Adolescentes acolhidos em casa lar: narrativas de transtornos mentais e violência / Adolescentes y casas de acogida: narrativas de trastornos mentales y violencia / Adolescents housed in an orphanage: narratives of mental disorders and violence

Objetivo: conhecer a trajetória de adolescentes acolhidos que vivem em uma casa lar e os impactos para a sua saúde. Materiais e método: pesquisa qualitativa realizada em 2021, a partir de entrevista semiestruturada com 10 adolescentes, utilizando a Plataforma Google Meet®. Para a análise e categorização das enunciações, utilizaram-se a análise de conteúdo e o software de dados qualitativos gratuito Qualitative Data Analysis (QDA Miner Lite®). Resultados: as enunciações dos adolescentes revelam uma trajetória marcada por violências física, psicológica e sexual, praticada pela família de origem. Isso repercutiu em trauma, sofrimento psíquico e transtornos mentais, além de cuidados medicamentosos e acompanhamento de saúde. Conclusões: os adolescentes acolhidos requerem atenção, cuidado, rede intersetorial e atuação interprofissional. O acompanhamento especializado é fundamental, visto que os transtornos mentais e a violência estão presentes na trajetória desses adolescentes.

Objetivo: conocer la trayectoria de un grupo de adolescentes protegidos que residen en una casa de acogida e identificar los impactos para su salud. Materiales y método: investigación cualitativa realizada en 2021 a partir de una entrevista semiestructurada a 10 adolescentes, utilizando la plataforma Google Meet®. Para el análisis y categorización de los enunciados se utilizó el software gratuito de análisis de contenido y datos cualitativos Qualitative Data Analysis (QDA Miner Lite®). Resultados: las declaraciones de los adolescentes revelan una trayectoria marcada por violencia física, psicológica y sexual ejercida por la familia de origen. Esta realidad ha generado traumas, sufrimiento psíquico y trastornos mentales, dando además lugar a atención farmacológica y seguimiento en salud. Conclusiones: los adolescentes objeto de protección requieren atención, cuidado, una red intersectorial y acción por parte de un equipo interprofesional. El seguimiento especializado es fundamental, puesto que los trastornos mentales y la violencia han estado presentes en la trayectoria de vida de estos jóvenes.

Objective: To know the trajectory of sheltered adolescents living in foster homes and the impacts on their health resulting from this situation. Materials and method: Qualitative research conducted in 2021 via a semi-structured interview with 10 adolescents, using the Google Meet® Platform. Free Qualitative Data Analysis (QDA Miner Lite®) - content and qualitative data analysis software - was used for the analysis and categorization of utterances. Results: Adolescents' statements reveal a trajectory marked by physical, psychological, and sexual violence by the family of origin. This reality has had repercussions on traumas, psychic suffering, and mental disorders, in addition to medication care and health monitoring. Conclusions: Sheltered adolescents require attention, care, intersectoral network support, and interprofessional action. Specialized follow-up is fundamental since mental disorders and violence are present in the lifetime trajectory of these individuals.

Acolhimento institucional na voz de cuidadoras de crianças e adolescentes que vivem em Casa Lar / Acogimiento institucional en la voz de cuidadores de niños y adolescentes que viven en Casa Lar / Institutional foster care in the voice of caregivers of children and adolescents living in Casa Lar

Objetivo: conhecer o acolhimento institucional realizado por profissionais cuidadores que atuam com crianças e adolescentes que residem em Casa Lar. Método: estudo qualitativo, descritivo e exploratório, no qual participaram 11 profissionais que trabalham com crianças e adolescentes acolhidos. A coleta de dados aconteceu de agosto a novembro de 2021, a partir de entrevista semiestruturada, na Plataforma Google Meet®. As enunciações foram submetidas à análise temática de conteúdo. Resultados: os profissionais que atuam na Casa Lar desenvolvem um trabalho desafiador no acolhimento institucional, pautado na interação e relação afetiva, acolhimento humanitário, favorecimento de estratégias para a socialização e desenvolvimento pessoal, por meio do trabalho em equipe, com vistas às vulnerabilidades, demandas dos acolhidos e fortalecimento de vínculos. Conclusão: ao acolher as crianças e adolescentes, é indispensável que os profissionais ofereçam um cuidado que atenda as demandas de saúde desses indivíduos, e que contemple as singularidades presentes no processo de acolhimento institucional.

Objective: to know the institutional care provided by professional caregivers who work with children and adolescents living in Casa Lar. Method: qualitative, descriptive and exploratory study, in which 11 professionals who work with children and adolescents sheltered participated. Data collection took place from August to November 2021, from a semi-structured interview, on the Google Meet® Platform. The enunciations were submitted to thematic content analysis. Results: professionals working at Casa Lar develop a challenging work in institutional care, based on interaction and affective relationship, humanitarian reception, favoring strategies for socialization and personal development, through teamwork, with a view to vulnerabilities, welcoming demands and strengthening bonds. Conclusion: when embracing children and adolescents, it is essential that professionals offer care that meets the health demands of these individuals, and that contemplates the singularities present in the process of institutional care.

