Asociación de experiencias adversas en la infancia con síntomas de asma en niños. Revisión bibliográfica / Association of adverse childhood experiences with asthma symptoms in children. A literature review

Las experiencias adversas en la infancia (EAI) tienen un impacto considerable en la salud física y mental de los niños y adolescentes. Esta revisión bibliográfica se centra en la asociación entre estas experiencias y la incidencia de síntomas asmáticos, así como en las alteraciones inmunológicas en la población pediátrica. Los estudios revisados muestran una correlación significativa entre la exposición a EAI y el asma, destacando la importancia de un enfoque biopsicosocial para su manejo. Además, se discuten las implicancias clínicas y las precauciones necesarias al interpretar estos hallazgos.

Adverse childhood experiences (ACEs) have a significant impact on the physical and mental health of children and adolescents. This literature review focuses on the association between these experiences and the incidence of asthma symptoms, as well as immunological alterations in the pediatric population. The reviewed studies show a significant correlation between ACE exposure and asthma, highlighting the importance of a biopsychosocial approach for its management. Additionally, the clinical implications and necessary precautions when interpreting these findings are discussed.

Family of Origin Characteristics as Predictors of Childbearing Motivations / Características de la familia de origen como predictores de las motivaciones para tener hijos

Abstract This study examines childhood experiences and the relationship with the family of origin as predictive variables for positive childbearing motivation (PCM). It was conducted through analyses using the method of Multigroup Structural Equation Modeling, which were conducted on a Peruvian sample (n = 1494, 72.2% females) and a Brazilian sample (n = 1507; 84.0% females). The results indicate that the variables caring of younger siblings and family adaptation are statistically significant predictors of PCM in both countries, while the variable number of siblings did not emerge as a predictor in either case. Family autonomy emerged as a predictor only in Brazil, and birth order only in Peru. Multigroup analysis shows that the difference in the effects of "family adaptation" and "family autonomy" on PCM is moderated by the country of origin. In summary, this study provides empirical evidence that family variables predict PCM and highlights the moderating effect of the country of origin in the analyzed samples.

Resumen En este estudio se analizan las experiencias de la infancia y la relación con la familia de origen como variables predictivas de la motivación para la parentalidad positiva (MPP). El estudio se llevó a cabo mediante análisis de Modelaje de Ecuaciones Estructurales Multigrupo como método, aplicándolo en una muestra peruana (n = 1494, 72.2% mujeres) y una brasileña (n = 1507; 84.0% mujeres). Los resultados evidencian que las variables cuidado de hermanos menores y adaptación familiar son predictores estadísticamente significativos de la MPP en ambos países, mientras que la variable número de hermanos no se presentó como predictor en ninguno de los casos. La autonomía familiar se mostró como un predictor solo en el caso de Brasil y el orden de nacimiento solo en Perú. El análisis multigrupo muestra que la diferencia en los efectos de la adaptación familiar y la autonomía familiar en la MPP está moderada por el país de origen. En resumen, este estudio proporciona evidencia empírica de que variables familiares predicen la MPP y destaca el efecto moderador del país de origen en las muestras analizadas.

Profiles of childhood trauma: epidemiological survey results of an educated young community cohort

Background: Childhood trauma is a major threat to the welfare and prosperity of any society. Young adult population is vulnerable due to increasing adverse childhood experiences and the likelihood of serious implications in educational performance and mental health. This survey was aimed to observe the proportion of various types of childhood traumas and their association with different socio-demographic characteristics among young university students of Karachi, Pakistan. Methods: This cross-sectional study was conducted among 300 young university students, during August-December 2023. Initially, cluster sampling was done deemed to the epidemiological survey. Afterwards, from the selected clusters, students from different universities were approached using non-probability convenient sampling technique. Self-reported data were collected through a questionnaire comprising of socio-demographic characteristics along with the types of traumas experienced during their childhood. SPSS Version 26.0 was used to analyse data. Results: Of the 300 university students with a mean age of 22.14±2 years, 55.3% were females. Overall, 63.6% of the participants experienced trauma before 18 years age. The most common trauma types reported were physical/verbal abuse (81%), unlawful touch/sexual abuse (45%), parents separated/divorced (31%) abandoned by parents (20%), lived with an alcoholic/drug addict (18%) or with a mentally ill adult (14%). There were no statistically significant findings between childhood trauma experience and socio-demographic traits. Conclusions: Various profiles of childhood trauma were found prevalent in young university level individuals. Current research does suggest a way forward to prevent this public health issue that can have detrimental consequences on an individual’s mental and physical health and stress reactivity.

Wiki educativa para la Clínica Virtual de Salud de Santiago de Cuba / Educational Wiki for the health virtual clinic in Santiago de Cuba

El programa de las tecnologías de la información y las comunicaciones se ha implementado en todas las instituciones pertenecientes al sector de la salud en Cuba, pues favorece la formación a través de los entornos de enseñanza y aprendizaje en función del desarrollo y las perspectivas académicas, mediante plataformas tecnológicas para facilitar el intercambio de información. En el presente artículo se destaca la necesidad de incrementar el uso de la wiki como herramienta educativa, que favorece el aprendizaje colaborativo como un proceso de creación de conocimiento a través de la web 2.0, donde no solo se publican contenidos sino que contribuye a desarrollar habilidades de cooperación en los procesos formativos de la salud pública.

