744 resultados para Child and adolescent psychiatry


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BACKGROUND: Pre- and post-migration trauma due to forced migration may impact negatively on parents' ability to care for their children. Little qualitative work has examined Somali-born refugees' experiences. The aim of this study is to explore Somali-born refugees' experiences and challenges of being parents in Sweden, and the support they need in their parenting. METHODS: A qualitative descriptive study was undertaken. Data were collected from four focus group discussions (FGDs) among 23 Somali-born mothers and fathers living in a county in central Sweden. Qualitative content analysis has been applied. RESULTS: A main category, Parenthood in Transition, emerged as a description of a process of parenthood in transition. Two generic categories were identified: Challenges, and Improved parenting. Challenges emerged from leaving the home country and being new and feeling alienated in the new country. In Improved parenting, an awareness of opportunities in the new country and ways to improve their parenting was described, which includes how to improve their communication and relationship with their children. The parents described a need for information on how to culturally adapt their parenting and obtain support from the authorities. CONCLUSIONS: Parents experienced a process of parenthood in transition. They were looking to the future and for ways to improve their parenting. Schools and social services can overcome barriers that prevent lack of knowledge about the new country's systems related to parenthood. Leaving the home country often means separation from the family and losing the social network. We suggest that staff in schools and social services offer parent training classes for these parents throughout their children's childhood, with benefits for the child and family.

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This paper explores the question: is working as young laborer harmful to an individual in terms of adult outcomes in income? This question is explored through the utilization of a unique set of instruments that control for the decision to work as a child and the decision of how much schooling to acquire. These instruments are combined with two large household survey data sets from Brazil that include retrospective information on the child labor and schooling of working-age adults: the 1988 and 1996 PNAD. Estimations of the reduced form earnings model are performed first by using OLS without controlling for the potential endogeneity of child labor and schooling, and then by using a GMM estimation of instrumental variables models that include the set of instruments for child labor and schooling. The findings of the empirical investigations show that child labor has large negative impact on adult earnings for both male and female children even when controlling for schooling. In addition, the negative impact of starting to work as a child reverses at around age 14. Finally, different child labor activities are examined to determine if some are beneficial while others harmful with the finding that working in agriculture as a child appears to have no negative impact over and above the loss of education.

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This paper analyzes how differences in the composition of wealth between human and physical capital among families affect fertility choices. These in tum influence the dynamics of wealth and income inequality across generations through a tradeoffbetween quantity and quality of children. Wealth composition affects fertility because physical capital has only a wealth effect on number of children, whereas human capital increases the time cost of child-rearing in addition to the wealth effect. I construct a model combining endogenous fertility with borrowing constraints in human capital investments, in which weaIth composition is determined endogenously. The model is calibrated to the PNAD, a Brazilian household survey, and the main findings of the paper can be summarized as follows. First, the model implies that the crosssection relationship between fertility and wealth typically displays a U-shaped pattem, reflecting differences in wealth composition between poor and rich families. Also, the quantity-quality tradeoff implies a concave cross-section relationship between investments per child and wealth. Second, as the economy develops and families overcome their bOlTowing constraints, the negative effect of weaIth on fertility becomes smaller, and persistence of inequality declines accordingly. The empirical evidence presented in this paper is consistent with both implications .

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This research had as purpose to establish the logic symbolic present in the contemporary society that facilitated the emergency of a public speech on the incest, and, consequently, to demonstrate the ideological nature that structures it. Event associated to the order of the taboo, the incest would be the transgression of the injunction that, second Lévi-Strauss, facilitated the emergency of the Culture while symbolic order, differentiated of the natural order. The injunction of the incest would reveal the elementary and universal structures of the order symbolic presents in the human societies: the demand of the Rule as rule; the reciprocity and the gift, present element in the social changes that it transforms the individuals in partners, increasing a new quality in the transferred value, according to Lévi-Strauss. Starting from this, I developed the hypothesis second which the phenomenon of the alone incest became an event of discursive order and public as right social transformations affected the normative system (social representations, values, moral) regulator of the relationships among the social subjects, being reflected like this, in the own structuring of the Law. A second work hypothesis was developed starting from that. I develop it leaving of the argument that if when inserting the discussion of the thematic of the defense of the children and adolescent rights, being then, considering it while "privileged modality of sexual abuse against children", the present central subjects in the structuring of the social entail would be leaved. Being like this, the partner-institutional speech on the incest would answer the social demands of order and social control, becoming like this, discursive formations of ideological character. This research work tried to follow the hypothesis above referred, demonstrating the singular sense that it will be attributed to the incest in the contemporary society, particularly, its relationship with the Law and the transgression in the contemporary society

