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3.
Ethics Hum Res ; 46(1): 26-36, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38240397

RESUMO

In 2021, we were designing a research study in Sweden in which we planned to use newspaper articles focusing on children and adolescents under the age of eighteen during the Covid-19 pandemic as empirical material. As we developed this study, an ethical question arose: do studies using journalistic articles that may contain health information about individuals as empirical material have to be approved by an ethics review committee? Sweden, in contrast to other countries, requires the approval of an ethics review committee for the use of publicly available material in research when such material might include sensitive personal data such as health-related information. This case study calls for harmonized laws and policies that support global research by clarifying what kinds of empirical material and what types of research must be assessed by national ethics review committees, including with consideration for children's safety and rights.


Assuntos
Revisão Ética , Comitês de Ética em Pesquisa , Criança , Adolescente , Humanos , Suécia , Pandemias , Menores de Idade
4.
Transcult Psychiatry ; 61(1): 47-59, 2024 02.
Artigo em Inglês | MEDLINE | ID: mdl-37097911

RESUMO

Unaccompanied refugee minors (URMs) are a group in an especially vulnerable situation with heightened psychological suffering due to both stressful life events and current daily stressors. Research has shown that certain coping strategies such as avoidance can be adaptive in the face of ongoing stress. We conceptualize social support as an essential coping resource that these strategies tap into. Since the interrelations between these factors are often not clear in the literature, this study strives to identify and link URMs' coping strategies, the respective coping resources and the various stressors they target, shortly after arrival in a high-income country. Seventy-nine URMs from various backgrounds were recruited in two first-phase reception centers in Belgium. In addition to self-report questionnaires to assess stressful life events and current daily stressors, we conducted semi-structured interviews, with cultural mediators if required. Thematic analysis was applied to the participants' accounts and resulted in the identification of four coping strategies: avoidance and distraction, continuity and coherence, selective reliance, and positive appraisal and acceptance. The relation between these coping strategies, the various coping resources used, and the specific stressors at which they aim are discussed. We conclude that avoidant coping and contact with the ethnic community, particularly the peer group, are fundamental strategies for successful coping. Practitioners need to support URMs in their coping efforts by providing and facilitating appropriate coping resources.


Assuntos
Refugiados , Transtornos de Estresse Pós-Traumáticos , Humanos , Bélgica , Refugiados/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Menores de Idade/psicologia
5.
J Clin Child Adolesc Psychol ; 53(1): 24-36, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-36726050

RESUMO

The number of unaccompanied immigrant minors (UIMs) and families from Central America seeking asylum in the U.S. continues to rise. This growth, combined with restrictive government policies, led to crowded and suboptimal conditions in Customs and Border Patrol and non-governmental organization facilities. COVID-19 further taxed facilities and exacerbated uncertainty surrounding length of detention, basic human rights, and family reunification. The current project features testimonies from the authors who work as clinical experts and providers in Texas - a top destination for Central American immigrants. In collaboration with a deputy director of a not-for-profit human rights organization, volunteer psychologists, and the director of a humanitarian respite center, we describe challenges faced by administrators and clinical staff in addressing the mental health needs of immigrant children and families during the COVID-19 pandemic. The primary themes identified were anti-immigrant policies that occurred concurrently with COVID-19; difficulty implementing COVID-19 protocols alongside scarcity of supplies and volunteers; increased mental health needs among UIMs and immigrant families; and challenges in UIM placement upon release from custody. Strategies for addressing clinical challenges in the near- and long-term and opportunities for improvement in care systems to immigrant youth, including correcting anti-immigrant policies, addressing ongoing COVID-19 protocols and challenges, meeting mental and physical health needs, facilitating release and reunification for unaccompanied immigrant minors, and maximizing youth resilience through trauma-informed interventions, are presented.


