Mental health promotion during pregnancy and early childhood : an action- research project in primary health care

ABSTRACT – Background: Primary Health Care (PHC) is usually the first contact with the health system, and health professionals are key mediators for enabling citizens to take care of their health. In Portugal, great improvements have been achieved in the biometric indicators of maternal and child health during the last decades. Nevertheless, scant attention has been paid to the mental health dimension, in spite of the recognition of its importance, being pregnancy and early childhood crucial opportunities in the lifecycle for mental health promotion, especially in the early years of life, with a strong impact in the health of the child. The impact of early attachment between mother and baby on maternal and child health has long been recognized. This attachment can be influenced by some factors, as the mother’s emotional adjustment. Attention to these factors may facilitate implementation of both positive conditions and preventative measures. Family support during the transition to parenthood has been highlighted as an effective measure and PHC professionals are in a privileged position as information sources as well as mediators. Aims: The project we present describes an action-research process developed together among academic researchers and health professionals to embrace these issues. We intend to enable health professionals to support families in the transition to parenthood thereby promoting children’s mental health. Approach: The project is driven by a participatory approach intended to lead to reorganization of health care during pregnancy and early childhood. Effective change happens when those involved are interested and motivated, what makes their participation so important. Reflection about current practices and needs, and knowledge about evidence-based interventions have been guiding the selection of changes to introduce in clinical practice for family support and development of parenthood skills and self-confidence. Development: We summarize the main steps in development: the initial assessment and the picture taken from the community under study; the decision making process; the training programme of PHC professionals in action; the review of the protocols of maternal consultation, home visits and antenatal education; the implementation planning; the plan for evaluation the effectiveness of the changes introduced in the delivery of maternal and child health care units. The already developed work has shown that motivation, leadership and organizational issues are decisive for process development.-------------------------- RESUMO - Os Cuidados de Saúde Primários são habitualmente o primeiro contacto com o sistema de saúde e os profissionais de saúde são mediadores chave na capacitação dos cidadãos para cuidarem da sua saúde. Em Portugal, nas últimas décadas, têm-se alcançado grandes melhorias nos indicadores biométricos de saúde materno-infantil. Contudo, tem-se dedicado pouca atenção à dimensão de saúde mental, apesar do reconhecimento da sua importância. A gravidez e primeira infância têm sido apontadas como uma oportunidade crucial no ciclo de vida para a promoção da saúde mental. É dado especial enfoque aos primeiros tempos de vida, dado o forte impacto na saúde da criança. O impacte da vinculação precoce entre a mãe e o bebé na saúde da mãe e da criança há muito que é reconhecido. Esta vinculação pode ser influenciada por vários factores, nomeadamente pelo ajustamento emocional da mãe. A focalização nestes aspectos pode facilitar a criação de condições favoráveis e a implementação de medidas preventivas. O suporte familiar durante o período de transição para a parentalidade tem sido enfatizado como uma medida eficaz e os Cuidados de Saúde Primários estão numa posição privilegiada como fontes de informação e como mediadores. O projecto que apresentamos descreve um processo de investigação- acção desenvolvido em parceria entre investigadores académicos e profissionais de saúde para abordar os aspectos referidos. Pretende-se capacitar os profissionais de saúde para apoiarem as famílias na transição para a parentalidade, promovendo assim a saúde mental das crianças. O projecto baseia-se numa abordagem participativa, direccionada para a reorganização dos cuidados durante a gravidez e primeiros tempos de vida. A mudança efectiva acontece quando os envolvidos estão interessados e motivados, o que torna a sua participação tão importante. A reflexão acerca das práticas e necessidades actuais e o conhecimento acerca de intervenções baseadas na evidência têm guiado a selecção das alterações a introduzir na prática clínica, no sentido de promover o suporte familiar e o desenvolvimento de competências parentais e auto-confiança. Neste artigo, apresentamos as etapas principais do desenvolvimento do projecto: avaliação inicial da comunidade em estudo; processo de tomada de decisão; programa de formação dos profissionais dos Cuidados de Saúde Primários; revisão dos protocolos da consulta de saúde materna, visita domiciliária e educação pré-natal; planeamento da implementação; plano de avaliação da efectividade das alterações introduzidas na prestação de cuidados. O trabalho já desenvolvido tem mostrado que a motivação, liderança e aspectos

Relatório de estágio de qualificação profissional (fase intercalar do estágio)

