Atuação profissional nos esportes de aventura: estudo de caso com uma treinadora de surfe / Professional work performance in adventure sports: case study with a surf coach

RESUMO O objetivo do estudo foi analisar o contexto de atuação profissional de uma treinadora de surfe da cidade de Florianópolis, Santa Catarina. Adotaram-se procedimentos de pesquisa qualitativa e estudo de caso, por meio da combinação de técnicas de observação participante e entrevista semiestruturada. Foi utilizada a técnica de Análise Temática para a análise dos dados. Verificou-se que o contexto de atuação profissional da treinadora investigada compreende um sistema amplo e complexo, marcado pela sua participação em diversas atividades e interações sociais, com o envolvimento pleno em seu local de atuação profissional. A intervenção pedagógica da treinadora para o ensino/treino do surfe é condicionado pela sazonalidade, pelas condições do ambiente de prática desta modalidade, assim como pelo tipo de orientação esportiva, com o propósito pessoal de transmitir o seu estilo de vida ligado ao surfe.

ABSTRACT The purpose of the study was to analyze the context of professional work performance of a surf coach from Florianópolis city, Santa Catarina. Qualitative research and case study procedures were adopted conbining participant observation and semi-structured interviews. Thematic Analysis was used for data analysis. It was verified that the coach's context of professional work performance comprises a broad and complex system, marked by her participation in various activities and social interactions, with full participation in her place of professional work. The coach's pedagogical intervention for teaching/coaching surfing is conditioned by seasonality, the environmental conditions to practice this sport, and the focus of sports instruction. Essentialy, the coach's personal goal is to share her surfing lifestyle.

Efeito de uma intervenção com jogos digitas e webgames na motivação intrínseca em escolares / Effect of an intervention with digital games and webgames on intrinsic motivation in schools

RESUMO O objetivo deste estudo foi analisar o efeito de uma intervenção com jogos digitais associados aos webgames na motivação intrínseca de crianças de uma escola pública de Florianópolis, Santa Catarina. Participaram deste estudo de desenho de um estudo de intervenção pedagógica não randomizado, 50 estudantes (52% de meninas), com idade média de 6,7 (±0,54) anos. Duas turmas da escola foram transformadas em dois grupos de pesquisa: 1) grupo intervenção (vivência prévia de jogos digitais no computador e webgames durante as aulas de educação física); e 2) grupo controle (apenas vivência de webgame). O Inventário de Motivação Intrínseca foi o instrumento utilizado, e para comparação intra e intergrupos utilizou-se o método de Equações de Estimativas Generalizadas, adotando-se o nível de significância de 5%. Não foi identificado efeito isolado do grupo ou interação grupo vs momento, o que indica que o grupo submetido a intervenção não se diferiu do grupo controle ao longo do tempo em termos de motivação. Conclui-se que o tipo de intervenção pedagógica realizada não foi capaz de aumentar a motivação intrínseca do grupo intervenção, sugerindo a necessidade de adaptações na estrutura e estratégias da intervenção em um próximo estudo.

ABSTRACT The objective of this study was to analyze the effect of an intervention with digital games associated with webgames on the intrinsic motivation of children from a public school in Florianópolis, Santa Catarina (Brazil). 50 students (52% girls) participated in this design study of non-randomized pedagogical intervention study, with a mean age of 6.7 (± 0.54) years. Two classroom groups were transformed into two research groups: 1) intervention group (preview experience of digital games on the computer and webgames during physical education classes); and 2) control group (only experience of webgame). The Intrinsic Motivation Inventory was the instrument used, and for intra and intergroup comparison, the Generalized Estimation Equations method was used, adopting a significance level of 5%. No isolated effect of the group or interaction between group vs moment was identified, which indicates that the group submitted to the intervention did not differ from the control group over time in terms of motivation. It is concluded that the type of pedagogical intervention performed was not able to increase the intrinsic motivation OF GROUP I, suggesting the need for adaptations in the structure and strategies of the intervention for future research.

