Segregación escolar del alumnado con necesidades educativas especiales en Educación Infantil en el contexto local / School segregation of students with special educational needs in Early Childhood Education in the local context

Esta investigación busca profundizar en la segregación escolar del alumnado con necesidades educativas especiales del segundo ciclo de Educación Infantil estimando su magnitud, determinando la incidencia de la titularidad del centro y de su adscripción al Programa Bilingüe y describiendo su evolución. Para ello, se realiza un estudio ex post facto con datos de los 10.182 estudiantes del segundo ciclo de Educación Infantil matriculados en alguno de los 77 centros ordinarios públicos y privados-concertados situados en dos ciudades de tamaño medio-grande de la Comunidad de Madrid. Los resultados indican que la magnitud de la segregación escolar está en torno al 0.20 (ISG); que la incidencia de la titularidad es baja (4.6 %), pero es alta la del Programa Bilingüe (17.2 % de promedio); y que la segregación ha descendido ligeramente en los últimos años, pero las diferencias entre centros atendiendo a su titularidad y adscripción al Programa Bilingüe han crecido. Con ello, se concluye que hay que prestar atención a la segregación en Educación Infantil y tomar medidas para combatirla. También se destaca la necesidad de replantear el Programa Bilingüe por su incidencia en la segregación escolar. (AU)

This research aims to explore the school segregation of students with special educational needs in the second cycle of Early Childhood Education by estimating its magnitude, determining the incidence of school ownership and affiliation to the Bilingual Program, and describing its evolution. To achieve this, we conduct an ex post facto study with data from the 10,182 students enrolled in one of the 77 public and private-subsidised schools in the Community of Madrid. The results indicate that the magnitude of school segregation is around 0.20 (ISG); that the incidence of school ownership is low (4.6 %), while the incidence of the Bilingual Program is high (17.2 % on average); and that segregation has slightly decreased in recent years, however the differences between schools based on ownership and affiliation to the Bilingual Program have increased. Therefore, we conclude that it is necessary to address segregation in Early Childhood Education and that measures need to be taken to combat it. We also highlight the importance of reconsidering the Bilingual Program due to its impact on school segregation. (AU)

Segregación escolar del alumnado con necesidades educativas especiales en Educación Infantil en el contexto local / School segregation of students with special educational needs in Early Childhood Education in the local context

Esta investigación busca profundizar en la segregación escolar del alumnado con necesidades educativas especiales del segundo ciclo de Educación Infantil estimando su magnitud, determinando la incidencia de la titularidad del centro y de su adscripción al Programa Bilingüe y describiendo su evolución. Para ello, se realiza un estudio ex post facto con datos de los 10.182 estudiantes del segundo ciclo de Educación Infantil matriculados en alguno de los 77 centros ordinarios públicos y privados-concertados situados en dos ciudades de tamaño medio-grande de la Comunidad de Madrid. Los resultados indican que la magnitud de la segregación escolar está en torno al 0.20 (ISG); que la incidencia de la titularidad es baja (4.6 %), pero es alta la del Programa Bilingüe (17.2 % de promedio); y que la segregación ha descendido ligeramente en los últimos años, pero las diferencias entre centros atendiendo a su titularidad y adscripción al Programa Bilingüe han crecido. Con ello, se concluye que hay que prestar atención a la segregación en Educación Infantil y tomar medidas para combatirla. También se destaca la necesidad de replantear el Programa Bilingüe por su incidencia en la segregación escolar. (AU)

This research aims to explore the school segregation of students with special educational needs in the second cycle of Early Childhood Education by estimating its magnitude, determining the incidence of school ownership and affiliation to the Bilingual Program, and describing its evolution. To achieve this, we conduct an ex post facto study with data from the 10,182 students enrolled in one of the 77 public and private-subsidised schools in the Community of Madrid. The results indicate that the magnitude of school segregation is around 0.20 (ISG); that the incidence of school ownership is low (4.6 %), while the incidence of the Bilingual Program is high (17.2 % on average); and that segregation has slightly decreased in recent years, however the differences between schools based on ownership and affiliation to the Bilingual Program have increased. Therefore, we conclude that it is necessary to address segregation in Early Childhood Education and that measures need to be taken to combat it. We also highlight the importance of reconsidering the Bilingual Program due to its impact on school segregation. (AU)

Differential constellations of dissociative symptoms and their association with childhood trauma - a latent profile analysis.

Background: While several studies documented a positive correlation between childhood maltreatment severity and dissociation severity, it is currently unknown whether specific dissociative symptoms cluster together among individuals with childhood trauma histories ranging from none to severe.Objective: We aimed to explore symptom constellations across the whole spectrum of dissociative processing from patients with severe dissociative disorders to healthy controls and relate these to maltreatment severity and sociodemographic characteristics.Methods: We employed latent profile analysis to explore symptom profiles based on five subscales, measuring absorption, depersonalization, derealization, somatoform and identity alteration, based on the 20 items of the German short version of the Dissociative Experiences Scale-II (Fragebogen zu Dissoziativen Symptomen-20) in a large aggregate sample (n = 3,128) overrepresenting patients with trauma-related disorders. We then related these profiles to maltreatment severity as measured by the five subscales of the Childhood Trauma Questionnaire as well as sociodemographic characteristics.Results: Based on the five FDS subscales, six clusters differentiated by symptom severity, but not symptom constellations, were identified. Somatoform dissociation varied in accordance with the remaining symptom clusters. The cluster with the highest overall symptom severity entailed nearly all subjects diagnosed with Dissociative Identity Disorder and was characterized by extreme levels of childhood maltreatment. Both abuse and neglect were predictive of cluster membership throughout.Conclusions: The higher the severity of dissociative processing in a cluster, the more subjects reported high severity and multiplicity of childhood maltreatment. However, some subjects remain resilient to the development of dissociative processing although they experience extreme childhood maltreatment.

Dissociative symptoms, including identity alterations, are closely related to the severity of experienced childhood abuse.Somatoform dissociation occurs on all levels of overall dissociation severity.Some subjects with a history extreme childhood maltreatment do not develop dissociative symptoms, while some subjects with extreme dissociative symptoms do not report any childhood maltreatment.

Childhood cancer survivors: current challenges.

Rates of childhood cancer survival in developed countries have risen to over 80-85 %. In consequence, the population of childhood cancer survivors (CCS) has grown considerably. Nevertheless, CCS present a high morbidity and mortality due to cancer or its treatment, with an increased risk of premature mortality, second primary tumors and late side effects, both physical and psychosocial, all of which decrease the quality of life. Long-term follow-up (LTFU) of CCS is recommended to prevent, detect and treat those health problems. Despite the advances achieved, the management of CCS is still not optimal. Among the areas for improvement discussed in this manuscript are: (1) Quantifying the real burden of morbimortality, by implementing new frequency measures (mean cumulative count and cumulative burden), to obtain more accurate assessments, and using simulation models, to determine individual risks; (2) Assessing the impact of risk factors for late side effects, related to the patient, tumor type, treatments, lifestyle, comorbidities, genetics and ageing; (3) Considering the impact of the international harmonisation of long-term follow-up guidelines, to generate homogeneous, evidence-based recommendations and an individualized LTFU and, (4) Challenges to LTFU implementation, considering models of care adapted to patient risk and needs, with special attention to the transition to adult-care follow-up. Finally, we comment on the situation of CCS in Spain and consider future prospects for improving the health and quality of life of this population.

