[Exploring Needs, Motivations, and Limitations Towards Healthy Eating and Digital Resources: A Qualitative Study in a Mexican Primary Education Setting]. / Exploración de necesidades, motivaciones y limitaciones en relación con la alimentación saludable y recursos digitales: un estudio cualitativo en un entorno de educación primaria en México.

OBJECTIVE: To explore the needs, motivations, and limitations related to healthy eating and digital materials, as well as to identify patterns for their design as a strategy aimed at Mexican families. DESIGN: A qualitative observational study of the phenomenon through focus group sessions. LOCATION: A public primary education center in the city of Querétaro, Mexico. PARTICIPANTS: Children aged 9 to 11 years and parents, mothers, or caregivers with children in primary education. METHOD: Twelve sessions were conducted with three groups of students and two sessions with parents, mothers, or caregivers using an interview guide. Various digital materials, developed based on social cognitive theory, were presented during the sessions. The sessions were recorded with the participants' or their guardians' prior consent and transcribed for analysis. Coding was performed for key points of analysis, and information saturation was confirmed. RESULTS: Students expressed motivation towards digital material that promotes play and experimentation, especially within the family context. The main perceived barrier was the caregivers' resistance to change. Parents expressed motivation and a need for explanatory material on diseases, with economic and time-related barriers. CONCLUSIONS: Digital material based on social cognitive theory, designed to improve nutrition, can be an effective strategy in nutritional education if it considers the circumstances of the target population. It is advisable to include affective and behavioral elements to achieve meaningful learning within households.

'My child could have died': counterfactual thoughts and psychological distress in parents of trauma survivors.

Background: After exposure to a potentially traumatic event, survivors may experience thoughts about 'what could have happened', referred to as counterfactual thoughts (CFTs). CFTs have been found to have a negative impact on survivors' mental health. This is the first study to investigate whether parents of trauma survivors experience CFTs and the association with psychological distress in this group.Objective: The main aim of the present study is to investigate CFTs in parents of trauma survivors and the relationship between the frequency and vividness of CFTs and psychological distress.Method: The participants (N = 310, 191 females) were parents of the youths targeted in the terror attack on Utøya island, Norway, in 2011. Frequency and vividness of CFTs, posttraumatic stress reactions (PTSR), and symptoms of anxiety and depression were measured 8.5-9 years post-terror.Results: The majority of the parents (74%) reported having experienced CFTs at some time point since the attack. For almost one-third of the parents, CFTs were still present more than eight years after the attack. Higher frequency and vividness of CFTs were uniquely associated with higher levels of PTSR, anxiety, and depression.Conclusion: The present findings suggest that frequent and vivid CFTs may contribute to mental health problems in parents of trauma survivors and should be addressed in therapy.

A quantitative study investigating the relationship between counterfactual thoughts and psychological distress, in parents of trauma survivors.The majority of the parents reported having experienced counterfactual thoughts at some time point since the attack. For almost one-third of the parents, counterfactual thouhgts were still present more than eight years after the attack. Higher frequency and vividness of counterfactual thoughts were uniquely associated with higher levels of psychological distress.The present findings suggest that frequent and vivid counterfactual thouhgts may contribute to mental health problems in parents of trauma survivors and should be addressed in therapy.

Stigma towards Child and Adolescent Mental Health Problems among Fathers and Mothers. A Cross-sectional Study / [El estigma de los padres y madres hacia los problemas de salud mental de niños y adolescentes. Un estudio transversal]

Background: Stigma toward child and adolescent mental health problems among parents has been understudied, despite its importance. Method: Sociodemographic variables, stigma associated with mental health problems in childhood and adolescence, myths about suicide, familiarity with mental health, and seeking professional help were assessed in a cross-sectional study in a Spanish sample (N = 268). Descriptive analyses, mean difference and regression models were carried out. Results: The results reveal medium levels of stigma, the presence of myths about suicide and average familiarity with mental health. Mothers and a higher level of education, showed lower levels of stigma and fewer myths about suicide. A regression model explains the 44% of the variance with myths about suicide, stigma and familiarity with mental health as predictors of seeking professional help attitudes. Conclusions: Stigma, myths surrounding suicide, and parental unfamiliarity with mental health may act as barriers to appropriate diagnosis and treatment. Practical implications and recommendations are discussed.(AU)

Antecedentes: La estigmatización de los problemas de salud mental en niños y adolescentes en los padres y madres no se ha estudiado lo suficiente a pesar de su importancia. Método: Se evaluaron variables sociodemográficas, el estigma asociado con los problemas de salud mental en la infancia y la adolescencia, mitos sobre el suicidio, conocimiento de la salud mental y la búsqueda de ayuda profesional en un estudio exploratorio transversal en una muestra española de padres y madres (N = 268). Se realizaron análisis descriptivos, de diferencia de medias y modelos de regresión. Resultados: Los resultados revelan un nivel medio de estigma, la presencia de mitos sobre el suicidio y un conocimiento medio con la salud mental. Las madres y un mayor nivel educativo mostraron menores niveles de estigma y menos mitos sobre el suicidio. El 44% de la varianza de la búsqueda de ayuda profesional se explica a través de los mitos sobre el suicidio, el estigma y el conocimiento de la salud mental como predictores de las actitudes de búsqueda de ayuda profesional. Conclusiones: Se establecen recomendaciones prácticas, subrayando cómo el estigma, los mitos sobre el suicidio y la falta de conocimiento de los progenitores de la salud mental pueden actuar como barreras para un diagnóstico y tratamiento adecuados. Se discuten las implicaciones prácticas y las recomendaciones.(AU)

Relación entre la conciencia de madres y padres sobre el abuso sexual y las habilidades de los niños para decir «no» / The relationship between parental awareness of sexual abuse and children's skills to say «no»

