A gestão do sofrimento psíquico infantojuvenil: Uma pesquisa com a Rede de Atenção Psicossocial do município do Rio de Janeiro / The management of child and adolescent psychological suffering: A study with the Psychosocial Care Network of the municipality of Rio de Janeiro

Nesta tese investigamos a noção de sofrimento psíquico, cotejando esse conceito com os de sofrimento social e transtorno mental, na rede de atenção psicossocial infantojuvenil do município do Rio de Janeiro. Consideramos como ponto de partida a construção do sentimento de infância e sua penetração no Brasil por meio do discurso higienista, resultando na tardia inserção da criança na agenda da atenção psicossocial brasileira. Em seguida, apontamos a polifonia discursiva contida na noção de sofrimento e abordamos o tema teoricamente a partir do método genealógico foucaultiano, identificando nessa polifonia os discursos: antropológico, biomédico e psicanalítico. A partir daí, exploramos os distintos níveis do governo da infância, tendo como guias os conceitos de biopoder, biopolítica, governamentalidade e medicalização. Para avançar na investigação, aplicamos metodologia qualitativa com a técnica de coleta de dados por meio de grupo focal, realizado a partir do relato de um caso traçador, eleito por cada equipe de quatro CAPSi da rede de atenção psicossocial infantojuvenil do município do Rio de Janeiro. Os achados da pesquisa nos mostram, por ora, que a noção de transtorno mental, representante do discurso biomédico, mantém-se presente nas práticas da saúde mental em paralelo às noções de sofrimento psíquico e sofrimento social. Há, no entanto, um certo mascaramento do sofrimento motivado pelo social em favor do sofrimento psíquico que, para ser reconhecido, precisa ser nomeado como transtorno. Esse achado nos parece se justificar pela própria condição psíquica da criança e mesmo do adolescente, ainda apresentados (falados) pelo outro. Em nossa interpretação, essa condição se radicaliza quando a história social da criança não lhe oferece marcas do infantil que favoreceriam que o sentimento de infância se fizesse representar nas histórias dessas crianças e adolescentes. (AU)

In this thesis, we investigate the notion of psychological suffering, comparing this concept with those of social suffering and mental disorder, in the child and adolescent psychosocial care network of the municipality of Rio de Janeiro. We consider as a starting point the construction of the feeling of childhood and its penetration in Brazil through the hygienist discourse, resulting in the late insertion of the child in the Brazilian psychosocial care agenda. Next, we point out the discursive polyphony contained in the notion of suffering and approach the subject theoretically from the Foucauldian genealogical method, identifying in this polyphony the discourses: anthropological, biomedical and psychoanalytic. From there, we explore the different levels of childhood government, guided by the concepts of biopower, biopolitics, governmentality and medicalization. To advance in the investigation, we applied a qualitative methodology with data collection technique through focus group, carried out from the report of a tracer case, elected by each team of four CAPSi from the child and adolescent psychosocial care network of the municipality of Rio de Janeiro. The research findings show us, for now, that the notion of mental disorder, representative of the biomedical discourse, remains present in mental health practices in parallel with the notions of psychic suffering and social suffering. However, there is a certain masking of suffering motivated by the social in favor of psychic suffering which, to be recognized, needs to be named as a disorder. This finding seems to be justified by the very psychic condition of the child and even of the adolescent, still presented (spoken) by the other. In our interpretation, this condition is radicalized when the child's social history does not offer him marks of the infantile that would favor the feeling of childhood to be represented in the stories of these children and adolescents. (AU)

Pathways to care in children- perspectives from a child guidance clinic in South India.

PURPOSE: In India the pathways to care in children with mental health problems remain relatively unexplored. Investigating the factors that drive the pathway will help determine interventions and also draft policies for a streamlined Child and adolescent mental health service. METHOD: Children who attended the Child Guidance Clinic sampled by WHO Pathways Encounter questionnaire. Statistical tests applied to find key influencers like gatekeepers, intermediate points of care, symptoms initiating referral, duration of untreated illness, time to arrive at appropriate care and primary diagnosis. RESULTS: The most common diagnostic category was externalizing disorder 51(37.5 %). The gatekeepers identified were 111(81.6 %) Parents/Relatives/Guardians and teachers 25 (18.3 %). Academic concerns identified by teachers took a mean of 72 months (30.271) to arrive at appropriate care versus 50.4 months (23.18) when identified by Parents/Relatives/Guardians group. Significant delays were observed with Neurodevelopmental disorders arriving to care with delays up to 130.2 (70.11) months (p < 0.001) and having 64.2 (33.7) months (p < 0.001) duration of untreated illness. Externalizing disorders took a duration of 94.08 (54.17) months (p < 0.001) to arrive to appropriate care and had 54.2 (36.33) months (p < 0.001) duration of untreated illness. Teachers took longer time in detecting the indicators and this caused duration of untreated illness of 73.44 (36.05) months (p < 0.001) and a delay of 128.08 (71.23) months (p < 0.001) to arrive to appropriate care. CONCLUSIONS: The pathways to care in children are characterized by long duration of untreated illness and undue time to care. Gatekeepers like teachers and intermediary points of care were associated with inadvertent delays along the pathway.

