Implicações da prática profissional no acolhimento institucional de crianças: perspectiva de cuidadoras / Implications of professional practice in children's institutional sheltering: caregivers' perspective / Implicaciones de la práctica profesional en el alojamiento institucional de niños: perspectiva de cuidadoras

Este estudo qualitativo teve como objetivo compreender, a partir da teoria de bioecológica de desenvolvimento, as implicações da prática profissional no processo de acolhimento de crianças em uma casa-abrigo, na perspectiva de cuidadoras. As participantes foram 10 profissionais de uma casa-abrigo localizada na região sul do Brasil. Utilizou-se a entrevista semiestruturada e a organização e análise dos dados sustentou-se na Grounded Theory, com auxílio do software Atlas.ti 8.4.14. Os resultados evidenciaram uma centralização das ações de acolhimento e atenção em torno dos cuidados físicos das crianças. As ações para promover suporte e cuidados emocionais dentro da casa-abrigo eram delegadas às profissionais da equipe técnica da instituição. Observou-se que as dificuldades encontradas pelas cuidadoras diziam respeito à falta de segurança e preparação para responder e acolher as demandas emocionais das crianças, as quais estão presentes em diversos momentos do processo de acolhimento. Percebeu-se que as práticas institucionais afetaram decisivamente tanto as ações de acolhimento das participantes e o suporte emocional oferecido às crianças na passagem pela casa-abrigo quanto as cuidadoras, no sentido de vivenciarem no trabalho sentimentos de insegurança. Os resultados tensionam ecologicamente a interação nos processos proximais presentes no desenvolvimento humano. Advoga-se pela reflexão sobre as implicações das práticas institucionais de uma casa-abrigo e o desenvolvimento infantil, visando o cuidado integral dos acolhidos.(AU)

Based on the developmental bioecological theory, this study analyzes the implications of professional practice in children's user embracement at a shelter from the caregivers' perspective. Semi-structured interviews were conducted with 10 professionals from a shelter located in southern Brazil. Data organization and analysis was performed based on Grounded Theory using the Atlas.ti 8.4.14 software. Results showed that embracement and attention focus on the physical care of children. Support and emotional care activities were delegated to the institution's technical team. Caregivers faced difficulties regarding the lack of security and preparation to respond to and accept the children's emotional demands, which arise at different moments in the embracement process. The institutional practices decisively affected both user embracement actions and the emotional support offered to the children, as well as the caregivers, in the sense of experiencing feelings of insecurity. These findings ecologically tension the interaction in the proximal processes present in human development. Further reflections on the implications of institutional shelter-based practices for child development are needed to provide comprehensive care.(AU)

Este estudio cualitativo tuvo como objetivo comprender, desde la perspectiva de la teoría bioecológica del desarrollo, las implicaciones de la práctica profesional en el proceso de acogida de niños en una institución infantil desde la perspectiva de las cuidadoras. Las participantes fueron 10 profesionales de una institución de acogida infantil ubicada en la región Sur de Brasil. Se utilizó la entrevista semiestructurada, y para la organización y análisis de datos se aplicó Grounded Theory, con el uso del software Atlas.ti 8.4.14. Los resultados mostraron que las acciones de recepción y atención se centran en el cuidado físico de los niños. Las acciones de promoción de apoyo y cuidado emocional dentro del alojamiento se asignaron a los profesionales del equipo técnico de la institución. Se observó que las dificultades encontradas por las cuidadoras estaban relacionadas con la falta de seguridad y preparación para responder y aceptar las demandas emocionales de los niños, las cuales se encuentran presentes en diferentes momentos del proceso de acogida. Se notó que las prácticas institucionales afectaron decisivamente tanto las acciones de acogida de las participantes como el apoyo emocional que la institución brinda a los niños durante su paso, así como a las cuidadoras en el sentido de experimentar sentimientos de inseguridad en el trabajo. Estos resultados tensan ecológicamente la interacción en los procesos proximales presentes en el desarrollo humano. Se aboga por reflexionar sobre las implicaciones de las prácticas institucionales en los alojamientos institucionales y el desarrollo infantil, apuntando a la atención integral de los acogidos.(AU)

Unintended births among adult immigrant and U.S.-born Mexican women in the Los Angeles Mommy and Baby (LAMB) survey.

