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1.
J Oral Sci ; 62(1): 89-92, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31996531

RESUMO

The oral hygiene and oral status of children with severe disabilities with both nutritional and respiratory complications who were institutionalized at Karugamonoie (KNI), a facility for children with disabilities, were investigated in this study. Their oral hygiene management was solely dependent on caregivers and nurses at the institution. Thirty children (13 females, 17 males; average age, 7.6 years) who had a tracheotomy and feeding tube (gastrostomy, nasogastric, or jejunostomy feeding tube) were included in the study. As for oral characteristics, poor control of tongue movement, anterior open-bite, abnormal strain of facial muscles, dry mouth, and swallowing dysfunction were found in 63.3%, 63.3%, 13.3%, 20.0%, and 100.0%, of the children, respectively. The mean ± standard deviation Decayed, Missing, Filled Teeth score was 0.13 ± 0.57. The Gingival Index (GI) showed that the children had mild (53.3%) to moderate (46.7%) gingivitis. The Simplified Oral Hygiene Index was excellent in 50.0% of the children, good in 23.3%, fair in 20.0%, and poor in 6.7% of the children. These indices were satisfactory in general except for GI management, which may have been hampered by abnormal oral functions and anterior open-bite. In conclusion, oral hygiene management of children with nutritional and respiratory complications at KNI was shown to be of high quality even without on-site intervention by dental specialists.


Assuntos
Cárie Dentária , Deficiência Intelectual , Criança , Criança Institucionalizada , Índice CPO , Feminino , Humanos , Masculino , Saúde Bucal , Higiene Bucal , Índice de Higiene Oral
2.
Dev Sci ; 23(1): e12872, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31148302

RESUMO

Exposure to early psychosocial deprivation as a result of institutional care disrupts typical brain development. The Bucharest Early Intervention Project (BEIP) is the first longitudinal study to investigate the neurodevelopment of institutionalized infants randomized to a foster care (FCG) intervention versus care as usual (CAUG). Here, we present findings from a follow-up assessment of brain electrical activity as indexed by resting EEG at age 16 years. In addition, we examined the effects of disruption of foster care placement (e.g. the number of moves among foster care placements) on brain electrical activity. Resting-state EEG was collected from 48 CAUG, 46 FCG and 48 never institutionalized (NIG) control participants. Absolute (µV2 ) and relative (proportion) power were computed from eyes closed, resting EEG data for theta, alpha and beta frequency bands. The CAUG displayed higher relative theta and lower relative alpha power compared to the FCG at 16 years of age. The FCG showed brain activity comparable to the NIG. The results further showed that disruptions following the original foster care placement had an adverse effect on brain electrical activity. Within the foster care group, there were no effects of age of placement on EEG power. Placement of children who have experienced early institutional rearing into stable foster care settings ensure long-term improvement in brain functioning.


Assuntos
Encéfalo/crescimento & desenvolvimento , Criança Institucionalizada , Eletroencefalografia , Cuidados no Lar de Adoção , Carência Psicossocial , Adolescente , Encéfalo/fisiologia , Eletroencefalografia/métodos , Feminino , Humanos , Estudos Longitudinais , Masculino
3.
Rev. enferm. UFSM ; 9: [17], jul. 15, 2019.
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1024189

RESUMO

Objetivo: compreender as perspectivas do cuidador a partir de sua interação com as crianças institucionalizadas. Método: pesquisa qualitativa que utilizou a Teoria Fundamentada nos Dados e o Interacionismo Simbólico para elaboração e análise dos dados. Os dados foram coletados de abril a julho de 2015, por meio de uma entrevista intensiva, com 15 cuidadoras em uma instituição de acolhimento infantil. Resultados: são apresentados em três categorias: Aprendendo a valorizar sua vida e sua família; Mudando a forma de ver e lidar com os outros; Percebendo a criança como ser capaz de mudar sua realidade. Considerações finais: identificou-se que na interação com a criança institucionalizada, a cuidadora passa a adotar novas formas de ver e agir no mundo, valorizando mais sua vida e sua família, além de desenvolver mais paciência, compaixão e amor por outras pessoas em condições de vulnerabilidade.


Aim: to understand the perspectives of the caregiver based on their interaction withthe institutionalized children. Method: qualitative research using Grounded Theory and Symbolic Interactionism for data elaboration and analysis. The data were collected from April to July 2015, through an intensive interview, with 15 caregivers in a child care institution. Results: are presented in three categories: Learning to value life and family; Changing the way you see and deal with others; Understanding the child as a personable to change their reality. Final considerations: it was identified that in the interaction with the institutionalized child, the caregiver starts adopting new ways of seeing and acting in the world, valuing his/her life and family, besides developing more patience, compassion and love for other people in conditions of vulnerability.