Challenges and Opportunities of Evidence Use in Practice in Australian Children's Development Programs.

This paper explores the role of evidence and its use in a cluster of Australian community-based child development programs. The paper draws on findings from a 2016-2017 study commissioned by a not-for-profit organization to review their programs' alignment with government evidence-based program expectations. Cunningham and Duffee's (2009) evidence-based practice style typology is utilized to examine how different purposes of use drive styles of and approaches to evidence sourcing, application, and reporting. Perspectives on what constitutes evidence and how such evidence is valued, used, and reported can vary considerably between individual programs, irrespective of enforced standards and expectations. It is argued that a single-dimensional approach to program evidence-based evaluation and reporting is not appropriate and potentially damaging in contexts where community-based programs have different purposes, structures, cultures, and intentions. Given a program's particular evidence-use style, evidence-based criteria, processes, and reporting requirements should be matched accordingly.

Audit of glycemic control in patients with type 1 diabetes referred to a pediatric clinic in a specialized center in Kuwait.

INTRODUCTION: Intensive glycemic control reduces the risk of microvascular and macrovascular complications. Furthermore, optimal glycemic control is essential for normal growth and development. Thus, there is a need to monitor and evaluate glycemic control in patients with type 1 diabetes (T1D). Our aim was to audit glycemic control in patients with T1D in a specialized center as per the Society of Pediatric and Adolescent Diabetes (ISPAD) Hemoglobin A1C (HbA1C) target recommendations published in 2014. METHODS: This is a retrospective cross-sectional study reporting on glycemic control (HbA1C) of patients younger than 21 years of age and with T1D treated at Dasman Diabetes Institute (DDI) between January 2013 and December 2015. RESULTS: A total of 470 patients with T1D (250 males and 220 females) were included. Only 53 (11.3%) patients met the ISPAD target for optimal glycemic control with HbA1C < 7.5% (58 mmol/mol). Older age was positively associated with poor glycemic control (p = 0.001) while Continuous Subcutaneous Insulin Infusion (CSII) therapy was negatively associated with poor glycemic control, adjusted Odds Ratio (OR) 0.33 (95% confidence interval (CI): 0.16-0.66) for CSII and adjusted OR 0.42 (95% CI: 0.27-0.64) for shifting to CSII (p < 0.001). CONCLUSION: Achieving optimal glycemic control is a significant challenge for young patients with T1D. Glycemic control goals should be individualized to achieve such goals safely, realistically and with a better quality of life for patients with T1D.

Similaridades e diferenças de crianças/cuidadores atendidos em serviço-escola de psicologia e psiquiatria / Similarities and differences of children/caregivers at traning-clinic of psychology and psychiatry / Semejanzas y diferencias de niños/cuidadores atendidos en servicio-escuela de psicología y psiquiatría

Para oferecer o melhor atendimento a crianças e adolescentes encaminhados para serviço-escola de Psicologia e Psiquiatria, buscou-se descrever e comparar o perfil de famílias que buscaram atendimento nesses serviços. Foram avaliadas 40 mães e crianças (20 participantes em cada grupo ­ lista de espera para atendimento psicológico ou para atendimento psiquiátrico). As mães responderam ao Inventário de Comportamentos para Crianças, Inventário Beck de Depressão, Escala de Ajustamento Conjugal e entrevista semiestruturada. As crianças atendidas na Psiquiatria obtiveram mais escores clínicos para queixas somáticas, problemas de pensamento e problemas externalizantes. A comparação do perfil das responsáveis indicou que a escolha da modalidade de tratamento infantil pode estar relacionada às variáveis maternas, sendo que as mães com maior adversidade e depressão optam pelo tratamento medicamentoso. Observa-se a importância de atendimento simultâneo para mãe e criança e de propostas voltadas para garantir a procura e adesão ao tratamento psicológico. (AU)