Diagnóstico genético de la hipoacusia neurosensorial infantil / Genetic diagnosis of childhood sensorineural hearing loss

Introducción: La hipoacusia neurosensorial (HNS) congénita o de inicio precoz es una de las enfermedades hereditarias más frecuentes en nuestro medio y es la deficiencia sensorial más frecuente. Es importante realizar un estudio etiológico de la hipoacusia y el estudio genético mediante la secuenciación de nueva generación (NGS) es la prueba con mayor rendimiento diagnóstico. Nuestro estudio muestra los resultados genéticos obtenidos en una serie de pacientes con HNS congénita/de inicio precoz bilateral. Material y método: Se incluyeron 105 niños diagnosticados de HNS bilateral a los que se les realizó un estudio genético entre los años 2019 y 2022. El estudio genético consistió en una secuenciación masiva del exoma completo, filtrando el análisis para los genes incluidos en un panel virtual de hipoacusia con 244 genes. Resultados: Se obtuvo un diagnóstico genético en 48% (50/105) de los pacientes. Se detectaron variantes patogénicas y probablemente patogénicas en 26 genes diferentes, siendo los genes más frecuentemente afectados el gen GJB2, USH2A y STRC. De las variantes detectadas 52% (26/50) se asociaron a una hipoacusia no sindrómica, 40% (20/50) una hipoacusia sindrómica y 8% restante (4/50) se podían asociar tanto a una hipoacusia sindrómica como no sindrómica. Conclusiones: El estudio genético constituye una parte fundamental del diagnóstico etiológico de la HNS bilateral. Nuestra serie muestra que el estudio genético de la hipoacusia mediante NGS tiene un alto rendimiento diagnóstico y nos proporciona información de gran utilidad en la práctica clínica.(AU)

Introduction: Congenital/early-onset sensorineural hearing loss (SNHL) is one of the most common hereditary disorders in our environment. There is increasing awareness of the importance of an etiologic diagnosis, and genetic testing with next-generation sequencing (NGS) has the highest diagnostic yield. Our study shows the genetic results obtained in a cohort of patients with bilateral congenital/early-onset SNHL. Materials and methods: We included 105 children with bilateral SNHL that received genetic testing between 2019 and 2022. Genetic tests were performed with whole exome sequencing, analyzing genes related to hearing loss (virtual panel with 244 genes). Results: 48% (50/105) of patients were genetically diagnosed. We identified pathogenic and likely pathogenic variants in 26 different genes, and the most frequently mutated genes were GJB2, USH2A and STRC. 52% (26/50) of variants identified produced non-syndromic hearing loss, 40% (20/50) produced syndromic hearing loss, and the resting 8% (4/50) could produce both non-syndromic and syndromic hearing loss. Conclusions: Genetic testing plays a vital role in the etiologic diagnosis of bilateral SNHL. Our cohort shows that genetic testing with NGS has a high diagnostic yield and can provide useful information for the clinical workup of patients.(AU)

Evaluación de las conductas de lactancia materna y las prácticas de alimentación complementaria de las madres turcas y las madres refugiadas sirias / Evaluation of breastfeeding behaviors and complementary feeding practices of Turkish and Syrian refugee mothers

Objetivos: el objetivo de este estudio fue comparar la lactancia y los factores relacionados (edad, nivel educativo, edad al momento del primer embarazo, etc.) y las prácticas de alimentación complementaria de las madres refugiadas sirias y las madres turcas. Materiales y métodos: este estudio descriptivo y comparativo analizó las características nutricionales de los bebés de 9 a 60 meses de edad cuyas madres fueran turcas o refugiadas sirias que asistieron al Hospital Público de Kiziltepe entre enero y julio de 2022. Resultados: se incluyó a 204 madres (126 turcas y 78 sirias). La edad promedio de las madres turcas era 27,60 ± 5,17 años y la de las refugiadas sirias, 28,91 ± 5,62 años, sin una diferencia significativa entre ambos grupos (p: 0,091). La lactancia materna posparto fue del 91,3 % y la duración de la lactancia fue de 12 meses (0-24) en las ciudadanas turcas, mientras que, en las refugiadas sirias, fue del 84,6 % y 9 meses (0-24), respectivamente (consumo de leche materna, p: 0,144; tiempo de consumo, p: 0,161; sin diferencias estadísticas). El 23,8 % de las ciudadanas turcas y el 5,1 % de las refugiadas sirias recibieron capacitación sobre la lactancia, con una diferencia significativa entre ambos grupos (p: 0,001). Conclusión: en los grupos de refugiadas, las prácticas de nutrición infantil y materna se ven alteradas. En colaboración con las organizaciones locales e internacionales y los organismos estatales que ayudan a los grupos de refugiados se podrían mejorar las prácticas de nutrición maternoinfantil y reducir las brechas.

Objectives: The purpose of this study was to compare breastfeeding and related factors (age, level of education, age at first pregnancy, etc.), and complementary feeding practices between Syrian refugee and native Turkish mothers. Material and methods: This descriptive-comparative study examined the nutritional characteristics of infants aged 9 to 60 months whose mothers were Turkish or Syrian refugees who attended Kiziltepe State Hospital between January 2022 and July 2022. Results: 204 mothers (126 Turkish and 78 Syrian) who had a child aged 9-60 months were included. The average age of the mothers was 27.60 ± 5.17 years for Turkish citizens and 28.91 ± 5.62 for Syrian refugees, without significant difference between the two groups (p: 0.091). Postpartum breastfeeding was 91.3% and breastfeeding duration was 12 (0-24) months in Turkish citizens; in Syrian refugees, breastfeeding was 84.6% and average breastfeeding time was 9 (0- 24) months (respectively, breast milk intake p: 0.144, uptake time p: 0.161; no statistical difference). Breastfeeding training was received by 23.8% of Turkish citizens and 5.1% of Syrian refugees; there was a significant difference between the two groups (p: 0.001). Conclusion: In refugee groups, infant and maternal nutrition practices are disrupted. Working in conjunction with local and international organizations and state agencies that give help to refugee groups, the appropriate interventions, initiatives, supports, and awareness-raising activities would strive to improve practices in mother and baby nutrition and narrow gaps.

