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1.
Child Abuse Negl ; 123: 105427, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34896879

RESUMO

BACKGROUND: Childhood institutional deprivation is associated with growth stunting in childhood but long-term effects in adulthood remain uncertain. OBJECTIVE: To examine the impact of global institutional deprivation experienced in early childhood on subsequent growth with a special focus on final adult height and puberty timing. PARTICIPANTS & SETTING: The study was originally set in the UK, though some adoptive families lived abroad by the time of the adult follow up. 165 individuals adopted by UK families before 43 months of age from Romanian orphanages after the fall of the Ceaușescu regime in the early 1990's were compared to 51 non-deprived UK adoptees, adopted before the age of 6 months. METHODS: The English and Romanian Adoptees (ERA) study is a 20-year longitudinal natural experiment on the effects of institutional deprivation on development. Key growth milestones were extracted from growth curve modelling of height data collected at ages 4, 6, 11, 15 and 23 years using a Bayesian approach to fit the JPA2 model. RESULTS: Deprivation effects on height were present at the take-off point of accelerating adolescent growth and persisted into adulthood - the largest effects being for individuals who experienced over six months of deprivation. Deprivation was associated with earlier take-off and achievement of peak height velocity of adolescent growth acceleration - an effect driven largely by females' data and correlated with parent ratings of pubertal development. CONCLUSIONS: Early deprivation appears to reset tempo of growth early in development leading to permanent growth stunting in adulthood and accelerated onset of puberty, specifically in females.


Assuntos
Adoção , Orfanatos , Adolescente , Adulto , Teorema de Bayes , Pré-Escolar , Feminino , Transtornos do Crescimento/epidemiologia , Transtornos do Crescimento/etiologia , Humanos , Estudos Longitudinais , Pais
2.
JAMA Netw Open ; 4(9): e2125365, 2021 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-34529063

RESUMO

Importance: In 2015, there were nearly 140 million orphaned children globally, particularly in low- and middle-income regions, and millions more for whom the street is central to their everyday lives. A total of 16.6 million children were orphaned because of deaths associated with HIV/AIDS, of whom 90% live in sub-Saharan Africa. Although most orphaned and separated children and adolescents in this region are cared for by extended family, the large number of children requiring care has produced a proliferation of institutional care. Few studies have investigated the association between care environment and physical health among orphaned and separated youths in sub-Saharan Africa. Objective: To examine the association of care environment with incident HIV and death among orphaned and separated children and adolescents who were living in charitable children's institutions, family-based settings, and street settings in western Kenya over almost 10 years. Design, Setting, and Participants: The Orphaned and Separated Children's Assessments Related to Their Health and Well-Being (OSCAR) project was an observational prospective cohort study conducted in Uasin Gishu County, Kenya. The cohort comprised 2551 orphaned, separated, and street-connected children from communities within 8 administrative locations, which included 300 randomly selected households (family-based settings) caring for children who were orphaned from all causes, 19 charitable children's institutions (institutional settings), and a convenience sample of 100 children who were practicing self-care on the streets (street settings). Participants were enrolled from May 31, 2010, to April 24, 2013, and were followed up until November 30, 2019. Exposures: Care environment (family-based, institutional, or street setting). Main Outcomes and Measures: Survival regression models were used to investigate the association between care environment and incident HIV, death, and time to incident HIV or death. Results: Among 2551 participants, 1230 youths were living in family-based settings, 1230 were living in institutional settings, and 91 were living in street settings. Overall, 1321 participants (51.8%) were male, with a mean (SD) age at baseline of 10.4 (4.8) years. Most participants who were living in institutional (1047 of 1230 youths [85.1%]) or street (71 of 91 youths [78.0%]) settings were double orphaned (ie, both parents had died). A total of 59 participants acquired HIV infection or died during the study period. After adjusting for sex, age, and baseline HIV status, living in a charitable children's institution was not associated with death (adjusted hazard ratio [AHR], 0.26; 95% CI, 0.07-1.02) or incident HIV (AHR, 1.49; 95% CI, 0.46-4.83). Compared with living in a family-based setting, living in a street setting was associated with death (AHR, 5.46; 95% CI, 2.30-12.94), incident HIV (AHR, 17.31; 95% CI, 5.85-51.25), and time to incident HIV or death (AHR, 7.82; 95% CI, 3.48-17.55). Conclusions and Relevance: In this study, after adjusting for potential confounders, no association was found between care environment and HIV incidence or death among youths living in institutional vs family-based settings. However, living in a street setting vs a family-based setting was associated with both HIV incidence and death. This study's findings suggest that strengthening of child protection systems and greater investment in evidence-based family support systems that improve child and adolescent health and prevent youth migration to the street are needed for safe and beneficial deinstitutionalization to be implemented at scale.


