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1.
Rev Prat ; 70(2): 215-217, 2020 Feb.
Artigo em Francês | MEDLINE | ID: mdl-32877144

RESUMO

Minor's medical information. In exercising parental authority, parents make medical treatment decisions on children's behalf. However, according to the French law, minors must receive clear medical informations and care-givers must seek their consent to treatment. In some situations, parental authority may be in conflict with child's will. This article examines legislative framework provided by the French law, to respect child's autonomy and situations in which parental authority is limited. In practice, the concept of child's 'best interests' remains the main key to resolve potential conflicts between parental authority and child's autonomy.


Assuntos
Menores de Idade , Pais , Criança , Humanos
2.
Rev Prat ; 70(2): 191-194, 2020 Feb.
Artigo em Francês | MEDLINE | ID: mdl-32877139

RESUMO

Preventing tobacco sales to minors. Since 2009, selling tobacco products in France to minors less than 18 years of age is forbidden by law, but this law is poorly enforced even though tobacco use mainly begins at adolescence. The aim of this study was to identify measures implemented by foreign countries leading to a better enforcement of tobacco sale ban to minors. The main measures are: organizing tobacco retailers training programs; using automated age-verification systems; requiring a valid photo ID from anyone who looks under the age of 25; developing communication campaigns directed to the general public in order to explain and promote age control for customers. Furthermore, in all studied countries, the only effective controls rely on "mystery shopping" with underage shoppers accompanied by dedicated inspectors, attempting to purchase tobacco products. In case of non-compliance with the law, these controls must lead to dissuasive financial as well as administrative penalties. In all studied countries, an efficient implementation of these measures has led to reduced tobacco sales to minors, and thus contributed to bring down underage smoking.


Assuntos
Menores de Idade , Tabaco , Adolescente , Comércio , França , Humanos , Fumar , Prevenção do Hábito de Fumar
3.
Pediatrics ; 146(Suppl 1): S25-S32, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32737229

RESUMO

In this article, I examine the role of minors' competence for medical decision-making in modern American law. The doctrine of parental consent remains the default legal and bioethical framework for health care decisions on behalf of children, complemented by a complex array of exceptions. Some of those exceptions vest decisional authority in the minors themselves. Yet, in American law, judgments of minors' competence do not typically trigger shifts in decision-making authority from adults to minors. Rather, minors' decisional capacity becomes relevant only after legislatures or courts determine that the default of parental discretion does not achieve important policy goals or protect implicated constitutional rights in a particular health care context and that those goals can best be achieved or rights best protected by authorizing capable minors to choose for themselves. It is at that point that psychological and neuroscientific evidence plays an important role in informing the legal inquiry as to whether minors whose health is at issue are legally competent to decide.


Assuntos
Tomada de Decisão Clínica , Competência Mental/legislação & jurisprudência , Menores de Idade/legislação & jurisprudência , Consentimento dos Pais/legislação & jurisprudência , Adolescente , Desenvolvimento do Adolescente , Criança , Desenvolvimento Infantil , Serviços de Saúde da Criança/legislação & jurisprudência , Educação Infantil , Bem-Estar da Criança/legislação & jurisprudência , Direitos Civis , Tomada de Decisão Clínica/ética , Família , Acesso aos Serviços de Saúde/legislação & jurisprudência , Humanos , Consentimento Informado por Menores/ética , Consentimento Informado por Menores/legislação & jurisprudência , Competência Mental/normas , Menores de Idade/psicologia , Relações Pais-Filho , Consentimento dos Pais/ética , Patient Self-Determination Act , Autonomia Pessoal , Procurador/legislação & jurisprudência , Recusa do Paciente ao Tratamento/legislação & jurisprudência , Estados Unidos
4.
Cuad. Hosp. Clín ; 61(1): [17], jul. 2020. ilus.
Artigo em Espanhol | LILACS, LIBOCS | ID: biblio-1118869

