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1.
Soins ; 65(843-844): 28-29, 2020.
Artigo em Francês | MEDLINE | ID: mdl-32563503

RESUMO

People of all ages leave their own country to migrate to France. Isolated foreign minors are received and assisted by France Terre d'Asile an association promoting human rights and providing support to people in need of protection. This article looks back on the experience of two young minors.


Assuntos
Menores de Idade , Apoio Social , Migrantes , França , Direitos Humanos , Humanos
2.
PLoS Med ; 17(3): e1003076, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32231358

RESUMO

BACKGROUND: Information regarding the prevalence of infectious diseases (IDs) in child and adolescent refugees in Europe is scarce. Here, we evaluate a standardized ID screening protocol in a cohort of unaccompanied refugee minors (URMs) in a municipal region of southwest Germany. METHODS AND FINDINGS: From January 2016 to December 2017, we employed a structured questionnaire to screen a cohort of 890 URMs. Collecting sociodemographic information and medical history, we also performed a standardized diagnostics panel, including complete blood count, urine status, microbial stool testing, tuberculosis (TB) screening, and serologies for hepatitis B virus (HBV) and human immunodeficiency virus (HIV). The mean age was 16.2 years; 94.0% were male, and 93.6% originated from an African country. The most common health complaints were dental problems (66.0%). The single most frequent ID was scabies (14.2%). Of the 776 URMs originating from high-prevalence countries, 7.7% and 0.4% tested positive for HBV and HIV, respectively. Nineteen pathogens were detected in a total of 119 stool samples (16.0% positivity), with intestinal schistosomiasis being the most frequent pathogen (6.7%). Blood eosinophilia proved to be a nonspecific criterion for the detection of parasitic infections. Active pulmonary TB was identified in 1.7% of URMs screened. Of note, clinical warning symptoms (fever, cough >2 weeks, and weight loss) were insensitive parameters for the identification of patients with active TB. Study limitations include the possibility of an incomplete eosinophilia workup (as no parasite serologies or malaria diagnostics were performed), as well as the inherent selection bias in our cohort because refugee populations differ across Europe. CONCLUSIONS: Our study found that standardized ID screening in a URM cohort was practicable and helped collection of relevant patient data in a thorough and time-effective manner. However, screening practices need to be ameliorated, especially in relation to testing for parasitic infections. Most importantly, we found that only a minority of infections were able to be detected clinically. This underscores the importance of active surveillance of IDs among refugees.


Assuntos
Doenças Transmissíveis/epidemiologia , Programas de Rastreamento/estatística & dados numéricos , Menores de Idade/estatística & dados numéricos , Refugiados/estatística & dados numéricos , Adolescente , África/etnologia , Doenças Transmissíveis/etiologia , Estudos Transversais , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Prevalência
3.
Pediatrics ; 145(5)2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32321778

RESUMO

BACKGROUND AND OBJECTIVES: A previous single-county study found that retail stores usually asked young-looking tobacco customers to show proof-of-age identification, but a large proportion of illegal tobacco sales to minors occurred after the customers had shown identification proving they were too young to purchase tobacco. We sought to investigate these findings on a larger scale. METHODS: We obtained state reports for federal fiscal years 2017 and 2018 from a federal agency that tracks tobacco sales to supervised minors conducting compliance checks in retail stores. We used descriptive and multivariable logistic regression methods to determine (1) how often stores in 17 states requested identifications, (2) what proportion of violations occurred after identification requests, and (3) if violation rates differed when minors were required versus forbidden to carry identification. RESULTS: Stores asked minors for identification in 79.6% (95% confidence interval: 79.3%-80.8%) of compliance checks (N = 17 276). Violations after identification requests constituted 22.8% (95% confidence interval: 20.0%-25.6%; interstate range, 1.7%-66.2%) of all violations and were nearly 3 times as likely when minors were required to carry identification in compliance checks. Violations were 42% more likely when minors asked for a vaping product versus cigarettes. CONCLUSIONS: Stores that sell tobacco to underage customers are more likely to be detected and penalized when youth inspectors carry identification during undercover tobacco sales compliance checks. The new age-21 tobacco sales requirement presents an opportunity to require identifications be carried and address other long-standing weaknesses in compliance-check protocols to help combat the current adolescent vaping epidemic.


