Sympatistress : En kvalitativ intervjustudie om socialarbetares upplevelser av sekundär traumatisk stress och utbrändhet

The purpose of the study is to investigate social workers experiences of compassion fatigue as well as their thoughts about health and risk factors in the area. The method used is a qualitative interview study in which eight social workers, investigating child welfare matters, were individually interviewed. The study shows that most of the social workers describe their own experiences of burnout but not of secondary traumatic stress. The most important support for not suffer from compassion fatigue is to be supported and the possibility to ventilate with colleagues and managers. However, the social workers consider that the risk of burnout is primarily due to a heavy workload in terms of the number of cases and high staff turnover. Finally, the study indicates that social workers do not have experience of secondary traumatic stress because they are using tools that prevent this. However, the risk of experiencing burnout is high since they have not found strategies for managing workplace stress.

Det handlar om anknytning : En kvalitativ studie om socialsekreterares resonemang om anknytningens betydelse för en gynnsam utveckling

The aim of this study was to receive a rapt understanding of how child-welfare officer’s reasons about the meaning of attachment theory, from the child´s best, in placements of a child. The aim was also to examine the possibilities child-welfare officer´s feel they have to work with the child´s best and attachment in focus. The study has a qualitative approach and the empirical material is collected thru semi-structured interviews. The theoretical framework used is attachment theory, the child´s best and street-level bureaucracy. The result of the study shows that child-welfare officers have equivalent knowledge, experiences and thoughts about the meaning of attachment theory for a favorable development in foster children. The study concludes is that more knowledge about attachment theory is necessary and child-welfare officers demands methods to better assess attachment patterns in children. The child-welfare officers express frustration when they talk about matters in the "grey area" and situations where different perspectives clashes and the child´s best end up in the background.

Early administration of inhaled nitric oxide to children with acute respiratory distress syndrome and its effects on oxygenation and ventilator settings: prospective preliminary report of ten patients

Aim. To establish a protocol for the early introduction of inhaled nitric oxide (iNO) therapy in children with acute respiratory distress syndrome (ARDS) and to assess its acute and sustained effects on oxygenation and ventilator settings.Patients and Methods. Ten children with ARDS, aged 1 to 132 months (median, 11 months), with arterial saturation of oxygen <88% while receiving a fraction of inspired oxygen (FiO(2)) 0.6 and a positive end-expiratory pressure of greater than or equal to 10 cm H2O were included in the study. The acute response to iNO was assessed in a 4-hour dose-response test, and positive response was defined as an increase in the PaO2/FiO(2) ratio of 10 mmHg above baseline values. Conventional therapy was not changed during the test. In the following days, patients who had shown positive response continued to receive the lowest iNO dose. Hemodynamics, PaO2/FiO(2), oxygenation index, gas exchange, and methemoglobin levels were obtained when needed. Inhaled nitric oxide withdrawal followed predetermined rules.Results. At the end of the 4-hour test, all the children showed significant improvement in the PaO2/FiO(2) ratio (63.6%) and the oxygenation index (44.9%) compared with the baseline values. Prolonged treatment was associated with improvement in oxygenation, so that FiO(2) and peak inspiratory pressure could be quickly and significantly reduced., No toxicity from methemoglobin or nitrogen dioxide was observed.Conclusion. Administration of iNO to children is safe. iNO causes rapid and sustained improvement in oxygenation without adverse effects. Ventilator settings can safely be reduced during iNO treatment.

Cárie precoce: influência de variáveis sócio-comportamentais e do locus de controle da saúde em um grupo de crianças de Araraquara, São Paulo, Brasil

O objetivo deste estudo foi verificar a relação entre a cárie precoce, variáveis sócio-comportamentais e o locus de controle da saúde em um grupo de crianças de 24 a 35 meses de idade de Araraquara, São Paulo, Brasil. Foram envolvidas todas as crianças de ambos os sexos, na mencionada faixa etária, matriculadas em sete Centros Municipais de Educação e Recreação Infantil, totalizando 110 crianças. Os exames foram realizados por um examinador, previamente, calibrado para a aplicação dos critérios propostos pela OMS para determinação da condição dentária. Um questionário foi respondido pelas mães, sendo que seu conteúdo incluía informações referentes às características sócio-econômicas, comportamentos e atitudes relacionados à saúde bucal da criança, além da escala multidimensional do locus de controle da saúde. A prevalência de cárie precoce (lesões cavitadas e não cavitadas) foi de 28,2%. Observou-se associação significativa entre a escolaridade paterna (p = 0,01) e cárie precoce; não houve associação significativa entre as médias de nenhuma das subescalas do locus de controle e a cárie precoce. Os resultados sugerem que os pais não devam ser tidos apenas como provedores, mas como uma importante influência no desenvolvimento infantil como um todo.

