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2.
Soins Pediatr Pueric ; 40(309): 44-46, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31331602

RESUMO

Teleconsultations facilitating access to care, offer undeniable added value to the digital care pathway of children with multiple disabilities. This innovation transforms and enhances practices and collaboration methods between healthcare, medico-social and private practice professionals. An interview with Monique Bredillot, general care coordinator for CESAP, the committee for studies, education and care for people with multiple disabilities.


Assuntos
Serviços de Saúde da Criança/organização & administração , Crianças com Deficiência , Acesso aos Serviços de Saúde , Consulta Remota , Criança , Humanos
4.
BMC Public Health ; 19(1): 839, 2019 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-31248395

RESUMO

BACKGROUND: The main objective of this study was to explore the contextual determinants of child health policies. METHODS: The Horizon 2020 Models of Child Health Appraised (MOCHA) project has one Country Agent (CA) in all 30 EU and EEA countries. A questionnaire designed by MOCHA researchers as a semi-structured survey instrument asked CAs to identify and report the predominating public and professional discussions related to child health services within the last 5 years in their country and the various factors which may have influenced these. The survey was issued to CAs following validation by an independent Expert Advisory Board. The data were collected between July and December 2016. The data was qualitatively analysed using software Nvivo11 for data coding and categorization and constructing the scheme for identified processes or elements. RESULTS: Contextual determinants of children's health care and policy were grouped into four categories. 1) Socio-cultural determinants: societal activation, awareness, communication, trust, freedom, contextual change, lifestyle, tolerance and religion, and history. 2) Structural determinants which were divided into: a) external determinants related to elements indirectly correlated with health care and b) internal determinants comprising interdependent health care and policy processes. 3) International determinants such as cross-nationality of child health policy issues. 4) The specific situational determinants: events which contributed to intensification of debates which were reflected by behavioural, procedural, institutional and global factors. CONCLUSIONS: The influence of context across European countries, in the process of children's health policy development is clearly evident from our research. A number of key categories of determinants which influence child health policy have been identified and can be used to describe this context. Child health policy is often initiated in reaction to public discontentment. The multiple voices of society resulted, amongst others, in the introduction of new procedures, action plans and guidelines; raising levels of awareness, intensifying public scrutiny, increasing access and availability of services and provoking introduction of structural changes or withdrawing unfavourable changes.


Assuntos
Saúde da Criança , Política de Saúde , Formulação de Políticas , Criança , Serviços de Saúde da Criança , Europa (Continente) , Humanos , Pesquisa Qualitativa , Inquéritos e Questionários
5.
Sante Publique ; Vol. 31(1): 165-175, 2019 January February.
Artigo em Francês | MEDLINE | ID: mdl-31210511

RESUMO

OBJECTIVE: Community Health Workers (CHWs) were promoted in Benin to improve maternal and child health care (MCH). To improve community health workers' performance, a Quality Improvement Team (QIT) was set up to reinforce CHW capacities. The objective of this work is to present an assessment of QIT's contribution to CHW's performance and MCH coverage in the municipality of Savè. METHODOLOGY: The design of the study includes a pre- and post- analysis. Data were extracted from CHWs' activity reports and routine health information systems from 2011 to 2014 in 22 health facilities. Individual in-depth interviews were also performed with some key informants. The performance of CHW and the MCH indicators were determined according to the National Community Health Policy. RESULTS: The QIT improved Community Health Workers' performance and maternal and child health indicators in Savè. Educational sessions, skilled delivery care coverage, percentage of newborn seen over twice a week, percentage of children treated according national standards, percentage of children fully immunized, percentage of women using family planning methods were increased. CONCLUSION: The establishment of QIT improved CHW's performance and the use of maternal and child health services in Savè. This strategy could be useful for community-based surveillance.


