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1.
Am J Clin Hypn ; 62(1-2): 60-73, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31265372

RESUMO

This article examines the spatial and social nature of human relationships with children and adolescents in clinical hypnosis. Beginning with the unique way in which the phenomenon of rapport is intrinsic to the therapeutic uses of hypnosis and is distinct among other therapies, the stage is set for the importance of relational hypnosis. Through the use of case vignettes that illustrate developmental imperatives, relationship factors influencing the clinical interaction are demonstrated in practice. These include transference and countertransference, safety, embodiment, novelty, creativity, respect, trust, equality, being with, loving responses, synchronicity, and empathy. Hypnotic relating exists in a framework through which absorption in play and imagination evokes the child's resources and suggestions are made. In this receptive stance the personalized suggestions lead to an environment for positive change.


Assuntos
Hipnose , Imaginação , Adolescente , Criança , Desenvolvimento Infantil , Pré-Escolar , Feminino , Humanos , Masculino , Relações Profissional-Paciente , Aliança Terapêutica
2.
Rev. Esc. Enferm. USP ; 53: e03484, Jan.-Dez. 2019. tab
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1020386

RESUMO

RESUMO Objetivo Relatar a experiência de estudantes e docentes de um projeto de extensão universitária no planejamento e realização de oficinas educativas sobre desenvolvimento infantil com educadoras de creche. Método Relato de experiência alicerçado nos referenciais das Necessidades Essenciais das Crianças e na Teoria Bioecológica do Desenvolvimento Humano. Resultados Participaram das oficinas oito graduandas, duas docentes de Enfermagem de uma universidade pública e 24 educadoras de uma creche localizada no município de São Paulo, em região de alta vulnerabilidade social. As oficinas educativas abordaram os temas: fundamentos do desenvolvimento infantil, marcos do desenvolvimento nas áreas pessoal e social, linguagem, motor fino e grosseiro e promoveram o desenvolvimento infantil na creche. Como estratégias pedagógicas, foram utilizadas dinâmicas interativas, jogos didáticos e recursos midiáticos. As oficinas educativas favoreceram a translação do conhecimento sobre o desenvolvimento infantil e as necessidades essenciais das crianças. Conclusão As ações de extensão proporcionaram articulação entre a universidade e a comunidade por meio do compartilhamento de saberes entre profissionais da saúde e da educação visando à promoção do desenvolvimento infantil.


RESUMEN Objetivo Relatar la experiencia de estudiantes y docentes de un proyecto de extensión universitaria en la planificación y realización de talleres educativos acerca del desarrollo infantil con educadoras de guarderías. Método Relato de experiencia cimentado en los marcos de referencia de las Necesidades Esenciales de los Niños y la Teoría Bioecológica del Desarrollo Humano. Resultados Participaron en los talleres ocho estudiantes de graduación, dos docentes de Enfermería de una universidad pública y 24 educadoras de una guardería ubicada en el municipio de São Paulo, en zona de alta vulnerabilidad social. Los talleres educativos abordaron los temas: fundamentos del desarrollo infantil, hitos del desarrollo en las áreas personal y social, lenguaje, motricidad fina y gruesa, y promovieron el desarrollo infantil en la guardería. Como estrategias pedagógicas, fueron utilizadas dinámicas interactivas, juegos didácticos y recursos mediáticos. Los talleres favorecieron la traslación del conocimiento acerca del desarrollo infantil y las necesidades esenciales de los niños. Conclusión Las acciones de extensión proporcionaron articulación entre la universidad y la comunidad mediante el intercambio de saberes entre los profesionales sanitarios y de la educación a fin de promover el desarrollo infantil.


ABSTRACT Objective To report the experience of students and teachers of a university extension project in the planning and performance of educational workshops on child development with educators of a day care center. Method Report of experience based on frameworks of The Irreducible Needs of Children and the Bioecological Theory of Human Development. Results The workshops included eight undergraduate students, two nursing professors from a public university and 24 educators from a day care center located in a region of high social vulnerability in São Paulo. The educational workshops promoted child development in the day care center and the following themes were addressed: child development fundamentals, developmental milestones in the personal and social areas, language, fine and gross motor coordination. Interactive dynamics, didactic games and media resources were used as pedagogical strategies. The educational workshops favored the transfer of knowledge on child development and irreducible needs of children Conclusion Extension activities provided a link between the university and the community through the sharing of knowledge among health and education professionals aimed at promoting child development.


Assuntos
Humanos , Feminino , Desenvolvimento Infantil , Educação em Saúde , Enfermagem Pediátrica , Creches , Saúde da Criança
3.
Estud. pesqui. psicol. (Impr.) ; 19(3): 686-703, dez. 2019. tab
Artigo em Português | LILACS, Index Psicologia - Periódicos técnico-científicos | ID: biblio-1046000