In order to provide the best care to children and adolescents referred for university-based psychology and psychiatry centers, this research describes and compares the profile of families who looked for treatment in these services. Forty mothers and children were assessed (20 participants in each group ­ Waiting list for psychological counseling or psychiatric care). The mothers completed the Child Behavior Checklist, Beck Depression Inventory, Marital Adjustment Scale and semi-structured interview. The children referred to psychiatry services had higher scores in the clinical range for somatic complaints, thought problems and externalizing problems. The comparison of the caregivers' profiles indicated that the choice of the type of service for the child was related to maternal variables, since mothers with greater adversity levels and depression choose drug treatment. This highlights the importance of simultaneously care for mother and child and proposals to ensure demand and adherence to psychological treatment. (AU)

Para ofrecer mayor atendimiento a niños y adolescentes encaminados para el servicio escuela de psicología y psiquiatría, se buscó describir y comparar el perfil de familias que buscaron ayuda en estos servicios.Fueron evaluados 40 madres y niños (20 participantes en cada grupo - Lista de espera para atendimiento psicológico o atendimiento psiquiátrico). Las madres respondieron al Inventario de Comportamiento para Niños, Inventario Beck de Depresión, Escala de Ajustamiento matrimonial y entrevista semi-estructurada. Los niños atendidos en psiquiatría obtuvieron mayores resultados clínicos para las quejas somáticas, problemas de pensamiento y problemas externos. La comparación de perfil de los responsables indicó que la elección de la modalidad de tratamiento infantil puede estar relacionada a las variables maternas. Madres con mayor adversidad o con depresión optan por tratamiento farmacológico. Se considera importante la atención simultánea (madre y niño) y también propuestas para garantizar la búsqueda y adhesión al tratamiento psicológico. (AU)

[Medical evaluation for suspected sexual violence against girls].

INTRODUCTION: Sexual violence against children is a hidden problem. Medical examination and evaluation is needed to search for possible injuries, exclude infections, procure legal evidence and ensure the child´s welfare. We assessed medical evaluations done at Landspitali University Hospital and in the Reykjavik Children's House, a specialized clinic for childhood abuse cases. MATERIAL AND METHODS: Retrospective descriptive analysis was performed on the standardized medical examinations. Age, sex, waiting time from reported violence until examination and recorded aberrant external genitalia findings were noted, and classified by the medically--oriented Adams system. Offence severity stages were assigned. RESULTS: Medical examination cases numbered 224 for 220 girls aged 1-17 years. Records were available on 218 standarized examinations among girls; 201 were adequate (92%). Most were conducted within a month (medium waiting-time 28 days; range 1-166). Hymenal changes were in 24 cases possibly associated with sexual violence, including 21 in a girl not sexually active. Two girls had human papillomavirus warts (1%) and one chlamydial infection (0.5%). Medical examination was normal in 85% (165/193) of girls who were not sexually active; 24 had possibly experienced sexual violence and four results were uncertain/controversial. For 71 offence severity was serious. CONCLUSION: Most examinations were conducted on prepubertal girls, were not a matter of urgency and showed normal results. Possible relation to sexual violence was described for one in eight. Infections were rare. When child sexual abuse is suspected, care with methodology and procedures is needed, both for elective and acute medical examinations. Key words: Violence, child sexual abuse, children, external genitalia, injuries, severity grading. Correspondence: Ebba Margret Magnusdottir, ebbamag@landspitali.is.

[ Symptom Severity and the Role of Friendship in Children at a Child Guidance Center from Parents' Point of View]. / Symptombelastung und die Rolle von Freundschaften bei Kindern in einer Erziehungsberatungsstelle aus Elternsicht.

By means of the Child Behavior Checklist (CBCL) it was assessed how much children who are attended to a child guidance center suffer from behavior problems and emotional distress. Furthermore, the interaction between straining and supporting influences was examined. Results show that symptom severity lies in the range of clinical significance. Children of divorced parents show more internalizing as well as externalizing problems than children of nuclear families. High social integration is correlated with lower psychic symptomatic - yet, this finding was dependent on family situation: While frequency to meet friends in children from nuclear families was correlated with lower symptomatic, this effect could not be found in children of divorced parents.