Assuntos
Agentes Comunitários de Saúde/organização & administração , Serviços de Saúde Materno-Infantil/organização & administração , Melhoria de Qualidade/organização & administração , Benin , Criança , Saúde da Criança , Serviços de Saúde da Criança/organização & administração , Serviços de Saúde da Criança/normas , Agentes Comunitários de Saúde/normas , Feminino , Humanos , Recém-Nascido , Serviços de Saúde Materno-Infantil/normas
6.
Lima; Perú. Ministerio de Salud; 20190600. 37 p. tab, ilus.
Monografia em Espanhol | LILACS, LIPECS | ID: biblio-1005180

RESUMO

Contribuir a la conservación de la salud de la población infantil y prevenir precoz y oportunamente la morbilidad, discapacidad y mortalidad mediante la detección de alteraciones metabólicas, auditivas y visuales en la etapa neonatal, favoreciendo el adecuado desarrollo infantil temprano en el país.


Assuntos
Desenvolvimento Infantil , Triagem Neonatal , Normas Técnicas , Serviços de Saúde da Criança
7.
Harefuah ; 158(5): 309-312, 2019 May.
Artigo em Hebraico | MEDLINE | ID: mdl-31104391

RESUMO

BACKGROUND: Papua New Guinea (PNG) is a young nation. It has been independent since 1975. It consists of more than 290 inhabited islands, and its people speak more than 800 different languages. The GDP per capita is $2100, and only 4.3% is spent on health care. Government services are scarce in remote islands. It is a tropical country, with many tropical diseases. YWAM Medical Ships - Australia is a Christian charity that is actively developing communities by addressing health care and training needs in PNG in partnership with the relevant national and provincial government administrations. The program is guided by the PNG's National Health Plan: 2011- 2020. METHODS: As part of this effort YWAM runs the YWAM PNG, a large hospital ship that serves the remote parts of the country. The services provided include mentoring and support of local health care teams, eye surgery, dentistry, and three mobile teams that include primary health care, mother and child care, childhood immunizations, physiotherapy, optometry and health education The Israeli Ministry for Foreign Affairs signed a joint declaration of intent (DOI) with YWAM last year. The DOI outlines the Ministry for Foreign Affairs commitment to encourage Israeli medical professionals to volunteer onboard the MV YWAM PNG, in rural and remote areas of PNG. RESULTS: This paper summarizes the experience of four infectious diseases specialists on board. The main infections observed were malaria, tuberculosis, tropical ulcers and filariasis. CONCLUSIONS: The exposure to primary care in a remote part of the world is an emotional, personal and professional experience which can benefit the population the ship serves, as well as the volunteers, for whom the outreach on the ship is a memorable experience.


Assuntos
Assistência à Saúde , Atenção Primária à Saúde , Voluntários , Austrália , Criança , Serviços de Saúde da Criança , Humanos , Israel , Papua Nova Guiné
8.
Anaesth Intensive Care ; 47(2): 189-192, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31088128

RESUMO

Follow-up for ongoing management and monitoring of patients is important in clinical practice and research. While common, telephone follow-up is resource intensive and, in our experience, yields low success rates. Electronic communication using mobile devices including smartphones and tablets can provide efficient alternatives - including SMS (text), online forms and mobile apps. To assess attitudes towards electronic follow-up, we surveyed 642 parents and carers at Perth Children's Hospital, targeting demographics, device ownership and attitudes towards electronic follow-up. Mobile phone ownership was effectively universal. Almost all respondents were happy to communicate electronically with the hospital. Promisingly, 93.2% of respondents were happy to receive follow-up SMSs from the hospital and 80.3% were happy to reply to SMS questions. There was less enthusiasm regarding other modalities, with 59.9% happy to use a website and 69.0% happy to use a mobile app. The results support the introduction of electronic communication for follow-up in our paediatric population.