RESUMO

OBJETIVO: Probar una metodología de enseñanza-aprendizaje, instrumentos de medición y sistema de implementación de la ECOE en relación con lactancia materna, alimentación complementaria, crecimiento y consejería. MATERIAL Y MÉTODOS: Se estudió la adquisición de competencias sobre alimentación en menores de dos años en internos de pediatría aplicando la evaluación clínica objetiva estructurada (ECOE) antes y después del desarrollo de un proceso de enseñanza aprendizaje (PEA) estructurado. Se organizaron cuatro estaciones de evaluación de los aspectos centrales de alimentación y crecimiento, en un grupo de internos seleccionados al azar. RESULTADOS: Las cuatro estaciones de la ECOE se aplicaron sin dificultades antes y después del PEA. Los resultados mostraron una mejora en el rendimiento de los internos, de manera individual y de grupo; en este último las diferencias en la media fueron para alimentación complementaria pre 2,5 (DE 0,93) y post 5 (DE 2,39); consejería pre 5,75 (DE 1,49) y post 8,13 (DE 1,25); lactancia materna pre 12,63 (DE 2,5) y post 16,38 (DE 2) y velocidad de crecimiento pre 3,13 (DE 1,36) y post 3,38 (DE 0,92). Los resultados fueron estadísticamente significativos para los tres primeros rubros. CONCLUSIONES: En base a estos resultados se sugieren mejoras en el programa de enseñanza y se verifica la aplicabilidad de la ECOE en el internado del Hospital del Niño Dr. Ovidio Aliaga Uría.


OBJECTIVE: To test a teaching-learning methodology, measurement tools and OSCE implementation system in relation to breastfeeding, complementary feeding, growth and counseling. METHODOLOGY: The acquisition of competences was studied by applying objective structured clinical examination (OSCE) before and after the development of a structured teaching-learning process. Four assessment stations were organized considering central aspects on feeding and growth of children under two years of age, in a group of randomly selected students during medical internship. RESULTS: The four OSCE stations were applied without difficulties before and after the learning and teaching process. The results showed an improvement in the performance of interns, individually and in groups; in the latter, mean differences were: for complementary feeding pre 2.5 (SD 0.93) and post 5 (SD 2.39); counseling pre 5.75 (SD 1.49) and post 8.13 (SD 1.25); breastfeeding pre 12.63 (SD 2.5) and post 16.38 (SD 2) and growth velocity pre 3.13 (SD 1.36) and post 3.38 (SD 0.92). The results were statistically significant for the first three items. CONCLUSIONS: Based on these results, the authors suggest improvements in the teaching program, and verify the applicability of the OSCE for the evaluation of rotatory internship at the Hospital del Nino Dr. Ovidio Aliaga Uria.


Assuntos
Humanos , Lactente , Aleitamento Materno , Menores de Idade , Internato e Residência , Ensino , Aprendizagem , Métodos
5.
Soins ; 65(843-844): 28-29, 2020.
Artigo em Francês | MEDLINE | ID: mdl-32563503

RESUMO

People of all ages leave their own country to migrate to France. Isolated foreign minors are received and assisted by France Terre d'Asile an association promoting human rights and providing support to people in need of protection. This article looks back on the experience of two young minors.


Assuntos
Menores de Idade , Apoio Social , Migrantes , França , Direitos Humanos , Humanos
6.
Av. enferm ; 38(1): 46-54, ene.-abr. 2020. tab, graf
Artigo em Português | LILACS, BDENF - Enfermagem, COLNAL | ID: biblio-1089009

RESUMO

Resumo Objetivo: Analisar a evolução temporal das hospitalizações, de crianças menores de cinco anos, por condições sensíveis à atenção primária em Teresina-PI, Brasil, de 2003 a 2012. Método: Trata-se de estudo retrospectivo, descritivo e quantitativo, realizado a partir de dados secundários extraídos da Rede Interagencial de Informações para a Saúde, disponíveis no sítio eletrônico do Departamento de Informática do Sistema Único de Saúde. As hospitalizações foram analisadas em dois grupos etários: crianças menores de um ano de idade e crianças entre um e quatro anos de idade. Resultados: Apesar das flutuações no período analisado, a taxa de hospitalizações teve um decréscimo de 71,88 %. Em crianças menores de um ano, o declínio foi de 7149 % e, com idade entre um e quatro anos, a redução foi de 72,30 %. A maioria das hospitalizações ocorreu no sexo masculino, e as causas que predominaram foram gastroenterites infecciosas e pneumonias bacterianas. Conclusões: As hospitalizações por condições sensíveis à atenção primária tiveram um declínio ao longo da década analisada, entretanto houve um predomínio de condições sensíveis que poderiam ser evitadas ou até mesmo solucionadas se fossem aplicadas as medidas disponíveis e de baixo custo nos serviços primários de saúde.