A prática psicológica e a ludicidade na hospitalização pediátrica: relato de experiência / Psychological practice and playing in pediatric hospitalization: experience report / La práctica psicológica y la ludicidad en la hospitalización pediátrica: informe de experiencia

INTRODUÇÃO: A inserção da psicologia e o método lúdico de intervenção na esfera hospitalar surge para promover bem-estar frente às vivências das crianças em condição de internação. O enfrentamento de uma hospitalização no período da infância pode provocar impactos significativos do ponto de vista orgânico, psíquico e ambiental, por ser um momento de estruturação do indivíduo enquanto sujeito psíquico. OBJETIVO: Posto isso, o presente artigo objetiva refletir sobre a relação da família e da equipe de saúde com crianças hospitalizadas e a relevância da utilização dos recursos lúdicos, a partir de um relato de experiência de estagiários de um curso de graduação em psicologia. MÉTODO: Logo, trata-se de um relato de experiência, de abordagem qualitativa e de natureza descritiva, realizado de março de 2022 a junho de 2023, em uma Unidade Pediátrica de um Hospital Público Brasileiro. RESULTADOS E DISCUSSÃO: A partir disso, observaram-se na prática reações de estranhamento dos pacientes ao se depararem com a permanência no hospital, o adoecimento e os procedimentos das equipes multiprofissionais de saúde; bem como evidenciou-se a importância da transmissão das informações e do preparo verbal ante intervenções, visando a participação ativa do paciente em seu tratamento. Também observou-se a significância do uso de ferramentas lúdicas nas intervenções com as crianças, que facilitam a adaptação ao contexto e proporcionam âncora para estas elaborarem suas vivências. CONCLUSÃO: Portanto, conclui-se que a utilização de recursos lúdicos favorece o atendimento psicológico na infância e período de hospitalização.

INTRODUCTION: The integration of psychology and the playing method of intervention in the hospital setting emerges to promote wellbeing in the face of children's experiences during hospitalization. Confronting hospitalization during childhood can lead to significant impacts from organic, psychological, and environmental standpoints, as it represents a pivotal moment in the individual's psychological development. OBJECTIVE: With this in mind, the present article aims to reflect on the relationship between families and healthcare teams with hospitalized children and the relevance of using playful resources, based on an experience report from interns of an undergraduate psychology course. METHOD: Therefore, it constitutes an experiential account, employing a qualitative and descriptive approach, conducted from March 2022 to June 2023, in a Pediatric Unit of a Brazilian Public Hospital. RESULTS AND DISCUSSION: From this perspective, practical observations revealed patients' feelings of unfamiliarity upon facing hospital stays, illness, and procedures performed by multidisciplinary healthcare teams; as well as the significance of conveying information and verbal preparation before interventions was highlighted, aiming to actively involve the patient in their treatment. It was also observed the significance of using playful tools in interventions with children, which facilitates adaptation to the context and provides an anchor for them to elaborate on their experiences. CONCLUSION: Thus, it can be concluded that the use of playful resources enhances psychological care during childhood and the hospitalization period.

INTRODUCCIÓN: La inserción de la psicología y el método lúdico de intervención en el ámbito hospitalario surge con el propósito de promover el bienestar frente a las experiencias de los niños en condiciones de hospitalización. Enfrentar la hospitalización durante la infancia puede generar impactos significativos desde un punto de vista orgánico, psicológico y ambiental, ya que representa un momento de estructuración del individuo como sujeto psíquico. OBJETIVO: En este sentido, el presente artículo tiene como objetivo reflexionar sobre la relación de la familia y el equipo de salud con niños hospitalizados y la relevancia de utilizar recursos lúdicos, a partir de un relato de experiencia de practicantes de un curso de grado en psicología. MÉTODO: Por lo tanto, se trata de un informe de experiencia con enfoque cualitativo y de naturaleza descriptiva, llevado a cabo desde marzo de 2022 hasta junio de 2023 en una Unidad Pediátrica de un Hospital Público Brasileño. RESULTADOS Y DISCUSIÓN: A partir de esto, se observaron reacciones de desconcierto por parte de los pacientes al enfrentar la permanencia en el hospital, la enfermedad y los procedimientos realizados por los equipos de salud multidisciplinarios; así como también se resaltó la importancia de la transmisión de información y la preparación verbal antes de las intervenciones, con el objetivo de involucrar activamente al paciente en su tratamiento. También se observó la importancia del uso de herramientas lúdicas en las intervenciones con niños, ya que facilitan la adaptación al contexto y brindan un punto de referencia para que estos niños elaboren sus experiencias. CONCLUSIÓN: Por lo tanto, se concluye que el uso de recursos lúdicos favorece la atención psicológica durante la infancia y el período de hospitalización.

Perfil epidemiológico de internações por doenças infecciosas e bacterianas em menores de 5 anos, de 2017 a 2021 / Perfil epidemiológico de las hospitalizaciones por enfermedades infecciosas y bacterianas más prevalentes en niños menores de 5 años, de 2017 a 2021 / Epidemiological profile of hospitalizations for the most prevalent infectious and bacterial diseases in children under 5 years, from2017 to 2021

Introdução:A internação representa um impacto considerável na vida de qualquer pessoa, podendo tomar proporções ainda maiores quando se trata de uma criança. A impossibilidade de realizar sua rotina, como brincar e ir à escola, faz com que a internação infantil assuma um contexto marcante.Dito isso, nota-se que grande parte dessas internações é evitável, sendo denominadasde Internações por Condições Sensíveis à Atenção Primária. Dessa forma, o atendimento ambulatorial de qualidade poderia resolver a maioria das enfermidades infantis, evitando esse desfecho.Objetivo:Elaborar um perfil epidemiológico de internações por doenças infecciosas e bacterianas mais prevalentes em menores de 5 anos, de 2017 a 2021, no Brasil. Metodologia:A pesquisa em questão se trata de um estudo ecológico de série temporal,elaborado através de informações coletadas por vias secundárias.Os dados foram coletados na plataforma DataSUS e no Sistema de Informação Hospitalar. Posteriormente, os dados foram processados e armazenados no aplicativo Microsoft Excel®, onde foram tratados e selecionados de acordo com sua relevância para a pesquisa. Resultados:Constata-se que a faixa etária situadaabaixo do primeiro ano de vidaapresenta um grau de hospitalização superior ao dascrianças que vãodo primeiro ao quarto ano completo.Quanto àfrequência relativa, depreende-se que diarreia e gastroenterite de origem infecciosa presumível apresentaram o maior índice de prevalência em relação às demais patologias, com o maior número chegando a 23,8% no ano de 2017 e o menor situando-se na faixa de 13,22% em 2020. Conclusões: Apesar do avanço na Atenção Primária à Saúde e da cobertura pré-natal, a assistência ainda é deficitária, sendo necessários mais investimentos na área e o fomento de políticas públicas que abranjam essa população (AU).

