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1.
Ned Tijdschr Tandheelkd ; 128(7-8): 395-401, 2021 Jul.
Artigo em Holandês | MEDLINE | ID: mdl-34242386

RESUMO

The new Dutch clinical practice guideline Oral Care for Children and Young People advises parents to visit the oral care professional before or from the eruption of the first tooth, because oral care starts with the first deciduous tooth. However, this is not yet standard for everyone. Still, almost all parents of newborns (> 95%) visit well-baby clinics with their newborn. This article describes how well-baby clinics and oral care can collaborate and how in the Netherlands, young children and their parents can be contacted earlier for (preventive) dental care. There are a few examples of projects in which well-child clinics and oral care collaborate, such as the Gezonde Peutermonden project (toddlers' healthy mouths project), the GigaGaaf project (giga whole project) and the case of a practice in Haarlem, in the Schalkwijk district. Because these projects are still in progress, it is not yet clear whether a collaboration between well-child clinics and oral care will also have an effect on the caries prevalence in children.


Assuntos
Cárie Dentária , Odontologia Preventiva , Adolescente , Criança , Cuidado da Criança , Pré-Escolar , Cárie Dentária/epidemiologia , Cárie Dentária/prevenção & controle , Humanos , Lactente , Recém-Nascido , Países Baixos , Saúde Bucal , Pais
2.
Rev Bras Enferm ; 74(3): e20200265, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34133680

RESUMO

OBJECTIVE: Identify the theoretical concepts that have been used in the context of nursing care for hospitalized children. METHODS: Scoping review was carried out according to the PRISMA-ScR methodology. The research limitations included: primary studies dealing with the use of theoretical concepts of nursing in the provision of care to hospitalized children, access in full text, in Portuguese or English and published between 2000 and 2019. Research was carried out on grassroots platforms (EBSCOhost, PubMed, SciELO and Web of Science), gray literature and in the bibliography of selected articles. RESULTS: 21 studies were found and 10 theoretical conceptions of nursing were identified, with family-centered care being the most used. FINAL CONSIDERATIONS: The variability of the identified theoretical conceptions is emphasized, with no evidence to support the use of one in detriment of the other. A more integrative theoretical conception, which adds care centered both on the family and the child, emerges as a research trend.


Assuntos
Criança Hospitalizada , Cuidados de Enfermagem , Criança , Cuidado da Criança , Saúde da Criança , Humanos
3.
J Korean Med Sci ; 36(25): e184, 2021 Jun 28.
Artigo em Inglês | MEDLINE | ID: mdl-34184439

RESUMO

BACKGROUND: Coronavirus disease 2019 (COVID-19) is different from previous disasters in that it continues to the present and has affected all aspects of family life. During epidemics, psychosocial support is not less important than infection control. During COVID-19-related school closures, prolonged partial closures of schools could have detrimental social and health consequences for children and may increase the burden on the family. Based on a community sample in Korea, this study identified parental concerns, children's media usage, other various factors and examined whether parental stress level or depression were positively associated with problem behaviors, media exposure, and sleep problems of the primary school children during school closure under COVID-19. METHODS: Participants were 217 parents residing in Suwon, South Korea, who had primary school children and responded to a web-based questionnaire on parental concerns from school closure under COVID-19, subjective stress, depression, whether having received mental health services, and family characteristics; children's sleep patterns, problem behaviors, media usage during the online-only class period, and changes in activity level following the pandemic. RESULTS: During school closure, children gained body weight, spent less time in physical activities and more in media usage. Besides online learning content (97.2%), YouTube was highly used content (87.6%), and games followed (78.3%). Parental subjective stress index was highly associated with parental depression (Pearson correlation 0.439, P < 0.001), children's sleep problems (0.283, P < 0.001), tablet time (0.171, P = 0.012) and behavior problems (0.413, P < 0.001). Parental depression was associated with children's sleep problems (0.355, P < 0.001), TV time (0.153, P = 0.024), tablet time (0.159, P = 0.019), and behavior problems (0.524, P < 0.001). Parents who previously received mental services seemed to be more concerned about the problems their children already have getting worse because of COVID-19 than the disease itself. Children's sleep problem was associated with tablet (0.172, P = 0.011) and smartphone time (0.298, P < 0.001), but not its frequency. CONCLUSION: During COVID-19-related school closures, many parents and children had various difficulties relating to mental health. Ongoing monitoring of mental health of high-risk groups and multiple support systems may need to be expanded to cover those parents having difficulty in caring for their children.


