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Journal articles on the topic '1984-2024'
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Reinertsen, Hilde. "1984–2024–2064." Nytt Norsk Tidsskrift 41, no. 1 (March 21, 2024): 2–4. http://dx.doi.org/10.18261/nnt.41.1.1.
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Caresana, Ana M. "The Bhopal disaster (1984 – 2024): Reflections on the anniversary of a wound that does not heal." Poison 1, no. 2 (June 30, 2024): 37–38. http://dx.doi.org/10.62129/tzgd8946.
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Aubin, Emmanuel. "Fonction publique, statut et indépendance des enseignants-chercheurs." Titre VII N° 12, no. 1 (July 19, 2024): 54–62. http://dx.doi.org/10.3917/tvii.012.0054.
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L’étude des relations entre la fonction publique, le statut et l’indépendance constitutionnelle des enseignants-chercheurs met en évidence une évolution contrastée. Si, d’un point de vue théorique, l’indépendance consacrée en 1984 par le Conseil constitutionnel peut toujours être qualifiée, en 2024, de matrice du statut des enseignants-chercheurs, l’évolution des normes et de la jurisprudence relatives au statut des enseignants-chercheurs a eu pour effet d’affaiblir constitutionnellement leur statut dont la singularité tend à se réduire pour rapprocher leur situation de celle des fonctionnaires de l’État nonobstant le particularisme de leur mission de service public au sein des établissements d’enseignement supérieur.
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Akasheva, Anna Anatol'evna. "Teaching Informatics and Mathematics to History Students: Experience of Lobachevsky University of Nizhny Novgorod." Историческая информатика, no. 1 (January 2024): 123–36. http://dx.doi.org/10.7256/2585-7797.2024.1.70278.
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The article is based on the report made by the author at the scientific and methodological seminar of the Association "History and Computer" and the Faculty of History of Moscow State University, which was held on January 2024. The subject of the analysis are the names and hourly volume (in academic hours) of disciplines of informatics and mathematical cycle of the National Research Nizhny Novgorod State University named after N.I. Lobachevsky or Lobachevsky University) from 1984 to 2023. N.I. Lobachevsky National Research State University from 1984 to 2023, the names of graduate qualification works made at the Department of Information Technologies in Humanities from 2007 to 2023, the names of teaching aids for 2010 to 2023, published by teachers of the department. It is revealed that the subjects of information and mathematical cycle for 40 years of their teaching in IMOMI NNGU have become more specialised and practice-oriented, both in bachelor's and master's degrees. The restored initial period of teaching quantitative methods in history in the 1980s, based on the recollections of colleagues and the first lecturer S.V. Subbotin, is of independent importance. A complete list of information and mathematical disciplines in 2023-2024 is given. The basic information about the Department of Information Technologies in Humanities Studies, which has been responsible for teaching the above disciplines since 2007, is given. It is found that since 2007 the ITGI department has graduated 86 students, 31 per cent of whom used quantitative methods and computer technologies in their final qualification works. The importance of cloud technologies in the possibilities of distributed project work of undergraduate students is shown. It is concluded that the main formed information competence of historians is a critical attitude to the digitisation of historical sources and their publication on the Internet.
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Ruparelia, Sanjay. "The BJP's Drive for Hegemony." Dissent 71, no. 2 (March 2024): 27–36. http://dx.doi.org/10.1353/dss.2024.a929036.
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ABSTRACT: In 2014, the Hindu-nationalist Bharatiya Janata Party captured national power in the world's largest democracy. Under its controversial new leader, Narendra Modi, the BJP established India's first single-party majority government since 1984 and became the only party besides the Indian National Congress to accomplish this feat since the country won independence, in 1947. In the 2019 general election, despite a disappointing economic record, growing communal strife, and disruptive policy decisions, the BJP increased its vote share and seats in Parliament. The victory emboldened the party to further its longstanding agenda to transform India's secular constitutional democracy into a de facto Hindu nation. Modi remained popular throughout India's terrible pandemic. Now, with a return of high economic growth and the unity of opposition parties in question, most observers expect him to win the 2024 general election, which concludes in June.