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Teaching Mathematics in a contextualized and significant manner, in the world of the child and the adolescent, requires a solid theoretical and methodological basis on the part of the researcher. The present work found this foundation in two ways: teaching with projects and ethnomathematics. It is understood that these ways have points in common, such as: the real, interdisciplinarity, teaching methods, flexibility in sequencing the curriculum and interactive learning. This makes possible a theoretical cross-fertilization, which is important for the teaching/learning of Mathematics. Those points are merged in the present proposal, making possible new strategies, distinct from those of the Traditional Teaching Methodology and giving raise to an Alternative Teaching Methodology, which is to be lived in the Mathematics classrooms. This work gives a new direction to teaching, going beyond the traditional forms of education by allowing the teaching of Mathematics to become integrated with other school subjects, resulting in significant learning. In order to implement the proposal, it is necessary to form partnerships with teachers, pupils and the whole community, so that the way can be traced by continual dialogue

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An extensive international literature has been developed regarding the risk trajectories of sex trade-involved children and youth. This literature has not, however, substantially incorporated the narratives of youths regarding their experiences. In this article, the contemporary literature on child and youth sex trade-involvement is reviewed and the findings of a qualitative analysis of the narratives of 14 youth from São Paulo, Brazil and 58 youth from Toronto, Canada are presented. Substantial similarities were found between the groups of narratives with respect to abusive and unstable home experiences, pathways into the sex trade, social exclusion, and the impacts of the sex trade on physical and mental health. Key areas of divergence included the roles of poverty and drug use in entering the sex trade. The implications of shared experiences of social exclusion and fragmented identity across differing sociocultural contexts for policy and intervention are discussed.

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OBJETIVOS: avaliar percepções e sentimentos de puérperas adultas e adolescentes, relacionados ao filho e a assistência materno-infantil, em hospital universitário de nível terciário. MÉTODOS: estudo transversal, envolvendo 180 puérperas, no Alojamento Conjunto (AC) e no Berçário Interno (BI) do Hospital das Clínicas da Faculdade de Medicina de Botucatu , entrevistadas no segundo e terceiro dia pós-parto e distribuídas em três grupos: adultas primíparas, adultas multíparas e adolescentes. Para comparação entre grupos e locais de internação utilizou-se o chi2 ou teste de Fisher. RESULTADOS: ultrasom obstétrico e cardiotocografia tiveram impacto positivo na emoção materna. Houve pouca diferença entre os grupos quanto aos sentimentos antes e após o parto, sendo felicidade, amor, responsabilidade, ansiedade e medo os mais freqüentes. A culpa predominou nas adolescentes do BI. As percepções relacionadas ao filho, a avaliação da assistência e equipe, não diferiram entre adultas e adolescentes. Nas duas enfermarias o relacionamento entre mães e cuidadores foi bom, as mães mostraram-se satisfeitas com a equipe e a assistência, mas o aleitamento materno foi pouco valorizado e poucas mães conheciam o médico. CONCLUSÕES: está ocorrendo um processo de humanização na assistência materno-infantil deste hospital universitário, mas alguns aspectos precisam ser melhorados, especialmente a valorização do aleitamento materno e a individualização no contato médico-paciente.

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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This study aimed to investigate the profile of the occurrence of abuse against children and adolescents. We analyzed the data recorded in police reports from the Department of Women's Defense, Araçatuba-SP, in 2008, relating to assault, victim-offender relationship, sociodemographic characteristics of offenders and victims, and victims' demand for health services. Among the accusations, there was a higher prevalence of physical abuse, being the residence the place of higher incidence of aggression. In most cases, the aggressor was the mother of the child, being the subject of aggression not reported, in most cases. Thus, we can define the profile of violent incidents against children, contributing to the visualization, knowledge and to deal with the problem.

