Social network of families involved in child neglect: building a multidimensional perspective. / Rede social de famílias envolvidas na negligência contra crianças e adolescentes: construindo um olhar multidimensional.

Neglect is one of the most frequently reported forms of violence against children and adolescents, although it has rarely been explored in national studies. In this light, the present study aimed to analyze the personal social network of families involved in negligence against children and adolescents. This work takes a qualitative approach, anchored in the Paradigm of Complexity, conducted with twenty families involved in negligence against children and adolescents in a municipality in the countryside of the state of São Paulo, Brazil. Data collection took place through minimal maps of the personal social network and semi-structured interviews in January 2021. The networks were limited, with little to no interaction among the different services and sectors, and were predominantly homogeneous. Because they have many weakened ties, they are relatively unsupportive, pointing out difficulties in access to work, education, and health. Due to the characteristics of the network, the complexity of the phenomenon of neglect was identified, in which elements condition and perpetuate experiences of absence and fragility. Interprofessional and intersectoral views and actions are requested and recommended.

A negligência constitui uma das violências contra crianças e adolescentes mais notificadas, entretanto ainda pouco explorada em estudos nacionais. O objetivo deste estudo foi analisar a rede pessoal social de famílias envolvidas na negligência contra crianças e adolescentes. Estudo qualitativo, ancorado no paradigma da complexidade, realizado junto a 20 familiares envolvidos na negligência contra crianças e adolescentes em município do interior de São Paulo, Brasil. A coleta de dados se deu por mapas mínimos da rede pessoal social e entrevistas semiestruturadas em janeiro de 2021. As redes se apresentaram reduzidas, com pouca ou nenhuma articulação entre os diferentes serviços e setores e predominantemente homogêneas. Por terem muitos vínculos fragilizados, mostrou-se pouco sustentadora, apontando dificuldades no acesso a trabalho, educação e saúde. Pelas características da rede, identificou-se a complexidade do fenômeno da negligência, em que elementos condicionam e perpetuam vivências de ausências e fragilidades. Olhares e ações interprofissionais e intersetoriais são pleiteadas e recomendadas.

Rede social de famílias envolvidas na negligência contra crianças e adolescentes: construindo um olhar multidimensional / Social network of families involved in child neglect: building a multidimensional perspective

Resumo A negligência constitui uma das violências contra crianças e adolescentes mais notificadas, entretanto ainda pouco explorada em estudos nacionais. O objetivo deste estudo foi analisar a rede pessoal social de famílias envolvidas na negligência contra crianças e adolescentes. Estudo qualitativo, ancorado no paradigma da complexidade, realizado junto a 20 familiares envolvidos na negligência contra crianças e adolescentes em município do interior de São Paulo, Brasil. A coleta de dados se deu por mapas mínimos da rede pessoal social e entrevistas semiestruturadas em janeiro de 2021. As redes se apresentaram reduzidas, com pouca ou nenhuma articulação entre os diferentes serviços e setores e predominantemente homogêneas. Por terem muitos vínculos fragilizados, mostrou-se pouco sustentadora, apontando dificuldades no acesso a trabalho, educação e saúde. Pelas características da rede, identificou-se a complexidade do fenômeno da negligência, em que elementos condicionam e perpetuam vivências de ausências e fragilidades. Olhares e ações interprofissionais e intersetoriais são pleiteadas e recomendadas.

Abstract Neglect is one of the most frequently reported forms of violence against children and adolescents, although it has rarely been explored in national studies. In this light, the present study aimed to analyze the personal social network of families involved in negligence against children and adolescents. This work takes a qualitative approach, anchored in the Paradigm of Complexity, conducted with twenty families involved in negligence against children and adolescents in a municipality in the countryside of the state of São Paulo, Brazil. Data collection took place through minimal maps of the personal social network and semi-structured interviews in January 2021. The networks were limited, with little to no interaction among the different services and sectors, and were predominantly homogeneous. Because they have many weakened ties, they are relatively unsupportive, pointing out difficulties in access to work, education, and health. Due to the characteristics of the network, the complexity of the phenomenon of neglect was identified, in which elements condition and perpetuate experiences of absence and fragility. Interprofessional and intersectoral views and actions are requested and recommended.