Prevalence of Malocclusion and Related Oral Habits in 5-to 6-year-old Children

Purpose: To verify the prevalence of malocclusion and the influence of harmful oral habits on deciduous dentition in 5- and 6-year-old children enrolled in Brazilian public elementary schools during 2010.Materials and Methods: Exams were conducted in 1385 children from 56 Brazilian elementary schools using the method recommended by the World Health Organization (WHO) for epidemiological surveys on oral health. Information about the type of arch, social and economic data and harmful oral habits of the children were collected through a structured questionnaire.Results: In relation to canine occlusion, a high prevalence of Class I (74.5%), followed by Class II (19.4%), was found. Among all participants, 22% showed high overjet, 7.8% showed edge-to-edge occlusion and 2.3% showed anterior crossbite. In relation to overbite, 13.2% had short overbite, 14.3% open bite and 16.8% high overbite. The presence of posterior crossbite occurred in 14.6% of children. Maxillae predominantly exhibited the type I arch (67.9%) and mandibles predominantly exhibited type II (51.7%). In relation to harmful oral habits, 43.4% used a pacifier, 84.8% used a bottle and finger sucking was reported by 17.2%.Conclusion: There was a high prevalence of malocclusion associated with oral habits harmful to deciduous dentition.

Freqüência e variáveis associadas ao aleitamento materno em crianças com até 12 meses de idade no município de Araçatuba, São Paulo, Brazil

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Intoxicação por chumbo e saúde infantil: ações intersetoriais para o enfrentamento da questão

Inquérito epidemiológico realizado pela Secretaria de Estado da Saúde de São Paulo e Secretaria Municipal de Saúde de Bauru visou à realização de exames de plumbemia em 853 crianças de 0 a 12 anos, em Bauru, São Paulo, Brasil (2002), a partir de indícios de chumbo oriundo de resíduos industriais nas proximidades de uma fábrica de baterias. Os níveis sangüíneos de chumbo no grupo controle foram inferiores aos apresentados pelo grupo exposto (p < 0,05). Mediante a existência de 314 crianças com taxas de plumbemia superiores àquelas aceitáveis pelo Centers for Disease Control and Prevention (10µgPb/dl sangue), foi desencadeado um conjunto de ações com participação dos serviços públicos, universidades e voluntariado, para promover o diagnóstico e a assistência à saúde da população atingida. Ações emergenciais, visando a reduzir riscos de recontaminação, incluíram a raspagem de camada superficial das vias públicas, resultando em 1.392m³ de terra contendo material tóxico, que permanece depositada nas dependências da fábrica. Foi promovida a aspiração de poeira do interior das residências e a lavagem e vedamento das caixas d'água. O Grupo de Estudo e Pesquisa da Intoxicação por Chumbo em Crianças de Bauru, por meio deste trabalho, faz o compartilhamento de uma experiência intersetorial, multidisciplinar e interinstitucional.

Assessment of health-related quality of life in children with functional defecation disorders

Objective: To evaluate the health-related quality of life in children with functional defecation disorders. Methods: One hundred children seen consecutively were enrolled and subdivided into three subsets according to the Roma II classification criteria: functional constipation (n = 57), functional fecal retention (n = 29) and nonretentive functional soiling (n = 14). The generic instrument Child Health Questionnaire - Parent Form 50 (CHQ-PF50®), was used to measure quality of life and to assess the impact of these disorders from the point of view of parents. The instrument measures physical and psychosocial wellbeing in 15 health domains, each of which is graded on a scale from 0 to 100, with higher values indicating better health and greater wellbeing. Ten of these are then used to obtain two aggregated and summary scores: the physical and psychosocial scores. Results: No statistically significant differences were detected between subsets in terms of demographic or anthropometric characteristics. In 14 domains, children with defecation disorders scored lower than healthy children. When subsets were compared, statistically significant differences were detected between children with nonretentive functional soiling (lower scores) and those with functional constipation. Physical and psychosocial scores for the entire sample were lower than those for the group of healthy children used as controls. Conclusions: The CHQ-PF50® was considered adequate for demonstrating compromised quality of life in children with functional defecation disorders, as has been reported for other diseases, being a useful tool for making treatment decisions and for patient follow-up. Copyright © 2006 by Sociedade Brasileira de Pediatria.