Objetivo: conocer la acogida institucional realizada por profesionales cuidadores que actúan con niños y adolescentes que residen en Casa Lar. Método: estudio cualitativo, descriptivo y exploratorio, en el cual participaron 11 profesionales que trabajan con niños y adolescentes acogidos. La recolección de datos tuvo lugar de agosto a noviembre de 2021, a partir de una entrevista semiestructurada, en la Plataforma Google Meet®. Las enunciaciones fueron sometidas al análisis temático de contenido. Resultados: los profesionales que actúan en la Casa Lar desarrollan un trabajo desafiante en la acogida institucional, pautado en la interacción y relación afectiva, acogida humanitaria, favorecimiento de estrategias para la socialización y desarrollo personal, por medio del trabajo en equipo, con vistas a las vulnerabilidades, demandas de los acogidos y fortalecimiento de vínculos. Conclusión: al acoger a los niños y adolescentes, es indispensable que los profesionales ofrezcan un cuidado que atienda las demandas de salud de esos individuos, y que contemple las singularidades presentes en el proceso de acogida institucional.

Psicologia na defesa dos direitos humanos de crianças e adolescentes / Psychology in the defense of children and adolescents' human rights / La psicología en la defensa de los derechos humanos de la niñez y la adolescencia

A propósito da história mais recente da Psicologia no Brasil, considerando o período a partir da Constituição Federal de 1988, tomada aqui como acontecimento que favorece a emergência da Psicologia como uma área comprometida com a garantia dos Direitos Humanos, este artigo traz para conhecimento e análise fragmentos de memórias de egressos de instituições totais, como os antigos orfanatos, manicômios e preventórios, como parte de uma política de assistência ao chamado menor abandonado. É possível identificar nas lembranças em questão, com bastante clareza, o entendimento da criança como sendo objeto das ações dos adultos e das instituições, inclusive sendo submetida a práticas de abuso sexual e exploração no trabalho, e não como um sujeito de direitos cuja vida deve ser mantida, reconhecida e valorizada em todas as suas dimensões. Este texto também procura relembrar os vários movimentos de resistências que lutaram pela modificação desse tipo de situação, para que se possa enfrentar os problemas da atualidade, muitos decorrentes da pandemia vivida pela população.(AU)

Regarding the most recent history of Psychology in Brazil, since the 1988 Federal Constitution, considered here as a favorable event for the emergence of Psychology as an area committed to guaranteeing Human Rights, this article analyzes fragments of memories of individuals held at total institutions - such as the old orphanages, asylums and preventive care centers -, as part of an aid policy to the so-called neglected minor. These memories clearly show the understanding of the child as an object of the actions of adults and institutions, including being subjected to sexual abuse and exploitation, and not as a subject of rights whose life must be preserved, recognized and valued in all its dimensions. It also evokes the several resistance movements that fought to change this scenario, so that we can face today's challenges, many of them resulting from the pandemic experienced by the population.(AU)

Considerando la historia más reciente de la Psicología en Brasil a partir de la Constitución Federal de 1988 tomada aquí como un acontecimiento que favorece el surgimiento de una Psicología comprometida con la garantía de los Derechos Humanos, este artículo expone y analiza fragmentos de memorias de egresados de instituciones totales como los antiguos orfanatos, asilos y centros de atención preventiva como parte de una política de asistencia al llamado menor abandonado. Se puede identificar claramente en estas memorias la comprensión del niño como objeto de las acciones de adultos e instituciones, incluso víctimas de abuso sexual y explotación en el trabajo, y no como sujeto de derechos cuya vida debe ser mantenida, reconocida y valorada en todas sus dimensiones. Además, se busca destacar los momentos de resistencia en la lucha por cambios en estas situaciones, llevados a cabo en la pandemia que afectó a la población.(AU)

Casais de genitores procuram o judiciário para entregar criança para adoção / Parental couples seek judiciary to consent their children's adoption / Parejas de padres buscan el poder judicial para entregar niños en adopción

A entrega de crianças para adoção por suas genitoras se tornou objeto de constantes normatizações, a exemplo da lei que alterou o Estatuto da Criança e do Adolescente, visando garantir à mulher o direito de não exercer a maternidade e à criança a possibilidade de ter seu direito à convivência familiar e comunitária preservado. Em 2009, a Segunda Vara da Infância e Juventude do Recife iniciou o atendimento a mulheres que manifestam o interesse em entregar sua criança para adoção, através do Programa Mãe Legal. Durante esses anos, verificou-se que, por vezes, é o casal de genitores que comparece para manifestar a intenção de entregar a criança para adoção. O objetivo geral desta pesquisa foi compreender as motivações dos genitores ao decidirem pela entrega ou desistência da colocação de uma criança para adoção, no âmbito do Programa Mãe Legal. Pretende-se analisar o processo pelo qual os genitores vivenciam a parentalidade e compreender o contexto vivido pelo casal que influenciou na sua decisão. A pesquisa foi de natureza qualitativa e teve como instrumental a análise de documentos do processo judicial. Cinco casos foram selecionados para o estudo, e os dados foram analisados por meio da análise de conteúdo temática. Os resultados apontaram que, além das questões subjetivas, as motivações têm suas raízes em fatores externos como o contexto em que o casal está vivendo; a violência e o desgaste da conjugalidade; a interrupção dos sonhos planejados; a falta de planejamento da gravidez; o desemprego e as dificuldades financeiras.(AU)