Assuntos
Telefone Celular , Serviços de Saúde da Criança , Aplicativos Móveis , Pais , Austrália , Criança , Seguimentos , Humanos , Pediatria , Inquéritos e Questionários
9.
BMC Health Serv Res ; 19(1): 324, 2019 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-31117997

RESUMO

BACKGROUND: Technological advances in health care currently provide better care conditions and have increased survival rates of premature infants, along with increasing the life expectancy of chronically ill children. In this context, the home care service has emerged as an effective tool for the treatment of this group of children. Thus, this preliminary study aimed at evaluating the effectiveness of the Home Care Service (HCS) with regard to pediatric care. METHODS: A cross-sectional study was performed through a medical record analysis of a tertiary hospital in Minas Gerais/Brazil. Two groups were compared: 36 patients from the HCS (home group) and 13 patients hospitalized with an indication for home care (hospital group). To analyze the effectiveness of HCS, we evaluated the number of readmissions, infection rate, number of procedures, and optimization of beds. RESULTS: The hospital group presented 6.04 times more infections and was submitted to 6.43 times more procedures. The home group presented lower readmission rates; with 41.66% of children studied not being readmitted and 76.19% of those who needed readmissions did so after more than 30 days from hospital discharge. HCS optimized hospital beds and allowed, over five (5) years, the hospitalization of around 102 patients in the hospital studied. CONCLUSION: In this preliminary study, HCS reduced the number of procedures and infections compared to hospitalized patients. Moreover, HCS presented lower readmission rates and optimized hospital beds, which could be considered an indication of effectiveness.


Assuntos
Serviços de Assistência Domiciliar/normas , Hospitalização/estatística & dados numéricos , Infecção/terapia , Brasil/epidemiologia , Criança , Serviços de Saúde da Criança/estatística & dados numéricos , Doença Crônica , Estudos Transversais , Testes Diagnósticos de Rotina/estatística & dados numéricos , Feminino , Humanos , Lactente , Infecção/epidemiologia , Masculino , Alta do Paciente/estatística & dados numéricos , Readmissão do Paciente/estatística & dados numéricos
10.
Einstein (Sao Paulo) ; 17(3): eAO4412, 2019 May 16.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31116228

RESUMO

OBJECTIVE: To analyze frequency, age and time trend of complementary feeding introduction in infants. METHODS: Retrospective study of infants' data evaluated at nutrition sector of Programa de Atenção aos Bebês of Programa Einstein na Comunidade de Paraisópolis from 2012 to 2015. Survival analyzes were performed, and the outcome considered was the time until the introduction of each specific food. RESULTS: Participants were 700 infants, with 5.5 months of median age. Water was the most consumed supplement (80.0%), followed by infant formula (64.1%) and juice (51.1%). Regarding the beginning of complementary feeding, water, infant formula and tea were the first to be introduced, with a median age of 3 months. It is noteworthy that almost one-fifth of the infants had already received processed foods. Water introduction proportions showed a significant tendency to increase over the years, and among infants at 6 months of age, varied from 72.8%, in 2012, to 91.1%, in 2015. The introduction of processed food category items presented a significant trend of change, showing, however, a reduction from 30.8%, in 2012, to 15.6%, in 2015, in this same age group. Among the processed foods, flour based thickeners (36.3%) and biscuits (26.3%) presented the highest proportions of consume. CONCLUSION: Water and infant formula were the most widely consumed and early introduced foods. Among the studied years, water introduction presented a significant tendency to increase and processed foods category to reduce consumption.


Assuntos
Fenômenos Fisiológicos da Nutrição do Lactente , Serviços de Saúde da Criança , Aconselhamento , Humanos , Lactente , Estudos Retrospectivos
11.
J Glob Health ; 9(1): 0010503, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31131105