Contação de histórias durante a hospitalização de crianças: percepções das mães à luz do Interacionismo Simbólico / Storytelling during children's hospitalization: mothers' perceptions in the light of Symbolic Interactionism / Narración de cuentos durante la hospitalización infantil: las percepciones de las madres a la luz del Interaccionismo Simbólico

Objetivo: descrever as percepções de acompanhantes sobre o impacto da contação de histórias durante a hospitalização de crianças. Métodos: trata-se de estudo qualitativo, apoiado no Interacionismo Simbólico, desenvolvido na unidade de internação pediátrica de um Hospital Universitário. Foram entrevistadas, entre junho e julho de 2023, nove mulheres, acompanhantes de crianças hospitalizadas, que participaram da atividade semanal de contação de histórias. A análise dos dados foi direcionada pela Análise Temática de Conteúdo. Resultados: a contação de histórias foi significada enquanto um contraponto ao cotidiano entediante e imerso em preocupações que marcam a hospitalização infantil. Emergiram duas categorias temáticas da percepção das mães sobre contação de histórias no contexto da hospitalização de crianças, "Estreitamento das relações entre crianças, acompanhantes e contadores de histórias", que contribuiu para o fortalecimento do vínculo entre acompanhante, criança e equipe multiprofissional e "Momento de acolhimento para as crianças e acompanhantes", que revela o efeito de proporcionar um momento de distração, alegria e conforto para as mães. Conclusão: a contação de histórias promove ambiência propícia para o enfrentamento da doença, proporciona bem-estar, alegria e conforto para as mães acompanhantes. Impacta positivamente no comportamento das crianças e acompanhantes durante a internação e estimula sua continuidade no ambiente domiciliar.

Objective: to describe companions' perceptions of the impact of storytelling during children's hospitalization. Methods: this is a qualitative study, supported by Symbolic Interactionism, developed in the pediatric inpatient unit of a university hospital. Between June and July 2023, nine women, companions of hospitalized children, who participated in the weekly storytelling activity, were interviewed. Data analysis was directed by thematic content analysis. Results: storytelling was meant as a counterpoint to the boring daily life and immersed in concerns that characterize children's hospitalization. Two thematic categories emerged from mothers' perception of storytelling in the context of children's hospitalization, "Strengthening relationships between children, companions and storytellers", which contributed to strengthening the bond between companion, child and multidisciplinary team, and "Moment of welcoming for children and companions", which reveals the effect of providing a moment of distraction, joy and comfort for mothers. Conclusion:storytelling promotes an environment conducive to coping with the disease, providing well-being, joy and comfort for accompanying mothers. It positively impacts the behavior of children and companions during hospitalization and encourages their continuity in home environments.

Objetivo: describir las percepciones de los acompañantes sobre el impacto de la narración de cuentos durante la hospitalización de los niños. Métodos: se trata de un estudio cualitativo, sustentado en el Interaccionismo Simbólico, desarrollado en la unidad de internación pediátrica de un hospital universitario. Entre junio y julio de 2023, fueron entrevistadas nueve mujeres, acompañantes de niños hospitalizados, que participaron de la actividad semanal de cuentacuentos. El análisis de los datos fue guiado por el análisis de contenido temático. Resultados: la narración de cuentos pretendía ser un contrapunto a la vida cotidiana aburrida y sumergida en las inquietudes que caracterizan la hospitalización de los niños. Dos categorías temáticas surgieron de la percepción de las madres sobre la narración de cuentos en el contexto de la hospitalización infantil, "Fortalecimiento de las relaciones entre niños, acompañantes y narradores", que contribuyó a fortalecer el vínculo entre acompañante, niño y equipo multidisciplinario, y "Momento de acogida para niños y acompañantes", que revela el efecto de brindar un momento de distracción, alegría y consuelo a las madres. Conclusión: la narración de cuentos promueve un ambiente propicio para el afrontamiento de la enfermedad, brindando bienestar, alegría y consuelo a las madres acompañantes. Impacta positivamente en el comportamiento de los niños y acompañantes durante la hospitalización y fomenta su continuidad en el ambiente hogareño.

Acute kidney injury in severely injured patients admitted to the intensive care unit.