RESUMO

Estudar metas parentais de socialização emocional permite conhecer particularidades de contextos socioculturais e seus impactos no desenvolvimento infantil. Para analisar essas metas em mães e pais e sua relação com a valorização da autonomia ou da relação, realizou-se um estudo exploratório em que foram entrevistadas 60 duplas mãe-pai de filhos com até três anos, residentes na cidade do Rio de Janeiro. As respostas das entrevistas foram analisadas por uma técnica de análise de conteúdo e, posteriormente, foram calculadas frequências de evocações para as categorias identificadas e empregados procedimentos estatísticos descritivos e testes de associação entre grupos. Os resultados indicaram que as características emocionais desejadas por mães e pais para os filhos quandoadultos sinalizavam valorização da autonomia, independência e autoconfiança emocional, com as condições para o seu desenvolvimento estando principalmente centradas no contexto. A atuação parental prevalente foi a de educar/orientar para o desenvolvimento das metas emocionais que estabeleceram. Não foram encontradas diferenças significativas entre mães e pais, nem entre mães-pais de meninos e meninas quanto a quaisquer dos aspectos investigados. Sugere-se novos estudos abarcando distintas configurações familiares, com participantes de variados níveis de escolaridade e em outros contextos socioculturais.(AU)


Studying parental socialization goals allows us to understand the characteristics of sociocultural contexts and its impacts on child development. In order to analyze such goals in mothers and fathers and its relationship with their values regarding autonomy and relatedness, an exploratory study was conducted in which we interviewed 60 mother-father couples of children up to three years of age, living in the city of Rio de Janeiro. Interview responses were analyzed by a content analysis technique and, subsequently, emission frequencies were calculated for the identified categories and descriptive statistical procedures and association tests between groups were employed. Results showed that the emotional characteristics that the parents desired for their children as adults valued autonomy, independence and emotional self-confidence, with the conditions for child development mostly centered in contextual factors. The most frequently reported parental behavior was involvement in education/guidance towards their child developmental goals. No differences were found between mothers and fathers, neither between parents of girls or boys regarding any of the variables analyzed. Further studies are suggested covering different family configurations, with participants of varying levels of education and in other socio-cultural contexts.(AU)


Estudiar metas parentales de socialización emocional permite conocer particularidades de contextos socioculturales y sus impactos en el desarrollo infantil. Para analizar esas metas en madres y padres y su relación con la valorización de la autonomía o de la relación, se realizó un estudio exploratorio y se entrevistó 60 dobles madre-padre de hijos con hasta tres años, residentes en la ciudad de Río de Janeiro. Las respuestas de la entrevista se analizaron mediante técnica de análisis de contenido y, posteriormente, se calcularon las frecuencias de emisión para las categorías identificadas y se emplearon procedimientos estadísticos descriptivos y pruebas de asociación entre grupos. Los resultados indicaron que las características emocionales deseadas por madres y padres para los hijos cuando adultos señalaban valorización de autonomía, independencia y autoconfianza emocional, con las condiciones para su desarrollo estando principalmente centradas en el contexto. La actuación parental prevalente fue la de educar/orientar para el desarrollo de las metas emocionales que establecieron. No se encontraron diferencias significativas entre madres y padres, ni entre madres-padres de niños y niñas en cuanto a cualquiera de los aspectos investigados. Se sugieren estudios adicionales que abarquen diferentes configuraciones familiares, participantes de diferentes niveles de educación y en otros contextos socioculturales.(AU)


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Adulto , Desenvolvimento Infantil , Poder Familiar , Socialização , Relações Pai-Filho , Relações Mãe-Filho
4.
J Glob Health ; 9(3): 020703, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31673352

RESUMO

Background: Approximately 250 million children under the age of five in low and middle-income countries (LMICs) will not achieve their developmental potential due to poverty and stunting alone. Investments in programming to improve early childhood development (ECD) have the potential to disrupt the cycle of poverty and therefore should be prioritised. Support for ECD has increased in recent years. Nevertheless, donors and policies continue to neglect ECD, in part from lack of evidence to guide policy makers and donors about where they should focus policies and programmes. Identification and investment in research is needed to overcome these constraints and in order to achieve high quality implementation of programmes to improve ECD. Methods: The Child Health and Nutrition Research Initiative (CHNRI) priority setting methodology was applied in order to assess research priorities for improving ECD. A group of 348 global and local experts in ECD-related research were identified and invited to generate research questions. This resulted in 406 research questions which were categorised and refined by study investigators into 54 research questions across six thematic goals which were evaluated using five criteria: answerability, effectiveness, feasibility, impact, and effect on equity. Research options were ranked by their final research priority score multiplied by 100. Results: The top three research priority options from the LMIC experts came from the third thematic goal of improving the impact of interventions, whereas the top three research priority options from high-income country experts came from different goals: improving the integration of interventions, increasing the understanding of health economics and social protection strategies, and improving the impact of interventions. Conclusion: The results of this process highlight that priorities for future research should focus on the need for services and support to parents to provide nurturing care, and the training of health workers and non-specialists in implementation of interventions to improve ECD. Three of the six thematic goals of the present priority setting centred on interventions (ie, improving impact, implementation of interventions and improving the integration of interventions). In order to achieve higher coverage through sustainable interventions to improve ECD with equitable reach, interventions should be integrated and not be sector driven.