Objetivo: comprender las perspectivas del cuidador a partir de su interacción con los niños institucionalizados. Método: investigación cualitativa basada enla Teoría Fundamentada en los Datos y el Interaccionismo Simbólico para elaboración y análisis de los datos. Los datos fueron recolectados de abril a julio de 2015, por medio de una entrevista intensiva, con 15 cuidadoras, en una institución de acogida infantil. Resultados: se presentaron tres categorías: aprendiendo a valorar su vida y su familia; cambiando la forma de ver y tratarcon los demás; comprendiendo elniño como ser capaz de cambiar su realidad. Consideraciones finales: se identificóque en la interacción con el niño institucionalizado, la cuidadora pasa a adoptar nuevas formas de ver y actuar en el mundo, valorando más su vida y su familia, además de desarrollar más paciencia, compasión y amor por otras personas en condiciones de vulnerabilidad


Assuntos
Humanos , Criança Institucionalizada , Enfermagem , Cuidadores , Relações Interpessoais
4.
BMC Psychiatry ; 19(1): 129, 2019 04 30.
Artigo em Inglês | MEDLINE | ID: mdl-31039767

RESUMO

BACKGROUND: Mental health problems are an important issue among institutionalized children. Although positive communication with parents is essential for children's well-being, it has not been sufficiently verified how interactions with parents affect mental health among institutionalized children, who have experienced childhood adversity and likely lack secure attachment formation with their parents. The objectives of this study were to investigate the association between parental visitation and depressive symptoms among institutionalized children in Japan, and to explore whether the established security of attachment interacts with that association. METHODS: A cross-sectional data from 399 institutionalized children aged 9 to 18 in Japan was used for the analysis. A mixed effects regression analysis was conducted to investigate the associations. RESULTS: Institutionalized children who had parental visitation showed higher depressive symptoms than those who did not. In particular, father's visitations were significantly associated with higher depressive symptoms. There was a significant interaction with score of secure attachment; children with low scores on secure attachment showed higher levels of depression with their father's visitation, whereas children with high scores on secure attachment did not. CONCLUSIONS: Findings suggested that parental visitation and the frequency of visitation were not actually associated with better psychological status, but that instead, father's visitations were associated with higher depressive symptoms among institutionalized children. It should be noted that our cross-sectional results cannot infer any causal relationship and do not emphasize that parental visitation should be avoided. However, it may be important to conduct careful assessment before starting parental visitation, especially when children seem to have problems with attachment formation.


Assuntos
Criança Institucionalizada/psicologia , Depressão/epidemiologia , Depressão/psicologia , Visitas a Pacientes/psicologia , Adolescente , Criança , Estudos Transversais , Depressão/diagnóstico , Feminino , Humanos , Japão/epidemiologia , Masculino , Saúde Mental , Pais/psicologia , Inquéritos e Questionários
5.
PLoS One ; 14(3): e0214285, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30913238

RESUMO

Early social deprivation (i.e., an insufficiency or lack of parental care) has been identified as a significant adverse early experience that may affect multiple facets of child development and cause long-term outcomes in physical and mental health, cognition and behavior. Current research provides growing evidence that epigenetic reprogramming may be a mechanism modulating these effects of early adversities. This work aimed to investigate the impact of early institutionalization-the immersion in an extreme socially depriving environment in humans-on the epigenome and adaptive behavior of young children up to 4 years of age. We conducted a cross-sectional study involving two comparison groups: 29 children raised in orphanages and 29 children raised in biological families. Genome-wide DNA methylation profiles of blood cells were obtained using the Illumina MethylationEPIC array; the level of child adaptive functioning was assessed using the Vineland Adaptive Behavior Scales-II. In comparison to children raised in families, children residing in orphanages had both statistically significant deficits in multiple adaptive behavior domains and statistically significant differences in DNA methylation states. Moreover, some of these methylation states may directly modulate the behavioral deficits; according to preliminary estimates, about 7-14% of the deviation of adaptive behavior between groups of children may be determined by their difference in DNA methylation profiles. The duration of institutionalization had a significant impact on both the adaptive level and DNA methylation status of institutionalized children.