Introduction: Hospitalization represents a considerable impact on the life of any person, and can even take on even greater proportions when it comes to a child. The impossibility of realizing their routine, such as playing and going to school, means that hospitalization during childhood takes ona remarkable context. That said, it is noted that mostofthese hospitalizations are avoidable,and are called Ambulatory Care Sensitive Conditions. Thus, quality ambulatory care could solve most childhood illnesses, avoiding this outcome.Objective:To elaborate an epidemiological profile of hospitalizations for the most prevalent infectious and bacterial diseases in children under 5 years of age,from 2017 to 2021,in Brazil. Methodology: The research in question is an ecological study of time series, elaborated through information collected through secondary data sources. Data were collected from the DataSUS platform and the Hospital Information System. Subsequently, data were processed and stored in Microsoft Excel® application, where they were managedand selected according to their relevance to the research. Results:It is observed that the age group below the first year of life presents a higher degree of hospitalization thanthat of children ranging from the first to the fourth year. As for the relative frequency, it can be seen that diarrhea and gastroenteritis of presumable infectious origin had the highest prevalence rate compared to other pathologies, with the highest number reaching 23.8% in 2017 and the lowest being in the range of 13.22% in 2020. Conclusions: Despite the advances in Primary Health Care and prenatal coverage, assistance is still deficient, requiring more investments in the area and the promotion of public policies that cover this population (AU).

Introducción: La hospitalización representa un impacto considerable en la vida de cualquier persona, quepuede adquirir proporciones aún mayores cuando se trata de un niño. La imposibilidadde realizar su rutina, como jugar e ir al colegio, hace que la hospitalización infantiltengaun contexto notable. Dicho esto, cabe señalar que una gran parte de estas hospitalizaciones son evitables, denominándose Hospitalizaciones por Condiciones Sensibles a la Atención Ambulatoria. Así pues, una atención ambulatoria de calidad podría resolver la mayoría de las enfermedades infantiles, evitando este desenlace. Objetivo: Elaborar un perfil epidemiológico de las hospitalizaciones por enfermedades infecciosas y bacterianas más prevalentes en niños menores de 5 años, de 2017 a 2021, en Brasil. Metodología: La investigación en cuestión es un estudio ecológico de series temporales, elaborado a partir de información recogida por vías secundarias. Los datos se recogieron de la plataforma DataSUS y del Sistema de Información Hospitalaria. Posteriormente, los datos se procesaron y almacenaron en la aplicación Microsoft Excel®, donde se trataron y seleccionaron en función de su relevancia para la investigación. Resultados: Se observa que el grupo de edad inferior al primer año de vida presenta un mayor grado de hospitalización que los niños del primero al cuarto año completo. En cuanto a la frecuencia relativa, se puede inferirque la diarreay lagastroenteritis presumible origen infeccioso tuvieron la tasa de prevalencia más alta en relación con las demáspatologías, siendola cifra más alto el 23,8% en 2017 y lamás bajael rango del 13,22% en el 2020. Conclusiones: A pesar de los avances en la Atención Primariade Salud y en la cobertura prenatal, la asistencia aún es deficiente, por lo que se requieren mayoresinversiones en el área y la promoción de políticas públicas que cubran a esta población (AU).

Internações na infância por doenças do aparelho respiratório no Brasil de 2013 a 2022 / Hospitalizaciones infantiles por enfermedades del sistema respiratorio en Brasil de 2013 a 2022 / Hospitalizations during childhood due to respiratory system diseases in Brazil from 2013 to 2022

Introdução: As doenças do sistema respiratório se mostram como uma das causas mais preocupantes de internações hospitalares no país. Nessa perspectiva, o perfil das internações por doenças respiratórias em crianças permite observar os parâmetros desta problemática, fornecendo um conhecimento amplo acerca do processo saúde e doença nessa população. Objetivo: Analisar o perfil epidemiológico das internações hospitalares por causas do aparelho respiratório em crianças de 0 a 9 anos no Brasil e regiões, entre os anos de 2013 e 2022. Metodologia: Trata-se de um estudo ecológico, realizado no Brasil, a partir de dados secundários do Sistema de Informações Hospitalares. A população escolhida para este estudo foram crianças de 0 a 9 anos deidade. Os dados foram coletados em 26 de novembro de 2022. As variáveis dependentes do estudo são as internações de crianças de 0 a 9 anos por doenças do aparelho respiratório no Brasil e suas regiões. Já, como variáveis independentes, tem-se o tempo, do período de janeiro de 2013 a setembro de 2022, regiões e faixa etária. Resultados: Há uma tendência de queda das internações por causa respiratória até o ano de 2016, seguido de um crescimento gradativo até 2019. Entretanto, em 2020, a taxa de hospitalização reduziu drasticamente em todas as localidades. As regiões Sul, Norte e Centro-Oeste permaneceram com taxas maiores que o Brasil em todo o período estudado. A internação em menores de 1 ano representa o maior quantitativo de internações sendo a pneumonia a causa mais prevalente. Conclusões: As taxas de internação infantil por doenças respiratórias representam importante preocupação para saúde pública. Assim, destaca-se a relevância da efetividade da Atenção Primária à Saúde, que possui grande impacto no desfecho dos adoecimentos em crianças, especialmente das doenças respiratórias (AU).

Introduction: Respiratory system diseases are one of the most worrying causes of hospital admissions in the country. From this perspective, the profile of hospitalizations for respiratory diseases in children allows us to notice the parameters of this problem, providing a broad understanding of the health and disease process in this population.Objective: To analyze the epidemiological profile of hospital admissions due to respiratory causes in children aged 0 to 9 in Brazil and its regions between 2013 and 2022. Methodology: This is an ecological study held in Brazil using secondary data from the Hospital Information System. The population chosen for this study consisted of children aged 0 to 9. Data were collected on November 26, 2022. The dependent variables of this study are hospitalizations of children aged 0 to 9 due to respiratory diseases in Brazil and its regions. The independent variables are time, from January 2013 to September 2022, regions, and age group.Results: There was a downward trend in hospitalizations due to respiratory causes until 2016, followed by a gradual increase until 2019. Nonetheless, in 2020, the hospitalization rate fell dramatically in all locations. The South, North and Mid-West regions remained with higher rates than Brazil throughout the studied period. Hospitalization of children under 1 year old represents the largest number of admissions, with pneumonia being Revista Ciência Plural. 2024; 10(1): e31414 3the most prevalent cause.Conclusions: Hospitalization rates during childhood due to respiratory diseases represent a major public health concern. Thus, one can highlight the importance of the effectiveness of Primary Health Care, which has a major impact on the outcome of illnesses in children, especially respiratory diseases (AU).

