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1.
Medwave ; 22(6): e002567, 29-07-2022.
Article in English, Spanish | LILACS-Express | LILACS | ID: biblio-1381410

ABSTRACT

Introducción El suicidio es la segunda causa de muerte prematura en personas entre 15 y 29 años, y la tercera en jóvenes entre 15 y 19 años. La adolescencia es un periodo crítico, dado que existe mayor vulnerabilidad para conductas suicidas. La situación en América Latina es crítica, siendo Chile uno de los dos países donde las tasas de suicidio de niños y adolescentes aumentan año tras año. En este estudio se analizan factores de riesgo clínicos, psicológicos y sociofamiliares asociados con la conducta suicida, en una muestra clínica de adolescentes atendidos en el sistema de salud público de la región del Maule. Método El diseño del presente estudio es transversal. En él se utilizó una muestra de 388 adolescentes de 10 a 21 años ingresados al sistema de salud de la Región del Maule. Durante la recogida de información se aplicaron cinco instrumentos de medición (escalas de impulsividad de Barrat, de dificultades de regulación emocional, de depresión, ansiedad y estrés, cuestionario general de búsqueda de ayuda para problemas de salud mental en adolescentes y escala de clasificación de gravedad del suicidio de Columbia). Además se recabó información sociofamiliar y antecedentes relevantes desde las fichas clínicas. Resultados El análisis realizado permitió identificar características distintivas de la conducta suicida adolescente, mediante la descripción de factores clínicos, psicológicos y sociofamiliares evaluados. Conclusión Los adolescentes con historial de intentos de suicidio se caracterizan por presentar ideación suicida, sintomatología ansiosa- depresiva, estrés, insomnio e impulsividad. Asimismo, reportan no tener creencias religiosas, pertenecer a minorías sexuales y haber sido víctima de acoso y/o abuso sexual.


Introduction Suicide is the second leading cause of premature death in people between 15 and 29 years old and the third in young people between 15 and 19 years old. Adolescence is a critical period concerning mental health disorders since there is greater vulnerability to suicidal behaviors. The situation in Latin America is worrying, with Chile being one of the two countries where suicide rates of children and adolescents increase yearly. This study aims to analyze clinical, psychological, family, and social risk factors associated with suicidal behavior in a clinical sample of adolescents treated in the public health system of the Maule region. Methods The study design is cross- sectional. We used a sample of 388 adolescents between 10 and 21 years old admitted to the health system of the Maule Region. The participants were evaluated by applying five measuring instruments (The Barrat Impulsivity Scale, The Difficulties in Emotional Regulation Scale, The Depression, Anxiety and Stress Scale, The General Help-Seeking Questionnaire for mental health problems in adolescents, and The Columbia Suicide Severity Rating Scale) in addition to collecting social and family information and relevant clinical history from the medical records. Results The analysis allowed us to identify distinctive characteristics of adolescent suicidal behavior by describing clinical, psychological, and family social factors. Conclusions Adolescents with a history of suicide attempts are characterized by having suicidal ideation, anxious-depressive symptoms, stress, insomnia, and impulsiveness. Likewise, they report being non-religious, belonging to sexual minorities, and victims of sexual harassment and/or abuse.

2.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 44(3): 264-270, May-June 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1374604

ABSTRACT

Objective: Adapt and validate the Mood Rhythm Instrument (MRhI), a self-reported questionnaire that assesses self-perceived rhythmicity of mood-related symptoms in adults, into a version that assesses and evaluates perceived mood-related symptoms in adolescents (MRhI-Y). Methods: Adaptation of the Brazilian Portuguese version of the MRhI for an adolescent population followed three steps: review by consultants, analysis by experts, and pilot testing through a visual analogue scale (VAS). The final questionnaire (MRhI-Y) was applied to 171 adolescents aged 12-17 years. Internal consistency was calculated using Cronbach's alpha and McDonald's omega. The psychometric properties of the MRhI-Y were evaluated using exploratory factor analysis (EFA). Results: The MRhI-Y was designed to use wording more appropriate for adolescents than that of the MRhI. Expert agreement about item quality ranged between 82 and 100%. Adolescents' VAS ratings indicated good comprehension of the items. Cronbach's alpha and McDonalds' omega coefficients were 0.71 and 0.74. The EFA resulted in a three-factor solution (affective, cognitive, and somatic). Younger adolescents (ages 12 to 13) reported lower rhythmicity scores than older groups (ages 14 to 15 and 16 to 17), even controlling for chronotype. Conclusions: The Brazilian Portuguese version of the MRhI-Y presented adequate comprehension by adolescents and good internal consistency. The MRhI-Y is a promising tool to improve our understanding of the underlying characteristics of mood fluctuation in adolescence.

3.
Ciênc. Saúde Colet ; 27(6): 2143-2152, jun. 2022. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1375022

ABSTRACT

Abstract Health-related quality of life (HRQoL) represents the perception of each person about different aspects of their lives in the health context (physical, psychological, social environment and interpersonal relationships). Among adolescents, HRQoL can change considering habits adopted in this phase of life. This study analyzed the association between time used on different sedentary behaviors (SB) and HRQoL in adolescents. This is a cross-sectional epidemiological study with adolescents between 10 - 15 years of age. The SB was measured using a questionnaire (n = 1,455 adolescents) and accelerometer (n = 844 adolescents), and HRQoL using KIDSCREEN - 27. Time on videogames/cell phones/tablets was inversely associated with overall HRQoL (β = -0.021; 95%CI: -0.026; -0.006), psychological well-being (β = -0.030; 95%CI: -0.050; -0.010), peer social support (β = -0.041; 95%CI: -0.066; -0.016) and school environment (β = -0.033; 95%CI: -0.056; -0.010) scores. Screen time was inversely associated with the school environment score (β = -0.011; 95%CI: -0.020; -0.003). Computer time was positively associated with the psychological well-being (β = 0.025; 95%CI: 0.006; 0.043) and peer social support scores (β = 0.029; 95%CI: 0.004; 0.053). It concluded that adolescents with more screen time had lower HRQoL. However, theses associations varied with the type and method of SB measurement and the HRQoL dimension.


