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O referido trabalho visa apresentar a importância do cirurgião dentista, especialista em odontopediatria, em ambiente hospitalar, esclarecendo sinais e manifestações orais que devam despertar a atenção de um possível abuso sexual infantil, a fim de que seja feita uma notificação plausível e baseada em evidências. Esta revisão de literatura tem bibliografia baseada em artigos da Constituição Federal e artigos científicos buscados na plataforma Scientific Electronic Library Online (SciELO). A busca foi feita por meio de palavras-chave em um intervalo de 2002 a 2022, não se resumindo a um período máximo de 10 anos devido à dificuldade em encontrar referências atuais. Cerca de 29 artigos foram encontrados e após a leitura do título e resumo de cada um, 14 foram excluídos em razão de seu conteúdo não estar relacionado ao tema proposto. 15 foram lidos na íntegra. 3 manuais disponibilizados para profissionais da saúde e artigos do Estatuto da Criança e do Adolescente, bem como 1 lei municipal do Rio de Janeiro foram utilizados. Como resultado geral, foram encontradas manifestações orais e Infecções Sexuais Transmissíveis (ISTs) mais recorrentes, sinais apresentados por pacientes vítimas de abuso sexual, quais condutas obrigatórias a seguir e a importância do odontopediatra, em ambiente hospitalar, mais precisamente na Unidade de Terapia Intensiva.
This work aims to present the importance and role of the dental surgeon, specialist in pediatric dentistry, in a hospital environment, clarifying which signs, and oral manifestations should draw attention to a possible child sexual abuse, in order to make a plausible report and evidence-based. A literature review was carried out with bibliography based on articles of the Federal Constitution and scientific articles found in platform Scientific Electronic Library Online (SciELO). The search was carried out using keywords in a range from 2002 to 2022, not limited to a maximum period of 10 years due to the difficulty in finding current references. About 29 articles were found and after reading the title and abstract of each one, 14 were excluded because their content was not related to the proposed theme. 15 were read in full. 3 manuals made available to health professionals and articles from the Child and Adolescent Statute, as well as 1 municipal law of Rio de Janeiro were used. As a general result, more recurrent oral manifestations and Sexually Transmitted Infections (STIs) were found, signs presented by patients victims of sexual abuse, what mandatory conducts to follow and the importance of the pediatric dentist in a hospital environment, more precisely in the Intensive Care Unit.
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Unidades de Cuidados IntensivosRESUMEN
Acute leukemia（AL）is a common hematological malignancy in children and adolescents. Chemotherapy is currently the primary treatment for AL.Alternative therapies，such as hematopoietic stem cell transplantation（HSCT），targeted therapy，and immunotherapy also offer greater hope for the survival of refractory/relapsed patients. Chemotherapeutic drugs，radiotherapy，targeted drugs and immunotherapeutic drugs are well-applied clinically，meanwhile posing threats to non-target systems. The adverse effects on the reproductive system may lead to the dilemma of infertility，thus reducing the long-term quality of life. As the survival rate of AL patients keeps increasing continuously，the influence of different treatments on the gonad function needs to be clarified. With the help of targeted fertility prevention，the patient′s quality of life can be enhanced in parallel with life span. This article aims to review the impact of AL treatment on ovarian function in female children and adolescents and provide ideas for the long-term fertility protection of leukemia patients.
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【Objective】 To understand the obesity status of Kazakh children and adolescents in the agricultural and pastoral areas of Xinjiang and its association with lifestyle, so as to provide reference and help for maintaining good body shape and health intervention for Kazakh children and adolescents in agricultural and pastoral areas. 【Methods】 From April to June 2022, 6 242 Kazakh children and adolescents aged 10 - 20 years were tested for obesity and surveyed by lifestyle questionnaires using stratified whole-group sampling in the farming and herding areas of Yili Kazakh Autonomous Prefecture and Altay Region, Xinjiang. χ2 test and Logistic regression analysis were used to analyze data. 【Results】 The obesity detection rate of Kazakh children and adolescents in Xinjiang farming and herding areas was 18.71%, with higher rates in boys (22.24%) compared to girls (15.12%), and the difference was statistically significant (χ2 =52.04, P<0.01). Significant differences were observed in the obesity rates based on grade level, fruit consumption frequency, screen time of television, feeling hopeful for the future, fatigue, loneliness, and sadness (χ2 =24.29, 4.61, 694.51, 7.15, 10.33, 6.51, 8.07, P<0.01). Logistic regression analysis showed that female students (OR=0.63, 95%CI: 0.56 - 0.69) and students who felt hopeful about the future (OR=0.96, 95%CI: 0.94 - 0.99) were protective factors against obesity (P<0.05); while high school and lower grades (senior high school OR=1.38, 95%CI: 1.24 - 1.57; junior high school OR=1.82, 95%CI: 1.58 - 2.06; primary school OR=2.67, 95%CI: 2.33 - 2.99), fruit consumption ≥1time/d (OR=1.07, 95%CI: 1.03 - 1.16), watching TV ≥2h/d (OR=1.07, 95%CI: 1.02 - 1.17), frequent feeling of fatigue (OR=1.07, 95%CI: 1.03 - 1.12), loneliness (OR=1.08, 95%CI: 1.02~1.19) and sadness (OR= 1.09, 95%CI: 1.04 - 1.14) of students were risk factors for the development of obesity (P<0.05). 【Conclusions】 The obesity rate of Kazakh children and adolescents in the agricultural and pastoral areas of Xinjiang is high and closely associated with lifestyle. Therefore, it is crucial to improve unhealthy lifestyles in order to reduce obesity and promote the physical and mental well-being of this population.