Pedagogical intervention in team sports: a systematic review / Intervenção pedagógica nos esportivos coletivos: uma revisão sistemática

ABSTRACT The production of literature with intervention programs was analyzed, applied to team sports. The databases consulted on the subject, in the last 20 years, were the Web of Science, Scielo and PubMed. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines were used with the keywords: team sports and team sports games, associated with the terms: teaching models, sports teaching, teaching-learning-training, pedagogical intervention, tactical-technical performance and cognitive processes, in Portuguese, English and Spanish. After screening with defined criteria, 39 manuscripts were selected to compose the sample. The descriptive analysis showed that the years 2016 and 2018 presented a higher number of publications (17.95% each year); the English language most used in publications (69.24%); football and basketball have comprised the highest number of studies (25.64% and 17.95%, respectively); the teaching programs spanned between 5 and 54 class sessions; the sample of studies with schoolchildren was the most chosen (64.1%); most teaching programs focused on tactics; and the main variables analyzed were tactical knowledge, tactical-technical performance and specific skills. In the production of literature analyzed, there was a tendency in the last 10 years to apply sports teaching programs with tactical approaches and also change and/or add content to these programs, in order to enhance the development of students/athletes. These changes leave open reflections on possible changes in teacher guidance in the praxis in teaching-learning of team sports.

RESUMO Analisou-se a produção da literatura com programas de intervenção, aplicados aos esportes coletivos. As bases de dados consultadas quanto ao tema, nos últimos 20 anos, foram o Web of Science, Scielo e PubMed. Utilizou-se as diretrizes PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) com as palavras-chave: jogo coletivo e jogos esportivos coletivos, associados aos termos: modelos de ensino, ensino do esporte, ensino-aprendizagem-treinamento, intervenção pedagógica, desempenho tático-técnico e processos cognitivos, nos idiomas português, inglês e espanhol. Após triagem com critérios definidos, 39 manuscritos foram selecionados para compor a amostra. A análise descritiva apontou que os anos de 2016 e 2018 apresentou maior quantitativo de publicações (17,95% cada ano); a língua inglesa a mais utilizada nas publicações (69,24%); as modalidades futebol e basquetebol compreenderam o maior número de trabalhos (25,64% e 17,95%, respectivamente); os programas de ensino abrangeram entre 5 e 54 sessões de aula; a amostra dos estudos com escolares foi a mais eleita (64,1%); a maioria dos programas de ensino centrou-se na tática; e as principais variáveis analisadas foram conhecimentos táticos, desempenho tático-técnico e habilidades específicas. Na produção de literatura analisada observou-se uma tendência nos últimos 10 anos à aplicação de programas de ensino dos esportes com abordagens táticas e ainda alterar e/ou agregar conteúdos a esses modelos, com o intuito de potencializar o desenvolvimento de alunos/atletas. Essas mudanças deixam abertas as reflexões sobre possíveis alterações de orientação docente na práxis no ensino-aprendizagem dos esportes coletivos.

Intervención educativa para elevar el nivel de conocimiento sobre hipertensión arterial en adolescentes / Educational intervention to raise the level of knowledge on arterial hypertension in adolescents

RESUMEN Introducción: la hipertensión arterial del adulto tiene sus inicios en la niñez, por lo que la percepción de riesgo debe aumentar en las edades pediátricas. Objetivo: elevar el nivel de conocimiento sobre hipertensión arterial en adolescentes de la Escuela Secundaria Básica Antonio Rodríguez, del municipio Colón, provincia de Matanzas. Materiales y métodos: se realizó un estudio de intervención educativa en 80 estudiantes de 8vo grado, en el período de febrero de 2017 a junio de 2018. Se aplicó un cuestionario para medir percepción de riesgo de enfermar, conocimientos sobre factores de riesgo y síntomas de hipertensión arterial antes y después de la intervención. Se crearon cuatro grupos de 20 adolescentes, que tuvieron una sesión semanal durante 6 semanas. Se desarrollaron seis temas relacionados con la enfermedad, en los que se utilizaron técnicas participativas de educación para la salud. Resultados: el 96,1 % de los adolescentes no percibían el riesgo de enfermar de hipertensión arterial antes de la intervención. Luego de esta, la percepción de riesgo se presentó en el 65,4 %. Un 43,6 % de los participantes desconocían los factores de riesgo, y el 69,2 % no conocían los síntomas. Después de la intervención, el 73 % de la muestra tenían un conocimiento parcial sobre los factores de riesgo; el 57,7 % conocían los síntomas, y el 37,2 % los conocían parcialmente. Conclusiones: la intervención educativa sobre hipertensión arterial contribuyó a elevar los conocimientos y la percepción de riesgo en los adolescentes. Se aportaron elementos para modificar estilos de vida poco saludables (AU).

