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PM R ; 16(2): 122-131, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37314306


BACKGROUND: There is a limited evidence-base describing clinical features of delirium in youth. What is known is largely extrapolated from studies of adults or samples with heterogeneous etiologies. It is unclear if the symptoms experienced by adolescents differ from those experienced by adults, or the degree to which delirium impacts the ability of adolescents to return to school or work. OBJECTIVE: To describe delirium symptomatology among adolescents following a severe traumatic brain injury (TBI). Symptoms were compared by adolescent delirium status and across age groups. Delirium and its relationship with adolescent employability 1 year post-injury was also examined. DESIGN: Exploratory secondary analysis of prospectively collected data. SETTING: Free-standing rehabilitation hospital. PATIENTS: Severely injured TBI Model Systems neurorehabilitation admissions (n = 243; median Glasgow Coma Scale = 7). The sample was divided into three age groups (adolescents, 16-21 years, n = 63; adults 22-49 years, n = 133; older adults ≥50 years, n = 47). INTERVENTIONS: Not applicable. MEASURES: We assessed patients using Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) diagnostic criteria and the Delirium Rating Scale-Revised 98 (DRS-R-98). The employability item from the Disability Rating Scale was the primary 1-year outcome. RESULTS: Most items on the DRS-R-98 differentiated delirious from non-delirious adolescents. Only "delusions" differed among age groups. Among adolescents, delirium status 1 month post-TBI provided acceptable classification of employability prediction 1 year later (area under the curve [AUC]: 0.80, 95% confidence interval [CI]: 0.69-0.91, p < .001). Delirium symptom severity (AUC: 0.86, 95% CI: 0.68-1.03, SE: 0.09; p < .001) and days of post-traumatic amnesia (AUC: 0.85, 95% CI: 0.68-1.01, SE: 0.08; p < .001) provided excellent prediction of outcomes for TBI patients in delirium. CONCLUSIONS: Delirium symptomatology was similar among age groups and useful in differentiating the delirium status within the adolescent TBI group. Delirium and symptom severity at 1 month post-TBI were highly predictive of poor outcomes. Findings from this study support the utility of DRS-R-98 at 1 month post-injury to inform treatment and planning.

Lesões Encefálicas Traumáticas , Lesões Encefálicas , Delírio , Humanos , Adolescente , Idoso , Adulto Jovem , Adulto , Retorno à Escola , Lesões Encefálicas Traumáticas/complicações , Lesões Encefálicas Traumáticas/diagnóstico , Lesões Encefálicas/complicações , Emprego , Delírio/diagnóstico , Delírio/etiologia
Pediatr Crit Care Med ; 24(10): 807-817, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-38156082


Objective: To present the results of an abbreviated testing protocol used to screen for neurocognitive and psychological sequelae of critical illness among pediatric intensive care unit (PICU) survivors with acquired brain injury in our post-discharge follow-up programs, and describe our process for facilitating this population's return to academic life. Design: Retrospective cohort study. Setting: Neurocritical care follow-up programs at two U.S. academic, tertiary medical/surgical PICUs. Patients: Children age > 4 years enrolled in the neurocritical care follow-up programs (n=289) at these institutions who underwent neurocognitive and psychological testing between 2017-2021. Interventions: None. Measurements and Main Results: One month after discharge from the hospital, nearly half of the children and/or their parents (48%) in our neurocritical care follow-up programs identified some type of emotional or behavioral concern compared to their premorbid state, and 15% reported some type of cognitive concern. On evaluation, 35% of the children were given a new neurocognitive diagnosis. Neurocognitive domains regulated by the executive functioning system were the most commonly affected, including attention (54%), memory (31%) and processing speed (27%). One-quarter of the children were given a new psychological diagnosis, most commonly post-traumatic stress disorder (PTSD) or stress-related symptoms (12%). Over 80% of patients in the programs were given new recommendations for school, for both new academic services and new classroom accommodations. Over half of children (57%) were referred for comprehensive follow-up neuropsychological evaluation. Conclusions: Abbreviated neurocognitive and psychological evaluation successfully identifies the same deficits commonly found among PICU survivors who undergo longer, more complete testing protocols. When combined with services aimed at successfully re-integrating PICU survivors back to school, this focused evaluation can provide an effective and efficient means of screening for cognitive and emotional deficits among PICU survivors, and establish a rationale for early academic support upon the child's return to school.

Lesões Encefálicas , Alta do Paciente , Criança , Humanos , Pré-Escolar , Seguimentos , Estudos Retrospectivos , Assistência ao Convalescente , Retorno à Escola , Unidades de Terapia Intensiva Pediátrica , Lesões Encefálicas/complicações , Lesões Encefálicas/diagnóstico
PeerJ ; 11: e15871, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37927795


Background: To explore the direct effect of core self-evaluation and the indirect effects of positive and negative coping styles on school adaptation of high school students after their return to school during the COVID-19 pandemic. Methods: The Core Self-Evaluation Scale, Simple Coping Style Scale, and School Adaptation Questionnaire were used for the psychometric analysis of 500 high school students (229 males and 271 females) one month after their return to school. The bootstrap method was applied for mediation analysis. Results: A positive correlation was noted between core self-evaluation and school adaptation (r = 0.56), and the predictive effect was significant (ß = 0.43). Core self-evaluation positively predicted positive coping styles, which positively predicted school adaptation, while core self-evaluation negatively predicted negative coping styles, which negatively predicted school adaptation. Positive and negative coping styles played a significant mediating role between core self-evaluation and school adaptation. The mediating effect included the indirect effects generated by two pathways: core self-evaluation → positive coping style → school adaptation (95% CI [0.08-0.19]) and core self-evaluation → negative coping style → school adaptation (95% CI [0.03-0.11]). Conclusion: There is a positive association between the core self-evaluation and school adaptation of high school students after their return to school during the COVID-19 pandemic. It may directly or indirectly affect the school adaptation of high school students after their return to school through positive or negative coping styles. After returning to school, educators should guide students to view themselves positively, cultivate healthy core self-evaluation, and enable them to have good school adaptation.