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Silva dos Santos, Doiara, and Clarisse Silva Caetano. "AS PROMESSAS DE PARIS 2024: UMA “NOVA VISÃO DO OLIMPISMO”?" RENEF 15, no. 23 (April 17, 2024): 81–95. http://dx.doi.org/10.46551/rn2024152300085.
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Do criador francês Pierre de Coubertin e sua proposição dos Jogos Olímpicos no século XIX à criatura, os Jogos Olímpicos, que atravessam os 127 anos de existência, houve transformações sociais e rupturas da estrutura do esporte e, com isso, mudanças nas formas de ver, viver e praticar o denominado Olimpismo. A cidade de Paris reúne elementos históricos singulares ao que se configura como Movimento Olímpico (MO) não apenas por ser no país do seu fundador. Além de ter sido a sede do I Congresso Olímpico em que se instituiu o Comitê Olímpico Internacional em 1984, duas edições dos Jogos de verão foram sediadas em Paris, a saber: os da segunda e da oitava Olimpíadas, respectivamente, 1900 e 1924. Ao longo dos séculos que atravessou, o MO se conectou em diálogo com (e/ou pressionado por) questões sociais urgentes. Ao retornarem ao país do seu fundador em 2024, os Jogos Olímpicos englobam os tensionamentos do esporte global frente aos desafios sociais e a moldura singular de arcabouço de valores, pedagogia, símbolos e rituais idealizados por seu fundador. Este trabalho tem por objetivo analisa as narrativas da candidatura da cidade de Paris aos Jogos Olímpicos de 2024 no contexto de pautas globais que pressionam as narrativas do Olimpismo. Para tanto, utilizou-se como fonte de dados os livros de candidatura da cidade de Paris aos Jogos Olímpicos de 2024, em sua versão de língua inglesa, publicados em 2016. Como resultados, verifica-se que os livros de candidatura de Paris 2024 expressam alinhamento com o desenvolvimento da cidade e com a Agenda 2020 do Movimento Olímpico, reproduzindo lógicas de candidaturas anteriores, mas, avançando em outras questões. Nesse sentido, entendemos que o neo-olimpismo se verifica nas narrativas para além de retomar a proposta de retomar a filosofia original, mas, de conciliação dessa filosofia com temas emergentes, como a diversidade, anunciada como valor desta candidatura e, notavelmente, que se alinha a questões sociais urgentes.
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Maclellan, Nic. "OBITUARY: Arnold Clemens Ap: His West Papuan legacy lives on." Pacific Journalism Review : Te Koakoa 30, no. 1and2 (July 1, 2024): 246–50. http://dx.doi.org/10.24135/pjr.v30i1and2.1350.
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Arnold Clemens Ap was born on 1 July 1946 on Numfor Island in Biak, at the time, part of the Dutch colony of Netherlands New Guinea. After schooling at church missions in Biak, he studied geography at the Teacher Training School of Cenderawasih University in Abepura, Jayapura, between 1967 and 1973. That year, he was appointed as the curator of the university’s museum, known as Loka Budaya, which became a centre for West Papuan cultural revival. His work to collect and perform songs in Papuan languages played a vital role in the development of a West Papuan national identity, transcending colonial boundaries and inter-tribal conflicts. He was murdered by Indonesian special forces in 1984. This year, 26 April 2024, marked the 40th anniversary of the death of this charismatic cultural leader. For West Papuans, in exile and at home, it has been an important time for commemoration.
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Utomo, Sulistyo Budi. "Eksplorasi Karakteristik Penelitian Manajemen Pemasaran Digital di Era Globalisasi." Jurnal Multidisiplin West Science 3, no. 04 (April 30, 2024): 459–68. http://dx.doi.org/10.58812/jmws.v3i04.1105.