Introducción: El abuso sexual infantil es un problema social global y multidimensional que provoca resultados devastadores y permanentes en las relaciones psicológicas, emocionales, cognitivas, conductuales, físicas, sexuales e interpersonales. Este estudio examina la relación entre la capacidad de decir «no» y la conciencia de madres y padres sobre el abuso sexual en estudiantes de 4.° de primaria. Métodos: El estudio se realizó entre abril de 2022 y junio de 2022 en escuelas primarias de un distrito central provincial en el noreste de Turquía. La muestra del estudio estuvo formada por 310 alumnos de 4.° de primaria y sus madres y padres. Compilamos los datos del estudio con el Formulario de información personal, la Escala de capacidad para decir «no» para niños y la Escala de conciencia de abuso sexual para padres. Resultados: Hubo una correlación positiva débil (p˂0,05) entre las puntuaciones medias de conciencia de las madres sobre el abuso sexual y las puntuaciones medias de rechazo y resistencia de los niños, y una correlación positiva débil (p˂0,05) entre las puntuaciones medias de la conciencia de los padres sobre el abuso sexual y las puntuaciones medias de rechazo de los niños. Conclusión: A medida que aumentó la conciencia de las madres y los padres sobre los mitos y las enseñanzas sobre el abuso sexual y las acciones para combatir el abuso sexual, también aumentó la negativa de los niños. Se encontró que a medida que aumentaba la conciencia de los padres sobre las señales de abuso sexual, aumentaba la negativa de los niños.(AU)

Introduction: Child sexual abuse is a global and multidimensional social problem and causes devastating and permanent psychological, emotional, cognitive, behavioural, physical, sexual and interpersonal sequelae. This study examines the relationship between the ability to say «no» and parental awareness of sexual abuse in 4th grade primary school students. Methods: The study was conducted between April 2022 and June 2022 in primary schools in the central district of a province in north-eastern Turkey. The sample consisted of 310 students enrolled in 4th grade and their parents. We collected the data through a personal information form, the ability to say «no» scale for children and the sexual abuse awareness scale for parents. Results: There was a weak positive correlation between the mean maternal scores of sexual abuse awareness and the mean scores of refusal and resistance in children (P˂.05), as well as a weak positive correlation between the mean paternal scores of sexual abuse awareness and the mean scores of refusal and resistance in children (P˂.05). Conclusion: As mothers’ and fathers’ awareness of sexual abuse myths and of teachings and actions to combat sexual abuse increased, the refusal of children also increased. Also, as fathers’ awareness of the signs of sexual abuse increased, children's refusal increased.(AU)

The relationship between parental awareness of sexual abuse and children's skills to say "no".

INTRODUCTION: Child sexual abuse is a global and multidimensional social problem and causes devastating and permanent psychological, emotional, cognitive, behavioural, physical, sexual and interpersonal sequelae. This study examines the relationship between the ability to say "no" and parental awareness of sexual abuse in 4th grade primary school students. METHODS: The study was conducted between April 2022 and June 2022 in primary schools in the central district of a province in north-eastern Turkey. The sample consisted of 310 students enrolled in 4th grade and their parents. We collected the data through a personal information form, the Ability to Say "No" Scale for Children and the Sexual Abuse Awareness Scale for Parents. RESULTS: There was a weak positive correlation between the mean maternal scores of sexual abuse awareness and the mean scores of refusal and resistance in children (P < .05), as well as a weak positive correlation between the mean paternal scores of sexual abuse awareness and the mean scores of refusal and resistance in children (P < .05). CONCLUSION: As mothers' and fathers' awareness of sexual abuse myths and of teachings and actions to combat sexual abuse increased, the refusal of children also increased. Also, as fathers' awareness of the signs of sexual abuse increased, children's refusal increased.

Perfis de envolvimento parental no futebol juvenil: Um estudo com jovens atletas / Perfiles de participación de los padres en el fútbol juvenil: Un estudio con atletas jóvenes / Parental involvement profiles in football: A study with young players

Este estudo analisou as diferenças na perceção dos atletas acerca dos comportamentos parentais, considerando também a importância do escalão desportivo dos atletas. Além disso, foi analisado se diferentes perfis de envolvimento parental, segundo a avaliação dos atletas aos seus pais, correspondiam a diferenças na orientação motivacional e na perceção de rendimento dos jovens atletas. Participaram no estudo 292 atletas do sexo masculino com idades compreendidas entre os 12 e 19 anos (M = 15.0; DP = 1.5), praticantes de futebol no campeonato nacional. Foram aplicados três instrumentos, (1) Questionário de Comportamentos Parentais no Desporto; (2) Escala de Objetivos de Realização no Desporto Juvenil; (3) Questionário de Perceção de Rendimento Desportivo. Os resultados indicaram (a) diferenças na perceção de comportamentos do pai e da mãe separadamente, sendo que, a perceção dos atletas variou em função do seu escalão desportivo; e (b) a orientação motivacional e a perceção de rendimento variaram em função do perfil de envolvimento parental percebido. Em suma, os resultados demonstram a importância do envolvimento parental no desporto juvenil, devendo este fator ser considerado pelos profissionais que intervêmjunto dos jovens atletas.(AU)

Este estudio analizó las diferencias en la percepción de los atletas sobre los comportamientos de sus padres, considerando también la importancia del nivel deportivo de los atletas. Además, se analizó si los diferentes perfiles de participación de los padres, según la evaluación de los deportistas sobre sus padres, se correspondían con diferencias en la orientación motivacional y en la percepción del rendimiento de los jóvenes deportistas. Participaron del estudio 292 atletas masculinos con edades entre 12 y 19 años (M = 15,0; SD = 1,5), futbolistas del campeonato nacional. Se aplicaron tres instrumentos, (1) Cuestionario de Conductas Parentales en el Deporte; (2) Escala de Metas de Logro en Deportes Juveniles; (3) Cuestionario de Percepción del Rendimiento Deportivo. Los resultados indicaron: (a)diferencias en la percepción de los comportamientos del padre y de la madre por separado, y la percepción de los deportistas varió según su nivel deportivo; e (b)la orientación motivacional y la percepción de rendimiento varió según el perfil de participación parental percibida. En resumen, los resultados demuestran la importancia de la participación de los padres en el deporte juvenil, y este factor debe ser considerado por los profesionales que trabajan con jóvenes deportistas.(AU)

This study analysed the differences in athletes’ perception of parental behaviours, considering the importance of athletes’ age category. It was also verified if different parental involvement profiles, according to athletes’ evaluation of their parents’ behaviours, corresponded to differences in motivational orientation and in performance perception of the young athletes. The study included 292 male athletes, aged between 12 and 19 years old (M = 15.0; DP = 1.5), playing football in the national championship. Three instruments were used: (1) Parental Behaviours in Sports Questionnaire; (2) Achievement goal scale for youth sport; (3) Sport Performance Perception Questionnaire. The results indicated: (a)differences in the perception of father’s and mother’s behaviours, separately, and these differences changed according to athletes’ age category; and (b)motivational orientation and performance perception varied according to the perceived parental involvement profile. In sum, the results demonstrate the importance of parental behaviours in youth sports and this aspect should be considered by professionals who work with young athletes.(AU)

Posttraumatic stress and depression symptom classes in parents of trauma-exposed children: a transdiagnostic perspective using pooled individual participant data.