Assuntos
Adaptação Psicológica , Epigênese Genética , Criança Institucionalizada , Pré-Escolar , Estudos Transversais , Metilação de DNA , Redes Reguladoras de Genes , Humanos , Lactente , Orfanatos , Análise de Componente Principal , Receptores de Glucocorticoides/genética
6.
J Trace Elem Med Biol ; 53: 91-97, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30910214

RESUMO

In childhood and adolescence an adequate mineral intake is essential for normal growth and immune function, and to prevent chronic diseases in adulthood. The aim of this study was to analyse the dietary intake of Ca, Mg, Fe, Zn and Cu in children and adolescents from an orphanage-school in Guatemala and to assess the mineral contribution of nutritional supplements used by this population. Mineral content was analysed in nutritional supplements, bioaccesible fractions obtained after an in vitro gastrointestinal method, and diets sampled by a 7-day duplicate diet study. The average mineral content in the duplicate diets, including supplements, was (mg/d): Ca 452, Mg 230, Fe 25, Zn 8 and Cu 0.22. Especially Ca and Cu values were below recommended daily intakes. The content of these minerals in the nutritional supplements (mg/serving) was 49-112 for Ca, 1.2-3.8 for Fe, 24-47 for Mg, 0.7-4.16 for Zn and 0.08-0.23 for Cu. A great proportion of dietary minerals was provided by supplements, the contribution of which was: Ca 53.1%, Mg 58.4%, Fe 27.6%. Zn 82.2% and Cu 98.5%. Mineral bioaccessibility in supplements was particularly low for Ca and, to a lesser extent, for Fe and Zn. In spite of the high supplement consumption (up to 4 servings/d) important mineral deficiencies were detected in the diet of institutionalised children. Findings suggest that formulation and nutritional values of supplements used in Latin America should be carefully reviewed, in order to be a useful tool in the prevention and treatment of hidden hunger.


Assuntos
Cálcio/análise , Criança Institucionalizada , Cobre/análise , Dieta/estatística & dados numéricos , Suplementos Nutricionais/análise , Ferro/análise , Manganês/análise , Zinco/análise , Adolescente , Cálcio/administração & dosagem , Criança , Pré-Escolar , Cobre/administração & dosagem , Feminino , Guatemala , Humanos , Ferro/administração & dosagem , Masculino , Manganês/administração & dosagem , Estado Nutricional , Zinco/administração & dosagem
7.
Neural Plast ; 2019: 1676285, 2019 01 14.
Artigo em Inglês | MEDLINE | ID: mdl-30774652

RESUMO

Experience plays an essential role in building brain architecture after birth. The question we address in this paper is what happens to brain and behavior when a young child is deprived of key experiences during critical periods of brain development. We focus in particular on the consequences of institutional rearing, with implication for the tens of millions of children around the world who from an early age experience profound psychosocial deprivation. Evidence is clear that deprivation can lead to a host of both short- and long-term consequences, including perturbations in brain structure and function, changes at cellular and molecular levels, and a plethora of psychological and behavioral impairments.


Assuntos
Encéfalo/crescimento & desenvolvimento , Desenvolvimento Infantil/fisiologia , Criança Institucionalizada/psicologia , Carência Psicossocial , Criança , Pré-Escolar , Humanos
8.
Proc Natl Acad Sci U S A ; 116(5): 1808-1813, 2019 01 29.
Artigo em Inglês | MEDLINE | ID: mdl-30642973

RESUMO

Children experiencing psychosocial deprivation as a result of early institutional rearing demonstrate many difficulties with memory and executive functioning (EF). To date, there is scant evidence that foster care placement remediates these difficulties during childhood. The current study examined longitudinal trajectories of memory and EF from childhood to adolescence in the Bucharest Early Intervention Project, a randomized controlled trial of foster care for institutionally reared children. We demonstrate that both ever- and never-institutionalized children show age-related improvements on several measures of memory and EF from age 8 to 16. Distinct patterns were observed for different domains of functioning: (i) Early-emerging disparities in attention and short-term visual memory, as well as spatial planning and problem solving, between ever- and never-institutionalized children persisted through adolescence; (ii) the gap in spatial working memory between ever- and never-institutionalized children widened by adolescence; and (iii) early difficulties in visual-spatial memory and new learning among children in foster care were mitigated by adolescence. Secondary analyses showed that higher resting EEG alpha power at age 8 predicted better EF outcomes in several domains at age 8, 12, and 16. These results suggest that early institutional rearing has enduring consequences for the development of memory and EF, with the possibility of catch-up among previously institutionalized children who start out with higher levels of problems. Finally, interindividual differences in brain activity relate to memory and EF across ages, thus highlighting one potential biological pathway through which early neglect impacts long-term cognitive functioning.