RESUMO

Background: Diarrhea is the second leading cause of infectious deaths in children under-five globally. Oral rehydration salts (ORS) and zinc could avert an estimated 93% of deaths, but progress to increase coverage of these interventions has been largely stagnant over the past several decades. The Clinton Health Access Initiative (CHAI), along with donors and country governments in India, Kenya, Nigeria, and Uganda, implemented programs to scale-up ORS and zinc coverage from 2012 to 2016. The programs sought to demonstrate that increases in pediatric diarrhea treatment rates are possible at scale in high-burden settings through a holistic approach addressing both supply and demand barriers. We describe the overall program model and the activities undertaken in each country. The overall goal of the paper is to share the program results and lessons learned to inform other countries aiming to scale-up ORS and zinc. Methods: We used a triangulation approach, using population-based household surveys, public facility audits, and private outlet surveys, to evaluate the program model. We used pre- and post-program population-based household survey data to estimate the changes in coverage of ORS and zinc for treatment of diarrhea cases in children under-five in program areas. We also conducted secondary analysis of Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS) surveys in surrounding regions and compared annual coverage changes in the CHAI-supported program geographies to the surrounding regions. Results: Across CHAI-supported focal geographies, the average ORS coverage across the program areas increased from 35% to 48% and combined ORS and zinc coverage increased from 1% to 24%. ORS coverage increases were statistically significant in the program states in India, from 22% (95% confidence interval CI = 21-23%) to 48% (95% CI = 47-50%) and program states in Nigeria, from 38% (95% CI = 32-40%) to 55% (95% CI = 51-58%). For combined ORS and zinc, coverage increases were statistically significant in all program geographies. Compared to surrounding regions, the estimated annual changes in combined ORS and zinc coverage were greater in program geographies. Using the Lives Saved Tool and based on the coverage changes during the program period, we estimated 76 090 diarrheal deaths were averted in the program geographies. Conclusions: Increasing ORS and zinc coverage at scale in high-burden countries and states is possible through a comprehensive approach that targets both demand and supply barriers, including pricing, optimal product qualities, provider dispensing practices, stocking rates, and consumer demand.


Assuntos
Serviços de Saúde da Criança/organização & administração , Diarreia/terapia , Hidratação/estatística & dados numéricos , Zinco/administração & dosagem , Pré-Escolar , Efeitos Psicossociais da Doença , Diarreia/epidemiologia , Saúde Global , Humanos , Lactente , Recém-Nascido , Avaliação de Programas e Projetos de Saúde
12.
Clin Child Psychol Psychiatry ; 24(2): 203-222, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30968724

RESUMO

The care of children and adolescents whose experience of the body is at odds with their gender feelings raises a number of questions that are as much ethical as medical or psychological. In this article I highlight some areas of ethical concern from the point of view of a senior clinician at the nationally commissioned UK Gender Identity Development Service (GIDS). I make the assumption that ethical deliberation is relational and grounded in the natural, social, political and institutional worlds in which the ethical questions arise. I try to show how matters of empirical fact, alongside an appreciation of broad social contexts, and historic and current power relations, provide an essential framework for the ways that ethical choices are framed by key groups of people as they take up different, sometimes opposing, ethical positions. I argue that practising ethically in such a service is not helpfully reduced to a single event, a treatment decision aimed at achieving the morally 'right' outcome, but an extended process in time. In the charged debate surrounding the recognition of these young people's needs, we must do more to promote responsible debate about the scope of sound ethical practice.


Assuntos
Desenvolvimento do Adolescente , Serviços de Saúde do Adolescente/ética , Desenvolvimento Infantil , Serviços de Saúde da Criança/ética , Identidade de Gênero , Minorias Sexuais e de Gênero , Adolescente , Criança , Humanos , Reino Unido
13.
Br J Nurs ; 28(7): 461-466, 2019 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-30969872

RESUMO

Europe is in the midst of a large-scale migration crisis, which has implications for healthcare provision for asylum-seeking children and families. The authors set out to identify the psychological status of asylum-seeking children and highlight their needs. A search of three electronic databases was carried out, resulting in 15 studies. Data show that asylum-seeking children appear to experience many mental health difficulties, including post-traumatic stress disorder, depression, self-harm, sleep disturbance and behavioural difficulties. The daily living situation includes a range of psychological stressors, such as lack of space and control; fear of deportation; feelings of inadequacy and hopelessness; poor parental mental health; lack of recreational facilities; communication issues; and financial worries. Since many asylum-seeking children have experienced past trauma, hospitalisation and healthcare encounters may trigger traumatic memories and cause further distress. Awareness of the psychological impact of the situation on children and families may help nurses to provide empathetic, sensitive and culturally competent care.