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【Objective】 To analyze the association of overweight and obesity with elevated blood pressure(BP) among children and adolescents in Mengzi City, in order to provide reference for making effective interventions. 【Methods】 A total of 30 classes of students in 14 schools were selected into this study by a stratified random cluster sampling method from October 2020 to September 2021. The paticipants completed a questionnaire survey, and had their height, weight and BP measured. Logistic regression analysis was used to evaluate the association of overweight and obesity with elevated BP. 【Results】 A total of 4 015 children and adolescents aged 7 - 17 years were involved in the study. The detection rate of overweight, obesity and elevated BP was 12.53%, 10.01% and 12.38%, respectively. The detection rate of elevated BP was 9.96%, 19.48% and 25.62% in normal weight, overweight and obese groups, respectively. The risk of elevated BP in the overweight and obese groups was 2.190 times(95%CI: 1.696 - 2.926, P<0.001) and 3.243 times(95%CI: 2.501 - 4.204, P<0.001) as high as that in normal weight groups. The dietary and exercise behaviors of 1 604 adolescents were analyzed, it was found that the detection rate of obesity was significntly higher in non-boarding students(15.09%) and those who consumed fresh fruits at least once a day(13.49%)(χ2=18.012, 7.225, P<0.05), the detection rate of elevated BP was significantly higher in among those who did not consume sugary beverages(16.88%), and performed moderate-to-high intensity physical exercise of 60 minutes or more ≤ 2 days per week(16.88%)(χ2=9.403, 14.921,P<0.01). 【Conclusions】 The risk of developing hypertension increases with the high prevalence of overweight and obesity and is strongly associated with multiple factors. Therefore, it is essential to conduct effective weight control and behavioral lifestyle interventions among children and adolescents.
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In medical research,predictive models have been widely used to predict disease progression and identify high-risk populations in advance, especially in the prevention and diagnosis of chronic diseases. In ophthalmology, the predictive and diagnostic models for fundus diseases such as age-related macular degeneration and diabetic retinopathy have demonstrated expert-level accuracy. However, the application of predictive models is still in the exploratory stage as for myopia prevention and control. The establishment of a predictive model is helpful to identify the high-risk myopic children in advance, so that preventive measures such as adequate outdoor activities and reducing near work can be taken in time, which is of great significance to prevent or slow down the occurrence and development of myopia. Because the mechanism of myopia has not been fully elucidated, there are still challenges and limitations in the selection of application objects, predictors and predictive outcomes. This paper reviews the research progress of different types of myopia predictive models in order to provide reference for further development and improvement.
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AIM: To evaluate the value of the ratio of axial length to corneal radius of curvature(AL/CR)in the diagnosis of myopia in children and adolescents.METHODS: The refraction and ocular biometric parameters of 2 182 cases of children and adolescents(4 364 eyes)who initially visited the optometry clinic of the Second People's Hospital of Beihai from January 2022 to December 2023 were collected and analyzed.RESULTS: The receiver operating characteristic curve(ROC curve)showed that AL/CR had a higher area under the curve(AUC=0.925, 95%CI: 0.917-0.933)in diagnosing myopia. When AL/CR was 3.053, the Youden index was the largest. As the threshold of AL/CR decreased, the sensitivity of myopia diagnosis increased, while the specificity decreased. Compared with screening myopia, the sensitivity of AL/CR=3.053 in diagnosing myopia was low, but the specificity was high, especially in the cases of hyperopia and pre-myopia.CONCLUSION: The accuracy of AL/CR in diagnosing myopia is superior to that of axial length and average corneal curvature, with higher specificity. As the threshold of AL/CR decreases, the sensitivity of diagnosing myopia increases, but the specificity decreases. In cases of hyperopia and pre-myopia, the specificity of AL/CR in diagnosing myopia is higher than that of screening myopia.
