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1.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 41(2): 138-147, Mar.-Apr. 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-990818

RESUMO

Objective: To describe the service use profile of Child and Adolescent Psychosocial Care Centers (Centro de Atenção Psicossocial Infanto-Juvenil [CAPSi]) in Brazil regarding diagnostic categories, sociodemographic aspects, and care modalities between 2008 and 2012. Methods: A descriptive, ecological study was performed using data from the Unified Health System regarding high-complexity procedure authorizations (Autorização de Procedimentos de Alta Complexidade [APAC]) for the period from 2008-2012. The variables sex, age, diagnosis (F00-F99 of ICD-10), and type of care provided were examined. The data were processed using TabWin and STATA version 12. Results: A total of 837,068 records were examined, each representing one visit to CAPSi. Most visits were by male users (68.8%). The most common diagnoses were hyperkinetic disorders (13%), pervasive developmental disorders (12.4%), and conduct disorders (8.4%). Conclusions: Behavioral and emotional disorders that usually appear during childhood or adolescence and psychological development disorders were frequent, with more than 50% of the latter comprising autism spectrum disorders. Regional differences were observed, with a higher presence of this diagnosis in the Southeast, while the North and Northeast had a high percentage of visits due to mental retardation.


Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Adolescente , Adulto Jovem , Serviços de Saúde da Criança/estatística & dados numéricos , Serviços de Saúde do Adolescente/estatística & dados numéricos , Transtornos Mentais/terapia , Serviços de Saúde Mental/estatística & dados numéricos , Fatores Socioeconômicos , Brasil , Grupos Diagnósticos Relacionados , Distribuição por Idade , Transtornos Mentais/classificação
2.
Braz J Psychiatry ; 41(2): 138-147, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30540024

RESUMO

OBJECTIVE: To describe the service use profile of Child and Adolescent Psychosocial Care Centers (Centro de Atenção Psicossocial Infanto-Juvenil [CAPSi]) in Brazil regarding diagnostic categories, sociodemographic aspects, and care modalities between 2008 and 2012. METHODS: A descriptive, ecological study was performed using data from the Unified Health System regarding high-complexity procedure authorizations (Autorização de Procedimentos de Alta Complexidade [APAC]) for the period from 2008-2012. The variables sex, age, diagnosis (F00-F99 of ICD-10), and type of care provided were examined. The data were processed using TabWin and STATA version 12. RESULTS: A total of 837,068 records were examined, each representing one visit to CAPSi. Most visits were by male users (68.8%). The most common diagnoses were hyperkinetic disorders (13%), pervasive developmental disorders (12.4%), and conduct disorders (8.4%). CONCLUSIONS: Behavioral and emotional disorders that usually appear during childhood or adolescence and psychological development disorders were frequent, with more than 50% of the latter comprising autism spectrum disorders. Regional differences were observed, with a higher presence of this diagnosis in the Southeast, while the North and Northeast had a high percentage of visits due to mental retardation.


Assuntos
Serviços de Saúde do Adolescente/estatística & dados numéricos , Serviços de Saúde da Criança/estatística & dados numéricos , Transtornos Mentais/terapia , Serviços de Saúde Mental/estatística & dados numéricos , Adolescente , Distribuição por Idade , Brasil , Criança , Pré-Escolar , Grupos Diagnósticos Relacionados , Feminino , Humanos , Lactente , Masculino , Transtornos Mentais/classificação , Fatores Socioeconômicos , Adulto Jovem
3.
Pediatr Allergy Immunol ; 27(4): 398-403, 2016 06.
Artigo em Inglês | MEDLINE | ID: mdl-26843104

RESUMO

BACKGROUND: Asthma prevalence in Latin America is high and continues to increase. There is evidence that the psychologic characteristics of the child are associated with greater asthma morbidity. This study aimed to investigate the independent effect of internalizing/externalizing problems on two asthma/wheeze outcomes: (i) remission and (ii) progression to severity on Latin American children with mild asthma symptoms at baseline. METHODS: This was a prospective study in a cohort of 371 asthmatic children living in a poor urban area in Salvador, Brazil. The psychologic characteristics of the child were assessed using the Child Behavior Checklist (CBCL), and wheezing was defined using the ISAAC questionnaire at the start and end of follow-up. A multiple logistic regression model with random effects was used to examine the association between the psychologic components and both outcomes. RESULTS: Remission of symptoms of wheeze was observed among 229 (61.73%) children. Remission was 56% lower among children with internalizing problems (OR = 0.54, 95% CI 0.33-0.87, p = 0.01). In addition, we found that 19 (8.76%) of the children acquired severe symptoms during follow-up and there was strong evidence of the effect of internalizing problems in increasing the risk of progression to severe wheeze symptoms (OR = 4.03, 95% CI 1.39-11.70, p = 0.01). CONCLUSIONS: Children with internalizing problems but not externalizing had less remission of wheezing, and a higher risk of acquiring severe symptoms. These results highlight the importance of psychologic care for children with asthma, to improve the prognosis of this condition.