Assuntos
COVID-19/epidemiologia , Meios de Comunicação de Massa , Pandemias , Pais/psicologia , Psicologia da Criança , SARS-CoV-2 , Instituições Acadêmicas , Isolamento Social , Adulto , Índice de Massa Corporal , Criança , Transtornos do Comportamento Infantil/epidemiologia , Transtornos do Comportamento Infantil/etiologia , Cuidado da Criança , Depressão/epidemiologia , Depressão/etiologia , Educação à Distância , Exercício Físico , Feminino , Humanos , Renda , Atividades de Lazer , Masculino , Serviços de Saúde Mental/estatística & dados numéricos , Relações Pais-Filho , Utilização de Procedimentos e Técnicas , Quarentena , República da Coreia/epidemiologia , Comportamento Sedentário , Transtornos do Sono-Vigília/epidemiologia , Transtornos do Sono-Vigília/etiologia , Apoio Social , Estresse Psicológico/epidemiologia , Estresse Psicológico/etiologia , Inquéritos e Questionários
4.
J Korean Med Sci ; 36(25): e184, 2021 Jun 28.
Artigo em Inglês | MEDLINE | ID: covidwho-1286919

RESUMO

BACKGROUND: Coronavirus disease 2019 (COVID-19) is different from previous disasters in that it continues to the present and has affected all aspects of family life. During epidemics, psychosocial support is not less important than infection control. During COVID-19-related school closures, prolonged partial closures of schools could have detrimental social and health consequences for children and may increase the burden on the family. Based on a community sample in Korea, this study identified parental concerns, children's media usage, other various factors and examined whether parental stress level or depression were positively associated with problem behaviors, media exposure, and sleep problems of the primary school children during school closure under COVID-19. METHODS: Participants were 217 parents residing in Suwon, South Korea, who had primary school children and responded to a web-based questionnaire on parental concerns from school closure under COVID-19, subjective stress, depression, whether having received mental health services, and family characteristics; children's sleep patterns, problem behaviors, media usage during the online-only class period, and changes in activity level following the pandemic. RESULTS: During school closure, children gained body weight, spent less time in physical activities and more in media usage. Besides online learning content (97.2%), YouTube was highly used content (87.6%), and games followed (78.3%). Parental subjective stress index was highly associated with parental depression (Pearson correlation 0.439, P < 0.001), children's sleep problems (0.283, P < 0.001), tablet time (0.171, P = 0.012) and behavior problems (0.413, P < 0.001). Parental depression was associated with children's sleep problems (0.355, P < 0.001), TV time (0.153, P = 0.024), tablet time (0.159, P = 0.019), and behavior problems (0.524, P < 0.001). Parents who previously received mental services seemed to be more concerned about the problems their children already have getting worse because of COVID-19 than the disease itself. Children's sleep problem was associated with tablet (0.172, P = 0.011) and smartphone time (0.298, P < 0.001), but not its frequency. CONCLUSION: During COVID-19-related school closures, many parents and children had various difficulties relating to mental health. Ongoing monitoring of mental health of high-risk groups and multiple support systems may need to be expanded to cover those parents having difficulty in caring for their children.


Assuntos
COVID-19/epidemiologia , Meios de Comunicação de Massa , Pandemias , Pais/psicologia , Psicologia da Criança , SARS-CoV-2 , Instituições Acadêmicas , Isolamento Social , Adulto , Índice de Massa Corporal , Criança , Transtornos do Comportamento Infantil/epidemiologia , Transtornos do Comportamento Infantil/etiologia , Cuidado da Criança , Depressão/epidemiologia , Depressão/etiologia , Educação à Distância , Exercício Físico , Feminino , Humanos , Renda , Atividades de Lazer , Masculino , Serviços de Saúde Mental/estatística & dados numéricos , Relações Pais-Filho , Utilização de Procedimentos e Técnicas , Quarentena , República da Coreia/epidemiologia , Comportamento Sedentário , Transtornos do Sono-Vigília/epidemiologia , Transtornos do Sono-Vigília/etiologia , Apoio Social , Estresse Psicológico/epidemiologia , Estresse Psicológico/etiologia , Inquéritos e Questionários
5.
Artigo em Inglês | MEDLINE | ID: mdl-34063208

RESUMO

With the increase in the number of childcare facilities, childcare providers' coping skills to take quick action in emergencies have become crucial. This study was to examine Korean childcare providers' knowledge, attitudes, concerns, and practices regarding febrile convulsions (FCs), and to identify factors influencing their management of FCs. A cross-sectional study was conducted using a questionnaire of 216 Korean childcare providers. Descriptive statistics were used to describe the sample characteristics and FC questionnaires. The differences in the FC practice by demographic variables were assessed using t-test and one-way analysis of variance. The relationships between FC practice and other variables were investigated using Pearson correlations and regression analysis. The childcare providers showed unfavorable levels of outcomes regarding FCs with a low percentage of correct answers on FC knowledge and recommended practices as well as negative attitudes and concerns toward FCs. Additionally, results indicated that the knowledge, education, attitudes toward, and actual experiences of FCs were related to FC practices. The current findings provide important evidence to develop interventions targeting childcare providers.