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Abstract Objective To evaluate the lifestyle and quality of life in Brazilian children and adolescents during the COVID-19 social distancing period in 2020. Methods This cross-sectional study evaluated children and adolescents (2-18 years of age) and their parents, who voluntarily participated in an online survey. Snowball sampling was used to recruit participants during the first 6 months of the pandemic. A questionnaire was used to characterize the study population. The PedsQL 4.0 and the EUROHIS-QOL 8-item index were used to assess the quality of life (QoL) in children/adolescents and parents, respectively. Data were analyzed using SPSS 18.0 statistical program through the ANOVA with post hoc Bonferroni analysis, student's t test, and the generalized estimating equation. Results Mean screen time increased from 2h pre-pandemic to 5h during the pandemic (p <0.001), which was associated with a decline in PedSQL4.0 scores (from 75.7 ± 2.6 to 71.3 ± 13.7, p <0.001). Unhealthy eating habits increased from 11% to 34% and were associated with worse QoL scores compared with improved or unchanged eating habits during the pandemic (69.7 ± 13.3 vs 72.80 ± 13.4 vs 76.4 ± 12.6; p <0.001). Poor sleep quality increased from 9% to 31.7% and was associated with worse QoL scores compared to improved or unchanged sleep quality during the pandemic (67.3 ± 13.1 vs 74.5 ± 13.1 vs 76.8 ± 12.2; p <0.05). Physical exercise was associated with better PedSQL4.0 scores (77.5 ± 12.3 vs 72.5 ± 14.4; p <0.001). Children aged 2-4y old had the best QoLscores. Conclusions Pandemic-related social distancing promoted significant lifestyle changes in children and adolescents, increasing screen time, reducing physical activity, and worsening food and sleep quality, which resulted in worse QoL scores.
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Resumo Objetivou-se evidenciar na literatura científica o que se foi discutido sobre o enfrentamento à violência contra crianças e adolescentes no âmbito da Estratégia Saúde da Família. Trata-se de uma revisão integrativa da literatura, realizada nas bases de dados Medical Literatute Analysisand Retrieval System Online (Medline), Literatura Latino-americana e do Caribe em Ciências da Saúde (LILACS), Web of Science e American Psychological Association (PsycINFO) e nestas, utilizaram-se os descritores controlados em Ciências da Saúde (DeCs) e do Medical Subject Headings (MeSH), sendo estes: "domestic violence", "child abuse", "educational technology", "primary health care" para DeCs e MeSh. Obteve-se um total de 2.403 resultados, com aplicação dos critérios de inclusão e exclusão foram analisados 15 artigos. A violência é vista como um problema de saúde pública, sendo identificada como um problema sensível a APS. Apesar da identificação de casos de violência contra crianças e adolescentes na ESF, o despreparo dos profissionais e a fragilidade na rede de enfrentamento fragmentam a assistência adequada a este público. Assim, há necessidade de fortalecimento da rede disponibilizada e incentivo a capacitação e formação dos profissionais atuantes na APS.
Abstract The scope of this study was to highlight what has been discussed about addressing violence against children and adolescents in the context of the Family Health Strategy in the scientific literature. It involved an integrative review of the literature, conducted in the Medical Literature Analysis and Retrieval System Online (Medline), Latin American and Caribbean Literature on Health Sciences (LILACS), Web of Science and American Psychological Association (PsycINFO) databases. In the survey, the controlled descriptors in Health Sciences (DeCS) and the Medical Subject Headings (MeSH) were used, including domestic violence, child abuse, educational technology and primary health care for DeCS and MeSH. A total of 2,403 results were obtained, with the application of the inclusion and exclusion criteria, and 15 articles were analyzed. Violence has been seen as a public health problem, being identified as a sensitive problem in PHC. Despite the identification of cases of violence against children and adolescents in the FHS, the lack of preparedness of professionals and the fragility in the coping network prejudice the adequate care for this public. Thus, there is a need to strengthen the network available and encourage the capacity building and training of professionals working in PHC.
