Auditory Electrophysiological Thresholds With Different Chirps and Their Correlation With Behavioral Thresholds in Hearing-Impaired Children.

OBJECTIVES: Research focusing on changes in the clinical practice of audiological diagnosis has become increasingly necessary, particularly in pediatric audiology. The pursuit of accurate and reliable examinations has intensified given the importance of early detection and intervention in cases of childhood hearing loss. Thus, this study aims to investigate the correlation between electrophysiological auditory thresholds, as obtained through frequency-specific auditory brainstem responses with two distinct chirp stimuli (narrow-band CE-Chirp Level Specific and narrow-band iChirp), in children with hearing impairments. In addition, this research set out to correlate these thresholds with behavioral responses while simultaneously comparing the examination durations relative to the type of stimuli and the degree of hearing loss. DESIGN: A cohort of 20 children (aged 6 months to 12 years) with varying degrees of hearing impairment (ranging from mild to profound) were recruited. The participants underwent bilateral measurement of their electrophysiological thresholds via auditory brainstem responses across different frequencies (500, 1000, 2000, and 4000 Hz), and the timeframe for determining these thresholds was carefully recorded. Subsequently, behavioral thresholds were ascertained using pure-tone audiometry or visual reinforcement audiometry based on the child's age. The data collected was subsequently analyzed using Pearson and Spearman correlation coefficients. To compare examination times, the Student t test and the Kruskal-Wallis test were used. RESULTS: There was a pronounced correlation between the thresholds obtained through both narrow-band chirp stimuli. Moreover, a substantial correlation was found between electrophysiological and behavioral thresholds at 1000, 2000, and 4000 Hz, especially when compared with pure-tone audiometry. The mean differences between the electrophysiological and behavioral thresholds were below 6 dB nHL, and the exam duration was relatively consistent across both devices, averaging 47.63 (±19.41) min for the narrow-band CE-Chirp Level Specific and 52.42 (±26) min for the narrow-band iChirp. Notably, variations in exam duration did not relate to varying degrees of hearing loss when using the narrow-band CE-Chirp Level Specific. Nevertheless, the narrow-band iChirp indicated significantly shorter durations in instances of profound degree measurements, demonstrating a statistically significant difference. CONCLUSIONS: The narrow-band CE-Chirp Level Specific and narrow-band iChirp stimuli provided similar estimates of electrophysiological auditory thresholds in children with hearing impairments, giving accurate estimations of behavioral thresholds. The time it took to complete the assessment is comparable between both stimuli. For the narrow-band iChirp, the degree of hearing loss was shown to impact the testing time, and children with profound hearing loss underwent faster exams. Ultimately, this study exhibits significant clinical implications as it reveals that the narrow-band CE-Chirp Level Specific and narrow-band iChirp stimuli could be remarkably promising for clinically exploring electrophysiological thresholds in children with hearing impairments.

Congenital toxoplasmosis and auditory disorders: a literature review.

Background: Congenital toxoplasmosis (CT) occurs mainly by primary maternal infection during pregnancy. It is estimated that the incidence of vertical transmission to the fetus is 20% and that infected women are more likely to have a premature birth or low birth weight neonate since there is an association between CT and the rate of premature birth and low birth weight. In addition to severe neurological and ophthalmic consequences, hearing disorders such as hearing loss are also among the clinical manifestations seen in children with CT. Given the above, the objective of this study is to verify what are the auditory disorders seen in children with CT. Methods: This literature review was structured according to the PRISMA statement and based on the terms of Study Target Population, Intervention, Comparison, Outcomes, and Study Types (PICOS). To obtain the studies, the following electronic databases were consulted: PubMed, Web of Science, Scopus, and Lilacs. The combined terms used for the search were: ("auditory evoked potentials" OR "hearing" OR "hearing loss") AND ("congenital toxoplasmosis"). The selection of articles was carried out independently, blindly, by two of the authors, to minimize risk of bias. Results: The search in the databases identified 172 articles, after excluding duplicate articles, 105 studies were identified. From the selection made by reading the titles and abstracts, 11 studies were selected for full-text reading. A total of 94 studies were excluded. An article was selected from the list of references. Therefore, 12 studies were included in the final analysis. It was observed that a significant percentage of studies sought to study the peripheral auditory pathway, verifying the occurrence or association between hearing loss and the presence of congenital infection. Only two studies evaluated the central auditory pathway, using the Brainstem Auditory Evoked Potential (BAEP) and the Frequency Following Response (FFR). Conclusion: Toxoplasmosis affects not only the peripheral areas but central areas as well. Most studies suggest this pathology as a risk factor for both peripheral and central impairment. Research has found a greater association between CT and mild to moderate hearing loss, in addition to alterations in exams such as BAEP and FFR. These data recommend that CT be reported as a global public health problem and can help assess complications and impacts of hearing disorders as a result of CT. There is a gap about studies that retract the co-occurrence between CT and other Risk Indicators for Hearing Loss (RIHL), such as prematurity, permanence in the intensive care unit, and use of ototoxic medications, lack of longitudinal studies, that accompany the development of hearing and language of children with CT, since the consequences of this infection may be late.

