Parente sensitive support by paediatric nurses

Introdução The hospitalization of a child is an experience that causes big changes in child and his family life. The parents often suffer from stress and anxiety. This can affect their relationship with the child. Because of the closeness to the parents, nurses have an important role in giving parents support so they can reduce their stress and have more energy to support and take care of their children and in the inclusion of the family in the process of care Objectivos The aim of this study was to define what family-centered care is, to define the needs of hospitalized children's parents and to identify the strategies and methods that the nurses use to give parental support adapted to the parent's needs. It was also a goal to identify and understand the main differences between parental support given by nurses in Belgium and Portugal. Metodologia The study exists out of two parts. First is an integrative review of literature. The search was performed using the databases MEDLINE, CINAHL , PubMed and Science Direct. 18 Articles were selected based on inclusion and exclusion criteria. They had to involve nurses, hospitalized children between 0 and 18 years and their parents. Second part was a focus group. The participants were pediatric nurses from Portugal and Belgium. The goal was to understand different perspectives related to the parental needs of hospitalized children and nursing interventions to answer that needs. Resultados family-centered care can be considered as a partnership between family and nurses. It has some general principles: information sharing, respect differences, negotiation and care in the context of the family. Parent's participation is important to reduce the parental stress and it is essential for meeting the needs of the children. Parents have different needs: knowledge and communication, support, comfort, proximity and assurance. Parents cope with stress in different ways and nurses can support them while they are in the hospital. It is a nurse task to identify the stressors and know methods of emotional support, so she can protect the family structure. Nurses should always see the family as a path to the child, with whom the nurses should worry about taking care and meeting their needs. This is crucial to ensure the family's well-being, adaption to hospitalization and the child's recovery. Conclusões Nurses should collect information about the family which includes family relationships, cultural and religious habits and familiar dynamic. Parents need interpersonal emotional support. It is important for parents to be close to their children but they also need to take care of themselves. When nurses have enough information they can use it to the identification of parental needs and the planning of nursing interventions. It is important that nurses create an environment where parents feel safe and that they have privacy. To create a therapeutic and professional relationship efficient communication is needed. Parents will experience less stress and anxiety.

A mãe nas ações de acompanhamento do crescimento e desenvolvimento infantil

ARAÚJO, Marluce Oliveira de; ENDERS, Bertha Cruz. A mãe nas ações de acompanhamento do crescimento e desenvolvimento infantil. Revista Baiana de enfermagem, Salvador, v.19,n.1/2/3,p.93-103, jan./dez. 2004, jann./dez.2005.

The principle of least effort within the hierarchy of linguistic preferences: external evidence from English