Assuntos
Convulsões Febris , Criança , Cuidado da Criança , Estudos Transversais , Conhecimentos, Atitudes e Prática em Saúde , Humanos , República da Coreia , Inquéritos e Questionários
6.
Artigo em Inglês | MEDLINE | ID: mdl-34067043

RESUMO

Characteristics of early childhood education and care (ECEC) centers might be relevant for children's health. This scoping review aims to provide an overview of the association between meso-level characteristics (MLCs) of ECEC centers with children's health, health behavior, and wellbeing. Five databases were searched for quantitative and qualitative research articles published in English or German since 1 January 2000 on health, health behavior, and wellbeing of children aged 0 to 6 years considering MLCs of ECEC centers. Two authors screened 10,396 potentially eligible manuscripts and identified 117 papers, including 3077 examinations of the association between MLCs and children's health indicators (Kappas > 0.91). Five categories of MLCs were identified: (1) structural characteristics, (2) equipment/furnishings, (3) location, (4) facilities/environment, (5) culture/activities/policies/practices, and 6) staff. Only very few studies found an association of MLCs with body weight/obesity, and general health and wellbeing. Especially physical activity and mental health were related to MLCs. In general, the location (rural vs. urban, neighborhood status) seemed to be a relevant health aspect. MLCs of ECEC centers appeared relevant for child health indicators to different degrees. Future research should focus on these associations, in detail, to identify concrete ECEC indicators that can support health promotion in early childhood.


Assuntos
Exercício Físico , Comportamentos Relacionados com a Saúde , Criança , Cuidado da Criança , Pré-Escolar , Promoção da Saúde , Humanos , População Rural
7.
Artigo em Inglês | MEDLINE | ID: mdl-34065537

RESUMO

Children are uniquely vulnerable to toxicant exposures in their environment, which can have long-lasting impacts on their health. Childcare providers are an important population to target for environmental health literacy, as most children in the United States under five years of age spend a significant number of waking hours in non-parental care. There is an increasing body of evidence that children are exposed to toxicants in the childcare environment, and yet little is known about what childcare providers know about environmental influences on the health of children in their care. We conducted semi-structured interviews with 36 home- and center-based Illinois childcare providers to better understand their knowledge, attitudes, and behaviors as they relate to environmental influences on children's health. We found that the majority of providers had a low level of understanding of potential sources of exposure in the childcare environment, and they did not feel that environmental exposures posed a significant risk to children. Future efforts to increase environmental health literacy should focus on raising awareness and knowledge of environmental health issues for childcare providers before addressing ways that providers can reduce or prevent toxicant exposures to children in their care.


Assuntos
Saúde da Criança , Letramento em Saúde , Criança , Cuidado da Criança , Saúde Ambiental , Humanos , Illinois
8.
Rev Saude Publica ; 55: 32, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34190898

RESUMO

OBJECTIVE: To investigate the association between child care attendance since birth and development in two-years-old Brazilian children. METHODS: The study used longitudinal data from the 2015 Pelotas Birth Cohort. The childhood development (cognitive, fine and gross motor skills, and language) at two-years-old children was assessed using INTER-NDA (INTERGROWTH-21st Neurodevelopment Assessment). The child care attendance was measured at ages one and two years and categorized as: a) never attended child care; b) attended some child care (one or two years); and c) always attended child care (one and two years). Demographic, socioeconomic, health, and child stimulation variables were considered as confounders. Crude and adjusted analyses of child care attendance and development were carried out using linear regression. RESULTS: Out of the 3,870 infants included in the analyses, around 1/3 attended center-based child care. In crude analyses, attending center-based child care was associated with positive developmental outcomes, except in motor domains. In adjusted analyses, compared to those children that have never attended child care, children who did attend presented higher scores for cognitive development (always in child care: ß: 2.44, 95%CI: 0.83-4.05; some child care: ß: 1.35, 95%CI: 0.17-2.53). CONCLUSIONS: This study suggests that center-based child care may help improve child cognitive development in the Brazilian context. Furthermore, the association was higher for early and continued attendance. Considering the low prevalence of children in external care, it is recommended to improve child care opportunities in early childhood.


Assuntos
Cuidado da Criança , Desenvolvimento Infantil , Brasil/epidemiologia , Criança , Saúde da Criança , Pré-Escolar , Estudos de Coortes , Humanos , Lactente
9.
Online braz. j. nurs. (Online) ; 20: e20216436, 05 maio 2021.
Artigo em Inglês, Espanhol, Português | LILACS, BDENF - Enfermagem | ID: biblio-1223161

RESUMO

OBETIVO: Apreender o vivido materno frente ao acompanhamento da criança até o sexto mês de vida pela Atenção Primária à Saúde. MÉTODO: Estudo com abordagem qualitativa fundamentado na Fenomenologia Social de Schütz, que ocorreu de janeiro a julho de 2018 no domicílio de 19 mães. RESULTADOS: Duas unidades temáticas: "Vivenciado o acompanhamento do filho pela Atenção Primária nos primeiros seis meses de vida" e "Desejos e expectativas frente à assistência à criança recebida pela Atenção Primária". DISCUSSÃO: O seguimento da criança deve acontecer na primeira semana de vida, pois o período neonatal precoce representa grande vulnerabilidade para o recém-nascido. A Atenção Primária é capaz de organizar as ações de acompanhamento por meio de visitas domiciliares e rotina de consultas na Unidade Básica de Saúde. CONCLUSÃO: As mães identificaram fragilidades no acompanhamento dos filhos, como ausência de visitas domiciliares e de alguns profissionais, e longos intervalos entre as consultas.