Resumo A qualidade de vida relacionada à saúde (QVRS) representa a percepção de cada pessoa sobre os diferentes aspectos de sua vida no contexto da saúde (físico, psicológico, meio social e relacionamento interpessoal). Entre os adolescentes, a QVRS pode mudar em função dos hábitos adotados nessa fase da vida. Este estudo analisou a associação entre o tempo utilizado em diferentes comportamentos sedentários (CS) e a QVRS em adolescentes. Trata-se de um estudo epidemiológico transversal com adolescentes de 10 a 15 anos de idade. O CS foi mensurado por meio de questionário (n = 1.455 adolescentes) e acelerômetro (n = 844 adolescentes) e a QVRS pelo KIDSCREEN - 27. O tempo em videogames/celulares/tablets foi inversamente associado à QVRS geral (β = -0,021; IC95%: -0,026; -0,006), bem-estar psicológico (β= -0,030; IC95%: -0,050; -0,010), apoio social de pares (β = -0,041; IC95%: -0,066; -0,016) e ambiente escolar (β = -0,033; IC95%: -0,056; -0,010). O tempo de tela se associou inversamente ao escore do ambiente escolar (β = -0,011; IC95%: -0,020; -0,003). O tempo de computador foi positivamente associado ao bem-estar psicológico (β= 0,025; IC95%: 0,006; 0,043) e escores de apoio social dos pares (β = 0,029; IC95%: 0,004; 0,053). Conclui-se que adolescentes com maior tempo na tela apresentaram menor QVRS. No entanto, essas associações variaram com o tipo e método de mensuração do CS e a dimensão da QVRS.

4.
Acta colomb. psicol ; 25(1): 137-150, ene.-jun. 2022. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1364262

ABSTRACT

Resumen En México, el estudio de la autolesión cuenta con pocas investigaciones, y menos si se trata de estudios que conformen posibles modelos explicativos. Teniendo esto en cuenta, en el presente trabajo se planteó como objetivo conocer la relación de la autolesión con la depresión, la desregulación emocional y los estilos de afrontamiento, con el fin de generar un modelo explicativo de la problemática. El estudio se realizó a partir de un diseño cuantitativo, transversal y con alcance explicativo, y se contó con una muestra de 5835 adolescentes (M edad = 11-15 años) inscritos en 62 secundarias públicas del estado de Sonora. Se realizaron regresiones logísticas para el análisis de los datos, y como resultado se encontró que, para los estudiantes con autolesión severa (3.54 %), el modelo explica el 61 % de la varianza en los datos (R1 de Nagelkerke = .61) y clasifica correctamente al 84.1 % de los participantes; mientras que, en la autolesión leve (5.29 %), el modelo explica el 72 % de la varianza en los datos (R2 de Nagelkerke = .72) y clasifica correctamente al 88.2 % de los estudiantes. Asimismo, las dimensiones de depresión mostraron el mayor nivel explicativo (cognitiva-afectiva, somática) y correlaciones positivas con la desregulación emocional y el estilo de afrontamiento de evitación, así como correlaciones negativas con el estilo de afrontamiento de aproximación. Al final se discute respecto a la importancia de las variables independientes para futuras investigaciones, y sobre los resultados anómalos y otros datos de interés.


Abstract In Mexico, there is little research on the study of self-injury and even less on possible explanatory models. With this in mind, this study aimed to determine the relationship between self-injury and depression, emotional dysregulation, and coping styles, to generate an explanatory model of the problem. The study was carried out using a quantitative, cross-sectional, explanatory scope, design and a sample of 5835 adolescents (Mage = 11-15 years) enrolled in 62 public high schools in the state of Sonora. Logistic regressions were performed for data analysis, and as a result it was found that, for students with severe self-injury (3.54 %), the model explains 61 % of the variance in the data (Nagelkerke's R2 = .61) and correctly classifies 84.1 % of the participants; whereas, in mild self-injury (5.29 %), the model explains 72 % of the variance in the data (Nagelkerke's R2 = .72) and correctly classifies 88.2 % of the students. Likewise, the depression dimensions showed the highest explanatory level (cognitive-affective, somatic) and positive correlations with emotional dysregulation and avoidance coping style, as well as negative correlations with approach coping style. At the end, the importance of the independent variables for future research is discussed, as well as anomalous results and other data of interest.

5.
Ciênc. Saúde Colet ; 27(5): 1827-1842, maio 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1374949

ABSTRACT

Abstract The aim of the study was to investigate the effects of physical activity (PA) on heart rate variability (HRV) in children and adolescents. We conducted a research of Web of Science, PubMed, ScienceDirect, Springer-Link and EBSCO-host. The revised Newcastle-Ottawa Scale was used in an investigative analysis to assess bias risk. A total of 21 studies were included. Overall, medium-sized associations were found between PA and low frequency and high frequency in children and adolescents. High PA level had significantly higher standard deviation of RR intervals and root of the mean of the sum of the squares of differences between adjacent RR intervals in children and adolescents. The effects of PA on HRV were consistent in children and adolescents. Our systematic review and meta-analysis revealed medium-sized between PA and HRV in children and adolescents. Promoting children's and adolescents' participation in moderate-to-vigorous physical activity (MVPA) will increase parasympathetic nerve activity and decreased sympathetic nerve activity. Our findings support motivating children and adolescents to engage in more MVPA in their daily lives to improve autonomic nervous system function and promote cardiovascular safety.


Resumo O objetivo do estudo foi investigar os efeitos da atividade física (AF) na variabilidade da frequência cardíaca (VFC) em crianças e adolescentes. Realizamos uma pesquisa nas bases Web of Science, PubMed, ScienceDirect, Springer-Link e EBSCO-host. A Escala Newcastle-Ottawa revisada foi utilizada para avaliar o risco de enviesamento. Um total de 21 estudos foi incluído. De forma geral, foram encontradas associações de médio porte entre AF e baixa frequência e alta frequência em crianças e adolescentes. O alto nível de AF teve um desvio padrão significativamente maior dos intervalos e raiz da média da soma dos quadrados de diferenças entre os intervalos RR adjacentes em crianças e adolescentes. Os efeitos de AF sobre VFC foram consistentes em crianças e adolescentes. Nossa revisão sistemática e meta-análise revelou que AF e VFC em crianças e adolescentes são de médio porte. Promover a participação de crianças e adolescentes em atividade física de moderada à vigorosa (AFMV) aumentará a atividade nervosa parassimpática e diminuirá a atividade nervosa simpática. Nossas descobertas apoiam a motivação de crianças e adolescentes a se envolverem mais na AFMV em suas vidas diárias para melhorar o funcionamento do sistema nervoso autônomo e promover a segurança cardiovascular.