Assuntos
Encéfalo/fisiologia , Função Executiva/fisiologia , Memória de Curto Prazo/fisiologia , Atenção/fisiologia , Criança Institucionalizada , Pré-Escolar , Feminino , Cuidados no Lar de Adoção/métodos , Humanos , Lactente , Estudos Longitudinais , Masculino , Fenômenos Fisiológicos do Sistema Nervoso , Orfanatos , Resolução de Problemas/fisiologia
9.
Brain Behav Immun ; 77: 168-177, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30639443

RESUMO

The developing immune system is an adaptive system, primed by antigens, responsive to infectious pathogens, and can be affected by other aspects of the early rearing environment, including deviations from the normal provision of parental care. We investigated whether early rearing in an institutional setting, even when followed by years living in supportive and well-resourced families, would be associated with a persistent shift in T cell profiles. Immunophenotyping was used to enumerate CD4+ CD57+ and CD8+ CD57+ subsets, with gating strategies employed to differentiate naïve, central-memory, effector-memory, and terminally differentiated EM cells expressing CD45RA (TEMRA). Blood samples were collected from 96 adolescents, and PBMC isolated via Ficol gradient, followed by an optimized immunophenotypic characterization. CMV antibody titers were determined via ELISA. Adopted adolescents had lower CD4/CD8 ratios than did the control adolescents. Early rearing had a significant effect on the T cells, especially the CD8+ CD57+ CM, EM, and TEMRA cells and the CD4+ CD57+ EM cells. Adolescents who had spent their infancy in institutions before adoption were more likely to be seropositive for CMV, with higher antibody titers. CMV antibody titers were significantly correlated with the percentages of all CD8+ CD57+ cell subsets. In the statistical modeling, CMV antibody titer also completely mediated the relationship between institutional exposure and the ratio of CD4-to-CD8 cells, as well as the percentages of CD4+ CD57+ and CD8+ CD57+ subsets. These findings demonstrate that persistent immune differences are still evident even years after adoption by supportive American families. The shift in the T cells was associated with being a latent carrier of CMV and may reflect the role of specific T cell subsets in Herpes virus containment. In older adults, sustained CMV antigen persistence and immunoregulatory containment ultimately contributes to an accumulation of differentiated T cells with a decreased proliferative capacity and to immune senescence.


Assuntos
Criança Institucionalizada/psicologia , Memória Imunológica/imunologia , Linfócitos T/imunologia , Adolescente , Experiências Adversas da Infância , Linfócitos T CD4-Positivos/imunologia , Linfócitos T CD8-Positivos/imunologia , Criança Adotada/psicologia , Citomegalovirus/imunologia , Infecções por Citomegalovirus/imunologia , Feminino , Humanos , Agências Internacionais , Leucócitos Mononucleares/imunologia , Ativação Linfocitária , Masculino , Subpopulações de Linfócitos T/imunologia , Adulto Jovem
10.
J Exp Psychol Gen ; 148(2): 388-399, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30221961

RESUMO

Risk-taking in adolescence has been often associated with early life adversities. However, the impact of such macrolevel factors on risk behavior has been rarely studied in humans. To address these gaps we recruited a sample of young adolescents who were part of a randomized control trial of foster care. Children institutionalized at or soon after birth were randomly assigned either to be removed from institutions and placed into a family or foster care intervention or to remain in institutions receiving care as usual. These children were subsequently followed up through 12 years of age and compared with a sample of children who had never been institutionalized. Using this sample, we examined the impact of early childhood deprivation on risk-taking behavior and explored the role of motivation (i.e., sensation seeking) and executive control (i.e., planning). Early psychosocial deprivation decreased engagement in risk-taking among young adolescents by reducing sensation seeking, a motivation often associated with risk-taking in adolescence. The impact of early psychosocial deprivation on sensation seeking and consequently on engagement in risk-taking was further reduced by its deleterious effects on executive control. These findings challenge the traditional view according to which risk behavior is a maladaptive response to adversities and suggest that it may represent adolescents' attempts to fulfill important motivations. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Comportamento do Adolescente/fisiologia , Criança Institucionalizada , Função Executiva/fisiologia , Motivação/fisiologia , Carência Psicossocial , Assunção de Riscos , Adolescente , Criança , Feminino , Humanos , Estudos Longitudinais , Masculino
11.
Child Psychiatry Hum Dev ; 50(3): 425-438, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30368618