OBJECTIVE: To grasp the maternal experience facing child monitoring by Primary Health Care up to the sixth month of life. METHOD: A study with a qualitative approach grounded on Schütz's Social Phenomenology and conducted from January to July 2018 in the homes of 19 mothers. RESULTS: Two thematic units: "The experience of child monitoring by Primary Care in the first six months of life" and "Wishes and expectations regarding the child care received by Primary Care". DISCUSSION: The follow-up of the child must take place in the first week of life, because the early neonatal period represents great vulnerability for the newborn. Primary Care is able to organize the monitoring actions through home visits and routine appointments in the Basic Health Unit. CONCLUSION: The mothers identified weaknesses in the monitoring of their children, such as absence of home visits and of some professionals, as well as long intervals between the appointments.


OBJETIVO: Comprender la experiencia materna del seguimiento del niño realizado por el servicio de Atención Primaria de la Salud hasta el sexto mes de vida. MÉTODO: Estudio con abordaje cualitativo basado en la Fenomenología Social Schütz, que se llevó a cabo de enero a julio de 2018 en el hogar de 19 madres. RESULTADOS: Dos unidades temáticas: "Experiencia en el seguimiento del niño en la Atención Primaria en los primeros seis meses de vida" y "Deseos y expectativas sobre la asistencia que recibe el niño por parte de la Atención Primaria". DISCUSIÓN: El seguimiento del niño debe realizarse en la primera semana de vida, ya que el período neonatal precoz representa una gran vulnerabilidad para el recién nacido. La Atención Primaria es capaz de organizar acciones de seguimiento a través de visitas domiciliarias y consultas de rutina en la Unidad Básica de Salud CONCLUSIÓN: Las madres identificaron deficiencias en el seguimiento de sus hijos, como la ausencia de visitas domiciliarias y de algunos profesionales, y largos intervalos entre las consultas.


Assuntos
Humanos , Recém-Nascido , Lactente , Atenção Primária à Saúde , Cuidado da Criança , Assistência Integral à Saúde , Serviços de Saúde Materno-Infantil , Mães , Continuidade da Assistência ao Paciente , Pesquisa Qualitativa , Visita Domiciliar
10.
Rev Gaucha Enferm ; 42(spe): e20200370, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34037187

RESUMO

OBJECTIVE: To comprehend the daily rites of child-mothers with congenital Zika virus syndrome for the prevention of COVID-19 during the pandemic. METHOD: Study with a qualitative-exploratory approach, in the light on the comprehensive sociology of Michel Maffesoli, carried out in WhatsApp groups of associations of families of children with the syndrome. 44 mothers answered the online questionnaire between April and May 2020. Lexical and similarity analyzes were used through IRaMuTeQ. RESULTS: Mothers encourage exercises for child development and help the children's school activities, watch television, sew, cook, support other mothers on social networks and find satisfaction in not meeting previously established schedules. To prevent COVID-19, mothers adopt physical distance, try to consume healthy foods and intensify hygiene measures. FINAL CONSIDERATIONS: Child-mothers experience, in physical distance being closer to their children and other mothers through the networks, and adopt preventive care to COVID-19, with care overload.


Assuntos
Atividades Cotidianas , COVID-19/prevenção & controle , Mães , Infecção por Zika virus/congênito , Adulto , COVID-19/epidemiologia , Cuidado da Criança/métodos , Desenvolvimento Infantil , Pré-Escolar , Humanos , Microcefalia/virologia , Pandemias , Distanciamento Físico , Pesquisa Qualitativa , Grupos de Autoajuda , Mídias Sociais , Inquéritos e Questionários , Adulto Jovem , Infecção por Zika virus/terapia
11.
Online braz. j. nurs. (Online) ; 20: e20216487, 05 maio 2021. tab
Artigo em Inglês, Espanhol, Português | LILACS, BDENF - Enfermagem | ID: biblio-1224139

RESUMO

OBJETIVO: Avaliar os efeitos da musicoterapia nas respostas fisiológicas do recém-nascido pré-termo (RNPT) em ventilação não invasiva. MÉTODO: Estudo quase-experimental, de grupo único, do tipo antes e depois, com trinta prematuros, hospitalizados em uma Unidade de Terapia Intensiva Neonatal. RESULTADOS: Em relação à frequência respiratória (FR), observou-se redução de até seis incursões por minuto (p=<0,001) e em relação à frequência cardíaca (FC), de até sete batimentos por minuto (p=<0,002). Na saturação de oxigênio, identificou-se o aumento em média de 2% (p=0,003). A temperatura axilar apresentou aumento de 0,1ºC após a intervenção (p=0,05). Na escala de dor, identificou-se uma redução de um ponto (p=0,001). DISCUSSÃO: A musicoterapia apresenta efeitos benéficos em relação a redução da FR, da FC e do nível de dor, bem como, aumento da saturação de oxigênio e da temperatura axilar. CONCLUSÃO: A musicoterapia interfere positivamente nas respostas fisiológicas do RNPT em ventilação não invasiva.