Mothers' consent to their children's adoption has become the subject of constant regulations, such as the law that changed the Children and Adolescents' Statute, aiming to guarantee to women the right to not exercise motherhood and to children the possibility of having their right to family and community life preserved. In 2009, the Second Childhood and Youth Court of Recife started assisting women who express an interest in consenting their child for adoption, by the Legal Mother Program. During these years, it was found that sometimes the couple of parents comes to express their intention to consent the adoption of a child. The general objective of this research was to understand the motivations of parents when deciding either on consenting or renouncing the placement of a child for adoption, within the scope of the Legal Mother Program. Analyzing the process by which parents experience parenting and to understanding the context experienced by the couple wich influenced their decision was the intention. The research had a qualitative nature and as instrument the analysis of judicial process documents. Five cases were selected for the study, and the data was analyzed by using thematic content analysis. The main results showed that, in addition to subjective issues, motivations have their roots in external factors such as the context in which the couple is living; the violence and the erosion of conjugality; the interruption of planned dreams; the lack of pregnancy planning; unemployment and financial difficulties.(AU)

La entrega de niños/as para la adopción por sus genitoras se ha transformado en objeto de continuas normativas, como la ley que cambió el "Estatuto da Criança e do Adolescente", con el objetivo de garantizar a la mujer el derecho de no ejercer la maternidad y al niño/a la posibilidad de tener su derecho a la convivencia familiar y comunitaria preservada. En el 2009, la "Segunda Vara da Infância e Juventude do Recife" ha iniciado la atención a las mujeres que desean dejar sus niños/as para adopción, a través del "Programa Mãe Legal". A lo largo de estos años se ha observado que, algunas veces, es la pareja de padres la que se presenta para manifestar el deseo de entregar el niño/a en adopción. El objetivo general de esta investigación fue comprender las motivaciones que llevan a los padres a decidir por la entrega o por la desistencia del acto de dejar el niño/a en adopción, en el marco del "Programa Mãe Legal". Se pretende analizar el proceso por el cual los padres vivencian la paternidad y comprender el contexto vivido por la pareja que ha influenciado la decisión. La investigación fue de naturaleza cualitativa y tuvo como herramienta el análisis de documentos del proceso judicial. Fueron seleccionados cinco casos para el estudio y los datos fueron analizados mediante la aplicación del método de análisis de contenidos temáticos. Los resultados señalaron que además de las cuestiones subjetivas, las motivaciones tienes sus raíces en factores externos, como el contexto en que vive la pareja, la violencia y el desgaste de la conyugalidad, la interrupción de los sueños, la falta de planificación del embarazo, el desempleo y la dificultad económica.(AU)

Pressupostos para a escuta psicanalítica em instituição de acolhimento de crianças e adolescentes / Assumptions for psychoanalytic listening in a children's and adolescents' hostelling institution / Presupuestos para la escucha psicoanalítica en una institución de acogida para niños y adolescentes

Partimos do trabalho em uma instituição de acolhimento para crianças e adolescentes propondo uma escuta orientada pela psicanálise. Considerando as tensões entre instituição e psicanálise, a questão que nos orienta é de que forma a transferência pode contribuir para uma instauração de escuta, que permitirá a elaboração da situação de vulnerabilidade desses sujeitos. Utilizamos como método de pesquisa a revisão bibliográfica associada à psicanálise aplicada e recorremos aos fragmentos de recordação das situações vividas no cotidiano institucional. Concluiu-se que há um lugar de escuta sob transferência a ser considerada na instituição e que o Plano Individual de Atendimento (PIA) necessita ser efetivado sob transferência, para que seja implementado como instrumento que valorize o surgimento das singularidades dos acolhidos.

We started from work at a host institution for children and adolescents, proposing a listening guided by psychoanalysis. Considering the tensions between institution and psychoanalysis, the question that guides us is how the transfer can contribute to establishing a listening that will allow the elaboration of the situation of vulnerability of these subjects. We used as a research method the bibliographic review associated with applied psychoanalysis and we also used fragments of remembrance of the situations experienced in the institutional daily life. It was concluded that there is a place of listening under the transfer to be considered in the institution and that the Individual Assistance Plan needs to be carried out under the transfer in order to be implemented as an instrument that values the emergence of the singularities of the sheltered.

Partimos desde el trabajo en una institución de acogida para niños y adolescentes proponiendo una escucha orientada por el psicoanálisis. Considerando las tensiones entre institución y psicoanálisis, la cuestión que nos orienta es de qué forma la transferencia puede contribuir al establecimiento de un escuchar que permitirá la elaboración de la situación de vulnerabilidad de esos sujetos. Utilizamos como método de investigación la revisión bibliográfica asociada al psicoanálisis aplicado y recurrimos a los fragmentos de recuerdos de las situaciones de la vida cotidiana institucional. Concluimos que hay un lugar de escucha bajo transferencia a ser considerado en la institución y que el Plan Individual de Atención necesita ser efectivado bajo transferencia para que sea implementado como un instrumento que valore el surgimiento de las singularidades de los acogidos.