Hearing rehabilitation of children and adolescents with unilateral hearing loss / Reabilitação auditiva de crianças e adolescentes com perda auditiva unilateral

ABSTRACT Purpose To describe the audiological characteristics and the type of intervention chosen on unilateral hearing loss cases in children and adolescents as well as to analyze correlations between the degree of hearing loss, the indication and the use of electronic devices. Methods Observational, descriptive and retrospective study, carried out with information of 34 medical records from children and adolescents with unilateral hearing loss, assessed by two auditory rehabilitation services of medium complexity, throughout 2016 to 2019. Descriptive and Inferential statistical analysis were performed with the data. Results A predominance of profound sensorineural unilateral hearing loss in the right ear, of pre-lingual character, with 20.6% of malformations. The most adopted intervention was the hearing aid indication, although its use is low, regardless of the degree of the hearing loss. An association was found between the degree of the hearing loss and the healthcare professionals in indicating the use of the devices. Conclusion The indication of hearing aids is the most frequent and this decision is influenced by the degree of the hearing loss, in which the devices are mostly indicated for mild to severe losses, with bigger divergence of conduct for profound hearing losses.

RESUMO Objetivo Descrever as características audiológicas e o tipo de intervenção tomada em casos de perda auditiva unilateral em crianças e adolescentes e analisar correlações entre o grau da deficiência auditiva, a indicação e o uso de auxiliares de audição. Método Estudo observacional, descritivo e retrospectivo, realizado com informações dos prontuários de 34 crianças e adolescentes com perda auditiva unilateral, atendidos em dois serviços de reabilitação auditiva de média complexidade, no período de 2016 a 2019. Realizou-se a análise estatística descritiva e inferencial dos dados. Resultados Predomínio de perda auditiva unilateral do tipo neurossensorial, de grau profundo à direita, pré-lingual com 20,6% de malformações. A intervenção mais adotada foi a indicação de prótese auditiva, porém o uso é baixo, independente do grau da perda. Houve associação entre o grau da perda auditiva e a decisão dos profissionais em indicar o uso dos dispositivos. Conclusão A indicação de próteses auditivas é a mais frequente e esta decisão é influenciada pelo grau da perda auditiva, sendo os aparelhos auditivos indicados para as perdas leves a severas, com uma maior divergência de condutas para as perdas profundas.

Hearing rehabilitation of children and adolescents with unilateral hearing loss.

PURPOSE: To describe the audiological characteristics and the type of intervention chosen on unilateral hearing loss cases in children and adolescents as well as to analyze correlations between the degree of hearing loss, the indication and the use of electronic devices. METHODS: Observational, descriptive and retrospective study, carried out with information of 34 medical records from children and adolescents with unilateral hearing loss, assessed by two auditory rehabilitation services of medium complexity, throughout 2016 to 2019. Descriptive and Inferential statistical analysis were performed with the data. RESULTS: A predominance of profound sensorineural unilateral hearing loss in the right ear, of pre-lingual character, with 20.6% of malformations. The most adopted intervention was the hearing aid indication, although its use is low, regardless of the degree of the hearing loss. An association was found between the degree of the hearing loss and the healthcare professionals in indicating the use of the devices. CONCLUSION: The indication of hearing aids is the most frequent and this decision is influenced by the degree of the hearing loss, in which the devices are mostly indicated for mild to severe losses, with bigger divergence of conduct for profound hearing losses.