Resumen Objetivo: Analizar la evolución temporal de las hospitalizaciones de niños menores de cinco años por condiciones asociadas a la atención primaria en Teresina-PI, de 2003 a 2012. Método: Estudio retrospectivo, descriptivo y cuantitativo basado en datos secundarios extraídos de la Red Interagencial de Información para la Salud, disponibles en el sitio web del Departamento de Informática del Sistema Único de Salud de Brasil. Se analizaron las hospitalizaciones en dos grupos de edad: niños menores de un año y niños entre uno y cuatro años. Resultados: A pesar de las fluctuaciones en el periodo de estudio las tasas de hospitalización se redujeron en un 71,88 %. En niños menores de un año la disminución fue del 71,49 % y en la edad entre uno y cuatro años fue del 72,30 %. La mayoría de las hospitalizaciones ocurrieron en hombres y las causas predominantes fueron la gastroenteritis infecciosa y la neumonía bacteriana. Conclusiones: Las hospitalizaciones por condiciones asociadas a la atención primaria tuvieron una reducción a lo largo de la década analizada. Sin embargo, hubo predominio de condiciones que se podrían evitar o incluso solucionar si se aplicaran las medidas disponibles y de bajo costo en los servicios de atención primaria.


Abstract Objective: To analyze a temporal evolution of hospitalizations of children under five years of age, affected by conditions associated with primary care in Teresina-PI, from 2003 to 2012. Method: This is a retrospective, descriptive and quantitative study, based on extracted secondary data of the Interagency Network of Health Information, available on the website of the Department of Informatics of the Unified Health System. The hospitalizations were analyzed in two age groups: children under one year of age and children between one and four years of age. Results: Despite fluctuations in the analyzed period, hospitalization rates decreased by 71.88 %. In children under one year the decrease was 71.49 % and the age between one and four years the reduction was 72.30 %. Most hospi-talizations occurred in males, and the causes that prevailed were infectious gastroenteritis and bacterial pneumonia. Conclusions: Hospitalizations for conditions associated with primary care presented a decline over the analyzed decade. However, there was a predominance of conditions that could have been avoided or even resolved by applying available and low-cost measures in primary health services.


Assuntos
Lactente , Pré-Escolar , Atenção Primária à Saúde , Criança , Saúde da Criança , Menores de Idade , Hospitalização
7.
PLoS Med ; 17(3): e1003076, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32231358

RESUMO

BACKGROUND: Information regarding the prevalence of infectious diseases (IDs) in child and adolescent refugees in Europe is scarce. Here, we evaluate a standardized ID screening protocol in a cohort of unaccompanied refugee minors (URMs) in a municipal region of southwest Germany. METHODS AND FINDINGS: From January 2016 to December 2017, we employed a structured questionnaire to screen a cohort of 890 URMs. Collecting sociodemographic information and medical history, we also performed a standardized diagnostics panel, including complete blood count, urine status, microbial stool testing, tuberculosis (TB) screening, and serologies for hepatitis B virus (HBV) and human immunodeficiency virus (HIV). The mean age was 16.2 years; 94.0% were male, and 93.6% originated from an African country. The most common health complaints were dental problems (66.0%). The single most frequent ID was scabies (14.2%). Of the 776 URMs originating from high-prevalence countries, 7.7% and 0.4% tested positive for HBV and HIV, respectively. Nineteen pathogens were detected in a total of 119 stool samples (16.0% positivity), with intestinal schistosomiasis being the most frequent pathogen (6.7%). Blood eosinophilia proved to be a nonspecific criterion for the detection of parasitic infections. Active pulmonary TB was identified in 1.7% of URMs screened. Of note, clinical warning symptoms (fever, cough >2 weeks, and weight loss) were insensitive parameters for the identification of patients with active TB. Study limitations include the possibility of an incomplete eosinophilia workup (as no parasite serologies or malaria diagnostics were performed), as well as the inherent selection bias in our cohort because refugee populations differ across Europe. CONCLUSIONS: Our study found that standardized ID screening in a URM cohort was practicable and helped collection of relevant patient data in a thorough and time-effective manner. However, screening practices need to be ameliorated, especially in relation to testing for parasitic infections. Most importantly, we found that only a minority of infections were able to be detected clinically. This underscores the importance of active surveillance of IDs among refugees.


