The invisibility of psychological violence against children

Introduction: Domestic violence is a social and public health problem and its rates are currently increasing. It is present in all social classes, ethnicities and educational levels. Objective: To analyse the actions done by health professionals who work in Basic Health Units (BHUs) to recognise cases of psychological violence against children. Methods: This is a qualitative, descriptive and exploratory study. It used an analysis of the thematic data content. Interviews were conducted with 24 professionals working in BHUs in a city in southern Brazil. Results: It was observed that physical symptoms are prioritised and there is an underestimation of mental health issues, especially those relating to psychological violence. Conclusions: It was identifi ed that professionals from the BHUs cannot intervene effectively because of the diffi culty in identifying cases of domestic violence and their lack of training for dealing with cases of violence against children

A invisibilidade da violência psicológica pelos profissionais de saúde

Introdução: A violência intrafamiliar é um problema social e de saúde pública e, atualmente, tem seus índices aumentados. Encontra-se presente em todas as classes sociais, étnicas ou grau de escolaridade. Objetivo: Identifi car as ações utilizadas pelos profi ssionais de saúde que trabalham nas Unidades Básicas Saúde da Família (UBSFs) para reconhecer os casos de violência psicológica contra a criança. Método: Este trabalho é uma pesquisa qualitativa, descritiva e exploratória. Foi utilizada a análise de conteúdo temática dos dados. Realizou-se entrevistas com 24 profi ssionais que trabalham em UBSFs, em um município do sul do Brasil. Resultados: Observou-se que os sintomas físicos são priorizados e ocorre a subestimação da saúde mental, principalmente da violência psicológica. Conclusões: Identifi cou-se que os profi ssionais das UBSFs não conseguem intervir de maneira efi caz, devido a difi culdade na identifi cação dos casos de violência intrafamiliar e da ausência de capacitação para atuar nos casos de violência contra a criança

Neurodevelopmental Outcomes among Brazilian Children with Cyanotic Congenital Heart Disease and Its Associated Factors

Objectives: The aim of this study was to evaluate neurodevelopmental outcomes (motor development, nonverbal intelligence, and attention) in children with cyanotic congenital heart disease (CHD) compared with healthy children from a public hospital in southern Brazil. Materials and Methods: This was a cross-sectional study with pediatric patients of both sexes: 37 children with cyanotic CHD and a control group with 38 healthy children. Parents/guardians undertook a questionnaire and the SNAP IV scale (to evaluate attention) was applied. Two instruments were applied to each child: the R-2 Non-Verbal Intelligence test and the motor development scale. To assess the factors associated with insufficient performance in the three fields of neurodevelopment, a Poisson regression analysis was performed with a robust estimate. Results: There were no significant differences between children with cyanotic CHD and the control group for any of the neurodevelopmental outcomes studied. Low socioeconomic class was a factor associated with worse performance on the intelligence test and inattention. Furthermore, age was a factor for performance on the intelligence test, while a greater number of siblings was a factor associated with worse performance on the attention test. Conclusions: Public policies regarding child health must involve prioritizing the improvement of families’ social conditions

A invisibilidade da violência psicológica pelos profissionais de saúde

Introdução: A violência intrafamiliar é um problema social e de saúde pública e, atualmente, tem seus índices aumentados. Encontra-se presente em todas as classes sociais, étnicas ou grau de escolaridade. Objetivo: Identifi car as ações utilizadas pelos profi ssionais de saúde que trabalham nas Unidades Básicas Saúde da Família (UBSFs) para reconhecer os casos de violência psicológica contra a criança. Método: Este trabalho é uma pesquisa qualitativa, descritiva e exploratória. Foi utilizada a análise de conteúdo temática dos dados. Realizou-se entrevistas com 24 profi ssionais que trabalham em UBSFs, em um município do sul do Brasil. Resultados: Observou-se que os sintomas físicos são priorizados e ocorre a subestimação da saúde mental, principalmente da violência psicológica. Conclusões: Identifi cou-se que os profi ssionais das UBSFs não conseguem intervir de maneira efi caz, devido a difi culdade na identifi cação dos casos de violência intrafamiliar e da ausência de capacitação para atuar nos casos de violência contra a criança

Newborn outcomes exposure to crack cocaine during pregnancy: a critical review / Recém-nascidos expostos ao crack durante a gestação: uma revisão crítica

Crack cocaine is a psychotropic and neurotoxic drug with high prevalence of consumption, considerate a public health problem and identified as risk factors to human health. Crack cocaine use among women in reproductive age increased in few year and the literature of the neonatal exposure to this substance during pregnancy are limited. Thus, this critical review discusses the major newborn outcomes reported in original studies, highlighting neurologic abnormalities and malformations outcomes. Sixteen studies were included in this review. The main physiological outcome found in newborn exposure to crack cocaine during gestation were lower birth weight; preterm birth; growth restricted infants; lower 5-minute Apgar scores; small for gestational age; and, small head circumference and congenital malformations. There were several negative neurologic and outcomes were reported on the literature. Moreover, there were still no consensus and the main criticism in this area is the limited studies available