Background: In the aftermath of child trauma, post-traumatic stress (PTS) and depression symptoms often co-occur among trauma exposed children and their parents. Studies have used latent class analysis (LCA) to examine PTS and depression symptoms and identify homogeneous subgroups among trauma exposed children. However, little is known about subgroups or classes of PTS and depression reactions of parents of traumatised children.Objectives: (1) Determine PTS and depression symptom classes at 2-9 months post-trauma, and (2) to examine sociodemographic covariates among parents of trauma exposed children.Methods: Using harmonised individual participant data (n = 702) from eight studies (Australia, UK, US) included in the Prospective studies of Acute Child Trauma and Recovery Data Archive (PACT/R), we modelled these phenomena at the symptom level using LCA.Results: Our LCA yielded three solutions: 'high internalizing symptom' class (11%); 'low PTS-high depression' class (17%); and 'low internalizing symptom' class (72%). Parents of children in the 'low PTS-high depression' class were more likely to have children of older age and be part of an ethnic minority, compared to the 'low internalizing symptoms' class. Mothers were more likely to be in the 'high internalizing symptom' class compared to the 'low internalizing symptoms' class.Conclusions: These findings reveal a qualitative structure and relationship between depression and PTS symptoms that highlights the importance of assessing and targeting a broad range of internalising symptoms in post-trauma psychological treatment.

Using harmonised individual participant data from eight studies included in the Prospective studies of Acute Child Trauma and Recovery (PACT/R) Data Archive we identified three distinct classes of parental internalising reactions using Latent Class Analysis.Mothers, family ethnic minority status, and children of older age were associated with distinct classes of problematic symptoms.The findings from the present study highlight the need for assessing and targeting a broad range of internalising symptoms after trauma, and that mothers, parents of older children and families with ethnic minority status might be at risk for elevated symptoms.

Somatic symptoms and insomnia among bereaved parents and siblings eight years after the Utøya terror attack.

Background: Levels of prolonged grief symptoms (PGS) and post-traumatic stress symptoms (PTSS) can be high, many years following bereavement after terror, but knowledge concerning somatic health is scarce. Terrorism is a serious public health challenge, and increased knowledge about long-term somatic symptoms and insomnia is essential for establishing follow-up interventions after terrorism bereavement.Objective: To study the prevalence of somatic symptoms and insomnia and their association with PGS, PTSS, and functional impairment among terrorism-bereaved parents and siblings.Methods: A cross-sectional quantitative study included 122 bereaved individuals from the Utøya terror attack in Norway in 2011. The sample comprised 88 parents and 34 siblings aged 19 years and above (Mage = 49.7 years, SDage = 13.8 years, 59.8% females). The participants completed questionnaires 8 years after the attack assessing somatic symptoms (Children's Somatic Symptoms Inventory) and insomnia (Bergen Insomnia Scale) along with measures of PGS (Inventory of Complicated Grief), PTSS (Impact of Event Scale-Revised), and functional impairment (Work and Social Adjustment Scale).Results: Fatigue was the most frequently reported somatic symptom (88% of females and 65% of males). Females reported statistically significantly more somatic symptoms than males. In total, 68% of the bereaved individuals scored above the cut-off for insomnia. There were no statistically significant gender differences for insomnia. Female gender, intrusion, and arousal were associated with somatic symptoms. Intrusion and somatic symptoms were associated with insomnia. Somatic symptoms, avoidance, and hyperarousal were associated with functional impairment.Conclusion: Many bereaved parents and siblings report somatic symptoms and insomnia eight years after the terror attack. Somatic symptoms are associated with functional impairment. Long-term follow-up and support after traumatic bereavement should focus on somatic symptoms and insomnia.

Many bereaved individuals, especially females, reported insomnia and somatic symptoms, including fatigue, pain, and other related symptoms.Somatic symptoms, avoidance, and hyperarousal were identified as being associated with functional impairment among the bereaved.Post-traumatic stress symptoms played a more significant role than prolonged grief symptoms in explaining the reduced physical health experienced by the bereaved.

Children's preoperative stress according to the parental presence evaluated by salivary cortisol and mYPAS: quasi-randomized trial / Estresse pré-operatório em crianças de acordo com a presença dos pais avaliada por cortisol salivar e mYPAS: ensaio quase-randomizado / Estrés preoperatorio en niños según la presencia de los padres evaluado mediante cortisol salival y mYPAS: ensayo cuasi-aleatorio

ABSTRACT Objective: The main objective of this study was to compare stress and anxiety levels in children undergoing surgical procedures with or without parental presence at induction of anesthesia by measuring salivary cortisol levels and applying the mYPAS. Method: Quasi-randomized trial with children aged 5-12 year, with ASA physical status I, II, or III, undergoing elective surgery. According to parents' willingness, the pair were defined as accompanied or unaccompanied group. Chi-square, Fisher's exact tests, Student's t test, Mann-Whitney, Hodges-Lehman and Spearman's tests were used for statistical analyzes. Results: We included 46 children; 63% were preschool children mostly accompanied by their mothers (80%). The median mYPAS score was 37.5 (quartile range, 23.4-51.6) in unaccompanied children, and 55.0 (quartile range, 27.9-65.0) in accompanied children, with an estimated median difference of +11.8 (95% CI of 0 to 23.4; p = 0.044). There were no significant differences in the mean salivary cortisol levels. Conclusion: The level of anxiety was higher in accompanied children. There were no differences in salivary cortisol levels between both groups. Brazilian Registry of Clinical Trials (ReBEC):RBR-9wj4qvy.