6.
An. bras. dermatol ; 97(2): 166-172, Mar.-Apr. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1374246

ABSTRACT

Abstract Background Androgenetic alopecia in the pediatric population is rarely discussed in the literature. Although the prevalence of the metabolic syndrome is increased in patients with early-onset androgenetic alopecia, the presence of metabolic syndrome risk factors in pediatric androgenetic alopecia is unknown. Objective To evaluate the demographics, medical and family histories, clinical and trichoscopic features, androgenic hormones, and metabolic syndrome risk factors in pediatric androgenetic alopecia. Methods The medical reports of pediatric patients with androgenetic alopecia were reviewed. Results The study included 23 patients (12 females and 11 males) with a mean age of 15,3 ± 2,1 years. Sixteen patients had adolescent androgenetic alopecia and seven, had childhood alopecia. Nine patients reported a family history, all of whom had adolescent androgenetic alopecia. Hyperandrogenism was noted in three patients with adolescent androgenetic alopecia. The most common hair loss pattern was diffuse thinning at the crown with preservation of the frontal hairline which was noted in 10 patients (43.5%), six of whom were males. Fourteen patients (60.9%) had at least one metabolic syndrome risk factor. The most common risk factor was obesity or overweight (47.8%) followed by insulin resistance (21.7%), high fasting blood glucose (13%), high blood pressure (4.4%) and lipid abnormalities (4.4%). Study limitations Retrospective study; lack of a control group. Conclusion Pediatric androgenetic alopecia is often associated with metabolic syndrome risk factors. Therefore, androgenetic alopecia in the pediatric population may indicate a future metabolic syndrome which warrants an accurate and prompt diagnosis for early screening and treatment.

7.
Arch. endocrinol. metab. (Online) ; 66(2): 222-228, Apr. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1374266

ABSTRACT

ABSTRACT Objective: There is little data about the remission phase in adolescents and young adults with newly diagnosed type 1 diabetes mellitus (T1D). The aims of this study were to determine the prevalence of remission and its predicting factors among adolescents and young adults with newly diagnosed T1D and to assess the association between remission and long-term glycemic control in this population. Subjects and methods: This is a longitudinal and retrospective study including 128 type 1 diabetic patients aged between 12 and 30 years at diabetes onset. Clinical, biological and therapeutic features were collected at diagnosis and for 5 years after diagnosis. Remission was defined by an HbA1c < 6.5% with a daily insulin dose < 0.5 IU/kg/day. Results: Twenty-three patients (18%) experienced a remission. The peak of remission prevalence was at 6 months after diabetes diagnosis. An insulin dose at discharge <0.8 IU/kg/day was independently associated with remission (p=0.03, adjusted OR [CI 95%] = 0.2 [0.1-0.9]). A low socioeconomic level was independently associated with non remission (p=0.02, adjusted OR [CI 95%] = 4.3 [1.3-14.3]). HbA1c was significantly lower during the first five years of follow-up in remitters. The daily insulin dose was significantly lower during the first four years of follow-up in remitters. Conclusions: Occurrence of remission in adolescents and young adults with newly diagnosed T1D is associated with better glycemic control and lower insulin requirements during the first 5 years of follow-up. A lower initial dose of insulin was associated with a higher percentage of remission.

8.
Rev. CES psicol ; 15(1): 44-67, ene.-abr. 2022. tab
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1376229

ABSTRACT

Resumo O presente estudo teve como objetivo principal explorar de que forma variáveis do funcionamento familiar se relacionam com a dependência da internet. A amostra final foi constituída por 568 participantes, com idades compreendidas entre os 14 e 18 anos, que frequentam o Ensino Secundário, num distrito da região Norte de Portugal. Foi usado um Questionário Sociodemográfico, o Internet Addiction Test (IAT) e o Systemic Clinical Outcome Routine Evaluation (SCORE-15). Verificou-se que 73.1% dos participantes apresentaram dependência leve a moderada, mas não foram encontradas diferenças na dependência da internet entre o sexo masculino e o feminino. Por outro lado, verificaram-se diferenças a nível de funcionamento familiar, sendo que o sexo masculino apresentou, ligeiramente, mais dificuldades na comunicação na família e dificuldades familiares. Observaram-se diferenças entre os grupos em estudo (utilizadores normais, utilizadores com dependência leve e utilizadores com dependência moderada) em todas as dimensões do funcionamento familiar. Para além disso, foi possível observar associações positivas entre as dimensões do funcionamento familiar e a dependência da internet. Por fim, verificou-se que a comunicação na família foi a única variável do funcionamento familiar que apresentou um papel preditor na dependência da internet. Portanto, as dificuldades no funcionamento familiar, sobretudo na comunicação na família, parecem apresentar um papel fundamental no desenvolvimento da dependência da internet, sendo que se considera importante o desenvolvimento de ações preventivas, com vista a promoção do funcionamento familiar saudável, assim como do uso saudável da internet.


Abstract This study aimed at exploring how family functioning variables are related to internet addiction. The final sample consisted of 568 participants, aged between 14 and 18, who attend Secondary Education, in a district in the North Region of Portugal. A Sociodemographic Questionnaire, the Internet Addiction Test (IAT) and the Systemic Clinical Outcome Routine Evaluation (SCORE-15) were used. It was found that 73.1% of the participants had mild to moderate addiction, but there were no differences in internet addiction between male and female. On the other hand, differences in terms of family functioning have been verified, with male presenting slightly more difficulties in communicating in the family and more family difficulties. Differences were observed between the study groups (normal users, users with mild dependence and users with moderate dependence) in all dimensions of family functioning. In addition, it was possible to observe positive associations between the dimensions of family functioning and internet addiction. Finally, it was found that communication in the family was the only variable of family functioning that had a predictive role in internet addiction. Therefore, difficulties in family functioning, especially in communication among the members, seem to play a fundamental role in the development of internet addiction, and it is crucial to develop preventive actions, to promote healthy family functioning, as well as healthy internet use.