Assuntos
Crianças Órfãs , Infecções por HIV/epidemiologia , Jovens em Situação de Rua , Orfanatos , Adolescente , Criança , Feminino , Infecções por HIV/mortalidade , Humanos , Incidência , Quênia/epidemiologia , Masculino , Estudos Prospectivos
3.
Pharmacol Biochem Behav ; 210: 173272, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34509501

RESUMO

The effect of experiences in infancy on human development is a central question in developmental science. Children raised in orphanage-like institutions for their first year or so of life and then adopted into well-resourced and supportive families provide a lens on the long-term effects of early deprivation and the capacity of children to recover from this type of early adversity. While it is challenging to identify cause-and-effect relations in the study of previously institutionalized individuals, finding results that are consistent with animal experimental studies and the one randomized study of removal from institutional care support the conclusion that many of the outcomes for these children were induced by early institutional deprivation. This review examines the behavioral and neural evidence for altered executive function, declarative memory, affective disorders, reward processing, reactivity to threat, risk-taking and sensation-seeking. We then provide a brief overview of the neurobiological mechanisms that may transduce early institutional experiences into effects on brain and behavior. In addition, we discuss implications for policy and practice.


Assuntos
Encéfalo/metabolismo , Comportamento Infantil/psicologia , Desenvolvimento Infantil , Orfanatos , Animais , Criança , Pré-Escolar , Função Executiva , Feminino , Humanos , Lactente , Aprendizagem , Masculino , Memória , Transtornos do Humor/epidemiologia , Neurobiologia/métodos , Recompensa , Assunção de Riscos , Fatores de Tempo
4.
Child Abuse Negl ; 120: 105222, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34364174

RESUMO

Estimates suggest that close to 3 million institutionalized children internationally have some family to whom they could go home. A proportion of these children is recruited from their communities under false pretenses and has false documentation that describes them as legal orphans. The orphanages where they live exploit them on the basis of their orphanhood. These children are known as paper orphans. The aim of the current article is to provide a profile of their origins and networks based on current available evidence, from an investigative interviewing perspective. Increased discussion and research of this problem will assist in supporting efforts towards reunification of children with families, investigations by law enforcement into orphanages, and successful prosecution of orphanage trafficking. The article provides an overview of the orphanage trafficking context, followed by a comparison of orphanage trafficking victims with other child trafficking victims from the perspective of investigative needs. Investigative needs are outlined with respect to two primary groups who would interview paper orphans and other involved parties (e.g., birth parents, orphanage staff)-law enforcement and reunification officers. In the final section of the article, we encourage further research on orphanage trafficking and provide initial guidance for interviewing in this unique context. This paper serves as a step to raise further awareness of paper orphans, orphanage trafficking, and the specific characteristics of their cases that affect research and planning into how to identify and interview them and others involved.


Assuntos
Crianças Órfãs , Orfanatos , Criança , Criança Institucionalizada , Coleta de Dados , Família , Humanos
6.
Eur J Psychotraumatol ; 12(1): 1915578, 2021 05 28.
Artigo em Inglês | MEDLINE | ID: mdl-34104349

RESUMO

Background: Child maltreatment (CM), particularly in institutional contexts, can affect the development of post-traumatic stress disorder (PTSD). Research suggests that factors during CM (e.g. severity, variety, duration) and in the aftermath of CM (e.g. stressful life events, and social acknowledgement, i.e. the degree to which an individual feels validated and supported following a traumatic event) can explain some of the heterogeneity in PTSD development. However, there is a lack of research on long-term correlates of CM and mitigating factors, with only a few studies having been conducted with older survivors of institutional upbringing. Such research is relevant, given the long-term associations between CM and the older age status of many survivors. Objective: The current study examined the link between CM and PTSD in older individuals with a history of institutional upbringing (risk group; RG) and a matched control group (CG). Differences in stressful life events and social acknowledgement were also investigated. Method: Participants were n = 116 RG (M age = 70.25 years, 41% female) and n = 122 CG (M age = 70.71 years, 51% female). Data was assessed using self-report questionnaires and a clinical interview. Results: The RG reported higher levels of exposure to CM. Lifetime PTSD showed a bigger association with the level of exposure to CM, compared to having an institutional upbringing. Participants with higher CM levels reported more stressful life events. High levels of social acknowledgement mediated the relationship between CM and PTSD in the CG. Conclusions: Exposure to CM had a stronger association with PTSD than a history of institutional upbringing. In the CG, the survivors' perception of social acknowledgement ameliorated lifetime PTSD to a small extent. A critical issue for policy makers should be to enhance safeguarding measures against CM exposure, not only in institutional contexts, but also more generally, given the link to PTSD.