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The present study aimed to identify the proportion of victimization, types of victimization, and risk factors associated to children and adolescents who were admitted into an outpatient protection center for children and adolescents in northern Chile during the years 2016 and 2017. Secondary data from the database pertaining to the protection center was used. The sample was non-probabilistic and included 6,499 cases. The research was descriptive-comparative with a non-experimental retrospective cross-sectional design. The results showed a higher percentage of victimization by neglect, followed by witnessing domestic violence and child sexual abuse. The sociodemographic variables showed a higher percentage of victimization at the age of 6 to 9 and 14 to 17 years old, in children and adolescents who were in the first and second cycle of elementary school and were Chilean. It was found that children victimized by child sexual abuse and bullying also had a drug diagnosis record. Logistic regression analyses showed that gender, age, schooling, nationality, and a drug diagnosis record increase the probability of occurrence of certain types of victimization. The results showed the magnitude of the problem concerning victimizations experienced by children and adolescents in northern Chile and the need to generate prevention strategies for this population.
El presente estudio tuvo como objetivo identificar la proporción de victimización, tipos de victimización y factores de riesgo asociados a los niños, niñas y adolescentes que ingresaron a un Centro de Protección a la infancia en el norte de Chile durante los años 2016 y 2017. Se utilizaron datos secundarios de la base de datos del sistema de protección a la infancia. La muestra fue no probabilística e incluyó 6.499 casos. La investigación fue descriptiva-comparativa con un diseño no experimental retrospectivo de corte transversal. Los resultados mostraron un mayor porcentaje de victimización por negligencia, seguido por presenciar violencia doméstica y abuso sexual infantil. Las variables sociodemográficas mostraron un mayor porcentaje de victimización en la edad de 6 a 9 y de 14 a 17 años, en niños y adolescentes que cursaban el primer y segundo ciclo de primaria y eran chilenos. Se encontró que los niños víctimas de abuso sexual infantil y bullying también tenían un registro de diagnóstico de drogas. Los análisis de regresión logística mostraron que el género, la edad, la escolaridad, la nacionalidad y un registro de diagnóstico de drogas aumentan la probabilidad de ocurrencia de ciertos tipos de victimización. Los resultados evidencian la magnitud del problema de las victimizaciones que sufren los niños, niñas y adolescentes del norte de Chile y la necesidad de generar estrategias de prevención para esta población.
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This study aimed to describe the Adverse Childhood Experiences (ACE) of perpetrators of sexual violence of children and adolescents and their relationship with the abusers' personal and situational factors (n = 30). Hence, a database composed of the transcripts of interviews was analyzed using content analysis, from which thematic categories emerged as proposed by the Adverse Childhood Experiences International Questionnaire (ACE-IQ). Physical abuse was the most frequently reported (70%). Sexual abuse was reported by almost half of the sample, which presented an increased risk in the face of the death and/or divorce of parents (RR = 4.21) and emotional neglect (RR = 3.2). In addition, the participants with higher ACE-Scores abused children more recurrently and less frequently consumed alcohol or other drugs. The interpretation of the results in light of the literature reinforces the hypothesis that the consequences of adversities during childhood are associated with a higher likelihood of becoming a victim throughout life and manifesting risky behaviors, such as aggressive sexual behavior. Future studies are suggested to apply the ACE-IQ to larger samples and implement a post-test to contribute to more effective interventions to treat this population.
Este estudio tuvo como objetivo analizar las Experiencias Adversas en la Infancia por parte de los perpetradores de agresión de niños y niñas y la asociación con factores personales y situacionales identificados. (n = 30). Para ello, se utilizó el instrumento de cribado del Cuestionario Internacional de Experiencias Adversas en la Infancia (ACE-IQ) para el análisis de los datos. El maltrato físico fue reportado con mayor frecuencia (70%) y el abuso sexual fue mencionado por casi la mitad de la muestra, con su riesgo aumentado ante la muerte y/o divorcio de los padres (RR = 4,21) y negligencia emocional (RR = 3.2). Participantes con ACE-Scores más altos han agredido repetidamente a sus víctimas y con menos necesidad de consumir alcohol y/o otras drogas. Los resultados muestran que las consecuencias de la exposición a la adversidad en la infancia están asociadas no solo a la probabilidad de convertirse en víctima a lo largo de la vida, sino también a caminos de transitar permeados por conductas de riesgo y criminalidad. Se sugiere que más estudios puedan aplicar el ACE-IQ a muestras más grandes, con la realización de una prueba posterior, lo que puede contribuir a intervenciones más efectivas al servicio de esta población.