Resumen El presente estudio tuvo como objetivo principal explorar cómo las variables del funcionamiento familiar están relacionadas con la adicción a internet. La muestra final consistió en 568 participantes, con edades comprendidas entre 14 y 18 años, que asisten a la Educación Secundaria, en un distrito en el norte de Portugal. Se utilizó cuestionario sociodemográfico, Internet Addiction Test (IAT) y Systemic Clinical Outcome Routine Evaluation (SCORE-15). Se encontró que el 73.1% de los participantes tenían una adicción leve a moderada, pero no hubo diferencias en la adicción a internet entre sexo masculino y femenino. Por otro lado, hubo diferencias en el funcionamiento familiar, ya que el género masculino tuvo un poco más de dificultades para comunicarse en la familia y más dificultades familiares. Se observaron diferencias entre los grupos de estudio (usuarios normales, usuarios con adicción leve y usuarios con adicción moderada) en todas las dimensiones del funcionamiento familiar. Además, fue posible observar asociaciones positivas entre las dimensiones del funcionamiento familiar y la adicción a internet. Finalmente, se descubrió que la comunicación en la familia era la única variable en el funcionamiento familiar que tenía un papel predictivo en la adicción a internet. Por lo tanto, las dificultades en el funcionamiento familiar, especialmente en la comunicación en la familia, parecen desempeñar un papel fundamental en el desarrollo de la adicción a internet, y se considera importante desarrollar acciones preventivas, con miras a promover un funcionamiento familiar saludable, así como el uso de internet saludable.

9.
Psicol. pesq ; 16(1): 1-25, jan.-abr. 2022. tab
Article in Portuguese | LILACS-Express | LILACS, INDEXPSI | ID: biblio-1356619

ABSTRACT

Para analisar a presença de práticas de autolesão sem intenção suicida na trajetória de adolescentes/ jovens, foi efetuada consulta a prontuários de pessoas de 12 a 24 anos internadas de 2016 a 2018 e entrevistados jovens na mesma faixa etária que passaram por internação em 2019 ou 2020 com suporte de roteiro de entrevista de história de vida temática. Identificaram-se múltiplos termos para designar os cortes sobre a pele feitos pelos adolescentes/jovens, a relação entre ações de violência contra si e o percurso por instituições de saúde, e autolesão como forma de aliviar a dor não expressa em palavras.


To analyze the presence of self-harm practices without suicidal intent in the trajectory of adolescents / young people, medical records of people aged 12 to 24 years hospitalized from 2016 to 2018 were consulted and young people within the same age group, who underwent hospitalization in 2019 or 2020, were interviewed with the support of a thematic life story interview script. Multiple terms were identified to designate the cuts on the skin made by adolescents / young people, the relationship between actions of violence against themselves and the journey through health institutions, and self-harm as a way to relieve the pain not expressed in words.


Para analizar la presencia de prácticas de autolesión sin intención suicida en la trayectoria de adolescentes / jóvenes, se consultaron historias clínicas de personas de 12 a 24 años, hospitalizadas entre 2016 y 2018 y entrevistas a jóvenes del mismo grupo etario que fueron hospitalizados en 2019 o 2020 con apoyo de la entrevista temática de la historia de vida. Se identificaron múltiples términos para designar los cortes en la piel que realizan los adolescentes / jóvenes, la relación entre las acciones de violencia contra ellos mismos y el recorrido por las instituciones de salud, y la autolesión como una forma de aliviar el dolor no expresado con palabras.

10.
Pediatr Panamá ; 51(1): 1-2, May2022.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1368291

ABSTRACT

El Estado panameño ratificó en el año 1990 la Convención sobre los Derechos del Niño y con ello asumió el compromiso de crear mecanismos para la protección de la niñez y la adolescencia, pero las actuales estadísticas señalan que los derechos de protección del menor siguen siendo vulnerados y van en aumento especialmente en las regiones comarcales indígenas en el país. Como vemos en el informe anual del Ministerio Público de Panamá para el año 2021 se registraron un total de 2,257 casos de "acceso sexual con una persona mayor de catorce (14) años y menor de dieciocho (18)" (artículo 176 del código penal) que representó un aumento del 18 % comparado a los 1,913 casos en 2020.


The Panamanian State ratified the Convention on the Rights of the Child in 1990 and thereby assumed the commitment to create mechanisms for the protection of children and adolescents, but current statistics indicate that the protection rights of minors continue to be violated and they are on the increase, especially in the indigenous regional regions of the country. As we see in the annual report of the Public Ministry of Panama for the year 2021, a total of 2,257 cases of "sexual access with a person over fourteen (14) years of age and under eighteen (18)" were registered (article 176 of the penal code ) which represented an increase of 18% compared to the 1,913 cases in 2020.

11.
Rev. bras. hipertens ; 29(1): 14-18, 10 març. 2022. tab
Article in Portuguese | LILACS, SES-SP, CONASS, SESSP-IDPCPROD, SES-SP | ID: biblio-1367456

ABSTRACT

ABSTRACT Clinical case of a female patient referred to our Institution at the age of seven years old with Systemic Arterial Hypertension. The patient had been severely obese since she was 4 years old and high blood pressure levels were detected in several medical consultations a few months ago. She has a history of prematurity, a sedentary lifestyle, and an inadequate diet, in addition to a family history of obesity and high blood pressure. We discussed the investigation of the etiology, the presence of target organ lesions, and the treatment of arterial blood pressure in youth. In the follow-up, there was adequate control of blood pressure after initiation of angiotensin-converting enzyme inhibitor, with great difficulty in weight reduction. Even under nutritional guidelines and reinforcement regarding lifestyle changes, the patient had a weight gain of 25 kilos. We report this case in view of the significant increase in the prevalence of Systemic Arterial Hypertension in children and adolescents. There are multifactorial aspects to the development of this scenario, largely associated with an inadequate lifestyle. The difficulties related to its management and the presence of comorbidities, especially obesity, highlight the need for a multidisciplinary approach so that the evolution of the patient's condition becomes as desired.


