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1.
Hosp Pediatr ; 10(9): 810-819, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32847961

RESUMO

The novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread quickly across the globe, creating unique and pressing challenges for today's physicians. Although this virus disproportionately affects adults, initial SARS-CoV-2 infection can present a significant disease burden for the pediatric population. A review of the literature yields descriptive studies in pediatric patients; however, no evidence-based or evidence-informed guidelines for the diagnosis and treatment of the hospitalized pediatric patient have been published in peer-reviewed journals. The authors, working at a quaternary care children's hospital in the national epicenter of the SARS-CoV-2 pandemic, found an urgent need to create a unified, multidisciplinary, evidence-informed set of guidelines for the diagnosis and management of coronavirus disease 2019 in children. In this article, the authors describe our institutional practices for the hospitalized pediatric patient with confirmed or suspected initial SARS-CoV-2 infection. The authors anticipate that developing evidence-informed and institution-specific guidelines will lead to improvements in care quality, efficiency, and consistency; minimization of staff risk of exposure to SARS-CoV-2; and increased provider comfort in caring for pediatric patients with SARS-CoV-2 infection.


Assuntos
Betacoronavirus , Bem-Estar da Criança/estatística & dados numéricos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/terapia , Procedimentos Clínicos/organização & administração , Pneumonia Viral/diagnóstico , Pneumonia Viral/terapia , Criança , Difusão de Inovações , Gerenciamento Clínico , Hospitais Pediátricos/organização & administração , Humanos , Pandemias , Equipe de Assistência ao Paciente/organização & administração
2.
PLoS One ; 15(5): e0231620, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32374786

RESUMO

BACKGROUND: There is little evidence on the child and family factors that affect the intensity of care use by children with complex problems. We therefore wished to identify changes in these factors associated with changes in care service use and its intensity, for care use in general and psychosocial care in particular. METHODS: Parents of 272 children with problems in several life domains completed questionnaires at baseline (response 69.1%) and after 12 months. Negative binominal Hurdle analyses enabled us to distinguish between using care services (yes/ no) and its intensity, i.e. number of contacts when using care. RESULTS: Change in care use was more likely if the burden of adverse life events (ALE) decreased (odds ratio, OR = 0.94, 95% confidence interval, CI = 0.90-0.99) and if parenting concerns increased (OR = 1.29, CI = 1.11-1.51). Psychosocial care use became more likely for school-age children (vs. pre-school) (OR = 1.99, CI = 1.09-3.63) if ALE decreased (OR = 0.93, CI = 0.89-0.97) and if parenting concerns increased (OR = 1.26, CI = 1.10-1.45). Intensity of use (>0 contacts) of any care decreased when ALE decreased (relative risk, RR = 0.95, CI = 0.92-0.98) and when psychosocial problems became less severe (RR = 0.38, CI = 0.20-0.73). Intensity of psychosocial care also decreased when severe psychosocial problems became less severe (RR = 0.39, CI = 0.18-0.84). CONCLUSIONS: Changes in care-service use (vs. no use) and its intensity (>0 contacts) are explained by background characteristics and changes in a child's problems. Care use is related to factors other than changes in its intensity, indicating that care use and its intensity have different drivers. ALE in particular contribute to intensity of any care use.


Assuntos
Transtornos do Comportamento Infantil/terapia , Cuidado da Criança , Serviços de Saúde da Criança/provisão & distribução , Serviços de Saúde da Criança/estatística & dados numéricos , Recursos em Saúde , Adolescente , Adulto , Criança , Transtornos do Comportamento Infantil/epidemiologia , Cuidado da Criança/métodos , Cuidado da Criança/estatística & dados numéricos , Serviços de Saúde da Criança/organização & administração , Bem-Estar da Criança/estatística & dados numéricos , Pré-Escolar , Estudos de Coortes , Família , Feminino , Seguimentos , Recursos em Saúde/organização & administração , Recursos em Saúde/estatística & dados numéricos , Recursos em Saúde/provisão & distribução , Humanos , Lactente , Recém-Nascido , Estudos Longitudinais , Masculino , Países Baixos/epidemiologia , Relações Pais-Filho , Poder Familiar , Fatores Socioeconômicos , Inquéritos e Questionários
5.
BMC Public Health ; 20(1): 20, 2020 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-31910835

