Association between environmental factors during the COVID-19 pandemic and functioning of infants with biological risk in the first year of life: Cross-sectional exploratory study.

BACKGROUND: Child development can be influenced by family and environmental factors, which changed during the COVID-19 pandemic. Thus, it is important to explore how these factors are associated with the functioning of infants with biological risk in the first year of life. OBJECTIVE: This study aimed to investigate associations between family factors, home opportunities, caregiver perception of environmental support and barriers at home and environmental factors during the COVID-19 pandemic and gross motor skills and home participation in infants with biological risk in the first year of life. METHODS: Fifty-six infants aged two to 12 months (M = 5.80 months; ±2.44) and their mothers performed remote assessments of gross motor skills using the Alberta Infant Motor Scale (AIMS); participation and environment (phone call) by the Young Children's Participation and Environment Measure (YC-PEM); family factors (income, age and maternal education), home opportunities - The Affordances in the Home Environment for Motor Development - Infant Scale (AHEMD-IS) and environmental factors during the COVID-19 pandemic (social distancing, emotional and financial factors and physiotherapy) (online forms). Regression models were constructed, considering gross motor skills and home participation as outcome variables, with a 5 % significance level. RESULTS: We found that older maternal age (p = 0.001), more home opportunities (p = 0.043), and less rigorous social distancing (as opposed to total social distancing [p = 0.045]) were significantly associated with better gross motor skills; and higher maternal education (p = 0.050) was associated with more involvement in home activities. CONCLUSION: Family factors, home opportunities and social distancing were differently associated with the gross motor skills and home participation of infants with biological risk in the first year of life.

Early Intervention Involving Specific Task-Environment-Participation (STEP) Protocol for Infants at Risk: A Feasibility Study.

Aims: To verify the feasibility and preliminary effects of the STEP protocol, an intervention based on specific motor skills, environmental factors and participation, in infants at biological risk.Methods: Twenty-eight at-risk infants (STEP Protocol = 14; Standard Intervention = 14), aged 3-9 months and at risk for developmental delay. The following outcomes were assessed: motor skills (Alberta Infant Motor Scale-AIMS); frequency and involvement of participation (Young Children's Participation and Environment Measure-YC-PEM), and home environment opportunities (Affordances in the Home Environment for Motor Development-AHEMD-IS). For both groups, interventions were provided by parents. The intervention for group was based on the following principles: (1) standard intervention: stimulation of motor skills; (2) STEP: stimulation of motor skills, participation, mother-infant interaction, environmental enrichment. A mean comparison test was applied to verify difference between groups after the intervention.Results: The protocol showed good retention and recruitment rates. The STEP group had significantly higher outcomes after intervention on the AIMS (p = 0.014); frequency (p = 0.02) and engagement (p = 0.03) in participation, when compared to standard intervention.Conclusions: The results showed that the STEP protocol is feasible, and presents better results compared to the standard intervention, which reinforces the importance of promoting participation, specific motor skills and family involvement.

Transição do cuidado da atenção terciária para a atenção primária: Revisão integrativa da literatura / Transición de la atención terciaria a la atención primaria: Revisión integrativa de la literatura / Transition from tertiary care to primary care: Integrative literature review

Objetivo: descrever, com base na literatura, quais as estratégias utilizadas na transição do cuidado de usuários do hospital para a atenção primária. Método: trata-se de revisão integrativa realizada a partir de coleta de artigos publicados entre 2016 e 2020 nas bases de dados LILACS, MEDLINE, por meio da PubMed, e Sci-Verse Scopus. Foram selecionados 13 artigos que atendiam aos critérios de inclusão. Resultados: estratégias descritas na literatura, envolvem a ação multidisciplinar, com destaque para a atuação do enfermeiro. Compreendem ações de transição do cuidado, planejamento de visitas e consultas. Conclusão: são estratégias apontadas na literatura para a transição do cuidado: clínica de transição com equipe de atenção primária; cronograma estruturado para visitas domiciliares; avaliação clínica e social; clínicas de cuidado transitório; programa de coordenação do cuidado.(AU)