COVID-19 , Masculino , Feminino , Humanos , COVID-19/epidemiologia , Pandemias , Autoavaliação Diagnóstica , Retorno à Escola , Adaptação Psicológica , Estudantes
Distúrb. comun ; 35(2): 59709, 02/08/2023.
Artigo em Inglês, Português | LILACS | ID: biblio-1452391


Introdução: O ensino remoto limitou a vivência de experiências concretas em espaços coletivos de formação de conhecimentos e intensificou a vulnerabilidade infantil quanto à educação formal, em especial as crianças em fase inicial de alfabetização. A partir deste panorama, tornou-se fundamental investigar o desempenho de escolares em busca de informações sobre a repercussão ocasionada pela pandemia de COVID-19 ao desenvolvimento infantil. Objetivo: Verificar o desempenho de pré-escolares em vocabulário e habilidades preditivas no ensino híbrido, frente aos impactos da pandemia de COVID-19. Método: Participaram deste estudo 12 escolares, com idade entre 5 a 6 anos, pertencentes ao terceiro período da educação infantil. Para a avaliação foram selecionados o Protocolo de Identificação Precoce dos Problemas de Leitura, e os Testes de Vocabulário Auditivo e de Vocabulário Expressivo. Resultados: Os dados obtidos demonstraram significância estatística para as provas de Vocabulário Receptivo em relação ao Expressivo, Nomeação Automática Rápida e Conhecimento do Alfabeto, Segmentação Silábica e Produção de Rima, acertos para Vocabulário Expressivo e Conhecimento do Alfabeto, assim como para a quantidade de erros em Vocabulário Expressivo e para a Nomeação Automática Rápida. Conclusão: O sucesso almejado para o ingresso no 1º ano do Ensino Fundamental dependerá das variações individuais de cada aluno quanto ao desempenho dos aspectos avaliados neste trabalho e à qualidade dos estímulos recebidos. (AU)

Introduction: Remote teaching limited the experience of concrete experiences in collective spaces for the formation of knowledge and intensified children's vulnerability in terms of formal education, especially children in the initial phase of literacy. From this panorama, it became essential to investigate the performance of students in search of information about the impact caused by the pandemic of COVID-19 on child development. Objective: To verify the performance of preschoolers in vocabulary and predictive skills in hybrid teaching, given the impacts of the COVID-19 pandemic. Method: Participated in this study 12 schoolchildren, aged between 5 and 6 years, belonging to the third period of early childhood education. For the evaluation were selected the Protocol for Early Identification of Reading Problems, and the Auditory Vocabulary and Expressive Vocabulary Tests. Results: The data obtained showed statistical significance for the tests of Receptive Vocabulary in relation to Expressive, Rapid Automatic Naming and Alphabet Knowledge, Syllabic Segmentation and Rhyme Production, correct answers for Expressive Vocabulary and Alphabet Knowledge, as well as for the number of errors in Expressive Vocabulary and for the Automatic Rapid Naming. Conclusion: The desired success for entering the 1st year of Elementary School will depend on the individual variations of each student regarding the performance of the aspects evaluated in this work and the quality of the stimuli received. (AU)

Introducción: La enseñanza a distancia limitó la vivencia de experiencias concretas en espacios colectivos de formación de saberes e intensificó la vulnerabilidad de los niños frente a la educación formal, especialmente de los niños en fase inicial de alfabetización. A partir de este panorama, se hizo imprescindible investigar el desempeño de los escolares en busca de información sobre el impacto que la pandemia de la COVID-19 provocó en el desarrollo infantil. Objetivo: Verificar el desempeño de preescolares en vocabulario y habilidades predictivas en aprendizaje semipresencial, ante los impactos de la pandemia del COVID-19. Método: Participaron en este estudio 12 escolares, con edades comprendidas entre los 5 y 6 años, pertenecientes al tercer ciclo de educación infantil. Para la evaluación se seleccionaron el Protocolo para la Identificación Temprana de Problemas de Lectura, y las Pruebas de Vocabulario Auditivo y Vocabulario Expresivo. Resultados: Los datos obtenidos mostraron significancia estadística para las pruebas de Vocabulario Receptivo en relación con Expresivo, Denominación Automática Rápida y Conocimiento del Alfabeto, Segmentación Silábica y Producción de Rimas, aciertos para Vocabulario Expresivo y Conocimiento del Alfabeto, así como para el número de errores en Vocabulario Expresivo y para Nomenclatura Automática Rápida. Conclusión: El éxito deseado para el ingreso al 1° año de la Enseñanza Fundamental dependerá de las variaciones individuales de cada estudiante en cuanto al desempeño de los aspectos evaluados en este trabajo y la calidad de los estímulos recibidos. (AU)

Humanos , Pré-Escolar , Criança , Vocabulário , Desempenho Acadêmico , Leitura , Escolas Maternais , Educação a Distância , Alfabetização , Retorno à Escola , COVID-19
Br J Sports Med ; 57(12): 798-809, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37316183


OBJECTIVE: To define the time frames, measures used and modifying factors influencing recovery, return to school/learn (RTL) and return to sport (RTS) after sport-related concussion (SRC). DESIGN: Systematic review and meta-analysis. DATA SOURCES: 8 databases searched through 22 March 2022. ELIGIBILITY CRITERIA: Studies with diagnosed/suspected SRC and interventions facilitating RTL/RTS or investigating the time and modifying factors for clinical recovery. Outcomes included days until symptom free, days until RTL and days until RTS. We documented study design, population, methodology and results. Risk of bias was evaluated using a modified Scottish Intercollegiate Guidelines Network tool. RESULTS: 278 studies were included (80.6% cohort studies and 92.8% from North America). 7.9% were considered high-quality studies, while 23.0% were considered high risk of bias and inadmissible. The mean days until symptom free was 14.0 days (95% CI: 12.7, 15.4; I2=98.0%). The mean days until RTL was 8.3 (95% CI: 5.6, 11.1; I2=99.3%), with 93% of athletes having a full RTL by 10 days without new academic support. The mean days until RTS was 19.8 days (95% CI: 18.8, 20.7; I2=99.3%), with high heterogeneity between studies. Several measures define and track recovery, with initial symptom burden remaining the strongest predictor of longer days until RTS. Continuing to play and delayed access to healthcare providers were associated with longer recovery. Premorbid and postmorbid factors (eg, depression/anxiety, migraine history) may modify recovery time frames. Though point estimates suggest that female sex or younger age cohorts take longer to recover, the heterogeneity of study designs, outcomes and overlap in CIs with male sex or older age cohorts suggests that all have similar recovery patterns. CONCLUSION: Most athletes have full RTL by 10 days but take twice as long for an RTS. PROSPERO REGISTRATION NUMBER: CRD42020159928.

