Health Professionals: Identifying and Reporting Child Physical Abuse-a Scoping Review.

Health professionals play a significant role in identifying and reporting child physical abuse (CPA). However, several studies have pointed out non-reporting behavior among these professionals, evidencing difficulties identifying and reporting suspected cases. This review aimed to explore the frequency and possible barriers in identifying and reporting CPA by health professionals worldwide and to identify associated factors. This scoping review was conducted in the Pubmed, Web Of Science, Scopus, and SciELO databases between July 2019 and December 2020. Analytical and qualitative observational epidemiological studies were selected and published in English, Portuguese, and Spanish, with data on the identification and/or reporting of CPA by health professionals. Twenty studies fulfilled the criteria of this review. The studies were conducted with dentists, nurses, pediatricians, and general practitioners. The frequency of identification of CPA ranged from 50% to 89%, while the frequency of reporting ranged from 8% to 47%. This review revealed that health professionals had a low frequency of reporting of CPA, especially for dentists. In addition, several associated factors and barriers in the identification and reporting of CPA were identified in the studies. These were discussed in five main themes: training and continuing education in CPA, impact on professional practice, experiences and perceptions about child protection services, the threshold for suspicion of the professional, and the professional category.

Effects of Lyophilized Açaí (Euterpe oleracea) Supplementation on Oxidative Damage and Intestinal Histology in Juvenile Shrimp Penaeus vannamei Reared in Biofloc Systems.

The objective of this was to evaluate the ability of bioflocs to assimilate and transfer antioxidant compounds present in açaí Euterpe oleracea to juvenile Penaeus vannamei shrimp grown in a biofloc system. Juvenile shrimp were distributed into four treatment groups (control, 5, 20, and 80 mg açaí L-1), containing 31 shrimps/tank (90 L), and cultivated for 30 days. Every 24 h throughout the experimental period, the respective açaí concentrations were added directly to the cultivation water. The bioflocs and hepatopancreas lost their antioxidant capacity with increasing concentrations of açaí; however, lipid damage was mitigated after treatment with 20 mg of açaí L-1 (p < 0.05). The application of 20 mg açaí L-1 increased the mean height and area of the middle intestinal microvilli (p < 0.05). Mortality and protein and lipid damage in shrimp muscle increased with daily administration of 80 mg açaí L-1 (p < 0.05). It is concluded that the bioflocs were able to assimilate the antioxidants present in açaí and transfer them to the shrimp, and the administration of 20 mg açaí L-1 presented the best performance, demonstrating the possibility of its application in the cultivation of P. vannamei in a biofloc system.

Prevalence of recognition and reporting of child physical abuse by dental surgeons and associated factors.

Studies evaluating the factors associated with under reporting and with the recognition and reporting of child physical abuse are scarce and highly necessary. This study aimed to assess the prevalence of recognition and reporting of child physical abuse (CPA) by Brazilian dentistsin primary care and associated factors. A cross-sectional study was carried out with a representative sample of dentistsfrom the Family Health Strategy in Belo Horizonte. A self-administered questionnaire validated to Brazilian Portuguesewas used for data collection. Statistical analysis included univariate and multiple analyses through Poisson regression. A total of 181dentists participated in the study. Among them, 73 (40.3%) had already recognized some cases of CPA, but only 11 (6.1%) ended up reporting. Dentists with six to 19 years of experience as a municipal worker presented 2.38 times [PR = 2.38 (95%CI: 1.29-4.41)] more probability to recognize cases of CPA than the ones with less than six years. Having a graduate degree with a major in childcare [PR = 4.50 (95%CI: 1.08-18.68)] was associated with a larger number of reports. The employment duration as municipal worker was positively associated with the recognition of CPA cases and the prevalence of reporting was low.

