First aid intervention with mothers/caregivers of children affected by the Zika virus in Brazil.

BACKGROUND: Children with microcephaly associated with the Zika virus are more likely to develop choking and apnea, so it is necessary that mothers of this population receive first aid training to cope with emergency situations that their children may experience. OBJECTIVE: To understand how an educational first aid intervention with mothers/caregivers of Brazilian children with congenital Zika virus syndrome impacts their management of seizures and choking. METHOD: A qualitative study conducted in a philanthropic institution with ten mothers/caregivers of children with congenital Zika virus syndrome. Data were collected between August and November 2018 through four focus groups with two meetings for intervention/educational workshops in first aid on situations of choking and seizure. After one month, two more meetings were held to evaluate the effectiveness of this action performed at home. The empirical material was submitted to Content Analysis, and discussed in the light of Paulo Freire's Pedagogy of Autonomy. RESULTS: The mothers/caregivers performed ineffective and harmful behaviors to the children in situations of choking and seizure before the intervention. Thus, the intervention empowered these caregivers through an exchange of experiences which began to present discernment, autonomy, resolving capacity and confidence to act in these experienced situations. They also became knowledge disseminators for family members and neighbors. CONCLUSION: The educational intervention can have satisfactory results in training mothers/caregivers in first aid, highlighting the importance of this initiative to reduce the morbidity and mortality of children who experience choking and seizures.

Persistence of metabolic syndrome and its impact on glucose metabolism in overweight and obese children and adolescents.

OBJECTIVE: To verify the effects of metabolic syndrome (MS) and its relation to insulin resistance (IR) in children and adolescents with overweight or obesity after 24 months of follow-up. DESIGN: Studies of repeated measures from April 2009 to April 2012. For both measurements, the evaluations performed were anthropometry, MS diagnosis, fasting blood glucose, glucose homeostasis model assessment (HOMA-IR), and insulin level; at a second evaluation, glycated hemoglobin (HbA1c) was used as an additional indicator of glucose metabolism alterations. Logistic regression between syndrome persistence and its components with glucose metabolism alterations was performed for each of its indicators. The SPSS version 17.0 software (95% CI) was used. LOCATION: Center for Childhood Obesity, Campina Grande, Brazil. SUBJECTS: Children and adolescents (n=133), aged 2-18 years, with overweight or obesity. RESULTS: There was a significant decrease in MS during the study period, with persistence of the syndrome in 17.3% of the individuals. The presence of at least one alteration in glucose metabolism occurred in 45.1% of children and adolescents. The systolic and diastolic blood pressure, and the average levels of HOMA-IR showed significant decrease at the end of 24 months (p<0.01), and an elevated waist circumference (WC) remained associated with IR (p<0.01). CONCLUSION: There was observed no relationship of IR or other indicator of glycemic disorders by persistence of MS. An elevated WC remained associated with IR after controlling for the effects of the following variables: gender, age group, and other MS components.

Hospitalized child and teenager with chronic diseases: feelings about death / Niño y adolescente hospitalizados con enfermedad crónica: sentimientos acerca de la muerte / Criança e adolescente com doença crônica hospitalizados: sentimentos sobre a morte

Objective.Analyze the feelings of hospitalized children and adolescents with chronic diseases towards death. Methodology. Qualitative research, with four children and one teenager with chronic diseases, aged between 11 and 13 years old, who were admitted at a teaching hospital in Brazil, in the period from January to March 2009. In-depth interviews were carried out using a ludic material for therapeutic purposes, named ''As a guest in the hospital". The empirical material was submitted to thematic analysis. Results. Two mains meanings were obtained: Feelings of hospitalized children and adolescents with chronic diseases dealing with the death of the other; and children and adolescents with chronic diseases and the fear of their own deaths. Hospitalization makes children and adolescents come across the death of other sick people, arousing feelings of sadness, consternation, anxiety, making the fear of their own death become a threat. Conclusion. The health team needs to be attentive to the feelings of hospitalized children and adolescents facing death so that they can get the demands, minimizing fears and anguish.