Is pilates better than other exercises at increasing muscle strength? A systematic review.

Our objective was to verify the effectiveness of Pilates method compared against other exercise modalities for muscle strength increase, balance and flexibility. Method: Databases used and its respective results were: CENTRAL (n = 456), CINAHL (n = 291), EMBASE (n = 313), PEDro (n = 176), PUBMED (n = 236), SCIELO (n = 98), SPORTDiscus (n = 197) e Web of Science (n = 150). It included randomized controlled studies using Pilates and others exercise modalities that measured muscle strength. Results: Eleven studies were included for analysis. The mean methodological quality score of these studies, evaluated by the PEDro scale, was 6 ± 1. For the primary outcome, not being observed this difference for dynamic force (SMD = -0.29; 95%IC -0.69; 0.10), isometric (SMD = 0.20; 95%IC -0.06; 0.47) or resistance (SMD = -0.19; 95%IC -0.46; 0.07). For secondary outcomes, there was no difference for balance and flexibility. Conclusion: In conclusion, there is very low to low evidence that there is no difference between Pilates and other exercise modalities for dynamic strength, isometric strength, resistance strength, balance and flexibility.

Long-Term Effects of a Kinematic Bikefitting Method on Pain, Comfort, and Fatigue: A Prospective Cohort Study.

The purpose of this study is to analyze the long-term riders' subjective responses to a standardized bikefitting method on their bicycles. Eighty-six amateur mountain bikers had their riding posture and bicycle components ergonomically adjusted through a 3D kinematic bikefitting method. Validated subjective scales (Feeling, OMNI, and Numerical Rating Pain Scale) were used to assess their overall riding comfort and fatigue along with localized pain for six body parts. Data were collected just before intervention (baseline or pre), immediately after (or post), and 30, 60, 90, and 120 days after the bikefit session. A Student's t-test comparing before bikefit and after 120 days showed significant (p < 0.05) reduction in localized pain for all six body parts and riding comfort along with a large effect size effect (d = 1.18) for riding comfort. Although initially reduced, fatigue scores gradually increased over the months, showing a high correlation (r = 0.946) with increased monthly training volume. In conclusion, overall riding discomfort and pain were significantly decreased after a standardized kinematic bikefit session even after 120 days post intervention. However, fatigue scores began to rise after 30 days, showing a high correlation with increasing monthly training volume.

The effect of child development on the components of the Frequency Following Response: Child development and the Frequency Following Response.

During childhood, neuronal modifications occur so that typical childhood communicative development occurs. This work aims to contribute to the understanding of differences in the speech encoding of infants and school-age children by assessing the effects of child development, in different phases of early childhood, on the encoding of speech sounds. There were 98 subjects of both sexes, aged from 1 day to 8 years and 9 months who participated in the study. All subjects underwent a Frequency Following Response (FFR) assessment. A regression and linear correlation showed the effects of age in the FFR components, i.e., significant decrease in the latency and increased amplitude of all FFR waves with age. An increase in the slope measure was also observed. Younger infants require more time and show less robust responses when encoding speech than their older counterparts, which were shown to have more stable and well-organized FFR responses.

Mismatch Negativity in children with Phonological Disorders.

OBJECTIVE: to characterize the latency, amplitude and area variables of the Mismatch Negativity (MMN) elicited with verbal stimuli in children with PD, in addition to assessing whether this potential can be a useful tool in capturing auditory perception and discrimination deficits related to this disorder. METHODS: MMN was recorded using a combination of speech contrast consisting of acoustic syllables [da vs ta], as the standard and deviant stimuli, in 34 children aged between 5 and 8 years. 14 children of the sample were already diagnosed with Phonological Disorder (PD) while 19 were characterized with typical development. RESULTS: No statistically significant differences were observed for the MMN responses recorded between children with PD and their typically developed peers. CONCLUSION: The results suggest that the MMN may not be the most suitable procedure to assess auditory perception and discrimination deficits that could potentially be related to PD.

Genetic differentiation and diversity of the Bolivian endemic titi monkeys, Plecturocebus modestus and Plecturocebus olallae.