Prevalence of recognition and reporting of child physical abuse by dental surgeons and associated factors / Prevalência de identificação e notificação de abuso físico infantil por dentistas e fatores associados

Abstract Studies evaluating the factors associated with under reporting and with the recognition and reporting of child physical abuse are scarce and highly necessary. This study aimed to assess the prevalence of recognition and reporting of child physical abuse (CPA) by Brazilian dentistsin primary care and associated factors. A cross-sectional study was carried out with a representative sample of dentistsfrom the Family Health Strategy in Belo Horizonte. A self-administered questionnaire validated to Brazilian Portuguesewas used for data collection. Statistical analysis included univariate and multiple analyses through Poisson regression. A total of 181dentists participated in the study. Among them, 73 (40.3%) had already recognized some cases of CPA, but only 11 (6.1%) ended up reporting. Dentists with six to 19 years of experience as a municipal worker presented 2.38 times [PR = 2.38 (95%CI: 1.29-4.41)] more probability to recognize cases of CPA than the ones with less than six years. Having a graduate degree with a major in childcare [PR = 4.50 (95%CI: 1.08-18.68)] was associated with a larger number of reports. The employment duration as municipal worker was positively associated with the recognition of CPA cases and the prevalence of reporting was low.

Resumo Estudos que avaliem os fatores associados à subnotificação e às dificuldades dos dentistas para identificar e notificar abuso físico infantil são escassos e necessários. Este estudo teve como objetivo investigar a prevalência de identificação e de notificação de abuso físico infantil (AFI) e fatores associados por dentistas da atenção primária. Trata-se de um estudo transversal com amostra representativa dos dentistas da Estratégia Saúde da Família de Belo Horizonte. Para a coleta de dados foi utilizado um questionário autoaplicável, validado para uso no Brasil. A análise estatística incluiu análise univariada e múltipla pela regressão de Poisson. Um total de 181 profissionais participaram do estudo. Destes, 73 (40,3%) já identificaram algum caso de AFI, mas apenas 11 (6,1%) realizaram a notificação. Dentistas com seis a 19 anos de trabalho no município apresentaram probabilidade 2,38 vezes [RP = 2,38 (CI 95%: 1,29-4,41)] maior de identificar casos de AFI do que aqueles com menos de seis anos de atuação. Possuir pós-graduação com foco em crianças [PR = 4,50(CI 95%: 1,08-18,68)] esteve positivamente associado a um maior número de notificações. O tempo de trabalho no município esteve associado à identificação de casos de AFI. A prevalência de notificação encontrada foi baixa.

Reporting of child physical abuse by a group of Brazilian primary care health professionals and associated factors.

BACKGROUND: Evidences points to the importance of health professionals to recognize child abuse, but also to a high frequency of underreporting, even in countries where reporting is mandatory, like Brazil. OBJECTIVE: To evaluate the frequency of non-reporting behavior of child physical abuse (CPA) among Brazilian primary care health professionals who recognized some cases in their careers and associated factors with reporting. METHODS: Cross-sectional study conducted with a representative sample of dentists, nurses, family physicians, and pediatricians from the Family Health Strategy network in the city of Belo Horizonte, Brazil. A validated self-administered questionnaire for use in Brazil was applied in-person to professionals in 2014 and 2015. Pearson's chi-squared test (p < 0.05) and a binary logistic regression model was used. RESULTS: A total of 715 professionals participated (response rate: 98.89%), 414 (57.3%) recognized cases, of which 171 (41.3%) reported. Reporting was associated with the type of profession, as pediatricians reported cases more than dentists [OR = 6.05 (95% CI: 1.24-29.50)], with the willingness to become involved [OR = 2.01 (95% CI: 1.02-3.97)] and knowledge regarding where to report cases [OR = 2.68 (95% CI: 1.25-5.74)]. Confidentiality was the barrier associated with a lower probability of reporting CPA cases [OR = 0.22 (95% CI: 0.08-0.66)]. CONCLUSIONS: There is a high frequency of non-reporting behavior. Pediatricians reported more CPA cases, followed by family doctors and nurses. Dentists were those who reported fewer cases. Reporting was also associated with a willingness to be involved in detecting/reporting abuse and knowing where to report CPA.