Assuntos
Desenvolvimento Infantil , Saúde Global , Pesquisa , Pré-Escolar , Humanos , Lactente , Desenvolvimento Sustentável
5.
Evid. actual. práct. ambul ; 22(3): e002013, nov. 2019. tab.
Artigo em Espanhol | LILACS | ID: biblio-1047069

RESUMO

Basándonos en una consulta de una niña que desea realizar una dieta vegetariana se realizó una búsqueda bibliográfica para identificar evidencia sobre el impacto de este tipo de dieta en la salud. La evidencia actual indica que la dieta vegetariana es una opción saludable que no produciría un impacto negativo en el crecimiento y desarrollo de los niños, si bien existiría la posibilidad de déficit de micronutrientes. (AU)


Based on a consultation of a girl who wishes to make a vegetarian diet, a literature search was conducted to identify evidence on the impact of this type of diet on health. Current evidence indicates that the vegetarian diet is a healthy option that would not have a negative impact on the growth and development of children, although there is a possibility of micronutrient deficits. (AU)


Assuntos
Humanos , Masculino , Feminino , Gravidez , Criança , Adolescente , Dieta Vegetariana/efeitos adversos , Deficiência de Vitamina B 12/dietoterapia , Desenvolvimento Infantil , Anemia Ferropriva/dietoterapia , Fatores Socioeconômicos , Dieta Vegetariana/classificação , Dieta Vegetariana/tendências , Micronutrientes/deficiência , Alimentos, Dieta e Nutrição , Dieta Saudável/tendências
6.
Lakartidningen ; 1162019 Oct 07.
Artigo em Sueco | MEDLINE | ID: mdl-31593283

RESUMO

Advances in perinatal intensive care have resulted in increased survival of the most immature preterm infants (born before 28 gestational weeks) and these new survivors are now entering school. While the clear majority of all children born preterm have a normal development, the extremely preterm infant is at a considerable risk for long term disabilities and rates of adverse development increase at lower gestational ages. Lung function is commonly affected in children born extremely preterm, and many have treatment for obstructive symptoms. The incidences of major neuromotor impairments, i.e. cerebral palsy, are low, but there is an increasing awareness of common cognitive and neuropsychiatric problems in extremely preterm children and their special needs in school. Extremely preterm children therefore need follow up of lung function and neurodevelopment at least until school start.


Assuntos
Nascimento Prematuro , Assistência ao Convalescente/organização & administração , Transtorno do Espectro Autista/epidemiologia , Criança , Desenvolvimento Infantil , Pré-Escolar , Feminino , Humanos , Hipertensão/epidemiologia , Lactente , Lactente Extremamente Prematuro/crescimento & desenvolvimento , Recém-Nascido , Recém-Nascido Prematuro/crescimento & desenvolvimento , Pneumopatias/epidemiologia , Gravidez , Nascimento Prematuro/epidemiologia , Fatores de Risco , Tempo
8.
Psychiatr Hung ; 34(3): 300-310, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31570661

RESUMO

This paper aims to review previous findings on the developmental trajectory of core executive functions - attentional control, inhibition, mental shifting, cognitive flexibility, and working memory - in adolescence with special attention to age-related stress-sensitivity in this period. More simple abilities, like attentional control and inhibition, go through a dramatic maturation process between the ages of 10 and 11. This is followed by a final progress, and as a result, after age 13-15 years acute stress deteriorates attentional control performance less, or it may even improve it. Working memory matures later, around 14-15 years, and it reaches the adult level at 17 years. Concerning mental shifting and cognitive flexibility, more maturation points could be identified: word fluency usually reaches full maturation at the age of 13, semantic fluency between the ages of 17 and 18, and general flexibility around 18-19 years. Based on the reviewed papers we could see that acute stress affects executive functions differently during adolescence, depending on how these functions mature. Those functions which develop later, are more sensitive to stress during the entire period of adolescence, and reviewed studies show that acute stress has a deteriorating effect on these functions. At the same time, early matured inhibition and attentional control are enhanced by acute stress in the half of the studies. Other theories and methodological issues are also discussed. Keywords: attentional control; inhibition; shifting; working memory.


Assuntos
Desenvolvimento Infantil , Função Executiva , Psicologia do Adolescente , Estresse Psicológico , Adolescente , Criança , Humanos , Memória de Curto Prazo , Adulto Jovem
9.
Medicine (Baltimore) ; 98(39): e17305, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574858

RESUMO

Until now, the recognition of sodium taurocholate cotransporting polypeptide (NTCP) deficiency has been mainly based on sporadic case reports. It was previously believed to be mildly symptomatic and resulting in mild liver dysfunction. However, to our knowledge, there have been no reports about the histopathologic and ultrastructural pathologic characteristics of the disease. The aim of the study was to analyze the clinical, histopathologic and ultrastructural pathologic characteristics of NTCP deficiency in 13 pediatric patients.From August 2012 to October 2018, this retrospective study conducted in the Department of Pediatrics of Tongji Hospital, China analyzed the data of 13 NTCP deficient patients with an SLC10A1 gene mutation. Except for NTCP deficiency, no other liver diseases were present in the patients, which was determined by both a genetic testing panel for jaundice and by reviewing medical records. The laboratory results, imaging, histopathologic, and ultrastructural pathologic information were recorded for analysis.The serum level of total bile acid was high in all 13 patients. All patients had adequate growth and development. Eight of the patients (8/13) presented with visible jaundice and 12 (12/13) were found to have hyperbilirubinemia. A needle liver biopsy was performed in 11 cases, which revealed slightly chronic inflammation in all 11 patients. One of the patients (1/13) was found to be suffering from gallstones.The data showed that although NTCP deficiency was often asymptomatic, some of the patients showed obvious clinical expressions, such as jaundice. Among the 13 pediatric patients with NTCP deficiency, both the biochemical and histopathologic features were similar to those of mild hepatocellular jaundice. In addition, it was determined that the clinical features in the patient with gallstones may have been caused by NTCP deficiency.