Assuntos
Doenças Transmissíveis/epidemiologia , Programas de Rastreamento/estatística & dados numéricos , Menores de Idade/estatística & dados numéricos , Refugiados/estatística & dados numéricos , Adolescente , África/etnologia , Doenças Transmissíveis/etiologia , Estudos Transversais , Feminino , Alemanha/epidemiologia , Humanos , Masculino , Prevalência
8.
Pediatrics ; 145(5)2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32321778

RESUMO

BACKGROUND AND OBJECTIVES: A previous single-county study found that retail stores usually asked young-looking tobacco customers to show proof-of-age identification, but a large proportion of illegal tobacco sales to minors occurred after the customers had shown identification proving they were too young to purchase tobacco. We sought to investigate these findings on a larger scale. METHODS: We obtained state reports for federal fiscal years 2017 and 2018 from a federal agency that tracks tobacco sales to supervised minors conducting compliance checks in retail stores. We used descriptive and multivariable logistic regression methods to determine (1) how often stores in 17 states requested identifications, (2) what proportion of violations occurred after identification requests, and (3) if violation rates differed when minors were required versus forbidden to carry identification. RESULTS: Stores asked minors for identification in 79.6% (95% confidence interval: 79.3%-80.8%) of compliance checks (N = 17 276). Violations after identification requests constituted 22.8% (95% confidence interval: 20.0%-25.6%; interstate range, 1.7%-66.2%) of all violations and were nearly 3 times as likely when minors were required to carry identification in compliance checks. Violations were 42% more likely when minors asked for a vaping product versus cigarettes. CONCLUSIONS: Stores that sell tobacco to underage customers are more likely to be detected and penalized when youth inspectors carry identification during undercover tobacco sales compliance checks. The new age-21 tobacco sales requirement presents an opportunity to require identifications be carried and address other long-standing weaknesses in compliance-check protocols to help combat the current adolescent vaping epidemic.


Assuntos
Comércio/legislação & jurisprudência , Menores de Idade/psicologia , Registros/legislação & jurisprudência , Produtos do Tabaco/legislação & jurisprudência , Adolescente , Comércio/normas , Feminino , Humanos , Masculino , Registros/normas , Produtos do Tabaco/normas , Estados Unidos/epidemiologia
11.
Neuropsychiatr ; 34(1): 15-21, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32002764

RESUMO

Little research has been performed so far on the mental health state of grieving and recently traumatized children. "The Buoy" ("Die Boje"), a low threshold ambulatory provides non-bureaucratic help and short time psychotherapy to children and adolescents in need of professional support at no charge and treats about 1400 minors per year. Whilst performing a study on these patients with special regard to their social network, we found the process of recruitment to be extraordinarily challenging. Only about 25% of the eligible patients could be recruited successfully within during the period of one year. In this paper we try to examine the barriers we had to overcome in gaining access to the sensitive field of grieving and traumatized children and adolescents who rely on low threshold psychotherapeutic and neuropsychiatric support and analyze the factors leading to the high number of dropouts. In addition, the consequences for our results will be discussed.