BACKGROUND: Unintended births are especially frequent among minority women. Predictors of unintended births among adult Mexican women living in the United States are poorly characterized. METHODS: Data are from vital statistics and the 2005 Los Angeles Mommy and Baby (LAMB) survey, a population-based study of women delivering a live birth in Los Angeles County, California (n = 1,214). Multivariable logistic regression assessed the relation of unintended birth with acculturation variables adjusting for background and psychosocial characteristics. Multinomial models assessed these relations for women with an unintended birth who did and did not use contraception. FINDINGS: Forty-one percent of women reported an unintended birth. Being a long-term immigrant and U.S.-born were positively associated with unintended birth compared with shorter term immigrants, but the adjusted relation was significant only for U.S.-born women (odds ratio [OR], 2.01; 95% CI, 1.19-3.39). Women reporting an unintended birth were younger, unmarried, and higher parity. If using contraception, the odds of unintended birth were increased for cohabiting women, those with high education, and those with greater stress during pregnancy. When not using contraception and reporting an unintended birth, women also have no usual place for health care, have depressive symptoms during pregnancy, and are dissatisfied with partner support. CONCLUSIONS: Women's background and psychosocial characteristics were central to explaining unintended birth among immigrant women but less so for U.S.-born Mexican mothers. Interventions to improve birth intentions should not only target effective contraception, but also important social determinants.

Parental investment and socioeconomic status influences on children's height in Honduras: An analysis of national data.

OBJECTIVES: This research analyzes variation in children's height-for-age z-scores from a nationally representative sample of children from Honduras in 2006. This work draws on theoretical perspectives from parental investment theory to describe the mediating effects that parental investment may have on children's health and nutrition, even in low socioeconomic status households. METHODS: This research uses the 2006 Demographic and Health Survey for the country of Honduras. The dependent variable is the child's height-for-age z-score (HFAZ). Variation in the HFAZ is analyzed using multiple regression and multilevel regression models to incorporate individual, family and higher-level predictors. RESULTS: The findings suggest that children who are more invested in by their parents had better outcomes (HFAZ) than children whose parents did not invest as much. Of the three measures of parental investment used in this study, child wantedness and adequate prenatal care represented significant effects on children's HFAZ, and breastfeeding duration exhibited an interactive effect with household socioeconomic status. CONCLUSIONS: Results suggest that families that can invest more in their children through breastfeeding and sufficient prenatal care can mediate the negative effects of poor socioeconomic status on their children's health. This suggests that these measures of investment used here may be effective at mediating the negative effects of low socioeconomic status for this particular child health outcome.

The estimation of unwanted fertility.

The estimation of unwanted fertility is a major objective of demographic surveys, including DHS surveys conducted in Asia, Africa, and Latin America. Levels and trends in unwanted fertility are important input to the formulation of population policy and the evaluation of family planning programs. Yet existing methods for estimating unwanted fertility are known to be defective, among other reasons because they rely on subjective data whose validity and reliability are questionable. In this article, we propose a new estimator of unwanted fertility-the "aggregate prospective estimator"--so named because it depends on the stated preference for another child at the time of the survey, the fertility-desires item consistently shown to possess the highest validity and reliability. Under reasonable assumptions, the aggregate prospective estimator produces less biased estimates of unwanted fertility than the most widely used existing methods. The new estimator has the limitation of generating only aggregate-level estimates, but such estimates are the primary data for policy formulation and program evaluation. The new estimator is presented in this article, along with an evaluation of its underlying assumptions and its sensitivity to several sources of error. In an illustrative application to recent DHS data from six countries, the new estimator yields substantially higher estimates of unwanted fertility than existing methods in all six countries.

Hijos especiales: ¿padres diferentes? / Special children: ¿different parents?

Es habitual que a los niños y jóvenes que presentan alguna discapacidad se los nomine como "especiales". Cabe preguntarse, desde el psicoanálisis, si cuando está en juego la discapacidad, las funciones parentales son diferentes o tienen algo de particular. En este contexto, los talleres con padres constituyen un espacio privilegiado porque ofrece la posibilidad de ligar el dolor a través del placer y la creatividad. Esto no sólo beneficia a los padres sino que enriquece la tarea cotidiana de quienes trabajamos con sus hijos

[Unwanted children after birth: frequency measurement and trends analysis]. / Hijo no deseado después del parto: medición de frecuencia y análisis de tendencia.