Objective: to describe, based on the literature, which strategies are used in the transition of care for hospital users to primary care. Method: this is an integrative review based on the compilation of articles published between 2016-and 2020 in the LILACS, MEDLINE databases, through PubMed, and Sci-Verse Scopus. Thirteen articles that met the inclusion criteria were selected. Results: strategies describer in the literature include multidisciplinary actions with emphasis on the role of nurses. They comprise care transition actions, planning of visits and consultations. Conclusion: strategies identified in the literature for the transition of care are: transition clinic with a primary care team; structured schedule for home visits; clinical and social assessment; transitional care clinics; care coordination program.(AU)

Objetivo: describir, con base en la literatura, qué estrategias se utilizan en la transición de la atención de los usuarios del hospital para la atención primaria. Método: se trata de una revisión integradora basada en la recopilación de artículos publicados entre 2016 y 2020 en las bases de datos LILACS, MEDLINE, a través de PubMed y Sci-Verse Scopus. Se seleccionaron trece artículos que cumplieron con los criterios de inclusión. Resultados: las estrategias descritas en la literatura implican una acción multidisciplinar, con énfasis en el papel de los enfermeros. Comprenden acciones de transición asistencial, planificación de visitas y consultas. Conclusión: las estrategias identificadas en la literatura para la transición de la atención son: clínica de transición con equipo de atención primaria; horario estructurado para visitas domiciliarias; evaluación clínica y social; clínicas de atención transitoria; programa de coordinación de cuidados.(AU)

Comportamento alimentar e imagem corporal em universitários da área de saúde / Eating behavior and body image in health sciences university students

OBJETIVO: Avaliar a associação da imagem corporal e o comportamento alimentar de universitários de uma capital do Nordeste do Brasil. MÉTODOS: Participaram da pesquisa universitários (n = 1570) da área da saúde de ambos os sexos, de quatro instituições de ensino superior. As dimensões da imagem corporal (i.e., perceptiva e atitudinal) foram avaliadas por meio da Escala de Silhuetas para adultos brasileiros; e o comportamento alimentar por meio da versão brasileira do Dutch Eating Behavior Questionnaire (DEBQ). Para a avaliação do estado nutricional, foram coletados peso corporal e estatura de modo autorreportado. A análise de associação foi feita pela regressão linear múltipla, após estratificação por sexo. RESULTADOS: Notou-se maior prevalência de universitárias do sexo feminino (72,9%), com idade média de 21,8 (DP = 4,1) anos. Foi encontrada associação entre percepção e (in)satisfação corporal com o comportamento alimentar em ambos os sexos. As mulheres que superestimaram o tamanho corporal obtiveram associação inversa com a dimensão alimentar restritiva (p = 0,001); e as insatisfeitas por magreza, associação direta entre alimentação restritiva; e inversa com o comportamento emocional (p < 0,001). Os homens que superestimaram seu tamanho corporal evidenciaram associação direta com a alimentação emocional; e entre os insatisfeitos por excesso de peso houve associação direta com a dimensão emocional (p = 0,032) e global (p = 0,046) do comportamento alimentar. CONCLUSÕES: O presente estudo demonstra que a imagem corporal negativa, considerando as duas dimensões avaliadas (i.e., perceptiva e atitudinal), foi associada ao comportamento alimentar entre universitários de ambos os sexos.