RESUMO Caso clínico de uma paciente do sexo feminino, encaminhada a nossa Instituição aos sete anos de idade por provável Hipertensão Arterial Sistêmica. A paciente apresentava obesidade grave desde os quatro anos e há alguns meses foram detectadas medidas de pressão arterial elevadas em várias consultas médicas. Tem antecedentes de prematuridade, sedentarismo e dieta inadequada, além de história familiar também de obesidade e hipertensão arterial. Discutimos as condutas quanto a investigação da etiologia, da presença de lesões de órgãos alvo e do tratamento. Na evolução, houve controle adequado da pressão arterial após início de inibidores da enzima de conversão da angiotensina, mas grande dificuldade na redução do peso. Ao longo do seguimento, mesmo sob orientações nutricionais e reforço quanto a modificações do estilo de vida, a paciente apresentou ganho ponderal de 25 quilos. Relatamos este caso atendendo a necessidade de discussão do tema frente ao aumento significativo da prevalência de HAS em crianças e adolescente. Existem aspectos multifatoriais para o desenvolvimento da hipertensão arterial na infância, em grande parte associada a um estilo de vida inadequado. As dificuldades relacionadas ao seu manejo a presença de comorbidades, em especial da obesidade, ressaltam a necessidade de uma abordagem multiprofissional para que a evolução do quadro da paciente venha a ser o desejado.


Subject(s)
Humans , Female , Child , Sedentary Behavior , Pediatric Obesity , Hypertension/drug therapy , Antihypertensive Agents/therapeutic use
12.
Arq. gastroenterol ; 59(1): 97-101, Jan.-Mar. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1374444

ABSTRACT

ABSTRACT Background Chronic abdominal pain (CAP) carries a significant burden of disease. The last edition of the Rome Criteria (Rome IV) allows the diagnosis of functional gastrointestinal disorders (FGIDs) according to symptoms-based criteria; however, patients continue to experience a delay in their diagnosis and to be submitted to different interventions before the establishment of a positive diagnosis. Objective We aimed to characterize etiology, clinical features, and interventions in a pediatric cohort of patients with CAP secondary to FGIDs, who were referred to our tertiary care university-affiliated hospital, in Brazil. Methods A retrospective descriptive study of children and adolescents (aged 20 years and younger) referred to our institution, from January/2013 to December/2018, for CAP, and who fulfilled criteria for FGIDs classified according to Rome IV criteria. Results Three hundred twenty-eight patients with CAP were screened, of which 67.9% (223 patients) fulfilled the criteria for FGIDs and were included in the study. Sixty percent were female, with a mean age of 8.3 years. At the time of referral, the mean duration of symptoms was 2.8 years. Length/height for age and weight for age mean z-scores were -0.08±1.87 and -0.38±1.62, respectively. Functional abdominal pain not otherwise specified was overall the most common diagnosis (70.4%). Before establishing the diagnosis of FGIDs, multiple pharmacological interventions were described, while after, the mainstay of therapy was education/reassurance and dietary interventions. Thirty-two percent of patients did not further require specialized follow-up. Conclusion Even at the tertiary care level, FGIDs were still the most common etiology of chronic abdominal pain, particularly functional abdominal pain not otherwise specified. Despite the relatively long duration of symptoms at referral, cessation of specialized care follow-up was possible in approximately a third of the cases.


RESUMO Contexto A dor abdominal crônica (DAC) pode acarretar importante morbidade. A última edição dos Critérios de Roma (Roma IV) permite o diagnóstico de distúrbios gastrointestinais funcionais (DGIFs) de acordo com critérios baseados em sintomas; no entanto, esses pacientes continuam a apresentar atraso no diagnóstico e a serem submetidos a diferentes intervenções antes do estabelecimento de um diagnóstico. Objetivo Caracterizar a etiologia, características clínicas e intervenções de crianças com DAC que não são mantidas na atenção primária e que foram encaminhadas ao nosso hospital universitário de nível terciário, no Brasil. Métodos Estudo retrospectivo descritivo de crianças e adolescentes (com idade igual ou inferior a 20 anos) encaminhados a nossa instituição, entre janeiro/2013 e dezembro/2018, por DAC e que preenchiam os critérios para DGIFs conforme o consenso de Roma IV. Resultados Trezentos e vinte e oito pacientes com DAC foram triados, 67,9% (223 pacientes) preencheram os critérios para DGIFs e foram analisados. Sessenta por cento do sexo feminino, com idade média de 8,3 anos. A duração média dos sintomas no encaminhamento era de 2,8 anos. Os escores z médios de estatura para idade e peso para idade foram -0,08±1,87 e -0,38±1,62, respectivamente. Dor abdominal funcional sem outra especificação foi o diagnóstico mais comum (70,4%). Antes do diagnóstico de DGIFs, múltiplas intervenções farmacológicas foram descritas, enquanto depois, a base da terapia foi a educação, passar segurança à família e intervenções dietéticas. Trinta e dois por cento dos pacientes apresentaram resolução dos sintomas e receberam alta do acompanhamento especializado. Conclusão Mesmo no nível terciário, as desordens gastrointestinais funcionais ainda constituem a etiologia mais comum da DAC, particularmente a dor abdominal funcional não especificada. Apesar da duração longa dos sintomas, alta do serviço especializados foi possível em aproximadamente um terço dos casos.

13.
Int. arch. otorhinolaryngol. (Impr.) ; 26(1): 38-45, Jan.-Mar. 2022. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1364922

ABSTRACT

Abstract Introduction Central auditory processing disorder (CAPD) has been diagnosed through behavioral tests. Moreover, screening tools as validated questionnaires may contribute to identify individuals at risk for this disorder, including adolescents. Objective (1) to characterize and compare adolescents' self-perception regarding their auditory behavior with their parents' perception; (2) to verify their agreement with behavioral evaluation of central auditory processing (CAP). Methods Cross-sectional, prospective, and descriptive study, in which 40 adolescents and 40 parents of both genders participated. All participants answered the scale of auditory behaviors questionnaire, and the behavioral evaluation of CAP was conducted with the adolescents. Findings were analyzed descriptively and inferentially, with a significance level of 5% (p ≤ 0.05) and application of the following tests: Test for equality of two proportions, Chi-squared, and Kappa concordance index. Results Most adolescents rated their auditory behavior as "low risk" for CAPD while their parents rated it as "typical." When comparing adolescents' self-perception and parents' perception about the auditory behavior with the behavioral evaluation outcome, a statistically significant difference was observed only in adolescents' selfperception. The results of the behavioral evaluation indicated that 42.5% of the adolescents showed alterations. The concordance index between adolescents' selfperception and parents' perception of auditory behavior showed a significant (minimal) difference. Conclusion Most adolescents were able to perceive difficulties regarding their auditory behavior and characterized it as "low risk" for CAPD, but the same did not occur regarding their parents. There was agreement only between the adolescents' self-perception and their performance in the behavioral evaluation of CAP.