RESUMO

Recent approaches have begun to identify common variance across co-occurring childhood adversities (CAs) and their associations with symptoms of psychopathology. However, few studies have investigated these questions in high-risk samples, and in different cultural contexts. This study examined common variance amongst 18 types of CAs and associated symptomatology in 457 children and adolescents living in 24 residential homes in Japan. Principal component analysis identified four significant components that explained 35.1% of the variance: parental abuse, parental psychosocial risks, parental absence, and parental neglect. Path analysis revealed general as well as differential associations with negative outcomes: parental abuse, parental neglect, and parental psychosocial risks significantly associated with conduct problems, whereas parental abuse uniquely associated with peer problems, and parental neglect with hyperactivity/inattention. As well as confirming prior knowledge, these findings also extended understanding of these associations to a new cultural context. Future studies should take into account the multidimensional nature when assessing CAs.


Assuntos
Adolescente Institucionalizado , Experiências Adversas da Infância/estatística & dados numéricos , Filho de Pais Incapacitados , Criança Institucionalizada , Transtornos Mentais , Adolescente , Adolescente Institucionalizado/psicologia , Adolescente Institucionalizado/estatística & dados numéricos , Sintomas Comportamentais/diagnóstico , Sintomas Comportamentais/psicologia , Criança , Filho de Pais Incapacitados/psicologia , Filho de Pais Incapacitados/estatística & dados numéricos , Criança Institucionalizada/psicologia , Criança Institucionalizada/estatística & dados numéricos , Feminino , Humanos , Japão/epidemiologia , Masculino , Pais , Psicopatologia
12.
Dev Psychopathol ; 31(4): 1477-1487, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-30588896

RESUMO

Early institutional rearing is associated with increased risk for subsequent peer relationship difficulties, but the underlying mechanisms have not been identified. Friendship characteristics, social behaviors with peers, normed assessments of social problems, and social cue use were assessed in 142 children (mean age = 10.06, SD = 2.02; range 7-13 years), of whom 67 were previously institutionalized (PI), and 75 were raised by their biological families. Anxiety and attention-deficit/hyperactivity disorder (ADHD) symptoms, often elevated among PI children, were examined as potential mediators of PI status and baseline social functioning and longitudinal follow-ups (2 and 4 years later). Twenty-seven percent of PI children fell above the Child Behavior Checklist Social Problems cutoff. An examination of specific social behaviors with peers indicated that PI and comparison children did not differ in empathic concern or peer social approach, though parents were more likely to endorse aggression/overarousal as a reason that PI children might struggle with friendships. Comparison children outperformed PI children in computerized testing of social cue use learning. Finally, across these measures, social difficulties exhibited in the PI group were mediated by ADHD symptoms with predicted social problems assessed 4 years later. These findings show that, when PI children struggle with friendships, mechanisms involving attention and behavior regulation are likely contributors.


Assuntos
Criança Institucionalizada/psicologia , Amigos/psicologia , Ajustamento Social , Comportamento Social , Adolescente , Agressão/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Criança , Feminino , Humanos , Masculino , Grupo Associado
13.
Rev. gaúch. enferm ; 40: e20180412, 2019.
Artigo em Inglês | LILACS | ID: biblio-1043033

RESUMO

Abstract Objective: To know the caregiver's perception about the work/care with the institutionalized child. Methods: Qualitative research that used the Theory of Attachment and Symbolic Interactionism as theoretical references and the Grounded Theory as a methodological reference. Data was collected through semi-structured interviews with 15 caregivers of a child sheltering institution, in the year 2015. The analysis was performed from the open coding and categorization. Results: Care work aims to meet the needs of institutionalized children, focusing on food, hygiene and education. In addition, it is little recognized, which generates a feeling of devaluation in caregivers. Conclusions: Continued qualification and support to the caregivers is indispensable for elaborating more effective and integral work/care strategies.


Resumen Objetivo: Conocer la percepción del cuidador acerca del trabajo/cuidado con el niño institucionalizado. Métodos: Investigación cualitativa que utilizó la Teoría del Apego y el Interaccionismo Simbólico como referenciales teóricos y la Teoría Fundamentada en los Datos como referencial metodológico. Se recolectaron los datos a través de entrevistas semiestructuradas con 15 cuidadoras de una institución de acogida infantil en el año 2015. Se realizó el análisis a partir de la codificación y la categorización. Resultados: El trabajo del cuidado busca atender las necesidades de los niños institucionalizados, enfocándose en la alimentación, la higiene y la educación. Además, es poco reconocido, lo que genera un sentimiento de desvalorización en las cuidadoras. Conclusiones: La calificación continuada y el apoyo a las cuidadoras son indispensables para elaborar estrategias de trabajo/cuidado más efectivas e integrales.