ABSTRACT Introduction: the adults' arterial hypertension begins in childhood, therefore the risk perception must increase in pediatric ages. Objective: to raise knowledge level on arterial hypertension in adolescents from the high school Antonio Rodriguez, municipality of Colon, province of Matanzas. Materials and methods: an educational interventional study was carried out in 80 8th-grade students, in the period from February 2017 to June 2018. A survey was applied to measure risk perception of developing the disease, knowledge on risk factors and symptoms of arterial hypertension before and after intervention. Four groups of 20 teenagers were created, having a weekly session during six weeks. Six themes related to the disease were developed, using different participatory techniques of health education. Results: 96.1% of adolescents did not perceive the risk of developing hypertension before the intervention. After it, risk perception was present in 65.4% of them. 43.6% of participants did not know the risk factors, and 69.2 % did not know the symptoms. After the intervention, 73% of the sample had partial knowledge on risk factors; 57.7% knew the symptoms, and 37.2% knew them partially. Conclusions: the educational intervention on arterial hypertension contributed to raise knowledge and risk perception in adolescents. Elements were given to modify unhealthy lifestyles (AU).

Early Surgical Intervention Improves Survival in Acute Intestinal Ischemia in the Intensive Care Unit.

The study is aimed at assessing whether the early surgical intervention improves survival in acute mesenteric ischemia with septic shock. A retrospective study design was applied to review the charts of patients admitted to the intensive care unit. The data were collected through a review of the full patient chart including physician and nursing notes, pathology reports, intraoperative findings, CT findings, and endoscopy. The diagnosis of AMI for each patient was determined through clinical presentation/endoscopic visualization/laboratory results/radiographic imaging, surgical exam (tissue or visual) and/or autopsy. Death and survival were evaluated between short and long-time-interval for septic shock groups using the chi-square test followed by calculating the P value. Total survival among the surgery group was 60 patients (95.24%) compared to 3 (4.76%) survival among patients who did not have surgery. The time from the onset of a shock to the time of surgical incision was calculated. The mean time to surgery was 17.7 hours. Total 65 patients (29.52%) had surgery between 4 and 12 hours from the onset of hypotension. Survivals among this group of patients were 41.7% (n = 25). The survival difference was statistically significant than died patients with respect to the time of surgical intervention (P = <0.001). Early removal of ischemic bowel in patients with AII-related surgery has improved survival.

Multi-stage Screening in Early Intervention: A Critical Strategy for Improving ASD Identification and Addressing Disparities.

Health disparities in ASD detection affect children's access to subsequent interventions. We examined potential disparities in implementation of a multi-stage ASD screening and diagnostic evaluation protocol in Part C Early Intervention with 4943 children ages 14-36 months (mean 22.0 months; 62.9% boys, 73.3% children of color, 34.9% non-English-primary language, 64.5% publicly-insured). Participation and follow-through were high (64.9% and 65.3% at first- and second-stage screening, respectively, 84.6% at diagnostic evaluation). Logistic regressions identified predictors of screening participation and outcomes at each stage; demographic differences (race, language, public insurance) were observed only at first-stage screening and reflected higher participation for children of color and higher positive screens for publicly-insured children. Results suggest the multi-stage screening protocol shows promise in addressing disparities in early diagnosis.

Oferta de programas para el desarrollo integral de la primera infancia en Chile: revisión exploratoria / Program offer for the integral development of early childhood in Chile: scoping review

OBJETIVO: Describir la oferta programática en primera infancia destinada a favorecer el desarrollo infantil integral en Chile. MÉTODO: Se realizó una revisión exploratoria siguiendo el marco método lógico del Joanna Briggs Institute. La búsqueda fue realizada por un investigador y los criterios de inclusión fueron: programas gubernamentales destinados al desarrollo integral en menores de 5 años en Chile. Los datos fueron organizados y sintetizados para describir características del programa y de la o las prestaciones que entrega. RESULTADOS: La búsqueda identificó 2060 documentos y 72 cumplieron los criterios de inclusión. Se describen 59 programas vigentes que abarcan la primera infancia, es tando principalmente a cargo de los Ministerio de Justicia, Educación, Salud y Desarrollo Social. Los programas están destinados en su mayoría a la promoción e intervención, se encuentran focalizados en población vulnerable, son intersectoriales y utilizan diversas estrategias para su implementación. CONCLUSIÓN: La oferta programática en Chile para la primera infancia presenta características sugeridas como efectivas para favorecer el desarrollo infantil.