RESUMO

BACKGROUND: Social capital is generally portrayed to be protective of adolescents' health and wellbeing against the effects of socioeconomic inequalities. However, few empirical evidence exist on this protective role of social capital regarding adolescents' wellbeing in the low-and middle-income country (LMIC) context. This study examines the potential for social capital to be a protective health resource by investigating whether social capital can mediate the relationship between socioeconomic status (SES) and wellbeing of Ghanaian adolescents. It also examines how SES and social capital relate to different dimensions of adolescents' wellbeing in different social contexts. METHODS: The study employed a cross-sectional survey involving a randomly selected 2068 adolescents (13-18 years) from 15 schools (8 Senior and 7 Junior High Schools) in Ghana. Relationships were assessed using multivariate regression models. RESULTS: Three measures of familial social capital (family sense of belonging, family autonomy support, and family control) were found to be important protective factors of both adolescents' life satisfaction and happiness against the effects of socioeconomic status. One measure of school social capital (school sense of belonging) was found to augment adolescents' wellbeing but played no mediating role in the SES-wellbeing relationship. A proportion of about 69 and 42% of the total effect of SES on happiness and life satisfaction were mediated by social capital respectively. Moreover, there were variations in how SES and social capital related to the different dimensions of adolescents' wellbeing. CONCLUSION: Social capital is a significant mechanism through which SES impacts the wellbeing of adolescents. Social capital is a potential protective health resource that can be utilised by public health policy to promote adolescents' wellbeing irrespective of socioeconomic inequalities. Moreover, the role of the family (home) in promoting adolescents' wellbeing is superior to that of school which prompts targeted policy interventions. For a holistic assessment of adolescents' subjective wellbeing, both life evaluations (life satisfaction) and positive emotions (happiness) should be assessed concomitantly.


Assuntos
Saúde do Adolescente/estatística & dados numéricos , Bem-Estar da Criança/estatística & dados numéricos , Capital Social , Classe Social , Estudantes/psicologia , Estudantes/estatística & dados numéricos , Adolescente , Estudos Transversais , Feminino , Gana , Humanos , Masculino
7.
Appl Ergon ; 83: 102983, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31731094

RESUMO

This study explores sex/gender-related differences in ergonomic exposures and musculoskeletal disorders for 4090 working Syrian refugee children (>8-≤18 years) in the Bekaa Valley, Lebanon (n = 2107 males; n = 1983 females). Data was collected on demographic, occupational, and socioeconomic indicators and musculoskeletal disorders. Results revealed that children engaged in strenuous work. Ergonomic exposures differed by sex/gender, with girls more likely to engage in repetitive movements and boys in heavy lifting. Girls bore a double burden of work inside and outside their households and were more prone to wrist and hand pain. More girls reported working under pressure to finish their job on time while more boys reported that their salary is based on finishing a specific number of items per day. Syrian refugee child workers need immediate protection to safeguard their health. Interventions could target children of legal age for work in safer conditions and keep younger children out of work.


Assuntos
Bem-Estar da Criança/estatística & dados numéricos , Doenças Profissionais/epidemiologia , Refugiados/estatística & dados numéricos , Adolescente , Criança , Bem-Estar da Criança/psicologia , Ergonomia/métodos , Feminino , Humanos , Masculino , Doenças Profissionais/psicologia , Ocupações/classificação , Refugiados/psicologia , Reprodutibilidade dos Testes , Trabalho de Resgate , Fatores Sexuais , Síria
8.
JAMA Netw Open ; 2(12): e1918281, 2019 12 02.
Artigo em Inglês | MEDLINE | ID: mdl-31880797