Resumo Objetivo: Conhecer a percepção do cuidador acerca do trabalho/cuidado com a criança institucionalizada. Métodos: Pesquisa qualitativa que utilizou a Teoria do Apego e o Interacionismo Simbólico como referenciais teóricos e a Teoria Fundamentada nos Dados como referencial metodológico. Os dados foram coletados por meio de entrevistas semiestruturadas com 15 cuidadoras de uma instituição de acolhimento infantil, no ano de 2015. A análise foi realizada a partir da codificação e categorização. Resultados: O trabalho do cuidado visa atender às necessidades das crianças institucionalizadas, focando na alimentação, higiene e educação. Além disso, é pouco reconhecido o que gera um sentimento de desvalorização nas cuidadoras. Conclusões: a qualificação continuada e o suporte às cuidadoras são indispensáveis para a elaboração de estratégias de trabalho/cuidado mais efetivas e integrais.


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adulto , Adulto Jovem , Criança Institucionalizada/psicologia , Cuidadores/psicologia , Percepção , Salários e Benefícios , Cuidado da Criança/organização & administração , Desenvolvimento Infantil , Criança Institucionalizada/educação , Pesquisa Qualitativa , Teoria Fundamentada , Relações Interpessoais , Atividades de Lazer , Pessoa de Meia-Idade , Motivação , Apego ao Objeto
14.
Rev Bras Enferm ; 71(suppl 6): 2650-2658, 2018.
Artigo em Inglês, Português | MEDLINE | ID: mdl-30540040

RESUMO

OBJECTIVE: to understand the perspective of caregivers about the formation and disruption of bonds with institutionalized children. METHOD: a qualitative research that used as a theoretical framework the Attachment Theory and the Symbolic Interactionism, and the Grounded Theory as methodological framework. Participating in the study were 15 female caregivers of children aged zero to three years, from a child care institution in the south of Brazil, from April to July 2015. RESULTS: three categories were elaborated: "Experiencing the formation of bond and attachment"; "Disrupting with the established bonds and detaching"; "Learning how to work with formation and disruption of bond". FINAL CONSIDERATIONS: we need to think of ways to minimize the negative effects formation and disruption of bonds. In this sense, active listening and the offer of psychological support favor the sharing of experiences and the emotional strengthening of the female caregivers.


Assuntos
Cuidadores/psicologia , Criança Institucionalizada/psicologia , Relações Interpessoais , Brasil , Criança , Serviços de Saúde da Criança , Pré-Escolar , Feminino , Teoria Fundamentada , Humanos , Lactente , Masculino , Pesquisa Qualitativa
15.
Pediatr Res ; 84(6): 842-848, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30323348

RESUMO

BACKGROUND: Reduced prenatal growth followed by rapid postnatal weight gain are risk factors for developing metabolic and cardiovascular disease. Children reared in institutions experience a similar pattern of growth restriction followed by catch-up growth after removal. We explored whether patterns of catch-up growth affect metabolic and cardiovascular outcomes in previously institutionalized adolescents. METHOD: A longitudinal study of institutionalized infants randomized to care as usual (n = 68) or foster care intervention (n = 68), and never institutionalized controls (n = 127). Body mass index (BMI) was measured at baseline (20 months), 30, 42 months, and ages 8, 12, 16. At age 16, metabolic and pro-inflammatory markers were derived from blood samples. RESULTS: Four BMI trajectories were derived (i.e., average-stable, low-stable, elevated, and accelerated). The accelerated trajectory was comprised predominately of children randomized to foster care, who also exhibited higher levels of glycosylated hemoglobin and C-reactive protein than the other three trajectories. Also, children placed in foster care at younger ages were more likely to be on the accelerated rather than the average-stable trajectory. CONCLUSIONS: Although catch-up growth is viewed as a positive improvement among post-institutionalized children, rapid/continuous increases in body size pose a health concern. Attention should be given to monitoring weight gain, diet, and physical activity.