A função paterna na clínica infantil / The paternal function in children's clinic / La función paterna en la clínica infantil

O objetivo deste trabalho é discutir a importância da função paterna no desenvolvimento e na clínica infantil. Tal função pode ser entendida, dentro da psicanálise, como responsável pelo amparo à mãe e pela introdução dos limites necessários ao bom desenvolvimento emocional. No caso de Marcelo, o terapeuta assume essa função, ajudando-o na organização e adotando uma postura firme que sustente os limites para o menino, partindo-se do vínculo estabelecido. Esse tipo de intervenção trouxe resultados positivos nesse caso, de forma que destaca-se a importância da função paterna e a possibilidade do terapeuta assumi-la quando isso se faz necessário.(AU)

The objective of this paper is to discuss the importance of the paternal function in children's development and clinic. Such function may be understood, in psychoanalysis, as responsible for the support of the mother and the introduction of the limits needed for good emotional development. In Marcelo's case, the therapist takes this role, helping in organization and embracing a rigid position that supports the limits for the boy, starting from the established bond. This type of intervention brought positive results in this case, so that stands out the importance of the paternal function and the possibility of the therapist to take this role when it is necessary.(AU)

El objetivo de este trabajo es discutir la importancia de la función paterna en el desarrollo y la clínica de los niños. Esta función puede ser entendida, dentro del psicoanálisis, como responsable del apoyo a las madres y de la introducción de límites necesarios para el adecuado desarrollo emocional. En el caso de Marcelo, el terapeuta asume esta función, ayudándole en la organización y tomando una posición firme que soporte los límites para el niño, a partir de la relación terapéutica establecida. Este tipo de intervención ha dado resultados positivos, por lo que pone de relieve la importancia de la función paterna y la posibilidad del terapeuta tomarla cuando sea necesario.(AU)

A função paterna na clínica infantil / The paternal function in children's clinic / La función paterna en la clínica infantil

O objetivo deste trabalho é discutir a importância da função paterna no desenvolvimento e na clínica infantil. Tal função pode ser entendida, dentro da psicanálise, como responsável pelo amparo à mãe e pela introdução dos limites necessários ao bom desenvolvimento emocional. No caso de Marcelo, o terapeuta assume essa função, ajudando-o na organização e adotando uma postura firme que sustente os limites para o menino, partindo-se do vínculo estabelecido. Esse tipo de intervenção trouxe resultados positivos nesse caso, de forma que destaca-se a importância da função paterna e a possibilidade do terapeuta assumi-la quando isso se faz necessário.

The objective of this paper is to discuss the importance of the paternal function in children's development and clinic. Such function may be understood, in psychoanalysis, as responsible for the support of the mother and the introduction of the limits needed for good emotional development. In Marcelo's case, the therapist takes this role, helping in organization and embracing a rigid position that supports the limits for the boy, starting from the established bond. This type of intervention brought positive results in this case, so that stands out the importance of the paternal function and the possibility of the therapist to take this role when it is necessary.

El objetivo de este trabajo es discutir la importancia de la función paterna en el desarrollo y la clínica de los niños. Esta función puede ser entendida, dentro del psicoanálisis, como responsable del apoyo a las madres y de la introducción de límites necesarios para el adecuado desarrollo emocional. En el caso de Marcelo, el terapeuta asume esta función, ayudándole en la organización y tomando una posición firme que soporte los límites para el niño, a partir de la relación terapéutica establecida. Este tipo de intervención ha dado resultados positivos, por lo que pone de relieve la importancia de la función paterna y la posibilidad del terapeuta tomarla cuando sea necesario.

[Anxious School Absenteeism: Cognitive-Behavioral Treatment of School Phobia at a Psychological Counseling Center]. / Angstbedingte Schulverweigerung: Verhaltenstherapeutisch orientiertes Vorgehen bei schulphobischem Verhalten an einer psychologischen Beratungsstelle.

Resulting from a shortage of possibilities in the ambulant treatment of school phobia behavior-therapeutic interventions were established at a psychological counseling center for families twenty years ago, which have been in existence to this day. The criteria of anxiety-based absenteeism as well as problems of terminology and classification will be presented with emphasis on school phobia as a combination of separation anxiety and social anxiety ("Schulphobie"). The multimodal treatment focuses on cognitive interventions, graduated exposition and close cooperation with teachers. The counselor is also in charge of the networking and cooperation of all people concerned. A short case study is used to illustrate the process. Measures such as training and information for teachers and school social workers and a manual for the comprehension and the treatment of school phobia, which was edited in cooperation with a psychological counseling center for schools complement the treatment.