RESUMO

Importance: The long-term association between sleep duration and mental health in children is currently unknown. Objective: To investigate the prospective associations between sleep duration and symptoms of emotional and behavioral disorders at ages 6, 8, 10, and 12 years. Design, Setting, and Participants: This population-based cohort study obtained data from the Trondheim Early Secure Study in Trondheim, Norway. A representative, stratified random sample of children born between January 1, 2003, and December 31, 2004, were invited to participate. Participants were followed up biennially from age 4 years (2007-2008) to 12 years (2013-2014). Data analysis was conducted from January 2, 2019, to May 28, 2019. Main Outcomes and Measures: Sleep duration was assessed with 1 week of continuous use of a triaxial accelerometer. Symptoms of emotional (anxiety and depression) and behavioral (oppositional defiant, conduct, and attention-deficit/hyperactivity) disorders were measured by semistructured clinical interviews (using the Preschool Age Psychiatric Assessment and the Child and Adolescent Psychiatric Assessment) with parents (at all ages) and children (from age 8 years). Results: The analytical sample comprised 799 children (mean [SD] age at time point 2, 6.0 [0.2] years; 405 [50.7%] boys; and 771 [96.5%] Norwegian). Shorter sleep duration at age 6 years (ß [unstandardized regression coefficient] = -0.44; 95% CI, -0.80 to -0.08; P = .02) and 8 years (ß = -0.47; 95% CI, -0.83 to -0.11; P = .01) forecasted symptoms of emotional disorders 2 years later. Comparatively short sleep duration at age 8 years (ß = -0.65; 95% CI, -1.22 to -0.08; P = .03) and 10 years (ß = -0.58; 95% CI, -1.07 to -0.08; P = .02) was associated with symptoms of behavioral disorders 2 years later among boys but not among girls at age 8 years (ß = -0.14; 95% CI,- 0.52 to 0.24; P = .48) or 10 years (ß = -0.05; 95% CI, = -0.49 to 0.40; P = .84). These associations were statistically significant among boys compared with girls at age 8 years (Δχ21 = 13.26; P < .001) and 10 years (Δχ21 = 10.25; P = .001). Symptoms of psychiatric disorders did not forecast sleep duration at any age. Conclusions and Relevance: This study found an association between short sleep duration and increased risk of future occurrence of emotional disorder symptoms in both boys and girls and between reduced sleep and behavioral disorder symptoms in boys. These results suggest that improving sleep in children may help protect against the development of symptoms of common psychiatric disorders and may be advantageous in the treatment of such disorders.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtornos do Comportamento Infantil/epidemiologia , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Adolescente , Transtornos de Ansiedade/epidemiologia , Criança , Bem-Estar da Criança/estatística & dados numéricos , Estudos de Coortes , Comorbidade , Feminino , Seguimentos , Humanos , Masculino , Noruega , Estudos Prospectivos , Sonambulismo/epidemiologia
9.
BMC Health Serv Res ; 19(1): 817, 2019 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-31703681

RESUMO

BACKGROUND: This study evaluated the Health Works (HWs) nutritional counselling skills and information shared with caregivers. This was a cross-sectional study in which an observation checklist was used to examine Growth Monitoring and Promotion (GMP) activities and educational/counselling activities undertaken by health workers (HWs) to communicate nutrition information to caregivers, depending on the ages of the children. METHODS: A total number of 528 counselling interactions between health workers and caregivers in 16 Child welfare Clinics (CWCs) in two rural districts in Ghana were observed. Frequencies were presented for the information that was obtained from each caregiver and those that were provided by the HWs during the nutritional counselling sessions. RESULTS: About 95.1 and 61.8% of the caregiver-HW interactions involved mothers of children who were less than 6 months of age and those above 6 months respectively. HWs counselled the caregivers on appropriate nutrition for the child. Health talk messages that were shared with caregivers focused mainly on the importance of attending CWCs and vaccination of children and rarely included any teaching materials. In most of the interactions, HWs made of child's feeding practices the past 1 month; and also did not provide advice on specific issues of IYCF. Nutritional counselling information given for non-breastfeeding children was inadequate and in some cases absent. Little attention was given to the feeding of children with animal products during counselling. CONCLUSION: Generally nutritional information given to caregivers who had children above 6 months was inadequate.


Assuntos
Cuidadores/educação , Bem-Estar da Criança/estatística & dados numéricos , Aconselhamento/normas , Educação em Saúde/normas , Estado Nutricional , Criança , Pré-Escolar , Enfermagem em Saúde Comunitária/normas , Enfermagem em Saúde Comunitária/estatística & dados numéricos , Aconselhamento/estatística & dados numéricos , Estudos Transversais , Feminino , Gana , Educação em Saúde/estatística & dados numéricos , Pessoal de Saúde/educação , Humanos , Lactente , Masculino , Mães/educação , Relações Profissional-Paciente , Saúde da População Rural
10.
Med J Aust ; 211 Suppl 9: S3-S46, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31679171