Selective inflammatory propensities in adopted adolescents institutionalized as infants.

This study examined whether early life adversity (ELA) limited to infancy was associated with an increase in circulating levels of proinflammatory cytokines and cellular cytokine responses to three stimulants [lipopolysaccharide (LPS), phytohemagglutinin (PHA), and phorbol myristate acetate plus ionomycin (PMA/IO)]. Participants were previously institutionalized (PI) youth (N = 45, 56 % female) who had spent their first years in institutional care (e.g., orphanages, baby homes) before being adopted into well-resourced homes (median age at adoption = 13 mos) and non-adopted comparisons (NA; N = 38, 55 % female). Their age range was 13.3-21.2 years (M = 16.3 years). This analysis followed up an earlier report on these youth (Reid et al., 2019a) that identified an increase in terminally differentiated CD8 + CD57 T cells among the PI relative to the NA youth. Cytokine levels in circulation were not highly correlated and thus examined separately. PI youth had higher circulating levels of Tumor Necrosis Factor-alpha (TNFα), but not Interleukin-1ß (IL-1ß) or Interleukin-6 (IL-6). Cytokine responses to in vitro activation within each stimulant condition were highly correlated and were thus combined to generate an index of the inflammatory reaction to each stimulant. Using Multivariate Analysis of Covariance, there was a highly significant multivariate effect of group, which was carried primarily by the PMA/IO condition, with PI youth exhibiting a larger inflammatory response than NA youth. Tests of mediation showed that both the early rearing effects on circulating TNFα and the composite inflammatory index of PMA/IO responsiveness were mediated in the statistical model by the percentage of CD8 + CD57+ TEMRA cells in circulation, a marker of replicative senescence in T cells. Sex differences were also found in circulating levels of IL-6 and TNFα, with males having higher levels than females.

Os aspectos psicológicos da criança e do adolescente na adoção tardia / Psychological features of late-adopted children and adolescents / Los aspectos psicológicos del niño y del adolescente en la adopción tardía

Em razão do número significativo de crianças maiores e adolescentes disponíveis para o processo de adoção no Cadastro Nacional de Adoção, e de a idade representar um fator de restrição e obstáculo para os pretendentes à adoção, torna-se necessário desmistificar as crenças enraizadas sobre adoção tardia. Pensando nessas questões, o presente estudo objetiva compreender os aspectos psicológicos e comportamentais das crianças e dos pais por adoção, comumente presentes no período de adaptação e convivência pós-adotiva, e analisar as atitudes dos pais diante dos obstáculos, observando a eficácia da preparação necessária aos pretendentes à adoção. Para tanto, a metodologia adotada consistiu inicialmente em embasar teoricamente a adoção tardia e suas fases de adaptação, com fundamentação psicanalítica, para a compreensão abrangente do assunto, e em uma pesquisa de campo com dois casais, pais por adoção que se encontravam no período de convivência de seis meses a um ano, para coletar dados relevantes e os correlacionar com a teoria. Por meio dos resultados obtidos, foram apontados os estágios de convivência e os aspectos psicológicos envolvidos nesse processo, bem como a importância de os pretendentes à adoção se instrumentalizarem com informações e se prepararem para a filiação afetiva. Assim, mesmo com todas as dificuldades que possam surgir no processo de adaptação na adoção tardia, em virtude de fatores como idade, preconceitos, mitos e histórico prévio de vida da criança, conclui-se que o afeto e a adoção recíproca prevalecem a qualquer desafio e que, se a experiência da adoção tardia for bem orientada, pode apresentar excelentes resultados.(AU)

Before the significant number of older children and adolescents available for adoption in the National Adoption Register, and considering age as both a restriction factor and an obstacle, rooted beliefs concerning late adoption must be demystified. In this scenario, this study aimed to understand the psychological and behavioral features of children and their adopting parents during the adjustment period soon after adoption, besides analyzing parents' attitudes toward obstacles in light of the necessary preparation on the part of couples intending to adopt. Based on psychoanalytical principles, this study first sets the theoretical foundations of late adoption and its adjustment phases to reach a comprehensive understanding of the issue. To collect data and relate them to the underlying theory, a field research was conducted with two adopting couples in the adjustment period, which ranges from six months to a year. The results indicate the adjustment phases and psychological features underlying this process, besides stressing the importance of parents who intend to adopt for searching for information on the issue and preparing themselves for an affective adoption. Despite the difficulties in late-adoption adaptation - due to age, prejudices, myths, and the previous lives of children, - affection and mutual adoption can overcome any challenges that may arise. Moreover, if the late adoption process is adequately guided, it may present excellent results.(AU)