Antecedentes: El maltrato infantil (MI), particularmente en contextos institucionales, puede incidir en el desarrollo del trastorno de estrés postraumático (TEPT). La investigación sugiere que los factores durante el MI (ej. gravedad, variedad, duración) y en el periodo posterior al MI (ej. eventos estresantes de la vida y reconocimiento social, es decir, el grado en que un individuo se siente validado y apoyado después de un evento traumático) pueden explicar en parte la heterogeneidad en el desarrollo del TEPT. Sin embargo, hay una falta de investigación sobre los correlatos a largo plazo del MI y los factores atenuantes, y solo se han realizado unos pocos estudios con personas mayores que han sobrevivido a la crianza institucional. Dicha investigación es relevante, dadas las asociaciones a largo plazo entre MI y el estado a mayor edad de muchos sobrevivientes.Objetivo: El presente estudio examinó el vínculo entre MI y TEPT en personas mayores con antecedentes de crianza institucional (grupo de riesgo; GR) y un grupo de control emparejado (GC). También se investigaron las diferencias en los eventos vitales estresantes y el reconocimiento social.Método: Los participantes fueron N = 116 en GR (edad promedio = 70,25 años, 41% mujeres) y N = 122 en GC (edad promedio = 70,71 años, 51% mujeres). Los datos se evaluaron mediante cuestionarios de auto-reporte y una entrevista clínica.Resultados: El GR reportó niveles más altos de exposición a MI. El TEPT durante la vida mostró una mayor asociación con el nivel de exposición a MI, en comparación con la crianza institucional. Los participantes con niveles más altos de MI reportaron más eventos vitales estresantes. Altos niveles de reconocimiento social mediaron la relación entre MI y TEPT en el GC.Conclusiones: La exposición a MI tuvo una asociación más fuerte con el TEPT que el historial de crianza institucional. En el GC, la percepción de reconocimiento social de los sobrevivientes mejoró en pequeña medida el TEPT durante la vida. Una cuestión fundamental para los responsables de la formulación de políticas debería ser mejorar las medidas de protección contra la exposición a MI, no solo en contextos institucionales, sino también de manera más general, dado el vínculo con el trastorno de estrés postraumático.


Assuntos
Sobreviventes Adultos de Maus-Tratos Infantis/estatística & dados numéricos , Maus-Tratos Infantis/estatística & dados numéricos , Acontecimentos que Mudam a Vida , Orfanatos , Transtornos de Estresse Pós-Traumáticos , Idoso , Criança , Feminino , Humanos , Masculino , Identificação Social , Transtornos de Estresse Pós-Traumáticos/etiologia , Transtornos de Estresse Pós-Traumáticos/psicologia
7.
Rev. SPAGESP ; 22(1): 83-97, ene.-jun. 2021.
Artigo em Português | LILACS, Index Psicologia - Periódicos | ID: biblio-1155516

RESUMO

Partimos do trabalho em uma instituição de acolhimento para crianças e adolescentes propondo uma escuta orientada pela psicanálise. Considerando as tensões entre instituição e psicanálise, a questão que nos orienta é de que forma a transferência pode contribuir para uma instauração de escuta, que permitirá a elaboração da situação de vulnerabilidade desses sujeitos. Utilizamos como método de pesquisa a revisão bibliográfica associada à psicanálise aplicada e recorremos aos fragmentos de recordação das situações vividas no cotidiano institucional. Concluiu-se que há um lugar de escuta sob transferência a ser considerada na instituição e que o Plano Individual de Atendimento (PIA) necessita ser efetivado sob transferência, para que seja implementado como instrumento que valorize o surgimento das singularidades dos acolhidos.


We started from work at a host institution for children and adolescents, proposing a listening guided by psychoanalysis. Considering the tensions between institution and psychoanalysis, the question that guides us is how the transfer can contribute to establishing a listening that will allow the elaboration of the situation of vulnerability of these subjects. We used as a research method the bibliographic review associated with applied psychoanalysis and we also used fragments of remembrance of the situations experienced in the institutional daily life. It was concluded that there is a place of listening under the transfer to be considered in the institution and that the Individual Assistance Plan needs to be carried out under the transfer in order to be implemented as an instrument that values the emergence of the singularities of the sheltered.