Assuntos
Tamanho Corporal , Doenças Cardiovasculares/epidemiologia , Transtornos do Crescimento/epidemiologia , Adolescente , Adolescente Institucionalizado , Índice de Massa Corporal , Doenças Cardiovasculares/complicações , Doenças Cardiovasculares/diagnóstico , Criança , Criança Institucionalizada , Pré-Escolar , Exercício , Feminino , Cuidados no Lar de Adoção , Transtornos do Crescimento/complicações , Transtornos do Crescimento/diagnóstico , Humanos , Lactente , Inflamação , Estudos Longitudinais , Masculino , Fatores de Risco , Romênia/epidemiologia , Ganho de Peso
16.
Infant Ment Health J ; 39(6): 718-729, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30339735

RESUMO

The present study is focused on child socioemotional problems 6 months after institutionalization, by considering the putative predictive role of child maltreatment, of developmental functioning at admission and the following months, and of the quality of institutional relational care. Fifty institutionalized infants and toddlers participated in this study. Child developmental functioning (i.e., cognitive, language, and motor development) was assessed at admission to the institution (Wave 0), and 3 (Wave 1) and 6 months (Wave 2) thereafter. The quality of institutional relational care-operationalized in terms of caregivers' sensitivity and cooperation-was measured at Wave 2. Caregivers reported on the presence of disturbed socioemotional behaviors at Wave 2. Child gestational age, birth weight, age, and stunted growth at admission to the institution served as covariates. Results revealed significant associations between socioemotional difficulties and lower levels of motor development at Waves 0 and 1, child maltreatment, and less sensitive caregiving. A logistic regression showed that child maltreatment and caregiver insensitivity were the only significant predictors of disturbed socioemotional functioning by the end of 6 months of institutionalization.


Assuntos
Maus-Tratos Infantis , Transtornos do Comportamento Infantil , Desenvolvimento Infantil/fisiologia , Criança Institucionalizada/psicologia , Criança , Maus-Tratos Infantis/psicologia , Maus-Tratos Infantis/reabilitação , Transtornos do Comportamento Infantil/etiologia , Transtornos do Comportamento Infantil/prevenção & controle , Transtornos do Comportamento Infantil/psicologia , Pré-Escolar , Ajustamento Emocional , Feminino , Transtornos do Crescimento/diagnóstico , Transtornos do Crescimento/etiologia , Humanos , Lactente , Relações Interpessoais , Masculino , Autoimagem
17.
J Pediatr ; 203: 345-353.e3, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30172435

RESUMO

OBJECTIVES: To determine the effects of foster care vs institutional care, as well as disruptions in the caregiving environment on physical development through early adolescence. STUDY DESIGN: This was a randomized controlled trial of 114 institutionalized, though otherwise healthy, children from 6 orphanages and 51 never institutionalized control children living in birth families (family care group) in Bucharest, Romania. Children were followed from baseline (21 months, range 5-31) through age 12 years for caregiving disruptions and growth trajectories and through age 14 years for pubertal development. RESULTS: Children randomized to the foster care group showed greater rates of growth in height, weight, and body mass index (BMI) through age 12 years than institutionalized group. Tanner development was delayed in institutionalized group boys compared with foster care group and family care group boys at 12 but not 14 years. There were no differences in Tanner development and age of menarche among foster care group, institutionalized group, and family care group girls at ages 12 and 14 years. More disruptions in caregiving between 30 months and 12 years moderated decreases in growth rates of height in foster care group and weight in foster care group and institutionalized group across age. institutionalized group boys with ≥2 disruptions showed lower Tanner scores at age 12 vs institutionalized group and foster care group boys with <2 disruptions. foster care group girls with ≥2 disruptions had higher Tanner scores at age 14 vs foster care group girls with <2 disruptions. Age of menarche was not affected by caregiving disruptions. CONCLUSIONS: For children who experienced early institutionalization, stable placement within family care is essential to ensuring the best outcomes for physical developmental. TRIAL REGISTRATION: clinicaltrials.gov: NCT00747396.


Assuntos
Desenvolvimento Infantil/fisiologia , Criança Institucionalizada , Cuidados no Lar de Adoção , Orfanatos , Adolescente , Índice de Massa Corporal , Peso Corporal , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Romênia
18.
Prax Kinderpsychol Kinderpsychiatr ; 67(6): 529-548, 2018 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-30182823

RESUMO

Symptoms of Attachment Disorder, Behavioral Regulation and Physiological Stress in Institutionalized Children The aim of the study was to investigate the influence of attachment status (availability of a specific caregiver) and caregiving quality on behavioral and physiological adaptation and attachment disorder in institutionalized children. In a sample of children from a Georgian children's home, attachment disorder symptoms were assessed by interview and attachment and exploration behavior as well as self-regulatory behavior were assessed by observation in the natural group setting as well in structured dyadic situations. The child circadian cortisol level was determined to assess physiological adaption. Quality of caregiving was assessed in terms of sensitivity by observation. While attachment status affected the occurrence of attachment disorder symptoms and physiological stress, patterns of regulation in terms of attachment-exploration-balance and self-regulatory behavior were predicted by caregiver sensitivity.