The thesis is an investigation of the principle of least effort (Zipf 1949 [1972]). The principle is simple (all effort should be least) and universal (it governs the totality of human behavior). Since the principle is also functional, the thesis adopts a functional theory of language as its theoretical framework, i.e. Natural Linguistics. The explanatory system of Natural Linguistics posits that higher principles govern preferences, which, in turn, manifest themselves as concrete, specific processes in a given language. Therefore, the thesis’ aim is to investigate the principle of least effort on the basis of external evidence from English. The investigation falls into the three following strands: the investigation of the principle itself, the investigation of its application in articulatory effort and the investigation of its application in phonological processes. The structure of the thesis reflects the division of its broad aims. The first part of the thesis presents its theoretical background (Chapter One and Chapter Two), the second part of the thesis deals with application of least effort in articulatory effort (Chapter Three and Chapter Four), whereas the third part discusses the principle of least effort in phonological processes (Chapter Five and Chapter Six). Chapter One serves as an introduction, examining various aspects of the principle of least effort such as its history, literature, operation and motivation. It overviews various names which denote least effort, explains the origins of the principle and reviews the literature devoted to the principle of least effort in a chronological order. The chapter also discusses the nature and operation of the principle, providing numerous examples of the principle at work. It emphasizes the universal character of the principle from the linguistic field (low-level phonetic processes and language universals) and the non-linguistic ones (physics, biology, psychology and cognitive sciences), proving that the principle governs human behavior and choices. Chapter Two provides the theoretical background of the thesis in terms of its theoretical framework and discusses the terms used in the thesis’ title, i.e. hierarchy and preference. It justifies the selection of Natural Linguistics as the thesis’ theoretical framework by outlining its major assumptions and demonstrating its explanatory power. As far as the concepts of hierarchy and preference are concerned, the chapter provides their definitions and reviews their various understandings via decision theories and linguistic preference-based theories. Since the thesis investigates the principle of least effort in language and speech, Chapter Three considers the articulatory aspect of effort. It reviews the notion of easy and difficult sounds and discusses the concept of articulatory effort, overviewing its literature as well as various understandings in a chronological fashion. The chapter also presents the concept of articulatory gestures within the framework of Articulatory Phonology. The thesis’ aim is to investigate the principle of least effort on the basis of external evidence, therefore Chapters Four and Six provide evidence in terms of three experiments, text message studies (Chapter Four) and phonological processes in English (Chapter Six). Chapter Four contains evidence for the principle of least effort in articulation on the basis of experiments. It describes the experiments in terms of their predictions and methodology. In particular, it discusses the adopted measure of effort established by means of the effort parameters as well as their status. The statistical methods of the experiments are also clarified. The chapter reports on the results of the experiments, presenting them in a graphical way and discusses their relation to the tested predictions. Chapter Four establishes a hierarchy of speakers’ preferences with reference to articulatory effort (Figures 30, 31). The thesis investigates the principle of least effort in phonological processes, thus Chapter Five is devoted to the discussion of phonological processes in Natural Phonology. The chapter explains the general nature and motivation of processes as well as the development of processes in child language. It also discusses the organization of processes in terms of their typology as well as the order in which processes apply. The chapter characterizes the semantic properties of processes and overviews Luschützky’s (1997) contribution to NP with respect to processes in terms of their typology and incorporation of articulatory gestures in the concept of a process. Chapter Six investigates phonological processes. In particular, it identifies the issues of lenition/fortition definition and process typology by presenting the current approaches to process definitions and their typology. Since the chapter concludes that no coherent definition of lenition/fortition exists, it develops alternative lenition/fortition definitions. The chapter also revises the typology of phonological processes under effort management, which is an extended version of the principle of least effort. Chapter Seven concludes the thesis with a list of the concepts discussed in the thesis, enumerates the proposals made by the thesis in discussing the concepts and presents some questions for future research which have emerged in the course of investigation. The chapter also specifies the extent to which the investigation of the principle of least effort is a meaningful contribution to phonology.

O docente generalista: a importância da continuidade pedagógica para o sucesso na aprendizagem

Relatório de Estágio apresentado à Escola Superior de Educação de Paula Frassinetti para obtenção do grau de Mestre em Educação Pré-Escolar e Ensino do 1º Ciclo do Ensino Básico

Perceção dos enfermeiros sobre as competências de supervisão clínica

Introdução: A evolução da ciência e tecnologia, as mudanças no seio das organizações de saúde, as novas e emergentes filosofias de cuidados, exigem dos profissionais de saúde uma participação ativa na formação dos seus pares, tendo o processo de supervisão clínica uma importância relevante. Objetivos: Identificar a perceção dos enfermeiros tutores especialistas sobre as competências do supervisor clínico na área de saúde infantil e pediatria. Métodos: Estudo qualitativo exploratório descritivo, fenomenológico, numa amostra de dez enfermeiros tutores dos serviços da área de pediatria do Hospital Dr. Nélio Mendonça, SESARAM. Recorremos à entrevista semiestruturada e áudio gravada. Efetuámos análise de conteúdo ao “corpus” de todas as entrevistas, com definição de subcategorias e indicadores. Resultados:. Emergiu a categoria competências do supervisor clínico e as subcategorias mais referenciadas foram as caraterísticas pessoais com 38% de unidade de registo e as competências profissionais (25,7%). Nos aspetos relevantes em saúde infantil e pediatria destacaram-se também as competências pessoais e profissionais com 40,4% cada. O principal fator facilitador da supervisão foi o ser um processo estruturado (21,6%), e o dificultador foi o deficit no relacionamento interpessoal (21,7%). No global houve mais unidades de registo relacionadas com os aspetos dificultadores. Conclusão: Conscientes das perceções dos supervisores numa área tão específica como é a área de saúde infantil e pediatria, pensamos que este estudo poderá contribuir para melhorar a qualidade do processo supervisivo na enfermagem. É necessário o esforço conjunto entre o supervisor e supervisionado, melhorando os processos mediados entre as instituições e os atores, onde proliferam a partilha de saberes, experiências e objetivos profissionais. Palavras-chave: Supervisor, Mentor, Supervisor clínico, Enfermagem, Supervisão.