The program of information and communications technologies has been implemented in all the institutions belonging to the health sector in Cuba, because it favors the training through the teaching and learning environments in function of development and academic perspectives, by means of technological platforms to facilitate the exchange of information. In this work the necessity to increase the wiki use as educational tool in enhanced, that favors the collaborative learning as a process of knowledge creation through the web 2.0, where contents are not only published but also contributes to develop cooperation abilities in the training processes of public health.

Experiencias de madres y padres adolescentes sobre educación sexual en colegios ecuatorianos / Experiences of adolescent mothers and fathers on sex education in Ecuadorian schools / Experiências de mães e pais adolescentes sobre educação sexual em escolas equatorianas

Resumen (analítico) La educación sexual en el sistema educativo es un derecho de los adolescentes. En Latinoamérica se evidencian avances, pero también se vislumbran deficiencias en la implementación de la educación sexual para prevención del embarazo adolescente. Con el objetivo de explorar las experiencias de educación sexual de padres y madres adolescentes en colegios, se realizó un estudio cualitativo en Cuenca. Se realizaron 19 entrevistas semiestructuradas (diez madres, nueve padres adolescentes) y un análisis temático de la información. Se encontró que, a pesar de los lineamientos establecidos, la educación sexual es escasa y sesgada. Su implementación es asistemática, con enfoque biomédico y moralista, y no considera necesidades del desarrollo sexual de adolescentes. Esto vislumbra preocupantes vacíos en el sistema educativo que aporten al desarrollo de habilidades necesarias para su vida.

Abstract (analytical) Sexual education in the educational system is a right of adolescents. In Latin America, despite the progress in the implementation of sexual education to prevent adolescent pregnancy, deficiencies are also evident. With the aim of exploring the sexual education experiences of adolescent fathers and mothers in schools, a qualitative study was developed in Cuenca. 19 semi-structured interviews were carried out (10 mothers; 9 adolescent fathers), and a thematic analysis of the information was used. It was found that, despite the established guidelines, sexual education is scarce and biased; Its implementation is unsystematic, with a biomedical and moralistic approach and; it does not consider sexual development needs of adolescents. This reveals worrying gaps in the educational system that may contribute to the development of life skills.

Resumo (analítico) A educação sexual no sistema educacional é um direito dos adolescentes. Na América Latina, o progresso é evidente, mas também são evidentes as deficiências na implementação da educação sexual para prevenir a gravidez na adolescência. Com o objetivo de explorar as experiências de educação sexual de pais e mães adolescentes nas escolas, foi realizado um estudo qualitativo em Cuenca. Foram realizadas 19 entrevistas semiestruturadas (10 mães; 9 pais adolescentes), foi realizada uma análise temática das informações. Constatou-se que, apesar das diretrizes estabelecidas, a educação sexual é escassa e tendenciosa; A sua implementação é assistemática, com uma abordagem biomédica e moralista e; não considera as necessidades de desenvolvimento sexual dos adolescentes. Isto revela lacunas preocupantes no sistema educativo que contribuem para o desenvolvimento de competências necessárias à vida.

Transiciones educativas de jóvenes en contexto rural mapuche: experiencia, aspiraciones e identidad / Educational transitions of young people in a rural Mapuche context: experience, aspirations and identity / Transições educacionais de jovens em um contexto rural mapuche: experiência, aspirações e identidade

Resumen (analítico) Considerando que las transiciones educativas son clave para dar cuenta de las desigualdades existentes en los caminos de la educación y el trabajo, centramos esta investigación en la transición educativa de primaria a secundaria; lo anterior, en jóvenes mapuche que estudian en zonas rurales y se movilizan a zonas urbanas en Chile, visualizando elementos estructurales y personales que inciden en ella. Utilizamos una metodología cualitativa de análisis de casos. Los resultados dan cuenta de diversos aspectos: políticas educativas que no consideran las particularidades culturales y territoriales del estudiantado, la movilidad rural-urbana que realizan estos individuos jóvenes, así como los aspectos sociales, familiares y subjetivos que inciden en sus experiencias, en la construcción de sus aspiraciones futuras y en aspectos de identidad en nuevos espacios educativos.

Abstract (analytical) Considering that educational transitions are key to account for existing inequalities in education and work pathways, this research focuses on the educational transition from primary to secondary school in Mapuche youth who study in rural areas and move to urban areas in Chile, visualizing structural and personal elements that affect them. A qualitative case study methodology is used. Results show several aspects: educational policies that do not consider cultural and territorial particularities of the-se students, the rural-urban mobility of these young people and the social, family and subjective aspects that influence experiences, construction of future aspirations of students and aspects of identity in new educational spaces.

Resumo (analítico) Considerando que as transições educacionais são fundamentais para dar conta das desigualdades existentes nas trajetórias de educação e trabalho, esta pesquisa enfoca a transição educacional do primário ao secundário em jovens Mapuche que estudam em áreas rurais e se mudam para áreas urbanas no Chile, visualizando elementos estruturais e pessoais que os afetam. É utilizada uma metodologia qualitativa de estudo de caso. Os resultados revelam vários aspectos: políticas educacionais que não consideram as particularidades culturais e territoriais desses alunos, a mobilidade rural-urbana realizada por esses jovens e os aspectos sociais, familiares e subjetivos que afetam as experiências, construção de aspirações futuras dos alunos e aspectos de identidade em novos espaços educativos.

