth order as a risk factor for being victim of sex trafficking in the northern triangle of Central America

RESUMEN Las redes de tráfico humano para la prostitución captan a menores vulnerables, en especial, a quienes consideran no les queda otra opción que emigrar al norte para hacer frente a problemas económicos graves. El objetivo del presente trabajo fue establecer si el orden de nacimiento representó un factor de riesgo, asociado a la vulnerabilidad para la trata sexual de menores centroamericanas, traficadas a Estados Unidos. Las entrevistadas mostraban vulnerabilidades vinculadas con estructuras sociales y conductas individuales. Por una parte, todas crecieron en hogares caracterizados por la pobreza extrema. Por otra parte, también presentaban vulnerabilidades relacionadas con el embarazo adolescente, la falta de educación, la disfuncionalidad familiar y la participación en mercados ilegales. Ocupar el primer lugar en orden de nacimiento eleva la vulnerabilidad de las menores a ser traficadas a Estados Unidos para el comercio sexual. Por el contrario, ocupar el último lugar disminuye este riesgo.

ABSTRACT Human trafficking networks for prostitution recruit vulnerable underage girls, especially those who are considered with no choice but to migrate north to cope with serious economic problems. The aim of this work was to determine if birth order represented a risk factor associated to the vulnerability for sex trafficking of Central American female minors. The interviewees presented vulnerabilities associated to social structures and individual behaviors. On the one hand, all of them grew up in house holds characterized by extreme poverty. On the other hand, they also had vulnerabilities related to teenage pregnancy, lack of education, family dysfunction and participation in illegal markets. Findings suggest that occupying the first place in the order of birth raises the vulnerability of minors to being trafficked to the United States for sex trade. On the contrary, occupying the last place decreases this risk.

Minoría de edad y aborto en España: pasado, presente y futuro / Minors and abortion in Spain: past, present and future / Menores e aborto na Espanha: passado, presente e futuro

Objetivo:analizar la regulación jurídica existente en España relativa a la capacidad de las jóvenes menores de edad para tomar decisiones por sí mismas en relación con la interrupción del embarazo. Metodología: se comparan las normas legales vigentes en España en las últimas décadas, así como la literatura jurídica más relevante sobre la temática de estudio y los posicionamientos al respecto de organismos internacionales. Resultados: se puede comprobar muy fácilmente el alto componente ideológico de esta problemática. La legislación ha sufrido numerosas reformas a lo largo de los años, otorgando una mayor o menor autonomía a las mujeres menores de edad dependiendo de la ideología política del partido político en el gobierno. Conclusión: se trata de un tema de gran trascendencia, por desgracia altamente ideologizado. Ante los diversos intereses en conflicto, parece que debe primar el respecto a los derechos sexuales y reproductivos de la mujer, aunque sea menor de edad, siempre que tenga suficiente capacidad natural de juicio. Existen varias las razones que abogan por otorgar plena capacidad a las menores de edad para decidir libremente la interrupción del embarazo sin que se requiera el consentimiento de sus representantes legales, tal y como vienen manifestando relevantes organismos internacionales.

Objective:to analyze the existing legal regulation in Spain regarding the decision-making capacity of underage adolescents in relation to abortion. Methods: comparison of the legislation in force in Spain in recent decades, the relevant legal literature on the subject and the positions of international organizations. Results: the high ideological component of this problem can be very easily demonstrated. The legislation has undergone numerous reforms over the years, granting certain autonomy to underage women, depending on the political ideology of the ruling party. Conclusion:this is a very important issue that is unfortunately highly ideologized. Given the various conflicting interests, it seems that respect for women's sexual and reproductive rights should take precedence, even if they are minors, provided they have sufficient judgment. There are several reasons for granting minors the full capacity to decide freely on abortion without the need for the consent of their legal representatives, as relevant international organizations have stated.

Objetivo:analisar a regulamentação legal existente na Espanha sobre a capacidade das menores deidade dedecidir por si mesmos em relação à interrupção da gravidez. Metodologia: comparam-se as normas jurídicas vigentes na Espanha nas últimas décadas, assim como a literatura jurídica mais relevante sobre o tema de estudo e as posições em relação aos organismos internacionais. Resultados: verifica-se muito facilmente o elevado componente ideológico desse problema. A legislação passou por inúmeras reformas ao longo dos anos, concedendo maior ou menor autonomia às mulheres menores de idade, dependendo da ideologia política do partido político no governo. Conclusão: trata-se de um tema de grande importância, infelizmente altamente ideologizado. Diante dos diversos interesses conflitantes, parece que deve prevalecer o respeito aos direitos sexuais e reprodutivos das mulheres, ainda que sejam menores de idade e desde que tenham capacidade de julgamento suficiente. São várias as razões que defendem a concessão de plena capacidade às menores para decidirem livremente sobre a interrupção da gravidez sem necessitarem do consentimento dos seus representantes legais, como têm afirmado as organizações internacionais relevantes.

Association of rs662799 and rs5070 genetic polymorphisms with hypertriglyceridemia and atherogenic dyslipidemia in pediatric patients in Southeast Mexico.