Assuntos
Necessidades e Demandas de Serviços de Saúde , Refugiados , Transtornos de Estresse Pós-Traumáticos/psicologia , Criança , Serviços de Saúde da Criança , Humanos , Serviços de Saúde Mental , Transtornos de Estresse Pós-Traumáticos/etnologia , Transtornos de Estresse Pós-Traumáticos/enfermagem
14.
J Pediatr Orthop ; 39(6): e456-e461, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31022016

RESUMO

BACKGROUND: Femoral shaft fractures are a common cause for hospital admission and surgery in pediatric patients, and laboratory studies are often ordered for historical concerns of excessive bleeding. Recent literature has challenged these assumptions, and unnecessary testing causes undue pain and costs in children. No previous studies have offered evidence-based recommendations for perioperative laboratories in isolated pediatric femoral shaft fractures. METHODS: We retrospectively reviewed all patients presenting with femoral shaft fractures at our pediatric trauma center between 2013 and 2017. Patients with multitrauma injuries, metabolic/neuromuscular diseases, or intensive care unit stays were excluded. Necessity of laboratory tests was determined by rates of anemia, blood transfusions, specialist consultations, and delayed surgeries. Ordering patterns were recorded, with cost estimation based on Healthcare Bluebook. RESULTS: We reviewed 95 patients (mean age, 7.9±4.8 y; 70 males). Treatments included elastic nails (33/95, 34.7%), reamed intramedullary nails (24/95, 25.3%), plates/screws (12/95, 12.6%), and spica casting (26/95, 27.4%). Of 32 patients with preoperative coagulation laboratories, 11 were abnormal; however none resulted in hematology consultations or procedure delays. Seventy-five patients (78.9%) and 15 patients (15.8%) had complete blood counts preoperatively and postoperative day 1, respectively. Four patients (4.2%) had hemoglobin<8 g/dL postoperatively, however, there were no perioperative blood transfusions. Of these 4, 3 underwent either reamed intramedullary nails or open reduction internal fixation with plates/screws. Twenty-six patients (27.4%) had preoperative basic metabolic panels that did not alter medical care. On the basis of our criteria, over 72% of laboratories appeared unnecessary, with a total potential cost of $8567. Over 80% of orders were from the emergency department by residents or attending physicians. CONCLUSIONS: Perioperative laboratory orders may be unnecessary in most isolated pediatric femoral shaft fractures, subjecting patients to extraneous costs, and associated pain. However, laboratories may be justified based on clinical circumstances or for older patients treated with reamed nails or plates/screws. Evidence-based recommendations for perioperative laboratory orders offer the potential to improve quality and value and minimize harm in pediatric orthopaedic trauma. LEVEL OF EVIDENCE: Level III-retrospective comparative study (therapeutic).


Assuntos
Fraturas do Fêmur/cirurgia , Testes Hematológicos/estatística & dados numéricos , Traumatismo Múltiplo , Centros de Traumatologia/estatística & dados numéricos , Adolescente , Criança , Serviços de Saúde da Criança , Pré-Escolar , Serviço Hospitalar de Emergência , Feminino , Fixação Intramedular de Fraturas/métodos , Testes Hematológicos/economia , Humanos , Lactente , Recém-Nascido , Masculino , Philadelphia , Estudos Retrospectivos , Resultado do Tratamento , Procedimentos Desnecessários
15.
Artigo em Inglês | PAHO-IRIS | ID: phr-50672