Concussão Encefálica , Esportes , Feminino , Masculino , Humanos , Retorno à Escola , Volta ao Esporte , Instituições Acadêmicas , Atletas , Concussão Encefálica/diagnóstico , Concussão Encefálica/epidemiologia
J Pediatr Hematol Oncol Nurs ; 40(4): 226-234, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37032468


Introduction: Psychosocial impacts of cancer are well-recognized for pediatric patients but few studies examine challenges specific to schooling after diagnosis and caregiver-related factors that may influence coping. This study describes caregiver experiences of school-related psychosocial functioning and how caregiver preparedness and understanding of these challenges influence coping. Methods: Caregivers of 175 childhood cancer survivors completed a nationally disseminated survey related to caregiver preparedness, clinician-provided education, and school-related experiences. Caregiver-reported preparedness and understanding were evaluated as predictors of psychosocial coping; factor analysis was performed to identify compound scales of preparedness and understanding. Results: Caregivers reported that the cancer treatment experience resulted in their children being more stressed and anxious about returning to school (60.2% and 70.2%, respectively) and more sensitive to peers (73.4%). It also made it harder for them to socialize and fit in with peers (58.2% and 49.7%, respectively). Caregiver preparedness and understanding predicted improved psychosocial coping with regard to child stress regarding socialization, fitting in, and anxiety but not sensitivity to peers. Teacher supportiveness and caregiver perception of clinician understanding also correlated with function. Discussion: Findings highlight the importance of caregiver education and preparedness as these reliably predict child psychosocial function and coping as they return to school after a cancer diagnosis and that all children are at risk for psychosocial challenges following a cancer diagnosis. Opportunities exist for clinicians to provide more education and anticipatory guidance to families as a potential means to reduce poor coping when a child returns to school following cancer.

Neoplasias , Reabilitação Psiquiátrica , Humanos , Criança , Retorno à Escola , Pais/psicologia , Adaptação Psicológica , Neoplasias/terapia , Instituições Acadêmicas
Public Health Rep ; 138(3): 509-517, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36891993


OBJECTIVES: Quarantine after exposure to COVID-19 has resulted in substantial loss of in-person learning in schools from prekindergarten through grade 12. Test to Stay (TTS), a strategy that limits the spread of SARS-CoV-2 while prioritizing in-person learning, requires substantial investment in resources. The objective of this study was to assess the perceived benefits, barriers, and facilitators of implementing TTS in an urban school district in the Midwest serving primarily Black or African American people with low income. METHODS: In December 2021, we used a concurrent mixed-methods approach to understand perceived benefits, barriers, and facilitators of implementing TTS by combining quantitative analysis of telephone surveys conducted with parents (n = 124) and a qualitative inquiry involving key informants from the school district and local health department (n = 22). We analyzed quantitative data using descriptive statistics. We used thematic analysis to analyze qualitative data. RESULTS: Quantitative findings showed that parents supported TTS because it was convenient (n = 83, 97%) and effective (n = 82, 95%) in keeping students learning in person (n = 82, 95%) and preventing the spread of COVID-19 (n = 80, 93%). Qualitative interviews with informants found that having a clear protocol and assigning staff to specified tasks allowed for successful TTS implementation. However, insufficient staffing and testing resources, parent mistrust of testing, and lack of communication from schools were perceived barriers. CONCLUSION: The school community strongly supported TTS despite the many implementation challenges faced. This study emphasized the importance of ensuring resources for equitable implementation of COVID-19 prevention strategies and the critical role of communication.

Negro ou Afro-Americano , Teste para COVID-19 , COVID-19 , Acessibilidade aos Serviços de Saúde , Retorno à Escola , Humanos , COVID-19/diagnóstico , COVID-19/epidemiologia , COVID-19/prevenção & controle , Pobreza , Pesquisa Qualitativa , SARS-CoV-2 , Estados Unidos/epidemiologia
J Head Trauma Rehabil ; 38(4): 329-335, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36727685


OBJECTIVE: Children who experience traumatic brain injury (TBI) of any severity may need accommodations when they return to school-the setting that manages academic achievement and learning. However, variations exist in current return to school (RTS) programs that address a child's transition to school following TBI. This article describes some of these return to school (RTS) programs and how they vary by setting. DESIGN: This article provides insights from a modified evaluability assessment that examined RTS programs and their readiness for rigorous evaluation. A secondary analysis was conducted to better describe the types and location of programs examined. RESULTS: Differences exist in program structure, access, and how care for children is monitored over time. RTS programs that serve children following TBI are located in healthcare settings, schools, and state agencies and vary in models of care due to their location and organizational structure. CONCLUSIONS: Children who experience TBI benefit from a healthcare assessment and follow-up upon RTS that includes parental involvement. Models of care for this process vary based on program location and organizational structure. Further research and program evaluation are needed to better understand effectiveness and how to optimally monitor and care for children returning to school after a concussion or TBI.

Sucesso Acadêmico , Concussão Encefálica , Lesões Encefálicas Traumáticas , Criança , Humanos , Retorno à Escola , Instituições Acadêmicas
J Pediatr Rehabil Med ; 16(3): 497-505, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36847024


PURPOSE: More than 50,000 children are hospitalized yearly in the U.S. for acquired brain injury (ABI) with no established standards or protocols for school re-entry and limited resources for hospital-school communication. While ultimately the school has autonomy over curricula and services, specialty physicians were asked about their participation and perception of barriers in the school re-entry process. METHODS: Approximately 545 specialty physicians were sent an electronic survey. RESULTS: 84 responses (43% neurologists and 37% physiatrists) were obtained with a response rate of ∼15%. Thirty-five percent reported that specialty clinicians currently make the plan for school re-entry. The biggest challenge for school re-entry noted by physicians was cognitive difficulties (63%). The biggest gaps perceived by physicians were a lack of hospital-school liaisons to help design and implement a school re-entry plan (27%), schools' inability to implement a school re-entry plan (26%), and an evidence-based cognitive rehab curriculum (26%). Forty-seven percent of physicians reported that they did not have adequate medical personnel to support school re-entry. The most commonly used outcome measure was family satisfaction. Ideal outcome measures included satisfaction (33%) and formal assessment of quality of life (26%). CONCLUSION: These data suggest that specialty physicians identify a lack of school liaisons in the medical setting as an important gap in hospital-school communication. Satisfaction and formal assessment of quality of life are meaningful outcomes for this provider group.