BACKGROUND AND AIMS: Triglycerides are the initiators of the metabolic changes that lead to atherogenic dyslipidemia (AD). The APOA5 and APOA1 genes are involved in the response and metabolism of serum lipids and lipoproteins, where single nucleotide polymorphisms (SNP) rs662799 (promoter region) and rs5070 (intronic region) have been associated with the susceptibility to dyslipidemia. Until now, few studies evaluate the association of these polymorphisms with the presentation of hypertriglyceridemia and AD among Mexican children. Therefore, the objective was to determine the association between rs662799 and rs5070 with hypertriglyceridemia and AD in a pediatric population of southeastern Mexico. MATERIALS AND METHODS: A case-control analysis was performed including 268 infants aged 2-16 years, anthropometric, clinical variables, and serum lipid profiles were analyzed. DNA was extracted from blood samples and genotyping of polymorphisms was executed with the TaqMan SNP genotyping assay. Allele and genotypic frequencies were calculated. For genetic association analysis, logistic regression models were fitted according to models of inheritance. RESULTS: The SNP rs662799 (C) was significantly associated with hypertriglyceridemia in the overdominant model (OR=3.89, p=0.001) and AD in the dominant model (OR=4.01, p=0.001). The SNP rs5070 (T) has a protective effect against hypertriglyceridemia in the additive risk model (OR=0.68, p=0.03). CONCLUSION: Polymorphism rs662799 was significantly associated with cases of hypertriglyceridemia and AD in minors in southeastern Mexico. On the other hand, rs5070 polymorphism was not associated with cases of hypertriglyceridemia or AD.

Capacity to Consent to Research Among Adolescent-Parent Dyads in Rakai, Uganda.

OBJECTIVES: To assess the cognitive capacity of early, middle, and late adolescents and their parents or guardians to provide informed consent to a population-based cohort study. STUDY DESIGN: Adolescent-parent/guardian dyads including 40 early (n = 80; 10-14 years), 20 middle (15-17 years), and 20 late (18-19 years) adolescents were recruited from the Rakai Community Cohort Study, an open demographic cohort in Uganda. Participants were administered the MacArthur Competence Assessment Tool for Clinical Research, a structured open-ended assessment; interviews were recorded and transcribed. Twenty transcripts were scored independently by two coders; the intraclass correlation coefficient was 0.89. The remaining interviews were scored individually. We compared mean scores for early and middle/late adolescents using a one-sided t test and score differences between parent/guardian and adolescent dyads using two-sided paired t tests. RESULTS: Early adolescents (mean score, 28.8; 95% CI, 27.1-30.5) scored significantly lower (P < .01) than middle/late adolescents (32.4; 31.6-33.1). In paired dyad comparisons, we observed no statistically significant difference in scores between parents/guardians and middle/late adolescents (difference, -0.2; 95% CI, -1.0-0.6). We found a statistically significant difference in scores between parents/guardians and early adolescents (difference, 3.0; 95% CI, 1.2-4.8). CONCLUSIONS: The capacity of adolescents-of different ages and in diverse settings-to comprehend risks, benefits, and other elements of informed consent is a critical but understudied area in research ethics. Our findings support the practice of having middle and late adolescents provide independent informed consent for sexual and reproductive health studies. Early adolescents may benefit from supported decision-making approaches.

Does computer-assisted navigation improve baseplate screw configuration in reverse shoulder arthroplasty? A systematic review and meta-analysis of comparative studies.

Introduction: Navigation technologies have improved accuracy and precision in positioning glenoid components during shoulder arthroplasty. The influence of navigation on baseplate screw placement has not been independently investigated. This study aimed to evaluate and synthesize the best scientific evidence on the influence of intraoperative navigation on the length and number of screws for primary baseplate fixation in reverse total shoulder arthroplasty procedures. Methods: In August 2022, PubMed, Scopus, and Embase databases were accessed. We analyzed the screw purchase length, the number of screws required for the fixation of the baseplate, and the proportion of cases fixed with two screws in all clinical trials, comparing navigation to standard instrumentation for reverse shoulder arthroplasty. Following an evaluation of the heterogeneity of the studies, DerSimonian-Laird random-effects models were utilized to merge data from separate studies. Results: The systematic search revealed a total of 2034 articles. After excluding duplicates and irrelevant studies, 633 shoulder arthroplasties from 6 trials were included in the analysis. The pooled mean difference in screw purchase length was 5.839 mm (95 %CI 4.496 to 7. 182) in favor of navigation (P < .001). In addition, significant differences were also found in the number of screws per case (- 0.547, 95 %CI -0.890 to -0.203, P = .002) and in the proportion of cases fixed with two screws (Odds Ratio 3.182 95 %CI 1.057 to 9.579, P = .040) in favor of the navigation group. Conclusions: Intraoperative navigation improves the baseplate screw placement, allowing for a greater screw purchase length and fewer screws to achieve primary fixation of the glenoid component during reverse shoulder arthroplasty. It is unclear whether these improvements will increase the longevity of the prosthesis or the clinical outcomes of the patients.

Factors associated with the use of oral health services in Peruvian children under the age of 12 years.