Este estudo objetivou descrever Experiências Adversas na Infância (EAI) relatadas por autores de agressão sexual de crianças e adolescentes e sua relação com fatores pessoais e situacionais identificados (n = 30). Para tanto, utilizou-se um banco de dados formado por transcrições de entrevistas previamente realizadas, cuja análise de conteúdo considerou categorias temáticas retiradas do Adverse Childhood Experiences International Questionnaire (ACE-IQ). O abuso físico foi o mais relatado (70%) e o abuso sexual mencionado por quase metade da amostra, tendo seu risco aumentado diante da morte e/ou separação dos pais (RR = 4.21) e negligência emocional (RR = 3.2). Participantes com maiores ACE-Scores agrediram de forma mais recorrente e com menor uso de álcool e/ou outras drogas. A interpretação dos resultados à luz da literatura da área reforça a hipótese de que as consequências da exposição à adversidade na infância estão relacionadas tanto à probabilidade de tornar-se vítima ao longo da vida quanto de vir a manifestar comportamentos de risco, como a conduta sexual agressiva. Estudos posteriores poderão aplicar o ACE-IQ diretamente e em amostras maiores, com a realização de pós-teste, o que favorecerá a promoção de intervenções mais eficazes no atendimento a essa população.
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Humanos , Masculino , Femenino , Niño , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Adulto Joven , Abuso Sexual Infantil/psicología , Encuestas y Cuestionarios , Criminales/psicología , Experiencias Adversas de la Infancia , Estudios Retrospectivos , Abuso Físico/psicologíaRESUMEN
Resumen El Servicio Mejor Niñez es un organismo público que tiene como objetivo garantizar la protección de derechos de niños, niñas y adolescentes al amparo de la Ley N.º 21302. En los últimos años, se ha visto cuestionado tanto por la opinión pública como por organismos internacionales, por incumplimiento de las funciones para la cual se creó. En esta línea, el objetivo de esta investigación se centró en la percepción de los profesionales interventores sobre la vulneración de derechos sobre niños, niñas y adolescentes en la zona centro-sur de Chile. Estas personas son profesionales en Psicología y Trabajo Social que durante años han trabajado en programas de protección de vulneración de derechos, y han desempeñado un rol protector en cuanto a la protección de estos derechos. Para ello, se utilizó un método cualitativo basado en un enfoque fenomenológico, a partir de entrevistas que permitieron conocer los significados y percepciones sobre su ejercicio profesional. Los resultados destacan la visión opuesta y extrema de los profesionales sobre el proceso de intervención (satisfactoria y frustrante), así como la diversidad de modelos o enfoques utilizados en el proceso, lo que parece indicar que no existe una sistematización teórica en cuanto a la intervención que cada programa utiliza. Se estableció una reflexión importante sobre la ejecución de políticas en infancia y adolescencia que buscan promover el desarrollo integral en el marco postpandemia por COVID-19, considerando que muchas personas menores de edad se vieron nuevamente expuestas a vulneraciones de derechos durante el proceso de pandemia.
Abstract The Childhood Improvement Service is a public agency whose objective is to guarantee protection of the rights of children and adolescents with respect to the enactment of Law No. 21302. This has been questioned in recent years by both public opinion and international organizations, in relation to a failure to fulfill the functions for which it was created. In this sense, the objective of this research focused on the perception of professionals involved in children's and adolescents' rights in the central-south zone of Chile. The professionals are psychologists and social workers who have worked to protect the rights circumscribing the different types of interventions and multidisciplinary approaches carried out. For this purpose, a qualitative method was used in phase with a phenomenological approach, based on interviews that allowed ascertaining the meanings and perceptions regarding their professional practice. The results highlight the opposed and extreme views of the professionals in the intervention process (satisfactory versus frustrating), as well as the diversity of models or approaches used in the process, which seems to indicate that there is no theoretical systematization regarding the intervention applied by each program. Establishing an important reflection on the implementation of policies in childhood and adolescence that seek to promote integral development in the post-Covid-19 Pandemic framework.
