Relatório de estágio: Atitudes dos adolescentes da Escola Secundária de São Lourenço face à sexualidade

Inserido no programa curricular do III Mestrado em Enfermagem com a área de especialização em Enfermagem Comunitária, o presente relatório tem o objectivo de descrever e avaliar as atividades desenvolvidas durante o estágio na comunidade, e que permitiu aplicar na prática os conhecimentos adquiridos. A população-alvo de estudo e de intervenção foram os alunos dos oitavos e décimos-primeiros anos da Escol Secundária de São Lourenço – Portalegre, relativamente às suas atitudes e comportamentos perante a sexualidade. A sexualidade na adolescência tem sido objecto de estudo e de intervenção dadas as complicações evitáveis resultantes do desconhecimento ou falsos conhecimentos dos adolescentes sobre esta temática. O período de estágio decorreu entre junho de 2013 e janeiro de 2014, seguindo-se a metodologia do Planeamento em saúde. Numa fase diagnóstica, foi realizado um estudo que envolveu 214 alunos da escola, que após identificação de necessidades, permitiu delinear estratégias de intervenção. Foram realizadas nove sessões de educação para a saúde sobre educação sexual, tendo envolvido 205 adolescentes. Após avaliação com um questionário de satisfação, salienta-se que 60,5% sentiram-se muito satisfeitos em relação às temáticas abordadas, 59,5% sentiram-se muitos satisfeitos sobre a utilidade dos temas e 52,7% consideraram-se muito satisfeitos em relação à utilidade das sessões. Este estágio permitiu de forma significativa, adquirir competências com Enfermeiro Especialista em Enfermagem Comunitária

Students’ Involvement in School and Parental Support: Contributions to the Socio-Educational Intervention

Student involvement in the school and the perception of parental support are core variables in the context of studies on personal and school adjustment of children and adolescents and should be considered in the context of socio-educational intervention. In this study, we formulated the following objectives: i) to understand the differences in students’ involvement in school and the perception of parental support, according to several socio- demographic and school variables, ii) to analyse the relationship between involvement and the perception of parental support iii) to outline socio-educational intervention strategies in the contexts of children’s lives. This is a non-experimental, correlational and cross-sectional study by means of a non-probabilistic convenience sample consisting of 150 children, aged between 10 and 16 years, attending the 2nd and 3rd cycles basic education [5th – 9th years of schooling] attending a school in the central region of Portugal. The data collection instruments were “Students’ Engagement in School: a Four-Dimensional Scale – SES-4DS” (Veiga 2013, 2016), the “Perceived Parental Support Scale” (Veiga, 2011) and a part with socio-demographic and school questions was added. We found significant differences in overall (and partial) amounts of student involvement and the perception of parental support, depending on the age, gender (in agency and behaviour subscales), school difficulties/retentions and methods of study (time, a place to study and a study schedule). We also found positive and significant relationships between student involvement and perception of parental support. The results are in line with the scientific literature in the field, which highlights the key role of the variables, student involvement and perception of parental support in the academic and psychosocial adjustment of young people. These should be considered in the context of socio-educational intervention. Given the above, we present areas and action strategies promoting parent and student involvement in the educational process.

Impacto de la implementación de un modelo de gestión integral de atención de la enfermedad y cuidado coordinado en la población en diálisis en Colombia

La atención hospitalaria en el costo global de la atención de los pacientes en diálisis es muy importante. Este estudio se realizó con el fin de evaluar resultados posteriores a la implementación de un modelo de gestión de la enfermedad y cuidado coordinado en una red de diálisis en Colombia, evaluando los cambios específicos en las tasas de hospitalización de una cohorte de pacientes renales con dos años de seguimiento. El modelo se enfoca básicamente en mejorar la atención de los pacientes en diálisis protocolizando en el manejo de comorbilidades (diabetes, riesgo cardiovascular, patologías infecciosas) y en el cuidado coordinado entre el tratamiento ambulatorio y hospitalario de los pacientes en diálisis asegurando la continuidad en el proceso de atención de los pacientes. El Estudio observacional analítico de cohortes compuesto por 2 fases una primera cohorte histórica retrospectiva y una segunda con dos cohortes prospectivas, incluyó pacientes mayores de 18 años, con más de 90 días en diálisis, con al menos tres meses de intervención con el modelo de gestión de enfermedad en la red Renal Therapy Services (RTS®). En conclusión, la realización de este estudio, se pudo asociar a la reducción en la atención hospitalaria de pacientes en diálisis y a una menor mortalidad, modelos como este y otras soluciones para mejorar los desenlaces en salud en los pacientes en diálisis deben seguir siendo implementados para aliviar la carga de la enfermedad y reducir los costos de la atención en salud de esta población.