RESUMO

[ABSTRACT]. This analysis reviews the situation of child and adolescent mental health in Chile, organizational determinants, and the initiatives and interventions implemented to enhance child development despite the country’s inequities. Progressive development of national mental health plans is covered, from the country’s first plan in 2000, to growing the number of mental health professionals and the training they receive, such as MhGAP, to the implementation of “Chile Crece Contigo,” whose preliminary evaluations are starting to show some effectiveness. However, the World Health Organization reports that progress in complying with the United Nations Convention of Children´s Rights is insufficient. A set off legislative initiatives on behalf of children and adolescents have been passed, while others are being discussed in Parliament. There is much to be done in the nation as a whole and within its health system to ensure improved child and adolescent mental health and wellbeing. More research into child and adolescent mental health should be undertaken. Adequate funding and policymaking are also crucial to giving priority to child and adolescent mental health in Chile.


[RESUMEN]. En este análisis se examina la situación de la salud mental de niños y adolescentes en Chile, los determinantes institucionales y las iniciativas e intervenciones ejecutadas para mejorar el desarrollo infantil a pesar de las inequidades del país. Se ha abarcado el desarrollo progresivo de los planes nacionales de salud mental, desde el primer plan nacional en el año 2000, pasando por el aumento del número de profesionales de salud mental y la capacitación que reciben, como el programa MhGAP, hasta la ejecución de “Chile Crece Contigo”, cuyas evaluaciones preliminares están comenzando a mostrar cierta eficacia. Sin embargo, la Organización Mundial de la Salud informa que el progreso en el cumplimiento de la Convención de las Naciones Unidas sobre los Derechos del Niño es insuficiente. Se ha aprobado un conjunto de iniciativas legislativas a favor de los niños y adolescentes, mientras que otras están tratándose en el parlamento. Es mucho lo que hay por hacer en el país en general y en su sistema de salud para garantizar el mejoramiento de la salud mental y el bienestar de niños y adolescentes. Es necesario aumentar la investigación sobre la salud mental de niños y adolescentes. La disponibilidad de fondos suficientes y la formulación de políticas son también cruciales para dar prioridad a la salud mental de niños y adolescentes en Chile.


[RESUMO]. Uma análise foi realizada para examinar a situação da saúde mental de crianças e adolescentes no Chile, determinantes organizacionais e iniciativas e intervenções implementadas para melhorar o desenvolvimento infantil diante das iniquidades no país. É descrita a evolução dos planos nacionais de saúde mental, a partir do primeiro plano elaborado em 2000, o crescimento do número de profissionais de saúde mental e a capacitação recebida, como parte do programa mundial de ação para reduzir as lacunas em saúde mental da OMS (MhGAP), e a implementação do programa Chile Crece Contigo cujas avaliações preliminares indicam certo grau de efetividade. Porém, segundo informou a Organização Mundial da Saúde (OMS), houve pouco progresso no cumprimento da Convenção das Nações Unidas sobre os Direitos da Criança. Um conjunto de iniciativas legislativas em prol das crianças e adolescentes foi aprovado e outras propostas estão em debate no congresso. Há ainda muito a ser feito no país como um todo e dentro do sistema de saúde para garantir melhor saúde mental e bem-estar para crianças e adolescentes. Devem ser realizadas outras pesquisas sobre saúde mental da criança e do adolescente. É indispensável dispor de financiamento e políticas adequados que priorizem a saúde mental da criança e do adolescente no Chile.


Assuntos
Serviços de Saúde Mental , Serviços de Saúde da Criança , Serviços de Saúde do Adolescente , Programas Nacionais de Saúde , Chile , Serviços de Saúde Mental , Serviços de Saúde da Criança , Serviços de Saúde do Adolescente , Programas Nacionais de Saúde , Serviços de Saúde Mental , Serviços de Saúde da Criança , Serviços de Saúde do Adolescente , Programas Nacionais de Saúde
16.
Rev. pesqui. cuid. fundam. (Online) ; 11(3): 748-755, abr.-maio 2019.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-987750