RESUMO Objetivo: O principal objetivo deste estudo foi comparar os níveis de estresse e ansiedade em crianças submetidas a procedimentos cirúrgicos com ou sem presença dos pais na indução da anestesia, medindo os níveis de cortisol salivar e aplicando o mYPAS. Método: Ensaio quaserandomizado com crianças de 5 a 12 anos, com estado físico ASA I, II ou III, submetidas a cirurgia eletiva. De acordo com a disposição dos pais, o par foi definido como grupo acompanhado ou não acompanhado. Foram utilizados testes de qui-quadrado, exato de Fisher, t de Student, Mann-Whitney, Hodges-Lehman e Spearman para as análises estatísticas. Resultados: Foram incluídas 46 crianças; 63% delas em idade préescolar, principalmente acompanhadas por suas mães (80%). A pontuação mYPAS mediana foi de 37,5 (intervalo interquartil, 23,4-51,6) em crianças não acompanhadas e de 55,0 (intervalo interquartil, 27,9-65,0) em crianças acompanhadas, com uma diferença mediana estimada de +11,8 (IC de 95% de 0 a 23,4; p = 0,044). Não houve diferenças significativas nos níveis médios de cortisol salivar. Conclusão: O nível de ansiedade foi maior em crianças acompanhadas. Não houve diferenças nos níveis de cortisol salivar entre os dois grupos. Registro Brasileiro de Ensaios Clínicos (ReBEC):RBR-9wj4qvy.

RESUMEN Objetivo: El objetivo principal de este estudio fue comparar los niveles de estrés y ansiedad en niños sometidos a procedimientos quirúrgicos con o sin presencia de los padres en la inducción de la anestesia mediante la medición de los niveles de cortisol salival y la aplicación del mYPAS. Método: Ensayo cuasi-aleatorio con niños de 5 a 12 años, con estado físico ASA I, II o III, sometidos a cirugía electiva. Según la disposición de los padres, se definieron como grupo acompañado o no acompañado. Se utilizaron pruebas de chi-cuadrado, exacta de Fisher, t de Student, Mann-Whitney, Hodges-Lehman y Spearman para los análisis estadísticos. Resultados: Se incluyeron 46 niños; el 63% eran niños en edad preescolar, en su mayoría acompañados por sus madres (80%). La puntuación mYPAS mediana fue de 37,5 (rango intercuartílico, 23,4-51,6) en niños no acompañados y de 55,0 (rango intercuartílico, 27,9-65,0) en niños acompañados, con una diferencia mediana estimada de +11,8 (IC del 95% de 0 a 23,4; p = 0,044). No hubo diferencias significativas en los niveles medios de cortisol salival. Conclusión: El nivel de ansiedad fue mayor en los niños acompañados. No hubo diferencias en los niveles de cortisol salival entre ambos grupos. Registro Brasileño de Ensayos Clínicos (ReBEC):RBR-9wj4qvy.

Adolescentes a vivenciar o cancro parental: um estudo qualitativo / Adolescents experiencing parental cancer: a qualitative study / Adolescentes que experimentan cáncer en sus padres: un estudio cualitativo

RESUMO Objetivo: analisar necessidades dos adolescentes vivenciando o cancro parental. Método: estudo qualitativo exploratório e descritivo. Coleta de dados foi realizada através de entrevistas semiestruturadas em 2021. Amostra de conveniência foi composta por adolescentes dos 14-19 anos, com pais com doença oncológica na fase de tratamento, acompanhados em um hospital oncológico português. Tratamento de dados foi realizado com recurso à análise de conteúdo. Resultados: da análise das 13 entrevistas, emergiram cinco domínios: Confronto com a doença; Conhecimento sobre a doença; Experiências anteriores com a doença oncológica; Vivência do cancro parental; e Alterações somáticas. Os resultados evidenciam que os adolescentes vivenciando cancro parental apresentam necessidades emocionais, educacionais e psicossociais. Conclusão: este estudo permitiu conhecer as necessidades dos adolescentes, compreendendo as dificuldades sentidas e os desafios que a experiência acarreta. Os resultados permitirão sustentar o desenho de um programa de intervenção de enfermagem para a díade que vivencia o cancro parental.

ABSTRACT Objective: to analyze the needs of adolescents experiencing parental cancer. Method: an exploratory and descriptive qualitative study. Data collection was carried out through semi-structured interviews in 2021. The convenience sample was composed of adolescents aged 14-19, with parents with oncological disease in the treatment phase, followed in a Portuguese oncology hospital. Data processing was carried out using content analysis. Results: from the analysis of the 13 interviews, five domains emerged: Coping with the disease; Knowledge about the disease; Previous experiences with the oncological disease; Experiencing parental cancer; and Somatic changes. The results show that adolescents experiencing parental cancer have emotional, educational and psychosocial needs. Conclusion: this study allowed us to understand adolescents' needs, understanding the difficulties experienced and the challenges that the experience entails. The results will support the design of a nursing intervention program for the dyad experiencing parental cancer.

RESUMEN Objetivo: analizar las necesidades de los adolescentes que experimentan cáncer en sus padres. Método: estudio cualitativo exploratorio y descriptivo. La recolección de datos se realizó mediante entrevistas semiestructuradas en 2021. La muestra por conveniencia estuvo compuesta por adolescentes de 14 a 19 años, con padres con enfermedad oncológica en fase de tratamiento, seguidos en un hospital oncológico portugués. El procesamiento de los datos se realizó mediante análisis de contenido. Resultados: del análisis de las 13 entrevistas surgieron cinco dominios: Enfrentamiento a la enfermedad; Conocimiento sobre la enfermedad; Experiencias previas con la enfermedad oncológica; Experiencia del cáncer de los padres; y Cambios somáticos. Los resultados muestran que los adolescentes que padecen cáncer en sus padres tienen necesidades emocionales, educativas y psicosociales. Conclusión: este estudio permitió comprender las necesidades de los adolescentes, comprendiendo las dificultades vividas y los desafíos que conlleva la experiencia. Los resultados apoyarán el diseño de un programa de intervención de enfermería para la díada que sufre cáncer en sus padres.