Assuntos
Ácidos e Sais Biliares/sangue , Icterícia , Hepatopatias , Fígado , Transportadores de Ânions Orgânicos Dependentes de Sódio , Simportadores , Desenvolvimento Infantil , Pré-Escolar , China/epidemiologia , Testes Genéticos/métodos , Humanos , Biópsia Guiada por Imagem/métodos , Lactente , Icterícia/diagnóstico , Icterícia/etiologia , Fígado/metabolismo , Fígado/patologia , Hepatopatias/diagnóstico , Hepatopatias/genética , Hepatopatias/fisiopatologia , Hepatopatias/terapia , Testes de Função Hepática/métodos , Glicoproteínas de Membrana/metabolismo , Mutação , Transportadores de Ânions Orgânicos Dependentes de Sódio/deficiência , Transportadores de Ânions Orgânicos Dependentes de Sódio/genética , Pediatria/métodos , Estudos Retrospectivos , Simportadores/deficiência , Simportadores/genética
10.
N Engl J Med ; 381(17): 1644-1652, 2019 10 24.
Artigo em Inglês | MEDLINE | ID: mdl-31597037

RESUMO

Genome sequencing is often pivotal in the diagnosis of rare diseases, but many of these conditions lack specific treatments. We describe how molecular diagnosis of a rare, fatal neurodegenerative condition led to the rational design, testing, and manufacture of milasen, a splice-modulating antisense oligonucleotide drug tailored to a particular patient. Proof-of-concept experiments in cell lines from the patient served as the basis for launching an "N-of-1" study of milasen within 1 year after first contact with the patient. There were no serious adverse events, and treatment was associated with objective reduction in seizures (determined by electroencephalography and parental reporting). This study offers a possible template for the rapid development of patient-customized treatments. (Funded by Mila's Miracle Foundation and others.).


Assuntos
Proteínas de Membrana Transportadoras/genética , Mutagênese Insercional , Lipofuscinoses Ceroides Neuronais/tratamento farmacológico , Lipofuscinoses Ceroides Neuronais/genética , Oligonucleotídeos Antissenso/uso terapêutico , Medicina de Precisão , Doenças Raras/tratamento farmacológico , Biópsia , Criança , Desenvolvimento Infantil , Descoberta de Drogas , Drogas em Investigação/uso terapêutico , Eletroencefalografia , Feminino , Humanos , Testes Neuropsicológicos , RNA Mensageiro , Convulsões/diagnóstico , Convulsões/tratamento farmacológico , Pele/patologia , Sequenciamento Completo do Genoma
11.
Rev Lat Am Enfermagem ; 27: e3216, 2019.
Artigo em Inglês, Português, Espanhol | MEDLINE | ID: mdl-31664417

RESUMO

OBJECTIVE: To analyze the effectiveness of an educational intervention with mothers to stimulate children under two years of age at risk for neuropsychomotor development. METHOD: Before-after intervention study, conducted with 52 mothers of children under two years old, enrolled in reference centers in early childhood education. Initially, maternal knowledge regarding child development and stimulation was assessed through a structured instrument. Then, workshops were held with the mothers and, after three months, maternal knowledge was revised, reapplying the data collection instrument. In the analysis, descriptive and inferential statistics were used, applying the McNemar and Wilcoxon tests and the Rasch Model from the Item Response Theory. RESULTS: after the intervention, there was a significant increase in scores regarding the following aspects: knowledge of mothers about child development and stimulation from 5.77 ± 1.85 to 18.60 ± 1.94 (p <0.001); reduction of the maternal difficulty index in answering the instrument questions from 1.17 ± 0.57 to -1.98 ± 1.63 (p 0.01). CONCLUSION: the educational intervention contributed to the improvement of maternal knowledge regarding the development and forms of child stimulation, corroborating the importance of this action to advance the health of children at risk under maternal care at home.


Assuntos
Desenvolvimento Infantil , Conhecimentos, Atitudes e Prática em Saúde , Mães/educação , Adulto , Criança , Feminino , Humanos , Masculino , Fatores Socioeconômicos , Adulto Jovem
12.
ABCS health sci ; 44(2): 85-91, 11 out 2019. tab
Artigo em Português | LILACS | ID: biblio-1022335