OBJECTIVE: To describe the program offering designed to promote comprehensive early childhood de velopment in Chile. METHOD: A scoping review was carried out following the Joanna Briggs Institute's methodological framework. A researcher conducted the review considering as inclusion criteria go vernment programs aimed at the comprehensive development of children under 5 years of age in Chile. The data were organized and synthesized to describe the characteristics of the program and the service(s) it provides. RESULTS: The search identified 2.060 documents and 72 met the inclusion crite ria. 59 current programs are covering early childhood, which are mainly managed by the Ministries of Justice, Education, Health, and Social Development. Most of the programs are aimed at promotion and intervention, focusing on vulnerable populations, are cross-sectoral, and use different strategies for their implementation. CONCLUSION: The program offering in Chile for early childhood has charac teristics suggested as effective to promote child development.

Pediatric Prevention: Academic Behavior.

Many children in the United States are performing below basic standards in reading, mathematics, and writing. Children at risk for academic problems often have comorbid classroom behavior problems and/or are diagnosed with high-incidence disabilities. Early intervention to prevent academic problems is a key goal of school-wide response-to-intervention models. The goal of school-based instructional intervention is to increase children's strength of responding so basic academic skills can be combined to solve more complex tasks. Parents and caregivers can support intervention efforts at school by engaging in frequent communication with student assistance teams and helping children with academic work completion at home.

Adherence to screening and referral guidelines for autism spectrum disorder in toddlers in pediatric primary care.

OBJECTIVES: Although the American Academy of Pediatrics recommends screening for autism spectrum disorder (ASD) for all young children, disparities in ASD diagnosis and intervention in minority children persist. One potential contributor to disparities could be whether physicians take different actions after an initial positive screen based on patient demographics. This study estimated factors associated with physicians completing the follow-up interview for the Modified Checklist for Autism in Toddlers with Follow-up (M-CHAT-F), and referring children to diagnostic services, audiology, and Early Intervention (EI) immediately after a positive screen. METHODS: Children seen in a large primary care network that has implemented universal ASD screening were included if they screened positive on the M-CHAT parent questionnaire during a 16-30 month well child visit (N = 2882). Demographics, screening results, and referrals were extracted from the electronic health record. RESULTS: Children from lower-income families or on public insurance were more likely to have been administered the follow-up interview. Among children who screened positive, 26% were already in EI, 31% were newly referred to EI, 11% were referred each to audiology and for comprehensive ASD evaluation. 40.2% received at least one recommended referral; 3.7% received all recommended referrals. In adjusted multivariable models, male sex, white versus black race, living in an English-speaking household, and having public insurance were associated with new EI referral. Male sex, black versus white race, and lower household income were associated with referral to audiology. Being from an English-speaking family, white versus Asian race, and lower household income were associated with referral for ASD evaluation. A concurrent positive screen for general developmental concerns was associated with each referral. CONCLUSIONS: We found low rates of follow-up interview completion and referral after positive ASD screen, with variations in referral by sex, language, socio-economic status, and race. Understanding pediatrician decision-making about ASD screening is critical to improving care and reducing disparities.

Assessing an intervention to increase knowledge related to cervical cancer and the HPV vaccine.