Implementación de intervenciones que aborden las experiencias adversas en la infancia en atención primaria: una revisión exploratoria

Introducción: La vivencia de experiencias adversas en la infancia (EAI) se asocia a mayor riesgo de presentar conductas de riesgo y enfermedades crónicas a largo plazo. A nivel mundial, se han comenzado a pesquisar y abordar en las atenciones de salud. Sin embargo, en Chile aún no existe una sugerencia a nivel nacional para incorporarlo. El fin de este artículo es proveer de información y recomendaciones a la práctica clínica. Métodos: Se realizó una revisión exploratoria en PubMed, LILACS y PsycInfo usando el marco metodológico del Joanna Briggs Institute para identificar la literatura disponible sobre implementación de intervenciones en detección y abordaje de EAI dentro de un sistema de salud, con foco en atención infantil ambulatoria. Resultados: Se encontraron 34 estudios atingentes al tema, los que muestran que implementar mecanismos de detección y abordaje de EAI es factible y aceptable, tanto para el personal de salud como para los usuarios, pero debe ser realizado dentro de un modelo de cuidado que incorpore a las familias y comunidad, además de trabajar con los equipos en capacitación, gestión del cambio, implementación y evaluación. Conclusiones: La Atención Primaria de Salud (APS) resulta ser un lugar privilegiado para su implementación dada la cercanía y relación de confianza que se establece con las familias. Este estudio muestra que es posible implementar un modelo de detección y abordaje de EAI en APS, lo que resulta crucial dentro de su rol preventivo-promocional si se quiere generar un impacto en la salud de niños, niñas y adolescentes ahora y en el futuro.

Introduction: Adverse childhood experiences (ACEs) are associated with an increased risk of developing risky health behaviors and chronic diseases in the long term. Screening for ACEs is beginning to be implemented worldwide in healthcare settings due to their known impact on present and future health. However, in Chile, there are no recommendations to incorporate ACEs screening into usual care. Methods: A scoping review was conducted using the Joanna Briggs Institute methodological framework to identify available literature on the implementation of interventions aimed at the detection and management of ACEs within a health system, specifically pediatric primary care. The search included PubMed, LILACS, and PsycInfo databases. Results: A total of 34 studies were included. They show that screening for ACEs is feasible and acceptable for both health care providers and users. However, it must be implemented as a part of a model of care that considers families and communities, besides working with health teams in training, change management, implementation, and evaluation. Conclusions: Primary Health Care (PHC) is a privileged setting for screening implementation because of the longitudinal and trust relationships established with families. This study concludes that it is possible to implement a model for detecting and managing ACEs in PHC, which will be crucial for its promotional and preventive role if there is a desire to generate an impact on infant and adolescent health now and in the future.

Perception of Medical Students Regarding Implementing Telemedicine Practice Activities at a University Center in Brazil / Percepção de Estudantes de Medicina sobre a Implementação de Vivências em Telemedicina em um Centro Universitário do Brasil

Objective: evaluate medical students' perceptions regarding implementing Telemedicine teaching during their undergraduate studies. Methods: this is a cross-sectional qualitative study with 30 medical students. Three focus group sessions were conducted, and the data were analyzed using a content analysis approach. Results/Discussion: the students recognized the importance of digital health strategies and digital information and communication technologies (ICTs) for the healthcare ecosystem. However, some students pointed out that this area is still challenging for some doctors who oppose Telemedicine. They reported a need for training professionals and students, emphasizing the need to improve skills and competencies for teleconsultation and other Telemedicine modalities. They stated that these experiences helped them enhance their empathy skills for establishing a good doctor-patient relationship. When referring to the negative aspects of the experiences, they mentioned the dependence on reliable internet connection and digital tools. Another limitation mentioned was the difficulty in conducting specific physical examination components. Conclusions: the students experienced Telemedicine activities in a safe healthcare environment, learning about the bioethical principles for responsible teleconsultations, understanding the limiting factors of the method, and having the opportunity to improve skills and competencies for their future professional practice.

Objetivo: avaliar a percepção dos estudantes de Medicina quanto à implementação do ensino da Telemedicina durante a graduação. Métodos: trata-se de um estudo qualitativo transversal com 30 alunos do curso de Medicina. Foram realizadas três sessões de grupos focais e os dados foram analisados através de uma abordagem de análise de conteúdo. Resultados/Discussão: os estudantes reconheceram a importância das estratégias de Saúde Digital e das Tecnologias Digitais de Informação e Comunicação (TIC) para o ecossistema de saúde. Contudo, alguns estudantes apontaram que esta área ainda é um desafio para alguns médicos que se opõem à prática da Telemedicina. Relataram a necessidade de capacitação de profissionais e estudantes, enfatizando a necessidade de aprimoramento de habilidades e competências para teleconsultas e outras modalidades de Telemedicina. Afirmaram que as vivências os ajudaram a melhorar as suas capacidades de empatia para estabelecer uma boa relação médico-paciente. Ao se referirem aos aspectos negativos das atividades, mencionaram a dependência de conexão confiável à internet e de ferramentas digitais. Outra limitação citada foi a dificuldade na realização de etapas específicas do exame físico. Conclusões: os estudantes vivenciaram as atividades de Telemedicina em um ambiente de saúde seguro, conhecendo os princípios bioéticos para a prática de teleconsultas responsáveis, compreendendo os fatores limitantes do método e tendo a oportunidade de aprimorar habilidades e competências para a sua futura prática profissional.