No âmbito do Mestrado em Educação Pré-Escolar e Ensino do 1º Ciclo do Ensino Básico e da Prática Pedagógica Supervisionada, realizada em contexto de Creche, foi desenvolvido o presente relatório de estágio de qualificação profissional na Educação Pré-Escolar. A prática educativa sustentou-se num quadro teórico-concetual de referência, com vista à construção de saberes para a Educação de Infância, pelo compromisso e responsabilização progressiva da ação docente, tendo sido encarado como um momento de singular importância. Desta forma, este documento procura ilustrar o processo de desenvolvimento de competências profissionais pela estudante para este nível de educação. Nesta linha de pensamento, importa referenciar a metodologia de investigação-ação, que fundamentou a prática pedagógica da estudante ao longo das várias etapas do processo educativo: Observação, Planificação, Ação, Avaliação, Comunicação e Articulação. Assim, apoiada em estratégias e atitudes investigativas e reflexivas, esta metodologia potenciou a transformação, melhoria e adequação das suas práticas. O contexto de formação assumiu-se, portanto, como um lugar privilegiado de articulação entre teoria e prática, onde o processo de ensino e aprendizagem ficou pautado por intencionalidades educativas com vista ao desenvolvimento integral de cada criança, bem como pela construção de saberes e competências profissionais pela estagiária, elencadas nos Decretos-Lei n.º 240 e 241 de 2001. Tomando em consideração o processo desenvolvido, importa realçar a importância de uma formação profissional ao longo da vida, de modo a potenciar o desenvolvimento de uma atitude perante a Educação cada vez mais crítica, problematizadora, indagadora, reflexiva e investigativa, em prol do desenvolvimento holístico de cada criança.

Analysis of the process of translation of knowledge regarding early childhood at the undergraduate level

Objective To analyze innovative contents on Early Child Development Promotion. Method This action-research involves nine faculties from four Higher Education Institutions at inner-state of São Paulo, Brazil.Data were collected by syllabi analyses (2009-2011), interviews and focus group. We have adopted an ECDP underpinning from international consensus, thus evaluating KT Results We have found relevant incorporation between teaching and extension in Nursing (87,5%) and Psychology (75%) undergraduate courses, while Pedagogy was restricted to teaching. Conclusion This KT evaluation has evinced innovative potential of extension, regardless teaching and research, for a better Early Childhood.


Early childhood caries in Switzerland: a marker of social inequalities.

BACKGROUND: Early childhood caries (ECC) is a marker of social inequalities worldwide because disadvantaged children are more likely to develop caries than their peers. This study aimed to define the ECC prevalence among children living in French-speaking Switzerland, where data on this topic were scarce, and to assess whether ECC was an early marker of social inequalities in this country. METHODS: The study took place between 2010 and 2012 in the primary care facility of Lausanne Children's Hospital. We clinically screened 856 children from 36 to 71 months old for ECC, and their caregivers (parents or legal guardians) filled in a questionnaire including items on socioeconomic background (education, occupation, income, literacy and immigration status), dental care and dietary habits. Prevalence rates, prevalence ratios and logistic regressions were calculated. RESULTS: The overall ECC prevalence was 24.8 %. ECC was less frequent among children from higher socioeconomic backgrounds than children from lower ones (prevalence ratios ≤ 0.58). CONCLUSIONS: This study reported a worrying prevalence rate of ECC among children from 36 to 71 months old, living in French-speaking Switzerland. ECC appears to be a good marker of social inequalities as disadvantaged children, whether from Swiss or immigrant backgrounds, were more likely to have caries than their less disadvantaged peers. Specific preventive interventions regarding ECC are needed for all disadvantaged children, whether immigrants or Swiss.

The ISSA Pedagogical Standards: a tool to influence quality in early childhood programs

The ISSA Pedagogical Standards were first published in 2001 as a network-developed tool that defined quality in teaching practices and the classroom environment and captured the changes that had occurred in the region since 1994 when the Step by Step Program, an initiative to promote democratic principles in early childhood development and education, was launched. The Program was built on belief that each child has the right to receive maximum support for the development of his or her full potential, and this work should be done in partnership and close cooperation with families, communities and professionals