RESUMO

Objective: The study's purpose has been to identify the scientific knowledge about the prognosis of newborns in Neonatal Intensive Care Units (NICUs). Methods: This is an integrative review that explored 11 articles from the following databases: PubMed/MEDLINE, CINAHL, Web of Science, LILACS, Science Direct, and SCOPUS. Results: Studies on the factors associated with the prognosis of newborns in NICUs and the interventions that influenced this prognosis were identified. The main clinical factors associated with the prognosis were low birth weight, prematurity, and asphyxia. These factors also influenced the mortality among newborns, which was the main prognosis evaluated by most of the studies. Conclusions: Low weight and prematurity were identified as the main factors leading to NICU admission. Weight gain was understood as means for improving the prognosis. Furthermore, prematurity and low weight associated with other pathologies worsened the prognosis, leading to the death of newborns


Objetivo: Identificar na literatura evidências científicas acerca do prognóstico de recém-nascidos internados em Unidades de Terapia Intensiva Neonatal (UTIN). Métodos: Trata-se de uma revisão integrativa que explorou 11 artigos nas bases de dados: PubMed/MEDLINE, CINAHL, Web of Science, LILACS, Science Direct, SCOPUS. Resultados: Identificaram-se estudos que abordaram os fatores associados ao prognóstico de recém-nascidos internados em UTIN e as intervenções que influenciam o prognóstico do recém-nascido. Os principais fatores clínicos associados ao prognóstico foram o baixo peso, a prematuridade e a asfixia, esses mesmos fatores influenciaram a mortalidade, principal prognóstico avaliado pela maior parte dos estudos. Conclusão: Identificaram-se baixo peso e a prematuridade foram os principais fatores que levam à internação em UTIN. A melhoria do prognóstico é vislumbrada com o ganho de peso. Quando a prematuridade e o baixo peso estão associados a outras patologias há piora no prognóstico, tendo a morte neonatal como desfecho


Objetivo: Identificar en la literatura evidencias científicas acerca del pronóstico de recién nacidos internados en Unidades de Terapia Intensiva Neonatal (UTIN). Métodos: Se trata de una revisión integrativa que exploró 11 artículos en las bases de datos: PubMed / MEDLINE, CINAHL, Web of Science, LILACS, Science Direct, SCOPUS. Resultados: Se identificaron estudios que abordaron los factores asociados al pronóstico de recién nacidos internados en UTIN y las intervenciones que influencian el pronóstico del recién nacido. Los principales factores clínicos asociados al pronóstico fueron el bajo peso, la prematuridad y la asfixia, esos mismos factores influenciaron la mortalidad, principal pronóstico evaluado por la mayor parte de los estudios. Conclusión: Se identificaron bajo peso y la prematuridad fueron los principales factores que llevan a la internación en UTIN. La mejora del pronóstico es vislumbrada con la ganancia de peso. Cuando la prematuridad y el bajo peso están asociados a otras patologías hay empeoramiento en el pronóstico, teniendo la muerte neonatal como desenlace


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Prognóstico , Unidades de Terapia Intensiva Neonatal/estatística & dados numéricos , Mortalidade Infantil/tendências , Serviços de Saúde da Criança
17.
Manchester; The National Institute for Health and Care Excellence (NICE); Apr. 2019. 53 p.
Monografia em Inglês | BIGG | ID: biblio-1014919

RESUMO

This guideline covers specific aspects of respiratory support (for example, oxygen supplementation, assisted ventilation, treatment of some respiratory disorders, and aspects of monitoring) for preterm babies in hospital.