Recognition of child physical abuse by a group of Brazilian primary care health professionals.

BACKGROUND: Child maltreatment is a complex social and public health problem. AIM: To evaluate the frequency of the recognition by Brazilian health professionals in primary care of child physical abuse (CPA) and associated factors. DESIGN: A representative cross-sectional study was conducted with dentists, nurses, family physicians, and pediatricians who participated in the network of the Family Health Strategy in the city of Belo Horizonte, Brazil. Data collection involved in the administration of a questionnaire validated for use in Brazil. Data were collected from 181 dentists, 235 nurses, 203 family physicians, and 96 pediatricians. RESULTS: Among the 715 health professionals, 499 (69.8%) had some type of postgraduate degree and 414 (57.9%) recognized suspected or proved cases of CPA. The recognition was associated with occupation, as pediatricians recognized 14.11-fold [OR = 14.11 (95% CI: 3.73 to 53.43)] more cases of CPA compared with dentists. The recognition was also associated with a longer period of time working in the city [OR = 2.79 (95% CI: 1.24 to 6.29)]. CONCLUSION: The recognition of cases was positively associated with the longer working time in the municipal network and with pediatricians. The dentist was the category that was least associated with the recognition of CPA.

Traumatic dental injuries in Brazilian children and oral health-related quality of life.

BACKGROUND/AIMS: Population-based studies that investigate the impact of TDI on oral health-related quality of life (OHRQoL) among school children and its association with socioeconomic factors are scarce and offer conflicting results. The aim of this study was to evaluate the impact of TDI on OHRQoL among school children and its association with socioeconomic status. MATERIALS AND METHODS: A cross-sectional study was conducted with 588 12-year-old children enrolled in public and private schools in the urban areas in the city of Diamantina (southeastern Brazil). Clinical examinations were performed for the diagnosis of traumatic dental injury based on Andreasen's classification. The Child Perceptions Questionnaire (CPQ11-14 ), which has been validated for the population in Brazil, was employed to evaluate oral health-related quality of life. Socioeconomic status and overjet were also analyzed. Statistical analysis involved the chi-square test and logistic regression. RESULTS: A total of 29.4% of the students exhibited some type of trauma to at least one tooth. A negative impact on oral health-related quality of life was found in 53.1% of the sample. Traumatic dental injury was associated with a high impact on oral health-related quality of life [OR = 1.61 (95% CI: 1.08-2.39)] and overjet >3 mm [OR = 5.42 (95% CI: 3.66-8.02)]. However, no statistically significant associations were found between TDI and socioeconomic status. CONCLUSIONS: Prevalence of traumatic dental injury was high among the children who participated in the study, and it was associated with a high impact on oral health-related quality of life as well as overjet >3 mm.

Frequência de identificação e notificação de abuso físico infantil por profissionais da Estratégia Saúde da Família e relação com fatores socioeconômicos / Identifying and reporting child physical abuse by professionals of the Family Health Strategy and associated factors

Objetivo: Avaliar a frequência de identificação e notificação de abuso físico infantil (AFI) por profissionais da Estratégia Saúde da Família (ESF) e fatores associados em regionais com diferente vulnerabilidade social de Belo Horizonte, Brasil. Métodos: Trata-se de um estudo transversal com amostra de conveniência de pediatras, dentistas, médicos da família e enfermeiros, de dois distritos da ESF de Belo Horizonte, Brasil. Os distritos foram selecionados tomando como referência os índices de vulnerabilidade social. Os profissionais foram convidados a responder um questionário autoaplicável desenvolvido na Universidade de Londres, adaptado para o uso no Brasil. Foram realizadas análises descritivas e analíticas, utilizando o teste qui-quadrado de Pearson (p<0,05). Resultados: Participaram do estudo 144 profissionais: 35 (24,3%) dentistas, 46 (31,9%) enfermeiros, 45 (31,2%) médicos da família e 18 (12,5%) pediatras. Do total, 86 (59,7%) profissionais já identificaram algum caso de AFI na experiência profissional, mas apenas 38 (26,4%) notificaram às autoridades. A identificação e notificação estiveram associadas à categoria profissional (p <0,001) e aos profissionais que realizaram pós-graduação com enfoque na criança (p < 0,001). A vulnerabilidade das regionais não esteve associada à identificação e notificação dos casos de AFI (p = 0,754). Conclusão: A identificação e notificação de casos de AFI associaram-se aos profissionais com formação voltada para o atendimento da criança e com a categoria profissional, sendo o pediatra e o enfermeiro os que mais identificaram e notificaram. A vulnerabilidade social da regional não esteve associada com a identificação e notificação.(AU)