OBJECTIVE: To evaluate the effects of music therapy on the physiological responses of preterm newborns (PTNBs) on non-invasive ventilation. METHOD: A quasi-experimental study, with a single group and of the before-and-after type, conducted with thirty premature infants in a Neonatal Intensive Care Unit. RESULTS: As for respiratory frequency (RF), a reduction of up to six breaths per minute was observed (p=<0.001) and, in relation to heart rate (HR), the reduction was up to seven beats per minute (p=<0.002). In oxygen saturation, a 2% (p=0.003) mean increase was identified. Axillary temperature presented a 0.1ºC increase after the intervention (p=0.05). In the pain scale, a one-point reduction (p=0.001) was identified. DISCUSSION: Music therapy presents beneficial effects in relation to reductions in RF, HR and pain level, as well as an increase in oxygen saturation and axillary temperature. CONCLUSION: Music therapy interferes positively with the physiological responses of PTNBs on non-invasive ventilation.


OBJETIVO: Evaluar los efectos de la musicoterapia sobre las respuestas fisiológicas de los recién nacidos prematuros (RNP) con ventilación no invasiva. MÉTODO: Estudio cuasiexperimental, de un solo grupo, del tipo antes y después, con treinta prematuros, hospitalizados en una Unidad de Terapia Intensiva Neonatal. RESULTADOS: Se observó una reducción de la frecuencia respiratoria (FR) de hasta seis respiraciones por minuto (p=<0,001) y de la frecuencia cardíaca (FC) de hasta siete latidos por minuto (p=<0,002). Se detectó un aumento del 2% (p=0,003) en la saturación de oxígeno. La temperatura axilar aumentó 0,1ºC tras la intervención (p=0,05). Se identificó la reducción de un punto (p=0,001) en la escala de dolor. DISCUSIÓN: La musicoterapia tiene efectos beneficiosos en cuanto a la reducción de la FR, FC y el nivel de dolor, así como también, un aumento de la saturación de oxígeno y temperatura axilar. CONCLUSIÓN: La musicoterapia interfiere positivamente en las respuestas fisiológicas del RNP con ventilación no invasiva.


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Recém-Nascido Prematuro , Ventilação não Invasiva , Monitorização Fisiológica , Musicoterapia , Unidades de Terapia Intensiva Neonatal , Cuidado da Criança , Saúde da Criança , Hospitais Universitários
12.
JAMA Netw Open ; 4(4): e213997, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: covidwho-1162460

RESUMO

Importance: In March 2020, US public buildings (including schools) were shut down because of the COVID-19 pandemic, and 42% of US workers resumed their employment duties from home. Some shutdowns remain in place, yet the extent of the needs of US working parents is largely unknown. Objective: To identify and address the career development, work culture, and childcare needs of faculty, staff, and trainees at an academic medical center during a pandemic. Design, Setting, and Participants: For this survey study, between August 5 and August 20, 2020, a Qualtrics survey was emailed to all faculty, staff, and trainees at University of Utah Health, an academic health care system that includes multiple hospitals, community clinics, and specialty centers. Participants included 27 700 University of Utah Health faculty, staff, and trainees who received a survey invitation. Data analysis was performed from August to November 2020. Main Outcomes and Measures: Primary outcomes included experiences of COVID-19 and their associations with career development, work culture, and childcare needs. Results: A total of 5030 participants completed the entire survey (mean [SD] age, 40 [12] years); 3738 (75%) were women; 4306 (86%) were White or European American; 561 (11%) were Latino or Latina (of any race), Black or African American, American Indian, Alaska Native, and Native Hawaiian or Pacific Islander; and 301 (6%) were Asian or Asian American. Of the participants, 2545 (51%) reported having clinical responsibilities, 2412 (48%) had at least 1 child aged 18 years or younger, 3316 (66%) were staff, 791 (16%) were faculty, and 640 (13%) were trainees. Nearly one-half of parents reported that parenting (1148 participants [49%]) and managing virtual education for children (1171 participants [50%]) were stressors. Across all participants, 1061 (21%) considered leaving the workforce, and 1505 (30%) considered reducing hours. Four hundred forty-nine faculty (55%) and 397 trainees (60%) perceived decreased productivity, and 2334 participants (47%) were worried about COVID-19 impacting their career development, with 421 trainees (64%) being highly concerned. Conclusions and Relevance: In this survey of 5030 faculty, staff, and trainees of a US health system, many participants with caregiving responsibilities, particularly women, faculty, trainees, and (in a subset of cases) those from racial/ethnic groups that underrepresented in medicine, considered leaving the workforce or reducing hours and were worried about their career development related to the pandemic. It is imperative that medical centers support their employees and trainees during this challenging time.