Introducción: Las enfermedades del sistema respiratorio son una de lascausas más preocupantes de hospitalizaciones en el país. Desde esta perspectiva, el perfil de hospitalizaciones por enfermedades respiratorias en niños permite observar los parámetros de este problema, proporcionando una amplia comprensión del proceso de salud y enfermedad en esta población.Objetivo: Analizar el perfil epidemiológico de las internaciones por causas respiratorias en niños de 0 a 9 años en Brasil y sus regiones entre 2013 y 2022. Metodología: Se trata de un estudio ecológico conducido en Brasil a partir de datos secundarios del Sistema de Información Hospitalaria. La población elegida para este estudio fueron los niños de 0 a 9 años. Los datos se recogieron el 26 de noviembre de 2022. Las variables dependientes del estudio son las hospitalizaciones de niños de 0 a 9 años por enfermedades respiratorias en Brasil y sus regiones. Las variables independientes son el tiempo, de enero de 2013 a septiembre de 2022, las regiones y la franja etaria.Resultados: Se nota una tendencia a la baja de las hospitalizaciones por causas respiratorias hasta 2016, seguida de un aumento gradual hasta 2019. Sin embargo, en 2020, la tasa de hospitalización cayó drásticamente en todas las localidades. Las regiones Sur, Norte y Medio Oeste se mantuvieron con tasas másaltas que Brasil durante todo el período estudiado. Las hospitalizaciones en niños menores de 1 año representan el mayor número de internaciones, siendo la neumonía la causa más prevalente.Conclusiones: Las tasas de hospitalización infantil por enfermedades respiratorias representan un importante problema de salud pública. Así, se subraya la importancia de la eficacia de la Atención Primaria de Salud, que tiene un gran impacto en el resultado de las enfermedades en los niños, especialmente las respiratorias (AU).

Síndrome de Rapunzel: atadura sicológica y simulación orgánica / Rapunzel syndrome: psychological bondage and organic simulation

Introducción. El síndrome de Rapunzel es una entidad infrecuente, que se presenta como un tricobezoar a causa de una aglomeración de cabello acumulado dentro del tracto gastrointestinal, por lo que simula otras patologías quirúrgicas. Caso clínico. Paciente femenina de 10 años de edad, con tricotilomanía y tricofagia, dolor abdominal y síntomas inespecíficos de obstrucción intestinal de ocho meses de evolución. Al examen físico se encontró abdomen con distensión y masa palpable en epigastrio y mesogastrio. La ecografía permitió hacer el diagnóstico de tricobezoar gástrico extendido hasta el intestino delgado, por lo que se llevó a cirugía para gastrotomía y se extrajo el tricobezoar, con evolución satisfactoria de la paciente. El abordaje integral permitió conocer la atadura sicológica por posible maltrato infantil. Resultado. La paciente tuvo una evolución satisfactoria y se dio egreso al quinto día de hospitalización. Actualmente se encuentra en seguimiento por sicología, siquiatría infantil y pediatría. Discusión. El caso clínico denota la importancia en reconocer situaciones de presentación infrecuente en pediatría, que puedan estar asociadas a alteraciones sicológicas o presunción de maltrato infantil y que se presenten como una condición orgánica recurrente que simule otras patologías abdominales frecuentes en la infancia. El retraso diagnóstico puede conducir a un desenlace no deseado con complicaciones. Conclusión. Se hace mandatorio el manejo integral del paciente pediátrico y aumentar la sensibilidad para reconocer situaciones de presunción de maltrato infantil, sobre todo en pacientes con una condición orgánica quirúrgica recurrente.

Introduction. Rapunzel syndrome is an uncommon condition that manifests as trichobezoars, which are hair bundles in the stomach or small intestine that can mimics other surgical illnesses. Multiple complications can arise from delayed diagnosis and treatment. Clinical case. A 10-year-old female patient with trichotillomania and trichophagia, with abdominal pain and nonspecific symptoms of intestinal obstruction of eight months of evolution. Physical examination revealed epigastric tenderness and a solid mass was palpable in the mesogastric and epigastric region. An abdominal ultrasound showed gastric trichobezoar that extended into the small intestine. A gastrotomy was performed and the trichobezoar was extracted with satisfactory evolution of the patient. The comprehensive approach allowed knowing the psychological bond due to possible child abuse. Results. The patient had a satisfactory evolution and was discharged on the fifth day of hospitalization. He is currently being monitored by psychology, child psychiatry and pediatrics. Discussion. This clinical case highlights the importance of recognizing situations that seldom present in pediatrics, which may have a psychological aspect due to the presumption of child abuse, and which present as a recurrent organic condition simulating other frequent abdominal pathologies in childhood; all of which may lead to an unwanted outcome due to diagnostic delay. Conclusion. The comprehensive management of the pediatric patient is mandatory to recognize situations of presumed child abuse, in the face of a recurrent surgical conditions.

Necesidades de Intervención en Prisión con Internos con Pedofilia / Intervention Needs in Prison With Pedophile Inmates

En prisión existen programas específicos de tratamiento para condenados por agresión sexual a menores; sin embargo, quienes además tienen pedofilia, requieren una atención específica. El objetivo del presente estudio es doble: primero, ofrecer una propuesta de intervención específica para pedofilia en el entorno penitenciario basada en la evidencia científica disponible y complementaria al Programa de Control de la Agresión Sexual y después, justificar dicha propuesta a través del caso de un interno con pedofilia. En concreto, proponemos una intervención individual y centrada en personas con pedofilia; trabajando la baja autoestima, evaluando la ideación suicida y reestructurando las distorsiones cognitivas con menores, facilitando la creación de relaciones personales funcionales con adultos, evaluando la polivictimización pasada y su posible influencia sobre la conducta sexual posterior, proporcionar a los internos psicoeducación sobre pedofilia; atender de forma específica las fantasías sexuales con menores, evitando las conductas disexuales y la eliminación del consumo de material abusivo.(AU)

There are specific treatment programs in prisons for those convicted of sexually assaulting minors; however, those who also have pedophilia require specific attention. The aim of this study is twofold: first, to offer a specific intervention proposal for pedophilia in the prison setting based on the available scientific evidence, and complementary to the Sexual Assault Control Program, and second, to justify this proposal through the case of an inmate with pedophilia. Specifically, we propose an individual intervention focused on people with pedophilia; working on low self-esteem, assessing suicidal ideation and restructuring cognitive distortions with minors, facilitating the creation of functional personal relationships with adults, assessing past polyvictimization and its possible influence on subsequent sexual behavior, providing inmates with psychoeducation on pedophilia; specifically addressing sexual fantasies with minors, avoiding dyssexual behavior, and eliminating the consumption of abusive material.(AU)

Diferencias en la evolución del sobrepeso y la obesidad infantil en España en el periodo 2011-2019 por sexo, edad y nivel socioeconómico: resultados del estudio ALADINO / Differences in the temporal trends of childhood overweight and obesity in Spain in the 2011-2019 period by sex, age and socioeconomic level: Results of the ALADINO study