RESUMO

INTRODUÇÃO: A prevalência da desnutrição infantil vem diminuindo em todo o mundo, mas ainda acomete milhões de crianças, especialmente indígenas. Devido ao elevado número de doenças infecciosas associadas à desnutrição, a antibioticoterapia faz parte da terapêutica recomendada. OBJETIVO: Observar os casos de desnutrição entre crianças indígenas e não indígenas hospitalizadas e a terapêutica empregada durante o tratamento. MÉTODOS: Estudo de coorte retrospectivo, farmacoepidemiológico, realizado com informações extraídas de prontuários arquivados do período de janeiro de 2012 a dezembro de 2014 de um hospital público. RESULTADOS: Participaram 166 crianças, sendo o número de crianças indígenas aproximadamente seis vezes maior do que não indígenas. Houve maior prevalência entre lactentes e crianças com idade inferior a um ano apresentaram mais chances de serem internadas por desnutrição. Os diagnósticos de desnutrição mais vistos foram os inespecíficos, com uma proporção significativa de óbitos relacionados ao diagnóstico E43. As infecções mais comuns foram do sistema digestório e respiratório. Crianças indígenas tiveram quase cinco vezes mais chances de apresentarem infecção respiratória. A maior proporção recebeu até três antibióticos, havendo crianças que receberam mais que sete antibióticos diferentes durante o período de internação. CONCLUSÃO: A população infantil deve ser acompanhada por meio de inquéritos que possam subsidiar políticas de saúde que atendam suas necessidades. É necessária a capacitação dos profissionais envolvidos no cuidado da criança desnutrida, recursos materiais e financeiros, a fim diminuir o número de diagnósticos inespecíficos e evitar o uso indiscriminado de antibióticos, sendo imprescindível uma política de controle efetiva no uso da politerapia antimicrobiana.


INTRODUCTION: The prevalence of child malnutrition is declining worldwide, but still affects millions of children, especially indigenous people. Due to the high number of infectious diseases associated with malnutrition, antibiotic therapy is part of the recommended therapy. OBJECTIVE: To observe the cases of malnutrition among hospitalized indigenous and non-indigenous children and the therapy used during treatment. METHODS: Retrospective cohort study, pharmacoepidemiological, carried out with information extracted from medical records filed from January 2012 to December 2014 of a public hospital. RESULTS: 166 children participated, with the number of indigenous children being approximately six times higher than that of nonindigenous children. There was a higher prevalence among infants and children under one year of age who were more likely to be hospitalized for malnutrition. The most frequent diagnoses of malnutrition were nonspecific, with a significant proportion of deaths related to diagnosis E43. The most common infections were of the digestive and respiratory system. Indigenous children were almost five times more likely to have respiratory infection. The highest proportion received up to three antibiotics, with children receiving more than seven different antibiotics during the hospitalization period. CONCLUSION: The child population must be accompanied by surveys that can subsidize health policies that meet their needs. It is necessary to train the professionals involved in the care of malnourished children, material and financial resources, in order to reduce the number of non-specific diagnoses and to avoid the indiscriminate use of antibiotics, a policy of effective control in the use of antimicrobial polytherapy is essential.


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Índios Sul-Americanos , Desenvolvimento Infantil/efeitos dos fármacos , Desnutrição , Saúde de Populações Indígenas , Antibacterianos/uso terapêutico , Resistência Microbiana a Medicamentos , Transtornos da Nutrição Infantil/tratamento farmacológico , Saúde da Criança , Farmacorresistência Bacteriana/efeitos dos fármacos
13.
Nutr. hosp ; 36(5): 1037-1042, sept.-oct. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-184623

RESUMO

Introduction: adolescents' health and nutritional status is demonstrated in the quality of their growth and development. Bone age (BA) is the skeletal development index, which reflects an individual's maturation and is considered as the best expression of human development. Poor nutritional conditions, which extend for long periods, may influence bone development, causing a delay in BA, in relation to chronological age (CA). The aim of this study is evaluating the relation between adolescents' body mass index and bone age. Methods: cross-sectional study carried out with 172 adolescents. The variables evaluated were body mass index (BMI), CA, BA and maturational stage. The BA was determined by taking digital carpal radiographs. Results: the majority of the adolescents presented an adequate nutritional state (73.9%), 42.5% were classified as initial pubertal, followed by 40.6% as in peak height velocity (PHV), with a difference between the sexes (p < 0.001). PHV adolescents presented higher BA averages in both sexes (p = 0.005). There was a correlation between BMI and BA, with a strong correlation for girls in the pre-pubertal stage (r = 0.998; p < 0.05) and moderate correlation for those in PHV (r = 0.421; p < 0.001). By analyzing the relation of the variables to predict adolescents' BA, it was observed that the CA model, maturational stage and BMI explained the variability noted in BA in up to 50.3%. Conclusion: BMI has a relation with BA. It should be noted that BA is influenced by CA, the maturational stage and BMI


Introducción: la salud y el estado nutricional de los adolescentes se manifiestan directamente en la calidad de su crecimiento y desarrollo. La edad ósea (EO) es el índice de desarrollo del esqueleto, que refleja la maduración del individuo y es considerada como la mejor expresión del estado del desarrollo humano. Las condiciones nutricionales deficientes que perduran durante largos periodos pueden influir en el desarrollo óseo, provocando retraso en la EO en relación a la edad cronológica (EC). El objetivo del estudio es evaluar la relación entre el índice de masa corpórea y la edad ósea de adolescentes. Métodos: estudio transversal realizado con 172 adolescentes. Las variables evaluadas fueron índice de masa corpórea (IMC), EC, EO y etapa de maduración sexual. La EO se determinó a partir de la realización de radiografías carpales de archivo digital. Resultados: la mayoría de los adolescentes presentaban un adecuado estado nutricional (73,9%), el 42,5% estaban clasificados como púber inicial, seguidos del 40,6% que fueron considerados en el pico de la velocidad de crecimiento (PVC), con diferencias entre sexos (p < 0,001). Los adolescentes en PVC presentaron mayores medias de EO, en ambos sexos (p = 0,005). Se observó una correlación entre IMC y EO, con fuerte correlación para las niñas en la etapa prepúber (r = 0,998; p < 0,05) y correlación moderada para aquellas en el PVC (r = 0,421; p < 0,001). Al analizar la relación de las variables para predecir la EO de los adolescentes, se observó que el modelo con IC, etapa maduracional e IMC fue capaz de explicar hasta en un 50,3% la variabilidad observada en la EO. Conclusión: el IMC presenta relación con la EO. Se resalta que en la EO influyen la EC, la etapa maduracional y el IMC