Assuntos
Comércio/legislação & jurisprudência , Menores de Idade/psicologia , Registros/legislação & jurisprudência , Produtos do Tabaco/legislação & jurisprudência , Adolescente , Comércio/normas , Feminino , Humanos , Masculino , Registros/normas , Produtos do Tabaco/normas , Estados Unidos/epidemiologia
6.
MMWR Morb Mortal Wkly Rep ; 69(7): 189-192, 2020 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-32078593

RESUMO

Raising the minimum legal sales age (MLSA) for tobacco products to 21 years (T21) is a strategy to help prevent and delay the initiation of tobacco product use (1). On December 20, 2019, Congress raised the federal MLSA for tobacco products from 18 to 21 years. Before enactment of the federal T21 law, localities, states, and territories were increasingly adopting their own T21 laws as part of a comprehensive approach to prevent youth initiation of tobacco products, particularly in response to recent increases in use of e-cigarettes among youths (2). Nearly all tobacco product use begins during adolescence, and minors have cited social sources such as older peers and siblings as a common source of access to tobacco products (1,3). State and territorial T21 laws vary widely and can include provisions that might not benefit the public's health, including penalties to youths for purchase, use, or possession of tobacco products; exemptions for military populations; phase-in periods; and preemption of local laws. To understand the landscape of U.S. state and territorial T21 laws before enactment of the federal law, CDC assessed state and territorial laws prohibiting sales of all tobacco products to persons aged <21 years. As of December 20, 2019, 19 states, the District of Columbia (DC), Guam, and Palau had enacted T21 laws, including 13 enacted in 2019. Compared with T21 laws enacted during 2013-2018, more laws enacted in 2019 have purchase, use, or possession penalties; military exemptions; phase-in periods of 1 year or more; and preemption of local laws related to tobacco product sales. T21 laws could help prevent and reduce youth tobacco product use when implemented as part of a comprehensive approach that includes evidence-based, population-based tobacco control strategies such as smoke-free laws and pricing strategies (1,4).


Assuntos
Comércio/legislação & jurisprudência , Menores de Idade/legislação & jurisprudência , Produtos do Tabaco/legislação & jurisprudência , Humanos , Estados Unidos
7.
Neuropsychiatr ; 34(1): 15-21, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32002764

RESUMO

Little research has been performed so far on the mental health state of grieving and recently traumatized children. "The Buoy" ("Die Boje"), a low threshold ambulatory provides non-bureaucratic help and short time psychotherapy to children and adolescents in need of professional support at no charge and treats about 1400 minors per year. Whilst performing a study on these patients with special regard to their social network, we found the process of recruitment to be extraordinarily challenging. Only about 25% of the eligible patients could be recruited successfully within during the period of one year. In this paper we try to examine the barriers we had to overcome in gaining access to the sensitive field of grieving and traumatized children and adolescents who rely on low threshold psychotherapeutic and neuropsychiatric support and analyze the factors leading to the high number of dropouts. In addition, the consequences for our results will be discussed.


Assuntos
Intervenção na Crise , Saúde Mental , Menores de Idade/psicologia , Trauma Psicológico/psicologia , Trauma Psicológico/terapia , Psicoterapia , Adolescente , Criança , Feminino , Pesar , Humanos , Masculino
8.
Am J Public Health ; 110(3): 351-353, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31944836