Introducción: El exceso de peso infantil es un problema de salud pública creciente. El objetivo del trabajo es estudiar la evolución de la prevalencia de sobrepeso, de obesidad y de obesidad central en escolares de 6 a 9años en España entre 2011 y 2019 según características demográficas y socioeconómicas.MetodologíaSe incluyeron las rondas 2011, 2015 y 2019 del estudio observacional, descriptivo y transversal ALADINO en escolares de ambos sexos de 6 a 9años. Se realizó un análisis descriptivo de la evolución de la prevalencia de sobrepeso y de obesidad según los criterios de la Organización Mundial de la Salud (OMS) y la International Obesity Task Force (IOTF), así como obesidad central, y las variables demográficas y socioeconómicas asociadas.ResultadosEntre 2011 y 2019 se redujo la prevalencia de sobrepeso (criterios OMS) en niños de 6, 7 y 8años (−5,4, −5,7 y −5,3 puntos porcentuales, respectivamente) y niños cuyos progenitores tenían estudios superiores (−5,3 puntos porcentuales). Por renta, el sobrepeso en niños se redujo en todos los niveles de ingresos. Sin embargo, entre 2011 y 2019 se mantuvieron estables tanto la prevalencia de sobrepeso en niñas como la prevalencia de obesidad según las referencias OMS e IOTF y la de obesidad central en ambos sexos.ConclusionesLas prevalencias de sobrepeso y de obesidad en escolares de 6 a 9años en España siguen siendo altas. Entre 2011 y 2019 disminuyó la prevalencia de sobrepeso en niños de 6 a 8años y aquellos cuyos progenitores tienen estudios universitarios, mientras que la obesidad en niños, el sobrepeso y la obesidad en niñas, y la obesidad central en ambos sexos han permanecido estables. (AU)

Introduction: Childhood excess weight is a growing public health problem. The aim of this study was to assess temporal trends in the prevalence of overweight, obesity and central obesity in schoolchildren aged 6 to 9years in Spain between 2011 and 2019 based on demographic and socioeconomic characteristics.MethodologyThe analysis included data from the 2011, 2015 and 2019 rounds of the cross-sectional observational and descriptive ALADINO study in schoolchildren of both sexes aged 6 to 9years. We conducted a descriptive analysis of the trends in the prevalence of overweight and obesity (defined according to the criteria of the World Health Organization [WHO] and the International Obesity Task Force [IOTF]) and of central obesity, in addition to associated demographic and socioeconomic variables.ResultsBetween 2011 and 2019, the prevalence of overweight (WHO criteria) decreased in boys aged 6, 7 and 8years (by −5.4%, −5.7% and −5.3%, respectively) and boys whose parents had a higher educational attainment (by −5.3%). In relation to the socioeconomic level, overweight in boys declined at all income levels. However, between 2011 and 2019, both the prevalence of overweight in girls and the prevalence of obesity (applying the WHO and IOTF criteria) and the prevalence of central obesity in both sexes remained stable.ConclusionsThe prevalence of overweight and the prevalence of obesity in schoolchildren aged 6 to 9years in Spain remain high. Between 2011 and 2019, the prevalence of overweight in children aged 6 to 8years and in children whose parents had university degrees decreased, whereas obesity in boys, overweight and obesity in girls and central obesity in both sexes remained stable. (AU)

El tratamiento del dolor agudo pediátrico en España EN 2021: resultado de una encuesta nacional entre anestesiólogos pediátricos / The management of paediatric acute pain in Spain IN 2021: Results of a national survey among paediatric anaesthesiologists

Objetivo: Mejorar el conocimiento acerca de la práctica clínica habitual en el tratamiento del dolor agudo pediátrico en España.MétodosSe llevó a cabo una encuesta telemática a través de Internet en una muestra representativa de profesionales sanitarios involucrados en el tratamiento del dolor agudo pediátrico (concretamente anestesiólogos) en España. La encuesta incluyó 28 cuestiones acerca de su práctica clínica habitual en la valoración y el tratamiento del dolor agudo, así como aspectos formativos y organizativos en el dolor agudo pediátrico.ResultadosLa encuesta fue completada durante el mes de marzo de 2021 por 150 especialistas en anestesiología. Los encuestados presentaron una amplia experiencia en el tratamiento del dolor agudo pediátrico (media de años de experiencia: 14,3; DE: 7,8) y básicamente en dolor agudo postoperatorio (97% casos). Aunque el 80% de los mismos utilizaba de modo habitual escalas validadas de valoración de dolor agudo pediátrico, solo el 2,6% utilizaba las específicas adaptadas para pacientes con discapacidad cognitiva. La mayoría de los encuestados empleaba habitualmente fármacos analgésicos como el paracetamol (99%) o el metamizol (92%), pero solo el 84% los complementaba con alguna técnica de bloqueo loco-regional u otra medicación tipo antiinflamatorio no esteroideo (62%). Además, únicamente un 62,7% reconocía haber recibido formación específica en dolor agudo pediátrico, solo un 45% seguía protocolos institucionales hospitalarios y un escaso 28% lo hacía a través de unidades de dolor infantil.ConclusionesLa encuesta identificó importantes puntos de mejora en la formación y organización del tratamiento del dolor agudo de los pacientes españoles en edad pediátrica. (AU)

Objective: To improve knowledge about routine clinical practice in the management of paediatric acute pain in Spain.MethodsA telematic survey was conducted via the Internet on a representative sample of healthcare professionals involved in the management of paediatric acute pain (specifically anaesthesiologists) in Spain. The survey included 28 questions about their usual clinical practice in the assessment and treatment of acute pain, and also training and organisational aspects in paediatric acute pain.ResultsThe survey was completed during March 2021 by 150 specialists in anaesthesiology. The respondents widely experienced in the management of acute paediatric pain (mean years of experience: 14.3: SD: 7.8), essentially in acute postoperative pain (97% of cases). Although 80% routinely used validated paediatric acute pain assessment scales, only 2.6% used specific scales adapted for patients with cognitive impairment. Most of the respondents routinely used analgesic drugs such as paracetamol (99%) or metamizole (92%), but only 84% complemented these drugs with a loco-regional blocking technique or other non-steroidal anti-inflammatory drugs (62%). Furthermore, only 62.7% acknowledged having received specific training in paediatric acute pain, only 45% followed hospital institutional protocols, and a scant 28% did so through paediatric pain units.ConclusionsThe survey identified important points for improvement in the training and organisation of acute pain management in Spanish paediatric patients. (AU)

Ajuste y adaptación psicosocial de adultos jóvenes supervivientes de un cáncer en etapa pediátrica: Revisión sistemática / Psychosocial adjustment and adaptation in young adults surviving pediatric cancer: A systematic review