The genetic variability of New World primates is still poorly documented. We present the first genetic study on two threatened endemic titi monkey species in northern Bolivia (Plecturocebus modestus and Plecturocebus olallae) using six microsatellite markers to investigate genetic structure and variability of 54 individuals from two wild populations. A low level of genetic diversity was found (34 alleles in the total sampled population). Locus 1118 presented the greatest number of alleles. The mean number of alleles per locus in the total population was 5.6 and the average heterozygosity was 0.38 (range 0.12-0.88). The FIS value for the total population using all microsatellite loci shows a statistically significant heterozygote deficit. The inbreeding coefficients (FIS) were positive and significantly different from zero (0.064 for P. olallae and 0.213 for P. modestus). The genetic differentiation between populations (FST) was moderate with a pair-wise FST estimate of 0.14. Population structure analyses assigned the two populations to two differentiated clusters (K = 2). These results suggest that these two species with very close distributional ranges arose from a single population, and that they remain in a process of genetic differentiation and speciation. This study further underlines the urgent need for conservation actions for both endemic primate species.

Evasion of Newborn Hearing Screening retest: relation with risk factors for hearing impairment / Evasão no reteste da Triagem Auditiva Neonatal: relação com indicadores de risco para deficiência auditiva

ABSTRACT Purpose: to analyze the evasion rate of the Newborn Hearing Screening program's retest, to verify whether the presence of risk indicators for hearing loss influences it, and to describe which risk indicators for hearing loss occur more frequently in these cases. Methods: 1,287 newborns/infants participated, who were screened between June 2015 and June 2018. All of them obtained "fail" as the Newborn Hearing Screening result, were referred to the retest and did not attend it. Information related to the occurrence of risk indicators for hearing loss was observed. Results: the study found that the evasion rate was of 15.23%. The presence of risk indicators for hearing loss did not show an association with non-attendance at this stage of the program (p-value = 0.087). The most frequent indicators in the cases of non-attendance at the retest were: ototoxic medication use and intensive care unit stay for more than five days. Conclusion: high evasion rate of the retest has been observed. It has been found that the presence of risk indicators did not influence the retest evasion rate. Use of ototoxic medication and stay at the intensive care unit were the most frequent indicators among those who did not attend the retest.

RESUMO Objetivo: analisar o índice de evasão no reteste do programa de Triagem Auditiva Neonatal, verificar se a presença de Indicadores de Risco para Deficiência Auditiva o influencia e descrever quais Indicadores de Risco para Deficiência Auditiva ocorrem com maior frequência nestes casos. Métodos: participaram 1287 neonatos/lactentes, triados no período de junho de 2015 a junho de 2018, que obtiveram resultado "falha" na Triagem Auditiva Neonatal, encaminhados para o reteste e não compareceram. Foram observadas informações relacionadas a ocorrência dos Indicadores de Risco para Deficiência Auditiva. Resultados: o estudo constatou que o índice de evasão foi de 15,23%. A presença de indicadores de risco para deficiência auditiva não demonstrou associação com o não comparecimento a essa etapa do programa (p-valor= 0,087). Os indicadores de maior ocorrência nos casos de não comparecimento no reteste foram: medicação ototóxica e permanência em Unidade de Tratamento Intensivo por período maior que cinco dias. Conclusão: observou-se elevado índice de evasão no reteste. Verificou-se que a presença dos indicadores de risco não influenciou no índice de evasão do reteste. O uso de medicação ototóxica e a permanência em Unidade de Terapia Intensiva foram os indicadores mais frequentes naqueles que não compareceram ao reteste.

Atuação estratégica em direitos humanos contra o afastamento arbitrário de bebês do convívio familiar: reflexões sobre a prática / Strategic action on human rights against the arbitrary withdrawal of infantis from the family: reflections on the practice

O presente artigo oferece um relato da experiência de trabalho da Clínica de Direitos Humanos da UFMG, a partir do método da advocacia estratégica em direitos humanos, frente ao problema do afastamento arbitrário de recém-nascidos do convívio familiar e a sistemática de violações de direitos humanos e estigmatização enfrentada por mães em situação de vulnerabilização social no contexto da cidade de Belo Horizonte.(AU)

This article offers an experience report of the work developed by the UFMG Human Rights Clinic through the use of the strategic advocacy method in human rights, in order to approach the problem of arbitrary State removals of newborn children from their familiar atmosphere and the systematic human rights violations and stigmatization suffered by their vulnerable mothers, in the context of the city of Belo Horizonte.(AU)