RESUMO

Objectives. To estimate the percentage of Texas judicial bypass petitions for abortion denied annually from 2001 to 2018, and to assess whether that fraction changed after the state's 2016 bypass process change.Methods. Because official statistics on Texas judicial bypass case counts and outcomes are only available for 2016 and later, we systematically reviewed monthly internal reports from Jane's Due Process (JDP), an organization providing legal representation to pregnant minors seeking bypass from 2001 to 2018. We report numbers and percentages of JDP cases denied for 2001 to 2018 and numbers and percentages of all cases denied from official Texas statistics for 2016 to 2018 (all available years).Results. At least 1 denial occurred in 11 out of 15 years observed before the bypass law changed in Texas (percentages = 0%-6.2%). After Texas made its bypass process more restrictive, the percentage denied increased (from 2.8% in 2015 to 10.3% in 2016 among JDP cases).Conclusions. We found the greatest percentages of judicial bypass for abortion petitions denied after the policy was implemented and after the bypass process changed. Judicial bypass for abortion may expose pregnant minors to judicial veto of their abortion decision.


Assuntos
Aborto Legal/legislação & jurisprudência , Função Jurisdicional , Menores de Idade/legislação & jurisprudência , Adolescente , Feminino , Humanos , Consentimento dos Pais/legislação & jurisprudência , Gravidez , Texas
9.
Clin Child Psychol Psychiatry ; 25(1): 213-226, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31315450

RESUMO

There are high rates of post-traumatic stress disorder (PTSD) in unaccompanied asylum-seeking minors (UAM) and there is a requirement for feasible, acceptable and evidence-based treatments. Narrative Exposure Therapy (NET) is a short-term treatment for PTSD following multiple traumatic events. This article aims to examine the applicability of NET for UAM in routine clinical practice and to provide preliminary feasibility, acceptability and effectiveness data. The participants were four UAM receiving NET within a dedicated child and adolescent mental health service for refugee children. Semi-structured interviews were conducted to understand the acceptability of this approach and standardised measures of PTSD were used to provide preliminary data regarding the effectiveness of NET for these clients. The clients attended NET consistently with few missed appointments. At post-treatment, two clients' symptom scores were below the clinical cut-off for PTSD and all three clients who completed NET met reliable improvement criteria. The clients reported improvements in functional outcomes and mentioned that they would encourage other young people with similar difficulties to engage in NET. This study was limited by the small sample size and naturalistic time limitations in clinicians' contracts. This article highlights that it is possible to implement NET within routine clinical practice and observed improvements in PTSD symptoms and functional outcomes for UAM.


Assuntos
Terapia Implosiva , Menores de Idade/psicologia , Terapia Narrativa , Refugiados/psicologia , Transtornos de Estresse Pós-Traumáticos/terapia , Adolescente , Prática Clínica Baseada em Evidências , Estudos de Viabilidade , Feminino , Humanos , Masculino , Projetos Piloto , Transtornos de Estresse Pós-Traumáticos/psicologia , Resultado do Tratamento
10.
West Afr J Med ; 36(3): 274-279, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31622491

RESUMO

INTRODUCTION: Despite increasing awareness, sexual abuse of children is still prevalent in the society. This is due to lack of unified description of what constitutes child sexual abuse. This study is aimed to highlight the pattern of sexual abuse among secondary school adolescents in Rivers State. METHODS: The study was a descriptive cross-sectional survey carried out among secondary school adolescents in Port Harcourt Metropolis in Rivers State in 2014. Multistage sampling was employed to recruit study participants. A semi structured pretested self-administered questionnaire was used to obtain necessary information on socio-demographic characteristics of participants and the pattern of sexual abuse. Discretion of information obtained was guaranteed. SPSS version 20 was used for analysis. Bivariate analysis was by Chi square test while test for association between two subgroups was by odd ratio, the level of significance was put at P < 0.05. RESULTS: 1298 adolescents participated in the study, 462 (35.6%) had experienced sexual abuse. The victims consists of 176(38.1%) males and 286 (61.9%) females. (c² =12.02, p = < 0.001). Gender was significantly associated with penetrative (p= 0.006, OR=1.74, CI=1.15 -2.64) and contact with no penetrative ( p=<0.001 , ROR= 2.42, CI= 0.26-0.64) forms of sexual abuse. Adult males were the major perpetrators with adolescents themselves constituting 33.1% of the perpetrators. 33% of the perpetrators were family acquaintances while family members and classmates constituted 20.6% and 22.7% of the perpetrators respectively, with house helps accounting for 18.0% and teachers 3.0 %. About fifty percent of the abuse occurred at the victim's residence. CONCLUSION: Sexual abuse of minors is prevalent in Port Harcourt. The perpetrators are mainly adult males known to the victims. Child perpetrators are not uncommon, with the victims experiencing various forms of sexual abuse. Interventional program designed to create awareness to the public on the enormity of sexual abuse of children is needed so as to arm guardians, parents and even the children on how to prevent such crime.