Assuntos
COVID-19 , Emigrantes e Imigrantes , Criança , Adolescente , Humanos , Pandemias , Menores de Idade/psicologia , Saúde Mental
6.
J Med Ethics ; 50(3): 157-162, 2024 Feb 20.
Artigo em Inglês | MEDLINE | ID: mdl-37169548

RESUMO

Developmentally, adolescence sits in transition between childhood and adulthood. Involving adolescents in their medical decision-making prompts important and complex ethical questions. Originating in the UK, the concept of Gillick competence is a dominant framework for navigating adolescent medical decision-making from legal, ethical and clinical perspectives and is commonly treated as comprehensive. In this paper, we argue that its utility is far more limited, and hence over-reliance on Gillick risks undermining rather than promoting ethically appropriate adolescent involvement. We demonstrate that Gillick only provides guidance in the limited range of cases where legal decisional authority needs to be clarified. The range of cases where use of Gillick actually promotes adolescent involvement is narrower still, because several features must be present for Gillick to be enacted. Each of these features can, and do, act as barriers to adolescent involvement. Within these limited situations, we argue that Gillick is not specific or strong enough and is reliant on ethically contestable principles. Moreover, in most situations in adolescent healthcare, Gillick is silent on the ethical questions around involving adolescents. This is because it focuses on decisional authority-having the final say in decision-making-which is one small subset of the many ways adolescents could be involved in decision-making. The implication of our analysis is that use of Gillick competence tends to limit or undermine adolescent involvement opportunities. We propose that those working with adolescents should be judicious in seeking Gillick's guidance, instead drawing on and developing alternative frameworks that provide a comprehensive model for adolescent involvement.


Assuntos
Consentimento Livre e Esclarecido , Menores de Idade , Adolescente , Humanos , Criança
7.
Drug Alcohol Rev ; 43(1): 141-155, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37934620

RESUMO

ISSUES: Young people are particularly impressionable when it comes to forming expectations and attitudes around alcohol consumption. Any stimuli that normalise and foster positive expectations around alcohol use may increase the risk of underage alcohol consumption. Alcohol venues that market themselves as being appropriate 'family friendly' establishments for children risk exposing minors to environments that are saturated with alcohol-related stimuli. However, research examining how exposure to licenced venues affects underage people is very limited. The aim of this narrative review was to identify and synthesise relevant evidence to better understand how attending these venues might affect minors. APPROACH: A narrative review of research published between January 2016 and November 2022 was conducted to investigate the potential effects on underage people of exposure to licenced venues and stimuli encountered in/around these venues. Examined stimuli included alcohol advertising, people consuming alcohol and alcohol outlets. KEY FINDINGS: The reviewed literature indicates that the risk of alcohol-related harm among minors is likely to increase with greater exposure to alcohol venues due to the associated exposure to alcohol advertising, exposure to others consuming alcohol and higher outlet density. In combination, these factors are likely to normalise alcohol consumption for minors and create positive alcohol expectancies. IMPLICATIONS AND CONCLUSION: Venues serving alcohol should be discouraged from targeting families and parents should be warned about the risks associated with taking minors to venues where alcohol is sold and consumed.


Assuntos
Bebidas Alcoólicas , Consumo de Álcool por Menores , Criança , Humanos , Adolescente , Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/efeitos adversos , Etanol , Publicidade , Menores de Idade
9.
Rev Med Suisse ; 19(855): 2412-2415, 2023 Dec 20.
Artigo em Francês | MEDLINE | ID: mdl-38117112

RESUMO

Growing up in a climate of domestic violence can have serious repercussions on the health and development of minors. The Child Abuse and Neglect Team (CAN Team) specializes in detecting and analyzing this type of violence. Based on the literature, a tool for structuring the clinical assessment of the child's situation has been created, considering the context of the violence and the risk and protective factors. The tool is described in this article, which offers recommendations for primary care physicians in assessing the danger to a child or adolescent's development.