Interagindo com a família do paciente hospitalizado: vivência do técnico em enfermagem / interacting with family members of hospitalized patients: a nursing technician's experience / interactuando con la familia del paciente hospitalizado: experiencia del técnico en enfermería

Este estudo teve como objetivo compreender o significado atribuído pelo técnico em enfermagem à vivência de interagir com a família do paciente hospitalizado. Trata-se de uma pesquisa qualitativa, que utilizou como referencial teórico o Interacionismo Simbólico, e o metodológico, a Análise Qualitativa de Conteúdo. Participaram nove técnicos em enfermagem que atuavam nas unidades de clínica médica de dois hospitais públicos, sendo os dados coletados por entrevista semiestruturada e observação participante. Revelaram as dificuldades, ambiguidade e despreparo vivenciados pelos profissionais na interação com a família, embora reconheça sua importância, e a ausência de sua interação com conteúdo a respeito da temática, tanto no curso técnico como na vida profissional. Constatou-se que, na vivência com familiares, faltam-lhes conhecimento e habilidade para lidar com o cuidado da família, assim, necessitam de suporte teórico e prático para enfrentamento de tal situação.

This study aimed to understand the meaning attributed by nursing technicians to the experience of interacting with the family of hospitalized patients. It is a qualitative research supported by the Symbolic Interactionism theoretical framework, and the Qualitative Content Analysis methodological framework. It had the participation of nine nursing technicians that worked at the medical clinic units of two public hospitals. Data were collected through semi-structured interview and participant observation. They revealed the difficulties, ambiguities and unpreparedness experienced by the professionals in the interaction with the echnical course and in their professional lives. It was found that, in their experience with relatives, the nurse technicians lack knowledge and skills to deal with the care of the family; thus, they need theoretical and practical support to face such a situation.

Este estudio tuvo como objetivo comprender el significado atribuido por el técnico en enfermería a la experiencia de interactuar con la familia del paciente hospitalizado. Se trata de una investigación cualitativa, que utilizó como referencial teórico el Interaccionismo Simbólico, y para el metodológico, el Análisis Cualitativo de Contenido. Participaron nueve técnicos en enfermería que actuaban en las unidades de clínica médica de dos hospitales públicos, siendo los datos recolectados por entrevista semiestructurada y observación participante. Revelaron las dificultades, ambigüedad y falta de preparación vividas por los profesionales en la interacción con la familia, aunque reconozca su importancia, y la ausencia de su interacción con el contenido a respecto del tema, tanto en el curso técnico como en la vida profesional. Se constató que, en la experiencia con familiares, les faltan conocimiento y habilidad para lidiar con el cuidado de la familia, así, necesitan de soporte teórico y práctico para el enfrentamiento de tal situación.

The family living the child recovery process after hospital discharge.

OBJECTIVE: to understand the meaning attributed by the family to its experience in the recovery process of a child affected by an acute disease after discharge, and to develop a theoretical model of this experience. Symbolic interactionism was adopted as a theoretical reference, and grounded theory was adopted as a methodological reference. METHOD: data were collected through interviews and participant observation with 11 families, totaling 15 interviews. A theoretical model consisting of two interactive phenomena was formulated from the analysis: Mobilizing to restore functional balance and Suffering from the possibility of a child's readmission. RESULTS: the family remains alert to identify early changes in the child's health, in an attempt to avoid rehospitalization. CONCLUSION: the effects of the disease and hospitalization continue to manifest in family functioning, causing suffering even after the child's discharge and recovery.

A família vivenciando o processo de recuperação da criança pós-alta hospitalar / La familia que vive el proceso de recuperación de niños después del alta hospitalaria / The family living the child recovery process after hospital discharge

RESUMOObjetivo:compreender o significado atribuído pela família à sua vivência no processo de recuperação da criança acometida por doença aguda, após a alta hospitalar e elaborar um modelo teórico a respeito dessa experiência. O Interacionismo Simbólico foi adotado como referencial teórico e a Grounded Theory como metodológico.Método:os dados foram coletados por meio de entrevista e observação participante com 11 famílias, totalizando 15 entrevistas. A análise levou à formulação de um Modelo Teórico composto por dois fenômenos interativos: Mobilizando-se para resgatar o equilíbrio de seu funcionamento e Sofrendo com a possibilidade de reintegrar a criança.Resultados:estes revelaram que a família mantém-se em alerta para identificar precocemente alterações de saúde da criança na tentativa de evitar uma reinternação.Conclusão:os efeitos da doença e hospitalização continuam a manifestar-se no funcionamento familiar, gerando sofrimento mesmo após a alta e a recuperação da criança.