Técnicas de manejo de conducta en odontopediatría: aspectos éticos y legales / Behavioral management techniques in pediatric dentistry: ethical and legal aspects

Introducción: la profesión odontológica es una actividad orientada al cuidado de personas, entre ellos los niños, que necesitan un cuidado más específico estando en pleno desarrollo físico y emocional. Al trabajar con los niños se tiene que lidiar con la ansiedad con la que el pequeño entra por primera vez a la consulta. Para solucionar este problema, se han descrito diferentes técnicas cuya elección depende de la edad, de las necesidades del paciente y de la habilidad profesional. Estas técnicas se pueden agrupar en tres grupos: técnicas farmacológicas, técnicas comunicativas y técnicas no comunicativas. Objetivo: revisar la evidencia científica sobre los aspectos éticos y legales de las técnicas de manejo de conducta en odontopediatría. Material y método: se realizó una búsqueda en las bases de datos de PubMed/ Medline, Google Scholar y Scopus de acuerdo a unos criterios de inclusión y exclusión. Resultados: los resultados determinan que el empleo de las técnicas de manejo de conducta disminuye los niveles de ansiedad durante el tratamiento dental. El bajo nivel socioeconómico y educativo, y la utilización frecuente de videojuegos aumentan la ansiedad dental mientras la realización de deporte y una vida saludable la disminuyen. Conclusiones: entre las técnicas de manejo de conducta del paciente pediátrico, las de gestión comunicativa son las más aceptadas por los padres. Aunque no hay ninguna prohibición legal en el uso de técnicas farmacológicas o no comunicativas, estas la mayoría de las veces son rechazadas por los padres. (AU)

Introduction: The dental profession is an activity oriented to the people care, including children, who need more specific care being in full physical and emotional development. When working with children you have to deal with the anxiety with which the child first enters the consultation. To solve this problem, different techniques have been described whose choice depends on the age, patient needs and professional skills. These techniques can be grouped into three groups: pharmacological techniques, communicative techniques and noncommunicative techniques. Objective: To review scientific evidence on the ethical and legal aspects of behavioral management techniques in pediatric dentistry. Material and method: A search was performed in the databases of PubMed/ Medline, Google Scholar y Scopus, according to inclusion and exclusion criteria. Results: The results determine that the use of behavioral management techniques decreases anxiety levels during dental treatment. The low socioeconomic and educational level and the frequent use of video games increase dental anxiety while the performance of sports and a healthy life decrease it. Conclusions: Among the pediatric patient behavior management techniques, those with communicative management were the most accepted by parents. Although there is no legal prohibition on the use of pharmacological or non-communicative techniques, these are most often rejected by parents. (AU)

Estrés de la crianza, estilos maternos de alimentación y su relación con el índice de masa corporal del preescolar / Parenting stress, maternal feeding styles related to preschooler body mass index

Introducción: el exceso de peso en la infancia se ve influenciado por múltiples factores; la crianza podría contribuir a este problema, dado que durante la etapa infantil son los padres y principalmente la madre los responsables de proporcionar alimento y de alimentar a sus hijos. Objetivo: explorar la relación del estrés de la crianza y los estilos maternos de alimentación con el IMC del hijo preescolar. Materiales y métodos: estudio transversal. Participaron 382 díadas madre e hijo, los últimos de 3-5 años. Los hijos asistían a instituciones públicas de educación preescolar. Las madres participantes contestaron la Escala de Estrés de la Crianza y el Cuestionario de Estilos de Alimentación del Cuidador. Se midió peso, talla y se calculó el IMC del preescolar. Resultados: el 34 % de las madres utilizaban con mayor frecuencia un estilo indulgente y el 28,2 % de los hijos preescolares tenía sobrepeso-obesidad. Las madres con estilo autoritario presentaban el rango promedio más alto de estrés de la crianza comparado con las otras categorías (H = 15,302, gl = 3, p = 0,002). Se identificó que la escolaridad materna, la dimensión de la responsabilidad y la demanda contribuyen al IMC del hijo preescolar. Conclusión: el estrés de la crianza y los estilos de alimentación son variables que contribuyen al riesgo de sobrepeso-obesidad en los hijos preescolares. (AU)

Introduction: excess weight in childhood is influenced by multiple factors; parenting could contribute to this problem, given that during the infant stage the parents, and mainly the mother, are responsible for providing food and feeding their children. Objective: to explore the relationship of parenting stress and maternal feeding styles with preschool BMI. Materials and methods: a cross-sectional study. A total of 382 dyads, mother and child (3-5 years of age) participated. The children attended public preschool institutions. Participating mothers completed the Parenting Stress Scale and the Caregiver Feeding Styles Questionnaire. Weight and height were measured, and the child’s BMI was calculated. Results: 34 % of the mothers more frequently used an indulgent style, 28.2 % of the preschool children had overweight-obese. Mothers with an authoritative style had the highest mean range of parenting stress compared to other categories (H = 15.302, gl = 3, p = 0.002). Maternal schooling, responsibility and demand dimensions were identified as contributing to preschooler BMI. Conclusion: parenting stress and feeding styles are variables that contribute to the risk of overweight-obesity in preschool children. (AU)

Percepciones maternas sobre la sexualidad como tabú en personas con discapacidad

Fundamento: Una persona con discapacidad además de las barreras físicas enfrenta limitaciones sexuales, afectados por estereotipos sociales de diversa índole. Objetivo: Analizar las percepciones maternas sobre la sexualidad como un tabú para las personas que tienen algún tipo de discapacidad física o intelectual. Metodología: Estudio cualitativo con enfoque fenomenológico; se entrevistaron 100 madres, las cuales tienen familiares con discapacidad intelectual y física. Se analizó su sexualidad como tabú, y en función de ello varios subtemas y códigos de análisis. Se empleó la entrevista, procesada con Atlas. Resultados: Se observó que algunas personas con discapacidad tienen pérdida del deseo sexual; y sus familiares el sexo lo conceptualizan y lo relacionan con la prostitución. A muchos de ellos los esterilizan sin su consentimiento con la idea de que no serían capaces de ser responsables de formar una familia, o que los hijos tengan la misma discapacidad que sus progenitores. Conclusiones: Existe rechazo social a las personas con discapacidad, todavía no hay una inclusión total a la sociedad y peor aún a sus derechos de sexualidad. A las personas con discapacidad en ocasiones se les ha privado de las decisiones corporales de control natal por prejuicios y miedos de sus familiares por factores hereditarios; idea esta muy presente en el contexto estudiado; por ello, el sexo es un tabú para las madres entrevistadas de personas con discapacidad.