Debido al número significativo de niños mayores y adolescentes disponibles para el proceso de adopción en el Catastro Nacional de Adopción, y siendo la edad un factor de restricción y obstáculo para los adoptantes, es necesario desmitificar las creencias en relación a la adopción tardía. En este sentido, el presente trabajo tiene por objeto comprender los aspectos psicológicos y comportamentales de los niños y de los padres por adopción, comúnmente presentes en el período de adaptación y convivencia postadoptiva, así como analizar las actitudes de los padres ante a los obstáculos, observando la eficacia de la preparación necesaria para los aspirantes a adopción. Para ello, la metodología adoptada consistió inicialmente en basar teóricamente la adopción tardía y sus fases de adaptación, con fundamentación psicoanalítica, para una comprensión más amplia del asunto, y una investigación de campo con dos parejas, que son padres por adopción entre seis meses a un año, para recoger datos relevantes y correlacionarlos con la teoría. Los resultados apuntan las etapas de convivencia y los aspectos psicológicos que involucran este proceso, así como la importancia de los aspirantes a adopción para conseguir informaciones y prepararse para la filiación afectiva. Incluso con todas las dificultades que puedan surgir en el proceso de adaptación en la adopción tardía, en virtud de la edad, de los prejuicios, mitos y por el histórico previo de vida que el niño carga, se concluye que el afecto y la adopción recíproca prevalecen ante cualquier desafío y que si bien orientada la experiencia de la adopción tardía se puede presentar excelentes resultados.(AU)

Fatores Protetivos e de Risco na Transição entre o Acolhimento Institucional e a Vida Adulta / Protective and Risk Factors During Transition from Care to Independent Living / Factores Protectores y de Riesgo en la Transición entre Hogares de Acogida y la Vida Adulta

Este estudo teve por objetivo identificar os fatores de proteção e de risco envolvidos no processo de transição entre o acolhimento institucional e a vida adulta. Participaram 13 jovens entre 18 e 24 anos, de ambos os sexos, egressos do sistema de proteção da cidade de Curitiba, no sul do Brasil. Cinco cuidadores também participaram, representando cada uma das unidades de acolhimento de onde os jovens provieram. Os dados foram coletados por meio de entrevistas em profundidade e submetidos à análise temática. Os temas e subtemas identificados dentro de dois eixos temáticos (fatores de proteção e fatores de risco) atravessam diferentes níveis contextuais e revelam um desequilíbrio que dificulta o processo de transição. Conclui-se que, além da maior observância às políticas e diretrizes já existentes, é necessário formular programas novos e específicos para esses jovens, alicerçados na concepção de que eles próprios devem ser os protagonistas de suas trajetórias. (AU)

The study aimed to identify protective and risk factors involved in the transition process from residential care to independent living. Participants were 13 young people from 18 to 24 years old, man and women, who aged out of care in the city of Curitiba, south of Brazil. A total of five caregivers also participated, each representing one of the residential centers where those young people used to live. Data were collected with in depth semi structured interviews and analyzed through thematic analysis. The themes and subthemes, identified in two thematic axes (protective factors and risk factors), permeate different contexts and disclose an imbalance that hinders the transition process. We conclude that, in addition to compliance of existing social policies, it is necessary to create new and specific programs for young people aging out of care, based on a youth-centered approach. (AU)

Este estudio tuvo por objetivo identificar los factores de protección y de riesgo implicados en el proceso de transición entre el acogimiento institucional y la vida adulta. Participaron 13 jóvenes entre 18 e 24 años, de ambos sexos, egresados del sistema de protección de la ciudad de Curitiba, en el sur de Brasil. Cinco cuidadores también participaron, representando cada uno de los hogares de acogida donde vivieron esos jóvenes. Los datos fueron recogidos a través de entrevistas en profundidad y sometidos a análisis temático. Los temas y subtemas, identificados dentro de dos ejes temáticos (factores de protección y factores de riesgo), atraviesan distintos niveles contextuales y demuestran un desequilibrio que dificulta el proceso de transición. Se concluye que, además de cumplir las políticas y directrices ya existentes, es necesario formular programas nuevos y específicos para esta población, considerando que los propios jóvenes deben ser los protagonistas de sus trayectorias. (AU)

Recomendaciones de salud ambiental para espacios comunitarios cerrados: ancianatos, orfelinatos y otros lugares residenciales colectivos / Environmental Public Health Recommendations for Collective Residential Places: Nursing Homes, Orphanages, and Other Collective Residential Places / Recomendações de saúde ambiental para espaços comunitários fechados asilos, orfanatos e outros locais de residência coletiva

Los ancianatos, orfelinatos y otros lugares residenciales colectivos que prestan servicios a grupos de personas en condiciones de vulnerabilidad son fundamentales para el bienestar de la sociedad. Es muy importante que estos espacios comunitarios cerrados cuenten con condiciones ambientales y de higiene adecuadas para proteger la salud de los cuidadores, visitantes y los residentes (ancianos, niños). Esta nota incluye recomendaciones para proteger la salud durante la pandemia de COVID-19. Instruir a los cuidadores, personal de servicio, residentes, familia y visitantes en las indicaciones de esta ficha técnica.

This technical note presents the main recommendations for collective residential places that provide services to groups of people in vulnerable conditions, such as nursing homes and orphanages, in the areas of drinking water, hand washing, surface cleaning, laundry, ventilation, and management of solid waste. Additionally, recommendations are provided to prepare 0.05% and 0.1% sodium hypochlorite solutions, depending on the needs for cleaning and prevention against SARS-COV-2 and other infectious agents.