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Background: Cross-sectional studies have associated poor insight in patients with obsessive-compulsive disorder (OCD) with increased OCD symptom severity, earlier age of onset, comorbid depression, and treatment response. The goal of this current study was to examine the relationship between dimensions of OCD symptomatology and insight in a large clinical cohort of Brazilian patients with OCD. We hypothesized that poor insight would be associated with total symptom severity as well as with hoarding symptoms severity, specifically. Methods: 824 outpatients underwent a detailed clinical assessment for OCD, including the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the Dimensional Yale-Brown Obsessive-Compulsive Scale (DY-BOCS), the Brown Assessment of Beliefs Scale (BABS), a socio-demographic questionnaire, and the Structured Clinical Interview for axis I DSM-IV disorders (SCID-P). Tobit regression models were used to examine the association between level of insight and clinical variables of interest. Results: Increased severity of current and worst-ever hoarding symptoms and higher rate of unemployment were associated with poor insight in OCD after controlling for current OCD severity, age and gender. Poor insight was also correlated with increased severity of current OCD symptoms. Conclusion: Hoarding and overall OCD severity were significantly but weakly associated with level of insight in OCD patients. Further studies should examine insight as a moderator and mediator of treatment response in OCD in both behavioral therapy and pharmacological trials. Behavioral techniques aimed at enhancing insight may be potentially beneficial in OCD, especially among patients with hoarding. © 2011.

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Background and Objective: Simple Measure of the Impact of Lupus Erythematosus in Youngsters (SMILEY) is a health-related quality of life (HRQOL) assessment tool for pediatric systemic lupus erythematosus (SLE), which has been translated into Portuguese for Brazil. We are reporting preliminary data on cross-cultural validation and reliability of SMILEY in Portuguese (Brazil). Methods: In this multi-center cross-sectional study, Brazilian children and adolescents 5-18 years of age with SLE and parents participated. Children and parents completed child and parent reports of Portuguese SMILEY and Portuguese Pediatric Quality of Life Inventory (PedsQLTM) Generic and Rheumatology modules. Parents also completed the Childhood Health Assessment Questionnaire (CHAQ). Physicians completed the SLE disease activity index (SLEDAI), Physician's Global Assessment of disease activity (PGA) and Systemic Lupus Erythematosus International Collaborating Clinics ACR Damage Index (SDI). Results: 99 subjects (84 girls) were enrolled; 93 children and 97 parents filled out the SMILEY scale. Subjects found SMILEY relevant and easy to understand and completed SMILEY in 5-15 minutes. Brazilian SMILEY was found to have good psychometric properties (validity and reliability), and the child-parent agreement was moderate. Conclusion: SMILEY may eventually be used routinely as a research/clinical tool in Brazil. It may be also adapted for other Portuguese-speaking nations offering critical information regarding the effect of SLE on HRQOL for children with SLE. © The Author(s), 2012.

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Meta-analysis of the heterogeneous symptoms of obsessive-compulsive disorder (OCD) has found a four-factor structure of symptom dimensions consisting of cleaning, forbidden thoughts, symmetry, and hoarding. Research into age of onset of symptom dimensions has yielded inconsistent results, and it is unknown whether symptoms along these dimensions differ in their clinical course. We assessed age of onset and clinical course of different OCD symptom dimensions in a large cohort of adult patients. Nine-hundred fifty-five subjects were assessed using the Dimensional Yale-Brown Obsessive-Compulsive Scale. For age of onset analysis, we tested across three methods of classification: (1) primary (more severe) symptom dimension (2) clinically significant symptoms within a dimension or (3) any symptoms within a dimension. Age of onset was defined as the earliest age of onset reported for any individual item within a symptom dimension. For analysis of different types of clinical course, we used chi-square tests to assess for differences between primary symptom dimensions. OCD symptoms in the symmetry dimension had an earlier age of onset than other OCD symptom dimensions. These findings remained significant across all three methods of classification and controlling for gender and comorbid tics. No significant differences were found between the other dimensions. Subjects with primary OCD symptoms in the forbidden thoughts dimension were more likely to report a waxing-and-waning course, whereas symmetry symptoms were less likely to be associated with a waxing-and-waning course. © 2013.

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Incluye Bibliografía

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Pós-graduação em Odontologia Preventiva e Social - FOA