Human papillomavirus (HPV) infection is the primary risk factor for cervical cancer. While the HPV vaccine significantly reduces the risk of HPV infection and subsequent cervical cancer diagnosis, underuse is linked to lack of knowledge of its effectiveness in preventing cervical cancer. The purpose of this study was to evaluate a cancer educational intervention (titled "MOVENUP") to improve knowledge of cervical cancer, HPV, and the HPV vaccine among predominantly African American communities in South Carolina. The MOVENUP cancer educational intervention was conducted among participants residing in nine South Carolina counties who were recruited by community partners. The 4.5-h MOVENUP cancer educational intervention included a 30-min module on cervical cancer, HPV, and HPV vaccination. A six-item investigator-developed instrument was used to evaluate pre- and post-intervention changes in knowledge related to these content areas. Ninety-three percent of the 276 participants were African American. Most participants reporting age and gender were 50+ years (73%) and female (91%). Nearly half of participants (46%) reported an annual household income <$40,000 and 49% had not graduated from college. Statistically significant changes were observed at post-test for four of six items on the knowledge scale (P<0.05), as compared to pre-test scores. For the two items on the scale in which statistically significant changes were not observed, this was due primarily due to a baseline ceiling effect.

A Qualitative Exploration of Women's Experiences with a Community Health Volunteer-Led Cervical Cancer Educational Module in Migori County, Kenya.

Detection and treatment of human papillomavirus (HPV) and cervical precancer through screening programs is an effective way to reduce cervical cancer deaths. However, high cervical cancer mortality persists in low- and middle-income countries. As screening programs become more widely available, it is essential to understand how knowledge about cervical cancer and perceived disease risk impacts screening uptake and acceptability. We evaluated women's experiences with a cervical cancer education strategy led by community health volunteers (CHVs) in Migori County, Kenya, as part of a cluster randomized controlled trial of cervical cancer screening implementation strategies. The educational modules employed simple language and images and sought to increase understanding of the relationship between HPV and cervical cancer, the mechanisms of self-collected HPV testing, and the importance of cervical cancer screening. Modules took place in three different contexts throughout the study: (1) during community mobilization; (2) prior to screening in either community health campaigns or health facilities; and (3) prior to treatment. Between January and September 2016, we conducted in-depth interviews with 525 participants to assess their experience with various aspects of the screening program. After the context-specific educational modules, women reported increased awareness of cervical cancer screening and willingness to screen, described HPV- and cervical cancer-related stigma and emphasized the use of educational modules to reduce stigma. Some misconceptions about cervical cancer were evident. With effective and context-specific training, lay health workers, such as CHVs, can help bridge the gap between cervical cancer screening uptake and acceptability.

Kids Intervention Therapy - Aquatic Environment (KITE) for babies 4 to 18 months old, by following the International Classification of Functioning (ICF): clinical trial protocol

Abstract Introduction: the biopsychosocial (BPS) model from the perspective of the International Classification of Functioning (ICF) agrees with the current theories regarding child development. They state the interdependence between the individual's relations, environment and received stimuli. The early interventions, particularly in the aquatic environment (AE), present gaps concerning their systematization, above all in their being in accordance with the ICF. Objectives: to describe an ICF-based aquatic early intervention program, named KITE, for the neuropsychomotor development (NPMD) of typical, at-risk and/or delayed babies 4 to 18 months old. Methods: the KITE is a program systematized on the AE, centered on the family and the daycare environment; it takes place twice a week, lasting for 4 weeks, in 45- to 60-minute sessions. The assessments and interventions are systematized by following the ICF. For the main outcome on the NPMD, the Alberta Infant Motor Scale (AIMS) and the Denver Developmental Screening Test II (DDST-II) are used, and as the secondary outcome on the stimulation received, quality of life and aquatic skills, the Affordances in the Home Environment for Motor Development - Infant Scale (AHEMD-IS), the Pediatric Quality of Life Inventory (PedsQL™) and the Aquatic Functional Assessment Scale - Baby (AFAS Baby) are used, respectively. Conclusion: This study has presented tools for the application of a clinical trial through the KITE for the NPMD of babies, systematized and based on the BPS perspective of the ICF, and discussed according to the neuroplastic evidence of the child development.

The importance of CT quantitative evaluation of emphysema in lung cancer screening cohort with negative findings by visual evaluation.