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Humanos , Masculino , Femenino , Defensa del Niño , Estudio de Vulnerabilidad , Chile , Entrevista , COVID-19RESUMEN
The sale of soft drinks in and around primary schools is recurrent in Côte d'Ivoire. The objective of this work is to evaluate the rate of some biochemical and physicochemical parameters and the health risks related to the consumption of soft drinks. The biochemical and physicochemical parameters were determined according to the standard SOXHLET technique, that of Kjeldhal and also that described by Dubois et al in1956. Potentially pathogenic and pathogenic germs were enumerated and researched according to reference methods described by AFNOR. The moisture content of the different beverages ranged from 3.9±0.05 to 3.2±0.05, and the sugar content from 26.06±2.05 to 5.96±1.60. For the acidity, the higher value was 0.93± 0.15 (Bissap juice) and the lowest was 0.64± 0.02 (Tamarind juice). For proteins, the high value was 44.15 ± 0.11 (Milk Mint Juice) and the low value was 38.15 ± 0.11 (Ginger Juice). As for dry matter, the highest value was found in ginger juice (44.76 ±0.02) and the lowest in bissap juice (40.96 ±0.01). Soft drinks sold in Williamsville schools contain such potentially pathogenic species as Staphylococcus aureus and Bacillus cereus with a wide range of loadings in the drinks. Escherichia coli was not identified. No Salmonella was observed in the different soft drinks analyzed. The presence of potentially pathogenic germs could pose a danger to school children.
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Resumen Introducción: El tratamiento del TDAH es seguro y eficaz, pero con frecuencia existen bajos niveles de adherencia al tratamiento. En este artículo describimos factores asociados a la adherencia des critos en la literatura disponible. Métodos: Realizamos una búsqueda bibliográfica no sistemática sobre artículos recientes sobre la adherencia a la medicación en niños y adolescentes con TDAH. Resultados: Hay factores asociados al propio trastorno, al paciente, al sistema de salud, factores socio-económicos, a la medicación y al entorno que pueden reducir o aumentar la adherencia a la medicación. Algunos factores que mejoran la adhe rencia incluyen: el conocimiento sobre el TDAH, la medicación y sus beneficios y efectos adversos potenciales. Regímenes de medicación sencillos, una vez al día y de liberación prolongada. Edad del paciente menor de 12 años y sexo femenino. Menos barreras de acceso al sistema de salud. Actitud positiva y proactiva de los padres respecto al TDAH y el uso de medicación. Discusión: Se podría optimizar la adherencia y por lo tanto mejorar el pronóstico a largo plazo del TDAH reforzando estos factores que aumentan la adherencia, y reduciendo los sesgos y desconocimiento sobre el TDAH.
Abstract Introduction: ADHD treatment is safe and effective, but often, adherence to t reatment is suboptimal. We studied factors associated to adherence to treatment in ADHD described in the literature. Methods: We conducted a non-systematic bibliographic search on recent articles on medication adherence in children and adolescents with ADHD. Results: There are factors associated with the disorder itself, the patient, the health system, socio-economic factors, the medication and the environment that can reduce/improve medication adherence. Some factors that improve adherence include: knowledge about ADHD, medication and its benefits and potential adverse effects. Simple, once-daily, extended-release medication regimens. Age of the patient less than 12 years and female sex. Fewer barriers to access the health system. Positive and proactive attitude of parents regarding ADHD and the use of medication. Discussion: Adherence could be optimized and therefore the long-term prognosis of ADHD improved by reinforcingfactors that increase adherence, and reducing biases and ignorance about ADHD.
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@#Abstract: Objective To explore the regional, age and annual characteristics of distribution and variation trend of children and adolescents with poor vision in Hainan Province, and to provide a theoretical basis for the formulation of targeted and effective prevention and treatment strategies. Methods The eyesight monitoring data of 5 657 231 children and adolescents aged 6 to 19 from 17 cities and counties in Hainan Province from 2013 to 2020 were analyzed. Using the "Standard Logarithmic Vision Chart" (GB11533-2011) that complies with national standards for testing. Results The rate of poor vision among children and adolescents in Hainan Province increased significantly from 2013 to 2020, and the difference between the years was statistically significant (P<0.001). The total poor vision rate in the left eye increased 10.09% (32.79% to 42.88%), and that of severe poor vision rate increased 6.68%, while that of the right eye increased 9.80% (33.11% to 42.91%) and 6.49%. The poor vision rate was significantly higher in females than in males of same year (P<0.001), but the increase pattern was the same. In 2020, there were significant differences between the same age groups in different cities and counties and between different age groups in the same city and county (P<0.001), and they all tended to increase with age. The result of analyzing the distribution characteristics of the total poor vision rate of different age groups children in the eastern (Qionghai), southern (Sanya), western (Changjiang), northern (Haikou) and central (Dingan) cities showed that the regional rate difference was small at 6-7 years old, and then increased with the increase of age. The poor vision rate of Haikou City ranked the first in all age groups, and reached the highest at 17 years old, with 76.32% and 80.89% of total poor vision rate of left and right eyes respectively. Sanya City ranked second, Qionghai ranked third. The poor vision rate of Changjiang County was lower and the growth rate was slower according to age. Conclusions From 2013 to 2020, the total and severe poor vision rates in left and right eyes of children aged 6-19 in Hainan Province increased year by year, with the ascension range of female higher than that of male, and right eye higher than that of left eye. In the same year, the poor vision rate increase rapidly with age. It is recommended to further strengthen the daily intervention and management of key populations and special age groups to reduce the rate of low vision in children and adolescents.