Aim: To evaluate the frequency of identification and report of child physical abuse (CPA) by professionals of the Family Health Strategy (FHS) and associated factors in regional health clinics with different social vulnerabilities in Belo Horizonte, Brazil. Methods: This is a cross-sectional study with a convenience sample of dentists, nurses, family doctors and pediatricians from two districts in Belo Horizonte, Brazil. The districts were selected based on the social vulnerability index (SVI). The professionals were invited to answer a self-administered questionnaire, which was developed at the University of London and adapted for use in Brazil. Descriptive and analytical analyses were performed using Pearson's chi-square test (p <0.05). Results: A total of 144 professionals participated: 35 (24.3%) dentists, 46 (31.9%) nurses, 45 (31.2%) family doctors, and 18 (12.5%) pediatricians. Out of this total, 86 (59.7%) professionals had already identified some case of CPA in their professional experience, but only 38 (26.4%) had reported it to the authorities. The identification and reporting were associated with the professional category (p <0.001) and professionals who had done postgraduate studies focused on children (p <0.001). The vulnerability of regional health clinics was not associated with the identification and notification of the cases from the CPA (p = 0.754). Conclusion: The identification and reporting of CPA were associated with the professionals with training focused on the child care and the professional category, with pediatricians and the nurses representing the professionals who most identified and notified cases. The regional social vulnerability was not associated with identification and reporting.(AU)

The prevalence of inhalant use and associated factors among adolescents in Belo Horizonte, Brazil.

The scope of this study was to establish the prevalence of inhalant use among adolescents and its association with marijuana use, alcohol consumption, socioeconomic status and gender. A cross-sectional study was performed with a representative sample of 891 adolescents from public and private schools in the city of Belo Horizonte, Brazil. Data were collected using two self-administered questionnaires: the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) and the Alcohol Use Disorders Identification Test (AUDIT C). The socioeconomic status was evaluated using the Social Vulnerability Index, mother's education level and type of school (public or private). The data were analyzed using the chi-square test (p < 0.05) and logistic regression analysis. The prevalence of inhalant use was 7.9%. No significant association was found between the use of inhalants and socioeconomic status after the logistic regression analysis. Inhalant use among adolescents was associated with marijuana use (OR: 4.61; 95% CI: 2.27 - 9.36) and with binge drinking (OR: 5.02; 95% CI: 2.57 - 9.81).

[Cross-cultural adaptation and reproducibility of a questionnaire to assess the knowledge and attitude of health professionals in cases of child physical abuse]. / Adaptação transcultural e reprodutibilidade de questionário para avaliação de conhecimento e atitude de profissionais de saúde frente a casos de abuso físico infantil.

The scope of this study was to conduct cross-cultural adaptation and evaluate the reproducibility of a questionnaire designed by a team from the University of London to assess knowledge and attitudes of health professionals during primary care when faced with cases of child physical abuse. The translation rigorously followed the criteria described by Herdman (1998), to maintain maximum functional equivalence. The adapted questionnaire was tested on 107 health care professionals from Belo Horizonte. Standard and Weighted Kappa tests were used to evaluate the reproducibility of the instrument. Most of the questions achieved Kappa test values above 80% (excellent). The Brazilian version of the questionnaire was, therefore, adapted and had proven reproducibility.