Lesões Encefálicas , Médicos , Humanos , Criança , Qualidade de Vida , Retorno à Escola , Instituições Acadêmicas
JAMA Netw Open ; 6(1): e2251839, 2023 01 03.
Artigo em Inglês | MEDLINE | ID: mdl-36662524


Importance: Determining how the timing of return to school is related to later symptom burden is important for early postinjury management recommendations. Objective: To examine the typical time to return to school after a concussion and evaluate whether an earlier return to school is associated with symptom burden 14 days postinjury. Design, Setting, and Participants: Planned secondary analysis of a prospective, multicenter observational cohort study from August 2013 to September 2014. Participants aged 5 to 18 years with an acute (<48 hours) concussion were recruited from 9 Canadian pediatric emergency departments in the Pediatric Emergency Research Canada Network. Exposure: The independent variable was the number of days of school missed. Missing fewer than 3 days after concussion was defined as an early return to school. Main Outcomes and Measures: The primary outcome was symptom burden at 14 days, measured with the Post-Concussion Symptom Inventory (PCSI). Symptom burden was defined as symptoms status at 14 days minus preinjury symptoms. Propensity score analyses applying inverse probability of treatment weighting were performed to estimate the relationship between the timing of return to school and symptom burden. Results: This cohort study examined data for 1630 children (mean age [SD] 11.8 [3.4]; 624 [38%] female). Of these children, 875 (53.7%) were classified as having an early return to school. The mean (SD) number of days missed increased across age groups (5-7 years, 2.61 [5.2]; 8-12 years, 3.26 [4.9]; 13-18 years, 4.71 [6.1]). An early return to school was associated with a lower symptom burden 14 days postinjury in the 8 to 12-year and 13 to 18-year age groups, but not in the 5 to 7-year age group. The association between early return and lower symptom burden was stronger in individuals with a higher symptom burden at the time of injury, except those aged 5 to 7 years. Conclusions and Relevance: In this cohort study of youth aged 5 to 18 years, these results supported the growing belief that prolonged absences from school and other life activities after a concussion may be detrimental to recovery. An early return to school may be associated with a lower symptom burden and, ultimately, faster recovery.

Concussão Encefálica , Retorno à Escola , Criança , Adolescente , Humanos , Feminino , Pré-Escolar , Masculino , Estudos de Coortes , Estudos Prospectivos , Canadá/epidemiologia , Concussão Encefálica/diagnóstico , Concussão Encefálica/complicações , Instituições Acadêmicas
Phys Sportsmed ; 51(6): 558-563, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36243035


INTRODUCTION: ACL reconstruction is commonly performed in school-aged patients for whom missed time from school can have an impact on their education. Additionally, the COVID-19 pandemic has led to different ways of accessing school content. We sought to determine how many days of school school-aged patients should expect to miss following ACL reconstruction and how the availability of remote learning during the COVID-19 pandemic affected this. METHODS: We evaluated 53 ACL reconstruction patients in grades 7-12 undergoing surgery during the school year. Demographic, medical, and educational information were collected. Patients were placed into 1 of 2 cohorts: Group A (surgery before the COVID-19 pandemic) or Group B (surgery during the COVID-19 pandemic). We calculated days missed from school after surgery until return to either virtual or in-person school. RESULTS: Overall, patients returned to school after missing an average of 4.4 (SD, 3.0) days of school after ACL reconstruction surgery. Patients in Group A missed an average of 5.5 (SD, 2.9) school days, while patients in Group B missed an average of 2.3 (SD, 1.4) school days (p <.001). Eighty-nine percent of Group B patients first returned to school utilizing a virtual option. Among those returning virtually, these patients missed an average of 1.9 (SD, 0.9) school days. CONCLUSIONS: A virtual distance learning option results in fewer missed days of school post ACL reconstruction. When given this option, school-aged patients can expect to return to school within two days post-op. Otherwise, patients should expect to miss about one week of in-person schooling. In this regard, the COVID-19 pandemic has positively impacted educational opportunities for students post-surgery, and physicians should advocate for continuing virtual options for students receiving medical treatment.

Lesões do Ligamento Cruzado Anterior , Reconstrução do Ligamento Cruzado Anterior , COVID-19 , Humanos , Criança , Lesões do Ligamento Cruzado Anterior/cirurgia , Pandemias , Retorno à Escola , Reconstrução do Ligamento Cruzado Anterior/métodos , Volta ao Esporte
Clin J Sport Med ; 33(3): 264-269, 2023 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-36395518


OBJECTIVE: To determine the association between academic time loss postconcussion and vision symptoms/impairments among pediatric patients. DESIGN: Cross-sectional. SETTING: Sports medicine clinic. PATIENTS: Pediatric patients seen for care in a sports medicine clinic between the ages 6 and 18 years (n = 212; mean age = 14.3, SD = 2.4 years; 48% female) were evaluated within 21 days of concussion (mean = 9.8, SD = 5.7 days). INDEPENDENT VARIABLE: Patients were grouped based on academic time loss (missed >5 days vs ≤5 days of school) at their initial postconcussion evaluation. OUTCOME MEASURES: Patients rated concussion symptoms using the Health and Behavior Inventory (HBI) and underwent near point of convergence (NPC) testing. We compared groups on specific HBI symptom ratings of dizziness, blurry vision, seeing double, and light sensitivity, as well as NPC break and recovery point distances. RESULTS: Two hundred twelve patients were included; n = 36 (17%) who reported missing >5 days of school. After adjusting for time since injury, parental education level, mechanism of injury, and preinjury anxiety, patients who reported missing >5 days of school had higher ratings of double vision (ß = 0.27; 95% confidence interval [CI], 0.01-0.53; P = 0.04) and light sensitivity (ß = 0.506; 95% CI, 0.061-0.951; P = 0.02), but not dizziness (ß = 0.390; 95% CI, -0.047 to 0.827; P = 0.08) or blurry vision (ß = 0.026; 95% CI, -0.352 to 0.404; P = 0.89). CONCLUSION: Missing >5 days of school was associated with worse double vision and light sensitivity symptoms. Given the importance of vision in learning, assessing postconcussion vision symptoms may facilitate a successful return to school. Clinicians should assess a wide spectrum of vision-specific symptoms to ensure appropriate support during the return-to-school process.