BACKGROUND: A significant proportion of pregnancies occurring in Metropolitan Santiago are unplanned and unwanted. It is reasonable to postulate that the frequency of unwanted children must be high. AIM: To measure the frequency of unwanted children in newborns of a public hospital of Santiago. MATERIAL AND METHODS: In a period of fourteen months a score assigning survey to detect unwanted children was applied, after birth, to 741 women delivering at San Juan de Dios Hospital in Metropolitan Santiago. Women whose newborns were hospitalized or had congenital malformations were excluded from the survey. RESULTS: Forty children (5.4%) scored as unwanted while 52 (7%) qualified as being in a doubtful situation. When compared to desired children, unwanted infants had a lower frequency of suitable pregnancy controls (p < 0.0002) and a higher incidence of mothers declaring bad relations with children's father (p < 0.0002). A trend towards higher frequency of single mothers (p: 0.044) was observed. A lower frequency of first born children (p: 0.017) and a higher frequency of children born in the fourth place, was observed among unwanted newborns (p < 0.002). CONCLUSIONS: In the last 15 years, previous studies, carried out with similar methodologies, have showed a comparable frequency of unwanted children. These condition seems to be associated with poor pregnancy control, high birth order and bad relations with the child's father.

Hijo no deseado después del parto: medición de frecuencia y análisis de tendencia / Frequency of unwanted children after birth

Background: A significant proportion of pregnancies occurring in Metropolitan Santiago are unplanned and unwanted. It is reasonable to postulate that the frequency of unwanted children must be high. Aim: To measure the frequency of unwanted children in newborns of a public hospital of Santiago. Material and methods: In a period of fourteen months a score assigning survey to detect unwanted children was applied, after birth, to 741 women delivering at San Juan de Dios Hospital in Metropolitan Santiago. Women whose newborns were hospitalized or had congenital malformations were excluded from the survey. Results: Forty children (5.4 percent) scored as unwanted while 52 (7 percent) qualified as being in a doubtful situation. When compared to desired children, unwanted infants had a lower frequency of suitable pregnancy controls (p <0.0002) and a higher incidence of mothers declaring bad relations with children's father (p <0.0002). A trend towards higher frequency of single mothers (p: 0.044) was observed. A lower frequency of first born children (p: 0.017) and a higher frequency of children born in the fourth place, was observed among unwanted newborns (p <0.002). Conclusions: In the last 15 years, previous studies, carried out with similar methodologies, have showed a comparable frequency of unwanted children. These condition seems to be associated with poor pregnancy control, high birth order and bad relations with the child's father

El contexto sociofamiliar de los hijos de madres adolescentes cuyos embarazos fueron consecuencia de violación / The social-familiar context of the children of adolescent females with pregnancy by rape

Se estudió un grupo de 203 madres adolescentes, cuyos embarazos fueron consecuencia de violación. A todas ellas se les aplicó una entrevista en profundidad al momento del ingreso del control prenatal y posteriormente un años después del nacimiento del hipo. Se seleccionaron variables tanto personales como familiares para este análisis. El objetivo del estudio fue comparar las variables personales como familiares que se asocian con el rechazo del hijo y la tuición del mismo por personas distintas a la madre biológica. Los resultados muestran que el rechazo por el hijo se asocia a la crianza de la adolescente por ambos padres y a la violación de tipo intrafamiliar. La tuición del hijo por otras personas se asocia con la violación intrafamiliar

[Unwanted fertility in Mexico]. / La fecundidad no deseada en Mexico.

PIP: Data from the 1987 National Health and Fertility Survey were used to explore trends and differentials in unwanted fertility in Mexico. Women were classified in three educational categories: illiterate or incomplete primary, complete primary or some secondary, and complete secondary or more. The four urbanization categories were: under 2500; 2500 to 19,999; 20,000 and more; and metropolitan areas. The place of primary socialization was the place of residence until age 12. Two categories of employment of household head were included, agricultural or nonagricultural. The categories for mother's employment considered employment until the union and employment between the time of union and the birth of the first child. The proportion of births that were unwanted was estimated by calculating the total fertility rate for the year before the survey and comparing it to desired family size. The "total desired family size" was 2.4 for the entire sample. In other words, nearly 37% of the total fertility rate was undesired. The greatest differentials in percentages of undesired fertility were found in educational categories. 40.7% of the total fertility rate in the least educated groups vs. 13.6% in the most educated groups was undesired. Differentials in the other categories ranged from 1.9 for a history of employment before the birth of the first child to 8.8 for agricultural or nonagricultural employment of the household head. When effects of education were controlled, the percentage of undesired fertility declined as educational level increased for all rural or urban residence categories, places of socialization, and employment groups except women who worked before the first child was born. Women with more education, urban residence, and with histories of employment had the lowest levels of undesired fertility.^ieng

[The embryo, the human and the humanized]. / El embrión, lo humano y lo humanizado.

Since the moment of fecundation the human embryo is endowed with the properties of unity and uniqueness and its existence is therefore inviolable. Disputing arguments against this thesis are analyzed. Recent views of some biologists negate the human character to the embryo since the essence of a human being would be its cultural nature and ability to communicate. However, the embryo contains all the genetic information that will allow him to develop the ability to communicate. Any attempt to separate the 3 moments of time, past present and future is a definitive violation of ethics. A basic foundation of ethics is that present and future are implicit in the past and vice-versa. Finally, the idea that the unwanted child is not a cultural being should be discarded.