OBJECTIVE: To analyze an association of image and eating behavior of university students from a capital city in Northeast Brazil. METHODS: Participated in university research (n = 1570) in the health area of both sexes, from four higher education institutions. The dimensions of body image (that is, perceptual and attitudinal) were assessed using the Brazilian Adult Silhouettes Scale; and eating behavior using the Brazilian version of the Dutch eating behavior questionnaire (DEBQ). For an assessment of nutritional status, body weight and height were collected automatically reported. An association analysis was performed using the selected linear regression, after stratification by sex. RESULTS: There is no higher prevalence of women (72.9%), with a mean age of 21.8 (SD = 4.1) years. An association was found between perception and (in) body satisfaction with eating behavior in both sexes. Women who overestimated body size had an inverse association with the restrictive dietary dimension (p = 0.001); and as dissatisfied by law, direct association between restrictive eating; and inverse with emotional behavior (p < 0.001). Men who overestimate their body size, showed an association with emotional nutrition; among those dissatisfied with excess weight, there was an association with emotional (p = 0.032) and global (p = 0.046) dimensions of eating behavior. CONCLUSIONS: The present study demonstrates that a negative body image, considering two dimensions evaluated (that is, perceptual and attitudinal), was associated with eating behavior among university students of both sexes.

Discriminant ability and criterion validity of the Trunk Impairment Scale for cerebral palsy.

Aims: To compare the performance of children with mild and moderate-to-severe cerebral palsy (CP) on the Trunk Impairment Scale (TIS), Gross Motor Function Measure (GMFM), and on center-of-pressure variables; to establish the discriminant ability of these tools to predict severity of motor impairment in CP; and to investigate the criterion validity of the TIS. Methods: Children with mild (n = 18, 11 males, 7 females, mean age = 9.5 ± 2.9 years, Gross Motor Function Classification System I-II) and moderate-to-severe (n = 18, 11 males, 7 females, mean age = 9.2 ± 229, Gross Motor Function Classification System III-IV) CP were tested using the TIS and the GMFM, and during static sitting on force-plate. Results: Children with mild CP showed better trunk (median; 95% confidence interval = 22.5; 21.29-22.59 vs. 13; 11.97-14.8; p < 0.001) and gross motor (60; 57.73-59.3 vs. 40; 38.96-46.25; p < 0.001) scores, and better postural control (lower center of pressure (CoP) displacement [anterior-posterior: (0.42; 0.32-1.11 vs. 0.89; 0.70-1.65; p = 0.022); medial-lateral: (0.42; 0.31-1.08 vs. 0.91; 0.65-1.17; p = 0.044)], and lower area of sway, (0.05; -0.15-0.97 vs. 0.44; 0.23-0.90; p = 0.008) than the moderate-to-severe group. Trunk control and gross motor function explained 81.5% of the variance in the severity of motor condition. Correlations between the TIS and the GMFM were excellent (ρ = 0.944, p < 0.001); correlations between the TIS and CoP variables were low (anterior-posterior displacement: ρ = -0.411, p < 0.05; medial-lateral displacement: ρ = -0.327, p < 0.05); area of sway: ρ = -0.430, p < 0.05; velocity of sway: ρ = -0.308, p < 0.05). Conclusions: The TIS is able to differentiate levels of trunk control across various levels of motor impairments in CP. It is a valid tool to assess trunk control, showing very high concurrent validity with the GMFM sitting dimension. Implications for Rehabilitation Trunk Impairment Scale (TIS) can be used by rehabilitation professionals to differentiate levels of trunk control across levels of motor impairment. TIS showed concurrent validity with Gross Motor Function Measure and should be used to assess trunk control in children with cerebral palsy (CP) in clinical settings. The use of TIS allows a reliable assessment of postural control in children with CP in clinical settings.

Impact of extrinsic factors on fine motor performance of children attending day care / Repercussões de fatores extrínsecos no desempenho motor fino de crianças frequentadoras de creches

Abstract Objective: To assess the impact of extrinsic factors on fine motor performance of children aged 2-years old. Methods: 73 children attending public and 21 private day care centers were assessed. Day care environment was evaluated using the Infant/Toddler Environment Rating Scale-Revised Edition (ITERS-R), fine motor performance was assessed through the Bayley Scales of Infant and Toddler Development-III (BSITD-III), socioeconomic data, maternal education and time of start at the day care were collected through interviews. Spearman's correlation coefficient was calculated to assess the association between the studied variables. Results: The time at the day care was positively correlated with the children's performance in some fine motor tasks of the BSITD-III, showing that the activities developed in day care centers were important for the refinement of specific motor skills, while the overall fine motor performance by the scale was associated with maternal education and the ITERS-R scale sub-item “language and understanding”. Conclusions: Extrinsic factors such as higher maternal education and quality of day care centers are associated with fine motor performance in children attending day care.

