RESUMO
In March 2020, the closure of schools in most countries and the implementation of virtual education were ordered as a control measure to slow the spread of SARS-CoV-2. This, along with social distancing, represented a threat to the mental health of school children. In this context, access to information technologies was a determining factor in countering social isolation and allowing the continuity of the school's role in this population. In this sense, several studies reported that the suspension of in-person classes and the use of virtual education, adopted because of the pandemic, had both positive and negative effects on the mental health of the pediatric population; conditioned by individual, family, and socioeconomic factors. Thus, in terms of development and mental health, the reopening of educational institutions after a prolonged period of mobility restriction and social distancing constituted both an opportunity and a challenge for the pediatric population and the family. The objective of this article is to reflect on the differential impact that school closures and the implementation of virtual education during the COVID-19 pandemic had on the development and mental health of the school-aged population, and on the potential effects of returning to in-person education. It is hoped that this reflection will be useful in guiding the implementation of educational and child mental health care actions in future pandemics.
RESUMO
El objetivo del presente artículo es aportar pautas para la evaluación y tratamiento de pacientes agresivos mediante el uso del aislamiento. A esos efectos, se realizó una revisión narrativa de la literatura, basada en la búsqueda mediante la combinación de las palabras "seclusion" y/o "patient seclusion" y/o "Restraint, Physical" y/o "Mentally Ill Persons", en las bases de datos MEDLINE, Ovid, SciELO, HINARI, LILACS, IMBIOMED y Latindex. Se seleccionaron 12 de 8.418 artículos de mayor relevancia para su aplicación en nuestro medio, teniendo como límites de la búsqueda revisiones, metanálisis, estudios controlados aleatorizados y estudios clínicos, adultos, ambos géneros, humanos, idioma inglés y español, de los años 2002 a 2007. Se halló un conocimiento amplio en el tratamiento del paciente agresivo. Las indicaciones del aislamiento no difieren con respecto a las de restricción, siendo importantes los riesgos de hetero o autoagresividad y de daño al entorno físico. Las contraindicaciones y consideraciones éticas, médicas y legales son claras y se deben implementar para una adecuada práctica clínica. El uso adecuado del aislamiento por parte del personal de salud debe formar parte de un plan terapéutico adecuado y tener en cuenta las recomendaciones para su uso en el contexto local.
The objective of the present study is to contribute rules for the evaluation and treatment of an aggressive patient by means of seclusion. We searched the literature in the MEDLINE, Ovid, SciELO, HINARI, LILACS, IMBIOMED and Latindex databases, using the combination of the following words: "seclusion" and/or "patient seclusion" and/or "restraint, physical" and/or "mentally ill persons". Twelve out of 8,418 articles were selected for their application in Colombia according to the following limits of the search: clinical trial, meta-analysis, randomized controlled trial, review of the literature, adults, both genders, published between 2002 and 2007 in the English and Spanish languages. There is wide knowledge about the treatment of aggressive patient. The seclusion indications do not differ from those of restriction, with these important aspects: risk of violence and damage to the facility. The contraindications and ethical, medical, and legal implications of the seclusion procedures are clear and should be accepted in the clinical practice. The appropriate uses of the seclusion in mental health units should make part of a convenient therapeutic plan taking into consideration the national context.