Traumatismos em Atletas , Concussão Encefálica , Síndrome Pós-Concussão , Humanos , Feminino , Criança , Adolescente , Masculino , Traumatismos em Atletas/complicações , Traumatismos em Atletas/diagnóstico , Diplopia/complicações , Fotofobia/complicações , Retorno à Escola , Estudos Transversais , Concussão Encefálica/complicações , Concussão Encefálica/diagnóstico , Síndrome Pós-Concussão/diagnóstico , Síndrome Pós-Concussão/complicações , Tontura , Transtornos da Visão/etiologia , Vertigem , Instituições Acadêmicas
J Sch Nurs ; 39(6): 422-430, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34287070


Although all states have legislation pertaining to youth sports concussion, most of these laws focus on return-to-play procedures; only a few address return-to-learn (RTL) accommodations for students who have experienced a concussion. To address this gap in the legislation, some states and nongovernmental organizations have developed RTL guidelines to advise school personnel, parents, and health care providers on best practices for accommodating students' postconcussion reintegration into academic activity. In 2018, the Massachusetts Department of Public Health (MDPH) developed RTL guidelines which were disseminated to school nurses (SNs) at all public and nonpublic middle and high schools in the state. In 2020, the MDPH engaged the Injury Prevention Center at Boston Medical Center to survey Massachusetts SNs to assess the usefulness of the guidelines. The response rate was 63%; 92% found the booklet extremely useful or moderately useful; and 70% endorsed that the booklet fostered collaboration among stakeholders.

Traumatismos em Atletas , Concussão Encefálica , Adolescente , Humanos , Retorno à Escola , Instituições Acadêmicas , Massachusetts , Inquéritos e Questionários
Psicol. ciênc. prof ; 43: e252476, 2023. graf
Artigo em Português | LILACS, Index Psicologia - Periódicos | ID: biblio-1448942


Este artigo tem como objetivo analisar a vivência de trabalho precoce de adolescentes e jovens em cumprimento de medida socioeducativa, no estado da Paraíba. Os instrumentos utilizados foram um Questionário Mosquito Diagnóstico e uma Entrevista Semiestruturada. A análise foi realizada com o software Iramuteq, (Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires), através da Análise Hierárquica Descendente, que gerou seis classes: significado do trabalho; infância e escola; condições objetivas de vida; trabalho, drogas e ato infracional; consequências do trabalho infantil; e trabalho infantojuvenil. A perspectiva teórica utilizada foi a psicologia histórico-cultural e os dados discutidos a partir do conceito de vivência. Conclui-se que as vivências e situações sociais de desenvolvimento foram caracterizadas pelo trabalho precoce que oportunizou o envolvimento com atos infracionais e as instituições responsáveis pela garantia de direitos em vez de garantir a proteção social, criminalizaram por meio de medidas socioeducativas.(AU)

This article aims to analyze the experience of child labor of adolescents and youngsters that are complying a social-educational measure, in the State of Paraíba. The instruments utilized were a Questionnaire Mosquito Diagnóstico and a Semi-Structured Interview. The analysis was performed by using the Iramuteq software (Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires), by using Descending Hierarchical Analysis, which generated six classes: meaning of labor; childhood and school; objective conditions of life; labor, drugs, and act of infraction; consequences of child labor; and child labor. The theoretical perspective used was historical-cultural psychology and the data were discussed from the concept of experience. It was concluded that the experiences and social situations of development were characterized by child labor, which enabled the involvement with acts of infraction; and the institutions responsible for guaranteeing rights, instead of guaranteeing social protection, criminalized by using social-educational measures.(AU)

Este artículo tiene como objetivo analizar la vivencia precoz de adolescentes y jóvenes que cumplen medidas socioeducativas en el estado de Paraíba (Brasil). Los instrumentos utilizados fueron un Cuestionario Mosquito Diagnóstico y una entrevista semiestructurada. El análisis se realizó con el software Iramuteq (Interface de R pour les Multidimensionnelles Analyzes de Textes et de Questionnaires), mediante análisis jerárquico descendente, que generó seis clases: Significado del trabajo; Infancia y escuela; Condiciones objetivas de vida; Trabajo, drogas y acto de infracción; Consecuencias del trabajo infantil; y Trabajo infantojuvenil. La perspectiva teórica que se utilizó fue la psicología histórico-cultural, y los datos se discutieron desde el concepto de vivencia. Se concluye que las vivencias y situaciones sociales de desarrollo se caracterizaron por trabajo infantil que permitió la participación en infracciones y que las instituciones responsables de garantizar los derechos en lugar de la protección social los criminalizaron mediante medidas socioeducativas.(AU)

Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Trabalho Infantil , Adolescente , Educação , Personalidade , Jogos e Brinquedos , Pobreza , Preconceito , Trabalho Sexual , Psicologia , Política Pública , Punição , Instituições Acadêmicas , Autoimagem , Mudança Social , Classe Social , Condições Sociais , Apoio Social , Socialização , Fatores Socioeconômicos , Estereotipagem , Evasão Escolar , Tentativa de Suicídio , Roubo , Violência , Comportamento e Mecanismos Comportamentais , Jornada de Trabalho , Abuso Sexual na Infância , Inclusão Escolar , Riscos Ocupacionais , Acidentes de Trabalho , Família , Drogas Ilícitas , Criança Abandonada , Defesa da Criança e do Adolescente , Criança Institucionalizada , Proteção da Criança , Comportamento Autodestrutivo , Direitos Civis , Política de Planejamento Familiar , Assédio Sexual , Comunicação , Adulto , Legislação , Aconselhamento , Crime , Comportamento Perigoso , Saúde do Adolescente , Morte , Desinstitucionalização , Amigos , Menores de Idade , Agressão , Violação de Direitos Humanos , Escolaridade , Emprego , Vulnerabilidade em Saúde , Mercado de Trabalho , Bullying , Remuneração , Discriminação Social , Tráfico de Drogas , Pessoas Escravizadas , Capital Social , Ajustamento Emocional , Consumo de Álcool por Menores , Alfabetização , Comportamento de Busca de Ajuda , Autocontrole , Reabilitação Psiquiátrica , Sistemas de Apoio Psicossocial , Equilíbrio Trabalho-Vida , Fragilidade , Sobrevivência , Reincidência , Fracasso Acadêmico , Experiências Adversas da Infância , Cyberbullying , Análise de Dados , Internação Involuntária , Retorno à Escola , Sustento , Abuso Emocional , Estresse Financeiro , Perspectiva de Curso de Vida , Instabilidade Habitacional , Vulnerabilidade Social , Cidadania , Homicídio , Zeladoria , Direitos Humanos , Institucionalização , Delinquência Juvenil , Idioma , Serviços de Saúde Mental
Psicol. ciênc. prof ; 43: e255165, 2023.
Artigo em Português | LILACS, Index Psicologia - Periódicos | ID: biblio-1529227


O presente estudo qualitativo objetivou compreender as expectativas de mães e cuidadoras sobre a sua participação no Programa ACT para Educar Crianças em Ambientes Seguros na versão remota, no período da pandemia de covid-19. Também visou identificar a percepção das participantes sobre educar uma criança em um ambiente seguro. Foram realizadas entrevistas semiestruturadas on-line com doze mães e cuidadoras, antes da participação no Programa ACT. Os resultados indicaram diferentes expectativas sobre a participação no Programa ACT, entre elas: adquirir novos conhecimentos, aprimorar as habilidades parentais, trocar experiências, receber auxílio no momento da pandemia de covid-19 e possibilitar para a criança um desenvolvimento saudável. Na percepção das mães e cuidadoras, a versão remota do Programa ACT apresenta aspectos positivos; entre eles, a participação de pais e cuidadores que não residem na cidade em que é oferecida a intervenção. No entanto, apontaram como fatores negativos a ausência do contato físico e as interrupções que podem acontecer a partir das falhas de internet. Para as mães e cuidadoras, educar a criança em um ambiente seguro estava relacionado a promover os direitos estabelecidos no Estatuto da Criança e do Adolescente (ECA), como educação, saúde, lazer, cuidado, afeto, assim como protegê-la de situações de violência. Considera-se que as expectativas das participantes estavam alinhadas aos objetivos do Programa ACT. Torna-se prioritário oferecer programas de prevenção à violência aos pais e cuidadores, em especial em momentos adversos como o da pandemia de covid-19, a fim de promover o desenvolvimento e a saúde das crianças, assim como prevenir situações de violação de direitos.(AU)

This qualitative study aims to understand the expectations of mothers and caregivers about participating in the ACT Raising Safe Kids Program in its remote version, during the COVID-19 pandemic period. It also aims to identify the participants' perception of raising a child in a safe environment. Semi-structured on-line interviews were conducted with 12 mothers/caregivers, prior to participation in the ACT Program. The results indicated different expectations regarding the participation in the ACT Program, for example: acquiring new knowledge, improving parenting skills, exchanging experiences, receiving support during the COVID-19 pandemic, and enabling the child to have a healthy development. In the perception of mothers and caregivers, the remote version of the ACT Program has positive aspects, such as the participation of parents and caregivers who do not live in the city where the intervention is offered. However, they pointed out as negative factors absence of physical contact and interruptions due to internet failures. For the mothers/caregivers, educating children in a safe environment was related to promoting the rights established by the Brazilian Child and Adolescent Statute, namely education, health, leisure, care, affection, as well as protecting them from situations of violence. The expectations of the participants were aligned with the objectives of the ACT Program. Offering violence prevention programs to parents and caregivers is a priority, especially in adverse moments such as the COVID-19 pandemic, in order to promote the development and health of children, as well as prevent situations of violation of rights.(AU)

Este estudio cualitativo pretendió comprender las expectativas de madres y cuidadoras sobre la participación en el Programa de ACT para Educar a Niños en Ambientes Seguros en la versión remota, en el periodo de la pandemia de la COVID-19. También se propuso identificar la percepción de las participantes sobre educar a un niño en un ambiente seguro. Se llevaron a cabo entrevistas semiestructuradas en línea con 12 madres/cuidadoras, antes de la participación en el Programa ACT. Los resultados señalaron diferentes expectativas con la participación del Programa de ACT, entre ellas: adquirir nuevos conocimientos, perfeccionar las habilidades parentales, intercambiar experiencias, recibir auxilio en el momento de la pandemia de la COVID-19 y posibilitar al niño un desarrollo saludable. En la percepción de las madres y cuidadoras, la versión remota del Programa de ACT presenta aspectos positivos, como la participación de padres y cuidadores que no residen en la ciudad donde es ofrecida la intervención. Sin embargo, señalaron como factores negativos la ausencia del contacto físico y las interrupciones, que pueden ocurrir por fallas en Internet. Para las madres/cuidadoras, educar al niño en un ambiente seguro estaba relacionado a promover los derechos establecidos en el Estatuto del Niño y del Adolescente de Brasil, como educación, salud, ocio, cuidado, afecto, así como protegerlo de situaciones de violencia. Se considera que las expectativas de las participantes estaban alineadas con los objetivos del Programa de ACT. Es prioritario ofrecer programas de prevención a la violencia a los padres y cuidadores, en especial en momentos adversos como el de la pandemia de la COVID-19, con el fin de promover el desarrollo y la salud de los niños, así como prevenir situaciones de vulneración de derechos.(AU)

Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Maus-Tratos Infantis , Prevenção de Doenças , Intervenção Psicossocial , Apetite , Desenvolvimento da Personalidade , Ludoterapia , Resolução de Problemas , Psicologia , Desempenho Psicomotor , Política Pública , Segurança , Instituições Acadêmicas , Delitos Sexuais , Autoritarismo , Ajustamento Social , Classe Social , Isolamento Social , Responsabilidade Social , Apoio Social , Estresse Psicológico , Síndrome da Criança Espancada , Comportamento e Mecanismos Comportamentais , Sintomas Comportamentais , Abuso Sexual na Infância , Brasil , Sistemas On-Line , Caráter , Criança , Criança Abandonada , Cuidado da Criança , Proteção da Criança , Saúde Mental , Negociação , Entrevista , Violência Doméstica , Coronavirus , Distúrbios de Guerra , Meios de Comunicação , Assistência Integral à Saúde , Crime , Ameaças , Sintomas Afetivos , Cultura , Vigilância em Desastres , Morte , Denúncia de Irregularidades , Populações Vulneráveis , Agressão , Sonhos , Conflito Familiar , Relações Familiares , Terapia Familiar , Pandemias , Rede Social , Narrativa Pessoal , Transtornos Relacionados a Trauma e Fatores de Estresse , Trauma Psicológico , Assistentes Sociais , Criança Acolhida , Frustração , Crescimento Psicológico Pós-Traumático , Respeito , Angústia Psicológica , Trauma Sexual , Inclusão Social , Retorno à Escola , Abastecimento de Alimentos , COVID-19 , Ambiente Domiciliar , Vulnerabilidade Social , Cidadania , Hematoma , Homicídio , Visita Domiciliar , Direitos Humanos , Infanticídio , Acontecimentos que Mudam a Vida , Amor , Imperícia , Bem-Estar Materno , Transtornos Mentais , Narcisismo , Apego ao Objeto
Notas enferm. (Córdoba) ; 23(40): 4-12, dic.2022.
Artigo em Espanhol | LILACS, BDENF - Enfermagem, BINACIS, UNISALUD | ID: biblio-1401321


La COVID-19 provocó el cierre de las escuelas, y trasladó las actividades a los entornos virtuales por casi dos años. Posteriormente, los gobiernos otorgaron a las instituciones educativas, planes de retorno seguro a las actividades escolares para mejorar una transición a la presencialidad de la comunidad escolar y mantener a un mínimo los casos nuevos de la COVID-19. El profesional de enfermería, a través del Proceso de Atención de Enfermería (PAE), posee las herramientas y conocimientos necesarios para operativizar estos lineamientos e implementarlos de forma efectiva en las comunidades escolares. Objetivo: Implementar el PAE para facilitar el retorno seguro a las actividades escolares en una escuela primaria de México. Metodología: Estudio de caso comunitario con PAE, implementado en una escuela primaria pública de México. Para la valoración se utilizaron técnicas cualitativas y de participación comunitaria (entrevistas, cartografía social, etc) y para el proceso diagnóstico, resultados e intervenciones se utilizó la taxonomía NANDA 2021-2023, Clasificación de Resultados NOC y Clasificación de Intervenciones NIC. Resultados: Se trabajó en torno a un diagnóstico, un resultado y dos intervenciones sobre la participación comunitaria en programas educativos y de comunicación en salud, así como la disminución de las conductas de riesgo para la salud en la comunidad. Conclusiones: El PAE permitió mejorar las conductas promotoras de la salud en torno al uso de cubrebocas, sana distancia y lavado de manos en la comunidad. Se elaboraron materiales de comunicación en salud como técnica de refuerzo de los hábitos aprendidos[AU]

COVID-19 caused the closure of schools, moving activities to virtual environments for almost two years. Subsequently, governments give educational institutions plans for the safe return to school activities to improve a transition to face-to-face attendance for the school community and keep new cases of COVID-19 to a minimum. Te nursing professional, through the Nursing Care Process (NCP), has the necessary tools and knowledge to operationalize these guidelines and implement them effectively in school communities. Objective: To facilitate a safe return to school activities in a primary school in Mexico. Methodology: A community case study with NCP, establishing the community of a primary school as a patient, for the assessment qualitative techniques and community participation were used and for the diagnostic process, results, and interventions the NANDA 2021-2023 taxonomy was used, Classifcation of NOC Results and classifcation of NIC Interventions. Results: Work was carried out around a diagnosis, a result, and two interventions on community participation in educational and health communication programs, as well as the reduction of risk behaviors for health in the community. Conclusions: Te NCP made it possible to improve health-promoting behaviors around the use of face masks, healthy distance, and hand washing in the community. By considering the assessment of different actors, health communication materials were made as a technique to reinforce learned habits[AU]

A COVID-19 provocou o fechamento de escolas, deslocando as atividades para ambientes virtuais por quase dois anos. Posteriormente, os governos concedem às instituições de ensino planos para o retorno seguro às atividades escolares para melhorar a transição para o atendimento presencial para a comunidade escolar e reduzir ao mínimo os novos casos de COVID-19. O profssional de enfermagem, por meio do Processo de Cuidar de Enfermagem (PCE), possui as ferramentas e conhecimentos necessários para operacionalizar essas diretrizes e implementá- las efetivamente nas comunidades escolares. Objetivo: Facilitar o retorno seguro às atividades escolares em uma escola primária no México. Metodologia: Estudo de caso comunitário com PCE, estabelecendo a comunidade de uma escola primária como paciente, para a avaliação foram utilizadas técnicas qualitativas e participação da comunidade e para o processo diagnóstico, resultados e intervenções foi utilizada a taxonomia NANDA 2021-2023, Classifcação da NOC Resultados e classifcação das intervenções NIC. Resultados: Trabalhou-se em torno de um diagnóstico, um resultado e duas intervenções sobre a participação da comunidade em programas educativos e de comunicação em saúde, bem como a redução de comportamentos de risco para a saúde na comunidade. Conclusões: O PCE possibilitou melhorar os comportamentos de promoção da saúde em torno do uso de máscaras faciais, distanciamento saudável e lavagem das mãos na comunidade. Tendo em conta a avaliação dos diferentes atores, foram elaborados materiais de comunicação em saúde como técnica para reforçar os hábitos aprendidos[AU]

Humanos , Masculino , Feminino , Criança , Participação da Comunidade , Comunicação em Saúde , Retorno à Escola , COVID-19/enfermagem , COVID-19/prevenção & controle , Processo de Enfermagem , Relatos de Casos
Cienc. act. fis. (Talca, En linea) ; 23(2): 1-12, dez. 2022. tab
Artigo em Espanhol | LILACS | ID: biblio-1421094