Grandir dans un climat de violences conjugales peut avoir de graves répercussions sur la santé et le développement des mineurs. Le CAN Team (Child Abuse and Neglect Team), groupe hospitalier de protection de l'enfant, est spécialisé dans la détection et l'analyse de ce type de violences. Sur la base de la littérature, un outil permettant de structurer l'évaluation clinique de la situation de l'enfant a été élaboré, en tenant compte du contexte de violences et des facteurs de risque et de protection. Cet instrument est décrit dans cet article qui propose des recommandations aux médecins de premier recours pour apprécier le danger pesant sur l'évolution de l'enfant ou de l'adolescent.


Assuntos
Violência Doméstica , Criança , Adolescente , Humanos , Violência Doméstica/prevenção & controle , Menores de Idade
10.
Artigo em Inglês | MEDLINE | ID: mdl-37998285

RESUMO

Tobacco vendors are critical stakeholders in the tobacco supply chain. This study examined their perception, compliance, and potential economic impact of Nigeria's tobacco control laws related to the retail setting. This was a qualitative study involving in-depth interviews of 24 purposively selected tobacco vendors. The face-to-face interviews were aided by a semi-structured interview guide, audio-recorded, transcribed verbatim, and analyzed using thematic analysis with NVivo version 12. Five themes emerged, encompassing reasons for selling tobacco, awareness, perception, compliance with tobacco sales laws, the potential economic impact of the laws, and law enforcement activities. Vendors commenced tobacco sales due to consumers' demand, profit motives, and advice from close family relatives. They were unaware and non-compliant with most of the retail-related laws. Most participants had positive perceptions about the ban on sales to and by minors, were indifferent about the ban on Tobacco Advertising Promotion and Sponsorships (TAPS) and product display, and had negative perceptions about the ban on sales of single sticks. Most vendors stated quitting tobacco sales would not have a serious economic impact on their business. In conclusion, the vendors demonstrated limited awareness and non-compliance with various retail-oriented tobacco control laws in Nigeria. Addressing these gaps requires targeted educational campaigns and effective law enforcement strategies to enhance vendors' compliance.


Assuntos
Produtos do Tabaco , Humanos , Controle do Tabagismo , Nigéria , Comércio , Menores de Idade
11.
BMJ Open ; 13(11): e072411, 2023 11 03.
Artigo em Inglês | MEDLINE | ID: mdl-37923349

RESUMO

OBJECTIVES: The minimum age for cigarette sales in Thailand was increased from 18 to 20 years, as stipulated in the Tobacco Products Control Act B.E. 2017. This study investigated tobacco retailers' perceptions, cigarette sales behaviour and other factors relevant to selling cigarettes to people younger than 20 years in areas surrounding schools in Thailand. DESIGN: Cross-sectional survey. SETTING: Tobacco shops within a radius of 500 m of secondary schools across four regions of Thailand. Data collection took place between May and August 2019. PARTICIPANTS: 1440 tobacco retailers (grocery or convenience stores) were sampled via a stratified, two-stage cluster sampling method. 1021 retailers completed the self-administered questionnaire. OUTCOME MEASURES: Tobacco sales to people younger than 20 years. RESULTS: The prevalence of the retailers' cigarette sales to youth younger than 20 years was 38.20% (95% CI 35.2% to 41.3%). Multivariable logistic regression analysis revealed associations with sale of single cigarettes (adjusted OR (AOR) 23.14, 95% CI 15.13 to 35.39), self-service sale of cigarettes (4.21, 2.59 to 6.86) and display of cigarettes at the point of sale (2.39, 1.47 to 3.89). Cigarette sales to underage youth were higher among retailers located in the northeast region (AOR 2.09, 95% CI 1.20 to 3.64) and among those who did not perceive the prosecution of violators in the past year (1.85, 1.16 to 2.96). CONCLUSION: A large percentage of cigarette retailers violated the laws related to underage cigarette sales. Measures to minimise retailers' legally non-compliant sales behaviours should be implemented along with improved legal enforcement.