Healthcare professionals’ attitudes and experiences of domestic violence

Background: Domestic violence (DV) or intimate partner violence has been declared as public health epidemic by the WHO. Healthcare professionals (HCPs) have an important role in addressing the victims of DV or abuse and are the first to offer them care. Aim of study was to assess the attitude and professional experiences of HCPs concerning DV and their female patients.Methods: The study is conducted using pre-structured questionnaire and via google form sent to the study subjects through a WhatsApp link on their mobiles. The study population were comprises consultants, resident doctors and nurses. The study subjects’ response about receiving adequate training and their attitude whether enquiry about DV was considered an essential part of their job were the main outcomes.Results: A total of 392 responses were received. Overall, 50.3% of HCPs agreed that the incidence of DV has increased in the covid era and only 49.2% believe that enquiry about DV is an essential part of their job; 49.0% of HCPs agreed that they are comfortable while asking questions pertaining to DV. Only 17.4% of HCPs received adequate support during training period in regards to evaluating patients with DV.Conclusions: Training of all HCPs to identify and manage patients with DV is needed in order to deal efficiently with this public health problem. The attitude of HCPs towards DV needs to be addressed.

Internal experiences of financial toxicity in cancer patients: a Meta-synthesis / 中国实用护理杂志

Objective:This study aims to investigate the inner experiences of cancer patients when confronting financial toxicity through a Meta-analytical approach. The goal is to provide evidence-based insights and theoretical references for clinical healthcare professionals to fully understand the feelings and experiences associated with financial toxicity in cancer patients, thereby laying a foundation for targeted interventional measures.Methods:A computerized search was conducted across databases including CINAHL, PubMed, PsycINFO, Embase, Scopus, Web of Science, CNKI, WanFang, VIP, Sinomed and other databases, collecting qualitative studies related to the inner experience of financial toxicity among cancer patients, up until April 12, 2023. Quality appraisal of the included literature was carried out according to JBI′s standards for qualitative research, and results were synthesized using Meta-aggregation methods.Results:Twenty-three studies were included, from which 82 specific outcomes were extracted. These were categorized into 11 new thematic groups and ultimately synthesized into four integrated findings: the impact of objective costs, subjective burden, and unreasonable expectations; diverse cognitive attitudes and management coping strategies; multiple pressures and challenges on patients and their families; and the articulation of needs and perceptions of beneficial growth.Conclusions:Healthcare professionals should pay attention to the financial toxicity issues that patients face at the initial stage of cancer diagnosis. Timely communication about economic issues between patients and healthcare providers is essential to help patients have a preliminary understanding of the impending financial toxicity at the onset of the disease. A comprehensive intervention that emphasizes different aspects of objective and subjective financial toxicity, coupled with multi-dimensional mitigation strategies, can promote active coping in patients, enhance familial emotional and financial support to overcome challenges together, and prioritize patients′ needs and expectations to guide them towards reinforcing positive experiences and minimizing the impact of financial toxicity.

Research progress on physical pain and social pain in non-suicidal self-injury and their influencing factors / 中国神经精神疾病杂志

Non-suicidal self-injury is a prevalent pathological behavior in clinical settings,significantly impacting both physical and mental health.Non-suicidal self-injury is closely associated with the abnormal perception of pain.Pain can be classified as physiological pain and social pain.In contrast to healthy people,individuals engaging in non-suicidal self-harm exhibit lower sensitivity to physiological pain but higher sensitivity to social pain.Their physiological pain thresholds are elevated,while their social pain thresholds are reduced.The alterations in pain sensitivity led them to alleviate emotions through a"pain to counter pain"approach.The abnormalities in pain sensitivity among individuals who engage in non-suicidal self-injury are closely linked to their social and psychological factors.Self-criticism,depressive symptoms,and adverse childhood experiences are all associated with the pain sensitivity of non-suicidal self-harm patients.

Association between subthreshold depression and psychotic like experiences with non suicidal self injury among adolescents in Shandong Province / 中国学校卫生

Objective@#To investigate the association between subthreshold depression, psychotic like experiences (PLEs), and their interactions with non suicidal self injury (NSSI) in adolescents from Shandong, so as to provide a reference for the prevention and early intervention of NSSI in adolescents.@*Methods@#A random cluster sampling method was used to select a total of 6 090 adolescents aged 13-22 from two cities along the coast and inland of Shandong Province. Electronic surveys were administered using the SelfInjurious Behavior Questionnaire, Community Assessment of Psychic Experiencepositive 8 items(CAPE-P8), and the Center for Epidemiological Studies Depression Scale(CES-D). The relationship between subthreshold depression, PLEs, and their interaction with NSSI was analyzed using multivariate Logistic regression.@*Results@#The detection rate of NSSI among adolescents was 21.3%. The highest NSSI reporting rate (27.9%) was found in the age group of 13-15 years.The NSSI reporting rates for those detected with subthreshold depression and PLEs were 49.9% and 30.7%, respectively. Multivariate analysis indicated that individuals with subthreshold depression were 3.47 times more likely to engage in NSSI [OR(95%CI)=3.47(2.68-4.50)]. Those identified with PLEs had 5.32 times higher risk of engaging in NSSI than those without such experiences [OR(95%CI)=5.32(4.10-6.89)]. When both subthreshold depression and PLEs coexist, the risk of engaging in NSSI was 18.47 times higher than in individuals with neither condition [OR(95%CI)=18.47(14.75-23.13)] (P<0.01). The relative excess risk due to interaction (RERI), attributable proportion (AP), and synergy index (S) were 11.44, 0.61, and 2.89, respectively, indicating that the combined interaction of subthreshold depression and PLEs accounted for 61% of adolescent NSSI.@*Conclusions@#Subthreshold depression and psychoticlike experiences are associated NSSI in adolescents and exhibit an additive interaction. Alleviating subthreshold depression in adolescents and reducing psychotic experiences may play a positive role in preventing the occurrence of NSSI.