RESUMO

Mood and psychotic syndromes most often emerge during adolescence and young adulthood, a period characterised by major physical and social change. Consequently, the effects of adolescent-onset mood and psychotic syndromes can have long term consequences. A key clinical challenge for youth mental health is to develop and test new systems that align with current evidence for comorbid presentations and underlying neurobiology, and are useful for predicting outcomes and guiding decisions regarding the provision of appropriate and effective care. Our highly personalised and measurement-based care model includes three core concepts: ▶ A multidimensional assessment and outcomes framework that includes: social and occupational function; self-harm, suicidal thoughts and behaviour; alcohol or other substance misuse; physical health; and illness trajectory. ▶ Clinical stage. ▶ Three common illness subtypes (psychosis, anxious depression, bipolar spectrum) based on proposed pathophysiological mechanisms (neurodevelopmental, hyperarousal, circadian). The model explicitly aims to prevent progression to more complex and severe forms of illness and is better aligned to contemporary models of the patterns of emergence of psychopathology. Inherent within this highly personalised approach is the incorporation of other evidence-based processes, including real-time measurement-based care as well as utilisation of multidisciplinary teams of health professionals. Data-driven local system modelling and personalised health information technologies provide crucial infrastructure support to these processes for better access to, and higher quality, mental health care for young people. CHAPTER 1: MULTIDIMENSIONAL OUTCOMES IN YOUTH MENTAL HEALTH CARE: WHAT MATTERS AND WHY?: Mood and psychotic syndromes present one of the most serious public health challenges that we face in the 21st century. Factors including prevalence, age of onset, and chronicity contribute to substantial burden and secondary risks such as alcohol or other substance misuse. Mood and psychotic syndromes most often emerge during adolescence and young adulthood, a period characterised by major physical and social change; thus, effects can have long term consequences. We propose five key domains which make up a multidimensional outcomes framework that aims to address the specific needs of young people presenting to health services with emerging mental illness. These include social and occupational function; self-harm, suicidal thoughts and behaviours; alcohol or other substance misuse; physical health; and illness type, stage and trajectory. Impairment and concurrent morbidity are well established in young people by the time they present for mental health care. Despite this, services and health professionals tend to focus on only one aspect of the presentation - illness type, stage and trajectory - and are often at odds with the preferences of young people and their families. There is a need to address the disconnect between mental health, physical health and social services and interventions, to ensure that youth mental health care focuses on the outcomes that matter to young people. CHAPTER 2: COMBINING CLINICAL STAGE AND PATHOPHYSIOLOGICAL MECHANISMS TO UNDERSTAND ILLNESS TRAJECTORIES IN YOUNG PEOPLE WITH EMERGING MOOD AND PSYCHOTIC SYNDROMES: Traditional diagnostic classification systems for mental disorders map poorly onto the early stages of illness experienced by young people, and purport categorical distinctions that are not readily supported by research into genetic, environmental and neurobiological risk factors. Consequently, a key clinical challenge in youth mental health is to develop and test new classification systems that align with current evidence on comorbid presentations, are consistent with current understanding of underlying neurobiology, and provide utility for predicting outcomes and guiding decisions regarding the provision of appropriate and effective care. This chapter outlines a transdiagnostic framework for classifying common adolescent-onset mood and psychotic syndromes, combining two independent but complementary dimensions: clinical staging, and three proposed pathophysiological mechanisms. Clinical staging reflects the progression of mental disorders and is in line with the concept used in general medicine, where more advanced stages are associated with a poorer prognosis and a need for more intensive interventions with a higher risk-to-benefit ratio. The three proposed pathophysiological mechanisms are neurodevelopmental abnormalities, hyperarousal and circadian dysfunction, which, over time, have illness trajectories (or pathways) to psychosis, anxious depression and bipolar spectrum disorders, respectively. The transdiagnostic framework has been evaluated in young people presenting to youth mental health clinics of the University of Sydney's Brain and Mind Centre, alongside a range of clinical and objective measures. Our research to date provides support for this framework, and we are now exploring its application to the development of more personalised models of care. CHAPTER 3: A COMPREHENSIVE ASSESSMENT FRAMEWORK FOR YOUTH MENTAL HEALTH: GUIDING HIGHLY PERSONALISED AND MEASUREMENT-BASED CARE USING MULTIDIMENSIONAL AND OBJECTIVE MEASURES: There is an urgent need for improved care for young people with mental health problems, in particular those with subthreshold mental disorders that are not sufficiently severe to meet traditional diagnostic criteria. New comprehensive assessment frameworks are needed to capture the biopsychosocial profile of a young person to drive highly personalised and measurement-based mental health care. We present a range of multidimensional measures involving five key domains: social and occupational function; self-harm, suicidal thoughts and behaviours; alcohol or other substance misuse; physical health; and illness type, stage and trajectory. Objective measures include: neuropsychological function; sleep-wake behaviours and circadian rhythms; metabolic and immune markers; and brain structure and function. The recommended multidimensional measures facilitate the development of a comprehensive clinical picture. The objective measures help to further develop informative and novel insights into underlying pathophysiological mechanisms and illness trajectories to guide personalised care plans. A panel of specific multidimensional and objective measures are recommended as standard clinical practice, while others are recommended secondarily to provide deeper insights with the aim of revealing alternative clinical paths for targeted interventions and treatments matched to the clinical stage and proposed pathophysiological mechanisms of the young person. CHAPTER 4: PERSONALISING CARE OPTIONS IN YOUTH MENTAL HEALTH: USING MULTIDIMENSIONAL ASSESSMENT, CLINICAL STAGE, PATHOPHYSIOLOGICAL MECHANISMS, AND INDIVIDUAL ILLNESS TRAJECTORIES TO GUIDE TREATMENT SELECTION: New models of mental health care for young people require that interventions be matched to illness type, clinical stage, underlying pathophysiological mechanisms and individual illness trajectories. Narrow syndrome-focused classifications often direct clinical attention away from other key factors such as functional impairment, self-harm and suicidality, alcohol or other substance misuse, and poor physical health. By contrast, we outline a treatment selection guide for early intervention for adolescent-onset mood and psychotic syndromes (ie, active treatments and indicated and more specific secondary prevention strategies). This guide is based on experiences with the Brain and Mind Centre's highly personalised and measurement-based care model to manage youth mental health. The model incorporates three complementary core concepts: ▶A multidimensional assessment and outcomes framework including: social and occupational function; self-harm, suicidal thoughts and behaviours; alcohol or other substance misuse; physical health; and illness trajectory. ▶Clinical stage. ▶Three common illness subtypes (psychosis, anxious depression, bipolar spectrum) based on three underlying pathophysiological mechanisms (neurodevelopmental, hyperarousal, circadian). These core concepts are not mutually exclusive and together may facilitate improved outcomes through a clinical stage-appropriate and transdiagnostic framework that helps guide decisions regarding the provision of appropriate and effective care options. Given its emphasis on adolescent-onset mood and psychotic syndromes, the Brain and Mind Centre's model of care also respects a fundamental developmental perspective - categorising childhood problems (eg, anxiety and neurodevelopmental difficulties) as risk factors and respecting the fact that young people are in a period of major biological and social transition. Based on these factors, a range of social, psychological and pharmacological interventions are recommended, with an emphasis on balancing the personal benefit-to-cost ratio. CHAPTER 5: A SERVICE DELIVERY MODEL TO SUPPORT HIGHLY PERSONALISED AND MEASUREMENT-BASED CARE IN YOUTH MENTAL HEALTH: Over the past decade, we have seen a growing focus on creating mental health service delivery models that better meet the unique needs of young Australians. Recent policy directives from the Australian Government recommend the adoption of stepped-care services to improve the appropriateness of care, determined by severity of need. Here, we propose that a highly personalised approach enhances stepped-care models by incorporating clinical staging and a young person's current and multidimensional needs. It explicitly aims to prevent progression to more complex and severe forms of illness and is better aligned to contemporary models of the patterns of emergence of psychopathology. Inherent within a highly personalised approach is the incorporation of other evidence-based processes, includingreal-time measurement-based care and use of multidisciplinary teams of health professionals. Data-driven local system modelling and personalised health information technologies provide crucial infrastructure support to these processes for better access to, and higher quality of, mental health care for young people.