Caracterización de la mortalidad perinatal en Manizales, Colombia 2009-2012 / Caracterização da Mortalidade Perinatal em Manizales, Colômbia, 2009-2012 / Characterization of Perinatal Mortality in Manizales, Colombia, 2009-2012

Objetivo: Caracterizar la mortalidad perinatal en Manizales entre 2009 y 2012, según variables sociodemográficas, clínicas, de atención en salud, régimen de afiliación y sus relaciones. Método: Estudio descriptivo retrospectivo que incluyó todas las muertes perinatales (desde las 22 semanas de gestación o 500 gramos de peso, hasta los 7 días de vida) ocurridas entre enero de 2009 y diciembre de 2012. Se analizaron 212 fichas de mortalidad perinatal del Sistema de Vigilancia Epidemiológica. Resultados: La frecuencia de mortalidad perinatal y sus características es similar en ambos regímenes de afiliación (contributivo 50,9% y subsidiado 49,1%). La causa de muerte más frecuente fue la prematurez extrema e hipoxia intrauterina no especificada; la mortalidad mayor se presentó dentro de las primeras 24 horas de vida. La comuna más afectada fue Cumanday (29,1 x 1000 nv). Se observó baja correlación entre las variables de estudio; no obstante, a través de análisis de regresión se identificó que el número de controles prenatales, el peso al nacer y el momento en el que ocurrió la muerte, explican el 83% de las semanas de gestación al momento de morir. La mayor parte de los controles prenatales se realizaron en el primer nivel de atención, las muertes perinatales en el tercer nivel de atención. Conclusiones: Se plantea la hipótesis de una falla en la identificación del riesgo en la madre, en el control prenatal. Estos controles se realizan en el primer nivel; sin embargo, la atención al parto y la presentación de las muertes perinatales ocurren en el tercer nivel de atención.

Objective: To characterize perinatal mortality in the city of Manizales, Colombia between 2009 and 2012, according to socio demographic, clinical, health care, affiliation system variables and their relationships. Method: Retrospective, descriptive study that included all perinatal deaths (from the 23 weeks of gestation or 500 grams of weight to seven days of life after birth) that happened between January 2009 and December 2012. Two-hundred and twelve (212) perinatal mortality file cards from the Epidemiological Surveillance System were analyzed. Results: The perinatal mortality frequency and its characteristics are similar in both affiliation systems (contributory, 50.9% and subsidized, 49.1%). The most frequent causes of death were extreme prematurity and unspecified intra-uterine hypoxia; the highest mortality took place in the first 24 hours of life. The most affected commune (29.1 x 1000 nv) was the Cumanday commune. A low correlation among the variables of the study was observed; nevertheless, the regression analysis permitted to identify that the amount of prenatal controls, the weight at birth and the moment of death explain the 83% weeks of gestation at the moment of death. Most of the prenatal controls took place in the primary health care level. Conclusions: There is a hypothesis concerning a failure in the identification of the mother’s risk and in prenatal control. These controls take place in the primary health care level; however, labor care and the presence of perinatal deaths occur at the tertiary level of health care.

Objetivo: Caracterizar a mortalidade perinatal em Manizales entre 2009 e 2012, segundo variáveis sociodemográficas, clínicas, de atenção em saúde, regime de afiliação e suas relações. Método: Estudo descritivo retrospectivo que incluiu todas as mortes perinatais (desde as 22 semanas de gestação ou 500 gramas de peso, até os 7 dias de vida) ocorridas entre janeiro de 2009 e dezembro de 2012. Analisaram se 212 fichas de mortalidade perinatal do Sistema de Vigilância Epidemiológica. Resultados: A freqüência de mortalidade perinatal e suas características são similares em ambos os regimes de afiliação (contributivo 50,9% e subsidiado 49,1%). A causa de morte mais freqüente foi o prematuro extremo e hipoxia intra-uterina não especificada; a mortalidade maior se apresentou dentro das 24 horas de vida. A comuna mais afetada foi Cumanday ( 29,1 x 1000 nv). Observou se baixa correlação entre as variáveis de estudo; não obstante a traves de analise de regressão se identificou que o numero de controles pré-natais, o peso ao nascer e o momento no que ocorreu a morte, explicam o 83% das semanas de gestação ao momento de morrer. A maior parte dos controles pré- natais se realizou no primeiro nível de atenção, as mortes perinatais no terceiro nível de atenção. Conclusões: Estabelece se a hipótese de uma falha na identificação no risco na mãe, no controle pré-natal. Estes controles se realizaram no primeiro nível; entanto, a atenção ao parto e a apresentação das mortes perinatais ocorrem no terceiro nível de atenção.