Experiences and challenges of enrolled nurses undertaking a Bachelor of Nursing Science programme in Namibia

Background: Globally, enrolled nurses (ENs) are embarking on an educational journey to become registered nurses (RNs) in order to enhance their knowledge and career opportunities. However, their aspiration is not without challenges. In Namibia, the experiences of these nurses have not been extensively researched. Objectives: This study aims to explore and describe the experiences and challenges of ENs undertaking a Bachelor of Nursing Science at the University of Namibia. Method: A qualitative, exploratory, descriptive and contextual research strategy was followed as the basis of conducting the study. A sample of 15 nursing students was purposively selected from the target population of 73 nursing students. This sample size was determined by the saturation of data as reflected in repeating themes. The collected data were analysed thematically using an inductive approach. Results: Three main themes subsequently emerged from the study: ENs' positive experiences advancing in the Bachelor of Nursing Science (BNSc) programme; nurses' negative experiences advancing in the BNSc programme; and recommendations to ensure effective advancement in the BNSc programme Conclusion: The findings of this study revealed that ENs positively experience becoming a RN when it comes to self-development; however, they have negative experiences such as not receiving exemptions for prior learning and having to learn a new curriculum. Contribution: These findings may be used by the Faculty of Health Sciences, School of Nursing and Public Health management in order to develop targeted interventions and ongoing strategies during their curriculum review cycles to ensure positive student experiences and success within the programme.

Knowledge and practices of epistaxis in Eastern Tanzania: A cross-sectional study of an emergency in otorhinolaryngology

Introduction: It's approximated that 60% of the population globally experience epistaxis during lifetime. Despite epistaxis being prevalent in Tanzania, there are limited studies that have explored experience of participants on epistaxis. This study aims to determine knowledge on the causes, first aid management and practices of epistaxis among patients attending a health facility in Eastern Tanzania Methods: A descriptive cross-sectional study was conducted where 371 participants aged 15 years and above were interviewed using structured questionnaires. Data was analyzed using Statistical Package of Social Sciences version 23. Chi-square tests were performed and a p-value <0.05 was considered to be statistically significant Results: About two-thirds (60.9%) of the study participants had good knowledge of the causes of epistaxis. Majority of participants knew excessive nose manipulation (95.1%) to be the commonest cause of epistaxis and the least cause mentioned was chronic liver disease (24.8%). On the other hand, 77.6% of the participants had good knowledge while 22.4% had poor knowledge regarding first aid management of epistaxis. In this study, 328 (88.4%) participants knew pressing the nose could stop epistaxis, while 164(44.2%) knew the best position to stop epistaxis and that is to tilt the head forward and those who had history of epistaxis, 150 (73.2%) out of 205 pinched the nose as the first aid. Similarly, 133(35.8%) participants thought cessation of smoking has effect on decreasing the occurrence of epistaxis. A significant association was noted between knowledge of first aid management of epistaxis and some socio-demographic characteristics such as age and educational level. There was also a significant association between knowledge of the causes of epistaxis and educational level. Conclusion: Majority of the participants had good knowledge of the causes and first aid management of epistaxis.

Primary healthcare nurses' experiences in managing chronic diseases during COVID-19 in the North West province

Background: The World Health Organization, stated that the coronavirus disease 2019 (COVID-19) pandemic not only affected the socioeconomic well-being of millions but also had adverse effects on public health, particularly in the management of chronic diseases at the primary healthcare (PHC) level. What remained unknown was the experiences of professional nurses(PNs) working in PHC regarding this issue. Aim: The study aimed to explore and describe the lived experiences of PHC nurses in managing chronic diseases during the COVID-19 pandemic. Setting: The study was conducted in the North West province, South Africa. Methods: A qualitative descriptive phenomenological design was employed to collect and analyse data. Face-to-face interviews were conducted and audio recorded with 16 PNs from five high-volume PHC facilities selected purposively. Results: The study's findings reveal four themes: suboptimal care for patients with chronic disease, a lack of resources, mental health challenges experienced by PHC nurses, and stigma and discrimination from both family and community members. Conclusion: The neglect of PHC and its frontline healthcare staff has impeded the mental health of PHC workers and the management of chronic diseases thus any progress made in reducing the burden of chronic diseases is likely to have regressed during the COVID-19 pandemic.

Stress level and quality of life following pediatric cataract surgery / Avaliação do nível de estresse e de qualidade de vida em crianças submetidas à cirurgia de catarata

ABSTRACT Purpose: To evaluate the quality of life and stress level related to visual function following pediatric cataract surgery in a Brazilian public hospital. Methods: This prospective study analyzed children aged 6-14 years old who underwent cataract surgery. The Childhood Stress Scale and Children's Visual Function Questionnaire (CVFQ) were used to assess stress levels and quality of life, respectively. Both instruments were applied by two psychologists before and after the surgery. Eye examination was performed by two ophthalmologists. Preoperative and postoperative data were compared. Results: In total, 23 children (32 eyes) were enrolled in the study, of which 9 had bilateral cataracts. The average age group at the time of surgery was 9.65 ± 2.26 (6-14) years old. One month after the surgery, the spherical equivalent was -0.90 ± 1.66D, and the corrected distance visual acuity was 0.13 ± 0.10 (0-0.3) LogMAR in bilateral cases and 0.50 ± 0.39 (0-1.3) LogMAR in unilateral cases (p<0.01). According to the Childhood Stress Scale, 77.7% of the bilateral cases and 57.1% of the unilateral cases had stable stress levels, and 34.7% of the children improved their stress level. The analysis of the CVFQ was based on scores for general health, general vision health, competence, personality, and treatment. After cataract surgery, 78.2% of the patients had improved or maintained CVFQ scores in the general health domain; 82.6%, general vision health; 95.6%, competence; 56.5%, personality; and 78.2%, treatment. Conclusion: Pediatric cataract surgery improves the visual function and the quality of life even in patients undergoing surgical procedures, without increasing the stress levels.