OBJECTIVES: To determine the prevalence and factors associated with the use of oral health services in Peruvian children under 12 years of age. MATERIAL AND METHODS: A secondary analysis of 2019 Demographic and Family Health Survey was conducted. The sample consisted of 40,751 children. The main variable was the use of dental services (attended/not attended) in the last 6 months, and the independent variables were gender, age, area of residence, wealth quintile, health insurance coverage, information received on oral health care, age, and educational level of the caregivers. Analyses of absolute and relative frequencies, differences in proportions, and multivariate analysis using generalized linear models were performed. RESULTS: The dental service utilization prevalence during the last 6 months was 31%. Correlation was found with urban area residents (PRa = 0.945; 95% CI: 0.904-0.988), the Jungle geographical domain (PRa = 0.926; 95% CI: 0.877-0.977), the highest wealth quintile (PRa = 1.323; 95% CI: 1.232-1.421), the higher education level of the caregiver (PRa = 1.375; 95% CI: 1.231-1.536), affiliation with the Public Health Insurance (PRa = 1.112; 95% CI: 1.069-1.158), and the condition of having received information on oral health care (PRa = 2.355; 95% CI: 2.263-2.245) with respect to their baseline variables. CONCLUSIONS: Several socio-demographic factors were correlated with the use of oral health services in Peruvian children under 12 years of age and the percentage of their use was low. Information on oral health care had a more significant impact on both, the population from the highest wealth quintile and the highest educational attainment.

Study on pediatric scoliosis patients at hospital santa casa de misericórdia in são paulo / Estudo sobre pacientes com escoliose pediátrica no hospital santa casa de misericórdia de são paulo / Estudio sobre pacientes pediátricos con escoliosis en el hospital santa casa de misericórdia de são paulo

ABSTRACT: Objective: To carry out registration of patients with scoliosis under 18 years old, followed in a quarternary hospital of high complexity, who need surgical treatment, aiming to identify the reasons for the delay in treatment. Methods: Data collection was carried out in person and by spontaneous demand at the spinal orthopedic specialty outpatient clinic in a tertiary hospital of high complexity from January 2021 to December 2022. The results were compiled in the networked database (Red Cap®). Result: 59 patients were evaluated, 45 female (77.9%) and 14 male (22.1%), with a mean age of 13.7 years. Etiology: 30 idiopathic (50.8%), eight syndromic (13.5%), 11 neuromuscular (18.6%), and ten congenital (16.9%). Of the total, 46 (77.9%) were awaiting surgery and 13 (22.1%) were undergoing conservative treatment. The main causes of treatment delay: unavailability of intraoperative neurophysiological monitoring (19 - 41.3%); unavailability of specific surgical material (16 - 34.8%); difficulty of referral to our institution (6 - 13.1%); loss to follow-up (3 - 6.5%) and limitation in casting making (2 - 4.3%). The mean time between diagnosis and the first consultation is 17.25 months (0 - 140). The average surgical wait until December/2022 was 38.4 months (1 - 156). Conclusion: There is a lack of assistance in the steps of monitoring and treatment in the public health system, from directing the patient with scoliosis to the specialized center to performing the surgical procedure, mainly due to limitations in the use of intraoperative neurophysiological monitoring and the unavailability of specific materials to perform highly complex surgeries. Therapeutic Studies - Investigating the Results of Treatment.

RESUMO: Objetivo: Descrever a epidemiologia de pacientes, menores de 18 anos, com escoliose que aguardam cirurgia em hospital quaternário de alta complexidade e observar os motivos que acarretam atrasos no tratamento. Métodos: Coleta de dados presencial e espontaneamente no ambulatório de ortopedia da coluna vertebral num hospital de alta complexidade, de janeiro de 2021 a dezembro de 2022. Os resultados foram compilados no banco de dados (Red Cap®). Resultados: Foram avaliados 59 pacientes, 45 mulheres (77,9%) e 14 homens (22,1%), com média etária de 13,7 anos. Etiologia: 30 idiopáticas (50,8%), 8 sindrômicas (13,5%), 11 neuromusculares (18,6%) e 10 congênitas (16,9%). Do total, 46 (77,9%) aguardam cirurgia e 13 (22,1%) estavam em tratamento conservador. As principais causas de atraso do tratamento cirúrgico foram: indisponibilidade de monitoração neurofisiológica intraoperatória (19 - 41,3%); indisponibilidade de implantes para escoliose (16 - 34,8%); dificuldade no referenciamento para instituição (6 - 13,1%); perda de seguimento (3 - 6,5%) e limitação na confecção de colete (2 - 4,3%). Tempo médio entre diagnóstico e primeiro atendimento de 17,25 meses (0 - 140). A média de espera cirúrgica até dezembro/2022 era 38,4 meses (1 - 156). Conclusão: Há carência assistencial nas etapas do acompanhamento e no tratamento no Sistema Único de Saúde, desde o direcionamento do paciente com escoliose ao centro especializado até a realização do procedimento cirúrgico, sobretudo devido à limitação na utilização de monitoração neurofisiológica intraoperatória e indisponibilidade de materiais específicos para realização de cirurgias de alta complexidade. Estudos terapêuticos - Investigação dos resultados do tratamento.