Assuntos
Bem-Estar da Criança/estatística & dados numéricos , Transtornos Mentais/terapia , Saúde Mental , Planejamento de Assistência ao Paciente/organização & administração , Adolescente , Transtornos de Ansiedade/terapia , Austrália , Transtorno Bipolar/terapia , Gerenciamento Clínico , Diretrizes para o Planejamento em Saúde , Humanos , Masculino , Relações Profissional-Paciente , Transtornos Psicóticos/terapia , Adulto Jovem
12.
BMC Public Health ; 19(1): 1330, 2019 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-31640635

RESUMO

BACKGROUND: To reduce the under-five mortality (U5M), fine-gained spatial assessment of the effects of health interventions is critical because national averages can obscure important sub-national disparities. In turn, sub-national estimates can guide control programmes for spatial targeting. The purpose of our study is to quantify associations of interventions with U5M rate at national and sub-national scales in Uganda and to identify interventions associated with the largest reductions in U5M rate at the sub-national scale. METHODS: Spatially explicit data on U5M, interventions and sociodemographic indicators were obtained from the 2011 Uganda Demographic and Health Survey (DHS). Climatic data were extracted from remote sensing sources. Bayesian geostatistical Weibull proportional hazards models with spatially varying effects at sub-national scales were utilized to quantify associations between all-cause U5M and interventions at national and regional levels. Bayesian variable selection was employed to select the most important determinants of U5M. RESULTS: At the national level, interventions associated with the highest reduction in U5M were artemisinin-based combination therapy (hazard rate ratio (HRR) = 0.60; 95% Bayesian credible interval (BCI): 0.11, 0.79), initiation of breastfeeding within 1 h of birth (HR = 0.70; 95% BCI: 0.51, 0.86), intermittent preventive treatment (IPTp) (HRR = 0.74; 95% BCI: 0.67, 0.97) and access to insecticide-treated nets (ITN) (HRR = 0.75; 95% BCI: 0.63, 0.84). In Central 2, Mid-Western and South-West, largest reduction in U5M was associated with access to ITNs. In Mid-North and West-Nile, improved source of drinking water explained most of the U5M reduction. In North-East, improved sanitation facilities were associated with the highest decline in U5M. In Kampala and Mid-Eastern, IPTp had the largest associated with U5M. In Central1 and East-Central, oral rehydration solution and postnatal care were associated with highest decreases in U5M respectively. CONCLUSION: Sub-national estimates of the associations between U5M and interventions can guide control programmes for spatial targeting and accelerate progress towards mortality-related Sustainable Development Goals.