Os asilos, orfanatos e outros locais de residência coletiva que prestam serviços a grupos de pessoas em condições de vulnerabilidade são fundamentais para o bem-estar da sociedade. É muito importante que esses espaços comunitários fechados tenham condições ambientais e de higiene adequadas para proteger a saúde dos cuidadores, visitantes e residentes (idosos e crianças). Este documento inclui recomendações para proteger a saúde durante a pandemia de COVID-19. Instruir cuidadores, equipe de serviço, residentes, familiares e visitantes com as indicações desta ficha técnica.

Comparison of Outcomes of Vision and Eye Screening of Children of Four Orphanages and School Children of Riyadh.

PURPOSE: The purpose was to compare vision and ocular disease among orphans to age-matched school children and determine the barriers they faced for ophthalmic care in Riyadh, Saudi Arabia. METHODS: Children of four orphanages of Riyadh (Gr1) were screened for vision refractive error (RE) and eye ailment on "World Sight Day-2019." They were compared to age-matched school children (comparison group; Gr2). The rates of RE, strabismus, amblyopia, and allergic conjunctivitis were estimated in two groups. The coverage of existing eye services for orphan children was reviewed. RESULTS: We screened 53 children of Gr1 and 106 school children of Gr2. The risk of RE was statistically significantly higher in school children compared to orphan children (odds ratio [OR] = 2.4 [95% confidence interval (CI) 1.2; 4.8] P = 0.01). The coverage of refractive services for Gr1 was significantly lower than for Gr2 (OR = 0.09 [95% CI 0.02; 0.4] P = 0.001). In Gr1, blurry vision (12 children), red eye (2), and itchy eyes (1) were the main symptoms. In Gr2, no child had eye complaints. In Gr1, amblyopia (1), strabismus (1), history of ocular trauma and surgery (1), eye medications needed (2), and systemic health problems were noted in 9 children. In Gr2, amblyopia (4), strabismus (4), and history of ocular surgery were noted in 2 children. CONCLUSION: Orphan children had less rate of myopia compared to school children. However, unattended ocular pathologies were detected during the screening campaign. The coverage of refractive services was low in these underprivileged children compared to school children.

Skin diseases in rural Nyala, Sudan (in a rural hospital, in 12 orphanages, and in two refugee camps).

Skin diseases are considered to be common in Nyala, Sudan. This study was carried out to verify the prevalence of skin diseases in Nyala. This prospective observational study included skin examination of a total of 1802 people: 620 patients who were evaluated in the outpatient clinics (OC) and 1182 people from orphanages and refugee camps (ORC) in Nyala, Sudan. χ2 test was used. The total prevalence of skin disorders in the sample was 92.6% (1670/1802). One thousand and fifty of 1182 (88.8%) people from ORC had a skin disorder. The most common skin diseases in this community were: fungal infections (32.6%), dermatitis/eczema (10.5%), bacterial skin infections (10.3%), disorders of skin appendages (8.7%), parasitic infestations (7.7%), atrophic skin disorders (7.4%), disorders of pigmentation (7.4%), hypertrophic skin disorders (6.4%), viral infections (5.8), benign neoplasm (1.9%), dermatoses due to animal injury (0.4%), bullous dermatoses (0.1%), and malignant neoplasm (0.1%). Hypertrophic and atrophic disorders of the skin were mainly lesions of scarification (mostly atrophic) (5.7%) and keloids (5.6%). Fungal infection, bacterial infection, and parasitic infestation were more common in the ORC group, while dermatitis and eczema, disorders of skin appendages, hypertrophic and atrophic disorders of the skin, disorders of pigmentation, and benign neoplasm were more common in the OC group. The prevalence of skin diseases in the rural Nyala was more than our expectation and was dominated by infectious skin diseases. In addition, infectious skin diseases were more common in ORC rather than OC.

Development of a Tool for Health Screening and Assessment in Orphanages in Lesotho.

In low- and middle-income countries that have high burdens of disease, simple interventions such as health screenings can have a significant impact on health outcomes. Among vulnerable children, orphans in particular, deaths are often caused by conditions preventable through early identification and provision of basic health and nutritional needs. After consulting local preventative care guidelines and medical providers, a health screening tool for use in orphanages was created. This tool was used to screen children in two orphanages in Lesotho. Overall, the tool was found to be easy, efficient, and valuable in identifying both preventable and immediately treatable conditions in orphans. As a result, orphans with long-term medical needs were linked to community-based providers by developing individualized care plans in collaboration with orphanage colleagues. This preventative tool offers a screening strategy that directly aligns with the United Nations Agency for Development's Sustainable Development Goals and helps to advance the goal of universal health coverage.