RESUMENObjetivo:comprender el significado atribuido por la familia de su experiencia en la recuperación de los niños afectados por el proceso de la enfermedad aguda, después de la descarga y desarrollar un modelo teórico sobre la experiencia. El Interaccionismo Simbólico fue adoptado como un teórico y la Teoría Fundamentada como metodológico.Método:los datos fueron recolectados a través de entrevistas y observación participante con 11 familias, con un total de 15 entrevistas. El análisis dio lugar a la formulación de un modelo teórico consta de dos fenómenos interactivos: Movilización para restaurar el balance de su funcionamiento y Sufriendo con la posibilidad de reinternar el niño.Resultados:éstos revelaron que la familias e mantiene en alerta para la identificación temprana de la salud el niño en un intento de evitar un reingreso.Conclusión:Los efectos de la enfermedad y la hospitalización aún se manifiesta en el funcionamiento familiar, que produce sufrimiento, incluso después de la descarga y la recuperación del niño.

ABSTRACTObjective:to understand the meaning attributed by the family to its experience in the recovery process of a child affected by an acute disease after discharge, and to develop a theoretical model of this experience. Symbolic interactionism was adopted as a theoretical reference, and grounded theory was adopted as a methodological reference.Method:data were collected through interviews and participant observation with 11 families, totaling 15 interviews. A theoretical model consisting of two interactive phenomena was formulated from the analysis: Mobilizing to restore functional balance and Suffering from the possibility of a child's readmission.Results:the family remains alert to identify early changes in the child's health, in an attempt to avoid rehospitalization.Conclusion:the effects of the disease and hospitalization continue to manifest in family functioning, causing suffering even after the child's discharge and recovery.

Significado da ferida para portadores de úlceras crônicas / The meaning of the wound to sufferers of chronic ulcers

Trata-se de um estudo descritivo, de abordagem qualitativa, com o objetivo de compreender o significado da ferida para portadores de úlceras crônicas. A coleta de dados foi realizada de janeiro a maio de 2010, por meio da entrevista individual a cinco pacientes e consulta aos prontuários dos pacientes atendidos durante o período de 2008 a 2010, em unidade ambulatorial. Para a análise dos dados utilizou-se a técnica da Análise de Conteúdo Temático que permitiu a identificação das categorias Sensações marcantes, O cotidiano e a ferida crônica e O impacto emocional. Os resultados demonstram que ser portador de úlcera representa conviver com a dor, preconceito, dependência para atividades diárias, receios, medos e ansiedade quanto ao prognóstico. Espera-se nortear os profissionais de saúde quanto às principais necessidades dessa clientela para elaboração de estratégias individualizadas a pacientes e cuidadores no manejo dos enfrentamentos vivenciados.

[Family-centered care and its application in pediatric nursing]. / Cuidado centrado na família e sua aplicação na enfermagem pediátrica.

Family-centered care is a challenge for nursing area, although the home care was described in the professional history since its origins. The definition of this approach, its principles and the discussion about its application in pediatric nursing are described in the text aiming to lead to a reflection about the possibilities of family care, by means of attention to the individual and to the family unit. Among the several areas, the pediatric nursing is highlighted with researches and the development of theoretical assumptions.

Cuidado centrado na família e sua aplicação na enfermagem pediátrica / Family-centered care and its application in pediatric nursing / Cuidado centrado en la familia y su aplicación en la enfermería pediátrica

O cuidado centrado na família tem representado um desafio para a área da enfermagem, embora os cuidados domiciliares estejam descritos desde os primórdios na história da profissão. A definição dessa abordagem, seus princípios e a discussão da sua aplicação na enfermagem pediátrica estão descritos no texto com o objetivo de refletir acerca das possibilidades de cuidado à família por meio da atenção ao individuo e à unidade familiar. Dentre as diversas áreas, a enfermagem pediátrica vem se destacando com pesquisas e desenvolvimento de pressupostos teóricos.