INTRODUCTION: One-stop quantitative evaluation of emphysema and lung nodule in lung cancer screening is very important for patient. OBJECTIVE: To evaluate the quantitative emphysema in the large-sample low-dose CT lung cancer screening cohort with negative CT findings by subjective visual assessment. METHODS: One thousand, two hundred and thirty-one participants with negative visual evaluation were included in this retrospective study. The lungs were automatically segmented and the following were calculated: total lung volume (TLV), total emphysema volume (TEV), emphysema index (EI), 15th percentile lung density and mean lung density. EI ≥6% was defined as emphysema. The quantitative parameters were compared between different genders and ages. The quantitative parameters and risk factors were compared between emphysema and non-emphysema groups. RESULTS: The proportion of smokers, TLV, TEV and EI of men were greater than that of women (P < 0.001). No correlation was found between age and volumes; the TEV and EI of people older than 60 years were greater than those younger than 60 years (P < 0.05) by age categorisation. One hundred and two participants showed emphysema, accounting for 8.29%. The incidence of emphysema in men was greater than that in women in total (P < 0.05). All the CT quantitative parameters were significantly different between emphysema and non-emphysema groups. The ratio of male, secondhand smoke exposure and chronic bronchitis history was greater in emphysema than that in the non-emphysema group (P < 0.05). CONCLUSION: CT quantitative emphysema evaluation is recommended in people older than 60 years, especially in males, providing more precise information, aiding the early diagnosis of emphysema and informing early intervention.

Educational strategy intervention and remote supervision on the post-discharge management of tuberculosis diagnosed in the hospital: Randomized clinical trial.

INTRODUCTION: One of the most serious problems in TB control is non-adherence to treatment leading to the risk of drug resistance and subsequent treatment failure. OBJECTIVES: To assess the impact of an educational strategy intervention and remote supervision on the post-discharge management of new cases of TB diagnosed in hospital on TB cure rate. Secondarily, to assess the impact of this intervention on default rate. METHODS: Randomized control trial conducted at a general, tertiary care, university affiliated hospital. New cases of TB diagnosed in hospital were included. The primary outcome was cure rate and secondary outcome was default rate. Analysis was carried out by modified intention to treat. RESULTS: A total of 169 new tuberculosis patients were enrolled. Among them, 80 were assigned to intervention group and 89 to control group. The cure rate was 71.3% in the intervention group and 58.4% in the control group. In the multivariate binary logistic regression model to evaluate the effect of the intervention, controlled by age, sex, current smoking status and directly observed treatment short, intervention was independently associated with cure rate (OR = 0.47; 95% CI: 0.24-0.94; P = 0.033).There was a significant difference in the default rate between the control and intervention groups (18.0% vs 5.0%, respectively, P = 0.039). CONCLUSION: An educational strategy intervention and remote supervision on the post-discharge management of new cases of TB with in-hospital diagnosis had a positive effect of small magnitude on cure rate. Secondarily, the treatment default rate has been significantly decreased with the intervention.

Relación entre afrontamiento y problemas externalizados e internalizados en hermanos de niños con autismo / Relation between coping and externalized and internalized problems in siblings of children with autism

Introducción: El trastorno del espectro autista es un problema del neurodesarrollo caracterizado por la presencia de dificultades en la comunicación social e interacción y en el comportamiento, el cual suele ser estereotipado y con intereses restringidos. El impacto que tiene la presencia de un niño con este trastorno en los hermanos, tiene diferentes matices. Objetivo: Identificar las estrategias de afrontamiento que utilizan los hermanos de niños con trastorno del espectro autista y analizar su relación con problemas externalizados e internalizados. Resultados: Participaron 23 niños (15 niños y 8 niñas) de 8 a 12 años de edad (edad promedio: 9.8; DE= 1,5). Se aplicó una ficha sociodemográfica para niños, la escala infantil de afrontamiento y el cuestionario de problemas internalizados y externalizados para niños. Los resultados indican que el factor disfuncional se utiliza con mucha frecuencia y que existen correlaciones positivas entre el afrontamiento disfuncional con problemas externalizados e internalizados y entre los factores centrado en la emoción y el evitativo con problemas internalizados. Conclusiones: En este grupo de hermanos de niños con trastorno del espectro autista, la correlación significativa entre el afrontamiento disfuncional y los problemas externalizados e internalizados, indica la necesidad de una evaluación profunda de posibles problemas de conducta y emocionales, la necesidad de aprender a responder de manera funcional ante las situaciones cotidianas, así como de una intervención para desarrollar estrategias de afrontamiento funcionales(AU)