Assuntos
Produtos do Tabaco , Adolescente , Humanos , Adulto Jovem , Adulto , Estudos Transversais , Tailândia , Menores de Idade , Percepção
12.
Psychosoc Interv ; 32(3): 155-163, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37691716

RESUMO

Sexual solicitation and sexualized interaction with minors by adults constitute one of the most pernicious risks of the Internet. Little is known about the age range in which this phenomenon is most prevalent or the relationship and overlap of this problem with other risks, such as peer-to-peer cybervictimization and cyber dating abuse. Additionally, little empirical evidence exists on whether the overlap between these types of online victimization affects health-related quality of life (HRQoL). This study aimed to: 1) analyze the prevalence of sexual solicitation and interaction according to sex and stage of adolescence; 2) relate this problem to other forms of online victimization (cybervictimization and cyber dating abuse); 3) analyze the overlap between these forms of online victimization and differences in HRQoL scores. A cross-sectional and analytical study with 3,578 adolescents (52.7% girls) aged between 10-15 years was carried out. Of the adolescents in the study sample, 12.6% (n = 448) had received sexual requests and 6.4% (n = 230) had interacted sexually with adults. Sexual solicitation was most common among girls in middle adolescence. Of the participants, 33.9% (n = 1,216) had been involved in some form of online victimization. Peer cybervictimization and cyber dating abuse were positively and significantly correlated with sexualized solicitation/interactions with adults. Victims with the overlapping of all three types of online victimization (2.7%, n = 98) presented the lowest HQRoL scores (p < .001).


La solicitación e interacción sexual con menores por parte de adultos constituyen uno de los riesgos más perniciosos de Internet. Se sabe poco sobre la franja de edad en el que es más frecuente o sobre la relación y el solapamiento de este problema con otros riesgos, como la cibervictimización entre iguales y el abuso online en la pareja. Además, existen pocas evidencias empíricas sobre si el solapamiento entre estos tipos de victimización afecta a la calidad de vida relacionada con la salud (CVRS). Los objetivos de este estudio fueron: 1) analizar la prevalencia de la solicitación/interacción sexual en función del sexo y la etapa de la adolescencia, 2) relacionar esta problemática con la cibervictimización entre iguales y el abuso online en la pareja, 3) analizar el solapamiento entre estas formas de victimización online y sus diferencias en las puntaciones de CVRS. Se trata de un estudio transversal y analítico con 3,578 adolescentes (52.7% chicas) entre 10-15 años. El 12.6% (n = 448) habían recibido solicitaciones sexuales y el 6.4% (n = 230) había interactuado sexualmente con adultos. La solicitación sexual fue más frecuente en chicas en la adolescencia media. Un 33.9% (n = 1,216) había sufrido algún tipo de victimización online. La cibervictimización entre iguales y el abuso online en la pareja correlacionaron positiva y significativamente con solicitaciones/interacciones sexualizadas con adultos. Las víctimas que solaparon los tres tipos de victimización online (2.7%, n = 98) presentaron las puntuaciones de CVRS más bajas (p < .001).


Assuntos
Bullying , Qualidade de Vida , Adolescente , Feminino , Humanos , Adulto , Criança , Masculino , Menores de Idade , Prevalência , Estudos Transversais
13.
JAMA Pediatr ; 177(12): 1356-1358, 2023 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-37747718

RESUMO

This cross-sectional study examines online marijuana dispensaries and their age verification procedures to prevent youth access.