Tornar-se pai/mãe de uma criança com transtornos graves do desenvolvimento

The interest in research on parents of children with severe developmental disorders has known different focuses of interest over time, from a more psychopathological approach, interested in describing the negative aspects of the impact of having a child with disabilities, to the study of coping strategies used to deal with the situation, and the study of the strength and resilience mobilized by these parents. The big change, however, is that the concern about parents is not only because of the child, but also for what happens in their own development processes. This developmental perspective is addressed here to the construction of the fundamental attachment between mother/father and the baby, how this bond is broken, and how it can be reconstructed when the child has a severe disability diagnosis. Only the resumption of parents’ developmental process will enable them to perform their parenting in an emotionally appropriate and consistent manner, based on adequate responsiveness in everyday life situations. This view allows to open new interdisciplinary challenges about how to work on early intervention in child development and to a comprehensive understanding of the family centered intervention.

An intervention program for children with school failure problems.

School failure is a chronic problem in many developing countries and in some developed as Portugal due to factors like cognitive deficiencies of children, an inadequate family environment, low SES and bad teaching methods or school organization. It is important to develop effective and simple intervention strategies able to cope with the problem at an individual level independently of the cause. The general objective of the following study is to develop behavioral training techniques to help children with problems of school failure. 6 - 12 years old children attending ISCED 1, with academic difficulties because of family problems, social exclusion (living in poverty or belonging to an ethnic minority) or poor schooling were trained. Cognitive-behavioral techniques that have been widely used to train persons with intellectual, sensorial, physical or social deficiencies were applied. Results are evaluated in terms of % of attained objectives, time, and (subjective) teacher satisfaction. Some results of individual children are shown. Training programs seem to be successful independently of the (mostly unknown) cause of failure of the trained subject.

Multi-victim sexual assault : a case study in rural Australia

Objective: There is a paucity of information regarding cases of multi-victim sexual assault of children. The reported incidence suggests that these cases are rare. The aim of this paper is to provide practitioners with information about effective intervention strategies arising out of the direct experience of managing a case of multi-victim sexual assault in an Australian rural community. --------- Method: A descriptive, case-report methodology summarizing the investigation and intervention in a case of multi-victim sexual assault is reported. A community based intervention arising out of the disclosures of 21 male children is described. The intervention occurred at an individual, group, and community level using a coordinated multi-disciplinary team and natural helping networks. ---------- Results: The coordination of police and welfare services increased the communication flow to victims, their families, and the community. The case also demonstrated the utility in regularly briefing political and bureaucratic authorities as well as local officials about emergent issues. Coordinating political and bureaucratic responses was essential in obtaining ongoing support and sufficient researching to enable the effective delivery of services. ---------- Conclusions: Interventions were focused at an individual, group, and community level using a coordinated multi-disciplinary team and natural helping networks. This provided a choice of services which were sensitive to the case setting. Recommendations are offered for practitioners who are confronted with similar events. While this paper describes an approach for intervening in a case of multi-victim sexual assault, further empirical research is needed to enable service deliverers to efficaciously target interventions which offer choice to victims and their families.

Fathers as informants of children’s fears and worries

The recognition of excessive fears and worries in children is important for early intervention. Despite current knowledge about the important contribution fathers make to their children’s emotional, social and cognitive development, more emphasis is often given to the views of mothers in both research and practice. This paper reports on a community study of 220 families. Fathers, mothers and children reported on children’s fears and worries using three different methods. While father and mother ratings were moderately correlated on two of the measures, there was relatively poor parent-child agreement. Implications for the role of fathers in the assessment of childhood fears and worries are discussed.

A discrete-trial approach to the functional analysis of aggressive behaviour in two boys with autism

Intervention to reduce challenging behaviour may be enhanced when based on a prior functional analysis. The present study describes a discrete-trial approach for the functional analysis of aggressive behaviour in two boys with autism. Twenty brief assessment trials were conducted in the classroom by the teacher under each of three conditions (i.e., attention, task and tangible). The results showed a clear pattern to each child's aggressive behaviour and suggested logical intervention strategies, although the study is limited because it involved only two children. The discrete-trial approach would appear to represent a practical and ecologically valid technique for conducting a functional analysis of challenging behaviour in applied settings

Modeling the impact of potential vaccines on epidemics of sexually transmitted chlamydia trachomatis infection

Background. We investigated the likely impact of vaccines on the prevalence of and morbidity due to Chlamydia trachomatis (chlamydia) infections in heterosexual populations. Methods.An individual‐based mathematical model of chlamydia transmission was developed and linked to the infection course in chlamydia‐infected individuals. The model describes the impact of a vaccine through its effect on the chlamydial load required to infect susceptible individuals (the “critical load”), the load in infected individuals, and their subsequent infectiousness. The model was calibrated using behavioral, biological, and clinical data. Results.A fully protective chlamydia vaccine administered before sexual debut can theoretically eliminate chlamydia epidemics within 20 years. Partially effective vaccines can still greatly reduce the incidence of chlamydia infection. Vaccines should aim primarily to increase the critical load in susceptible individuals and secondarily to decrease the peak load and/or the duration of infection in vaccinated individuals who become infected. Vaccinating both sexes has a beneficial impact on chlamydia‐related morbidity, but targeting women is more effective than targeting men. Conclusions.Our findings can be used in laboratory settings to evaluate vaccine candidates in animal models, by regulatory bodies in the promotion of candidates for clinical trials, and by public health authorities in deciding on optimal intervention strategies.