Introduction: Autism Spectrum Disorder (ASD) is a neuro-developmental disorder characterized by the presence of difficulties in social communication, social interaction and behavior, which is usually stereotyped and with restricted interests. The impact of the presence of a child with ASD in the siblings has different connotations and it has been found that these children have more positive than negative aspects. Objective: To identify the coping strategies used by siblings of children with ASD, and analyze their relation with externalized and internalized problems. Results: Participants were 23 children (15 boys and 8 girls) from 8 to 12 years old (average age: 9.8, D.E = 1.5). A socio-demographic index card for children was used in addition to the Children Coping Scale and the Questionnaire on Internalized and Externalized Problems for Children (EIA and CPIEN, by its acronyms in Spanish, respectively). The results indicate that the dysfunctional factor is very frequently used and that there are positive correlations between dysfunctional coping with externalized and internalized problems, and also between the factors focused on emotion and the avoidance with internalized problems. Conclusions: In this group of siblings of children with Autism Spectrum Disorder, the significant correlation between disfunctional coping and externalized and internalized problems indicates the need of a deep assesment of possible behavioral and emotional problems, the need to learn how to respond in a functional way to daily life situations, as well as the need of an intervention to develop functional coping strategies(AU)

Intervención multidisciplinaria en paciente diagnosticado con el síndrome de Prader-Will / Interdisciplinary intervention in a pacient diagnosed with Prader-Willi síndrome

Introducción: El síndrome de Prader-Willi es una enfermedad genética, causada por deleciones de novo en la región 15q11q13 en el cromosoma paterno. Se caracteriza por falta de saciedad que conduce a obesidad mórbida, trastornos del comportamiento, discapacidad intelectual, baja estatura e hipogonadismo. Objetivo: Describir los resultados obtenidos del análisis e intervención multidisciplinar realizados en paciente diagnosticado con el síndrome de Prader-Willi. Presentación del caso: Análisis de caso clínico en menor de 8 años, sexo masculino, diagnosticado con síndrome de Prader-Willi, a través de intervención multidisciplinaria realizado en tres momentos: evaluación, diagnóstico e intervención con enfoque cognitivo conductual. Conclusiones: Las estrategias adoptadas generaron cambios significativos en el contexto familiar y social, entre ellas, apropiación de las recomendaciones suministradas, adopción de factores protectores, identificación de roles y optimización en la adherencia farmacológica. La atención a estas consideraciones proporciona mejoras, que apuntan a la calidad de vida y clínica del paciente(AU)

Introduction: Prader-Willi syndrome is a genetic disease caused by de novo deletions in the 15q11q13 region in the paternal chromosome. It is characterized by lack of satiety leading to morbid obesity, behavioral disorders, intellectual disability, short height and hypogonadism. Objective: To describe the results obtained from the multidisciplinary analysis and intervention performed in a patient diagnosed with Prader-Willi syndrome. Presentation of the clinical case: Clinical case analysis in an 8 years old child, male sex, diagnosed with Prader-Willi syndrome through a multidisciplinary intervention performed in three moments: assessment, diagnosis and intervention with cognitive behavioral approach. Conclusions: The strategies adopted generated significant changes in the social and family context, family´s appropriation of the recommendations provided, adoption of protective factors, roles identification and improving of adherence to treatment. By taking into account this considerations, improvements lead to clinic and life quality of the patient(AU)

What Drives Detection and Diagnosis of Autism Spectrum Disorder? Looking Under the Hood of a Multi-stage Screening Process in Early Intervention.

U.S. guidelines for detecting autism emphasize screening and also incorporate clinical judgment. However, most research focuses on the former. Among 1,654 children participating in a multi-stage screening protocol for autism, we used mixed methods to evaluate: (1) the effectiveness of a clinical decision rule that encouraged further assessment based not only on positive screening results, but also on parent or provider concern, and (2) the influence of shared decision-making on screening administration. Referrals based on concern alone were cost-effective in the current study, and reported concerns were stronger predictors than positive screens of time-to-complete referrals. Qualitative analyses suggest a dynamic relationship between parents' concerns, providers' concerns, and screening results that is central to facilitating shared decision-making and influencing diagnostic assessment.