Assuntos
Serviços de Saúde da Criança/organização & administração , Mortalidade da Criança/tendências , Bem-Estar da Criança/estatística & dados numéricos , Determinantes Sociais da Saúde/estatística & dados numéricos , Antimaláricos/uso terapêutico , Pré-Escolar , Feminino , Inquéritos Epidemiológicos , Humanos , Lactente , Recém-Nascido , Inseticidas/uso terapêutico , Modelos de Riscos Proporcionais , Fatores de Risco , Uganda
13.
Otolaryngol Pol ; 73(4): 1-7, 2019 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-31474621

RESUMO

INTRODUCTION: Thanks to the Polish Universal Neonatal Hearing Screening Program (PUNHSP), all newborns in Poland undergo a free, screening hearing examination. Between 2006 and 2015, the average number of tested children per year was 373,477. According to the analysis of The Central Database (CDB), only 55.8% of the children attended the detailed hearing examinations at the second level of the Program. AIM: The aim of this study is to analyse the dates concerning the attendance of the children at the diagnostic level of PUNHSP in different regions of Poland. MATERIALS AND METHODS: To conduct an analysis of this fact and find out the reasons for low attendance at the second level in 2015, a telephone survey questionnaire was developed for parents who had not registered their babies for further consultation - 3,239 randomly selected parents. RESULTS: The analysis revealed that the number of children examined at the second diagnostic level of the program is in fact much higher than the results of The Central Database show. The actual number is 83.6% as opposed to 55.8%. As a result of the telephone questionnaire some inaccuracies in the input data to the CDB were detected. The main errors in gathering the information for the CDB were incorrect OAE test result and no examination performed. C onclusion: In Poland the worst results (i.e. questionnaire results compared to CDB) for the attendance at the diagnostic level were shown in Pomorskie, Lubelskie, Mazowieckie and Podlaskie regions. In many cases there was a large discrepancy between the reality and the information in the CDB. The improvement of clarity concerning the CDB application is important in order to minimise the possibility of malformation in the CDB.


Assuntos
Bem-Estar da Criança/estatística & dados numéricos , Testes Auditivos/estatística & dados numéricos , Triagem Neonatal/métodos , Encaminhamento e Consulta/estatística & dados numéricos , Criança , Feminino , Seguimentos , Testes Auditivos/métodos , Humanos , Lactente , Recém-Nascido , Masculino , Programas Nacionais de Saúde/organização & administração , Polônia , Fatores de Risco
14.
Indian Pediatr ; 56(8): 633-638, 2019 08 15.
Artigo em Inglês | MEDLINE | ID: mdl-31477640

RESUMO

There is a large child work force in India reported to be about 40 million. Child labor is being regarded as a form of modern slavery, as children are forced to work or have no choice to refuse work. Children are employed in a variety of occupations, many of which are hazardous. Exposure to machinery, pesticides, dust in agricultural work and fumes, chemicals, acids, cotton and wool fiber in other forms of work is detrimental to health. A large number are held in bonded servitude. In urban areas, children are employed as domestic helpers and engaged in eateries and auto-repair work. Trafficking and trading of children for work and sexual slavery are also major concerns. Poverty and illiteracy are root causes of child labor, but iniquitous societal attitudes are responsible for abuse and exploitation. Working children are deprived of proper health care and education, and lose their childhood and dignity. Several legal measures exist to prevent child labor and protect them from harm, but are thwarted by the distressing socioeconomic conditions. Although child labor would be difficult to abolish, exploitation can be prevented with concerted efforts of the government agencies, professional bodies and the civil society.