RESUMEN: Objetivo: Describir la epidemiología de los pacientes menores de 18 años con escoliosis en un hospital cuaternario de alta complejidad y observar los motivos que llevan a retrasos en el tratamiento. Métodos: Recolección de datos presencial y espontánea en el ambulatorio de ortopedia de columna, de enero 2021 a diciembre 2022. Los resultados fueron recopilados en la base de datos (Red Cap®). Resultado: Se evaluaron 59 pacientes, 45 mujeres (77,9%) y 14 hombres (22,1%), con una edad promedio de 13,7 años. Etiología: 30 idiopáticas (50,8%), 8 sindrómicas (13,5%), 11 neuromusculares (18,6%) y 10 congénitas (16,9%). Del total, 46 (77,9%) estaban pendientes de cirugía y 13 (22,1%) estaban en tratamiento conservador. Las principales causas de retraso en el tratamiento quirúrgico fueron: indisponibilidad de monitorización neurofisiológica intraoperatoria (19 - 41,3%); indisponibilidad de implantes para escoliosis (16 - 34,8%); dificultad para hacer referencia a la institución (6 - 13,1%); pérdida de seguimiento (3 - 6,5%) y limitación en la confección de un chaleco (2 - 4,3%). Tiempo promedio diagnóstico y primera atención de 17,25 meses (0 - 140). Espera quirúrgica promedio: hasta diciembre/2022 fue de 38,4 meses (1 - 156). Conclusión: Existe falta de asistencia en las etapas de seguimiento y tratamiento en el Sistema Único de Salud, desde la dirección del paciente con escoliosis al centro especializado hasta la realización del procedimiento quirúrgico, debido principalmente a la limitación en el uso de instrumentos neurofisiológicos intraoperatorios. Estudios terapéuticos - Investigación de los resultados del tratamiento.

Minha cor não é essa, essa é a cor do remédio: imagem corporal de menores de 15 anos que tiveram hanseníase em Petrolina-PE e Juazeiro-BA / My color is not like this, this is the color of the medicine: body image of individuals under 15 years old who had leprosy in Petrolina, PE and Juazeiro, BA

Este artigo teve por objetivo compreender as repercussões da hanseníase na imagem corporal em menores de 15 anos afetados pela hanseníase. Participaram do estudo quatorze crianças e adolescentes menores de 15 anos que estavam cadastrados no programa de controle da Hanseníase de Petrolina-PE e Juazeiro-BA e que tiveram alta por cura. Utilizou-se a técnica de entrevista semiestruturada, que abrangeu questões norteadoras sobre a vivência da criança e do adolescente com a doença, abordando aspectos familiares, sociais e percepções advindas da experiência. Os dados obtidos foram analisados a partir do interacionismo simbólico e da sociologia de Erving Goffman, levando-se também em consideração leituras mais contemporâneas sobre performatividade. A partir das narrativas produzidas, buscou-se destacar os aspectos da imagem corporal da criança e do adolescente que tiveram hanseníase, organizados em eixos temáticos: imagem corporal, efeitos da hanseníase, racialização da doença e seus desdobramentos. Verifica-se que o elemento predominante da pesquisa ancora-se no corpo adoecido e marcado, imagens presentes em todas as entrevistas. Desse modo, para os participantes adoecidos pela hanseníase, o corpo é tido como "feio", "doente" e "rejeitado", sendo tal imagem corporal associada a repercussão negativa na sua autoimagem.

This article aimed to understand the repercussions of leprosy on body image in individuals under 15 years old affected by leprosy. Fourteen children and adolescents under 15 years old who were registered in the Leprosy Control Program of Petrolina-PE and Juazeiro-BA and who had been discharged as cured participated in the study. A semi-structured interview technique was used, covering guiding questions about the experiences of the child and adolescent with the disease, addressing family, social aspects, and perceptions arising from the experience. The data obtained were analyzed using symbolic interactionism and Erving Goffman's sociology, also taking into consideration more contemporary readings on performativity. Based on the narratives produced, the aspects of body image of children and adolescents with leprosy were highlighted and organized into thematic axes: body image, effects of leprosy, racialization of the disease, and its consequences. It is evident that the predominant element of the research is anchored in the diseased and marked body images present in all interviews. Thus, for participants afflicted by leprosy, the body is perceived as "ugly," "sick," and "rejected," and such body image is associated with a negative impact on their self-image.

Diseño y validación de un instrumento para medir compromiso con el lavado de manos en menores de edad / Design and Validation of an Instrument to Measure Commitment to Handwashing in Minors

Introducción: Los beneficios de lavarse las manos con agua y jabón son reconocidos en salud pública. En la actualidad es una de las acciones recomendadas para evitar la propagación de la COVID-19. No obstante, según datos de la Organización de las Naciones Unidas, a nivel mundial solo una de cada cinco personas lo realiza con la frecuencia y técnica adecuada. Se evidencia que el conocimiento no es el mejor predictor de la conducta, se le da mayor peso al compromiso. A la fecha, no se conoce un instrumento que determine esta actitud en menores de edad. Objetivo: Validar un instrumento electrónico diseñado para medir el grado de compromiso con el lavado de manos en menores de edad. Métodos: Estudio cuantitativo de validación en tres fases: a) diseño de los ítems del instrumento; b) validación de contenido por expertos; c) validación de constructo, confiabilidad y consistencia. Fue realizado en Mérida, Yucatán, México, entre septiembre de 2019 y marzo de 2020, con una selección a conveniencia de menores de edad escolarizados en 25 instituciones de educación primaria. Resultados: En la validación interna, el alfa de Cronbach obtuvo un valor aceptable (0,801), y la mayoría de los componentes arrojaron una confiabilidad por arriba de 0,70. La varianza total obtenida fue de 69,60 por ciento; en la prueba Kaiser-Meyer-Olkin el nivel general obtenido fue de 0,712. Conclusiones: Se diseñó un instrumento con validez interna, confiabilidad y aplicabilidad para medir el grado de compromiso frente al lavado de manos en menores de edad(AU)