Language Outcomes of the Play and Language for Autistic Youngsters (PLAY) Project Home Consultation model—An Extended Analysis

The current study is a post-hoc analysis of data from the original randomized control trial of the Play and Language for Autistic Youngsters (PLAY) Home Consultation program, a parent-mediated, DIR/Floortime based early intervention program for children with ASD (Solomon, Van Egeren, Mahone, Huber, & Zimmerman, 2014). We examined 22 children from the original RCT who received the PLAY program. Children were split into two groups (high and lower functioning) based on the ADOS module administered prior to intervention. Fifteen-minute parent-child video sessions were coded through the use of CHILDES transcription software. Child and maternal language, communicative behaviors, and communicative functions were assessed in the natural language samples both pre- and post-intervention. Results demonstrated significant improvements in both child and maternal behaviors following intervention. There was a significant increase in child verbal and non-verbal initiations and verbal responses in whole group analysis. Total number of utterances, word production, and grammatical complexity all significantly improved when viewed across the whole group of participants; however, lexical growth did not reach significance. Changes in child communicative function were especially noteworthy, and demonstrated a significant increase in social interaction and a significant decrease in non-interactive behaviors. Further, mothers demonstrated an increase in responsiveness to the child’s conversational bids, increased ability to follow the child’s lead, and a decrease in directiveness. When separated for analyses within groups, trends emerged for child and maternal variables, suggesting greater gains in use of communicative function in both high and low groups over changes in linguistic structure. Additional analysis also revealed a significant inverse relationship between maternal responsiveness and child non-interactive behaviors; as mothers became more responsive, children’s non-engagement was decreased. Such changes further suggest that changes in learned skills following PLAY parent training may result in improvements in child social interaction and language abilities.

Structures familiales, encadrement communautaire et survie des enfants. Une recherche en milieu rural malien

The influence of the family environment on child survival is difficult to study using retrospective data, especially in contexts where family structures are complex and where children are mobile. Data from a follow-up survey in rural Mali (1976-2009) are used here to address this question. Several indicators are constructed to test the effect of family structures on child mortality: morphology of the domestic group, availability of family resources, the child's place in the family and the presence of his or her parents. Bivariate and multivariate analyses find no difference in child mortality across different family environments. This finding suggests that the family and social networks still play a powerful role in regulating and managing risks of unequal treatment and care of children

Foster Fathers: their experiences and contributions to fostering

The paper reports some of the findings of an exploratory study which looks at foster fathers’ experiences of fostering and discusses their routes into foster care and their perspectives on their roles and tasks. The study collected quantitative and qualitative data by approaching all foster fathers registered with a single independent fostering agency based in southeast England. They were asked about their personal and professional attributes, and their experiences of and views concerning the role of foster father. The study discusses the foster fathers’ motivation to foster, and argues that what they see as its positives and drawbacks, and how it fits into their own family lives, are all relevant to improving service recruitment, delivery and retention. The study produced some evidence about the distinctive and positive contribution which foster fathers see themselves making to the lives of the children they foster. Further research is needed to refine our knowledge of what this contribution may be. Such knowledge could potentially develop our understanding of the roles of fathers in child development more generally as well as fine-tuning practice in matching what particular placements have to offer to the needs of individual children.