Assuntos
Centros Médicos Acadêmicos , Atitude do Pessoal de Saúde , COVID-19 , Pessoal de Saúde , Pandemias , Estresse Psicológico/etiologia , Equilíbrio Trabalho-Vida , Adulto , COVID-19/psicologia , Escolha da Profissão , Criança , Cuidado da Criança , Atenção à Saúde , Docentes de Medicina , Feminino , Pessoal de Saúde/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Poder Familiar , SARS-CoV-2 , Inquéritos e Questionários , Utah , Carga de Trabalho , Local de Trabalho , Adulto Jovem
13.
Cochrane Database Syst Rev ; 4: CD014955, 2021 04 22.
Artigo em Inglês | MEDLINE | ID: mdl-33884613

RESUMO

BACKGROUND: Drowning is responsible for an estimated 320,000 deaths a year, and over 90% of drowning mortality occurs in low- to middle-income countries (LMICs), with peak drowning rates among children aged 1 to 4 years. In this age group, mortality due to drowning is particularly common in rural settings and about 75% of drowning accidents happen in natural bodies of water close to the home. Providing adequate child supervision can protect children from drowning, and organized formal day care programs could offer a way to achieve this. OBJECTIVES: Primary objective • To assess the effects of day care programs for children under 6 years of age on drowning-related mortality or morbidity, or on total drowning accidents (fatal and non-fatal), in LMICs, compared to no day care programs or other drowning prevention interventions Secondary objectives • To assess the effects of day care programs in LMICs for children under 6 years of age on unsafe water exposure • To assess safety within these programs (e.g. transmission of infection within day care, physical or sexual abuse of children within day care) • To assess the incidence of unintentional injury within these programs • To describe the cost-effectiveness of such programs, in relation to averted drowning-related mortality or morbidity SEARCH METHODS: On November 23, 2019, and for an update on August 18, 2020, we searched MEDLINE (PubMed), Embase, CENTRAL, ERIC, and CINAHL, as well as two trial registries. On December 16, 2019, and for an update on February 9, 2021, we searched 12 other resources, including websites of organizations that develop programs targeted to children. SELECTION CRITERIA: We included randomized, quasi-randomized, and non-randomized controlled studies (with explicitly listed specific study design features) that implemented formal day care programs as a single program or combined with additional out-of-day care components (such as educational activities aimed at preventing injury or drowning or early childhood development activities) for children of preschool age (below 6 years of age) in LMICs for comparison with no such programs or with other drowning prevention interventions. Studies had to report at least one outcome related to drowning or injury prevention for the children enrolled. DATA COLLECTION AND ANALYSIS: Two review authors independently performed study selection and data extraction, as well as risk of bias and GRADE assessment. MAIN RESULTS: Two non-randomized observational studies, conducted in rural Bangladesh, involving a total of 252,631 participants, met the inclusion criteria for this review. One of these studies compared a formal day care program combined with parent education, playpens provided to parents, and community-based activities as additional out-of-day care components versus no such program. Overall we assessed this study to be at moderate risk of bias (moderate risk of bias due to confounding, low risk of bias for other domains). This study showed that implementation of a formal day care program combined with parent education, provision of playpens to parents, and community-based activities, in a rural area with a high drowning incidence, likely reduces the risk of death from drowning over the study period of 4 years and 8 months compared to no day care program (hazard ratio 0.18, 95% confidence interval [CI] 0.06 to 0.58; 1 study, 136,577 participants; moderate-certainty evidence). Drowning morbidity (non-fatal drowning resulting in complications), total drowning (fatal and non-fatal), unsafe water exposure, and program safety (e.g. transmission of infection within day care, physical or sexual abuse of children within day care) were not reported, nor was the incidence of other unintentional injuries. Cost-effectiveness was reported as 812 USD (95% CI 589 to 1777) per disability-adjusted life-year averted as a consequence of drowning (moderate-certainty evidence). The second study compared day care programs with or without playpens provided to parents as an additional component versus only playpens provided to parents as an alternative drowning prevention intervention. Overall we assessed the study to be at critical risk of bias because we judged bias due to confounding to be at critical risk. As the certainty of evidence was very low, we are uncertain about the effects on drowning mortality rate of implementing a day care program compared to providing playpens (rate ratio 0.25, 95% CI 0.15 to 0.41; 1 study; 76,575 participants; very low-certainty evidence). Likewise, we are uncertain about the effects of a day care program with playpens provided as an additional component versus playpens provided alone (rate ratio 0.06, 95% CI 0.02 to 0.12; 1 study, 45,460 participants; very low-certainty evidence). The other outcomes of interest - drowning morbidity, total drowning, unsafe water exposure, program safety, incidence of other unintentional injuries, and cost-effectiveness - were not reported. AUTHORS' CONCLUSIONS: This review provides evidence suggesting that a day care program with additional out-of-day care components such as community-based education, parent education, and playpens provided to parents likely reduces the drowning mortality risk in regions with a high burden of drowning compared to no intervention.


