Children and adolescents are not small adults: toward a better understanding of multimorbidity in younger populations.

Multimorbidity is of an increasing importance for the health of both children and adults but research has hitherto focused on adult multimorbidity. Hence, public awareness, practice, and policy lack vital information about multimorbidity in childhood and adolescence. We convened an international and interdisciplinary group of experts from six nations to identify key priorities supported by published evidence to strengthen research for children and adolescent with multimorbidity. Future research is encouraged (1) to develop a conceptual framework to capture unique aspects of child and adolescent multimorbidity-including definitions, characteristic patterns of conditions for different age groups, its dynamic nature through childhood and adolescence, and understanding of severity and trajectories for different clusters of multiple chronic conditions, (2) to define new indices to classify the presence of multimorbidity in children and adolescents, (3) to improve the availability and linkage of data across countries, (4) to synthesize evidence on the global phenomenon of multimorbidity in childhood and adolescence and health inequalities, and (5) to involve children and adolescents in research relevant to their health.

Can Positive Mindsets Be Protective Against Stress and Isolation Experienced during the COVID-19 Pandemic? A Mixed Methods Approach to Understanding Emotional Health and Wellbeing Needs of Perinatal Women.

The aim of this study was to explore the relationship between emotional health and wellbeing and support needs of perinatal women during the COVID-19 pandemic, and to understand their experiences and need for support. This is a potentially vulnerable group and a critical developmental phase for women and infants. A mixed methods design was used to collect quantitative and qualitative data that provided a robust insight into their unique needs. A total of 174 women who were either pregnant or post-birth participated. The main findings demonstrated that women in this cohort experienced varying levels of stress and isolation but also positive experiences. Exploring the relationship between mental health (perceived stress and wellbeing) and resilience (mindfulness and self-compassion) revealed an association between positive mental health and higher levels of mindfulness and self-compassion. Positive mindsets may be protective against psychological distress for the mother and her child, suggesting that meditation-based or similar training might help support expectant and post-birth mothers during times of crisis, such as a pandemic. This information could be used to make recommendations for future planning for practitioners and policymakers in preparing for prospective infection waves, pandemics, or natural disasters, and could be used to develop targeted tools, support, and care.

Contextualizando a estratégia saúde da família na atenção primária em saúde / Contextualizing the family health strategy in primary health care

As discussões sobre Atenção Primária em Saúde (APS) foram intensificadas no contexto mundial a partir da Conferência da Alma Ata (WHO, 1978), quando a Organização Mundial de Saúde (OMS) lançou a meta de Saúde para todos no Ano 2000.

Dimensões da atenção psicossocial na interface da estratégia saúde da família e saúde mental / Dimensions of psychosocial care at the interface of the family health strategy and mental health

A estratégia saúde da família (ESF) é um dispositivo de atenção complexo e requer atuação marcante quanto à responsabilidade sanitária no território e está apta a dar resolutividade à maioria das questões que são apresentadas pela população. É então, ponto estratégico para a transformação e adoção de outras práticas no campo da saúde, sendo sua organização primordial para se avançar na direção de um sistema de saúde que objetiva a qualidade de vida das pessoas. Para tanto, realiza práticas que acolhem, vinculam e, na medida do possível, resolvem os problemas em seu âmbito de ação, propiciando a constituição de novos modos de produção das ações de saúde.

Saúde indígena, atenção diferenciada e a equipe multidisciplinar de saúde índigena: interfaces com a estratégia saúde da família / Indigenous health, special attention and multidisciplinary team of Indigenous Health: interfaces with the family health strategy

A saúde indígena tem-se configurado como tema relevante, mas ainda muito pouco discutido nos meios acadêmicos da área da saúde. Assim, levando em conta a necessidade de ampliar o debate a respeito da situação da saúde dos povos indígenas do Brasil, o presente capítulo versa sobre a Política Nacional de Atenção à Saúde desses povos, analisando a sua diretriz Atenção Diferenciada e articulando-a com o processo de trabalho e formação dos profissionais da equipe multidisciplinar de saúde indígena e, ainda, fazendo um paralelo com o Programa de Saúde da Família. Cabe, por fim, ressaltar que desejamos poder contribuir para a reflexão dos formadores dos profissionais de saúde e, também, dos profissionais que atuam no campo da saúde indígena.

Effect of swimming pools on antibiotic use and clinic attendance for infections in two Aboriginal communities in Western Australia.

OBJECTIVE: To determine whether installation of swimming pools in remote Aboriginal communities reduces infection-related outpatient attendances and prescription of antibiotics. DESIGN AND SETTING: Swimming pools were opened in Jigalong and Mugarinya, Western Australia, in September 2000. We examined local clinic records to document illnesses occurring in children and adolescents under 17 years of age between 1998 and 2005. In Jigalong, we examined records of those enrolled in an ongoing study evaluating the effect of swimming pools on health. In Mugarinya, we examined clinic records of those residing there permanently. MAIN OUTCOME MEASURES: Clinic attendance rates for skin, middle-ear and respiratory tract infections and trauma, and prescription rates for antibiotics were analysed by using a community-based selection method in Jigalong, and a clinic-based selection method in both communities for comparison of the two communities and the two methods. RESULTS: We examined records of 131 children in Jigalong and 128 children in Mugarinya. After the pools had been installed, clinic attendance rates for skin infections declined by 68% in Jigalong and by up to 77% in Mugarinya. In Jigalong (where the pre-pool prevalence of infections was higher than in Mugarinya), rates of antibiotic prescription declined by 45%, as did clinic attendance for middle-ear infections (61% reduction) and respiratory tract infections (52% reduction). CONCLUSION: Swimming pools in remote communities are associated with reduced prevalence of skin infections. Where disease prevalence is high, pools are also associated with reduced rates of antibiotic prescriptions and middle-ear and respiratory tract infections. In communities with resident health staff, examination of clinic records is an efficient method of monitoring the effects of public health interventions on the burden of infectious diseases.