Resumo Objetivo: Verificar as repercussões de fatores extrínsecos no desempenho motor fino de crianças de dois anos. Métodos: Foram avaliadas 73 crianças de creches públicas e 21 de creches particulares. O ambiente da creche foi avaliado com a escala Infant/Toddler Environment Rating Scale - Revised Edition (ITERS-R), o desempenho motor fino pela escala Bayley Scales of Infant and Toddler Development - III (BSITD-III), dados socioeconômicos, escolaridade materna e tempo de ingresso na creche foram colhidos por meio de entrevista. Foi calculado o coeficiente de correlação pelo teste de Spearmann para verificar a relação entre as variáveis avaliadas. Resultados: O tempo de creche apresentou correlação positiva com o desempenho das crianças em algumas tarefas de motricidade fina da BSITD-III, demonstrou que as atividades desenvolvidas nas creches foram importantes para o refinamento de habilidades motoras específicas, enquanto o desempenho motor fino geral pela escala estava relacionado com a escolaridade materna e com o subitem da escala ITERS-R “Linguagem e compreensão”. Conclusões: Fatores extrínsecos como maior escolaridade materna e qualidade de creches estão relacionados com o desempenho motor fino de crianças frequentadoras de creches.

Impact of extrinsic factors on fine motor performance of children attending day care. / Repercussões de fatores extrínsecos no desempenho motor fino de crianças frequentadoras de creches.

OBJECTIVE: To assess the impact of extrinsic factors on fine motor performance of children aged two years old. METHODS: 73 children attending public and 21 private day care centers were assessed. Day care environment was evaluated using the Infant/Toddler Environment Rating Scale - Revised Edition (ITERS-R), fine motor performance was assessed through the Bayley Scales of Infant and Toddler Development - III (BSITD-III), socioeconomic data, maternal education and time of start at the day care were collected through interviews. Spearman's correlation coefficient was calculated to assess the association between the studied variables. RESULTS: The time at the day care was positively correlated with the children's performance in some fine motor tasks of the BSITD-III, showing that the activities developed in day care centers were important for the refinement of specific motor skills, while the overall fine motor performance by the scale was associated with maternal education and the ITERS-R scale sub-item "language and understanding". CONCLUSIONS: Extrinsic factors such as higher maternal education and quality of day care centers are associated with fine motor performance in children attending day care.

Motor performance of children with Down syndrome and typical development at 2 to 4 and 26 months.

PURPOSE: To compare gross motor performance of children with Down syndrome (DS) and typical development (TD) at 2 to 4 months (Phase I) and at 2 years of age (Phase II) and to investigate the relation between early motor performance and later outcome. METHODS: Seventeen infants (10 with TD and 7 with DS) were assessed in Phase I using the Test of Infant Motor Performance (TIMP); 25 children were assessed in Phase II using the gross motor scale of the Bayley Scales of Infant and Toddler Development (Bayley-III); 10 participants were enrolled in both phases. RESULTS: TIMP and Bayley-III scores were lower in the DS group. In both groups, TIMP z scores were predictive of Bayley-III scores. CONCLUSIONS: Children with DS show difficulties in early postural control and activities requiring speed, postural control, and balance. The finding that early performance relates to later outcome reinforces the relevance of early and task-specific intervention.