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Personalisasi dalam pemasaran telah menjadi semakin penting dalam konteks praktik bisnis yang berkelanjutan. Penelitian ini bertujuan untuk melakukan analisis bibliometrik yang komprehensif terkait personalisasi dalam implementasi manajemen pemasaran digital di era globalisasi. Pendekatan bibliometrik digunakan untuk mengeksplorasi tren penelitian, tema utama, dan kontribusi literatur dalam memahami praktik dan teori manajemen pemasaran digital. Data dianalisis dari periode 1984 hingga 2024 menggunakan basis data akademis yang terverifikasi. Hasil analisis menunjukkan dampak signifikan dari literatur dalam domain ini, dengan total 980 makalah dan 162.307 kutipan yang teridentifikasi. Analisis jaringan istilah mengungkapkan tema-tema utama seperti pemasaran internet, kecerdasan buatan, dan dampak pandemi COVID-19. Selain itu, peta densitas menyoroti area-area potensial untuk penelitian mendatang, termasuk penggunaan AI dalam pemasaran dan dampak digitalisasi dalam konteks global. Temuan ini memberikan wawasan yang berharga bagi praktisi bisnis dan akademisi dalam merancang strategi pemasaran yang efektif di era digital, serta memberikan kontribusi penting terhadap pengembangan teori dalam manajemen pemasaran digital.
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Mawa Mukulia, Prométhée, Désiré Katembo Kasekete, Gabriel Makabu Kayembe, Walere Muhindo Sahani, and Jean-Marie Kahindo Muhongya. "Analysis of the Morphology and Lithology of the Kisangani–Yangambi Section of the Congo River in the Democratic Republic of Congo." Modern Geográfia 19, no. 1 (2024): 59–80. http://dx.doi.org/10.15170/mg.2024.19.01.04.
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Vol. 19, Issue 1, 2024: 59–80 DOI: 10.15170/MG.2024.19.01.0459 Mawa Mukulia, Prométhée1 – Katembo Kasekete, Désiré2 – Makabu Kayembe, Gabriel3 – Muhindo Sahani, Walere 4 – Kahindo Muhongya, Jean-Marie5 Analysis of the Morphology and Lithology of the Kisangani–Yangambi Section of the Congo River in the Democratic Republic of Congo 6 ABSTRACT The Congo River, which is between 900 and 300 metres wide between the city of Kisangani and the town of Yangambi, is characterised by important socio-economic and conservation activities but also by a lack of knowledge on morphological and lithological matters. To fill the gaps, the lithology and the morphological dynamics of the riverbed were studied through a description of islands (between 1984 and 2017) and banks thanks to remote sensing and field work, respectively. With regard to the number of islands, the study revealed a loss of 5.13% and a recovery of 28.21% between 1984 and 2017. The direct factors of this dynamism are the erosion and landslides observed both on the banks and on the islands. The geological survey method allowed the collection of 4 samples of sound indurated rocks and 50 samples of loose rocks on the soil profiles of the islands and banks. The macroscopic description and sieving of the samples with 63 mm and 2 mm mesh size allowed the lithology map to be drawn up. The fine soil particles were analysed in the soil laboratory using the Robinson–Köhn pipette method to determine their texture. The USDA textural classification was used. The results of the analysis showed that sand is the predominant rock element in the area. Such a lithology would increase the sensitivity of the banks to mass movements observed here and there along the Kisangani–Yangambi river section.
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Morera Martín, Moisés, and Pablo Nicolás Biderbost. "Los 40 años de la Declaración de Cartagena sobre los Refugiados y la crisis migratoria venezolana." REVISTA CONTROVERSIA, no. 220 (June 15, 2023): 251–87. http://dx.doi.org/10.54118/controver.vi220.1289.
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América Latina se caracteriza por su liderazgo en materia de protección del asilo y refugio, y por sus legislaciones y prácticas de raíz consuetudinario-humanitarias muy avanzadas. La adopción de la Declaración de Cartagena sobre los Refugiados, en 1984, creó, de nuevo, vanguardia y presentó una definición ampliada del concepto de refugiado que sirve como complemento regional a la Convención de Ginebra de 1951.
La actual crisis migratoria venezolana está impactando en América Latina y el Caribe con una intensidad y velocidad nunca antes vistas. Casi 7 millones de venezolanos se han visto obligados a abandonar su país, la mayoría de los cuales (5,75 millones) ha llegado a países de la región, especialmente a Colombia. Ante esta crisis, el 40º aniversario de la Declaración de Cartagena, que se celebrará en 2024, presenta una ocasión única para el análisis de los avances y vacíos existentes en la protección regional de la población refugiada y migrante.
Dada la enorme legitimidad que tiene la Declaración de Cartagena, en este artículo se pretende posicionarla en la agenda latinoamericana al considerarse que puede ser parte de la solución buscada a esta crisis.