Consulting young children about barriers and supports to learning

From consideration of children's rights in general and equal opportunities for disabled children in particular, it is important to consult children about barriers and supports to learning and participation. Finding appropriate and feasible ways, however, to incorporate this into educational programmes for younger children can present challenges. Here we report on what happened when teachers from reception classes in England for children aged 4–5 years implemented activities designed to access pupils' views about what helps or hinders at school. Teachers evaluated the feasibility and usefulness of the activities and, together with a small sample of children's responses, this showed that young children could indeed identify aspects of school life they like or dislike, laying the foundations for identifying barriers and supports to learning. Teachers' responses highlighted the importance of careful choice of activity to meet the needs of young children, particularly those with communication difficulties and/or low self-confidence, with staff in some cases adapting and merging activities to suit pupils' needs. Sensitive issues emerged concerning the introduction of consultation activities early in children's school careers. The implications of a compliant rather than collaborative approach by teachers are discussed in the context of children's right to have their views heard, and their developing understanding of difference.

Rotinas e mediações na pré-escola

Pós-graduação em Educação - FCT

Implicações da teoria histórico-cultural no processo de formação de professores da educação infantil

Pós-graduação em Educação - FFC

O estágio curricular e a didática na formação de professores: desafios e possibilidades

In this paper we addressed aspects of the disciplines “Curricular Training” and “Didactics” in the Pedagogy Course in training of teachers. The main objective is to emphasize upon submission of the work that we do in our teaching practice in the mentioned disciplines, the importance of linking the theory and the practice in training of teachers so that the teaching in the university it is not decontextualized but enriched with the issues of everyday school life. In this sense, we address, initially, the aspects of the Curricular training as a mediator link of the learning, of the articulation of the curriculum and of the practices and, in this view, as a productive conduit between the university and the basic education, stressing the need for the reception of the contribution that each institutions within its specificity, must provide in the training courses. In sequence, we present aspects of the structure of the work we do with our students in Early Childhood Education Curricular Training. Finally, are detailed the aspects of a Didactics for the teachers of early childhood education and for the early years of Fundamental Education, focusing on narratives of in-service teachers on their experiences teaching in search of new systematization of pedagogical practice and on by own teachers.

Ensino e aprendizagem da leitura e da escrita na educação de jovens e adultos: diálogos com a educação infantil

This article aims to present a discussion of the methodological aspects of teaching and learning to read and write in adult education, in an attempt to seek a dialogue with the Early Childhood Education by pointing convergent elements between these two instances. And, therefore, it proposes a reflection on the construction of human nature and ownership of reading and writing as a humanizing process from the perspective of historical-cultural theory advocated by Vygotsky and his collaborators. In this context it is presented a pedagogical situation in a public school for kindergarten in the state of Sao Paulo, followed by analysis from the perspective of Bakhtin in order to make some approximations in the teaching and learning of the mother tongue with adults and children.

Ensino Fundamental de nove anos: articulações necessárias com a Educação Infantil

This article leads to reflect on the analysis of contexts of early Childhood Education and Elementary School concerning the space for playtime in the educational routine with groups of children between five and six years old. There was a reflection on official documents about the extension of Elementary School and the presuppositions from the Cultural- -Historical Theory. Actions related to bibliographical research, questionnaire application, photographic and written documentation of playful practices observation, collective meetings with teachers and construction of a toy library have been taken. Specifically on the studied aspect, the make-believe play is the main child activity and may be considered as a mediator from the learning and from the humanization possibilities until about six years old. With this understanding, this issue deserves attention from the government (expressed in public policies), from the teachers and from the school staff in order to offer better conditions of success on the full formation during childhood.

Experiências de estágio curricular supervisionado e portfólios de aprendizagem

This article portrays Supervised Curricular Training experiences in Paulistas Universities by means of learning portfolios. The reflections presented indicate the pathways of experiences with this feature didactic-pedagogical motivator of qualitative advances in cultural formation of students and teachers of the Pedagogy Course. The methodological approach was chosen for consistent in the defense of necessary joints of dialogical, reflexive and emancipatory dimensions in training teachers for Early Childhood Education, and to contribute in the mediation of the activities carried out by undergraduates, with individualized follow in the formation of each one of them. The experience, stand out learnings regarding limits of this practice and the significant advances realized in each student, by means of their written work, sharing of knowledge, the interlocution between them and the teachers and the link with theory and practice through the Internship Supervised and the use of learning portfolios.

Possibilidades de atividades de comunicação emocional entre bebês: um estudo à luz da teoria histórico-cultural

Pós-graduação em Educação - FFC