Assuntos
Transtornos do Comportamento Infantil/diagnóstico , Criança Institucionalizada/psicologia , Transtorno Reativo de Vinculação na Infância/diagnóstico , Estresse Psicológico/complicações , Criança , Transtornos do Comportamento Infantil/fisiopatologia , Transtornos do Comportamento Infantil/psicologia , Pré-Escolar , Ritmo Circadiano/fisiologia , Comportamento Exploratório/fisiologia , Feminino , Alemanha , Humanos , Hidrocortisona/sangue , Lactente , Entrevista Psicológica , Masculino , Orfanatos , Determinação da Personalidade , Transtorno Reativo de Vinculação na Infância/fisiopatologia , Transtorno Reativo de Vinculação na Infância/psicologia , Autocontrole/psicologia , Estresse Psicológico/fisiopatologia
19.
Rev Bras Enferm ; 71(suppl 3): 1388-1394, 2018.
Artigo em Inglês, Português | MEDLINE | ID: mdl-29972539

RESUMO

OBJECTIVE: to evaluate the preparation and administration of oral medications to institutionalized children by nursing professionals. METHOD: quantitative study, developed from August to September 2016, in a shelter in Fortaleza, Ceará. 323 observations of preparation and administration of oral drugs were carried out. Interview and non-participant direct observation of the process of drug administration were performed, whose data were analyzed through descriptive statistics. RESULTS: Of the 29 actions of preparation and administration of the drugs, ten were considered satisfactory. Sanitizing of hands before touching the pills occurred in only 5.2% of the observations and cleansing of the bottle for liquid drugs was performed in 23.8%. The actions "check the right child"; "checking medication with the prescription", and "check the right dose" obtained percentages below 15%. CONCLUSION: measures recommended by the literature for the administration of medication were not, in their clear majority, followed, making specific training and protocols necessary.


Assuntos
Administração Oral , Criança Institucionalizada , Composição de Medicamentos/normas , Adulto , Brasil , Criança , Pré-Escolar , Composição de Medicamentos/métodos , Feminino , Humanos , Lactente , Entrevistas como Assunto/métodos , Masculino , Erros de Medicação/enfermagem , Pessoa de Meia-Idade
20.
Psychiatr Pol ; 52(2): 345-353, 2018 Apr 30.
Artigo em Inglês, Polonês | MEDLINE | ID: mdl-29975371

RESUMO

Emergence of mental health problems in childhood can seriously affect further development of a man and thus hamper his adaptation to adult life. Children in residential institutions may be particularly vulnerable at risk of abnormal mental development, this includes so-called 'children's homes'. In the article we present an overview of the few studies carried out so far in the European residential institutions, including children's homes, over the years 1940-2011 in the UK, Germany, Romania, and Poland. Firstly, we briefly describe a classic research carried out in the world in the 1940s among children from children's homes. Secondly, we present a study conducted in the UK among children and youth from different age groups staying in residential institutions, including children's homes. Then we focus on studies carried out among children and adolescents form German residential institutions and on a group of preschool children from Romanian children's homes. At the end of the article we describe the first epidemiological study carried out in Poland on the population of children and young people staying in children's homes in Warsaw. The review of researches shows that children from day-care facilities are a population with a high prevalence of psychiatric disorder. Children and youth staying in residential institutions probably require specialized psychiatric, psychological and psychotherapeutic care.


Assuntos
Transtornos do Comportamento Infantil/epidemiologia , Criança Abandonada/psicologia , Criança Institucionalizada/psicologia , Cuidados no Lar de Adoção/psicologia , Adolescente , Criança , Transtornos do Comportamento Infantil/psicologia , Criança Abandonada/estatística & dados numéricos , Criança Institucionalizada/estatística & dados numéricos , Pré-Escolar , Feminino , Cuidados no Lar de Adoção/estatística & dados numéricos , Alemanha , Humanos , Masculino , Orfanatos , Polônia , Prevalência , Roma , Reino Unido
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