Partimos desde el trabajo en una institución de acogida para niños y adolescentes proponiendo una escucha orientada por el psicoanálisis. Considerando las tensiones entre institución y psicoanálisis, la cuestión que nos orienta es de qué forma la transferencia puede contribuir al establecimiento de un escuchar que permitirá la elaboración de la situación de vulnerabilidad de esos sujetos. Utilizamos como método de investigación la revisión bibliográfica asociada al psicoanálisis aplicado y recurrimos a los fragmentos de recuerdos de las situaciones de la vida cotidiana institucional. Concluimos que hay un lugar de escucha bajo transferencia a ser considerado en la institución y que el Plan Individual de Atención necesita ser efectivado bajo transferencia para que sea implementado como un instrumento que valore el surgimiento de las singularidades de los acogidos.


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Psicanálise , Atenção , Orfanatos , Vulnerabilidade a Desastres , Albergado , Acolhimento , Criança Acolhida , Necessidades e Demandas de Serviços de Saúde
8.
J Public Health (Oxf) ; 43(1): 61-66, 2021 04 12.
Artigo em Inglês | MEDLINE | ID: mdl-32876673

RESUMO

BACKGROUND: To assess the impact of disinfection measures on the incidence of common diseases in children welfare institute during the epidemic of Corona Virus Disease 2019 (COVID-19), and provide a basis for the daily disinfection management of children welfare institute. METHODS: This study surveyed and analyzed common diseases among children under the age of 14 in one social children welfare institute in Shanxi Province from January to May in 2018-2020 by the year-on-year method. RESULTS: The prevalence rate of respiratory diseases in 2020 was a significantly negative growth compared with 2018 and 2019. There was no obvious pattern of changes in digestive diseases group. CONCLUSION: In view of the above anti-epidemic measures, it indicates that the children gathering institutions should strengthen effective personal protection and public health management to reduce infectious disease among children.


Assuntos
Orfanatos , Doenças Respiratórias/epidemiologia , Adolescente , COVID-19/prevenção & controle , Criança , Proteção da Criança , Pré-Escolar , China/epidemiologia , Feminino , Gastroenteropatias/epidemiologia , Humanos , Controle de Infecções , Masculino , Prevalência
9.
Glob Health Promot ; 28(3): 14-22, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33103585

RESUMO

Children who live in orphanages represent a population particularly vulnerable to transmissible diseases. Handwashing interventions have proven efficacy for reducing the rate of transmission of common infectious diseases. Few studies have analyzed the delivery of health interventions for children in orphanages in sub-Saharan Africa. To address this gap, we conducted an ecological assessment and piloted a handwashing intervention in an orphanage in rural Malawi, focusing on caregiver knowledge and behaviors, child handwashing behaviors, and disease incidence. A secondary study aim was to demonstrate program feasibility for a future randomized controlled trial. Orphanage caregivers participated in a three-module educational intervention on handwashing based on WHO recommendations and workshops on how to teach the curriculum to children. Seventeen orphanage caregivers and 65 children were monitored for handwashing behavior and child disease incidence. Friedman's tests were conducted to compare changes in caregiver knowledge and behaviors. Child handwashing behaviors and surveillance of child disease incidence were measured pre- and post-intervention. There were significant increases in caregiver hand hygiene knowledge. At six months post-intervention, handwashing with soap increased significantly among caregivers (p < 0.001) and was observed in children. The incidence of acute respiratory infections decreased from 30% to 6% post-intervention, resulting in an 80% decrease. The incidence of diarrhea decreased from 9.2% to 6.2% post-intervention, resulting in a 33% decrease. A brief educational intervention may improve handwashing knowledge and behaviors and help to decrease the incidence of common infectious diseases in an orphanage in rural Malawi. In addition, the caregiver uptake of the intervention demonstrated feasibility for future studies.