Assuntos
Intervenção na Crise , Saúde Mental , Menores de Idade/psicologia , Trauma Psicológico/psicologia , Trauma Psicológico/terapia , Psicoterapia , Adolescente , Criança , Feminino , Pesar , Humanos , Masculino
12.
MMWR Morb Mortal Wkly Rep ; 69(7): 189-192, 2020 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-32078593

RESUMO

Raising the minimum legal sales age (MLSA) for tobacco products to 21 years (T21) is a strategy to help prevent and delay the initiation of tobacco product use (1). On December 20, 2019, Congress raised the federal MLSA for tobacco products from 18 to 21 years. Before enactment of the federal T21 law, localities, states, and territories were increasingly adopting their own T21 laws as part of a comprehensive approach to prevent youth initiation of tobacco products, particularly in response to recent increases in use of e-cigarettes among youths (2). Nearly all tobacco product use begins during adolescence, and minors have cited social sources such as older peers and siblings as a common source of access to tobacco products (1,3). State and territorial T21 laws vary widely and can include provisions that might not benefit the public's health, including penalties to youths for purchase, use, or possession of tobacco products; exemptions for military populations; phase-in periods; and preemption of local laws. To understand the landscape of U.S. state and territorial T21 laws before enactment of the federal law, CDC assessed state and territorial laws prohibiting sales of all tobacco products to persons aged <21 years. As of December 20, 2019, 19 states, the District of Columbia (DC), Guam, and Palau had enacted T21 laws, including 13 enacted in 2019. Compared with T21 laws enacted during 2013-2018, more laws enacted in 2019 have purchase, use, or possession penalties; military exemptions; phase-in periods of 1 year or more; and preemption of local laws related to tobacco product sales. T21 laws could help prevent and reduce youth tobacco product use when implemented as part of a comprehensive approach that includes evidence-based, population-based tobacco control strategies such as smoke-free laws and pricing strategies (1,4).


Assuntos
Comércio/legislação & jurisprudência , Menores de Idade/legislação & jurisprudência , Produtos do Tabaco/legislação & jurisprudência , Humanos , Estados Unidos
13.
Am J Public Health ; 110(3): 351-353, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31944836

RESUMO

Objectives. To estimate the percentage of Texas judicial bypass petitions for abortion denied annually from 2001 to 2018, and to assess whether that fraction changed after the state's 2016 bypass process change.Methods. Because official statistics on Texas judicial bypass case counts and outcomes are only available for 2016 and later, we systematically reviewed monthly internal reports from Jane's Due Process (JDP), an organization providing legal representation to pregnant minors seeking bypass from 2001 to 2018. We report numbers and percentages of JDP cases denied for 2001 to 2018 and numbers and percentages of all cases denied from official Texas statistics for 2016 to 2018 (all available years).Results. At least 1 denial occurred in 11 out of 15 years observed before the bypass law changed in Texas (percentages = 0%-6.2%). After Texas made its bypass process more restrictive, the percentage denied increased (from 2.8% in 2015 to 10.3% in 2016 among JDP cases).Conclusions. We found the greatest percentages of judicial bypass for abortion petitions denied after the policy was implemented and after the bypass process changed. Judicial bypass for abortion may expose pregnant minors to judicial veto of their abortion decision.


Assuntos
Aborto Legal/legislação & jurisprudência , Função Jurisdicional , Menores de Idade/legislação & jurisprudência , Adolescente , Feminino , Humanos , Consentimento dos Pais/legislação & jurisprudência , Gravidez , Texas
14.
Clin Child Psychol Psychiatry ; 25(1): 213-226, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31315450

RESUMO

There are high rates of post-traumatic stress disorder (PTSD) in unaccompanied asylum-seeking minors (UAM) and there is a requirement for feasible, acceptable and evidence-based treatments. Narrative Exposure Therapy (NET) is a short-term treatment for PTSD following multiple traumatic events. This article aims to examine the applicability of NET for UAM in routine clinical practice and to provide preliminary feasibility, acceptability and effectiveness data. The participants were four UAM receiving NET within a dedicated child and adolescent mental health service for refugee children. Semi-structured interviews were conducted to understand the acceptability of this approach and standardised measures of PTSD were used to provide preliminary data regarding the effectiveness of NET for these clients. The clients attended NET consistently with few missed appointments. At post-treatment, two clients' symptom scores were below the clinical cut-off for PTSD and all three clients who completed NET met reliable improvement criteria. The clients reported improvements in functional outcomes and mentioned that they would encourage other young people with similar difficulties to engage in NET. This study was limited by the small sample size and naturalistic time limitations in clinicians' contracts. This article highlights that it is possible to implement NET within routine clinical practice and observed improvements in PTSD symptoms and functional outcomes for UAM.