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Determinação da Idade pelo Esqueleto/métodos , Índice de Massa Corporal , Estado Nutricional , Desenvolvimento Infantil/fisiologia , Estudos Transversais , Maturidade Sexual , Análise de Variância , Modelos Lineares
15.
Lakartidningen ; 1162019 09 09.
Artigo em Sueco | MEDLINE | ID: mdl-31503320

RESUMO

In South Asia, maternal and child undernutrition is common with consequences for short- and long-term health. In the MINIMat trial (Maternal and Infant Nutrition Interventions in Matlab) in Bangladesh 4436 pregnant women were allocated to early or later start of food supplements and different micronutrient alternatives. Children of mothers who received food supplementation from week 9 combined with multiple micronutrients showed a halved infant mortality rate. The early initiation of prenatal food supplementation reduced the risk of stunting up to five years and was associated with more favourable metabolic markers. The MINIMat study is run by icddr,b in Bangladesh and Uppsala University in collaboration with seven other universities. Twenty Ph.D. students have so far defended their theses and more than 100 scientific papers have been published.


Assuntos
Suplementos Nutricionais , Mortalidade Infantil , Fenômenos Fisiológicos da Nutrição Materna , Micronutrientes/administração & dosagem , Adolescente , Adulto , Bangladesh , Biomarcadores/análise , Índice de Massa Corporal , Criança , Desenvolvimento Infantil , Pré-Escolar , Dieta , Status Econômico , Escolaridade , Feminino , Hemoglobinas/análise , Humanos , Lactente , Recém-Nascido , Paridade , Vigilância da População , Gravidez , Resultado da Gravidez , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores Socioeconômicos , Adulto Jovem
16.
Klin Padiatr ; 231(5): 262-268, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31505693

RESUMO

OBJECTIVE: The consumption of illegal substances during pregnancy is an increasing social and medical issue. Main substances of prenatal drug exposure are beside tehtrahydrocannabinol (THC), opioids and methamphetamine. The effect of these substances on the long-term development of children remains uncertain. METHODS: Since 2012 newborn infants born at the university hospital of children at Leipzig which were prenatal exposed to drugs were followed long-term at the out-patient clinic for child protection. For 42 children with prenatal opioid or methamphetamine exposure the developmentent was analysed using the Bayley Scales (BSID III) at the age of 2-3 years. The children were compared with 84 unexposed control children. One case matched to 2 controls, adapted by age, gender, gestational age and birth weight. RESULTS: Motoric development between prenatal methylamphetamine, opioid exposed children and the control group showed no significant difference. Methylamphetamine exposed children (n=23) At 2 exposure show significantly lower scores in cognition and language (79,1 compared 95,9 of the control group), opioid exposed children have a slight cognitive deficits with a medium score of 91,7 (n=19). 56% of the methamphetamine group were developmentally retarded at the measurement date. Additionally, children had significant lower Bayley Scores which had single parent and/ or low educational and professional qualifications of their caregiver. Both substances increased the risk of postnatal complications to 46-53% despite of similar gestational ages in all groups. CONCLUSION: Children with prenatal methamphetamine or opioid exposure seem to have cognition and language deficits at 2 and 3 years of age. Methamphetamine might have a higher negative effect than opioids. The psychosocial risk factors associated with parental drug abuse are important for achieving age-appropriate development.


Assuntos
Analgésicos Opioides/toxicidade , Desenvolvimento Infantil/efeitos dos fármacos , Cognição/efeitos dos fármacos , Metanfetamina/toxicidade , Atividade Motora/efeitos dos fármacos , Efeitos Tardios da Exposição Pré-Natal/induzido quimicamente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Comportamento do Lactente/efeitos dos fármacos , Comportamento do Lactente/psicologia , Recém-Nascido , Linguagem , Gravidez , Efeitos Tardios da Exposição Pré-Natal/fisiopatologia , Efeitos Tardios da Exposição Pré-Natal/psicologia
17.
BJOG ; 126(13): 1588-1597, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31529591