Objetivo.Analizar los sentimientos de niños y adolescentes hospitalizados con enfermedades crónicas en relación con la muerte. Metodología. Investigación cualitativa de cuatro niños y un adolescente con enfermedad crónica con edades de 11 a 13 años, ingresados en un hospital universitario en Brasil, de enero a marzo de 2009. Se realizaron entrevistas a profundidad mediante material del juego con propósitos terapéuticos llamado ''Como huésped en el hospital."La información fue sometida a análisis temático. Resultados. Se obtuvieron dos unidades de significado: Los sentimientos de los niños y adolescentes con enfermedades crónicas hospitalizados frente a la muerte del otro; y los niños y adolescentes con enfermedades crónicas y el miedo de la propia muerte. Conclusión. La hospitalización lleva a los niños y adolescentes a enfrentar la muerte de los demás enfermos, despertando sentimientos de tristeza, consternación, ansiedad, lo que hace que el miedo por la propia muerte se convierta en una amenaza. El equipo de salud tiene que estar atento a los sentimientos de los niños y adolescentes hospitalizados frente a la muerte para que pueda aceptar las demandas, lo que minimiza los temores y angustias.

Objetivo.Analisar os sentimentos de crianças e adolescentes com doenças crônicas hospitalizados em relação à morte.Metodologia. Pesquisa qualitativa, com quatro crianças e um adolescente com doenças crônicas em idade entre 11 e 13 anos, internadas em um hospital escola no Brasil, no período de Janeiro a Março de 2009. Realizaram-se entrevistas em profundidade por meio do material lúdico com fins terapêuticos, denominado ''Como hóspede no hospital". O material empírico foi submetido à áática. Resultados. Foram obtidos dois núcleos de sentido: Sentimentos de crianças e adolescentes com doenças crônicas hospitalizados frente à morte do outro; e Crianças e adolescentes com doenças crônicas e o temor da própria morte. A internação hospitalar leva crianças e adolescentes a se depararem com a morte de outros enfermos, despertando sentimentos de tristeza, consternação, ansiedade, fazendo com que o medo da própria morte se torne uma ameaça.Conclusões.A equipe de saúde precisa estar atenta aos sentimentos das crianças e adolescentes hospitalizados diante da morte para que possa acolher as demandas, minimizando temores e angústias.

Hospitalized child and teenager with chronic diseases: feelings about death.

OBJECTIVE: Analyze the feelings of hospitalized children and adolescents with chronic diseases towards death. METHODOLOGY: Qualitative research, with four children and one teenager with chronic diseases, aged between 11 and 13 years old, who were admitted at a teaching hospital in Brazil, in the period from January to March 2009. In-depth interviews were carried out using a ludic material for therapeutic purposes, named ''As a guest in the hospital". The empirical material was submitted to thematic analysis. RESULTS: Two mains meanings were obtained: Feelings of hospitalized children and adolescents with chronic diseases dealing with the death of the other; and children and adolescents with chronic diseases and the fear of their own deaths. Hospitalization makes children and adolescents come across the death of other sick people, arousing feelings of sadness, consternation, anxiety, making the fear of their own death become a threat. CONCLUSION: The health team needs to be attentive to the feelings of hospitalized children and adolescents facing death so that they can get the demands, minimizing fears and anguish.

[Longitudinality in childcare provided through Family Health Strategy]. / Longitudinalidade do cuidado à criança na Estratégia Saúde da Família.

OBJECTIVE: To evaluate the longitudinality attribute in childcare provided through the Family Health Strategy. METHOD: Quantitative survey performed with 344 caregivers of children below 10 years old, registered in the family health strategy of Distrito Sanitario III in João Pessoa, Paraiba. Data were collected from July to December, 2012, from the Brazil PCATool child version form and analyzed using descriptive statistics. RESULTS: Among the aspects evaluated, it is highlighted that 89.5% of caregivers said they were consulted by the same professionals, and 81.9% felt good talking to the professional. The average score for the longitudinality component was satisfactory, with a 6.6 value. CONCLUSION: The health facilities assessed are guided towards the longitudinality attribute, however, the target mean score was exactly the cutoff value, implying the need for a thoughtful look at the improvement of the attribute in the care of children under ten years.