Tratamento padrão de enfermagem em adolescentes com psicose prodrômica precoce: estudo quase experimental / Standard nursing treatment on adolescents with early prodromal psychosis: a quasi-experimental study / Tratamiento estándar de enfermería para adolescentes con psicosis prodrómica precoz: estudio casi experimental

OBJETIVO: determinar o efeito do tratamento padrão de enfermagem sobre a ansiedade e a autoestima em adolescentes com psicose prodrômica precoce, residentes de orfanatos. MÉTODO: um pré-pós-teste quase experimental sem grupo de controle foi conduzido com 77 adolescentes, selecionados por técnica de amostragem intencional. Os dados foram analisados pelo teste t. RESULTADO: após o tratamento padrão de enfermagem, os adolescentes apresentaram diminuição significativa nos sintomas de psicose prodrômica precoce (de 9,16 a 7,13) e escore de ansiedade (de 17,03 a 13,70) e aumento significante da autoestima (de 45,97% para 63,77%) com valor de p <0,05. CONCLUSÃO: recomenda-se o tratamento padrão de enfermagem para adolescentes com psicose prodrômica precoce no orfanato que têm ansiedade e baixa autoestima.

AIM: to determine the effect of standard nursing treatment on anxiety and self-esteem among adolescents living in orphanages with early prodromal psychosis. METHOD: this is a quasi-experimental pre and post-test, without a control group, that was conducted with 77 adolescents, selected by the intentional sampling technique. Data were analyzed using the t-test. RESULT: after the standard nursing treatment was received, the adolescents showed a significant decrease in the symptoms of early prodromal psychosis (from 9.16 to 7.13) and an anxiety score (from 17.03 to 13.70) and a significant increase in self esteem (from 45.97% to 63.77%) with p-value <0.05. CONCLUSION: the standard nursing treatment is recommended for adolescents with early prodromal psychosis in the orphanage who have anxiety and low self-esteem.

OBJETIVO: Determinar el efecto del tratamiento estándar de enfermería sobre la ansiedad y la autoestima de adolescentes con psicosis prodrómica precoz, residentes en orfanatos. MÉTODO: Se condujo un pre-post-test casi experimental sin grupo de control con 77 adolescentes, seleccionados por técnica de muestreo intencional. Los datos se analizaron por el test t. RESULTADO: Después del tratamiento estándar de enfermería, los adolescentes presentaron disminución significativa de los síntomas de psicosis prodrómica precoz (de 9,16 a 7,13) y escore de ansiedad (de 17,03 a 13,70) y aumento significante de la autoestima (de 45,97% a 63,77%) con valor de p <0,05. CONCLUSIÓN: se recomienda el tratamiento estándar de enfermería para adolescentes con psicosis prodrómica precoz que tienen ansiedad y baja autoestima, en el orfanato.

Risk Factors and Treatment Needs among Orphan School Children.

AIM: The aim of the study was to identify risk factors and treatment needs of orphan children of Selangor, Kuala Lumpur, Malaysia. Ob ectives: (1) To identify the association between the frequency of snacking and caries among orphan schoolchildren, (2) To assess Streptococcus mutans and Lactobacilli (microbiological assessment) in saliva of orphan children, and (3) To formulate treatment needs for orphan children. MATERIALS AND METHODS: A cross-sectional study was done among 253 children of 5-, 12-, and 15-year-olds living in various orphanage houses of Selangor, Kuala Lumpur, Malaysia. Demographic data, and dietary and oral hygiene practices were collected through a structured questionnaire. Clinical examinations of children were conducted to assess oral health status and recorded in the World Health Organization oral health assessment form (1997). Stimulated saliva was collected for S. mutans and Lactobacilli levels. The statistical software, namely, Statistical Package for the Social Sciences version 19.0 was used for the analysis of the data. RESULTS: The final data analysis included 253 children of which 116 (45.8%) were boys and 137 (54.2%) were girls. Overall, 140 (55.33%) children were caries-free and 113 (44.66%) children presented with caries (decayed/missing/filled surface >0). High levels of salivary microbiological counts (S. mutans and Lactobacilli), i.e., ≥105, stress the importance of necessary preventive oral health services. Treatment needs among orphan children showed that most of the children, i.e., 58 (22.9%), need preventive or caries-arresting care followed by 49 (19.4%) who require two-surface filling as an immediate measure. CONCLUSION: From the results of our study, orphan children have low utilization of preventive and therapeutic oral health services. Urgent attention is required to plan a comprehensive dental health-care program to improve their oral health status. CLINICAL SIGNIFICANCE: Parents are the primary caretakers of children, but woefully some of them have to lead their lives without parents, the latter either being dead or incapable of bringing up their children. Such a group of children is known as orphans. As oral health is an integral part of general health, it is essential for health-care policy makers to address oral health needs of this underprivileged group of society. This article highlights the risk factors and treatment needs among orphan schoolchildren.