14.
Arch. latinoam. nutr ; 72(1): 31-42, mar. 2022. tab
Article in Spanish | LILACS, LIVECS | ID: biblio-1368363

ABSTRACT

El índice de masa corporal (IMC) es una eficaz herramienta para detectar la sobrecarga ponderal en niños y adolescentes, asociado a la adiposidad corporal. Objetivo. Analizar la concordancia, sensibilidad y especificidad de tres referencias internacionales de IMC/edad (OMS, IOTF y CDC) para diagnosticar el exceso ponderal y conocer su precisión diagnóstica para identificar el exceso de adiposidad con relación al área grasa braquial (AGB) en población infanto juvenil de Argentina. Materiales y métodos. Se realizó un estudio multicéntrico, descriptivo-comparativo y transversal entre 2003 y 2008, en 22.658 niños y adolescentes argentinos de 4 a 13 años de edad. A partir del peso, talla, circunferencia del brazo y pliegue tricipital, se calcularon IMC y AGB. Se analizó la concordancia, sensibilidad y especificidad de referencias de IMC/edad (OMS, CDC, IOTF) y la precisión diagnóstica (curvas ROC) para identificar exceso de adiposidad, a partir del AGB, así como el punto de corte óptimo (PCO). Resultados. Las tres referencias tuvieron buena concordancia. La mayor sensibilidad correspondió a OMS y la mayor especificidad a IOTF. El área bajo la curva (ABC) fue mayor en Z-IMC/IOTF en varones y en Z-IMC/OMS en mujeres. Los PCO mostraron discrepancias, siendo mayores con OMS. Conclusión. Las tres referencias muestran similar precisión diagnóstica para detectar alta reserva calórica, con puntos de corte óptimo para las puntuaciones Z-IMC menores a 2 Z scores. Esto resulta relevante para la identificación de exceso de adiposidad en poblaciones, en relación con la implementación de políticas públicas de prevención de enfermedades crónicas no transmisibles(AU)


The body mass index (BMI) is an effective tool to detect weight overload in children and adolescents, associated with body adiposity. Objective. To analyze the concordance, sensitivity and specificity of three international BMI/age references (WHO, IOTF and CDC) to diagnose excess weight and to know their diagnostic accuracy to identify excess adiposity in relation to the brachial fat area (BFA) in Argentine child-youth population. Materials and methods. A multicenter, descriptive- comparative and cross-sectional study was carried out between 2003 and 2008 in 22.658 Argentine children and adolescents between aged 4 to 13 years. From the weight, height, arm circumference and tricipital fold, BMI and BFA were calculated. The concordance, sensitivity, and specificity of BMI / age references (WHO, IOTF, CDC,) were analyzed and the diagnostic precision (ROC curves) to identify excess adiposity, from the BFA, as well as the optimal cut-off point (OCP). Results. The three references had good agreement, the highest sensitivity corresponded to WHO and the highest specificity to IOTF. The area under the curve (AUC) was greater in Z-BMI/IOTF in men and in Z-BMI/WHO in women. The OCPs showed discrepancies, being higher with WHO. Conclusion. The three references show similar diagnostic accuracy to detect high caloric reserve, but with cut-off points for Z-BMI scores less than 2 Z scores. This is relevant for the identification of excess adiposity in populations in relation to the implementation of public policies for the prevention of chronic non-communicable diseases(AU)


Subject(s)
Humans , Male , Female , Child , Adolescent , Mid-Upper Arm Circumference , Body Mass Index , Nutritional Status , Body Fat Distribution , Students , Weight by Height , Malnutrition , Pediatric Obesity
15.
Ciênc. Saúde Colet ; 27(3): 1147-1155, mar. 2022. tab, graf
Article in English | LILACS | ID: biblio-1364683

ABSTRACT

Abstract This article aims to analyze the association between sleep time and handgrip strength in adolescents belonging to the 1997/1998 São Luís Birth Cohort. This was a cross-sectional study nested in a birth cohort study. One thousand two hundred sixty-nine individuals (18 and 19 years) wore an Actigraph® GTX3+ accelerometer on their wrist 24 hr/day for 7 consecutive days. Handgrip strength was measured using a digital hand dynamometer. We used directed acyclic graphs (DAG) to identify confounding variables. This sample of adolescents was mostly composed of men, with brown skin color, economic class C, which did not work, did not consume alcohol, did not smoke, and never used drugs. The mean value of handgrip strength was 28.2 (±9.3) kgf, and the mean of sleep time was 6 (±1.0) hours per day. The crude analysis showed an association between sleep time and muscle strength. An increase of one hour of sleep reduced the handgrip strength by 1.95 kgf (95%CI:-2.51;-1.39). However, after adjustment for confounders, the association was not maintained (β:-0.07; 95%CI:-0.48;0.36). Sleep time is not associated with handgrip strength in adolescents in São Luís.


Resumo O objetivo deste artigo é analisar a associação entre tempo de sono e força de preensão manual em adolescentes da Coorte de Nascimentos de São Luís 1997/1998. Estudo transversal aninhado a um estudo de coorte de nascimentos. Mil duzentos e sessenta e nove indivíduos (18 e 19 anos) usaram um acelerômetro Actigraph® GTX3 + em seu pulso 24 horas/dia por sete dias consecutivos. A força de preensão manual foi medida por meio de um dinamômetro digital de mão. Usou-se gráficos acíclicos direcionados (DAG) para identificar variáveis ​​de confusão. A amostra de adolescentes foi composta em sua maioria por homens, de cor da pele parda, classe econômica C, que não trabalhava, não consumiam álcool, não fumavam e nunca usaram drogas. O valor médio da força de preensão manual foi de 28,2 (±9,3) kgf, e a média do tempo de sono foi de seis (±1,0) horas por dia. A análise bruta mostrou associação entre tempo de sono e força muscular. O aumento de uma hora de sono reduziu a força de preensão manual em 1,95 kgf (IC95%:-2,51;-1,39). No entanto, após o ajuste para fatores de confusão, a associação não foi mantida (β:-0,07; IC95%:-0,48;0,36). O tempo de sono não foi associado à força de preensão manual em adolescentes de São Luís.