Assuntos
Cannabis , Humanos , Menores de Idade , Comércio
14.
Adv Exp Med Biol ; 1425: 291-301, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37581803

RESUMO

Data related to the stress of employees in shelters for unaccompanied minors are scarce, especially when considering the escalation of the refugee issue. This study analyzed aspects of this issue as it was carried out in child protection organizations in Greece, which is a country where a huge number of immigrants and refugees pass through and thousands of professionals are employed in this field.More specifically, the aim of this study was to examine the stress (general, perceived, work-related) and burnout symptoms of a specific group of employees exposed to the COVID-19 quarantine restrictions, employees at the 'front line' of care in shelters that host unaccompanied minors and teenagers.The study was carried out from March 2020 to December 2021, when social restrictions and other preventive measures were imposed. The study sample was recruited from non-governmental organizations and shelters for unaccompanied minors, in the urban area of the center of Athens, i.e. the International Organization for Migration, The Home Project, Arsis, Iliachtida, and Zeuxis. The sample consisted of employees at the 'front line' of care in shelters that hosted unaccompanied minors and teenagers. Participants were professionals whose duty was to deal with and respond to the needs of children and adolescents within the shelters they lived in. Participants completed the following questionaires before and after the pandemic restrictions: the Job Stress Measure (JSM), the Maslach Burnout Inventory (MBI), the Perceived Stress Scale (PSS), the Stress in General Scale (SiGS) and a questionnaire of 11-items regarding COVID-19, focusing on the professionals' perceived stress, working conditions, working demands and the impact of COVID-19 on all the aforementioned.The study sample consisted of 50 employees (40 females, 10 males; mean age ± SD 31.46 ± 7.91 years) in hostels for unaccompanied minors. A statistically significant difference was found only in SiGS, with increased stress after COVID-19 (p = 0.001). In terms of sex, significant differences were found at baseline in PSS and Emotional Exhaustion (p = 0.036 and p = 0.028, respectively) (females revealed higher levels than males). Age and educational level were factors that interacted with the increased levels in SiGS after COVID-19 (p = 0.015 and p = 0.006, respectively). Moreover, significant differences were found at baseline in PSS (p = 0.004), with higher levels observed in employees with higher education. Workers who did not work remotely had lower levels in Personal Accomplishment after COVID-19 compared to employees who worked remotely (p = 0.050). Interestingly, the JSM showed a tendency for decreased stress levels after the implementation of the quarantine, suggesting that the employees' work-related stress remained approximately at the same levels. On the other hand, perceived stress increased as the job demands remained the same, while social and personal outlet was in appeasement.The necessity for more research to be held among health professionals is evident and is also imperative to carry out interventional studies to manage stress and thus, provide better mental health services to unaccompanied minors. There is also need for further research in similar populations of professionals outside the urban context of Athens, i.e. in the Greek islands near the sea borders, where the refugees' entries are higher in number and more frequent.


Assuntos
Esgotamento Profissional , COVID-19 , Estresse Ocupacional , Adolescente , Criança , Feminino , Humanos , Masculino , Atitude , COVID-19/epidemiologia , Menores de Idade/psicologia , Pandemias , Adulto Jovem , Adulto
15.
J Pediatr ; 262: 113589, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37399918

RESUMO

OBJECTIVE: To evaluate the ethics of involving adolescents in HIV research, we conducted a systematic review of the empiric literature. METHODS: Electronic databases Ovid Medline, Embase, and CINAHL were systematically searched using controlled vocabulary terms related to ethics, HIV, specified age groups, and empiric research studies. We reviewed titles and abstracts, including studies that collected qualitative or quantitative data, evaluated ethical issues in HIV research, and included adolescents. Studies were appraised for quality, data were extracted, and studies were analyzed using narrative synthesis. RESULTS: We included 41 studies: 24 qualitative, 11 quantitative, 6 mixed methods; 22 from high-income countries (HIC), 18 from low- or middle-income countries (LMIC), and 1 from both HIC and LMIC. Adolescent, parent, and community perspectives assert the benefits of involving minors in HIV research. Participants in LMIC expressed mixed views regarding parental consent requirements and confidentiality, given adolescents' both increasing autonomy and continued need for adult support. In studies in HIC, sexual or gender minority youth would not participate in research if parental consent were required or if there were confidentiality concerns. There was variation in the comprehension of research concepts, but adolescents generally demonstrated good comprehension of informed consent. Informed consent processes can be improved to increase comprehension and study accessibility. Vulnerable participants face complex social barriers that should be considered in study design. CONCLUSIONS: Data support the inclusion of adolescents in HIV research. Empiric research can inform consent processes and procedural safeguards to ensure appropriate access.