Assuntos
Adaptação Psicológica , Asma/psicologia , Comportamento Infantil , Efeitos Psicossociais da Doença , Pulmão/fisiopatologia , Sons Respiratórios , Fatores Etários , Asma/diagnóstico , Asma/fisiopatologia , Brasil , Lista de Checagem , Criança , Pré-Escolar , Progressão da Doença , Feminino , Humanos , Modelos Logísticos , Masculino , Análise Multivariada , Razão de Chances , Estudos Prospectivos , Indução de Remissão , Fatores de Risco , Índice de Gravidade de Doença , Inquéritos e Questionários
4.
BMC Public Health ; 8: 202, 2008 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-18534035

RESUMO

BACKGROUND: There is evidence that poverty, health and nutrition affect children's cognitive development. This study aimed to examine the relative contributions of both proximal and distal risk factors on child cognitive development, by breaking down the possible causal pathways through which poverty affects cognition. METHODS: This cohort study collected data on family socioeconomic status, household and neighbourhood environmental conditions, child health and nutritional status, psychosocial stimulation and nursery school attendance. The effect of these on Wechsler Pre-School and Primary Scale of Intelligence scores at five years of age was investigated using a multivariable hierarchical analysis, guided by the proposed conceptual framework. RESULTS: Unfavourable socioeconomic conditions, poorly educated mother, absent father, poor sanitary conditions at home and in the neighbourhood and low birth weight were negatively associated with cognitive performance at five years of age, while strong positive associations were found with high levels of domestic stimulation and nursery school attendance. CONCLUSION: Children's cognitive development in urban contexts in developing countries could be substantially increased by interventions promoting early psychosocial stimulation and preschool experience, together with efforts to prevent low birth weight and promote adequate nutritional status.


Assuntos
Cognição/fisiologia , Inteligência , Análise de Variância , Peso ao Nascer , Brasil , Proteção da Criança , Pré-Escolar , Estudos de Coortes , Diarreia/epidemiologia , Avaliação Educacional , Feminino , Humanos , Renda/classificação , Testes de Inteligência , Masculino , Estado Nutricional , Características de Residência , Escolas Maternais/estatística & dados numéricos , Meio Social , Fatores Socioeconômicos
5.
Lancet ; 370(9599): 1622-8, 2007 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-17993362

RESUMO

BACKGROUND: A city-wide sanitation intervention was started in Salvador, Brazil, in 1997 to improve sewerage coverage from 26% of households to 80%. Our aim was to investigate the epidemiological effect of this city-wide sanitation programme on diarrhoea morbidity in children less than 3 years of age. METHODS: The investigation was composed of two longitudinal studies done in 1997-98 before the intervention (the sanitation programme) and in 2003-04 after the intervention had been completed. Each study consisted of a cohort of children (841 in the preintervention study and 1007 in the postintervention study; age 0-36 months at baseline) who were followed up for a maximum of 8 months. Children were sampled from 24 sentinel areas that were randomly chosen to represent the range of environmental conditions in the study site. At the start of each study an individual or household questionnaire was applied by trained fieldworkers; an environmental survey was done in each area before and after introduction of the sanitation programme to assess basic neighbourhood and household sanitation conditions. Daily diarrhoea data were obtained during home visits twice per week. The effect of the intervention was estimated by a hierarchical modelling approach fitting a sequence of multivariate regression models. FINDINGS: Diarrhoea prevalence fell by 21% (95% CI 18-25%)-from 9.2 (9.0-9.5) days per child-year before the intervention to 7.3 (7.0-7.5) days per child-year afterwards. After adjustment for baseline sewerage coverage and potential confounding variables, we estimated an overall prevalence reduction of 22% (19-26%). INTERPRETATION: Our results show that urban sanitation is a highly effective health measure that can no longer be ignored, and they provide a timely support for the launch of 2008 as the International Year of Sanitation.


Assuntos
Diarreia Infantil/epidemiologia , Saneamento/tendências , Brasil/epidemiologia , Pré-Escolar , Diarreia Infantil/prevenção & controle , Habitação , Humanos , Lactente , Recém-Nascido , Estudos Longitudinais , Prevalência , Análise de Regressão , Saneamento/economia , Vigilância de Evento Sentinela
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