Family planning, AIDS, and FHI.

PIP: Family Health International's (FHI) research and development activities in improving and developing contraceptives and making them available to the public are presented. While FHI, along with other agencies, has been actively promoting and contributing to ongoing international family planning efforts since its creation in 1971, the period 1971-91 has, nonetheless, witness more births, maternal deaths, induced abortions, and infant deaths than over any 20-year span in history. While family sizes have decreased over the period due to greater contraceptive awareness and use, politicians, civil servants, and theologians are indicted as partly responsible for retarding further positive change. The number of women of reproductive ages in developing countries will increase by almost 30% in the 1990s, and the world's population will at least double over the next century. 95% of new births will stem from developing countries. Concerted efforts and global commitments of policymakers must be forthcoming in the battle against both high fertility and AIDS prevention. Specifically, at least 130 million new contraceptive users must be recruited in the 1990s. Surveys and field experiences indicate a large degree of unmet need for contraceptive services, with 50-80% of married women in developing countries expressing their desire to limit or space future births. Demand for contraception only increases once a program is in place; rapid reductions of total fertility are exemplified in the cases of Thailand, Colombia, South Korea, Sri Lanka, and Indonesia. Given the resources and commitment, the number of users could be doubled within 10 years.^ieng

Early sexual experience and traditional values in Colombia.

PIP: Results on adolescent's knowledge, attitude, and practice in sexuality and reproductive health are presented from 2 surveys of 1199 middle-class youths aged 13-18 years in main cities of Colombia. Survey populations were selected from high schools and users of Family Compensation Fund. While traditional values and customs prevail among these youths, they nonetheless tend to begin sex between ages 15-18, and have little concern over the consequences of their sexual behavior. They are, moreover, quite ignorant about reproductive health. Sexuality is not thought of as part of marriage, women are expected to be virgins at marriage, and a resounding 87% of the study population rejected abortion legislation. 90% of the young men had their 1st sexual encounter with either a prostitute or domestic servant, while 90% of the young women had their 1st encounters with friends from within their social groups. Sexual relations from adolescence on were supported by 35% of the girls and 60% of the boys, 72% of the girls and 38% of the boys supported virginity, yet less than 10% were in favor of the notion of open relationships. 20% of the girls and 25% of the boys had active sex lives, with homosexuality representing 1.6% and 3.1% of the two sex groupings, respectively. Sex education is practically non-existent. Most young women know little of contraception, and fail to use it out of misconceptions regarding method safety, and fear of one's parents finding out. The young men, on the other hand, cite forgetfulness and inability to obtain contraception as reasons for use failure. Accordingly, 5% of the girls fell pregnant between ages 15-17, with 66% ending in abortion, and 18.6% of the girls and 12.3% of the boys admitted to having had a sexually transmitted disease. 55% indicated that they would not use contraceptives.^ieng

Niños entregados en adopción: factores desencadenantes / Children given to adoption: socioeconomic factors

En 1986 se entregaron 36 niños y 41 en 1987 para adopción, lo que corresponde a 0,3% de la población infantil de la Unión. La edad de las madres fluctuó entre 13 y 34 años, promedio 21,7 años. Alrededor de 30% eran adolescentes, alrededor de las tres cuartas partes eran solteras, de las cuales casi 80% habían tenido sólo convivencia ocasional con el padre y muy pocas, 35,89% (1987), tenían trabajo remunerado. La escolaridad de las madres era muy baja, con 24,24% (1986) y 5,12(1987) de analfabetismo. Ninguna tenía hogar bien constituido y todas vivían en condiciones de extrema pobreza. Los motivos más importantes para la entrega en adopción fue la falta de medios económicos y presión familiar

Enfoque de salud mental sobre el manejo integral del síndrome de maltrato / Focus the Mental Health on the Handling Integration the Symdrome Ill-Treatment

El niño panameño no es ajeno al maltrato pero en los últimos años se ha adquirido una mayor conciencia y divulgación, asi lo demuestran los intentos que se han realizado para organizar una comisión nacional institucional e interdisciplinaria del síndrome de maltrato y en trabajos de tesis de graduación que se han realizado en la Universidad de Panamá. El síndrome de maltrato incluye toda lesión física o mental infligida a un niño por sus padres tutores o responsables de sus cuidados como resultados de descuido, negligencia o premeditación. El maltrato no nace solo ni es del adulto solamente lo forman toda una serie de factores que forman el sistema social familiar