Factores y componentes del desempeño ocupacional en niños y niñas, en riesgo social e institucionalizados en la infancia temprana / Occupational performance components and factors of institutionalized children at social risk during early infancy

A través de un estudio descriptivo transversal realizado en un Hogar de Menores en Chile, durante el primer semestre del 2014, se estudiaron componentes y factores del desempeño ocupacional de veintiún niños y niñas institucionalizados por vulneración en sus derechos, entre los cero meses y cinco años once meses. Se utilizaron tres instrumentos de observación: la Ficha Clínica de cada niño, una Pauta de Observación y Evaluación del Ambiente Educativo y el Test de Evaluación del Desarrollo Infantil. Los resultados se agrupan en: caracterización de las causas de ingreso, descripción de las condiciones de salud asociadas, posibilidades que ofrece el ambiente de la residencia y la evaluación de las habilidades de desempeño ocupacional. Las causas de ingreso fueron: negligencia de los padres (55 por ciento), consumo de drogas de los padres (45 por ciento) y/o incompetencia de rol (40 por ciento). La participación en actividades favorecedoras del logro ocupacional estaba limitada por enfermedades respiratorias agudas y crónicas en un 65 por ciento de los casos. Respecto del rendimiento en las habilidades de desempeño, inferidas desde los resultados del Test de Evaluación del Desarrollo Infantil, se observó que el 38 por ciento de los niños y niñas presentaban riesgo o retraso en el desarrollo motor, cognitivo y del lenguaje; y un 23 por ciento presentaban retraso en el área socio - emocional. Esta caracterización permite identificar aquellas situaciones que merecen atención por parte de las instituciones y profesionales para aportar en el abordaje de esta problemática, demostrándose la utilidad de las evaluaciones utilizadas, para estudiar la situación de otros niños y niñas en condiciones similares.

Through a descriptive cross - sectional study conducted in a Children ́s Home in Chile during the first semester of 2014, there were studied occupational performance factors and components of twenty - one children institutionalized for violation of their rights was carried out between zero months and five years 11 months. Three observation instruments were used: each child’s Clinical Record, an adapted Guide to Observation and Assessment of the Educational Environment, and the “Test de Evaluación del Desarrollo Infantil”, a child development assessment test. The results are grouped in: characterization of the causes of admission, description of the associated health conditions, possibilities offered by the residence environment and the evaluation of occupational performance skills. The causes of admission were: parents’ negligence (55 percent), parental drug use (45 percent) and / or role incompetence (40 percent). Participation in activities conducive to occupational achievement was limited by acute and chronic respiratory diseases in 65 percent of cases. Regarding performance in performance skills, inferred from “Test de Evaluación del Desarrollo Infantil” results, it was observed that 38 percent of the children presented risk or delay in motor, cognitive and language development; And 23 percent had delays in the socio - emotional area. This characterization allows identifying those situations that deserve attention on the part of the institutions and professionals to contribute in the approach of this problematic, demonstrating the usefulness of the evaluations used, to study the situation of other children in similar conditions.

Chemical assessment of lead, cadmium, nitrate, and nitrite intakes with daily diets of children and adolescents from orphanages in Krakow, Poland.

The aim of this study has been to measure the level of lead, cadmium, nitrates, and nitrites in the daily diets of children and adolescents from orphanages located in Krakow (Poland). Diets were collected over four seasons of 2009. The content of cadmium and lead was measured with flameless atomic absorption spectrometry. Nitrates and nitrites in diets were measured using the Griess colorimetric method. In all orphanages, the average intake of lead with daily diets, regardless of the season, ranged from 1.11 ± 0.15 to 22.59 ± 0.07 µg/kg bw/week. The average cadmium intake by children and adolescents ranged between 3.09 ± 0.21 and 20.36 ± 2.21 µg/kg bw/week and, for all orphanages, exceeded the tolerable weekly intake (TWI) level. Daily intake of nitrates and nitrites ranged respectively from 27 to 289 % and from 9 to 99 % of the acceptable daily intake (ADI). The youngest children, with lower body mass, were particularly sensitive to the excessive intakes of cadmium and nitrates.

Intake of Vitamin C, ß-Carotene, and Polyphenolic Compounds by Children and Adolescents from Orphanages.

OBJECTIVE: The objective of this study was analytical assessment of the concentration of selected antioxidants as well as total antioxidant capacity of daily diets of children and adolescents from orphanages in Krakow (Poland). METHODS: Daily diets of children and adolescents were collected in 4 seasons of the year from 7 orphanages located in Krakow. The concentrations of vitamin C, ß-carotene, polyphenolic compounds, and antioxidant capacity were measured. RESULTS: The lowest content of vitamin C in diets of children and adolescents was measured in diets collected in autumn. The estimated average requirement (EAR) was in the range 49.0%-76.4%. In winter the content of this compound was significantly higher in daily diets (113.9%-192.0% coverage of EAR) compared to the level of this nutrient in daily diets from other seasons. The content of ß-carotene, lower than 50% of EAR value, calculated as the vitamin A equivalent, has been demonstrated in 4 orphanages in summer and in one in spring and autumn. The highest mean content of this antioxidant in daily diets was found in winter, when ß-carotene intake met recommendations in the range 131%-368%. The mean concentration of polyphenolic compounds per year was in the range 301.5-537.5 mg/person/day. It has been observed that diets during the winter and autumn generally provide higher amounts of polyphenols than in other seasons. The highest antioxidant activity was measured in diets collected during the winter season. CONCLUSIONS: The results indicate that the diets of children and adolescents should contain more fresh vegetables and fruits, which are good source of natural antioxidants.