Caracterização do perfil de clientela de clínica-escola de psicopedagogia / Characterization of clinic-school clientele profile of educational psychology

OBJETIVO: Este artigo apresenta resultado de estudo retrospectivo desenvolvido com o objetivo de traçar o perfil de clientela atendida entre 2000 e 2009 na clínica-escola de Psicopedagogia a partir dos dados registrados em 5822 prontuários. MÉTODO: Para a coleta de dados foi elaborado protocolo abrangendo questões sociodemográficas e de evolução clínica. RESULTADOS: O estudo demonstrou que a população atendida é do sexo masculino (65,2%), aluno de escola pública (89,4%), com idade entre 7 e 13 anos (83,9%), em sua maioria, oriundos de famílias de baixa renda, encaminhado pela escola em função de dificuldades de aprendizagem da escrita (66%). Os pais são separados (61%), com baixo nível de escolaridade. CONCLUSÃO: Esses resultados indicam a necessidade do planejamento de políticas de saúde e educação e formação profissional condizentes com a realidade.(AU)

OBJECTIVE: This paper presents results of a retrospective study developed with the objective outlining the profile of clients served between 2000 and 2009, in the Psychopegagogy Clinic-School of UNIFIEO from data recorded on 5822 records. METHODS: For the data collection a protocol chart has been drawn up covering socio-demographic issues and clinical evolution. RESULTS: The study showed that the population served is male (65.2%), public school student, aged between 7 and 13 years (83.9%), mainly from low-income families, forwarded by the school because of learning difficulties in writing (73%). Parents are separated in 61% of cases, with low level of schooling. CONCLUSIONS: Concludes by the need of planning in health policies and education and training consistent with the reality.(AU)

Caracterização do perfil de clientela de clínica-escola de psicopedagogia / Characterization of clinic-school clientele profile of educational psychology

OBJETIVO: Este artigo apresenta resultado de estudo retrospectivo desenvolvido com o objetivo de traçar o perfil de clientela atendida entre 2000 e 2009 na clínica-escola de Psicopedagogia a partir dos dados registrados em 5822 prontuários. MÉTODO: Para a coleta de dados foi elaborado protocolo abrangendo questões sociodemográficas e de evolução clínica. RESULTADOS: O estudo demonstrou que a população atendida é do sexo masculino (65,2%), aluno de escola pública (89,4%), com idade entre 7 e 13 anos (83,9%), em sua maioria, oriundos de famílias de baixa renda, encaminhado pela escola em função de dificuldades de aprendizagem da escrita (66%). Os pais são separados (61%), com baixo nível de escolaridade. CONCLUSÃO: Esses resultados indicam a necessidade do planejamento de políticas de saúde e educação e formação profissional condizentes com a realidade...

OBJECTIVE: This paper presents results of a retrospective study developed with the objective outlining the profile of clients served between 2000 and 2009, in the Psychopegagogy Clinic-School of UNIFIEO from data recorded on 5822 records. METHODS: For the data collection a protocol chart has been drawn up covering socio-demographic issues and clinical evolution. RESULTS: The study showed that the population served is male (65.2%), public school student, aged between 7 and 13 years (83.9%), mainly from low-income families, forwarded by the school because of learning difficulties in writing (73%). Parents are separated in 61% of cases, with low level of schooling. CONCLUSIONS: Concludes by the need of planning in health policies and education and training consistent with the reality...

[Educational competence of parents with children participating in youth welfare measures]. / Erziehungskompetenz von eltern mit kindern in jugendhilfe-maßnahmen.

OBJECTIVE: The study examines the influence of specific risks on parenting at the beginning of youth welfare measures. METHOD: Family risk factors as well as parental behaviour styles of N = 74 parents were assessed with standardized questionnaires. RESULTS: The results were evaluated cross-sectionally with one-way factor analysis. Three groups were formed according to degree of risk factors. Families with special risks, i.e., material needs, physically ill parents, or single parents, show a significantly lower level of parenting competence. Differences in negative parenting features are not found to be under the influence of specific risks. CONCLUSIONS: Parents of children in youth welfare measures who are specifically stressed may need special training to increase their parenting skills, especially when pre-post comparisons show lower parenting quality in the group with specific risk factors at the end of an intervention.

