[Accidents and violence in childhood and adolescence: risk and protective factors]

O corpo da criança como receptáculo da violência física: análise dos dados epidemiológicos do Viva/Sinan

RESUMO A alta incidência da violência física contra a criança e o adolescente no Brasil aponta a necessidade urgente de elaboração de políticas públicas para enfrentar e prevenir esse problema. Objetivou-se estudar o perfil da violência física doméstica contra a criança e o adolescente no Brasil e regiões, no período de 2009 a 2019. Estudo descritivo, epidemiológico, baseado em dados secundários obtidos no Sistema de Informação de Agravos de Notificação (Sinan-NET) e sistema TabWin. A maior taxa de violência física doméstica se refere a meninas de 10 a 14 anos (248 por 100 mil habitantes). Em relação a crianças e adolescentes do sexo masculino, a faixa etária com maior taxa de violência física é de zero a 4 a anos (232 por 100 mil habitantes). A população indígena possui as maiores taxas de violência em todas as regiões. Pai e mãe são os agressores mais frequentes (41,13% e 39,84% respectivamente). Meninos são mais suscetíveis à violência física doméstica na infância, e meninas, na adolescência. A faixa etária mais acometida por violência física doméstica é de zero a 4 anos, e as raças mais acometidas são a indígena e a parda. Na maior parte das vezes, a violência aconteceu dentro de casa.

Prevention of domestic child accidents: an educational intervention conducted by Speech Therapy trainees in a Family Health Care Unit

ABSTRACT Purpose: to check the effect of an educational intervention on the prevention of domestic child accidents, carried out by Speech Therapy trainees. Methods: an interventional research that uses primary research data. The action was done by two interns of Speech Therapy with 30 caregivers of children who attended a Family Health Unit. For the carrying out of the educational intervention, two pictures with images which represented objects and situations of risk of accidents were used. Two interview scripts were elaborated, which allowed to identify the caregivers’ personal data and their knowledge about the risks of child accidents in the domestic environment before and after carrying out of the educational intervention. Results: before the educational action, the caregivers identified 187 situations for child accidents, and after the intervention, 215 dangers were identified. Among the 30 caregivers who participated, 23 had significant changes in their answers and seven did not have any change in their knowledge. The main change was in relation to "Accidental poisoning-intoxication by exposure to harmful chemicals" and "The impact caused by an object thrown, projected or falling". Conclusion: the intervention promoted an increase in the participants’ correct reports, and it can be incorporated to the actions of accidents prevention carried out by the trainees and professionals of Speech Therapy who work in basic healthcare.

The adolescent and the institutionalization: understanding the phenomenon and meanings attributed to it

OBJECTIVE

To understand the meaning of being institutionalized and in conflict with the law for the institutionalized adolescent.

METHOD

A qualitative, phenomenological-comprehensive study carried out in a Socio-educational Service Foundation in the northern region of Brazil, with 05 institutionalized adolescents. The analysis was carried out under the understanding of the content suggested by Heidgger, thus allowing the construction of analytical categories for a hermeneutical interpretation.

RESULTS

Conflicting with the law means something negative and bad for the institutionalized adolescents, in which they understand that although there is deprivation of liberty, the period of hospitalization is an important moment for the reflection on the need to start over.

CONCLUSION

The meaning of conflicting with the law goes far beyond a simple word, act or behaviour, it is something that only those who experience the phenomenon are able to unveil, arouse deep feelings and provide reflection to the adolescent about the damages caused by the infraction.

Maternal depression is associated with injuries in children aged 2-4 years: the Pelotas 2004 Birth Cohort

Introduction

Injuries during childhood, which mostly consist of falls, burns, drowning, poisonings and car crashes, are among the main causes of death among children and young adults in several countries.

Objectives

To investigate the association between maternal depression and the incidence of injuries during childhood.

Methods

In 2004, children who were born in the municipality of Pelotas, Brazil, were enrolled in a population-based birth cohort, with evaluations at birth and at 3, 12, 24 and 48 months of age. Maternal depression during pregnancy was evaluated at the time of delivery. At 12 and 24 months post partum, the Edinburgh Postnatal Depression Scale (EPDS) was used. The injuries incidence rates at ages of 24–48 months and the crude and adjusted IRRs were calculated with 95% CI through Poisson’s regression.

Results

A total of 3533 children were analysed. The incidence of injuries was higher among children whose mothers presented depressive symptoms during pregnancy and at 12 and 24 months compared with those whose mothers did not present any symptoms. In the adjusted analysis, the IRR among girls whose mothers presented depressive symptoms during pregnancy and EPDS ≥13 at 12 and 24 months was 1.31 (1.15–1.50); and, among boys, 1.18 (1.03–1.36).

Interpretation

Maternal depression is associated with higher incidence of injuries between 24 and 48 months of age, in both sexes.

ACIDENTES DOMICILIARES POR FORÇAS MECÂNICAS INANIMADAS EM CRIANÇAS, ADOLESCENTES E JOVENS

RESUMO Analisar o perfil dos atendimentos de urgência e emergência decorrentes de acidentes domiciliares causados por forças mecânicas inanimadas na população infantojuvenil. Trata-se de um estudo transversal com coleta retrospectiva de dados. Foram analisadas fichas de atendimento decorrentes de acidentes domiciliares por forças mecânicas inanimadas em pessoas com idade até 24 anos, atendidas por um serviço público de referência em urgência e emergência, durante o ano de 2013. Foram estudados 526 acidentes. Entre as vítimas prevaleceu o sexo masculino (56,1%) e faixa etária de 1 a 4 anos (47,9%). O acidente de maior frequência foi penetração de corpo entranho em orifício natural, sendo em maior proporção nas crianças de 1 a 4 anos (71,0%). Evidenciou-se grande variedade de acidentes por forças mecânicas inanimadas no ambiente domiciliar e presença de sequelas físicas imediatas em 0,8% das vítimas. Destaca-se a importância da implementação de medidas preventivas, único meio de se reduzir o evento, as lesões e sequelas decorrentes.