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AYDINER, Tolgahan. "Metropolitan Municipal Councils in the 100th Anniversary of the Republic: Balance Sheet Before 2024 Local Elections." Gaziantep University Journal of Social Sciences 22, Cumhuriyet'in 100. Yılı (October 28, 2023): 478–99. http://dx.doi.org/10.21547/jss.1359903.
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Bu çalışmada, Cumhuriyet’in 100. yılına ulaştığımız bu süreçte, büyükşehir belediye meclislerinin mevcut durumu incelenecektir. Türkiye’de büyük kentlerin yönetimi, yerel yönetim tartışmaları içerisinde önemli bir yer tutmaktadır. 1984 yılından bu yana fiilen uygulanan büyükşehir modelinin, 2004 ve 2012 yıllarındaki yasal düzenlemelerle, coğrafi ölçeği genişlemiştir. Bu gelişmeler, büyükşehir belediyelerinin karar organı olan büyükşehir belediye meclislerini de etkilemektedir. Zira Türkiye’de yerel demokrasinin işlevini azaltan birçok süreç, büyükşehir belediye meclislerinde daha çetrefilli bir hâl almaktadır. Özellikle son yıllarda, büyükşehir belediye başkanlarının ulusal siyasette daha da güçlü figürler hâline gelmeleri ve 6360 sayılı yasa ile mülki sınırda tek yetkili halen gelen büyükşehir belediyeleri, halihazırdaki güçlü başkan -zayıf meclis ilişkisini dönüştürmüş; merkezî yönetimin aktörlerinin kentsel planlama süreçlerine daha fazla müdahale etmesiyle, mekânsal planlama konusunda oldukça geniş yetkileri bulunan büyükşehir belediyelerinin konumu daha da karmaşıklaşmıştır. Ülke nüfusunun büyük bir çoğunluğunun büyükşehir statüsündeki kentlerde yaşadığı hesaba katıldığında, bu tartışmaları kapsamlı biçimde gündeme getirebilmek, Cumhuriyet’in ikinci yüzyılının başlangıcında ve 2024 Mahalli İdareler Genel Seçimleri öncesi süreçte, yerel yönetim tartışmaları için hayli önem taşımaktadır. Çalışma girişten sonra üç temel bölümden oluşmaktadır. İlk bölümde, büyükşehir belediyelerinin tarihsel bağlamda dönüşümü ele alınmıştır. İkinci bölümde, büyükşehir belediye meclislerinin temel yapısı/işleyişi ve büyükşehir belediye meclislerinde ortaya çıkan temel handikaplar analiz edilmiştir. Üçüncü bölümde, büyükşehir belediye meclislerinin güçlendirilmesine yönelik birtakım çözüm önerileri sunulmuştur. Büyükşehir belediye meclislerindeki temsil ve karar alma süreçlerini ele alan kitap, kitap bölümü, makale, proje raporu ve ulusal medyada yer alan haberler, nitel analiz yönteminin kullanıldığı çalışmanın temel veri kaynağını oluşturmaktadır.
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Maggs, Gregory E. "Amendments to the Rules for Courts-Martial Since 1984 (2024 Edition)." SSRN Electronic Journal, 2024. http://dx.doi.org/10.2139/ssrn.4703909.
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Maggs, Gregory E. "Amendments to the Military Rules of Evidence Since 1984 (2024 Edition)." SSRN Electronic Journal, 2024. http://dx.doi.org/10.2139/ssrn.4703947.
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Zhao, Bo. "Deep Learning-based Basketball Free Throw Attitude Analysis and Hit Probability Prediction System Research." Applied Mathematics and Nonlinear Sciences 9, no. 1 (January 1, 2024). http://dx.doi.org/10.2478/amns-2024-1984.