Introduction: The benefits of hand washing with soap and water are recognized in public health. It is currently one of the recommended actions to prevent the spread of VOCID-19. However, according to data from the United Nations, worldwide only one in five people do it with adequate frequency and technique. It is evident that knowledge is not the best predictor of behavior, but that greater weight is given to commitment. To date, there is no known instrument to determine this attitude in minors. Objective: To validate an electronic instrument designed to measure the degree of commitment to handwashing in minors. Methods: Quantitative validation study in three phases: 1) design of the instrument items; 2) content validation by experts; 3) construct validation, reliability and consistency. It was conducted in Merida, Yucatan, Mexico, between September 2019 and March 2020, with a convenience selection of school-aged children in 25 elementary schools. Results: In the internal validation, Cronbach's alpha obtained an acceptable value (0.801), and most of the components yielded a reliability above 0.70. The total variance obtained was 69.60 percent; in the Kaiser-Meyer-Olkin test the overall level obtained was 0.712. Conclusions: An instrument with internal validity, reliability and applicability was designed to measure the degree of commitment to handwashing in minors(AU)

Exposure to tobacco impressions during prime-time TV among Chilean minors by sex and socioeconomic status.

INTRODUCTION: We tested if tobacco impressions were delivered differentially to prime-time TV watching minors by sex and socioeconomic status. METHODS: Programs aired during prime-time for three random weeks in 2019 from the 15 highest audience channels in Chile were content-analyzed for the occurrence of tobacco for each one-minute interval of 92639 recorded. Such occurrences were categorized as actual use and whether they violated Chilean smoke-free law or tobacco brand appearances. We estimated the number of persons per hour (p/h) exposed to tobacco impressions for the 4 to 17 years age group by sex and socioeconomic status (SES). RESULTS: Minors spent over a billion p/h watching TV during the observation period. Minors were exposed to tobacco explicit use, branding and smoke-free violation impressions for 9.7 million, 1.2 million, and 1.0 million p/h, respectively. The odds ratios (OR) of exposure to total tobacco impressions were always greater among boys with higher SES compared to boys with low SES. However, they were greater among girls of low SES compared to those of high SES for all types of impressions. The OR of exposure to tobacco branding was higher among girls of any SES compared to boys of any SES. CONCLUSIONS: Minors need protection from tobacco imagery on television, particularly girls of low SES. To that end, new legislation should implement all measures to counter depictions of tobacco in entertainment media, as recommended in the WHO FCTC Article 13 guidelines. This should require strong anti-tobacco advertisements before any TV program portraying tobacco targeting minor audiences, particularly girls of low SES. Given that Chile has one of the highest prevalences in the world of current cigarette smoking among young females, the potential contribution of tobacco impressions on TV to smoking differentials across female socioeconomic groups should be further studied.

The importance of applying the statement of assent to children and adolescents: a qualitative study.

OBJECTIVES: To describe the importance of the Statement of Assent for children and adolescents invited to participate in a clinical study and their main reactions to its explanation. METHODS: This is an exploratory descriptive qualitative study of 17 children and adolescents, who were invited to participate in a clinical study in the field of oncology in a hospital located in Rio de Janeiro (Brazil). Data were analyzed using thematic analysis. RESULTS: Two thematic units were generated after data interpretation: signing the statement of assent, in which participants felt their main role when faced with the possibility of expressing their agreement or not to take part in the study; and understanding of the study, when they showed that they understood the steps of the study by asking pertinent questions to clarify their doubts. Children and adolescents understood the steps of the study contained in the Statement of Assent, were interested and asked questions to clarify their doubts about the study. CONCLUSIONS: The Statement of Assent was important for participants understanding the study and having autonomy over their participation. As the statement strengthened the main role of children and adolescents in the research process, the conclusion was that its use in studies involving the pediatric population should be encouraged.

Unaccompanied migrant youth from Central America: Challenges and opportunities.

Unaccompanied youth from the Northern Triangle countries of El Salvador, Guatemala, and Honduras represent a growing demographic in communities nationwide. This vulnerable group often presents with early childhood adversity and repeated traumas that heighten their risk for poor mental health outcomes such as depression, anxiety, and posttraumatic stress. Harsh and exclusionary policies that result in family separations, extended detention stays, and unequal access to healthcare further exacerbate suffering. For mental health providers, attention to premigration, migration, and post-migration experiences is essential to understanding the youth's mental health trajectory and applying trauma-informed interventions that maximize potential for a successful resettlement. Post-migration environments that offer opportunities for educational attainment and social engagement, promote a sense of belonging, and can enhance recovery and healing.