Assuntos
Desinfecção das Mãos , Orfanatos , Criança , Diarreia/epidemiologia , Diarreia/prevenção & controle , Humanos , Incidência , Malaui/epidemiologia
10.
Psychoneuroendocrinology ; 124: 105065, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33278786

RESUMO

This study examined whether early life adversity (ELA) limited to infancy was associated with an increase in circulating levels of proinflammatory cytokines and cellular cytokine responses to three stimulants [lipopolysaccharide (LPS), phytohemagglutinin (PHA), and phorbol myristate acetate plus ionomycin (PMA/IO)]. Participants were previously institutionalized (PI) youth (N = 45, 56 % female) who had spent their first years in institutional care (e.g., orphanages, baby homes) before being adopted into well-resourced homes (median age at adoption = 13 mos) and non-adopted comparisons (NA; N = 38, 55 % female). Their age range was 13.3-21.2 years (M = 16.3 years). This analysis followed up an earlier report on these youth (Reid et al., 2019a) that identified an increase in terminally differentiated CD8 + CD57 T cells among the PI relative to the NA youth. Cytokine levels in circulation were not highly correlated and thus examined separately. PI youth had higher circulating levels of Tumor Necrosis Factor-alpha (TNFα), but not Interleukin-1ß (IL-1ß) or Interleukin-6 (IL-6). Cytokine responses to in vitro activation within each stimulant condition were highly correlated and were thus combined to generate an index of the inflammatory reaction to each stimulant. Using Multivariate Analysis of Covariance, there was a highly significant multivariate effect of group, which was carried primarily by the PMA/IO condition, with PI youth exhibiting a larger inflammatory response than NA youth. Tests of mediation showed that both the early rearing effects on circulating TNFα and the composite inflammatory index of PMA/IO responsiveness were mediated in the statistical model by the percentage of CD8 + CD57+ TEMRA cells in circulation, a marker of replicative senescence in T cells. Sex differences were also found in circulating levels of IL-6 and TNFα, with males having higher levels than females.


Assuntos
Interleucina-6 , Fator de Necrose Tumoral alfa , Adolescente , Adulto , Citocinas , Feminino , Humanos , Lactente , Masculino , Orfanatos , Linfócitos T , Acetato de Tetradecanoilforbol/farmacologia , Adulto Jovem
11.
Vertex ; XXXII(154): 32-37, 2021 Dec.
Artigo em Espanhol | MEDLINE | ID: mdl-35041731

RESUMO

In Argentina, the National Mental Health Law (No. 26.657), from 2010, indicates that a specific budget is available to carry out particularly significant changes in the institutions where patients are admitted for mental health reasons. Voluntary or involuntary hospitalization in general hospitals is promoted throughout the country, while the closure of specialized mental health hospitals is anticipated. However, some demographic characteristics and the marked lack of accessibility to specialized resources throughout the country allow to locate a well-founded doubt to said proposal, even if the indicated resources were available and even more so, if it is intended to preserve the valuable rights that are in the spirit of the Law. Especially with regard to clinically involuntary hospitalizations outside the big cities. This article aims to illustrate and substantiate this position clinically -with the case of the girl Mariela-, in relation to mental health patients of all ages and to criticize this aspect of the Law, pointing out the risk for users of not creating increasingly complex public mental health systems accessible to the entire population of the country.


Assuntos
Transtornos Mentais , Orfanatos , Internação Compulsória de Doente Mental , Feminino , Hospitalização , Hospitais , Humanos , Saúde Mental , Pupila
12.
Psicol. ciênc. prof ; 41(spe3): e215129, 2021.
Artigo em Português | LILACS-Express | LILACS, Index Psicologia - Periódicos | ID: biblio-1340459

RESUMO

Resumo Em razão do número significativo de crianças maiores e adolescentes disponíveis para o processo de adoção no Cadastro Nacional de Adoção, e de a idade representar um fator de restrição e obstáculo para os pretendentes à adoção, torna-se necessário desmistificar as crenças enraizadas sobre adoção tardia. Pensando nessas questões, o presente estudo objetiva compreender os aspectos psicológicos e comportamentais das crianças e dos pais por adoção, comumente presentes no período de adaptação e convivência pós-adotiva, e analisar as atitudes dos pais diante dos obstáculos, observando a eficácia da preparação necessária aos pretendentes à adoção. Para tanto, a metodologia adotada consistiu inicialmente em embasar teoricamente a adoção tardia e suas fases de adaptação, com fundamentação psicanalítica, para a compreensão abrangente do assunto, e em uma pesquisa de campo com dois casais, pais por adoção que se encontravam no período de convivência de seis meses a um ano, para coletar dados relevantes e os correlacionar com a teoria. Por meio dos resultados obtidos, foram apontados os estágios de convivência e os aspectos psicológicos envolvidos nesse processo, bem como a importância de os pretendentes à adoção se instrumentalizarem com informações e se prepararem para a filiação afetiva. Assim, mesmo com todas as dificuldades que possam surgir no processo de adaptação na adoção tardia, em virtude de fatores como idade, preconceitos, mitos e histórico prévio de vida da criança, conclui-se que o afeto e a adoção recíproca prevalecem a qualquer desafio e que, se a experiência da adoção tardia for bem orientada, pode apresentar excelentes resultados.(AU)