Assuntos
Abuso Sexual na Infância/estatística & dados numéricos , Menores de Idade , Adolescente , Adulto , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Nigéria/epidemiologia , Prevalência , Instituições Acadêmicas , Inquéritos e Questionários
12.
Soins Psychiatr ; 40(324): 12-17, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31623800

RESUMO

Unaccompanied minors are particularly vulnerable due to their pathway marked with multiple bereavements and constant uprooting. They find themselves confronted with the ordeal of mistrust due to administrative contradictions between the need to protect and immigration control. They are particularly at risk of developing psychiatric pathologies. Care must be multidisciplinary and in continuity with the educational support, taking into account the young person's original culture.


Assuntos
Criança Abandonada , Menores de Idade , Determinação de Necessidades de Cuidados de Saúde , Refugiados , Adolescente , Criança , Humanos
13.
Soins Psychiatr ; 40(324): 18-20, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31623801

RESUMO

"Care is increasingly absent from the pathway of unaccompanied minors". Legal experts of the French ombudsperson work with professionals supporting unaccompanied minors on different levels. They can also have a watchdog role with legislative authorities and judicial bodies. They note in particular increasing difficulty for these youngsters in accessing appropriate care. Interview with Nathalie Lequeux, legal expert and coordinator at the French children's rights centre.


Assuntos
Criança Abandonada , Acesso aos Serviços de Saúde/legislação & jurisprudência , Menores de Idade , Refugiados , Adolescente , Criança , França , Humanos
14.
Soins Psychiatr ; 40(324): 21-24, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31623802

RESUMO

Emergency psychiatric units are receiving more and more foreign unaccompanied minors: for many of these young people it is their first contact with psychiatric services. This context of crisis crystallises the administrative and legal paradoxes at work in the support of these youngsters. Coordination between emergency care, statutory bodies and community-based care enables stability to be established while the care project is being set up.


Assuntos
Criança Abandonada/psicologia , Serviço Hospitalar de Emergência , Transtornos Mentais/terapia , Menores de Idade/psicologia , Unidade Hospitalar de Psiquiatria , Refugiados/psicologia , Adolescente , Criança , Humanos
15.
Soins Psychiatr ; 40(324): 25-28, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31623803

RESUMO

Pregnancy and motherhood are additional ordeals for young unaccompanied girls, a particularly vulnerable section of the population. They are marked by the revival of the traumatic valence, the need to reconstruct themselves through the pregnancy and the importance of establishing a relationship of trust with the professionals supporting them. A qualitative study was carried out through the prism of the perspective of these professionals.


Assuntos
Cuidadores/psicologia , Criança Abandonada , Menores de Idade , Refugiados , Adolescente , Criança , Feminino , Humanos , Gravidez , Pesquisa Qualitativa
16.
Soins Psychiatr ; 40(324): 29-32, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31623804

RESUMO

Many unaccompanied minors in the care of children's welfare services are housed in a children's home after their assessment. Adapting to this living environment means going from a high level of autonomy to being subject to certain rules, as well as giving oneself permission to settle and accept the support of the educational setting. Care is an important aspect of a children's home: the body is an indicator of the health of these youngsters.