Subject(s)
Humans , Male , Adolescent , Sleep/physiology , Hand Strength/physiology , Parturition , Cross-Sectional Studies , Cohort Studies
16.
Ciênc. Saúde Colet ; 27(1): 193-203, jan. 2022. tab
Article in Portuguese | LILACS | ID: biblio-1356045

ABSTRACT

Resumo Este artigo objetivou identificar e compreender os significados da família em situação de pandemia da COVID-19 para jovens do nordeste brasileiro. Trata-se de uma pesquisa qualitativa, com o uso do Procedimento DE-T. Participaram 32 adolescentes do nordeste brasileiro. Observou-se 13 temas, sendo os mais incidentes: distanciamento físico; sentimentos expressos; relações familiares integradoras; aparelhos tecnológicos; relações familiares desintegradoras. Conclui-se sobre a representação da potência familiar no enfrentamento da pandemia, bem como sobre o sofrimento e padecimento familiar frente ao problema de saúde pública que assola o país.


Abstract This paper aimed to identify and understand the meanings of family in a COVID-19 pandemic situation for adolescents in Northeastern Brazil. This qualitative research used the DE-T Procedure with 32 adolescents from Northeastern Brazil. Thirteen themes were observed, and the most incident were physical distance, expressed feelings, integrating family relationships, technological devices, and disintegrating family relationships. We finalize with the representation of family power in facing the pandemic and family suffering in the face of the public health problem that plagues the country.


Subject(s)
Humans , Adolescent , Pandemics , COVID-19 , Brazil/epidemiology , Qualitative Research , SARS-CoV-2
17.
Ciênc. Saúde Colet ; 27(1): 387-398, jan. 2022. tab
Article in English, Portuguese | LILACS | ID: biblio-1356025

ABSTRACT

Resumo O objetivo deste estudo foi descrever as mudanças na frequência do consumo de refeições de adolescentes residentes na região metropolitana do Rio de Janeiro, em período de 5 anos. Utilizaram-se dados de dois estudos transversais, de base populacional, que foram realizados por meio de visitas domiciliares. Em 2005, a amostra final foi de 1089 domicílios com 511 adolescentes (de 12 a 18 anos), e em 2010 de 1121 domicílios com 314 adolescentes. A frequência do consumo de refeições foi obtida por meio de questionário autopreenchido e a avaliação da adequação de peso dos adolescentes foi realizada com base nos pontos de corte do IMC por sexo e faixa etária. Houve aumento da substituição diária do almoço tradicional por lanche (3,7% para 13,7%) e no consumo do jantar tradicional (62,9% para 72,0%). Os adolescentes com sobrepeso consumiram o desjejum com menor frequência do que aqueles sem sobrepeso (2005: 68,3% vs 79,3% p=0,02, 2010: 59,5% vs 77,4% p=0,03). Conclui-se que houve aumento da substituição diária do almoço tradicional por lanche e no consumo do jantar tradicional no período de 5 anos. Ademais, a prática do desjejum diário se associou com a classificação de IMC nos dois momentos do estudo, de modo que aqueles com sobrepeso consomem o desjejum com menor frequência.


Abstract This study described changes in meal frequency over a 5-year period among adolescents living in the Rio de Janeiro metropolitan region. The data used were from two cross-sectional, population-based studies conducted by home visits. In 2005 the final sample was 1089 households with 511 adolescents (aged 12 to 18 years) and in 2010, 1121 households with 314 adolescents. Meal frequency was obtained through self-administered questionnaire and the adolescents were assessed for appropriate weight by BMI cut-off points, by sex and age group. Increasingly, traditional daily lunch was replaced by snacks (from 3.7% to 13.7%) and traditional dinner was eaten (62.9% to 72.0%). Overweight adolescents ate breakfast less often than those not overweight (in 2005, 68.3% and 79.3%, p=0.02 and, in 2010, 59.5% and 77.4%, p=0.03). Traditional daily lunch was increasingly replaced by snacks and consumption of traditional dinner increased over the 5-year period. Also, eating breakfast every day was associated with BMI classification at both study times: those who were overweight consumed breakfast less frequently.


Subject(s)
Humans , Feeding Behavior , Meals , Brazil/epidemiology , Body Mass Index , Cross-Sectional Studies
18.
International Eye Science ; (12): 298-303, 2022.
Article in Chinese | WPRIM | ID: wpr-913041

ABSTRACT

@#AIM: To investigate the status of astigmatism in children and adolescents aged 7-19 years in some areas of Xinjiang, and to analyze the distribution of astigmatism in children and adolescents in Xinjiang.METHODS: Cross-sectional study. This study took a purposive sampling survey of 41 schools in some areas of Xinjiang, including 20 primary schools and 21 middle schools, from May 2019 to December 2019. A total of 71 838 children and adolescents were included as the survey objects for relevant eye examinations.RESULTS: Among 71 838 students, 35 888 were found to have astigmatism(column ≤ -0.50D), and the astigmatism detection rate was 49.96%. The differences of astigmatism detection rate among different ages, genders, education levels, regions and ethnic groups were statistically significant(all <i>P</i><0.001). The detection rate of astigmatism increased with age from 7-16 years old, and reached the highest rate of 57.60% at 16 years old. The detection rate of astigmatism decreased from 16-19 years old, and the overall detection rate of astigmatism increased with age. With the increase of education level, the detection rate of astigmatism increases, and the detection rate of male astigmatism(51.25%)is higher than that of female astigmatism(48.62%). The detection rate of astigmatism in provincial capital cities(50.99%)is higher than that in non-provincial capital cities(48.05%); the detection rate of astigmatism in Han(53.41%)was higher than that in Uyghur(40.17%), Kazakhs(48.23%), Kyrgys(45.56%)and Hui(48.87%). The astigmatism type was mainly with-the-rule astigmatism(74.53%), and with the increase of age, the composition ratio of with-the-rule astigmatism decreased, while the composition ratio of against-the-rule astigmatism and oblique astigmatism increased. The final results of Logistic regression analysis showed that age, gender, nationality, region and education level were all influential factors of astigmatism.CONCLUSION: The prevalence of astigmatism in children and adolescents aged 7-19 years in some areas of Xinjiang is 49.96%, and the astigmatism is mainly with-the-rule astigmatism(74.53%). Age, gender, nationality, region and education level are the influential factors of astigmatism.