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Pediatric and adult spinal cord injuries (SCI) are distinct entities. Children and adolescents with SCI must suffer from lifelong disabilities, which is a heavy burden on patients, their families and the society. There are differences in Chinese and foreign literature reports on the incidence, injury mechanism and prognosis of SCI in children and adolescents. In addition to traumatic injuries such as car accidents and falls, the proportion of sports injuries is increasing. The most common sports injury is the backbend during dance practice. Compared with adults, children and adolescents are considered to have a greater potential for neurological improvement. The pathogenesis and treatment of pediatric SCI remains unclear. The mainstream view is that the mechanism of nerve damage in pediatric SCI include flexion, hyperextension, longitudinal distraction and ischemia. We also discuss the advantages and disadvantages of drugs such as methylprednisolone in the treatment of pediatric SCI and the indications and timing of surgery. In addition, the complications of pediatric SCI are also worthy of attention. New imaging techniques such as diffusion tensor imaging and diffusion tensor tractography may be used for diagnosis and assessment of prognosis. This article reviews the epidemiology, pathogenesis, imaging, clinical characteristics, treatment and complications of SCI in children and adolescents. Although current treatment cannot completely restore neurological function, patient quality of life can be enhanced. Continued developments and advances in the research of SCI may eventually provide a cure for children and adolescents with this kind of injury.
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Adulto , Niño , Humanos , Adolescente , Imagen de Difusión Tensora/métodos , Calidad de Vida , Traumatismos de la Médula Espinal/terapia , Pronóstico , Traumatismos en Atletas , Médula Espinal/patologíaRESUMEN
Objective@#To investigate the clustering of health-risk behaviors and its influencing factors among children and adolescents in Yancheng City, Jiangsu Province, so as to provide insights into the prevention and control of health-risk behaviors among children and adolescents. @*Methods@#Students were randomly sampled from 4 primary schools, 4 junior high schools and 4 senior high schools in Yancheng City using a multi-stage stratified cluster random sampling method from September to December 2021. Students' demographics and 12 health-risk factors including unhealthy diet, insufficient physical activity and attempted smoking were collected using the Student's Health Status and Influencing Factors Questionnaire by Jiangsu Provincial Center for Disease Control and Prevention, and factors affecting the clustering of health-risk behaviors were identified using a multivariable linear regression model.@*Results@#A total of 2 925 valid questionnaires were recovered, and the respondents included 1 611 boys (55.08%) and 1 314 girls (44.92%). A total of 2 896 respondents were detected with health-risk behaviors, with a detection rate of 99.09%, and 2 772 respondents were detected with clustering of health-risk behaviors (93.06%). Insufficient sleep, insufficient physical activity and insufficient duration of outdoor activity were predominant patterns of clustering. The median number of health-risk behaviors was 4.00 (interquartile range, 2.00) per capita. Multivariable linear regression analysis showed that boys (β=0.232), grade (junior high school, β=0.519; senior high school, β=0.427), urban area (β=0.241), living at school (β=0.395), family structure (single parental family, β=0.188; other families, β=0.344) and father's education level of primary school and below (β=0.369) were factors affecting clustering of health-risk behavior among primary and high school students. @*Conclusions@#The detection of health-risk behaviors is high among children and adolescents in Yancheng City, and insufficient sleep, insufficient physical activity and insufficient duration of outdoor activity are predominant health-risk behaviors. Boys, junior high school and above, urban areas, living at schools, single parents, and fathers with a low educational level lead to a high degree of clustering of health-risk behaviors.