Ajustes nos movimentos de alcançar e apreender objetos: impacto da Síndrome de Down / Adjustments in the movements of reaching for and grasping objects: the impact of Down Syndrome

Verificar a influência das propriedades dos objetos nos ajustes realizados por lactentes típicos e com Síndrome de Down (SD) dos quatro aos oito meses de idade ao alcançar e apreender objetos. MÉTODOS: 16 lactentes, avaliados uma vez ao mês dos 4 aos 8 meses, sendo oito típicos e oito com SD. Quatro objetos esféricos (maleável grande, maleável pequeno, rígido grande e rígido pequeno) foram apresentados, e os cinco primeiros movimentos válidos foram registrados para análise das variáveis: ajuste proximal (uni e bimanual), ajuste distal (orientação da palma, abertura da mão) e apreensão do objeto. RESULTADOS: os lactentes típicos apresentaram mais ajuste bimanual para objetos grandes aos seis e oito meses e os com SD aos sete meses. Quanto aos ajustes distais, os lactentes típicos variaram seu comportamento enquanto os com SD apresentaram uso predominante da posição oblíqua. Em geral, o grupo típico apresentou maior sucesso na apreensão dos objetos rígidos e maleável pequeno quando comparados aos lactentes com SD. CONCLUSÕES: Os lactentes com SD apresentaram menor variedade de ajustes o que levou a um menor sucesso na apreensão, possivelmente devido a restrições intrínsecas da SD...

To verify the influence that properties of objects have on the reaching and grasping adjustments made by infants with and without Down syndrome (DS) between four to eight months of age. METHODS: 16 infants, eight typical and eight with DS, were evaluated once a month from months 4 to 8. Four spherical objects (large soft, small soft, large hard and small hard) were offered and the first five valid movements were recorded for analysis of the variables: proximal adjustment (uni- and bimanual), distal adjustments (palm orientation, hand opening) and grasping of the object. RESULTS: the typical infants displayed greater bimanual adjustment for large objects at six and eight months and those with DS at seven months. As for distal adjustments, typical infants varied their behavior while DS showed predominant use of the oblique position. In general, the typical group had greater success in grasping all hard and small soft objects when compared to the infants with DS. CONCLUSIONS: infants with Down syndrome showed a smaller variety of adjustments, which led to lower success in grasping, possibly due to the intrinsic limitations of DS...

Proposta de intervenção para redução dos casos de pessoas contaminadas por esquistossomose em um distrito de Caratinga Minas Gerais

Este projeto apresenta uma proposta de intervenção, para equipe de Estratégia da Família de Santa Efigênia, com a finalidade de reduzir os casos de pessoas contaminadas por esquistossomose no distrito de Santa Efigênia, município de Caratinga-MG que hoje atinge cerca de a 2.572 pessoas da população desta área. A esquistossomose é causada pelo helminto Schistossoma Mansoni, tem como hospedeiro intermediário uma espécie de caramujo, ambos tendo relação com água para evolução do seu ciclo de crescimento até contaminar o homem, seu novo hospedeiro finalizando o ciclo. A alta prevalência está relacionada às condições e qualidade de vida da população, falta de saneamento básico, educação em saúde, condições de trabalho para população rural, controle dos caramujos, quimioterapia, clima e a falta de medidas que façam com que o Programa de Controle da Esquistossomose (PCE) do Ministério da Saúde seja eficiente, tornando a doença um problema de saúde publica. O presente trabalho considerou para construção do plano de ação, além do diagnóstico situacional, pesquisas em base de dados do SIAB, revisão de periódicos online no Google Acadêmico, Scielo, BVS, livros e manuais e sites do Ministério da Saúde sobre tema. O plano de ação construído identificou a necessidade de criação de parcerias entre governantes, sociedade, Sindicado dos Trabalhadores Rurais e da Atenção Básica em Saúde, cada um em seu campo de atuação e ao mesmo tempo interagindo para que essa proposta seja eficiente e chegue a seu objetivo: a diminuição da incidência da doença. Acredita-se que esta proposta possa reduzir os casos da doença na região melhorando a qualidade de vida da população.