BACKGROUND: Our objective was to identify possible associations between clinical and laboratory variables and the risk of developing acute kidney injury (AKI) in severely injured patients admitted to the intensive care unit (ICU) for whom creatine kinase (CK) levels were available. METHODS: For this retrospective observational study, we analyzed adult trauma patients admitted to the ICU from 2011 to 2015 at Fundación Valle del Lili (FVL) University Hospital. Our primary outcome was the incidence of AKI. Multivariate regression analysis was used to assess risk factors for this outcome. RESULTS: A total of 315 patients were included. The trauma mechanisms were blunt (n = 130), penetrating (n = 66) and blast (n = 44) trauma. The median (interquartile range, IQR) of injury severity score (ISS) was 21 (16-29). AKI developed in 75 patients (23.8%). Multivariate regression analysis revealed that the thoracic abbreviated injury scale (AIS) value (median (IQR) in the AKI group: 3 (0-4)), Acute Physiology and Chronic Health Evaluation (APACHE II) score (median (IQR) in the AKI group: 18 (10-27)), CK greater than 5000 U/L, lactic acid concentration at admission, and dobutamine administration were independently associated with AKI. CONCLUSION: We found that age, APACHE II score, thoracic trauma, lactic acidosis, and dobutamine administration were independently associated with AKI. Trauma surgeons need to be aware of the increased odds of AKI if one of these factors is identified during the evaluation and treatment of injured patients.

[Clinical and laboratory characteristics of pregnant women with preeclampsia versus gestational hypertension]. / Características clínicas e laboratoriais de gestantes com pré-eclâmpsia versus hipertensão gestacional.

PURPOSE: To compare clinical and laboratory characteristics, obstetric and perinatal outcomes of patients with pre-eclampsia versus gestational hypertension. METHODS: A retrospective study was carried out to analyze medical records of patients diagnosed with pre-eclampsia and gestational hypertension whose pregnancies were resolved within a period of 5 years, for a total of 419 cases. We collected clinical and laboratory data, obstetric and perinatal outcomes. Comparisons between groups were performed using the test suitable for the variable analyzed: unpaired t test, Mann-Whitney U test or χ2 test, with the level of significance set at p<0.05. RESULTS: Were evaluated 199 patients in the gestational hypertension group (GH) and 220 patients in the pre-eclampsia group (PE). Mean body mass index was 34.6 kg/m2 in the GH group and 32.7 kg/m2 in the PE group, with a significant difference between groups. The PE group showed higher systolic and diastolic blood pressure and higher rates of abnormal values in the laboratory tests, although the mean values were within the normal range. Cesarean section was performed in 59.1% of cases of PE and in 47.5% of the GH group; and perinatal outcomes in terms of gestational age and birth weight were significantly lower in the PE group. CONCLUSION: Women with gestational hypertension exhibit epidemiological characteristics of patients at risk for chronic diseases. Patients with pre-eclampsia present clinical and laboratory parameters of greater severity, higher rates of cesarean delivery and worse maternal and perinatal outcomes.

Características clínicas e laboratoriais de gestantes com pré-eclâmpsia versus hipertensão gestacional / Clinical and laboratory characteristics of pregnant women with preeclampsia versus gestational hypertension

OBJETIVO: Comparar as características clínicas e laboratoriais, os resultados maternos e perinatais de gestantes com pré-eclâmpsia versus hipertensão gestacional. MÉTODOS: Análise retrospectiva dos prontuários médicos de pacientes com diagnóstico de pré-eclâmpsia e hipertensão gestacional, cujas gestações foram resolvidas em um período de cinco anos. Foram coletadas informações laboratoriais, resultados obstétricos e perinatais. As comparações entre os grupos foram realizadas com o uso do teste adequado para a variável analisada: teste t não pareado, teste U de Mann-Whitney, ou teste do χ2. Consideramos p<0,05 como nível de significância estatística. RESULTADOS: Foram avaliadas 199 pacientes no grupo com hipertensão gestacional (HG) e 220 pacientes no grupo com pré-eclâmpsia (PE). No grupo HG o índice de massa corpórea médio foi 34,6 kg/m2 e no grupo PE, 32,7 kg/m2, com diferença significativa. O grupo PE apresentou valores de pressão arterial sistólica superiores ao grupo HG. Em relação aos exames laboratoriais, a média de valores denotou, de uma forma geral, maior gravidade no grupo PE. Pacientes submetidas à cesárea foram 59,1% dos casos no grupo PE e 47,5% no grupo HG. Em relação aos resultados perinatais, a idade gestacional e o peso ao nascer foram significativamente inferiores no grupo PE. CONCLUSÃO: As mulheres com hipertensão gestacional apresentam características epidemiológicas de pacientes com risco de doenças crônicas. As pacientes com pré-eclâmpsia apresentam parâmetros clínicos e laboratoriais de maior gravidade, taxas superiores de cesárea e piores resultados maternos e perinatais. .