Early intervention program by ICF model for babies of 4-18 months frequenting daycare center: protocol for clinical trial

A daycare center is a long-term place for infants, which means that early intervention programs should be thought of in this environment. There are still many gaps regarding the best way of stimulation/intervention, duration and description of effects and controlled outcomes. Aim: The objective of this clinical trial is to propose an early physical activity intervention program performed in infants of 4-18 months with risk/delay and with typical development at infant's daycare. Method: The protocol of this study is indicated for a controlled trial, in a crossover format, to be applied in 4 groups composed by in 4-18 month-old infants who attend daycare: Intervention group 1 Typical, Intervention group 1 Risk/delay, group Intervention 2 Typical, group Intervention 2 Risk/delay, in 4-18 month old infants who attend daycare. The ICF criteria about functions and structure (through evaluation questionnaire) are considered, as well as activities and participation (AIMS, Denver II, and PedsQl™ evaluation), personal characteristics (questionnaire, ABEP and AHEMD-IS) and environmental factors (AHEMD-IS). Conclusion: This original proposal can highlight a low-cost intervention program performed in a daycare environment verifying the infant's NMD in a systematized way using theoretical basis.(AU)

Pilot of a Pediatric Palliative Care Early Intervention Instrument.

Current research demonstrates that pediatric symptom management care is often initiated in the late stages of disease once clinicians are no longer able to meaningfully impact symptom burden. Given that physicians or nurse practitioners are responsible for initiating palliative care referrals, it is incumbent upon registered nurses to advocate when improved symptom management care is needed. The pediatric palliative care screening instrument pilot provides a centralized instrument to document and quantify a patient's symptom profile, giving registered nurses the opportunity to objectively communicate and track a patient's need for improved symptom management care within the areas of pain, secretions, dyspnea, intractable seizures, nausea, vomiting, constipation, diarrhea, anorexia, cachexia, sleep disturbance, lethargy, anxiety, depression, and/or agitation. The 4-week quality improvement project at an academic teaching hospital formally incorporated the bedside registered nurses' symptom assessment into a centralized document. Fifty-three patients were identified as having an uncontrolled symptom burden in at least one of the symptom domains, indicating that excessive and untreated symptom burden was present on the acute care floor. The pediatric palliative care screening instrument could act as a conduit between bedside registered nurses and the palliative care team, serving to reduce the time between onset of excessive symptom burden and initiation of symptom management services.

How Does Context Relate to Nutrition Promotion and Mealtime Practice in Early Care and Education Settings? A Qualitative Exploration.

BACKGROUND: Early childhood educators have the potential to influence children's dietary outcomes through daily interactions. However, existing research suggests that educator practices are often suboptimal. Previous research has often focused on individual characteristics that affect practices. There is less study of contextual influences of practices of early childhood educators. OBJECTIVE: The purpose of this study was to understand and describe contextual factors evident in narratives of early childhood educators influencing mealtime and nutrition promotion practices. We use the Promoting Action on Research Implementation in Health Services framework to consider how contextual factors related to practices of early childhood educators. DESIGN: This cross-sectional, qualitative study collected data through in-depth interviews with early childhood educators. Analyses of the data reflected a factist perspective and semantic approach to complete thematic content analysis of in-depth interviews. PARTICIPANTS: The study used a stratified purposive sampling approach to recruit 28 educators to balance across educator role, agency type (Head Start vs state-funded), and obesity prevalence in the community. Early childhood educators were mostly lead teachers (62%), between the ages of 30 and 49 (82.1%), and white (75%) or African American (14.3%). RESULTS: The coders identified three primary themes: Mealtime Structures, Resources, and Classroom/Center Atmosphere. Mealtime Structures associated with detrimental practices included cafeteria meals with rigid schedules. Mealtime Structures associated with evidence-based practices (EBPs) included classroom meal service. Resources associated with detrimental practices included limited funding. Resources associated with EBPs included meals paid for early childhood educators and classroom food experiences. Classroom/Center Atmosphere factors associated with detrimental practices included poor food offerings and policies that conflicted (eg, allowing children to bring in outside foods). Classroom/Center Atmosphere factors associated with EBPs included clarity around meal service rules and healthy, appealing food offerings. CONCLUSIONS: This study highlighted that it may be difficult for an early childhood educator to adopt and maintain EBPs in certain contexts.