Assuntos
Maus-Tratos Infantis , Trabalho Infantil , Bem-Estar da Criança , Escravização , Tráfico de Pessoas , Criança , Maus-Tratos Infantis/legislação & jurisprudência , Maus-Tratos Infantis/prevenção & controle , Maus-Tratos Infantis/psicologia , Maus-Tratos Infantis/estatística & dados numéricos , Trabalho Infantil/legislação & jurisprudência , Trabalho Infantil/estatística & dados numéricos , Bem-Estar da Criança/legislação & jurisprudência , Bem-Estar da Criança/psicologia , Bem-Estar da Criança/estatística & dados numéricos , Escravização/legislação & jurisprudência , Escravização/prevenção & controle , Escravização/psicologia , Escravização/estatística & dados numéricos , Tráfico de Pessoas/legislação & jurisprudência , Tráfico de Pessoas/prevenção & controle , Tráfico de Pessoas/psicologia , Tráfico de Pessoas/estatística & dados numéricos , Humanos , Índia
15.
BMC Public Health ; 19(1): 1277, 2019 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-31533687

RESUMO

BACKGROUND: Current data suggest that approximately 466 million people (5.0%) of the world's population have disabling hearing loss, therefrom, 34 million children, impacting their quality of life. To provide estimates on the prevalence of hearing loss on a national level, we reviewed the epidemiological literature addressing hearing loss in children and adolescents living in Germany as an example for a Western country. METHODS: We searched Medline, Web of Science, Cochrane Library, ScienceDirect and LIVIVO to identify published data. Furthermore, we manually searched websites of relevant institutions and journals not listed in electronically and searched for ongoing studies and/or not yet published data in clinicaltrials.gov . Study selection, data extraction, and methodological assessment were carried out by two reviewers. RESULTS: In total, 11 reports provided data with sample sizes ranging from 310 up to more than 14 million children and adolescents. Prevalence data were collected by interviews (self-assessments), using pure-tone audiometry or the international classification of diseases (ICD-10) coding and ranged from 0.1 to 128 per 1000 children. Although the estimate of the prevalence of hearing loss goes down, when the threshold was raised, generating a comprehensive and coherent set of estimates proved challenging owing to clinical heterogeneity including variation in age, the study setting, the definition of hearing loss and the assessment method. Moreover, representativeness (external validity) was often impaired owing to estimates lacking currentness (i.e., referring to former West Germany) or selected (patient) data and may not be typical for a more general population. CONCLUSIONS: In conclusions, this work raises public awareness of the high prevalence of hearing loss, highlights issues associated with epidemiological research and is of great importance for researcher and those who use epidemiological data to inform clinical and political decision making.


Assuntos
Bem-Estar da Criança/estatística & dados numéricos , Auxiliares de Audição/estatística & dados numéricos , Perda Auditiva/epidemiologia , Qualidade de Vida/psicologia , Testes de Impedância Acústica , Adolescente , Criança , Surdez/epidemiologia , Alemanha/epidemiologia , Perda Auditiva/diagnóstico , Humanos , Masculino , Prevalência
16.
Am Fam Physician ; 100(4): 213-218, 2019 08 15.
Artigo em Inglês | MEDLINE | ID: mdl-31414772

RESUMO

The goals of the health maintenance visit in school-aged children (five to 12 years) are promoting health, detecting disease, and counseling to prevent injury and future health problems. During the visit, the physician should address patient and parent/caregiver concerns and ask about emergency department or hospital care since the last visit; lifestyle habits (diet, physical activity, daily screen time, secondhand smoke exposure, hours of sleep per night, dental care, safety habits); and school performance. Poor school performance may indicate problems such as learning disabilities, attention-deficit/hyperactivity disorder, or bullying. Previsit questionnaires and psychosocial screening questionnaires are also useful. When performing a physical examination, the physician should be alert for signs of abuse. Children should be screened for obesity (defined as body mass index at or above the 95th percentile for age and sex), and obese children should be referred for intensive behavioral interventions. Although its recommendations are primarily based on expert opinion, the American Academy of Pediatrics recommends screening for hypertension annually, vision and hearing problems approximately every two years, and dyslipidemia once between nine and 11 years of age; regular screening for risk factors related to social determinants of health is also recommended. There is insufficient evidence to recommend routine screening for depression before 12 years of age, but depression should be considered in children younger than 12 years presenting with unexplained somatic symptoms, restlessness, separation anxiety, phobias, or hallucinations. Children living in areas with inadequate levels of fluoride in the water supply (0.6 ppm or less) should receive daily fluoride supplements. Age-appropriate immunizations should be given, as well as any catch-up immunizations.


Assuntos
Serviços de Saúde da Criança/organização & administração , Bem-Estar da Criança/estatística & dados numéricos , Programas de Imunização/organização & administração , Exame Físico/estatística & dados numéricos , Atenção Primária à Saúde/organização & administração , Criança , Feminino , Humanos , Masculino , Medicina Preventiva/organização & administração
17.
Am Fam Physician ; 100(4): 219-226, 2019 08 15.
Artigo em Inglês | MEDLINE | ID: mdl-31414773