RESUMO Objetivo: Avaliar a qualidade de vida e o nível de estresse relacionada à função visual após a cirurgia de catarata pediátrica em um hospital público brasileiro. Métodos: Estudo prospectivo em crianças de seis a 14 anos submetidas à cirurgia de catarata. A Escala de Stresse Infantil e o Questionário de Função Visual em Crianças foram usados para avaliar o nível de estresse e a qualidade de vida, respectivamente. Ambos os instrumentos foram aplicados por duas psicólogas antes e após a cirurgia. O exame oftalmológico foi realizado por dois oftalmologistas. Os dados coletados no pré e pós-operatório foram comparados. Resultados: Vinte e três crianças (32 olhos) foram incluídas no estudo, nove delas apresentavam catarata bilateral. A média de idade na cirurgia foi de 9,65±2,26 (6 a 14) anos. Um mês após a cirurgia, o equivalente esférico foi de -0,90 ± 1,66D e a acuidade visual corrigida a distância foi de 0,13 ± 0,10 (0-0,3) LogMAR em casos bilaterais e 0,50 ± 0,39 (0-1,3) LogMAR em casos unilaterais (p<0.01). De acordo com a Escala de Stresse Infantil, 77,7% dos casos de catarata bilaterais, e 57,1% dos casos unilaterais mantiveram o nível de estresse e 34,7% das crianças melhoraram o nível de estresse. A análise do Questionário de Função Visual em Crianças foi baseada em pontuações para saúde geral, saúde geral da visão, competência, personalidade e tratamento. Após a cirurgia de catarata, 78,2% dos pacientes melhoraram ou mantiveram o escore do Questionário de Função Visual em Crianças na saúde geral, 82,6% na saúde geral da visão, 95,6% na competência, 56,5% na personalidade e 78,2% no tratamento. Conclusão: A cirurgia de catarata pediátrica melhora a função visual e a qualidade de vida em pacientes submetidos a procedimento cirúrgico, sem aumentar o nível de estresse.

Promovendo experiências significativas por meio da natação: um autoestudo / Promoting meaningful experiences through swimming: a self-study / Promoción de experiencias significativas a través de la natación: un autoestudio

O presente estudo tem como objetivo explorar as experiências de uma graduanda de Educação Física na promoção de experiências significativas por meio da natação. Foi realizado um autoestudo por uma estagiária de natação e seu amigo crítico, um professor com titulação de mestre com ampla experiência no ensino da natação. Para a coleta de dados, foram utilizadas múltiplas fontes: Mensagens de WhatsApp, E-mails, documentos de planejamento e conversas informais. A análise dos dados foi por meio da técnica de análise de conteúdo, com as categorias determinadas a posteriori. As experiências da graduanda foram descritas em três categorias: comparação entre a abordagem tradicional e da abordagem para a promoção da experiência significativa, experiências de intervenção nas aulas e reflexões finais. Conclui-se que para promover experiências significativas por meio da natação é necessário incluir a diversão, a interação social, o desafio e a aprendizagem pessoalmente relevante.

The present study aims to explore the experiences of a Physical Education ungraduate in promoting meaningful experiences through swimming. A self-study was carried out by a swimming intern and her critical friend, a teacher with a master's degree with extensive experience in teaching swimming. For data collection, multiple sources were used: WhatsApp messages, E-mails, planning documents and informal conversations. Data analysis was performed using the content analysis technique, with the categories determined a posteriori. The undergraduate student's experiences were described in three categories: comparison between the traditional approach and the approach to promoting meaningful experience, intervention experiences in classes and final reflections. It is concluded that to promote meaningful experiences through swimming it is necessary to include fun, social interaction, challenge and personally relevant learning.

El presente estudio tiene como objetivo explorar las experiencias de un licenciado en Educación Física en la promoción de experiencias significativas a través de la natación. Un autoestudio fue realizado por una pasante de natación y su amiga crítica, una docente con maestría y amplia experiencia en la enseñanza de la natación. Para la recolección de datos se utilizaron múltiples fuentes: mensajes de WhatsApp, correos electrónicos, documentos de planificación y conversaciones informales. El análisis de los datos se realizó mediante la técnica de análisis de contenido, determinando las categorías a posteriori. Las experiencias de los estudiantes de pregrado fueron descritas en tres categorías: comparación entre el enfoque tradicional y el enfoque de promoción de experiencias significativas, experiencias de intervención en clases y reflexiones finales. Se concluye que para promover experiencias significativas a través de la natación es necesario incluir diversión, interacción social, desafío y aprendizaje personalmente relevante.