La presente investigación tuvo como objetivo conocer el nivel de cumplimiento de las medidas académicas y de salud, limpieza e higiene que se implementaron en la sesión de educación física en el regreso a clases presenciales en México. Para ello, se siguió un diseño cuantitativo no experimental de corte transversal, a través de la cual se recogió información por medio de una escala tipo Likert. Los resultados indican que el 55% de los profesores de educación física están de acuerdo en que las medidas académicas establecidas, les facilitó lograr la recuperación y reforzamiento de los aprendizajes de sus alumnos, así mismo, el 81,2% afirma que se están llevando a cabo medidas preventivas de contagio y mitigación de la COVID-19 en las actividades escolares. Se concluye que las medidas propuestas por las autoridades educativas para el regreso a clases presenciales son aceptables, sin embargo, se identifican limitantes en lo que se refiere al abasto de materiales de sanitización y limpieza entregados por las autoridades educativas.

This research was conducted in order to determine the level of compliance to the health, cleanliness, and hygiene measures implemented during physical education sessions when returning to school in Mexico. For this purpose, a non-experimental cross-sectional quantitative design was followed, through which information was collected by means of a Likert-type scale. The results indicate that 55% of the physical education teachers agree that the measures established helped them to recover and reinforce what their students learnt. Likewise, 81,2% assert that they are now carrying out preventive measures for the contagion and mitigation of COVID-19 during school activities. It is concluded that the measures proposed by the educational authorities for the return to school are acceptable. However, there are some limitations identified in terms of the supply of sanitizing and cleaning materials provided by the educational authorities.

O objetivo desta pesquisa foi determinar o nível de cumprimento das medidas acadêmicas e de saúde, limpeza e higiene que foram implementadas na sessão de educação física ao retornar às aulas presenciais no México. Para isso, seguiu-se um delineamento quantitativo transversal não experimental, por meio do qual as informações foram coletadas por meio de uma escala do tipo Likert. Os resultados indicam que 55% dos professores de educação física concordam que as medidas acadêmicas estabelecidas facilitam a recuperação e o reforço da aprendizagem de seus alunos, da mesma forma, 81,2% afirmam que estão realizando medidas preventivas de contágio e mitigação de COVID-19 nas atividades escolares. Conclui-se que as medidas propostas pelas autoridades educacionais para o retorno às aulas presenciais são aceitáveis, porém, são identificadas limitações quanto ao fornecimento de materiais de higienização e limpeza entregues pelas autoridades educacionais.

Humanos , Masculino , Feminino , Adulto , Educação Física e Treinamento , Professores Escolares , Retorno à Escola , COVID-19/prevenção & controle , Higiene/normas , Estudos Transversais , Inquéritos e Questionários , México
Cienc. act. fis. (Talca, En linea) ; 23(2): 1-12, dez. 2022. graf
Artigo em Espanhol | LILACS | ID: biblio-1421101


El objetivo de la investigación fue conocer las percepciones de los estudiantes en Práctica de Síntesis Profesional (PSP) de la carrera de Educación Física de una universidad chilena respecto al retorno a la presencialidad tras dos años de confinamiento. Para el desarrollo de este estudio piloto se utilizó un enfoque cuantitativo, no experimental transversal con alcance descriptivo de tipo exploratorio La muestra se compuso de 45 estudiantes en PSP dentro de la región del Maule, Chile, con cursos que van desde Pre Básica hasta enseñanza media en establecimientos municipales, particulares y particulares subvencionados. Los resultados indican que los docentes en formación perciben el retorno a la presencialidad como un proceso complejo por el contexto vivido en la actualidad, experimentando desafíos educativos, adaptaciones y medidas sanitarias en el desarrollo de sus clases. Se concluye que existen diversos factores que han afectado el proceso de prácticas, generando la necesidad de reorientar las metodologías de trabajo de los docentes y reorganizando la realización de las clases, sin embargo, esto no significó que fuese un proceso negativo, donde a pesar de las dificultades, fue favorable y significativo volver a interactuar con los estudiantes presencialmente.

The present study aims to know the perception of students in Professional Synthesis Practice (PSP) from the Physical Education major, at a Chilean university, in regard to returning to in person teaching after two years of confinement where people were affected worldwide, leaving their daily lives behind, and education was no exception. The sample was comprised of 45 students who are carrying out their PSP in the Maule Region, Chile, taking courses that range from pre-basic to high school in public, private, and partly subsidized schools. The results indicate that teachers in training perceive returning to in-person teaching as a complex process due to the current context, as well as the experience of educational challenges, adaptations, and health measures in the development of their classes. It is concluded that several factors affected the internship process, generating the need to reorient the teachers' work methodologies, and reorganizing the way classes are conducted. However, this did not mean that it was a negative process, despite the difficulties; it was favorable and meaningful to interact with the students in person.

O objetivo foi conhecer as percepções dos estudantes em estágio profissional de síntese (PSP) do curso de Educação Física de uma universidade chilena sobre o retorno ao ensino presencial após dois anos de confinamento. Para o desenvolvimento deste estudo piloto, utilizou-se uma abordagem quantitativa, não experimental, transversal, com escopo descritivo exploratório. A amostra foi composta por 45 estudiantes de PSP da região de Maule, Chile, com cursos de pré-básico a ensino médio em estabelecimentos municipais, privados e privados subsidiados. Os resultados indicam que os professores em formação percebem o retorno ao ensino presencial como um processo complexo devido ao contexto atual, vivenciando desafios educacionais, adaptações e medidas de saúde no desenvolvimento de suas aulas. Conclui-se que são vários os fatores que afetaram o processo de estágio, gerando a necessidade de reorientar as metodologias de trabalho dos professores e reorganizar a condução das aulas, no entanto, isso não significa que tenha sido um processo negativo, onde apesar das dificuldades, foi favorável e significativo para interagir novamente com os alunos pessoalmente.

Humanos , Masculino , Feminino , Adulto , Adulto Jovem , Estudantes/psicologia , Retorno à Escola , Percepção , Adaptação Psicológica , Chile , Quarentena , Pandemias , COVID-19