Introducción: Los efectos a largo plazo de tumores en la infancia pueden alterar la trayectoria de adaptación y ajuste psicosocial de los supervivientes en etapas de vida posteriores. Objetivo: Esta revisión sistemática se centra en analizar las experiencias de crecimiento postraumático, estrés postraumático, malestar emocional y dificultades psicosociales sufridas por jóvenes adultos supervivientes a un cáncer en etapa pediátrica. Resultados: Los resultados sugieren una trayectoria mayoritaria que podría definirse como adaptativa, en la que se observa tanto crecimiento postraumático (prevalencia superior al 60%), como síntomas de estrés postraumático (prevalencia inferior al 30%). No obstante, en comparación con población control no oncológica, estos supervivientes tienen mayor riesgo de padecer síntomas de ansiedad y depresión, de alcanzar menores logros educativos y profesionales, y de permanecer solteros o vivir solos, lo que se hipotetiza que podría estar relacionado con las secuelas de cada tipo de tumor y tratamiento, y no únicamente con la vivencia de la enfermedad. Conclusiones: La atención a jóvenes adultos supervivientes a un cáncer pediátrico debería centrarse en proporcionar mayor apoyo médico y psicosocial a largo plazo, a través del abordaje interdisciplinar y la atención centrada en la persona, como aproximación que favorezca una trayectoria de ajuste adaptativa.(AU)

Introduction: Long-term effects of childhood tumors can alter the trajectory of adjustment and psychosocial adjustment of survivors later in life. Purpose: This systematic review focuses on analyzing the experiences of posttraumatic growth, posttraumatic stress, emotional distress, and psychosocial difficulties experienced by young adult survivors of pediatric cancer. Results: The results suggest a more prevalent trajectory that could be conceptualize as adaptive, in which both post-traumatic growth (prevalence greater than 50%) and post-traumatic stress symptoms (prevalence less than 30%) are observed. However, compared to the non-oncology control population, these survivors are at higher risk for anxiety and depressive symptoms, lower educational and occupational attainment, and remaining single or living alone, which is hypothesized to be related to the sequelae of each tumor type and treatment, and not just the disease experience. Conclusions: Care for young adult survivors of pediatric cancer should focus on providing enhanced long-term medical and psychosocial support through an interdisciplinary approach and person-centered care as an approach that supports a trajectory of adaptive adjustment.(AU)

FACTORS ASSOCIATED WITH EXTREME MATERNAL MORBIDITY IN A COHORT OF PREGNANT WOMEN IN A CALI EAPB 2019-2020 / FACTORES ASOCIADOS A LA MORBILIDAD MATERNA EXTREMA EN UNA COHORTE DE GESTANTES DE UNA EAPB CALI 2019-2020

Introduction: Extreme maternal morbidity (EMM) is an event of interest in public health that has an important impact when evaluating health services, since timely and quality care in a woman with a severe obstetric complication can prevent a fatal outcome. In an EAPB in the city of Cali during the 2019-2020 period, a need was evidenced to determine the behavior of the factors mostly associated with extreme maternal morbidity, this being a relevant study to support decision-making. Methodology: it is a type of observational analytical retrospective cohort study, we worked with a census of pregnant women registered in the insurer's nominal follow-up matrix, which is fed from various sources such as the single database of affiliates, SIVIGILA, RIPS among others, a characterization of the sociodemographic, clinical and health care factors was carried out by means of absolute and relative frequencies, later they were crossed in contingency tables to determine association by means of the chi square test and a regression model was carried out. binomial log to establish the factors that best explain EMM. Results: most of the pregnant women were between 18 and 35 years old, from the subsidized regime, from the urban area, with informal work, educational level of basic secondary, with a stable partner (married or in a free union), non-ethnic, (No perceived as indigenous, ROM or Afro-Colombian, were in their second or third pregnancy period, covered by IVE counseling and the psychoprophylactic course and began their prenatal care in the first trimester, and an incidence of 3,2% of EMM was estimated. Conclusions: the risk of EMM was higher in pregnant women without IVE advice, psychoprophylactic course, ultrasound, nutrition consultation, gynecology, iron sulfate, calcium or folic acid; also in adolescents, in those over 36 years of age, from rural areas, without a stable partner, ethnic, vulnerable population, primiparous, with a history of abortion, with weight/height alterations, with high obstetric risk, with Dx of HIV or gestational syphilis and with late start of prenatal care.

Introducción: La morbilidad materna extrema es un evento de interés en salud pública que tiene un impacto importante al evaluar los servicios de salud ya que una atención oportuna y de calidad en una mujer con una complicación obstétrica severa puede prevenir un desenlace fatal. En una EAPB en la ciudad de Cali durante el periodo 2019-2020 se evidencio una necesidad referente a determinar cuál es el comportamiento de los factores mayormente asociados a la morbilidad materna extrema, siendo este un estudio relevante para apoyar la toma de decisiones. Metodología: es un tipo de estudio observacional analítico de cohorte retrospectiva, se trabajó con un censo de las gestantes registradas en la matriz de seguimiento nominal de la aseguradora, que se alimenta de diversas fuentes como la base de datos única de afiliados, SIVIGILA, RIPS entre otras, se realizó una caracterización de los factores sociodemográficos, clínicos y de atención en salud  por medio de frecuencias absolutas y relativas, posteriormente se cruzaron en tablas de contingencias para determinar asociación por medio de la prueba chi cuadrado y se realizó un modelo de regresión log binomial para establecer los factores que mejor explican la Morbilidad Materna Extrema (MME). Resultados: en su mayoría las gestantes tenían entre 18 y 35 años, del régimen subsidiado, de la zona urbana, con trabajo informal, nivel educativo de básica secundaria, con pareja estable (casadas o en unión libre), no étnica, (No se perciben como indígena, ROM o afrocolombiana, cursaban su segundo o tercer periodo de gestación, con cobertura de asesoría de IVE y del curso psicoprofiláctico y iniciaron su control prenatal en el primer trimestre y se estimó una incidencia de 3,2% de MME. Conclusiones:  el riesgo de MME fue superior gestantes sin asesoría de IVE, curso psicoprofiláctico, ecografía, consulta de nutrición, ginecología, sulfato ferros, calcio o ácido fólico; además en adolescentes, en mayores de 36 años, de la zona rural, sin pareja estable, con pertenencia étnica, de población vulnerable, primigestantes, con antecedente de aborto, con alteraciones peso/talla, con alto riesgo obstétrico, con Dx de VIH o sífilis gestacional y con inicio tardío del control prenatal.

Differences in the temporal trends of childhood overweight and obesity in Spain in the 2011-2019 period by sex, age and socioeconomic level: results of the ALADINO study.

INTRODUCTION: Childhood excess weight is a growing public health problem. The aim of this study was to assess temporal trends in the prevalence of overweight, obesity and central obesity in schoolchildren aged 6-9 years in Spain between 2011 and 2019 based on demographic and socioeconomic characteristics. METHODOLOGY: The analysis included data from the 2011, 2015 and 2019 rounds of the cross-sectional observational and descriptive ALADINO study in schoolchildren of both sexes aged 6-9 years. We conducted a descriptive analysis of the trends in the prevalence of overweight and obesity (defined according to the criteria of the World Health Organization and the International Obesity Task Force) and of central obesity, in addition to associated demographic and socioeconomic variables. RESULTS: Between 2011 and 2019, the prevalence of overweight (WHO criteria) decreased in boys aged 6, 7 and 8 years (by -5.4%, -5.7% and -5.3%, respectively) and boys whose parents had a higher educational attainment (by -5.3%). In relation to the socioeconomic level, overweight in boys declined at all income levels. However, between 2011 and 2019, both the prevalence of overweight in girls and the prevalence of obesity (applying the WHO and IOTF criteria) and the prevalence of central obesity in both sexes remained stable. CONCLUSIONS: The prevalence of overweight and the prevalence of obesity in schoolchildren aged 6-9 years in Spain remain high. Between 2011 and 2019, the prevalence of overweight in children aged 6-8 years and in children whose parents had university degrees decreased, whereas obesity in boys, overweight and obesity in girls and central obesity in both sexes remained stable.