Family-centered care is a challenge for nursing area, although the home care was described in the professional history since its origins. The definition of this approach, its principles and the discussion about its application in pediatric nursing are described in the text aiming to lead to a reflection about the possibilities of family care, by means of attention to the individual and to the family unit. Among the several areas, the pediatric nursing is highlighted with researches and the development of theoretical assumptions.

El cuidado centrado en la família tiene representado un desafío para el área de enfermería, a pesar de los cuidados domiciliares ya tengan sido descriptos desde sus orígenes en la historia de la profesión. La definición de este abordaje, sus principios y la discusión de su aplicación en la enfermería pediatrica están descriptos en el texto con el objetivo de reflexionar acerca de las posibilidades de cuidado a la familia por medio de atención al individuo y a la unidad familiar. De entre las distintas áreas, la enfermería pediátrica viene destacándose con pesquisas y desarrollo de los presupuestos teóricos.

O processo de recuperação da criança após a alta hospitalar: revisão integrativa / The recovery process of children after discharge from hospital: an integrative review / El proceso de recuperación del niño después del alta hospitalaria: una revisión integradora

OBJETIVO: Identificar o conhecimento disponível a respeito do processo de recuperação da criança hospitalizada e de sua família após a alta. MÉTODOS: Revisão integrativa da literatura realizada em bases de dados, de âmbito nacional e internacional, com abordagem qualitativa dos dados. RESULTADOS: Os 16 artigos selecionados pertencem a periódicos internacionais, foram publicados entre 1990 a 2005 e permitiram a identificação dos seguintes temas: Manifestações biopsicossociais da criança e da família. Fatores relacionados às manifestações biopsicossociais da criança e da família; Benefícios da alta precoce da criança e Necessidades de informação e apoio. CONCLUSÕES: As intervenções voltadas à criança e à família devem ser iniciadas ainda na hospitalização, a fim de melhorar sua capacidade de enfrentamento. Há necessidade de aprimorar as pesquisas sobre essa temática nos países em desenvolvimento incluindo a perspectiva da família como unidade.

OBJECTIVE: To identify the available knowledge about the process of recovery of hospitalized children and their families after discharge. METHODS: Integrative review of literature in databases - national and international - with a qualitative approach. RESULTS: The 16 selected articles belonging to international journals were published between 1990 and 2005; they allowed the identification of the following topics: biopsychosocial manifestations of the child and his family; Biopsychosocial factors related to the manifestations of the child and his family; benefits of early discharge of the child; and, information and support needed. CONCLUSIONS: The interventions focused on the child and his family should be started in the hospital check-in in order to improve their ability to cope with the situation. There is need to enhance research on this topic in developing countries, including the prospect of the family as a unit.

OBJETIVO: Identificar el conocimiento disponible sobre el proceso de recuperación de los niños hospitalizados y sus familias después del alta. MÉTODOS: Revisión integradora de la literatura en bases de datos nacionales e internacionales, con enfoque cualitativo de los datos. RESULTADOS: Los 16 artículos seleccionados pertenecientes a las revistas internacionales, fueron publicados entre 1990 y 2005, estos permitieron identificar los siguientes temas: manifestaciones biopsicosociales del niño y la familia; factores biopsicosociales relacionados con las manifestaciones del niño y la familia; beneficios del alta temprana del niño; y, necesidades de información y apoyo. CONCLUSIONES: Las intervenciones dirigidas al niño y la familia se deben iniciar durante la hospitalización con la finalidad de mejorar su capacidad enfrentamiento. Se concluye, que existe la necesidad de mejorar la investigación sobre este tema en los países en desarrollo, incluyendo la perspectiva de la familia como una unidad.

O enfermeiro como cuidador na perspectiva da enfermagem pediátrica / The Nurse While Carer in the Perspective of the Pediatrician Nursing

A reflexão proposta neste trabalho é sobre o cuidado prestado pelo enfermeiro pediátrico, tendo como embasamento o cuidado humano e de enfermagem. O artigo apresenta os aspectos sobre o cuidado centrado na patologia, na criança e na família e a utilização da comunicação e do cuidado ao cuidador, como estratégias para a melhoria do atendimento em pediatria.