Impact of music therapy to promote positive parenting and child development

The effectiveness of a 10-week group music therapy program for marginalized parents and their children aged 0–5 years was examined. Musical activities were used to promote positive parent–child relationships and children’s behavioral, communicative and social development. Participants were 358 parents and children from families facing social disadvantage, young parents or parents of a child with a disability. Significant improvements were found for therapist-observed parent and child behaviors, and parent-reported irritable parenting, educational activities in the home, parent mental health and child communication and social play skills. This study provides evidence of the potential effectiveness of music therapy for early intervention.

Building resilience to prevent mental health problems in young people : The resourceful adolescent programme (RAP)

This chapter describes an evidence-based programme called the Resourceful Adolescent Program (RAP), which has been successful in building resilience in young people to prevent depressive symptoms developing.The programme adopts a strengths-focused approach. It aims to build a range of coping resources that foster teenagers’ abilities to maintain a positive sense of self and regulate emotions in the face of the vicissitudes of everyday struggles and difficult life events.This groupbased programme can be implemented routinely in schools or by counselling professionals as an early intervention or prevention programme. While there is no universal definition, ‘resilience’ generally means the process of avoiding the negative trajectories associated with exposure to risk factors (Fergus and Zimmerman, 2005). Current models of resilience are also very clear that there ‘are many pathways to resilience’ (Bonanno, 2004) and there is no

Learning barriers in continuous product innovation

In today's dynamic and turbulent environment companies are required to increase their effectiveness and efficiency, exploit synergy and learn product innovation processes in order to build competitive advantage. To be able to stimulate and facilitate learning in product innovation, it is necessary to gain an insight into factors that hinder learning and to design effective intervention strategies that may help remove barriers to learning. This article reports on learning barriers identified by product innovation managers in over 70 companies in the UK, Ireland, Italy, Netherlands, Sweden and Australia. The results show that the majority of the barriers identified can be labelled as organisational defensive routines leading to a chain of behaviours; lack of resources leads to under-appreciation of the value of valid information, absence of informed choice and lack of personal responsibility. An intervention theory is required which enables individuals and organisations to interrupt defensive patterns in ways that prevents them from recurring.

The phenomenon of resilience as described by adults who have experienced mental illness

Aim: This paper is a report of a study to explore the phenomenon of resilience in the lives of adult patients of mental health services who have experienced mental illness. ---------- Background: Mental illness is a major health concern worldwide, and the majority experiencing it will continue to battle with relapses throughout their lives. However, in many instances people go on to overcome their illness to lead productive and socially engaged lives. Contemporary mental health nursing practice primarily focuses on symptom reduction, and working with resilience has not generally been a consideration. ---------- Method: A descriptive phenomenological study was carried out in 2006. One participant was recruited through advertisements in community newspapers and newsletters and the others using the snowballing method. Information was gathered through in-depth individual interviews which were tape-recorded and subsequently transcribed. Colaizzi's original seven-step approach was used for data analysis, with the inclusion of two additional steps. ---------- Findings: The following themes were identified: Universality, Acceptance, Naming and knowing, Faith, Hope, Being the fool and Striking a balance, Having meaning and meaningful relationships, and 'Just doing it'. The conceptualization identified as encapsulating the themes was 'Viewing life from the ridge with eyes wide open', which involved knowing the risks and dangers ahead and making a decision for life amid ever-present hardships. ---------- Conclusion: Knowledge about resilience should be included in the theoretical and practical education of nursing students and experienced nurses. Early intervention, based on resilience factors identified through screening processes, is needed for people with mental illness.

Combining the parts to make the whole : integrated child and family services in Queensland

Over the past decade, the promotion of 'integrated child and family services' has emerged as a strong and consistent theme within Australian early childhood policy. Fuelling this trend is the belief that integrated service provision is more responsive to holistic family needs, offering better support to parents and thereby promoting better outcomes for young children. Adding further strength is the prevention and early intervention literature, and suggested social and economic benefits of 'effective' early years services and supports. States and territories are introducing new integrated child and family service models and Reflections is continuing to profile these. In this edition, we look at directions and new service models in Queensland, in particular, the new Early Years Centre service model.