The importance of applying the statement of assent to children and adolescents: a qualitative study / La importancia de la aplicación del término de consentimiento para niños y adolescentes: un estudio cualitativo / A importância da aplicação do termo de assentimento para crianças e adolescentes: um estudo qualitativo

Objective. To describe the importance of the Statement of Assent for children and adolescents invited to participate in a clinical study and their main reactions to its explanation. Methods. This is an exploratory descriptive qualitative study of 17 children and adolescents, who were invited to participate in a clinical study in the field of oncology in a hospital located in Rio de Janeiro (Brazil). Data were analyzed using thematic analysis. Results. Two thematic units were generated after data interpretation: signing the statement of assent, in which participants felt their main role when faced with the possibility of expressing their agreement or not to take part in the study; and understanding of the study, when they showed that they understood the steps of the study by asking pertinent questions to clarify their doubts. Children and adolescents understood the steps of the study contained in the Statement of Assent, were interested and asked questions to clarify their doubts about the study. Conclusion. The Statement of Assent was important for participants understanding the study and having autonomy over their participation. As the statement strengthened the main role of children and adolescents in the research process, the conclusion was that its use in studies involving the pediatric population should be encouraged.

Objetivo. describir la importancia del Formulario de Consentimiento Informado para los niños y adolescentes invitados a participar en un estudio clínico aleatorizado y sus principales reacciones a su explicación. Métodos. se trata de una investigación exploratoria descriptiva con abordaje cualitativo, realizada con 17 niños y adolescentes, quienes fueron invitados a participar de un estudio clínico en el área de oncología en un hospital ubicado en Río de Janeiro (Brasil). A los datos se les realizó análisis temático. Resultados. Luego de la interpretación de los datos, se generaron 2 unidades temáticas: la firma del formulario de consentimiento y la comprensión del estudio. Los niños y adolescentes entendieron las etapas del estudio contenidas en la firma del Término de Asentimiento y se interesaron, haciendo preguntas para aclarar sus dudas sobre la investigación. Conclusión. El consentimiento informado era importante para que los participantes entendieran la investigación y tuvieran autonomía sobre su participación. Al potenciar el protagonismo de los niños y adolescentes en el proceso de investigación, recomendamos que debe fomentarse su uso en los estudios con población pediátrica.

Objetivo. Descrever a importância do Termo de Assentimento para crianças e adolescentes convidados a participar de um estudo clínico e suas principais reações quanto à explicação do mesmo. Métodos. Trata-se de uma pesquisa do tipo descritiva exploratória com abordagem qualitativa, realizada com 17 crianças e adolescentes, que foram convidados a participar de um estudo clínico na área da oncologia em um hospital localizado no Rio de Janeiro (Brasil). Os dados foram analisados empregando-se a análise temática. Resultados. Após a interpretação dos dados, foram geradas 2 unidades temáticas: a assinatura do termo de assentimento em que os participantes se sentiram protagonistas frente a possibilidade de expressarem a concordância ou não em participar da pesquisa, e a compreensão sobre o estudo quando elas mostraram que entenderam as etapas do estudo fazendo perguntas pertinentes para esclarecer suas dúvidas. As crianças e adolescentes compreenderam as etapas do estudo que constavam no Termo de Assentimento e tiveram interesse, fazendo perguntas para esclarecer suas dúvidas com relação à pesquisa. Conclusão. O termo de assentimento foi importante para os participantes compreenderem sobre a pesquisa e para terem autonomia sobre sua participação. Por potencializar o protagonismo de crianças e adolescentes no processo de pesquisar conclui-se que seu uso em estudos que envolvem a população pediátrica deve ser incentivado.

Caregiving solutions in Mexican households during COVID-19 lockdown.

The COVID-19 quarantine in Mexico has meant that household members spend more time inside the home, increasing the demand for direct and indirect care by minors, the elderly, chronically ill and disabled. This forced a reconfiguration of the provision of these services by household members. The aim of the document is twofold: first, to describe socioeconomic and demographic aspects of Mexican households around care activities during the quarantine and second, to estimate the determinants of the provision of care in the quarantine. The information was obtained from the Survey of Care and COVID-19 in Mexican Homes during Quarantine (SCCMHQ). The propensity score-matching technique is used as a quasi-experimental procedure to estimate the causal effects of a treatment variable (presence of minors, elderly, chronically ill, disability, or domestic service in the home) in Mexican households. The Probit model shows that age and economic dependency are determinants of caregiving for treatment groups with minors, disability and chronic disease. In addition, sex, home income, and current employment situation are significant for treatment groups with a disability, paid domestic work, and minors, respectively. A positive "net" effect of the treatment variables in the probability of care provision was also observed. Particularly, the existence of minors at home was highly effective to promote direct and indirect care. The confinement solution is characterized by a balance between genders, except in the case of households with disabilities. This shows that a cultural and functional change is possible in the distribution of care responsibilities, which can be consolidated through public policies.