Assuntos
Cuidado da Criança/organização & administração , Países em Desenvolvimento , Afogamento/prevenção & controle , Avaliação de Programas e Projetos de Saúde , Bangladesh , Maus-Tratos Infantis , Abuso Sexual na Infância , Cuidado da Criança/métodos , Pré-Escolar , Intervalos de Confiança , Transmissão de Doença Infecciosa , Afogamento/mortalidade , Humanos , Lactente , Estudos Observacionais como Assunto
14.
Am J Prev Med ; 60(6): e269-e276, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33795181

RESUMO

INTRODUCTION: Vaccination mandates for elementary and middle school attendance have been shown to increase vaccination rates and decrease the burden of vaccine-preventable diseases. Fewer studies have evaluated similar requirements for child care attendance. This study provides robust, quasi-experimental estimates of the effect of state laws mandating the pneumococcal conjugate vaccine for child care attendance on vaccination coverage among children aged 19-35 months. METHODS: Using provider-verified immunization histories from the 2001-2018 waves of the National Immunization Survey-Child and leveraging the staggered implementation of vaccination requirements across states, a generalized difference-in-differences approach was implemented to compare regression-adjusted changes in vaccination coverage among children in states with and without a child care mandate for the pneumococcal conjugate vaccine. The dynamics of estimated treatment effects were analyzed using an event study analysis. All data analyses were conducted in 2019‒2020. RESULTS: State adoption of a child care mandate for the pneumococcal conjugate vaccine increased the likelihood that resident children aged 19-35 months completed the 4-dose pneumococcal conjugate vaccine series by 3.12 percentage points (p<0.01). Statistically significant gains in pneumococcal conjugate vaccine coverage were identified in the first year following policy implementation and were found to persist over a period of ≥7 years. CONCLUSIONS: Results indicate that state adoption of a child care mandate for the pneumococcal conjugate vaccine leads to an increase in the proportion of resident children aged 19-35 months who are up to date with pneumococcal conjugate vaccine.


Assuntos
Infecções Pneumocócicas , Cobertura Vacinal , Criança , Cuidado da Criança , Saúde da Criança , Humanos , Lactente , Infecções Pneumocócicas/prevenção & controle , Vacinas Pneumocócicas , Vacinação , Vacinas Conjugadas
15.
Rev Bras Enferm ; 74(suppl 4): e20190136, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-33909806

RESUMO

OBJECTIVE: To analyze the experiences of families in the exercise of the rights of children with chronic conditions in public health, education and social assistance institutions. METHOD: ethnographic multiple case study, with qualitative approach, following the theoretical approach of Boaventura Santos. Experiences of the families of these children in a city were studied through interviews with family members, managers and professionals from social institutions (35), participant observations in social spaces (13) and creation of eco-maps (3). Critical Discourse Analysis was performed. RESULTS: the offer of services is lower than the demand, and exclusion processes persist. Given the hegemony of neoliberal and normality ideologies, meetings between family members and professionals revealed obstacles to civil rights; however, when these ideologies were challenged, the realization of their rights was enhanced. FINAL CONSIDERATIONS: the care to promote civil rights requires family members, managers and professionals to develop subjectivities that overcome neoliberal and normality ideologies, recognizing these children as subjects of law.


Assuntos
Cuidado da Criança , Direitos Civis , Crianças com Deficiência , Seguridade Social , Antropologia Cultural , Criança , Doença Crônica , Família , Humanos , Enfermagem Pediátrica
16.
Rev Bras Enferm ; 74(suppl 4): e20200073, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-33909809

RESUMO

OBJECTIVE: To analyze the scientific literature on the application of management tools in the postoperative period of pediatric cardiac surgery. METHODS: integrative review including studies published between 2004 and 2018 in the following databases: LILACS, BDENF, coleciona SUS, MEDLINE/PUBMED, CINAHL and SCOPUS, via Portal de Periódicos da Capes, Scientific Electronic Library Online (SciELO) and Academic Google research. RESULTS: Twelve articles that met the inclusion criteria were analyzed. The studies demonstrated that strategies such as extracorporeal membrane oxygenation, renal replacement therapy and the risk scores for Risk Adjustment for Congenital Heart Surgery 1 and Aristotle Basic Score favored the stratification the demand for care and predicted the risk for mortality. FINAL CONSIDERATIONS: The applicability of risk scores and emerging strategies for the management of childcare in the postoperative period of cardiac surgery was described by the evaluation of possibilities of performance and/or efficiency of the treatments developed.


Assuntos
Procedimentos Cirúrgicos Cardíacos , Cuidados Críticos , Período Pós-Operatório , Criança , Cuidado da Criança , Humanos , Enfermagem Pediátrica , Fatores de Risco
17.
Artigo em Inglês | MEDLINE | ID: mdl-33805046

RESUMO

Children spend a large amount of time each day in early childhood education and care (ECEC) institutions, and the ECEC play environments are important for children's play opportunities. This includes children's opportunities to engage in risky play. This study examined the relationship between the outdoor play environment and the occurrence of children's risky play in ECEC institutions. Children (n = 80) were observed in two-minute sequences during periods of the day when they were free to choose what to do. The data consists of 935 randomly recorded two-minute videos, which were coded second by second for several categories of risky play as well as where and with what materials the play occurred. Results revealed that risky play (all categories in total) was positively associated with fixed equipment for functional play, nature and other fixed structures, while analysis of play materials showed that risky play was positively associated with wheeled toys. The results can support practitioners in developing their outdoor areas to provide varied and exciting play opportunities.