Assuntos
Unidades de Cuidados Respiratórios/organização & administração , Doenças Respiratórias/complicações , Nascimento Prematuro , Serviços de Saúde da Criança , Doenças do Recém-Nascido
18.
Gait Posture ; 70: 397-402, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30974395

RESUMO

BACKGROUND: The most prominent characteristics of hemiparetic cerebral palsy (hCP) children are structural and functional asymmetries. These children have low walking speeds, endurance and poor balance. The robotic walking devices repeat and experience symmetrical stepping at the corresponding speed and angles of the lower extremities. RESEARCH QUESTION 1: Are robotic walking devices effective in the development of walking in hCP children who can walk? RESEARCH QUESTION 2: How does the aerobic exercise experience with assisted and symmetrical movement affect the walking and local muscle, peripheral oxygenation of children with hCP? METHODS: This prospective, controlled study included 24 children with hCP. All children attended to a standard physiotherapy rehabilitation (PTR) program (three days a week for 12 weeks); those in the study group (n=12) also attended to an Robotic Gait Training (RGT) program three times a week. Evaluations performed before treatment, after treatment, and at the 3rd month after treatment included assessment of balance, functionality walking and measurements for oxygenation of vastus lateralis muscle and peripheral oxygenation. RESULTS: The evaluations were similar for both groups before treatment. After treatment, walking speed, endurance and peripheral O2 saturation were increased and balance abilities and functional performances improved in the RGT group as compared with the pre-treatment evaluations; these improvements in balance and functional performance were generally preserved after 3 months of treatment. An increase in 6-min walking distance and a partial increase in gross motor functions and functional muscle strength were observed in the control group; however, these abilities were not preserved after the treatment. SIGNIFICANCE: RGT can provide a faster and higher effect on the development of functional muscle strength, balance, walking speed and endurance than the standard PTR program. It improves functional walking performance. RGT can be used for aerobic exercise training in children with walking hCP.


Assuntos
Paralisia Cerebral/reabilitação , Terapia por Exercício , Robótica , Velocidade de Caminhada , Paralisia Cerebral/fisiopatologia , Criança , Serviços de Saúde da Criança , Pré-Escolar , Feminino , Humanos , Masculino , Estudos Prospectivos , Resultado do Tratamento
19.
Public Health Res Pract ; 29(1)2019 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-30972404

RESUMO

More than a quarter of Australian children are above a healthy weight (overweight or obese) and risk significant immediate and future health harms. While childhood overweight and obesity is a complex problem requiring multifaceted solutions, identifying children at risk and preventing these health harms should be a part of good clinical care in all health services. Effective secondary and tertiary prevention is feasible. This paper argues that health services can use serial growth assessment to routinely identify and manage children who are above a healthy weight, just as we might routinely identify and manage hypertension in older patients. We highlight the evidence for the acceptability and effectiveness of family-focused clinical intervention for weight management in children. We also outline system-level changes that health services should consider to enable and support routine clinical identification and management of affected children and their families.


Assuntos
Serviços de Saúde da Criança , Obesidade Pediátrica/prevenção & controle , Adolescente , Austrália/epidemiologia , Criança , Pré-Escolar , Família , Humanos , Obesidade Pediátrica/complicações , Obesidade Pediátrica/epidemiologia , Prevalência , Programas de Redução de Peso
20.
Public Health Res Pract ; 29(1)2019 03 06.
Artigo em Inglês | MEDLINE | ID: mdl-30972405

RESUMO

Early childhood provides an opportunity to support parents to promote a range of healthy behaviours at a time of high engagement with family-focused health services. The Infant Program is believed to be the first of its kind to address healthy behaviours and obesity risk in the first year of life using a universally delivered service. The program is an efficacious, low-cost intervention, and many lessons have been learnt across the journey from a randomised controlled trial to small-scale community implementation. The evolution of the Infant Program highlights the value of applying a translational research process to best position interventions to be implemented at scale. It also illustrates the benefits that a sequential approach, a receptive environment and system-level support provide when seeking to integrate new interventions into routine health service delivery. Understanding these processes and factors leads to a better appreciation of the role each step plays in implementing population health interventions at scale.


Assuntos
Serviços de Saúde da Criança , Obesidade Pediátrica/prevenção & controle , Criança , Humanos , Lactente , Avaliação de Programas e Projetos de Saúde , Vitória
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