Enfoque de derechos en las políticas de infancia: indicadores para su medición

Incluye Bibliografía

Childcare and parental leave

This issue of Challenges examines the progress made thus far on childcare leave for parents —mothers and fathers— and turns a spotlight on pending debts in this regard. Few legislative or practical measures exist for satisfying the many types of early childhood care needs, and inequalities of origin are still rife. In order to meet those needs, the policy response must be aimed at ensuring universal satisfaction of children's right to care regardless of the formal employment status (or otherwise) of their parents, and the existing models of care from birth must be thoroughly reviewed.

Cuidado infantil y licencias parentales

En este número se plantean avances y limitaciones en licencias parentales y maternales para el cuidado y se enfatizan las deudas pendientes. Las múltiples necesidades del cuidado en la primera infancia han tenido escasa traducción legal y práctica, y persisten desigualdades de origen. Para enfrentarlas se requiere de políticas que universalicen, más allá del empleo formal, el derecho de niños y niñas a recibir cuidados, además de un examen profundo de los modelos imperantes de provisión de cuidado infantil desde el nacimiento.

Infancia y la migración internacional en América Latina y el Caribe

La migración infantil en la región tiene aristas contradictorias, tal como se plantea en el artículo central de este boletín. Entre las positivas se destacan las mayores oportunidades educativas en los países de llegada y el mayor bienestar en los países de origen por efecto de las remesas; la más alta protección que se obtiene al migrar desde situaciones de violencia y riesgo social; y la apertura de nuevos horizontes para ampliar las experiencias de vida. Entre las aristas negativas se incluyen la precariedad y exposición a más riesgos en el entorno familiar cuando los padres migran y los hijos quedan a cargo de terceros; la exposición a abusos y violaciones de derechos en los procesos migratorios; y la degradación del estatus ciudadano en los países de recepción.

Children and international migration in Latin America and the Caribbean

Child migration in the region has many contradictory aspects, as reported in the feature article of this bulletin. On the positive side, there are better educational opportunities in countries of destination and, in countries of origin, greater well-being thanks to remittances; greater protection gained by migrating away from situations of violence and social risk; and new horizons for broadening life experiences. On the negative side, there are precariousness and heightened family environment risks when the parents migrate and the children are left behind in the care of others; exposure to abuse and violation of rights during migratory processes; and possibly lower citizen status in receiving countries.

Calidad del cuidado y la educación para la primera infancia en América Latina: Igualdad para hoy y mañana

Incluye bibliografía.

Derechos de la infancia en la era digital

La brecha digital exacerba desigualdades en el acceso a información y conocimiento, socialización con pares, visibilidad y manejo de herramientas básicas para desempeñarse en la sociedad. Reducir esta brecha permite sinergias virtuosas de inclusión social y cultural entre niños, niñas y adolescentes, con impactos positivos en el desarrollo de capacidades y generación de oportunidades para toda su vida. Si bien las nuevas generaciones están conectadas y sus miembros son nativos digitales, persisten desigualdades entre grupos socioeconómicos, aun cuando se han reducido gracias a los programas de conectividad en las escuelas públicas de la región. El artículo central de esta edición de Desafíos aborda –con información actualizada– las brechas y los avances en esta materia. El acceso es solo un primer paso; luego, es necesario proteger a niños y adolescentes contra los riesgos de la conectividad y potenciar los aprendizajes pertinentes y plenos de sentido, promoviendo usos más articulados con el currículo educativo. Por último, el artículo plantea que hay que vincular las políticas de conectividad con el cumplimiento de los derechos de la infancia en el marco de la Convención sobre los Derechos del Niño. Junto al artículo central, y como es habitual, se informa de encuentros y conferencias en la región durante el año y de publicaciones recientes en la materia. También se presentan buenas prácticas en el Perú para reducir brechas de género y una iniciativa conjunta de los operadores móviles y el UNICEF para proteger a la infancia en la era digital. En Puntos de vista se incluye la opinión de especialistas acerca de la potencialidad de las TIC como una herramienta a tener en cuenta para el ejercicio o vulneración de los derechos de niños, niñas y adolescentes.