Association between childhood trauma and postpartum depression among Brazilian puerperal women / Asociación entre traumas en la infancia y depresión posparto en puérperas brasileñas / Associação entre trauma na infância e depressão pós-parto em puérperas brasileiras

Objective: to evaluate the association between different forms of childhood trauma and postpartum depression in Brazilian puerperal women. Method: this cross-sectional survey included 253 puerperal women who were evaluated using the Edinburgh Postnatal Depression Scale and the Childhood Trauma Questionnaire. Multivariate logistic regression analyses were performed to verify the association of different types of trauma and the co-occurrence of forms of abuse and neglect with postpartum depression. Results: postpartum depression was identified in 93 women (36.8%; 95% Confidence Interval: 30.8-42.7). All forms of childhood trauma assessed (emotional abuse, emotional neglect, physical abuse, physical neglect and sexual abuse) were independently associated with postpartum depression after adjusting for confounding variables. Emotional abuse remained associated with postpartum depression when the co-occurrence of all forms of childhood trauma was analyzed. Conclusion: the results suggest an association between the different forms of childhood trauma and postpartum depression. In this sense, childhood trauma is an indicator for Nursing professionals to screen for risk factors of postpartum depression during obstetric_follow-up.

Objetivo: evaluar la asociación entre diferentes formas de traumas en la infancia y depresión posparto en puérperas brasileñas. Método: en este estudio transversal se incluyó a 253 puérperas que fueron evaluadas con la Edinburgh Postnatal Depression Scale y el Childhood Trauma Questionnaire . Se realizaron análisis de regresión logística multivariados para verificar la asociación de diferentes tipos de trauma y la coocurrencia de formas de abuso y negligencia con la depresión posparto. Resultados: se identificó depresión posparto en 93 mujeres (36,8%; intervalo de confianza del 95%: 30,8-42,7). Todas las formas de traumas en la infancia que se evaluaron (abuso emocional, negligencia emocional, abuso físico, negligencia física y abuso sexual) estuvieron asociadas de manera independiente con la depresión posparto después de ajustar por variables de confusión. El abuso emocional siguió estando asociado con la depresión posparto cuando se analizó la coocurrencia de todas las formas de traumas en la infancia. Conclusión: los resultados sugieren una asociación entre las diferentes formas de traumas en la infancia y la depresión posparto. En este sentido, los traumas en la infancia son un indicador para que los profesionales de Enfermería detecten factores de riesgo para la depresión posparto en los controles obstétricos.

Objetivo: avaliar a associação entre diferentes formas de trauma na infância e depressão pós-parto em puérperas brasileiras. Método: estudo transversal incluiu 253 puérperas que foram avaliadas pela Edinburgh Postnatal Depression Scale e pelo Childhood Trauma Questionnaire . Análises multivariadas de regressão logística foram realizadas para verificar a associação entre diferentes tipos de trauma e a coocorrência de formas de abuso e negligência com depressão pós-parto. Resultados: a depressão pós-parto foi identificada em 93 mulheres (36,8%; Intervalo de Confiança de 95%: 30,8-42,7). Todas as formas de trauma na infância avaliadas (abuso emocional, negligência emocional, abuso físico, negligência física e abuso sexual) foram independentemente associadas à depressão pós-parto após ajuste para variáveis de confusão. O abuso emocional permaneceu associado à depressão pós-parto quando foi analisada a coocorrência de todas as formas de trauma na infância. Conclusão: os resultados sugerem associação entre as diferentes formas de trauma na infância e depressão pós-parto. Nesse sentido, o trauma na infância é um indicador para os profissionais de Enfermagem rastrearem fatores de risco de depressão pós-parto durante o acompanhamento obstétrico.

Socioeconomic inequalities in health problems in the first two years of life: Pelotas (Brazil) birth cohort, 2015 / Desigualdades socioeconômicas em problemas de saúde nos primeiros dois anos de vida: coorte de nascimentos de Pelotas, Rio Grande do Sul, Brasil, 2015 / Desigualdades socioeconómicas en problemas sanitarios en los dos primeros años de vida: cohorte de nacimientos de Pelotas, Rio Grande do Sul, Brasil, 2015

Abstract: Brazil is characterized by an unfinished agenda of health inequalities, which impact health problems in the childhood. This study aimed to evaluate the socioeconomic inequalities of health problems in the early childhood. This is a prospective study, using data from the birth cohort carried out in the city of Pelotas (Rio Grande do Sul State, Brazil) in 2015. The outcomes were health problems presented at 12 and 24 months: cough, breathing difficulty, diarrhea, ear pain, pneumonia, urinary infection, hospitalization, and other health problems. Socioeconomic inequalities were measured applying the slope index of inequality (SII) and the concentration index (CIX), with wealth index and maternal schooling being the socioeconomic variables. The inequalities in the number of health problems were evaluated by Poisson regression. The perinatal sample comprised 4,275 children. At 12 months approximately 74% of the children presented 1 or more health problems, while at 24 months, approximately 44% presented 2 or more health problems. For all period, the mean number of health problems was 2.9 (standard deviation = 2.0). Higher frequencies were observed for children belonging to the poorest income quintile and with lower maternal education, except for 1 or more health problems at 24 months. The greatest absolute and relative inequality was observed for 2 or more health problems at 12 months (SII: -0.23, 95%CI: -0.29; -0.18 and CIX: -0.19, 95%CI: -0.25; -0.14). There is an opposite dose-response relation for the risk of accumulation of health problems according to maternal schooling (1.07, 95%CI: 1.04; 1.09) and wealth categories (1.03, 95%CI: 1.01; 1.04), in the full adjusted models. The study confirms inequalities due to health problems in Brazilian children, especially in the first year of life.