RESUMO

OBJECTIVE: To examine the association of prenatal alcohol exposure (PAE) on cognitive abilities and behaviour profiles of 4-year-old children. DESIGN: Prospective cohort study. SETTING: Cape Town, South Africa. POPULATION: A cohort of 500 children. METHODS: Children from the Safe Passage Study, which prospectively collected PAE, were included. Cognition and behavioural profiles were assessed. Children with and without PAE were compared. Mean scores were compared, with P ≤ 0.05 considered significant. Results were adjusted for confounding factors. MAIN OUTCOME MEASURES: The Kaufman Assessment Battery for children measured intellectual and mental ability; the NEPSY-II instrument assessed neurocognitive performance. The caregiver completed the Preschool Child Behaviour checklist to rate the child's problem behaviours and competencies. RESULTS: Two hundred children had no PAE, 117 children had mild to moderate PAE (with no binge episodes), 113 children had heavy PAE (with one or two binge episodes), and 70 children had very heavy PAE (with three or more binge episodes). Women who binge drank had significantly higher rates of smoking, marijuana use, and methamphetamine use. Low to moderate PAE had no effect on cognitive ability and behaviour. Very heavy PAE was associated with problems performing simultaneous as well as sequential functions, lower scores in the language and sensorimotor domain, and more attention and pervasive developmental problems. CONCLUSIONS: Low to moderate PAE was not associated with cognitive processing or developmental problems. Women who had many binge drinking episodes during pregnancy were the most at risk for cognitive processing, neurocognitive, and behaviour problems in their children at 4 years of age. TWEETABLE ABSTRACT: Low to moderate prenatal alcohol use was not associated with cognitive or behavioural problems in 4-year-olds.


Assuntos
Consumo de Bebidas Alcoólicas/efeitos adversos , Desenvolvimento Infantil/fisiologia , Transtornos do Neurodesenvolvimento/induzido quimicamente , Efeitos Tardios da Exposição Pré-Natal/induzido quimicamente , Pré-Escolar , Feminino , Seguimentos , Inquéritos Epidemiológicos , Humanos , Masculino , Transtornos do Neurodesenvolvimento/epidemiologia , Testes Neuropsicológicos , Gravidez , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Estudos Prospectivos , África do Sul/epidemiologia
19.
Cochrane Database Syst Rev ; 9: CD000371, 2019 09 11.
Artigo em Inglês | MEDLINE | ID: mdl-31508807

RESUMO

BACKGROUND: The World Health Organization (WHO) recommends treating all school children at regular intervals with deworming drugs in areas where helminth infection is common. Global advocacy organizations claim routine deworming has substantive health and societal effects beyond the removal of worms. In this update of the 2015 edition we included six new trials, additional data from included trials, and addressed comments and criticisms. OBJECTIVES: To summarize the effects of public health programmes to regularly treat all children with deworming drugs on child growth, haemoglobin, cognition, school attendance, school performance, physical fitness, and mortality. SEARCH METHODS: We searched the Cochrane Infectious Diseases Group Specialized Register; Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE; Embase; LILACS; the metaRegister of Controlled Trials (mRCT); reference lists; and registers of ongoing and completed trials up to 19 September 2018. SELECTION CRITERIA: We included randomized controlled trials (RCTs) and quasi-RCTs that compared deworming drugs for soil-transmitted helminths (STHs) with placebo or no treatment in children aged 16 years or less, reporting on weight, height, haemoglobin, and formal tests of cognition. We also sought data on other measures of growth, school attendance, school performance, physical fitness, and mortality. DATA COLLECTION AND ANALYSIS: At least two review authors independently assessed the trials for inclusion, risk of bias, and extracted data. We analysed continuous data using the mean difference (MD) with 95% confidence intervals (CIs). Where data were missing, we contacted trial authors. We stratified the analysis based on the background burden of STH infection. We used outcomes at time of longest follow-up. We assessed the certainty of the evidence using the GRADE approach. MAIN RESULTS: We identified 51 trials, including 10 cluster-RCTs, that met the inclusion criteria. One trial evaluating mortality included over one million children, and the remaining 50 trials included a total of 84,336 participants. Twenty-four trials were in populations categorized as high burden, including nine trials in children selected because they were helminth-stool positive; 18 with intermediate burden; and nine as low burden.First or single dose of deworming drugsFourteen trials reported on weight after a single dose of deworming drugs (4970 participants, 14 RCTs). The effects were variable. There was little or no effect in studies conducted in low and intermediate worm burden groups. In the high-burden group, there was little or no effect in most studies, except for a large effect detected from one study area in Kenya reported in two trials carried out over 30 years ago. These trials result in qualitative heterogeneity and uncertainty in the meta-analysis across all studies (I2 statistic = 90%), with GRADE assessment assessed as very low-certainty, which means we do not know if a first dose or single dose of deworming impacts on weight.For height, most studies showed little or no effect after a single dose, with one of the two trials in Kenya from 30 years ago showing a large average difference (2621 participants, 10 trials, low-certainty evidence). Single dose probably had no effect on average haemoglobin (MD 0.10 g/dL, 95% CI 0.03 lower to 0.22 higher; 1252 participants, five trials, moderate-certainty evidence), or on average cognition (1596 participants, five trials, low-certainty evidence). The data are insufficient to know if there is an effect on school attendance and performance (304 participants, one trial, low-certainty evidence), or on physical fitness (280 participants, three trials, very low-certainty evidence). No trials reported on mortality.Multiple doses of deworming drugsThe effect of regularly treating children with deworming drugs given every three to six months on weight was reported in 18 trials, with follow-up times of between six months and three years; there was little or no effect on average weight in all but two trials, irrespective of worm prevalence-intensity. The two trials with large average weight gain included one in the high burden area in Kenya carried out over 30 years ago, and one study from India in a low prevalence area where subsequent studies in the same area did not show an effect. This heterogeneity causes uncertainty in any meta-analysis (I2 = 78%). Post-hoc analysis excluding trials published prior to 2000 gave an estimate of average difference in weight gain of 0.02 kg (95%CI from 0.04 kg loss to 0.08 gain, I2 = 0%). Thus we conclude that we do not know if repeated doses of deworming drugs impact on average weight, with a fewer older studies showing large gains, and studies since 2000 showing little or no average gain.Regular treatment probably had little or no effect on the following parameters: average height (MD 0.02 cm higher, 95% CI 0.09 lower to 0.13 cm higher; 13,700 participants, 13 trials, moderate-certainty evidence); average haemoglobin (MD 0.01 g/dL lower; 95% CI 0.05 g/dL lower to 0.07 g/dL higher; 5498 participants, nine trials, moderate-certainty evidence); formal tests of cognition (35,394 participants, 8 trials, moderate-certainty evidence); school performance (34,967 participants, four trials, moderate-certainty evidence). The evidence assessing an effect on school attendance is inconsistent, and at risk of bias (mean attendance 2% higher, 95% CI 5% lower to 8% higher; 20,650 participants, three trials, very low-certainty evidence). No trials reported on physical fitness. No effect was shown on mortality (1,005,135 participants, three trials, low-certainty evidence). AUTHORS' CONCLUSIONS: Public health programmes to regularly treat all children with deworming drugs do not appear to improve height, haemoglobin, cognition, school performance, or mortality. We do not know if there is an effect on school attendance, since the evidence is inconsistent and at risk of bias, and there is insufficient data on physical fitness. Studies conducted in two settings over 20 years ago showed large effects on weight gain, but this is not a finding in more recent, larger studies. We would caution against selecting only the evidence from these older studies as a rationale for contemporary mass treatment programmes as this ignores the recent studies that have not shown benefit.The conclusions of the 2015 edition have not changed in this update.