Características neuropsiquiátricas de menores trabajadores y no trabajadores pertenecientes a una Institución Educativa en Colombia / Neuropsychiatric characteristics of working and non-working minors belonging to an Educational Institution in Colombia / Características neuropsiquiátricas de menores trabalhadores e não trabalhadores pertencentes a uma Instituição Educativa na Colômbia

Objetivo: determinar las funciones cognitivas afectadas en un grupo menores trabajadores y la diferencia en el perfil neuropsiquiátrico de estos respecto a un grupo de menores no trabajadores. Metodología: investigación de diseño no experimental, de tipo transversal, prospectivo y analítico con un muestreo aleatorio simple. Resultados: el trabajo infantil no afecta todas las funciones cognitivas. Los puntajes obtenidos en las pruebas de habilidades gráficas, percepción táctil, percepción auditiva, memoria de evocación visual, lenguaje de repetición, lenguaje de comprensión, habilidades espaciales y atención auditiva estaban en rangos normales para ambos grupos. Sin embargo, los puntajes en las pruebas de construcción con palillos, memoria de codificación visual, percepción visual, memoria de evocación auditiva, lenguaje expresivo, atención visual, habilidades conceptuales, fluidez verbal y fluidez gráfica se encuentran por debajo de lo esperado para ambos grupos. Conclusión: las dificultades que presentan tanto el grupo de menores trabajadores como el de no trabajadores se podrían explicar por las condiciones de vida de la población, lo que suscita la hipótesis de que la pobreza y la escasez en la estimulación ambiental afectan el desarrollo cognitivo tanto como el trabajo infantil.

Objective: The purpose of this investigation was to determine the cognitive functions affected in a group of working minors and the difference in their neuropsychiatric profile as compared to that of a group of non-working minors. Methodology: non-experimental, cross-sectional, prospective and analytical design with a simple random sampling. Results: It was observed that child labor does not affect all cognitive functions. The scores obtained in the graphic skills, tactile perception, auditory perception, visual evocation memory, repetition language, comprehension language, spatial skills and auditory attention tests are in normal ranges for both groups. However, the scores on the stick construction, visual coding memory, visual perception, auditory evocation memory, expressive language, visual attention, conceptual skills, verbal fluency, and graphic fluency tests are lower than expected for both groups. Conclusion: The difficulties presented by both the group of working minors and nonworking minors could be explained by the conditions of the population, which raises the hypothesis that the conditions of poverty and scarcity in the environmental stimulation to which children are exposed in non-working minors affect cognitive development as much as child labor.

Objetivo: determinar as funções cognitivas afetadas num grupo menores trabalhadorese a diferença no perfil neuropsiquiátrico destes com respeito a um grupo de menores não trabalhadores. Metodologia: investigação de desenho não experimental, de tipo transversal, prospectivo e analítico com uma amostragem aleatório simples. Resultados: o trabalho infantil não afeta todas as funções cognitivas. As pontuações obtidas nas provas de habilidades gráficas, percepção táctil, percepção auditiva, memóriade evocação visual, linguagem de repetição, linguagem de compreensão, habilidades espaciais e atenção auditiva estavam em faixas normais para ambos os grupos. Embora, as pontuações nas provas de construção com pauzinhos, memória de codificação visual, percepção visual, memória de evocação auditiva, linguagem expressivo, atenção visual, habilidades conceptuais, fluidez verbal e fluidez gráfica se encontram por debaixo do esperado para ambos os grupos. Conclusão: as dificuldades que apresentam tanto no grupo de menores trabalhadores quanto no de não trabalhadores se poderiam explicar pelas condições de vida da população, o que suscita a hipótese de que a pobreza e a escassez na estimulação ambiental afetam o desenvolvimento cognitivo tanto como o trabalho infantil.

Construção e aplicabilidade de um termo de assentimento em pesquisa em nutrição com crianças hospitalizadas em tratamento oncológico / Construction and applicability of a term of consent in nutrition research with children hospitalized for oncological treatment

Objetivo: relatar a experiência na construção e aplicabilidade de um termo de assentimento livre esclarecido em uma pesquisa com crianças pré-escolares e escolares hospitalizadas para tratamento oncológico. Material e método: trata-se de um relato de experiência sobre a construção e aplicabilidade de um Termo de Assentimento Livre e Esclarecido lúdico para realização de um estudo sobre perfil nutricional e educação alimentar e nutricional de crianças em tratamento oncológico de um hospital público infantil em Santa Catarina-Brasil. Resultados: a construção e aplicabilidade do Termo de Assentimento Livre Esclarecido permitiu melhor compreensão da criança anterior à realização da pesquisa referente às etapas e fases da coleta dos dados do estudo, assim como os riscos e benefícios do mesmo. Foi possível à criança esclarecer suas dúvidas e participar ativamente do estudo. Foram convidadas para participar do estudo 13 crianças de ambos os sexos entre 5 ­ 12 anos de idade que estavam internadas no ambulatório de oncologia. Considerações Finais: adoção do Termo de Assentimento Livre Esclarecido Lúdico construído mostrou-se efetivo ao alcance do objetivo de sua utilização no contexto ético em pesquisa e avançou no sentido de despertar sobre potencialidade para além da pesquisa e, também, como recurso fundamental para o assentimento das crianças em situações específicas no processo de adoecimento e internação, possibilitando o exercício de direito e compreensão do que está sendo realizado durante seu tratamento.