Background: A disabled person faces sexual limitations in addition to physical barriers, affected by various kinds of social stereotypes. Objective: To analyze maternal perceptions about sexuality as a taboo for persons who have some physical or intellectual disability. Methodology: Qualitative study with a phenomenological approach; 100 mothers were interviewed, all of whom have relatives with intellectual and physical disabilities. Their sexuality as a taboo was analyzed, and, in function of this, several sub-themes and analyses codes. The interview, processed with Atlas, was applied. Results: It was observed that some disabled persons have sexual desire loss, and their family members conceptualize sex and relate it with prostitution. Many of them are sterilized without their consent with the idea that they would not be capable to be responsible for raising a family, or that the children have the same disability as their parents. Conclusions: There is social rejection for people with disabilities; there is still no total inclusion in society and even worse to their sexuality rights. Persons with disabilities have on occasion been deprived of bodily birth control decisions because of prejudices and fears of their family members due to hereditary factors, this idea is very present in the studied context; therefore, sex is a taboo for the interviewed mothers of disabled persons.

Aplicación móvil para el seguimiento del crecimiento y cuidado nutricional del bebé en hogares colombianos

Introducción: El predominio y asequibilidad actual de los teléfonos móviles inteligentes han permitido una amplia difusión de variedad de aplicaciones a nivel mundial para el monitoreo del crecimiento y del estado nutricional de los lactantes. No obstante, la mayoría de estos recursos no son lo suficientemente completos para proveer una interfaz amigable de seguimiento del crecimiento, combinada con una adecuada educación parental en materia de nutrición y alimentación complementaria. Objetivos: Este trabajo pretende presentar el desarrollo y evaluación de la aplicación propuesta "Baby Home", con el fin de estudiar su potencial como herramienta digital de apoyo a padres y cuidadores en el cuidado nutricional de sus niños desde el hogar. Materiales y métodos: Baby Home integra una interfaz de seguimiento interactivo del crecimiento del bebé con una serie de contenidos educativos alimentarios, posibilitando al usuario consultar las prácticas recomendadas según el estado nutricional estimado de su bebé. Un conjunto de 7 jueces expertos fue reunido para evaluar la validez de estos contenidos consignados en la aplicación. Posteriormente, se llevó a cabo un estudio de prueba piloto con 8 madres participantes, las cuales aportaron en las fortalezas y debilidades de las funcionalidades propuestas. Resultados: la aplicación desarrollada muestra una aprobación positiva por los especialistas consultados y una aceptación satisfactoria entre las madres participantes gracias a su diseño amigable y funcionalidades de fácil uso. Los recursos visuales implementados prueban ser adecuados para la apropiación de los contenidos alimentarios y el empoderamiento del usuario en torno a los cuidados nutricionales que requieren sus niños. Conclusiones: Baby Home se ubica como un soporte práctico y accesible para el cuidado nutricional del lactante, otorgando seguridad y confianza al usuario en la alimentación de su niño y disponiendo la posibilidad de detectar oportunamente problemas de crecimiento.

Introduction: The current prevalence and affordability of smartphones have enabled a broad diffusion of a variety of mobile applications worldwide for monitoring infant's growth and nutritional status. However, most of these resources are not comprehensive enough to provide a user-friendly interface for growth tracking combined with proper parental education on nutrition and complementary feeding. Objectives: This work aims to present the development and evaluation of the proposed application "Baby Home", in order to study its potential as a digital tool for supporting parents and caregivers in the nutritional care of their children from home. Materials and methods: Baby Home integrates an interactive baby growth monitoring interface with a collection of educational content on infant feeding, allowing the user to check the recommended practices based on the estimated nutritional status of their baby. A panel of seven expert judges was assembled to evaluate the validity of these contents included in the application. Subsequently, a pilot study was carried out with eight participating mothers who contributed to the strengths and weaknesses of the proposed functionalities. Results: The developed application received positive feedback by the consulted specialists and a satisfactory acceptance within the participating mothers thanks to its friendly design and easy-to-use functionalities. The implemented visual resources proved to be well suited for the user's appropriation of feeding contents and their empowerment regarding the nutritional care required by their children. Conclusions: Baby Home is positioned as a practical and accessible support for the nutritional care of infants, providing safeness and confidence to the user in their child's feeding and the possibility of timely detection of growth problems.

Manual para la aplicación del instrumento de evaluación del Modelo Maternidades Nacer Con Cariño / Handbook for the Implementation of the Maternal Care Model Assessment Tool

El Modelo de Maternidades Nacer con Cariño (MNCC) se basa en el derecho de todas las madres y sus hijos a recibir atención adecuada, independientemente de su cultura, condición socioeconómica o edad, promueve el respeto por las tradiciones culturales, preferencias y valores de las embarazadas, su situación familiar y estilo de vida; se esfuerza por garantizar el derecho de la persona recién nacida recibir atención en un ambiente de confianza y seguridad, así como lograr que las relaciones entre autoridades de la institución, equipo de salud, padres y familias sean respetuosas, cálidas, efectivas coordinadas

The Model of Maternities Born with Love (MNCC) is based on the right of all mothers and their children to receive adequate care, regardless of their culture, socio-economic status or age, promotes respect for cultural traditions, preferences and values of pregnant women, their family situation and lifestyle; strives to guarantee the right of the newborn person to receive care in an atmosphere of trust and security, as well as to ensure that relations between authorities of the institution, Health team, parents and families be respectful, warm, effective coordinated