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A demand-capacity mismatch exists between the services for child and adolescent mental health and the needs of society， and the contradiction is becoming increasingly prominent. This study aims to present a thorough analysis of the current status of research in child and adolescent mental disorders and the direction of discipline development， which consists of the epidemiology， etiology and pathogenesis， diagnostic progress， treatment progress and disciplinary development in child and adolescent mental disorders. Mental disorders in children and adolescents are known to have a high prevalence rate， and the disease is most likely to continue into adulthood if it is not identified and treated in a timely manner， posing a serious burden on patients， families and society. Currently， the etiology and pathogenesis of mental disorders in children and adolescents still remain unclear due to its complexity and the numerous interrelated contributing factors such as genetics， environment， stress events and so on. And the diagnosis is limited to symptomatology and lacks objective indicators. Therapeutically， the various treatment options available have shown certain clinical effectiveness， while suboptimal treatment outcomes have been reported among some children， which require multidisciplinary comprehensive intervention. Furthermore， the research on imaging genetics， new drug-target search， wise information technology of med and brain sciences needs to be strengthened， thus providing a broader approach to better address the needs of mental health services for children and adolescents.
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The purpose of this paper is to review the research status on non-suicidal self-injury （NSSI） in children and adolescents， so as to provide references for the cognition and intervention of NSSI behavior in children and adolescents. NSSI behavior is an independent risk factor for suicide， which not only poses a serious threat to the mental health of children and adolescents， but also brings a great burden on families and society. This paper focuses on the epidemiology， etiology， relationship with other psychiatric disorders， and treatment of NSSI behaviors in children and adolescents.
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Objective:To study the effect of continuous subcutaneous insulin infusion(CSII)on the emotional disorder of children and adolescents with type 1 diabetes mellitus(T1DM)and their parents.Methods:A total of 72 children and adolescents with T1DM were divided into CSII group( n=40)and multiple daily injection(MDI)group( n=32).There were 58 healthy children and adolescents with their parents selected as control group.The emotional condition of children and adolescents in T1DM group and control group was evaluated by Depression Self-rating Scale for Children(DSRS)and the Screen for Child Anxiety Related Emotional Disorders(SCARED)respectively, and Symptom Checklist-90(SCL-90)was used for evaluating the mental health of all parents. Results:The average glycated hemoglobin A1c(HbA1c)of T1DM group was at the optimal level(7.406±1.294)%.The average HbA1c of CSII group was significantly lower than that of MDI group[(7.040±1.082)% vs(7.863±1.404)%, t=2.728, P=0.008].The depression rate of children and adolescents in T1DM group increased significantly than that of control group(31.9% vs 15.5%, χ2 =4.671, P=0.031).There were statistically significant differences among CSII group, MDI group and control group(20.0% vs 46.9% vs 15.5%, χ2 =11.591, P=0.003).The depression rate of children and adolescents in MDI group increased significantly than that of CSII group and control group(all P<0.05).CSII group showed similar results as compared with control group( P>0.05).Concerning the anxiety in children and adolescents, there was no significant difference between T1DM group and control group(19.4% vs 13.8%, χ2=0.730, P=0.393), and there were no significant differences among CSII group, MDI group and control group(15.0% vs 25.0% vs 13.8%, χ2=1.994, P=0.369).The emotional disorder prevalence of parents in T1DM group was remarkably higher than that of the control group(31.9% vs 5.2%, χ2=52.927, P<0.01).The factor scores of obsessive-compulsive symptoms, interpersonal sensitivity, depression, anxiety, hostility, paranoia and psychotic symptoms in T1DM group were higher than that of control group( P<0.05).There were statistically significant differences among CSII group, MDI group and control group(17.5% vs 50.0% vs 5.2%, χ2=26.126, P<0.01).The emotional disorder prevalence of parents in MDI group increased significantly than that of CSII group and control group(all P<0.05).But CSII group was same as that of control group( P>0.05). Conclusion:The children and adolescents with T1DM and their parents were high-risk population of emotional disorder.CSII can reduce not only the depression in the children and adolescents with T1DM, but also emotional disorder of their parents, thus CSII can improve the mental health in families suffering from T1DM.
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In February 2022, the German Society of Pediatric and Adolescent Medicine published the first Evidence-based Recommendations for the Treatment and Prevention of Non-specific Back Pain in Children and Adolescents, which provides clinical evidence and recommendations for the etiology, risk factors and diagnosis of back pain in children and adolescents, and the treatment and prevention suggestions on the non-specific back pain.Although the guideline for the diagnosis and treatment of non-specific low back pain have been launched in China, a specific description of back pain in children and adolescents is lacking.With regard to increasing incidence of low back pain in children and adolescents, and differences in term of the etiology, risk factors, diagnosis and treatment of back pain between children-adolescents and adults, this article aims to interpret the guidelines to provide references and guidance for the clinical diagnosis and treatment of back pain in children and adolescents.