Adaptação transcultural e reprodutibilidade de questionário para avaliação de conhecimento e atitude de profissionais de saúde frente a casos de abuso físico infantil / Cross-cultural adaptation and reproducibility of a questionnaire to assess the knowledge and attitude of health professionals in cases of child physical abuse

O objetivo deste estudo foi adaptar transculturalmente e avaliar a reprodutibilidade de um questionário desenvolvido por uma equipe da Universidade de Londres, usado na avaliação do conhecimento e da atitude de profissionais da atenção primária frente a casos de abuso físico infantil. A tradução seguiu os critérios descritos por Herdman, 1998, de forma criteriosa, de modo a preservar ao máximo a equivalência funcional. O questionário adaptado foi aplicado em 107 profissionais de saúde de Belo Horizonte. Os testes Kappa Simples e Ponderado foram utilizados para avaliar a reprodutibilidade deste instrumento. A maioria das questões apresentou valores aos testes Kappa acima de 80% (excelente). A versão brasileira do questionário apresentou-se, portanto, adaptada e com boa reprodutibilidade.

The scope of this study was to conduct cross-cultural adaptation and evaluate the reproducibility of a questionnaire designed by a team from the University of London to assess knowledge and attitudes of health professionals during primary care when faced with cases of child physical abuse. The translation rigorously followed the criteria described by Herdman (1998), to maintain maximum functional equivalence. The adapted questionnaire was tested on 107 health care professionals from Belo Horizonte. Standard and Weighted Kappa tests were used to evaluate the reproducibility of the instrument. Most of the questions achieved Kappa test values above 80% (excellent). The Brazilian version of the questionnaire was, therefore, adapted and had proven reproducibility.

The prevalence of inhalant use and associated factors among adolescents in Belo Horizonte, Brazil / Prevalência do uso de inalantes e fatores associados em adolescentes de Belo Horizonte, Brasil

The scope of this study was to establish the prevalence of inhalant use among adolescents and its association with marijuana use, alcohol consumption, socioeconomic status and gender. A cross-sectional study was performed with a representative sample of 891 adolescents from public and private schools in the city of Belo Horizonte, Brazil. Data were collected using two self-administered questionnaires: the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) and the Alcohol Use Disorders Identification Test (AUDIT C). The socioeconomic status was evaluated using the Social Vulnerability Index, mother's education level and type of school (public or private). The data were analyzed using the chi-square test (p < 0.05) and logistic regression analysis. The prevalence of inhalant use was 7.9%. No significant association was found between the use of inhalants and socioeconomic status after the logistic regression analysis. Inhalant use among adolescents was associated with marijuana use (OR: 4.61; 95% CI: 2.27 - 9.36) and with binge drinking (OR: 5.02; 95% CI: 2.57 - 9.81).

O objetivo deste estudo foi avaliar a prevalência do uso de inalantes em adolescentes e sua associação com o uso de maconha, consumo de álcool, condição socioeconômica e gênero. Um estudo transversal foi realizado em uma amostra representativa de 891 adolescentes de escolas públicas e privadas de Belo Horizonte, Brasil. Os dados foram coletados por meio de dois questionários autoaplicáveis: o Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) e o Alcohol Use Disorders Identification Test (AUDIT C). O Índice de Vulnerabilidade Social, o nível de escolaridade da mãe e o tipo de escola (pública ou privada) foram utilizados para determinar o nível socioeconômico. Os dados foram analisados utilizando o teste qui-quadrado (p < 0.05) e a análise de regressão logística. A prevalência do uso de inalantes foi de 7,9%. Não houve associação entre o uso de inalantes e o nível socioeconômico após a análise de regressão logística. O uso de inalantes por adolescentes esteve associado ao uso de maconha (OR: 4.61; 95% CI: 2.27 - 9.36) e ao consumo abusivo de álcool (OR: 5.02; 95% CI: 2.57 - 9.81).