Abstract Before the significant number of older children and adolescents available for adoption in the National Adoption Register, and considering age as both a restriction factor and an obstacle, rooted beliefs concerning late adoption must be demystified. In this scenario, this study aimed to understand the psychological and behavioral features of children and their adopting parents during the adjustment period soon after adoption, besides analyzing parents' attitudes toward obstacles in light of the necessary preparation on the part of couples intending to adopt. Based on psychoanalytical principles, this study first sets the theoretical foundations of late adoption and its adjustment phases to reach a comprehensive understanding of the issue. To collect data and relate them to the underlying theory, a field research was conducted with two adopting couples in the adjustment period, which ranges from six months to a year. The results indicate the adjustment phases and psychological features underlying this process, besides stressing the importance of parents who intend to adopt for searching for information on the issue and preparing themselves for an affective adoption. Despite the difficulties in late-adoption adaptation - due to age, prejudices, myths, and the previous lives of children, - affection and mutual adoption can overcome any challenges that may arise. Moreover, if the late adoption process is adequately guided, it may present excellent results.(AU)


Resumen Debido al número significativo de niños mayores y adolescentes disponibles para el proceso de adopción en el Catastro Nacional de Adopción, y siendo la edad un factor de restricción y obstáculo para los adoptantes, es necesario desmitificar las creencias en relación a la adopción tardía. En este sentido, el presente trabajo tiene por objeto comprender los aspectos psicológicos y comportamentales de los niños y de los padres por adopción, comúnmente presentes en el período de adaptación y convivencia postadoptiva, así como analizar las actitudes de los padres ante a los obstáculos, observando la eficacia de la preparación necesaria para los aspirantes a adopción. Para ello, la metodología adoptada consistió inicialmente en basar teóricamente la adopción tardía y sus fases de adaptación, con fundamentación psicoanalítica, para una comprensión más amplia del asunto, y una investigación de campo con dos parejas, que son padres por adopción entre seis meses a un año, para recoger datos relevantes y correlacionarlos con la teoría. Los resultados apuntan las etapas de convivencia y los aspectos psicológicos que involucran este proceso, así como la importancia de los aspirantes a adopción para conseguir informaciones y prepararse para la filiación afectiva. Incluso con todas las dificultades que puedan surgir en el proceso de adaptación en la adopción tardía, en virtud de la edad, de los prejuicios, mitos y por el histórico previo de vida que el niño carga, se concluye que el afecto y la adopción recíproca prevalecen ante cualquier desafío y que si bien orientada la experiencia de la adopción tardía se puede presentar excelentes resultados.(AU)


Assuntos
Humanos , Masculino , Feminino , Preconceito , Psicanálise , Adoção , Pais , Psicologia , Adaptação Psicológica , Família , Vida , Orfanatos , Afeto , Vulnerabilidade Social , Compreensão , Emoções , Fundações , Criança Adotada , Imperícia
13.
Viruses ; 12(9)2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-32883046

RESUMO

Significantly divergent polioviruses (VDPV) derived from the oral poliovirus vaccine (OPV) from Sabin strains, like wild polioviruses, are capable of prolonged transmission and neuropathology. This is mainly shown for VDPV type 2. Here we describe a molecular-epidemiological investigation of a case of VDPV type 3 circulation leading to paralytic poliomyelitis in a child in an orphanage, where OPV has not been used. Samples of feces and blood serum from the patient and 52 contacts from the same orphanage were collected twice and investigated. The complete genome sequencing was performed for five polioviruses isolated from the patient and three contact children. The level of divergence of the genomes of the isolates corresponded to approximately 9-10 months of evolution. The presence of 61 common substitutions in all isolates indicated a common intermediate progenitor. The possibility of VDPV3 transmission from the excretor to susceptible recipients (unvaccinated against polio or vaccinated with inactivated poliovirus vaccine, IPV) with subsequent circulation in a closed children's group was demonstrated. The study of the blood sera of orphanage residents at least twice vaccinated with IPV revealed the absence of neutralizing antibodies against at least two poliovirus serotypes in almost 20% of children. Therefore, a complete rejection of OPV vaccination can lead to a critical decrease in collective immunity level. The development of new poliovirus vaccines that create mucosal immunity for the adequate replacement of OPV from Sabin strains is necessary.