PURPOSE: To compare clinical and laboratory characteristics, obstetric and perinatal outcomes of patients with pre-eclampsia versus gestational hypertension. METHODS: A retrospective study was carried out to analyze medical records of patients diagnosed with pre-eclampsia and gestational hypertension whose pregnancies were resolved within a period of 5 years, for a total of 419 cases. We collected clinical and laboratory data, obstetric and perinatal outcomes. Comparisons between groups were performed using the test suitable for the variable analyzed: unpaired t test, Mann-Whitney U test or χ2 test, with the level of significance set at p<0.05. RESULTS: Were evaluated 199 patients in the gestational hypertension group (GH) and 220 patients in the pre-eclampsia group (PE). Mean body mass index was 34.6 kg/m2 in the GH group and 32.7 kg/m2 in the PE group, with a significant difference between groups. The PE group showed higher systolic and diastolic blood pressure and higher rates of abnormal values in the laboratory tests, although the mean values were within the normal range. Cesarean section was performed in 59.1% of cases of PE and in 47.5% of the GH group; and perinatal outcomes in terms of gestational age and birth weight were significantly lower in the PE group. CONCLUSION: Women with gestational hypertension exhibit epidemiological characteristics of patients at risk for chronic diseases. Patients with pre-eclampsia present clinical and laboratory parameters of greater severity, higher rates of cesarean delivery and worse maternal and perinatal outcomes. .

SIDUR: formulación de un sistema de información con uso de vocabulario controlado orientado a la caracterización y muestreo de la población con y sin discapacidad, atendida por las prácticas de los programas de Rehabilitación, Universidad del Rosario / SIDUR: development of an information system, using controlled vocabulary designed to the characterization and sample of population with and without disability, attended by Rehabilitation programs, University of Rosario

Introducción: el registro estadístico usado en los Programas Académicos de Campo (PAC) de Rehabilitación denota generalidades en la conceptualización del dato, lo cual complejiza la orientación fiable en la toma de decisiones y brinda un bajo sustento para la investigación en rehabilitación y discapacidad. En respuesta a esto, el grupo de investigación "Rehabilitación e integración social de la persona con discapacidad" ha trabajado en la creación de un registro para la caracterización de la población atendida por los PAC de rehabilitación, que incluye el uso de la Clasificación Internacional del Funcionamiento, la Salud y la Discapacidad (CIF) de la OMS. Metodología: el proyecto comprende dos fases metodológicas. La primera es un estudio descriptivo y la segunda se trata de la ejecución de la metodología Methontology, que integra la identificación y el desarrollo de la ontología al conocimiento. Este artículo contextualiza los avances realizados en la segunda fase. Resultados: El desarrollo del registro en el 2008, como un sistema de información, incluyó la revisión documental y el análisis de un posible escenario de uso que ayudara a orientar el diseño y desarrollo del sistema SIDUR. El sistema utiliza la CIF, al ser una estandarización de terminología que permite la reducción de ambigüedades y facilita la transformación de hechos reales de salud en datos traducibles a los sistemas de información. El registro formula tres categorías y un total de 129 variables. Conclusiones: SIDUR facilita la accesibilidad a información precisa y actualizada, útil para la toma de decisiones y la investigación.

Introduction: the statistical record used in the Field Academic Programs (PAC for it’s initials in Spanish) of Rehabilitation denotes generalities in the data conceptualization, which complicates the reliable guidance in making decisions and provides a low support for research in rehabilitation and disability. In response, the Research Group in Rehabilitation and Social Integration of Persons with Disabilities has worked on the creation of a registry to characterize the population seen by Rehabilitation PAC. This registry includes the use of the International Classification of Functioning, Disability and Health (ICF) of the WHO. Methodology: the proposed methodology includes two phases: the first one is a descriptive study and the second one involves performing methodology Methontology, which integrates the identification and development of ontology knowledge. This article contextualizes the progress made in the second phase. Results: the development of the registry in 2008, as an information system, included documentary review and the analysis of possible use scenarios to help guide the design and development of the SIDUR system. The system uses the ICF given that it is a terminology standardization that allows the reduction of ambiguity and that makes easier the transformation of health facts into data translatable to information systems. The record raises three categories and a total of 129 variables Conclusions: SIDUR facilitates accessibility to accurate and updated information, useful for decision making and research.