Shaken baby syndrome

This brochure explains shaken baby syndrome and some ways to prevent it.

A dimensão preventiva da intervenção precoce : intervenção psicomotora na creche

O presente relatório tem como principal objetivo apresentar a caracterização do estágio realizado na Equipa Móvel de Desenvolvimento Infantil e Intervenção Precoce (EMDIIP) no âmbito da promoção do desenvolvimento infantil de crianças em contexto de creche, ao longo do segundo ano do mestrado em Reabilitação Psicomotora. Toda a intervenção psicomotora foi planeada consoante os resultados das avaliações formais, das observações informais de cada criança e das preocupações e dificuldades enunciadas pela Educadora de Infância da creche tendo sempre em conta as práticas recomendadas da Intervenção Precoce. Para além das sessões de psicomotricidade realizadas em grupo e individualmente, foi desenvolvido um trabalho de formação parental, com o intuito de promover as interações familiares e divulgar informação sobre o desenvolvimento normal das crianças, e um ajustamento do contexto da sala Arco-Íris. A psicomotricidade revelou ser uma ferramenta essencial na promoção do desenvolvimento infantil não só na sua vertente (re)educativa e terapêutica mas também na sua vertente preventiva.

Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013

Background: Up-to-date evidence on levels and trends for age-sex-specific all-cause and cause-specific mortality is essential for the formation of global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013) we estimated yearly deaths for 188 countries between 1990, and 2013. We used the results to assess whether there is epidemiological convergence across countries. Methods We estimated age-sex-specific all-cause mortality using the GBD 2010 methods with some refinements to improve accuracy applied to an updated database of vital registration, survey, and census data. We generally estimated cause of death as in the GBD 2010. Key improvements included the addition of more recent vital registration data for 72 countries, an updated verbal autopsy literature review, two new and detailed data systems for China, and more detail for Mexico, UK, Turkey, and Russia. We improved statistical models for garbage code redistribution. We used six different modelling strategies across the 240 causes; cause of death ensemble modelling (CODEm) was the dominant strategy for causes with sufficient information. Trends for Alzheimer's disease and other dementias were informed by meta-regression of prevalence studies. For pathogen-specific causes of diarrhoea and lower respiratory infections we used a counterfactual approach. We computed two measures of convergence (inequality) across countries: the average relative difference across all pairs of countries (Gini coefficient) and the average absolute difference across countries. To summarise broad findings, we used multiple decrement life-tables to decompose probabilities of death from birth to exact age 15 years, from exact age 15 years to exact age 50 years, and from exact age 50 years to exact age 75 years, and life expectancy at birth into major causes. For all quantities reported, we computed 95% uncertainty intervals (UIs). We constrained cause-specific fractions within each age-sex-country-year group to sum to all-cause mortality based on draws from the uncertainty distributions. Findings Global life expectancy for both sexes increased from 65·3 years (UI 65·0-65·6) in 1990, to 71·5 years (UI 71·0-71·9) in 2013, while the number of deaths increased from 47·5 million (UI 46·8-48·2) to 54·9 million (UI 53·6-56·3) over the same interval. Global progress masked variation by age and sex: for children, average absolute differences between countries decreased but relative differences increased.For women aged 25-39 years and older than 75 years and for men aged 20-49 years and 65 years and older, both absolute and relative differences increased. Decomposition of global and regional life expectancy showed the prominent role of reductions in age-standardised death rates for cardiovascular diseases and cancers in high-income regions, and reductions in child deaths from diarrhoea, lower respiratory infections, and neonatal causes in low-income regions. HIV/AIDS reduced life expectancy in southern sub-Saharan Africa. For most communicable causes of death both numbers of deaths and age-standardised death rates fell whereas for most non-communicable causes, demographic shifts have increased numbers of deaths but decreased age-standardised death rates. Global deaths from injury increased by 10·7%, from 4·3 million deaths in 1990 to 4·8 million in 2013; but age-standardised rates declined over the same period by 21%. For some causes of more than 100 000 deaths per year in 2013, age-standardised death rates increased between 1990 and 2013, including HIV/AIDS, pancreatic cancer, atrial fibrillation and flutter, drug use disorders, diabetes, chronic kidney disease, and sickle-cell anaemias. Diarrhoeal diseases, lower respiratory infections, neonatal causes, and malaria are still in the top five causes of death in children younger than 5 years. The most important pathogens are rotavirus for diarrhoea and pneumococcus for lower respiratory infections. Country-specific probabilities of death over three phases of life were substantially varied between and within regions. Interpretation For most countries, the general pattern of reductions in age-sex specific mortality has been associated with a progressive shift towards a larger share of the remaining deaths caused by non-communicable disease and injuries. Assessing epidemiological convergence across countries depends on whether an absolute or relative measure of inequality is used. Nevertheless, age-standardised death rates for seven substantial causes are increasing, suggesting the potential for reversals in some countries. Important gaps exist in the empirical data for cause of death estimates for some countries; for example, no national data for India are available for the past decade.