Objective: report the experience in the construction and applicability of an informed term of consent in a survey of children hospitalized for cancer treatment. Material and method: experience report on the construction and applicability of a free and informed term of consent for conducting a study on the nutritional profile and food and nutrition education of children and adolescents undergoing cancer treatment at a public hospital in Santa Catarina, Brazil. Results: the construction and applicability of the informed term of consent allowed a better understanding of the child prior to conducting the research regarding the steps and phases of data collection, as well as its risks and benefits. It was possible for the child to clarify their doubts and actively participate in the study. Thirteen children of both sexes, aged between 5 - 12 years, hospitalized and in the oncology outpatient clinic, were invited to participate. Final considerations: adoption of the playful free and informed term of consent proved to be effective in reaching the objective of its use in the ethical research context and it has advanced in the sense of raising awareness of the potentiality beyond research, and also as a fundamental resource for the consent of children in specific situations in the illness and hospitalization process, enabling them to exercise their rights and understand what is happening during their treatment.

Guarda compartilhada à luz da bioética e do biodireito / Joint custody in the light of bioethics and biolaw / Custodia compartida a la luz de la bioética y el bioderecho

Resumo A família é a base fundante da sociedade e o melhor local para a educação e o crescimento da criança. O divórcio é deletério à saúde das crianças, impactando sobretudo na saúde mental e no desempenho escolar, além ter reflexos na vida adulta. O convívio por período igualitário com pai e mãe após o divórcio - a guarda compartilhada - garante benefícios, empiricamente comprovados, ao bem-estar físico e psicológico das crianças. No entanto, muitas decisões judiciais decretam guarda compartilhada em menos de um terço das separações. Ao analisar controvérsias éticas e morais na inter-relação das ciências jurídicas com as ciências da saúde, o biodireito faz com que a bioética tenha eficácia. Por esse motivo, argumenta-se que ações judiciais de família devem seguir critérios multidisciplinares que considerem as crianças como sujeitos vulneráveis que precisam de proteção.

Abstract Family is the founding basis of society and the best place for the education and growth of children. Divorce is deleterious to children's health, mainly impacting their mental health and school performance, in addition to having impacts on adulthood. Living both with the father and the mother for an equal period of time after divorce - joint custody - guarantees empirically proven benefits to the physical and psychological well-being of children. However, judicial decisions decree joint custody in less than a third of separations. By analyzing ethical and moral controversies in the interrelation of legal sciences and health sciences, biolaw makes bioethics effective. Thus, it is discussed that family lawsuits should follow multidisciplinary criteria that consider children as vulnerable subjects who need protection.

Resumen La familia es la base de la sociedad y es el mejor lugar para la educación y el crecimiento del niño. El divorcio es perjudicial para la salud de los niños, especialmente afecta la salud mental y escolar, con repercusiones en la vida adulta. Vivir juntos por un período igual con el padre y la madre después del divorcio, la custodia compartida, es un elemento con una relación causal estadística para proteger la salud de los niños. Sin embargo, las decisiones judiciales han decretado la custodia compartida en menos de un tercio de las separaciones. Bioderecho es una forma de hacer que la bioética sea efectiva, mediante el análisis de controversias éticas y morales en la interrelación entre las ciencias jurídicas y las ciencias de la salud. Las acciones legales familiares deben llevarse a cabo de manera multidisciplinaria, considerando al niño como el sujeto más vulnerable a proteger.

Aproximación al costo de oportunidad de los cuidadores menores de edad en México / Opportunity cost approximation of underage caregivers in Mexico

Resumen: Objetivo: Calcular el costo en que incurre la sociedad por contar con menores de edad que no estudian y que son cuidadores de adultos mayores con dependencia. Material y métodos: Se utilizó el Estudio Nacional de Salud y Envejecimiento en México (Enasem) 2015 para calcular el número de cuidadores menores de edad que no estudian. Se consultó la Encuesta Nacional de Ingresos y Gastos de los Hogares (ENIGH) 2018 para estimar diferencias salariales entre poblaciones con escolaridad de primaria y preparatoria terminada en edad laboral. Dichas diferencias fueron convertidas a valor presente, agregadas y multiplicadas por el número de cuidadores menores de edad. Resultados: El costo anual total de contar con cuidadores menores de edad que abandonan los estudios asciende a 1 112 179 210 pesos. Conclusiones: El tema de los cuidadores menores de edad no ha recibido la atención requerida de la bibliografía especializada y aún existe una gran brecha de investigación al respecto.

Abstract: Objective: To calculate the cost assumed by society for having underaged individuals who do not study and provide care to dependent older adults. Materials and methods: The Mexican Health and Ageing Study (MHAS) 2015 was used to calculate the number of underage caregivers who do not attend school. The Household Income and Expenditure Survey (ENIGH) 2018 was used to estimate wage differences between populations at working age with complete elementary and complete high school education. Those differences were then converted to present value, added and multiplied by the number of underage caregivers. Results: The total annual cost of having underage caregivers who drop out of school adds to 1 112 179 210 pesos. Conclusions: The topic concerning underage caregivers has not received enough attention from specialized literature and there is still a large research gap in this area.