As flores estão brotando: atendimento infantil em consultas terapêuticas / The flowers are blooming: child care in therapeutic consultations / Las flores están brotando: atención psicológica de los niños en consultas terapéuticas

As consultas terapêuticas são uma modalidade de atendimento psicoterápico que representa nova possibilidade de intervenção psicológica voltada para a escuta, para a prática e para a flexibilidade clínicas advindas da teoria do amadurecimento humano. Tal modalidade possibilita sustentação emocional para que o paciente possa retomar sua continuidade de ser e seu processo de amadurecimento emocional. Apresenta-se o caso de uma menina de oito anos de idade, atendida em consultas terapêuticas na clínica-escola de uma universidade pública. A procura pelo atendimento foi realizada pela mãe, que relatou como principais queixas: humor deprimido, dores no peito e temperamento difícil. O manejo clínico e as experiências constitutivas do si mesmo por meio do brincar compartilhado possibilitaram à criança a expressão do gesto espontâneo, da criatividade e de uma maior confiança na própria capacidade.(AU)

Therapeutic consultations are a modality of therapeutic assessment with possibility of psychological evaluation and intervention by means of practical, clinical flexibility and psychoanalysis of listening, in accordance with theory of human's maturity. This therapeutic modality provides an emotional support so the patient can retake his continuity of being and his emotional maturation process. This study presents eight year-old girl's case, in therapeutic consultations in a public university's school clinic. The demand for care was done by her mother who reported complaints such as depressed mood, chest pains and difficult temperament. The clinical handling and the experiences that constitutes itself through the shared play allowed the expression of child's spontaneous gesture, creativity and confidence in his ability.(AU)

Las consultas terapéuticas son una modalidad de psicoterapia que representa una nueva posibilidad de intervención psicológica centrado en la escucha, en la práctica y en la flexibilidad clínicas derivadas de la teoría de la maduración humana. Esta modalidad proporciona apoyo emocional para que el paciente pueda reanudar su continuidad existencial y su proceso de maduración emocional. Se presenta el caso de una niña de ocho años de edad, recibida en consultas terapéuticas en la clínica-escuela en una universidad pública. La demanda del servicio ha estado en manos de su madre, quien reportó las siguientes quejas: estado de ánimo depresivo, dolor en el pecho y temperamento difícil. La gestión clínica y las experiencias constitutivas del yo a través del juego compartido han permitido la expresión del gesto espontáneo, la creatividad y una mayor confianza en su capacidad.(AU)

As flores estão brotando: atendimento infantil em consultas terapêuticas / The flowers are blooming: child care in therapeutic consultations / Las flores están brotando: atención psicológica de los niños en consultas terapéuticas

As consultas terapêuticas são uma modalidade de atendimento psicoterápico que representa nova possibilidade de intervenção psicológica voltada para a escuta, para a prática e para a flexibilidade clínicas advindas da teoria do amadurecimento humano. Tal modalidade possibilita sustentação emocional para que o paciente possa retomar sua continuidade de ser e seu processo de amadurecimento emocional. Apresenta-se o caso de uma menina de oito anos de idade, atendida em consultas terapêuticas na clínica-escola de uma universidade pública. A procura pelo atendimento foi realizada pela mãe, que relatou como principais queixas: humor deprimido, dores no peito e temperamento difícil. O manejo clínico e as experiências constitutivas do si mesmo por meio do brincar compartilhado possibilitaram à criança a expressão do gesto espontâneo, da criatividade e de uma maior confiança na própria capacidade...

Therapeutic consultations are a modality of therapeutic assessment with possibility of psychological evaluation and intervention by means of practical, clinical flexibility and psychoanalysis of listening, in accordance with theory of human's maturity. This therapeutic modality provides an emotional support so the patient can retake his continuity of being and his emotional maturation process. This study presents eight year-old girl's case, in therapeutic consultations in a public university's school clinic. The demand for care was done by her mother who reported complaints such as depressed mood, chest pains and difficult temperament. The clinical handling and the experiences that constitutes itself through the shared play allowed the expression of child's spontaneous gesture, creativity and confidence in his ability...