Assuntos
Criança Abandonada/psicologia , Cuidados no Lar de Adoção/psicologia , Serviços de Saúde Mental , Menores de Idade/psicologia , Refugiados/psicologia , Criança , Humanos
17.
Soins Psychiatr ; 40(324): 33-36, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31623805

RESUMO

Transcultural consultations receive unaccompanied minors experiencing psychological distress as a result of their personal history in their country of origin, their harrowing journey until their arrival in France and their vulnerable situation. Presentation of the mental health pathway and identity issues of one of these young unaccompanied foreigners, and asylum seeker.


Assuntos
Criança Abandonada/psicologia , Menores de Idade/psicologia , Transtornos Psicóticos/terapia , Refugiados/psicologia , Estresse Psicológico/psicologia , Adolescente , Criança , Características Culturais , França , Humanos , Psicoterapia
18.
Artigo em Inglês | MEDLINE | ID: mdl-31618885

RESUMO

Indoor tanning is an important risk factor for the development of melanoma and non-melanoma skin cancer. With our nationally representative monitoring, we aimed at describing tanning bed use, user characteristics, reasons for use, and risk awareness over time. In the framework of the National Cancer Aid Monitoring (NCAM), we collected representative data on 12,000 individuals aged 14 to 45 years in annual waves of n = 3,000 participants in Germany between 2015 and 2018. We used descriptive statistics and chi²-tests to uncover group differences. To compare data from the different waves, we calculated confidence intervals. The use of tanning beds decreased from 2015 (11.0%, 95%-CI: 9.9%-12.1%) to 2018 (8.8%, 95%-CI: 7.8%-9.8%). However, this decrease did not affect all subgroups. For instance, there was an (non-significant) increase in minors and the prevalence remained stable for individuals with immigrant background and males. Attractiveness was an important reason for tanning bed use in each wave. Over time, there was an increase in medical-related reasons for use. Furthermore, monitoring showed a decrease in risk awareness regarding tanning bed use and ultraviolet (UV) radiation. While it is a positive development that the overall use of tanning beds in Germany has decreased over time, the increasing use by minors despite the legal ban is alarming. Due to the declining risk awareness it is necessary to implement prevention and education campaigns specifically targeted at this group.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Melanoma/etiologia , Neoplasias Cutâneas/etiologia , Banho de Sol/tendências , Raios Ultravioleta/efeitos adversos , Adolescente , Adulto , Conscientização , Feminino , Alemanha , Humanos , Masculino , Melanoma/prevenção & controle , Pessoa de Meia-Idade , Menores de Idade/psicologia , Menores de Idade/estatística & dados numéricos , Motivação , Fatores de Risco , Neoplasias Cutâneas/prevenção & controle , Adulto Jovem
20.
Prax Kinderpsychol Kinderpsychiatr ; 68(6): 488-502, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31480942

RESUMO

Quality of Life and Behavioral Problems of Unaccompanied Minor Refugees in Child Care Facilities Unaccompanied minor refugees (UMR) who arrive in Germany are generally placed in institutional child care facilities. UMR are a very burdened group, however other children and adolescents in institutional care are burdened as well, and their quality of life is often reduced. The aim of the current study was thus to compare quality of life and behavioral problems of UMR in child care facilities with those of other resident adolescents. For a total of 50 UMR, data regarding behavioral problems was available, for 41 UMR ratings on quality of life, both from external assessments. Two parallel comparison samples of other adolescents in the same institutional care facilities were drawn with adolescents with and without a migration background. Results show that in general, UMR show fewer behavioral problems than the other two groups, especially in externalizing behavior. For internalizing behavior, no differences were evident. For quality of life, no differences could be found between the three groups of inhabitants in institutional care. This indicates that the same factors determining quality of life are present in all three groups, but that the underlying mental problems are different in UMR than in other adolescents. Thus, staff in institutional care should possibly work differently with these group of adolescents than with other inhabitants and should be educated respectively.


Assuntos
Cuidado da Criança , Menores de Idade/psicologia , Comportamento Problema , Qualidade de Vida , Refugiados/psicologia , Adolescente , Criança , Cuidado da Criança/organização & administração , Alemanha , Instalações de Saúde , Humanos
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