Resumo: O Brasil é marcado por uma agenda inacabada em relação às desigualdades na saúde, impactando os problemas de saúde da infância. O objetivo deste estudo foi avaliar as desigualdades socioeconômicas relacionadas aos problemas de saúde da primeira infância. Este é um estudo prospectivo com base na coorte de nascimentos realizado na cidade de Pelotas (Rio Grande do Sul, Brasil) em 2015. Os desfechos foram problemas de saúde apresentados aos 12 e 24 meses de idade: tosse, dificuldade para respirar, diarreia, dor de ouvido, pneumonia, infecção urinária, hospitalização e outros problemas de saúde. As desigualdades socioeconômicas foram aferidas usando o índice de desigualdade absoluta (SII, acrônimo em inglês) e o índice de concentração (CIX, acrônimo em inglês), considerando o índice de riqueza e escolaridade materna como variáveis socioeconômicas. A regressão de Poisson foi utilizada para avaliar as desigualdades no número de problemas de saúde. Um total de 4.275 crianças foram incluídas na análise. Aos 12 e 24 meses, aproximadamente 74% e 44% apresentaram 1 ou mais e 2 ou mais problemas de saúde, respectivamente. Para todo o período, o número médio de problemas de saúde foi de 2,9 (desvio padrão = 2.0). Maiores frequências foram observadas para crianças no quintil de renda mais baixa e com menor escolaridade materna, exceto para 1 ou mais problemas de saúde aos 24 meses. A maior desigualdade absoluta e relativa foi observada para 2 ou mais problemas de saúde aos 12 meses (SII: -0,23, IC95%: -0,29; -0,18 e CIX: -0,19, IC95%: -0,25; -0,14). Com base nos modelos ajustados, foi encontrada uma relação dose-resposta oposta para o acúmulo de problemas de saúde com base na escolaridade materna (1,07, IC95%: 1,04; 1,09) e nas categorias de riqueza (1,03, IC95%: 1,01; 1,04). Portanto, o estudo confirma as desigualdades relacionadas aos problemas de saúde em crianças brasileiras, especialmente no primeiro ano de vida.

Resumen: Las desigualdades sanitarias en Brasil afectan a la salud infantil. El objetivo de este estudio fue evaluar las desigualdades socioeconómicas de los problemas sanitarios de la primera infancia. Este es un estudio prospectivo de una cohorte de nacimientos realizada en la ciudad de Pelotas (Rio Grande do Sul, Brasil) en 2015. Los desenlaces fueron problemas sanitarios de niños de 12 y 24 meses de edad como tos, dificultad para respirar, diarrea, dolor de oído, neumonía, infección del tracto urinario, hospitalización, entre otros problemas. Las desigualdades socioeconómicas se midieron con el índice de desigualdad absoluta (SII, por sus siglas en inglés) y el índice de concentración (CIX, por sus siglas en inglés). El índice de ingresos y nivel educativo de la madre fueron las variables socioeconómicas. Las desigualdades en el número de problemas sanitarios se evaluaron mediante la regresión de Poisson. La muestra perinatal fue conformada por 4.275 niños. A los 12 y 24 meses, aproximadamente el 74% y el 44% de los niños tenían uno o más y dos o más problemas de salud, respectivamente. Durante el período, el número promedio de problemas sanitarios fue de 2,9 (desviación estandar = 2.0). Se observaron frecuencias más altas para los niños pertenecientes al quintil de ingresos más pobres y con el nivel educativo de la madre más bajo, a excepción de uno o más problemas de salud a los 24 meses. La mayor desigualdad absoluta y relativa se observó en dos o más problemas sanitarios a los 12 meses (SII: -0,23, IC95%: -0,29; -0,18 e CIX: -0,19, IC95%: -0,25; -0,14). Con base en los modelos ajustados, se encontró una relación dosis-respuesta opuesta para la acumulación de problemas sanitarios en cuanto al nivel educativo de la madre (1,07, IC95%: 1,04; 1,09) y a los ingresos (1,03, IC95%: 1,01; 1,04). Este estudio confirma las desigualdades por problemas sanitarios de niños brasileños, especialmente en el primer año de vida.

Socio-cultural practices and experiences of menstruation among adolescents and women of Kurichiya tribe of Wayanad: an ethnographic study

Background: Menstruation and related cultural practices are widespread in Indian communities, particularly in tribal settlements. Past studies have highlighted the negative impact of these practices on women's mental health and well-being. However, there remains a lack of comprehensive understanding regarding the specific effects of these practices on women's lives. Methods: This study utilised an urban ethnographic research design to explore cultural practices and lived experiences within urban settings. It focused on Kurichiya settlements in Wayanad's Chennalode area, part of Kalpetta municipal town in Kerala's Wayanad district. Fourteen participants, women and adolescent girls aged 15 to 50, were involved in the study. Results: The qualitative analysis identified three core themes: cultural practices of menstruation, women’s menstrual experiences, and perspectives on menstrual practices. The examination of cultural practices revealed subthemes: menarche celebration and monthly period rituals. Women's menstrual experiences encompassed emotional experiences during menarche and each monthly period. Perspectives on menstrual practices highlighted effects on mental well-being and participant’s advocacy for change. Conclusions: The study portrayed how traditional practices affect daily life for Kurichiya women, causing emotional disruption. Despite some liberalisation, a full shift in these customs remains elusive in current times.