Assuntos
Infecções por HIV , Consentimento Livre e Esclarecido , Adulto , Adolescente , Humanos , Menores de Idade , Consentimento dos Pais , Pais , Confidencialidade
16.
Pediatr Radiol ; 53(10): 2054-2059, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37423916

RESUMO

BACKGROUND: Only verbal pregnancy screening is recommended for post-menarcheal females undergoing pelvic radiographs. In contrast, usually, a urine/serum pregnancy test for pelvic computed tomographic (CT) exams is required out of concern for higher radiation exposure. OBJECTIVE: To estimate patient-specific fetus absorbed dose to a potentially pregnant minor from an optimized dose CT of the pelvis for femoral version and surgical planning and provide evidence that such examinations of the pelvis can be performed with only verbal pregnancy screening. METHODS AND METHODS: A retrospective study was performed on 102 female patients between 12-18 years of age (15.4 ± 2.1 years) who underwent optimized dose CT of the pelvis for orthopedic evaluation of femoral version and surgical planning. Optimized CT exams were performed with weight-adjusted kVp and tube current modulation. Patient-specific dose from the optimized dose CT was calculated using the National Cancer Institute Dosimetry System for CT (NCICT) database by matching each patient to a phantom from the NCI non-reference phantom library based on patient sex, weight, and height. The calculated absorbed uterus dose was used as a surrogate for the fetus dose. Furthermore, patient-specific organ doses were used to estimate the effective dose. The strengths of the linear relationships between the dose metrics and patient characteristics were assessed using Pearson correlation coefficients through linear regression. RESULTS: The mean patient-specific effective dose for an optimized dose CT of the pelvis was 0.54 ± 0.20 mSv (range: 0.15-1.22 mSv). The mean estimated absorbed uterine dose was 1.57 ± 0.67 mGy (range: 0.42-4.81 mGy). Both effective dose and estimated uterine dose correlated poorly with patient physical characteristics (R = -0.26; 95% CI: [-0.43, -0.007] for age, R = 0.03; 95% CI: [-0.17, 0.22] for weight) but correlated strongly (R = 0.79, 95% CI: [0.7, 0.85]) with CTDIvol. CONCLUSION: The estimated fetus dose in case of pregnancy was significantly lower than 20 mGy for urine/serum pregnancy screening, suggesting that the pregnancy screening protocols in minors undergoing optimized dose CT require reassessment and may be safely performed by verbal attestation only.


Assuntos
Menores de Idade , Tomografia Computadorizada por Raios X , Gravidez , Humanos , Feminino , Adolescente , Doses de Radiação , Estudos Retrospectivos , Tomografia Computadorizada por Raios X/métodos , Feto/diagnóstico por imagem , Imagens de Fantasmas , Pelve/diagnóstico por imagem
17.
Pan Afr Med J ; 44: 157, 2023.
Artigo em Francês | MEDLINE | ID: mdl-37455891

RESUMO

In Tunis, the reported cases of children who are victims of sexual abuse have increased in recent years. Child psychiatrists are asked to perform a psychiatric evaluation and treat patients. The purpose of this study was to describe the socio-familial and clinical profile of children who were victims of sexual violence and to describe data concerning the circumstances and nature of sexual abuse. We conducted a descriptive and analytic, retrospective study of children examined by child psychiatrists practising at the Hédi CHAKER hospital in Sfax following sexual violence. The study covered the period from January 2011 to October 2017. Child psychiatrists evaluated 53 child sexual abuse cases during the study period. The victims were girls in 64.2% of cases, with an average age of 10 years and primary school students in 46.2% of cases. Intra-family conflict was reported in 16.6% of cases. Intra-familial abuse was reported in 25% of cases, touching and anal penetration were the most frequent types of violence observed (63.5% of cases and 26.9% of cases respectively). More than half of children who were victims had a psychiatric disorder (post-traumatic stress in 32.7% of cases). This study shows that child sexual abuse is a complex problem with serious consequences. Measures must be taken to ensure children have adequate treatment.