Percepción de apoyo social en padres de niños con diabetes mellitus tipo 1

Fundamento: el apoyo de familiares y del equipo de salud a los padres cuidadores de sus hijos diabéticos es fundamental para el afrontamiento a los cambios que provoca esta enfermedad en la dinámica familiar. Objetivo: describir la percepción de los padres cuidadores sobre el apoyo familiar y de los Sistemas de Salud en el comienzo de sus hijos con diabetes mellitus tipo 1. Métodos: estudio cualitativo descriptivo realizado mediante entrevista semiestructurada a cuatro padres cuidadores de niños con diagnóstico de diabetes tipo 1. El consentimiento informado fue realizado vía Google Forms y la entrevista fue vía plataforma ZOOM. Las entrevistas tuvieron una duración de 30 minutos. El análisis de las entrevistas se realizó utilizando el programa ATLAS.ti versión 22. Resultados: el comienzo de la enfermedad de los niños fue recibido por los padres con mucha confusión y falta de conocimiento. En cuanto a las redes de apoyo, los padres declararon la soledad como vivencia en el cuidado de los niños y, en relación a los equipos de salud, relataron que está enfocada en los cuidados básicos que tenían que cumplir, como la alimentación y el control glucémico, con ausencia de preocupación por el apoyo emocional. Conclusiones: las necesidades de apoyo desde los equipos de salud, a los padres cuidadores, más allá del control de la enfermedad, es una necesidad explícita desde la evidencia, que aún no ha sido considerada por los Sistemas de Salud. El apoyo debe trascender la familia, con una actuación importante de los profesionales de la salud y todo el contexto en que están insertos los niños, para contribuir a un manejo adecuado de la enfermedad.

Foundation: the support of family members and the health team for parents caring for their diabetic children is essential for facing with the changes that this disease causes in family dynamics. Objective: to describe the perception of parent caregivers about family support and Health Systems at the beginning of their children with type 1 diabetes mellitus. Methods: qualitative descriptive study carried out through semi-structured interviews with four parent caregivers of children with a diagnosis of type 1 diabetes. Informed consent was carried out via Google forms and the interview was via the ZOOM platform. The interviews lasted 30 minutes. The analysis of the interviews was carried out using the ATLAS.ti version 22 program. Results: the beginning of the children's illness was received by parents with much confusion and lack of knowledge. Regarding the support networks, the parents declared loneliness in the experience of caring for the children and, in relation to the health teams, they reported that it is focused on the basic care that they had to fulfill, such as food and hygiene, glycemic control, with absence of concern for emotional support. Conclusions: the support needs from health teams to parent caregivers, beyond disease control, is an explicit need from the evidence, which has not yet been considered by Health Systems. Support must go beyond the family, with important action by health professionals and the entire context in which children are inserted, to contribute to adequate management of the disease.

Divorcio parental, apego a los padres y satisfacción con la vida en adolescentes chilenos: un estudio comparativo

Si bien existen una serie de avances en la comprensión de los efectos del divorcio sobre el bienestar y desarrollo de los adolescentes, un aspecto que requiere mayor exploración es si existen variaciones en la satisfacción con la vida y la calidad de los vínculos de apego entre adolescentes que han experimentado o no el divorcio de sus padres. El presente estudio tuvo por objetivo evaluar diferencias en la satisfacción con la vida y en la calidad del apego a la madre y al padre entre adolescentes provenientes de familias intactas y quienes han experimentado el divorcio de sus padres. Mediante un estudio de corte transversal, se evaluó una muestra de 421 adolescentes chilenos entre 12 y 17 años, siendo un 54,6% hijos de padres casados y un 45,4% hijos de padres divorciados. Los análisis de diferencias de medias mediante pruebas t permitieron identificar que la satisfacción con la vida es mayor en los hijos de familias intactas. Asimismo, se detectaron diferencias en la calidad del apego hacia el padre, pero no hacia la madre. En específico, los hijos de padres divorciados reportaron menor calidad de la comunicación, menor confianza mutua y mayor alienación con sus padres que los hijos de familias intactas. Estos resultados, discutidos desde una perspectiva clínica, avanzan en la comprensión de los efectos del divorcio en adolescentes chilenos.

While there have been several advances in understanding the effects of divorce on the well-being and development of adolescents, one aspect that requires further exploration is whether there are variations in life satisfaction and the quality of attachment relationships among adolescents who have experienced their parents' divorce and those who have not. The present study aimed to assess differences in life satisfaction and the quality of attachment to both mothers and fathers among adolescents from intact families and those who have experienced their parents' divorce. Through a cross-sectional study, a sample of 421 Chilean adolescents aged 12 to 17 was evaluated, with 54.6% being children of married parents and 45.4% being children of divorced parents. Mean difference analyses using t-tests revealed that life satisfaction is higher among children from intact families. Additionally, differences in the quality of attachment to the father, but not to the mother, were detected. Specifically, children of divorced parents reported lower quality of communication, less mutual trust, and greater alienation from their parents than children from intact families. These results, discussed from a clinical perspective, contribute to the understanding of the effects of divorce on Chilean adolescents.

Técnicas de manejo de conducta en odontopediatría: aspectos éticos y legales / Behavioral management techniques in pediatric dentistry: ethical and legal aspects

Introducción: la profesión odontológica es una actividad orientada al cuidado de personas, entre ellos los niños, que necesitan un cuidado más específico estando en pleno desarrollo físico y emocional. Al trabajar con los niños se tiene que lidiar con la ansiedad con la que el pequeño entra por primera vez a la consulta. Para solucionar este problema, se han descrito diferentes técnicas cuya elección depende de la edad, de las necesidades del paciente y de la habilidad profesional. Estas técnicas se pueden agrupar en tres grupos: técnicas farmacológicas, técnicas comunicativas y técnicas no comunicativas. Objetivo: revisar la evidencia científica sobre los aspectos éticos y legales de las técnicas de manejo de conducta en odontopediatría. Material y método: se realizó una búsqueda en las bases de datos de PubMed/ Medline, Google Scholar y Scopus de acuerdo a unos criterios de inclusión y exclusión. Resultados: los resultados determinan que el empleo de las técnicas de manejo de conducta disminuye los niveles de ansiedad durante el tratamiento dental. El bajo nivel socioeconómico y educativo, y la utilización frecuente de videojuegos aumentan la ansiedad dental mientras la realización de deporte y una vida saludable la disminuyen. Conclusiones: entre las técnicas de manejo de conducta del paciente pediátrico, las de gestión comunicativa son las más aceptadas por los padres. Aunque no hay ninguna prohibición legal en el uso de técnicas farmacológicas o no comunicativas, estas la mayoría de las veces son rechazadas por los padres. (AU)