Assuntos
Exercício Físico , Jogos e Brinquedos , Criança , Cuidado da Criança , Pré-Escolar , Meio Ambiente , Humanos
18.
JAMA Netw Open ; 4(4): e213997, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33797552

RESUMO

Importance: In March 2020, US public buildings (including schools) were shut down because of the COVID-19 pandemic, and 42% of US workers resumed their employment duties from home. Some shutdowns remain in place, yet the extent of the needs of US working parents is largely unknown. Objective: To identify and address the career development, work culture, and childcare needs of faculty, staff, and trainees at an academic medical center during a pandemic. Design, Setting, and Participants: For this survey study, between August 5 and August 20, 2020, a Qualtrics survey was emailed to all faculty, staff, and trainees at University of Utah Health, an academic health care system that includes multiple hospitals, community clinics, and specialty centers. Participants included 27 700 University of Utah Health faculty, staff, and trainees who received a survey invitation. Data analysis was performed from August to November 2020. Main Outcomes and Measures: Primary outcomes included experiences of COVID-19 and their associations with career development, work culture, and childcare needs. Results: A total of 5030 participants completed the entire survey (mean [SD] age, 40 [12] years); 3738 (75%) were women; 4306 (86%) were White or European American; 561 (11%) were Latino or Latina (of any race), Black or African American, American Indian, Alaska Native, and Native Hawaiian or Pacific Islander; and 301 (6%) were Asian or Asian American. Of the participants, 2545 (51%) reported having clinical responsibilities, 2412 (48%) had at least 1 child aged 18 years or younger, 3316 (66%) were staff, 791 (16%) were faculty, and 640 (13%) were trainees. Nearly one-half of parents reported that parenting (1148 participants [49%]) and managing virtual education for children (1171 participants [50%]) were stressors. Across all participants, 1061 (21%) considered leaving the workforce, and 1505 (30%) considered reducing hours. Four hundred forty-nine faculty (55%) and 397 trainees (60%) perceived decreased productivity, and 2334 participants (47%) were worried about COVID-19 impacting their career development, with 421 trainees (64%) being highly concerned. Conclusions and Relevance: In this survey of 5030 faculty, staff, and trainees of a US health system, many participants with caregiving responsibilities, particularly women, faculty, trainees, and (in a subset of cases) those from racial/ethnic groups that underrepresented in medicine, considered leaving the workforce or reducing hours and were worried about their career development related to the pandemic. It is imperative that medical centers support their employees and trainees during this challenging time.


Assuntos
Centros Médicos Acadêmicos , Atitude do Pessoal de Saúde , COVID-19 , Pessoal de Saúde , Pandemias , Estresse Psicológico/etiologia , Equilíbrio Trabalho-Vida , Adulto , COVID-19/psicologia , Escolha da Profissão , Criança , Cuidado da Criança , Atenção à Saúde , Docentes de Medicina , Feminino , Pessoal de Saúde/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Poder Familiar , SARS-CoV-2 , Inquéritos e Questionários , Utah , Carga de Trabalho , Local de Trabalho , Adulto Jovem
20.
Lang Speech Hear Serv Sch ; 52(2): 686-701, 2021 04 20.
Artigo em Inglês | MEDLINE | ID: mdl-33788592

RESUMO

Purpose The purpose of this study is to examine the impact of an intervention in which childcare providers (CCPs) are coached to support toddlers' gesture use during every day classroom routines. Method This study uses a multiple-baseline across strategies single-case experimental design to examine the impact of a coaching intervention on three CCPs' use of communication strategies with toddlers experiencing early childhood poverty. The CCPs were coached with a systematic framework called Setting the Stage, Observation and Opportunities to Embed, Problem-solving and Planning, Reflection and Review as they learned to implement three strategies to support toddlers' gesture use-modeling gestures with a short phrase, opportunities to gesture, and responding/expanding child gestures. CCPs were coached during book sharing and another classroom routine of their choice. Social validity data on the coaching approach and on the intervention strategies were gathered from postintervention interviews. Results The visual analysis and nonoverlap of all pairs' effect size indicates that the coaching intervention had a functional relation with CCPs' use of modeling gestures and responding/expanding gestures during book sharing, play, and circle time. Social validity data indicate that CCPs found the coaching framework supportive of their learning and feelings of self-efficacy, and that the intervention strategies supported their toddlers' communication. Conclusions The coaching framework was used to increase CCP strategy use during everyday classroom routines with toddlers. CCPs endorsed the coaching approach and the intervention strategies. This study adds to the literature supporting efforts to enhance children's earliest language learning environments. Supplemental Material https://doi.org/10.23641/asha.14044055.


Assuntos
Cuidado da Criança , Gestos , Desenvolvimento da Linguagem , Aprendizagem , Tutoria , Adulto , Cuidadores , Criança , Pré-Escolar , Comunicação , Tomada de Decisões , Emoções , Humanos , Lactente , Linguística , Masculino , Pobreza , Resolução de Problemas
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