Assuntos
Poliomielite/virologia , Poliovirus/fisiologia , Anticorpos Antivirais/sangue , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Orfanatos/estatística & dados numéricos , Poliomielite/sangue , Poliomielite/epidemiologia , Poliomielite/transmissão , Poliovirus/genética , Poliovirus/isolamento & purificação , Vacina Antipólio Oral/administração & dosagem , Vacina Antipólio Oral/genética , Vacina Antipólio Oral/imunologia , Federação Russa/epidemiologia
14.
J Mycol Med ; 30(4): 101013, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32811733

RESUMO

We report an outbreak of Trichophyton soudanense causing tinea capitis and corporis in an orphanage in Myanmar. The thirty orphan children were suspected to have anthropophilic tinea but zoonotic tinea could not be excluded as all children were playing with stray dogs. Direct mycological examinations of hair and scalp samples showed filaments but culture assays remained sterile. We revealed T. soudanense as the infectious agent by PCR amplification of extracted fungal DNA and further sequencing of the PCR products. Children were successfully treated by terbinafine and reinfection was prevented by hygiene measures. This case report shed the light on T. soudanense infection on another continent than Africa and on the significant help of PCR identification.


Assuntos
Arthrodermataceae/isolamento & purificação , Surtos de Doenças , Orfanatos , Tinha do Couro Cabeludo/diagnóstico , Tinha/diagnóstico , Alopecia/diagnóstico , Alopecia/epidemiologia , Alopecia/microbiologia , Animais , Criança , Crianças Órfãs , Doenças do Cão/microbiologia , Doenças do Cão/transmissão , Cães , Feminino , Humanos , Masculino , Mianmar/epidemiologia , Couro Cabeludo/microbiologia , Tinha/epidemiologia , Tinha/microbiologia , Tinha do Couro Cabeludo/epidemiologia , Tinha do Couro Cabeludo/microbiologia , Zoonoses/microbiologia
15.
Environ Pollut ; 266(Pt 1): 115161, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32645554

RESUMO

As the number of Coronavirus Disease (2019) (COVID-19) cases increase globally, countries are taking more aggressive preventive measures against this pandemic. Transmission routes of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) include droplet and contact transmissions. There are also evidence of transmission through aerosol generating procedures (AGP) in specific circumstances and settings. Institutionalized populations without mobility and living in close proximity with unavoidable contact are especially vulnerable to higher risks of COVID-19 infection, such as the elderly in nursing homes, children in orphanages, and inmates in prisons. In these places, higher prevention and control measures are needed. In this study, we proposed prevention and control strategies for these facilities and provided practical guidance for general measures, health management, personal protection measures, and prevention measures in nursing homes, orphanages, and prisons, respectively.


Assuntos
Infecções por Coronavirus , Coronavirus , Pandemias , Pneumonia Viral , Prisões , Idoso , Betacoronavirus , COVID-19 , Criança , Humanos , Casas de Saúde , Orfanatos , SARS-CoV-2
16.
J Infect Dev Ctries ; 14(6.1): 48S-52S, 2020 06 29.
Artigo em Inglês | MEDLINE | ID: mdl-32614796

RESUMO

INTRODUCTION: Orphans are at high risk for neglected tropical diseases (NTDs) and other comorbidities such as malnutrition. We investigated how many orphans suffered from scabies, other NTDs and malnutrition. METHODOLOGY: A descriptive study using medical records of orphans referred to a teaching hospital in Addis Ababa, Ethiopia from December 2014 to December 2018 was done. Files documenting NTDs were reviewed in detail for age, referral diagnosis, and nutritional status. Nutritional assessment was done using the WHO Standard growth curve, classifying children as stunted (height for age Z score < -2SD or wasted (weight for length Z score < -2SD). RESULTS: Of the 852 orphans referred, 23.1% (196/852) was diagnosed with scabies, amongst which 28.1% (55/196) had multiple episodes. The median age (interquartile range) of the children with scabies was 3 (2-5) months. 85.2% (169/196) of the orphans with scabies were stunted and /or wasted. No other NTDs were reported. All of the scabies cases identified were not documented in the referral letter of the orphanage. CONCLUSIONS: There is ongoing transmission of scabies among children in the orphanage. Amongst orphans with scabies, an alarmingly high percentage was malnourished. Referrals from orphanages may provide an opportunity to detect NTDs and this is being missed.