Assuntos
Anti-Helmínticos/uso terapêutico , Helmintíase/tratamento farmacológico , Enteropatias Parasitárias , Estado Nutricional , Solo/parasitologia , Ganho de Peso , Peso Corporal , Criança , Desenvolvimento Infantil/efeitos dos fármacos , Cognição , Doenças Endêmicas , Humanos , Enteropatias Parasitárias/complicações , Enteropatias Parasitárias/tratamento farmacológico , Saúde Pública , Ensaios Clínicos Controlados Aleatórios como Assunto
20.
Rev. Bras. Saúde Mater. Infant. (Online) ; 19(3): 513-520, Jul.-Sept. 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1041086

RESUMO

Abstract Objectives: to compare the cognitive performance of schoolchildren born prematurely according to the presence of intracranial hemorrhage (ICH) during the neonatal period. Methods: a cross-sectional cohort study of schoolchildren between the ages of 6-8 years old, born prematurely with or without a history of neonatal ICH. Between January and December 2015, some children were followed up at the outpatient clinic of a tertiary hospital and underwent a cognitive evaluation by using the Wechsler Intelligence Scale for Children, Third Edition (WISC-III) and they were divided into two groups: those with no history of ICH (control group) and those with ICH (case group), confirmed by a transfontanelar ultrasound in the prenatal period. Results: 39 schoolchildren were included, 21 cases and 18 controls. There was no difference in gestational age or chronological age at evaluation between the groups. Also there was no significant difference in subtest scores between the groups. Conclusions: WISC-III evaluated the cognitive performance in children, born preterm, aged 6-8 years old, and had neonatal ICH did not differ from those of their peers without a history of ICH. These findings suggest that, in preterm infants, a neonatal diagnosis of ICH may not be associated with cognitive performance at school age and this should be investigated through a longitudinal study.


Resumo Objetivos: comparar o desempenho cognitivo de escolares, nascidos prematuramente, segundo a presença de hemorragia intracraniana (HIC) no período neonatal. Métodos: corte transversal de uma coorte de escolares com idade entre seis e oito anos que nasceram prematuramente e apresentaram ou não HIC, realizado entre janeiro e dezembro de 2015, acompanhados em ambulatório de seguimento de hospital terciário e submetidos à avaliação cognitiva, através da Escala de Inteligência Wechsler para Crianças-3ª edição (WISC-III), que foram divididos em dois grupos: sem HIC (grupo controle - GC) e com HIC (grupo de casos - GH) comprovada através de exame ultrassonográfico transfontanelar no período perinatal. Resultados: foram incluídos 39 escolares, 18 no GC e 21 no GH. Não se observou dife-rença entre os grupos quanto à idade gestacional e idade cronológica na qual eles foram avaliados. Não foi encontrada diferença estatística entre os grupos estudados nos valores dos subtestes. Conclusões: o desempenho cognitivo de crianças nascidas pré-termo que tiveram HIC não difere daquele que não a apresentaram quando avaliadas pelo WISC-III na faixa etária de seis a oito anos. Sugere-se que o diagnóstico neonatal de HIC pode não estar associado ao desempenho cognitivo de prematuros, na idade escolar, o que deverá ser investigado através de estudo longitudinal.


Assuntos
Humanos , Criança , Escalas de Wechsler , Recém-Nascido Prematuro , Cognição , Hemorragias Intracranianas , Desempenho Acadêmico , Desenvolvimento Infantil , Saúde da Criança , Estudos Transversais
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