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Abstract Traditional basketball free-throw hitting probability prediction mainly relies on naked eye vision to analyze basketball players, which makes it difficult to achieve stable and accurate free-throw hitting probability prediction. In this study, we propose a deep learning-based algorithm for recognizing basketball free throw poses and predicting the probability of hitting free throws, and we build a corresponding system framework. DetectNet is used to screen free throw motion detectors, real-time estimate and recognition of free throw poses, and code rewriting. At the same time, Open Pose is used as a human skeletal joint point detector to extract the joint point information of the free throw shooter. The joint points with wrong information are repaired, and the classification prediction of the free throw hitting result is realized based on the support vector machine. In the performance simulation experiments, the average accuracy of the free throw pose recognition method proposed in this paper is as high as 98.55% on the MSR Action 3D dataset, and the recognition rate of the elbow lift pose, which is the most difficult to recognize, is also higher than that of other comparative algorithms. The hit probability prediction method is also 12.64% and 6.25% more accurate than the OpenPose algorithm in hit-and-miss prediction, and the accuracy has also improved by 4.47% and 5.41%, respectively. The free throw pose recognition and hit probability prediction method in this paper has excellent performance.
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Bulfoni, Clara. "LE CERTIFICAZIONI DI LINGUA CINESE (HSK): CONFRONTO CON IL QCER." Italiano LinguaDue 14, no. 2 (January 17, 2023). http://dx.doi.org/10.54103/2037-3597/19611.
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L’articolo analizza la storia e l’evoluzione degli esami di certificazione della lingua cinese (HSK) a partire dal 1984, anno di inizio del progetto avviato dall’allora Istituto di Lingue di Pechino e dall’Ufficio della Commissione di Stato per l’Istruzione. Le prime sessioni di esami in Europa, e precisamente in Germania, in Francia e in Italia presso l’Università degli Studi di Milano, prima sede sul territorio nazionale, si sono svolte nel 1994. L’esame originario è ora denominato HSK 1.0, seguito, dopo una riforma del 2010, dall’HSK 2.0. Attualmente è in corso una terza riforma che dovrebbe essere conclusa nel 2024. L’articolo si focalizza sul confronto del prossimo HSK 3.0 con il Companion Volume del QCER, edito nel 2020, analizzando probabili differenze nei termini di competenze. Purtroppo l’analisi è incompleta e sarà possibile concludere il confronto non appena verranno pubblicate simulazioni d’esame non ancora disponibili.
The Chinese language certifications (HSK): comparison with the QCER
The article analyses the history and evolution of Chinese language certification exams (HSK) since 1984, when the project was started by the then Beijing Language Institute and the Office of the State Commission for Instruction. The first exam sessions in Europe and, specifically, in Germany, France and Italy at the University of Milan, the first Center in Italy, were held in 1994. The originally exam is now called HSK 1.0, followed by, after the 2010’s reform, HSK 2.0. A third reform is currently underway and is expected to be completed by 2024. The article focuses on the comparison of the upcoming HSK 3.0 with the Companion Volume of the CEFR, published in 2020, analysing possible differences in terms of skills. Unfortunately, the analysis is incomplete and it will be possible to conclude the comparison as soon as exam simulations, not yet available, will be published.
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Lopez, Clément, Mathieu Djaballah, and Dominique Charrier. "Olympic projects to leverage collaborative sport policies. The case of the partnership between the French cycling federation and Saint-Quentin-en-Yvelines community." Management et Organisations du Sport Issue 5 | 2023, Research articles (August 31, 2023). http://dx.doi.org/10.46298/mos-2023-10188.
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This article questions the leveraging effect of Olympic bids in kind of collaborative governance, by articulating federal-local interests. It is based on a case study of the collaborative relation between the Saint-Quentin-en-Yvelines Agglomeration Community and the French cycling federation from 2000 to 2020. The contribution retraces the local collaboration process in a specific context: first showing the role the 2012 Olympic bid played in the implementation of a federal-local partnership, 2nd explaining in which extent the 2024 Olympic bid has been used to foster the structuration of this partnership. This work uses Kingdon’ streams theory to put in light the capacity of Olympic bids to open up ‘policy windows’ for the implementation of collaborative sport policies. Le présent article interroge la capacité des candidatures olympiques à créer les conditions de l'articulation entre les politiques sportives fédérales et locales. Il s'appuie sur un cas d'étude portant sur la relation entre Saint-Quentin-en-Yvelines (un territoire intercommunal situé à 20 kilomètres de Paris) et la Fédération française de cyclisme entre 2000 et 2020. La contribution retrace le processus de collaboration entre ces deux organisations dans les contextes de candidature parisienne aux Jeux Olympiques et Paralympiques de 2012 et de 2024. En s'appuyant sur la force explicative des dynamiques locales, les auteurs mobilisent la théorie des flux de Kingdon (1984) pour souligner le rôle déterminant des candidatures olympiques dans la convergence des flux des problèmes, de la politique et des politiques publiques. Celles-ci favorisent donc l'ouverture de fenêtres d'opportunité vers la mise en place de politiques sportives partenariales.