Assuntos
Crianças Órfãs/estatística & dados numéricos , Desnutrição/epidemiologia , Escabiose/epidemiologia , Escabiose/transmissão , Criança , Pré-Escolar , Etiópia/epidemiologia , Feminino , Hospitais/estatística & dados numéricos , Humanos , Lactente , Recém-Nascido , Masculino , Estado Nutricional , Pesquisa Operacional , Orfanatos/normas , Pesquisa Qualitativa , Estudos Retrospectivos , Escabiose/diagnóstico
17.
Artigo em Chinês | MEDLINE | ID: mdl-32447889

RESUMO

Objective: To explore the status of job burnout of nurses for orphans and disabled children in Nanjing and its influencing factors, so as to provide reference for promoting the mental health of nurses for orphans and disabled children. Methods: From February to May, 2017, a cross-sectional survey was conducted among 236 nurses working in social welfare institutions for orphans and disabled children in Nanjing, using Occupational Stress Indicator (OSI) and Maslach Burnout Inventory (MBI) . It investigated the status of job burnout among nurses of orphans and disabled children, logistic regression analysis was used to explore the effect of occupational stress on the incidence of job burnout of nurses for orphans and disabled children. Results: The results showed that the incidence of job burnout was 67.37% (159/236) , the incidence of job burnout was negatively correlated with behavioral characteristics and family support, the incidence of emotional exhaustion was positively correlated with task control and job monotony (P<0.05) , and negatively correlated with role ambiguity and job satisfaction (P<0.05) . The incidence of depersonalization was negatively correlated with job monotony and peer support (P<0.05) . Conclusion: The nurses of orphans and disabled children have serious job burnout. Occupational stress factors, personality characteristics and relieving factors have influence on the incidence of job burnout.


Assuntos
Esgotamento Profissional , Cuidadores/psicologia , Cuidado da Criança , Orfanatos , Criança , China , Estudos Transversais , Humanos , Inquéritos e Questionários
18.
Washington, D.C.; PAHO; 2020-05-21. (PAHO/CDE/CE/COVID-19/20-0022).
em Inglês | PAHO-IRIS | ID: phr-52167

RESUMO

This technical note presents the main recommendations for collective residential places that provide services to groups of people in vulnerable conditions, such as nursing homes and orphanages, in the areas of drinking water, hand washing, surface cleaning, laundry, ventilation, and management of solid waste. Additionally, recommendations are provided to prepare 0.05% and 0.1% sodium hypochlorite solutions, depending on the needs for cleaning and prevention against SARS-COV-2 and other infectious agents.


Assuntos
SARS-CoV-2 , COVID-19 , Coronavirus , Saneamento , Higiene , Resíduos Sólidos , Orfanatos , Casas de Saúde
19.
Washington, D.C.; OPS; 2020-05-11. (OPS/CDE/CE/COVID-19/20-0022).
em Espanhol | PAHO-IRIS | ID: phr-52112

RESUMO

Los ancianatos, orfelinatos y otros lugares residenciales colectivos que prestan servicios a grupos de personas en condiciones de vulnerabilidad son fundamentales para el bienestar de la sociedad. Es muy importante que estos espacios comunitarios cerrados cuenten con condiciones ambientales y de higiene adecuadas para proteger la salud de los cuidadores, visitantes y los residentes (ancianos, niños). Esta nota incluye recomendaciones para proteger la salud durante la pandemia de COVID-19. Instruir a los cuidadores, personal de servicio, residentes, familia y visitantes en las indicaciones de esta ficha técnica.


Assuntos
COVID-19 , Coronavirus , Orfanatos , Vulnerabilidade em Saúde , Grupos de Risco , Instituição de Longa Permanência para Idosos
20.
Brasília, D.F.; OPAS; 2020-05-21. (OPAS/BRA/CDE/COVID-19/20-0022).
em Português | PAHO-IRIS | ID: phr2-52305

RESUMO

Os asilos, orfanatos e outros locais de residência coletiva que prestam serviços a grupos de pessoas em condições de vulnerabilidade são fundamentais para o bem-estar da sociedade. É muito importante que esses espaços comunitários fechados tenham condições ambientais e de higiene adequadas para proteger a saúde dos cuidadores, visitantes e residentes (idosos e crianças). Este documento inclui recomendações para proteger a saúde durante a pandemia de COVID-19. Instruir cuidadores, equipe de serviço, residentes, familiares e visitantes com as indicações desta ficha técnica.


Assuntos
COVID-19 , Coronavirus , Almshouses , SARS-CoV-2 , Higiene , Orfanatos
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