Introduction: The dental profession is an activity oriented to the people care, including children, who need more specific care being in full physical and emotional development. When working with children you have to deal with the anxiety with which the child first enters the consultation. To solve this problem, different techniques have been described whose choice depends on the age, patient needs and professional skills. These techniques can be grouped into three groups: pharmacological techniques, communicative techniques and noncommunicative techniques. Objective: To review scientific evidence on the ethical and legal aspects of behavioral management techniques in pediatric dentistry. Material and method: A search was performed in the databases of PubMed/ Medline, Google Scholar y Scopus, according to inclusion and exclusion criteria. Results: The results determine that the use of behavioral management techniques decreases anxiety levels during dental treatment. The low socioeconomic and educational level and the frequent use of video games increase dental anxiety while the performance of sports and a healthy life decrease it. Conclusions: Among the pediatric patient behavior management techniques, those with communicative management were the most accepted by parents. Although there is no legal prohibition on the use of pharmacological or non-communicative techniques, these are most often rejected by parents. (AU)

El pediatra y los padres en la toma de decisiones de tratamiento en plagiocefalia posicional: una revisión narrativa / The pediatrician and parents in treatment decision-making in positional plagiocephaly: A narrative review

La plagiocefalia posicional (PP) es una de las causas más frecuentes de consulta en neurocirugía pediátrica. La incidencia de PP aumentó en los '90, a partir de la campaña Dormir de espaldas. Junto con el aumento de la demanda de atención, se verifica un debate acerca de la eficacia de los distintos tratamientos. La interacción padres ­ pediatra orientada a elegir la mejor terapéutica adquiere importancia, particularmente cuando se trata de decisiones sensibles a la preferencia. Es necesario saber más acerca de la naturaleza de la toma de decisiones de tratamiento de PP, para contribuir al desarrollo de procesos decisorios eficaces. Se realizó una revisión narrativa sobre investigaciones en toma de decisiones de tratamiento en PP. Se identificaron artículos en PubMed y Google Scholar (1990 ­ 2022) en una búsqueda con los descriptores "plagiocephaly", "decision making" y "parents". Se incluyeron artículos cuyo tema central fuera la toma de decisiones en PP, o que la desarrollaran como parte de otro tema. Se excluyeron trabajos en los que la toma de decisiones aparece de modo secundario o tangencial. Se encontraron 3 artículos con distintos diseños metodológicos, en los que la severidad de la presentación, los elementos socioculturales y emocionales, y los aspectos relacionados con el tratamiento son los factores más implicados en la toma de decisiones. Las relaciones entre la ansiedad parental, las expectativas de tratamiento y la percepción subjetiva de la PP, y el rol del pediatra como proveedor de información válida y confiable son temas que necesitan de ulterior investigación (AU)

Positional plagiocephaly (PP) is one of the main reasons for consultation in pediatric neurosurgery. The incidence of PP increased in the 1990s, after the "Back to Sleep" campaign. Concurrently, the growing demand for care has led to a debate regarding the effectiveness of the different treatments. The parent-pediatrician interaction is aimed at choosing the best therapeutic approach becomes important, particularly when it comes to preference-sensitive decisions. There is a need to better understand the nature of PP treatment decision-making in order to contribute to the development of effective decisionmaking processes. In this narrative review, we evaluated the research on treatment decision-making in PP. Articles were identified in PubMed and Google Scholar (1990 - 2022) using the search terms "plagiocephaly", "decision-making" and "parents". Articles were included if their central theme was decision-making in PP, or if they developed it as part of another subject. We excluded articles in which decision-making appeared in a secondary or tangential way. Three articles were identified with different methodological designs, in which the severity of the presentation, sociocultural and emotional aspects, and aspects related to treatment were the factors most implicated in decision making. The relationships between parental anxiety, treatment expectations, subjective perception of PP, and the role of the pediatrician as a provider of valuable and reliable information are topics that require further investigation (AU)

Psychometric Properties of the Inventory of Parents-Peer Attachment (IPPA) in Adolescents with Behavioural Problems / Propiedades psicométricas del Inventario de Apego a Padres-Iguales (IPPA) en adolescentes con problemas de comportamiento

Background: The Inventory of Parental-Peer Attachment (IPPA) is an internationally recognized measure to assess the attachment of adolescents to their parents and peers. The objective of this study was to examine the psychometric properties of the IPPA in a sample of Spanish adolescents with behavioural problems. Method: The sample was composed of 294 Spanish adolescents (53% girls) with behavioural problems. The IPPA mother, father, and peer versions, along with other related measures, were administered. Results: The 25-item scale, distributed into three factors, was confirmed for both the mother and father versions but not for the peer version. The IPPA showed adequate values of reliability ranging from .79 to .86. Validity was demonstrated through correlations with emotional intelligence, antisocial behaviour, and aggressiveness. Conclusion: The three-factor version of the IPPA is a useful, reliable, and valid scale to assess the attachment of adolescents with problematic behaviours and their parents. (AU)

Antecedentes: El Inventario de Apego a Padres e Iguales (IPPA) es un instrumento reconocido internacionalmente para evaluar el apego de adolescentes hacia padres e iguales. El objetivo de este estudio ha sido examinar las propiedades psicométricas del IPPA en una muestra de adolescentes españoles con problemas de conducta. Método: La muestra estaba compuesta por 294 adolescentes españoles (53% chicas) con problemas de conducta. Se administraron las versiones de IPPA madre, IPPA padre e IPPA iguales, junto con otras medidas relacionadas. Resultados: Se ha confirmado la escala de 25 ítems, distribuida en tres factores, para la versión IPPA madre e IPPA padre, pero no para la versión de iguales. El IPPA ha mostrado valores adecuados de fiabilidad que oscilaban entre .79 y .86. La validez se demostró mediante las correlaciones significativas con las variables inteligencia emocional, conducta antisocial y agresividad. Conclusiones: La versión de tres factores del IPPA es una escala útil, fiable y válida para evaluar el vínculo de adolescentes que muestran conductas problemáticas con sus padres. (AU)