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Uslu, Esra, and Emrah Atılgan. "Ruh Sağlığı Alanında Yapay Zeka Araştırmaları: Bibliyometrik Bir Değerlendirme." OSMANGAZİ JOURNAL OF MEDICINE 46, no. 4 (July 8, 2024). http://dx.doi.org/10.20515/otd.1435157.
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Bu çalışmada ruh sağlığı alanındaki yapay zeka yayınlarının bibliyometrik olarak incelenmesi amaçlanmıştır. Çalışmada 1984 ile 2024 yılları arasında Web of Science veri tabanında İngilizce "mental health and artificial intelligence- ruh sağlığı ve yapay zeka" anahtar kelimeleri ile belirlenen 2773 makale incelenmiştir. Veri analizi ve grafiksel sunumlar, R yazılımındaki Bibliometrix Paketi kullanılarak yapılmıştır. Çalışmaların ortalama yayın yaşı 2,7 ve yıllık artış oranı %18,36 olarak belirlenmiştir. En aktif ülke Amerika Birleşik Devletleri ve Çin olup, en fazla yayın yapan dergi Frontiers in Psychiatry'dir. Makine öğrenimi konusu, alanın hem en sık kullanılanı hem de öncü temasıdır. Benzer şekilde, Chatbot, alanı şekillendiren temalar arasında yer almaktadır. Alzheimer Hastalığı ve bipolar bozukluk, ortaya çıkan veya kaybolan temalar (emerging or declining themes) arasındadır. Derin öğrenme, şizofreni ve demans konuları, alanı şekillendiren temaların gelişmeye devam etmekte, gelişmiş ancak izole kalmış, ortaya çıkan veya kaybolmaya başlayanların kesişim noktasında bulunmaktadır. Bu çalışma ile bibliyometrik verileriler kullanarak ruh sağlığı alanındaki YZ çalışmalarının performansı ve kapsamı analiz edilmiştir. Sonuçlar, konuya ilgi duyan bilgi teknolojileri ve ruh sağlığı profesyonellerine çalışmalarında rehberlik edebilir.
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Silva, Adriana Mendonça da, Rodrigo Tripodi Calumby, and Valéria Souza Freitas. "Epidemiologic profile and prevalence of live births with orofacial cleft in Brazil: a descriptive study." Revista Paulista de Pediatria 42 (2024). http://dx.doi.org/10.1590/1984-0462/2024/42/2022234.
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ABSTRACT Objective: To describe the epidemiological profile and prevalence of live births with orofacial clefts in Brazil between 1999 and 2020. Methods: Descriptive study. The population corresponded to live births with isolated orofacial clefts in Brazil registered in the Live Birth Information System between 1999 and 2020. Descriptive variables were selected according to their availability and grouped into socioeconomic and demographic, maternal and child health care, and biological variables. Data were submitted to a descriptive analysis using the Software for Statistics and Data Science (STATA). Results: During the period, 33,699 children were born with orofacial clefts, and 82.1% (27,677) of them were isolated clefts. Regarding these cases, the majority were cleft lip and palate (9,619 or 34.7%), followed by cleft palate (9,442 or 34.1%), and by cleft lip (8,616 or 31.3%). Conclusions: Live births with orofacial clefts in Brazil were male, white, with birthweight ≥2,500 g and gestational age ≥37 weeks, born by cesarean section, and with Apgar scores ≥7. The cases were more frequent among mothers who were in their first and single pregnancy and had seven or more prenatal appointments. The mothers were 20 and 29 years old, had eight to ten years of study, and were single. The national prevalence of clefts was 4.24/10,000. The South and Southeast regions of Brazil had the highest prevalence, while the lowest prevalence was recorded in the Northeast and North regions. For the Federative Units, the highest and lowest prevalences were found, respectively, in Paraná and Acre.