Assuntos
Abuso Sexual na Infância , Maus-Tratos Infantis , Feminino , Criança , Humanos , Masculino , Menores de Idade , Estudos Retrospectivos , Violência
19.
Rev Med Suisse ; 19(830): 1127-1131, 2023 Jun 07.
Artigo em Francês | MEDLINE | ID: mdl-37283381

RESUMO

The use of controlled substances (narcotics and psychotropic substances) poses increased risks for minors. However, minors are generally excluded from existing harm reduction services (e.g. drug consumption rooms, drug checking, exchange of consumption material). Based on public health considerations, the authors recommend the establishment of harm reduction services for minors.


La consommation de substances soumises à contrôle (stupéfiants et substances psychotropes) présente des risques accrus pour les mineur-e-s. Pourtant, ces derniers sont généralement exclus des offres existantes de réduction des risques et des méfaits (par exemple, locaux de consommation, drug checking, échange de matériel de consommation). Sur la base de considérations de santé publique, les auteurs recommandent la création de services de réduction des risques dédiés aux mineur-e-s.


Assuntos
Menores de Idade , Transtornos Relacionados ao Uso de Substâncias , Humanos , Redução do Dano , Saúde Pública , Psicotrópicos/efeitos adversos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle
20.
BMJ Open ; 13(6): e069237, 2023 06 06.
Artigo em Inglês | MEDLINE | ID: mdl-37280032

RESUMO

INTRODUCTION: Asylum seekers and refugees are at an elevated risk of self-harm, with younger age and traumatic experiences found to further increase such risk. Despite this, evidence regarding self-harm among unaccompanied asylum seekers and refugee minors has not been synthesised. As self-harm among minors is a risk factor for a range of adverse clinical and social outcomes, including suicide, such information may help to inform evidence-based prevention strategies among these vulnerable populations. This systematic review will synthesise findings from the literature regarding the prevalence, methods and characteristics of self-harm, including risk and protective factors, among unaccompanied asylum seekers and refugee minors internationally. METHODS AND ANALYSIS: We searched key electronic databases (PsycINFO, Scopus, PubMed and Ovid MEDLINE) and grey literature for relevant studies published in English from database inception to 10 February 2023. Our primary outcome is self-harm among unaccompanied asylum seekers and/or refugee minors. With the exception of single-case studies, clinical trials and case-control studies, we will include all types of study design that examine the prevalence of self-harm in unaccompanied asylum seekers and/or refugee minors. We will exclude dissertations, conference abstracts, letters, book chapters, editorials, study registrations, registered protocols and qualitative studies. Only studies reporting on participants aged <18 years will be eligible for inclusion. The Methodological Standard for Epidemiological Research Scale will be used to assess the quality of included studies. If there are sufficient studies and homogeneity between them, we will conduct meta-analyses to calculate pooled estimates of self-harm rates, as well as comparisons between subgroups of relevance. If the studies do not report sufficient data, or there is substantial heterogeneity, we will provide a narrative synthesis of the findings. ETHICS AND DISSEMINATION: This review is exempt from ethics approval. Our findings will be disseminated through peer-reviewed publications and conference presentations. PROSPERO REGISTRATION NUMBER: CRD42021292709.


Assuntos
Refugiados , Comportamento Autodestrutivo , Transtornos de Estresse Pós-Traumáticos , Humanos , Menores de Idade , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Prevalência , Comportamento Autodestrutivo/epidemiologia , Revisões Sistemáticas como Assunto
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