Cognitive factors as mediators of the relationship between childhood trauma and depression symptoms: the mediating roles of cognitive overgeneralisation, rumination, and social problem-solving.

Background: Childhood trauma has negative immediate and long-term impacts on depression. Questions remain, however, regarding the cognitive factors influencing this relationship. This study aimed to investigate the role of three cognitive factors - cognitive overgeneralisation, rumination and social problem-solving - as mediating factors in the relationship between childhood trauma and symptoms of depression.Methods: We conducted a cross-sectional study in Iran from March to July 2023. Participants (N = 227; Mean age 32.44 ± 8.95 years) with depression completed measures of childhood trauma, depression, self-overgeneralisation, cognitive errors, memory specificity, rumination and social problem-solving. The conceptual model was assessed using structural equation modelling.Results: Structural equation modelling indicated that childhood trauma had a positive direct effect on depression symptoms. Childhood trauma had a positive indirect effect on depression symptoms through both self-overgeneralisation and rumination and a negative indirect effect on depression through effective social problem-solving strategies.Conclusions: The findings suggest increased exposure to childhood trauma may be associated with elevated depression and self-overgeneralisation, rumination, and effective social problem-solving strategies may play an important role in this relationship. These findings hold potential implications for those working with patients with depression and a history of childhood trauma.

Since the relationship between childhood trauma and depression is not straightforward, the study addresses a significant gap in the understanding of the relationship between childhood trauma and depression symptoms by focusing on cognitive factors as potential mediators among depressed patients.Childhood trauma not only has a direct positive effect on depression symptoms but also indirectly influences depression through self-overgeneralisation and rumination, which contribute to elevated depression, while effective social problem-solving strategies act as a protective factor, leading to decreased depression symptoms.The significance of above cognitive overgeneralisation factors in shaping the relationship between childhood trauma and depression symptoms suggests that therapeutic interventions targeting these cognitive factors might be hold promise in improving mental health outcomes for this vulnerable population.

Using decision tree to predict non-suicidal self-injury among young adults: the role of depression, childhood maltreatment and recent bullying victimization.

Importance: Non-suicidal self-injury (NSSI) is a significant mental health issue requiring a deeper understanding of its underlying causes, such as childhood maltreatment, adult bullying victimization, and depression. Previous studies have not adequately addressed the cumulative risks of these factors on NSSI among college students. This population-based study investigates these cumulative risk factors.Design, setting, and participants: The cross-sectional study included 63 university's college students with a mean age of 19.6 years (N = 95,833).Main outcomes and measures: Two Chi-Square Automatic Interaction Detection (CHAID) decision tree models were used to classify subgroups based on childhood maltreatment and adult bullying victimization experiences and to investigate their cumulative risks of NSSI. Recursive partitioning algorithms determined each predictor variable's relative importance.Results: The CHAID model accurately predicted NSSI behaviours with an overall accuracy rate of 77.8% for individuals with clinically relevant depressive symptoms and 97.2% for those without. Among depressed individuals, childhood emotional abuse was the strongest NSSI predictor (Chi-Square, 650.747; adjusted P < .001), followed by sexual and physical abuse. For non-depressed individuals, emotional abuse in childhood was the strongest NSSI predictor (Chi-Square, 2084.171; adjusted P < .001), with sexual and verbal bullying in the past year representing the most significant proximal risks.Conclusions and relevance: Emotional abuse during childhood profoundly impacts individuals, increasing the risk of NSSI in both depressed and non-depressed individuals. Clinically relevant depressive symptoms have a moderating effect on the relationship between childhood maltreatment, adult bullying victimization, and NSSI. Identifying these factors can inform targeted interventions to prevent NSSI development among young adults.

Emotional abuse during childhood has a profound impact on individuals, increasing their risk of non-suicidal self-injury (NSSI), regardless of whether they are depressed or non-depressed.Among depressed individuals, childhood emotional abuse emerges as the strongest predictor of NSSI, followed by sexual and physical abuse.In non-depressed individuals, emotional abuse in childhood assumes a similar role as the strongest NSSI predictor, with sexual abuse and verbal bullying in the past year representing the most significant proximal risks.

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)

La violencia como problema de salud / Violence as a health problem

La violencia es un problema de salud pública. Esta, cuando afecta a la infancia, puede generar enfermedad a lo largo de toda la vida del individuo. Aparte de poder producir daños en la esfera física, psíquica y social, supone una vulneración de los derechos de los niños afectados y un elevado consumo de recursos tanto económicos como sociales.Multitud de investigaciones han mejorado la atención a esta violencia. Sin embargo, estos avances no son parejos con el manejo práctico que se realiza a las víctimas tanto en la atención primaria como en la hospitalaria. Existe una significativa área de mejora para la atención pediátrica.A través de este artículo, distintos profesionales de todas las áreas sanitarias pediátricas establecidas desarrollan líneas generales de conocimiento y actuación con respecto a la violencia contra la infancia. Se hace un recorrido a través de la legislación relacionada con la infancia, las distintas tipologías de maltrato que existen, sus efectos, manejo y prevención. Concluye con un epílogo, a través del cual pretendemos mover sensibilidades.En resumen, este es un trabajo que pretende fomentar la formación y sensibilización de todos los profesionales especializados en la salud infantil, para que persigan como objetivo el que sus pacientes alcancen su mayor potencial en la vida y, de esa manera, ayudar a crear una sociedad más sana, con menos enfermedad y más justa.(AU)

Violence is a public health problem, and when it affects childhood, it can cause illness throughout the individual's life. Apart from being able to cause damage in the physical, mental and social spheres, it represents a violation of the rights of the affected children, and a high consumption of resources, both economic and social.A multitude of investigations have improved attention to this violence. However, these advances are not consistent with the practical management of victims, both in Primary and Hospital Care. There is a significant area of improvement for paediatric care.Through this article, different professionals from all established paediatric health care facilities develop general lines of knowledge and action regarding violence against children. An overview is taken of the legislation related to childhood, the different types of abuse that exist, their effects, management and prevention. It concludes with an epilogue, through which we aim to move sensibilities.In summary, this work aims to promote the training and awareness of all professionals specialized in children's health, so that they pursue the goal of achieving their patients’ greatest potential in life, and in this way, to help create a healthier society, with less disease, and more justice.(AU)