Las consultas terapéuticas son una modalidad de psicoterapia que representa una nueva posibilidad de intervención psicológica centrado en la escucha, en la práctica y en la flexibilidad clínicas derivadas de la teoría de la maduración humana. Esta modalidad proporciona apoyo emocional para que el paciente pueda reanudar su continuidad existencial y su proceso de maduración emocional. Se presenta el caso de una niña de ocho años de edad, recibida en consultas terapéuticas en la clínica-escuela en una universidad pública. La demanda del servicio ha estado en manos de su madre, quien reportó las siguientes quejas: estado de ánimo depresivo, dolor en el pecho y temperamento difícil. La gestión clínica y las experiencias constitutivas del yo a través del juego compartido han permitido la expresión del gesto espontáneo, la creatividad y una mayor confianza en su capacidad...

El cambio conceptual de dos maestras en relación con la enseñanza y el aprendizaje de la lengua oral a través de un asesoramiento: un estudio de casos / The conceptual change of two teachers in relation to the teaching and learning of oral language through an assessment: a case study

En este trabajo presentamos los resultados de una investigación en la que han participado 4 maestras: 2 de educación infantil y 2 de educación primaria. Se ha llevado a cabo un asesoramiento utilizando la metodología conversacional a una maestra de cada nivel educativo con el objetivo de promover un cambio conceptual en relación con la representación sobre los procesos de enseñanza y aprendizaje de la lengua oral. Durante un periodo de 4 meses las 2 maestras del grupo experimental participaron en 4 reuniones de asesoramiento con algunos de los investigadores. Además se realizó un grupo de discusión con las 2 maestras del grupo experimental y del grupo control antes del asesoramiento y otro una vez finalizado este. Se elaboró un instrumento ad hoc para analizar las reuniones de asesoramiento y los grupos de discusión. Los resultados indican que las maestras del grupo experimental progresan desde una visión de la lengua oral centrada en aspectos de forma y contenido, y desde la consideración de los factores madurativos como principales responsables del aprendizaje de la lengua oral, hacia una conceptualización que otorga una importancia fundamental a los aspectos de uso del lenguaje, a la interacción social y a las estrategias que utilizan las maestras en clase como factores explicativos de la competencia oral de los alumnos (AU)

We present the results of a research project in which 4 teachers (2 kindergarten and 2 primary school teachers) took part. A counselling process using conversational methodology was carried out with one teacher from each setting to promote a conceptual change in the teachers’ representation of oral language teaching and learning processes. During a 4-month period, the 2 teachers in the experimental group participated in 2 counselling meetings with some of the researchers. We also carried out a focus group with all four teachers before and after the meetings. An ad hoc instrument was designed to analyze the meetings and the focus groups. The results show that teachers in the experimental group progressed from a conception focused on formal and content-based aspects of oral language to a conception that stresses language use, social interaction, and the strategies employed by teachers in class as explanatory factors for pupils’ oral language competence (AU)

"Profil des enfants avec infections respiratoires aigues recues au Centre Pediatrique 'Watoto"" de Lubumbashi; Congo"

3236 enfants souffrants des infections respiratoires aigues (IRA) ont ete recus au centre pediatrique WATOTO de Lubumbashi. Ces enfants avaient fait partie des 6499 enfants malades conduits a ce service pendant la periode donnee. Ils ont represente 52;5 des cas.Notre investigation a montre que L'atteinte respiratoire a predomine pendant la saison seche avec 57;6 des cas. Les enfants ages de 6 a 12 mois ont ete les plus affectes soit 23;0 ; les garcons ont ete plus affectes par rapport aux filles avec 53;4. Les IRA identifiees ont ete par ordre de frequence decroissant : la bronchite aigue; l'otite moyenne aigue; la bronchopneumonie; la rhinite; la rhinopharyngite; la pneumonie lobaire; l'amygdalite et l'adenoidite. Les decisions medicales prises ont ete les suivantes : 666 enfants avaient ete renvoyes a domicile; 72 de cas (soient 142 enfants) avaient ete mis en observation: 15;5 des cas (90 enfants) avaient ete hospitalises; 9;9 des cas 16 enfants etaient decedes : 1;7 des cas.La pneumonie lobaire avait totalise 55;7 des cas hospitalises et 68;7 des decedes. Les filles avaient eu plus de deces (56;2 ) que les garcons.Le taux de letalite a ete de 17;8.les maladies respiratoires aigues demeurent frequentes a Lubumbashi avec un taux de deces eleve