19.
Article in Chinese | WPRIM | ID: wpr-923484

ABSTRACT

@#Objective To systematically research the policies and core contents of World Health Organization (WHO) and United Nations Educational, Scientific and Cultural Organization (UNESCO) documents on policies, guidelines and standards for health-promoting schools and health services. Methods These policy documents included Making Every School a Health-promoting School: Implementation Guidelines, WHO Guidelines on School Health Services, and Making Every School a Health Promoting School Global Standards and Indicators, which construct a conceptual and policies framework for health-promoting schools. In perspective of health service system, this study systematically explored the policies, guidelines and standards of WHO and UNESCO on health-promoting schools and health services, as well as the role of health-promoting school component systems in promoting the health of children and how physical activity can be an important area of health-promoting schools. Results The Health Promoting Schools Initiative is an important area of research for the WHO health services. Making Every School a Health-promoting School: Implementation Guidelines primarily serves students aged five to 19, teachers and other staff in schools. WHO Guidelines on School Health Services cover a variety of activity types including health promotion, health education, preventive interventions, clinical assessment and health services management. Making Every School a Health Promoting School Global Standards and Indicators covers eight global criteria and thirteen specific areas in the areas of policy resources, curriculum and environment, and community engagement. Conclusion WHO and UNESCO have proposed a series of policies related to building health-promoting schools, which focus on child health and advocate the promotion of child and adolescent health, public health, education, social and economic development through schools to achieve the goal of safeguarding the health rights of children and adolescents and meeting health needs. Following the WHO Guidelines on School Health Services and Making Every School a Health Promoting School Global Standards and Indicators, it proposed to incorporate educational and physical education tools into the school health service system.

20.
Psicol. ciênc. prof ; 42: e233520, 2022.
Article in Portuguese | LILACS-Express | LILACS, INDEXPSI | ID: biblio-1356601

ABSTRACT

Resumo Este artigo objetiva problematizar as percepções de psicólogas de um Creas/Paefi da região metropolitana de Florianópolis acerca dos atendimentos psicossociais a crianças e adolescentes em situação de violência sexual. Foram realizadas entrevistas semiestruturadas com três psicólogas que atuam no serviço Paefi de um Creas. A análise das entrevistas está amparada pela perspectiva teórico-metodológica de análise das práticas discursivas e de produção de sentidos, conforme proposta por Spink e Medrado (2004). Elencaram-se as seguintes categorias de análise: a) percepções acerca da violência sexual contra crianças e adolescentes; b) percepções acerca do atendimento psicossocial; e c) percepções acerca da gestão de trabalho e das estratégias de intervenções psicossociais. De modo geral, destaca-se que as percepções sobre violência sexual variam entre leituras complexas e reducionistas; que existem dificuldades em fazer valer o Sistema de Garantia de Direitos de Crianças e Adolescentes e a efetivação de uma gestão de trabalho intersetorial e em rede; que o Estado é ausente e/ou negligente em contextos de vulnerabilidades; que as intervenções centram-se mais nas famílias e nas vítimas e menos nos autores de violência; que, apesar de impasses técnicos, busca-se atuar de acordo com prerrogativas da atuação profissional da psicologia no contexto do Suas. Considera-se que este estudo pode contribuir para a ampliação de problematizações acerca dos atendimentos psicossociais, no contexto do Suas, a crianças e adolescentes vítimas de violência sexual.(AU)


Abstract This article aims to problematize the perceptions of psychologists of a CREAS (Specialised Social Aid Reference Centre)/PAEFI (Protection and Specialised Care Services for Families and Individuals) from the Florianópolis metropolitan area on psychosocial care for children and adolescents in situations of sexual violence. We conducted semi-structured interviews with three psychologists working at CREAS/PAEFI service. The analysis of the interviews was supported by the theoretical and methodological framework of the analysis of discursive practices and production of meanings proposed by Spink and Medrado (2004). We listed the following categories of analysis: a) perceptions on sexual violence against children and adolescents; b) perceptions on psychosocial care; and c) perceptions on work management and strategies for psychosocial interventions. In general, we highlighted that perceptions on sexual violence vary between complex and reductionist understandings; that assuring the Rights Guarantee System for Children and Adolescents and making effective the intersectoral and network management of work is difficult; that the State is absent and/or negligent in contexts of vulnerability; that interventions focus more on families and victims and less on perpetrators of violence; that, despite technical impasses, psychologists act according to the prerogatives of professional practices in the context of SUAS (Single Social Welfare System). We consider that this study can contribute to the expansion of problematizations on psychosocial care, in the context of SUAS, to children and adolescents who are victims of sexual violence.(AU)


Resumen El propósito de este artículo es problematizar las percepciones de psicólogas de un Centro de Referencia Especializado de Asistencia Social del Servicio de Protección y Atención Especializada a Familias e Individuos (Creas/Paefi) de la área metropolitana de Florianópolis (Brasil) sobre la atención psicosocial a niños y adolescentes en situación de violencia sexual. Se realizaron entrevistas semiestructuradas con tres psicólogas que actúan en el servicio Paefi de un Creas. El análisis de las entrevistas se fundamenta en la perspectiva teórico-metodológica de análisis de las prácticas discursivas y de producción de sentidos, propuesta por Spink y Medrado (2004). Se enumeraron las siguientes categorías de análisis: 1) percepciones sobre la violencia sexual contra niños, niñas y adolescentes; 2) percepciones sobre la atención psicosocial; y 3) percepciones sobre la gestión del trabajo y estrategias para intervenciones psicosociales. En general, se destaca que las percepciones sobre la violencia sexual varían entre lecturas complejas y reduccionistas; que existen dificultades para hacer cumplir el Sistema de Garantía de los Derechos de la Niñez y la Adolescencia y hacer efectiva la gestión del trabajo intersectorial y en red; que el Estado se encuentra ausente y/o negligente en contextos de vulnerabilidad; que las intervenciones se centran más en las familias y las víctimas, y menos en los perpetradores de violencia; que, a pesar de los impasses técnicos, buscamos actuar de acuerdo con las prerrogativas del ejercicio profesional en psicología en el contexto del Sistema Único de Asistencia Social (Suas). Se espera que este estudio pueda contribuir a la expansión de problematizaciones sobre la atención psicosocial a niños y adolescentes víctimas de violencia sexual, en el contexto del Suas.(AU)


Subject(s)
Humans , Female , Adult , Middle Aged , Psychology , Sex Offenses , Social Support , Child , Adolescent , Mental Health Services , Poverty , Sex Education , Child Abuse, Sexual , Family , Culture , Emotions , Human Rights
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