Assuntos
Terapia Implosiva , Menores de Idade/psicologia , Terapia Narrativa , Refugiados/psicologia , Transtornos de Estresse Pós-Traumáticos/terapia , Adolescente , Prática Clínica Baseada em Evidências , Estudos de Viabilidade , Feminino , Humanos , Masculino , Projetos Piloto , Transtornos de Estresse Pós-Traumáticos/psicologia , Resultado do Tratamento
16.
Soins Psychiatr ; 40(324): 12-17, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31623800

RESUMO

Unaccompanied minors are particularly vulnerable due to their pathway marked with multiple bereavements and constant uprooting. They find themselves confronted with the ordeal of mistrust due to administrative contradictions between the need to protect and immigration control. They are particularly at risk of developing psychiatric pathologies. Care must be multidisciplinary and in continuity with the educational support, taking into account the young person's original culture.


Assuntos
Criança Abandonada , Menores de Idade , Determinação de Necessidades de Cuidados de Saúde , Refugiados , Adolescente , Criança , Humanos
17.
Soins Psychiatr ; 40(324): 18-20, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31623801

RESUMO

"Care is increasingly absent from the pathway of unaccompanied minors". Legal experts of the French ombudsperson work with professionals supporting unaccompanied minors on different levels. They can also have a watchdog role with legislative authorities and judicial bodies. They note in particular increasing difficulty for these youngsters in accessing appropriate care. Interview with Nathalie Lequeux, legal expert and coordinator at the French children's rights centre.


Assuntos
Criança Abandonada , Acesso aos Serviços de Saúde/legislação & jurisprudência , Menores de Idade , Refugiados , Adolescente , Criança , França , Humanos
18.
Soins Psychiatr ; 40(324): 21-24, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31623802

RESUMO

Emergency psychiatric units are receiving more and more foreign unaccompanied minors: for many of these young people it is their first contact with psychiatric services. This context of crisis crystallises the administrative and legal paradoxes at work in the support of these youngsters. Coordination between emergency care, statutory bodies and community-based care enables stability to be established while the care project is being set up.


Assuntos
Criança Abandonada/psicologia , Serviço Hospitalar de Emergência , Transtornos Mentais/terapia , Menores de Idade/psicologia , Unidade Hospitalar de Psiquiatria , Refugiados/psicologia , Adolescente , Criança , Humanos
19.
Soins Psychiatr ; 40(324): 25-28, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31623803

RESUMO

Pregnancy and motherhood are additional ordeals for young unaccompanied girls, a particularly vulnerable section of the population. They are marked by the revival of the traumatic valence, the need to reconstruct themselves through the pregnancy and the importance of establishing a relationship of trust with the professionals supporting them. A qualitative study was carried out through the prism of the perspective of these professionals.


Assuntos
Cuidadores/psicologia , Criança Abandonada , Menores de Idade , Refugiados , Adolescente , Criança , Feminino , Humanos , Gravidez , Pesquisa Qualitativa
20.
Soins Psychiatr ; 40(324): 29-32, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31623804

RESUMO

Many unaccompanied minors in the care of children's welfare services are housed in a children's home after their assessment. Adapting to this living environment means going from a high level of autonomy to being subject to certain rules, as well as giving oneself permission to settle and accept the support of the educational setting. Care is an important aspect of a children's home: the body is an indicator of the health of these youngsters.


Assuntos
Criança Abandonada/psicologia , Cuidados no Lar de Adoção/psicologia , Serviços de Saúde Mental , Menores de Idade/psicologia , Refugiados/psicologia , Criança , Humanos
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