RESUMO

School-aged children (five to 12 years) are establishing patterns of behavior that may last a lifetime; therefore, during health maintenance visits, it is important to counsel families on healthy lifestyle practices. Children should eat a diet high in fruits, vegetables, whole grains, low-fat or nonfat dairy products, beans, fish, and lean meats, while limiting sugar, fast food, and highly processed foods. Children should engage in 60 minutes of moderate to vigorous physical activity each day. A Family Media Use Plan should be used to individualize screen time limits and content for children. Nine to 12 hours of sleep per night is recommended for school-aged children. Inadequate sleep is associated with behavioral issues, difficulty concentrating at school, high blood pressure, and obesity. Children should brush their teeth twice per day with a pea-sized amount of toothpaste containing fluoride. Unintentional injury is the leading cause of death in this age group in the United States, and families should be counseled on vehicle, water, sports, firearm, home, environmental, and social safety. Because high-risk behaviors may start in early adolescence, many experts recommend discussing tobacco, alcohol, and drug use, including prescription drugs, beginning at 11 years of age. Sexually active adolescents should be counseled about the risk of sexually transmitted infections, and they should be screened for these infections if indicated.


Assuntos
Bem-Estar da Criança/estatística & dados numéricos , Aconselhamento/organização & administração , Promoção da Saúde/organização & administração , Obesidade Pediátrica/prevenção & controle , Criança , Feminino , Estilo de Vida Saudável , Humanos , Masculino , Estados Unidos
18.
Health Promot Pract ; 20(6): 818-823, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31465239

RESUMO

The interdependent relationship between health and education has long been documented by leading health and education scholars. Children who are not physically, mentally, socially, or emotionally healthy will not be ready to learn and thus hampered to achieve their full potential as productive members of society. Despite this evidence, the United States has yet to bridge the divide between the health and education systems. This perspective introduces three manuscripts in this Special School Health Education Collection on the future of school health education in the United States, and provides a context for the challenges and recommendations each article outlines to improve the quantity and quality of school health education for preK-12 youth. Although some of the challenges and recommendations are not novel, what is exciting is the opportunity to move the agenda forward given the Whole School, Whole Community, Whole Child model and the Every Student Succeeds Act of 2015. Aligning the forces of public health and school health educators is essential to make school health education a societal imperative.


Assuntos
Educação em Saúde/organização & administração , Educadores em Saúde/organização & administração , Promoção da Saúde/organização & administração , Serviços de Saúde Escolar/organização & administração , Adolescente , Criança , Bem-Estar da Criança/estatística & dados numéricos , Humanos , Saúde Pública , Estados Unidos
19.
Health Promot Pract ; 20(6): 824-833, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31465242

RESUMO

Changes in national and state policies in the past two decades have had a negative impact on school health education. During this same time, significant gains have been made in our understanding of the relationship between health and academic outcomes. This article proposes three challenges that could help refocus our country's efforts toward the positive impacts quality school health education can have on our population. Each of these challenges has corresponding recommendations to guide stakeholder efforts to help bring about these changes.


Assuntos
Bem-Estar da Criança/estatística & dados numéricos , Educação em Saúde/organização & administração , Letramento em Saúde/organização & administração , Serviços de Saúde Escolar/organização & administração , Adolescente , Criança , Promoção da Saúde/organização & administração , Humanos , Qualidade da Assistência à Saúde , Fatores Socioeconômicos , Estados Unidos
20.
Health Promot Pract ; 20(6): 834-844, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31465243

RESUMO

The long-held priority of teaching young people the knowledge and skills needed for healthy living has recently been diminished in many preK-12 schools. Driven by federal and state priorities, laws, and policies associated with high-stakes testing, instruction in untested subjects has been reduced or eliminated in most schools in order to devote more attention to tested subjects, like reading, math, writing, and science. This article proposes a pathway to ensure that all children are able to learn what society knows about health. To that end, four challenges to the reliable, large-scale implementation of effective school health education are identified: (1) establishing school health education as an undeniable social and cultural priority through improved advocacy; (2) strengthening educational institutions' capacities to reliably deliver large-scale, high-quality, school-based health education; (3) collaboratively coordinating efforts of health-promoting governmental and nongovernmental organizations that generate thought leadership for school health education; and (4) creating multidisciplinary research capacities for solving problems associated with the implementation of reliable, large-scale, effective school health education. By implementing specific strategies associated with each challenge, health educators can promote the social and system-level conditions required to support, elevate, and ensure delivery of effective health education to every student in every school every year.


Assuntos
Bem-Estar da Criança/estatística & dados numéricos , Educação em Saúde/organização & administração , Serviços de Saúde Escolar/organização & administração , Adolescente , Criança , Letramento em Saúde/organização & administração , Promoção da Saúde/organização & administração , Humanos , Qualidade da Assistência à Saúde , Fatores Socioeconômicos , Estados Unidos
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