Cognitive control as a moderator of temperamental motivations toward adolescent risk-taking behavior

Few studies have directly examined whether cognitive control can moderate the influence of temperamental positive and negative affective traits on adolescent risk-taking behavior. Using a combined multimethod, latent variable approach to the assessment of adolescent risk-taking behavior and cognitive control, this study examined whether cognitive control moderates the influence of temperamental surgency and frustration on risk-taking behavior in a sample of 177 adolescents (Mage = 16.12 years, SD = 0.69). As predicted, there was a significant interaction between cognitive control and frustration, but not between cognitive control and surgency, in predicting risk-taking behavior. These findings have important implications and suggest that the determinants of adolescent risk taking depend on the valence of the affective motivation for risk-taking behavior.

Screen-time weight-loss intervention targeting children at home (SWITCH): a randomized controlled trial study protocol

BACKGROUND: Approximately one third of New Zealand children and young people are overweight or obese. A similar proportion (33%) do not meet recommendations for physical activity, and 70% do not meet recommendations for screen time. Increased time being sedentary is positively associated with being overweight. There are few family-based interventions aimed at reducing sedentary behavior in children. The aim of this trial is to determine the effects of a 24 week home-based, family oriented intervention to reduce sedentary screen time on children's body composition, sedentary behavior, physical activity, and diet.

METHODS/DESIGN: The study design is a pragmatic two-arm parallel randomized controlled trial. Two hundred and seventy overweight children aged 9-12 years and primary caregivers are being recruited. Participants are randomized to intervention (family-based screen time intervention) or control (no change). At the end of the study, the control group is offered the intervention content. Data collection is undertaken at baseline and 24 weeks. The primary trial outcome is child body mass index (BMI) and standardized body mass index (zBMI). Secondary outcomes are change from baseline to 24 weeks in child percentage body fat; waist circumference; self-reported average daily time spent in physical and sedentary activities; dietary intake; and enjoyment of physical activity and sedentary behavior. Secondary outcomes for the primary caregiver include change in BMI and self-reported physical activity.

DISCUSSION: This study provides an excellent example of a theory-based, pragmatic, community-based trial targeting sedentary behavior in overweight children. The study has been specifically designed to allow for estimation of the consistency of effects on body composition for Māori (indigenous), Pacific and non-Māori/non-Pacific ethnic groups. If effective, this intervention is imminently scalable and could be integrated within existing weight management programs..

O papel das histórias no desenvolvimento da oralidade

Relatório de estágio para obtenção do grau de mestre em Educação Pré-Escolar e Ensino do 1.º Ciclo do Ensino Básico

Temperamento – Haverá diferenças no temperamento da criança em contexto de creche e em contexto familiar?

Relatório de estágio apresentado para obtenção do grau de Mestre em Educação Pré-Escolar