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Santos, Laura Goedel dos, Júlia Goedel dos Santos, Betine Moehlecke Iser, Kelser de Sousa Kock, and Karla Dal Bó. "Prescription of off-label and unlicensed medication for newborns hospitalized in the Intensive Care Unit." Revista Paulista de Pediatria 42 (2024). http://dx.doi.org/10.1590/1984-0462/2024/42/2023023.
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ABSTRACT Objective: To analyze the prevalence of off-label and unlicensed prescriptions for a population of neonates admitted to the Neonatal Intensive Care Unit in a hospital in southern Santa Catarina. Methods: Observational study with a cross-sectional design. All neonates admitted to the Intensive Care Unit during the period from March 2020 to March 2021 were included. Data collection was performed through a questionnaire made by the authors and the classification of drugs based on the Electronic Drug Description (Bulário Eletrônico) of the Brazilian Health Regulatory Agency and Drug Dex-Micromedex. Results: Data from 296 neonates were evaluated. The prevalence was 50,7% for prescribing off-label medications and 37,2% for unlicensed medications. The use of drugs was higher in preterm neonates, with low birth weight, 1st minute Apgar between 6–8, 5th minute Apgar between 7–8, and in need of invasive procedures. The most used off-label drugs were ampicillin, gentamicin and fentanyl (92.6, 92.0 and 26.6%, respectively), whereas the most used unlicensed drugs were caffeine, phenobarbital and bromopride (78.1, 16.3 and 10.9%, respectively). Conclusions: This study showed a large percentage of prescriptions made in the off-label (50.7%) and unlicensed (37.2%) form in the Neonatal Intensive Care Unit, corroborating the worrying world scenario. The most exposed neonates were precisely the most vulnerable ones and, among the most commonly prescribed medications, ampicillin and gentamicin stood out in off-label form and caffeine in unlicensed form.
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Santos Júnior, Claudio José dos, Maria Rosa da Silva, and Paulo José Medeiros de Souza Costa. "Psychometric properties and reliability of the Brazilian version of Parent Attitudes about Childhood Vaccine (PACV-BR)." Revista Paulista de Pediatria 42 (2024). http://dx.doi.org/10.1590/1984-0462/2024/42/2023019.
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ABSTRACT Objective: To evaluate the psychometric properties and reliability of the Brazilian version of the tool Parent Attitudes about Childhood Vaccine (PACV-BR). Methods: The sample included 110 parents of children up to two years old served by Family Health Basic Units. The tool's internal consistency and factor validity were respectively assessed by Cronbach's alpha and exploratory factor analysis (EFA). The test-retest reliability was assessed by the intraclass correlation coefficient (ICC). Results: The EFA results indicated a proper structural adequacy of the PACV-BR (15 items and two factors). The reliability generated Cronbach's alpha values between 0.715 and 0.854 for the items, of 0.918 for the tool as a whole, of 0.877 for factor 1 and of 0.825 for factor 2, in addition to an ICC of 0.984. Conclusions: The PACV-BR showed evidence of construct validity and reliability.
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Fonseca, Marlene de Melo, Rafaela Vitoria Guilherme Coimbra, Julia Silva e. Oliveira, Anne Danieli Nascimento Soares, and Júnia Maria Geraldo Gomes. "Consumption of ultra-processed foods and associated factors in children from Barbacena (MG), Brazil." Revista Paulista de Pediatria 42 (2023). http://dx.doi.org/10.1590/1984-0462/2024/42/2022127.
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Abstract Objective: To evaluate the prevalence of ultra-processed food consumption and associated factors among children enrolled in the public school system of the city of Barbacena, Minas Gerais, Brazil. Methods: This is a cross-sectional study conducted with schoolchildren aged 7–9 years, of both sexes, enrolled in state public schools. Food intake was assessed using the Previous Day Food Questionnaire and the level of physical activity by the Previous Day Physical Activity Questionnaire. The listed foods were classified according to the extent and purpose of industrial processing, using the NOVA classification. Pearson’s χ2 test, Fisher’s exact test, χ2 with Yates correction, and Poisson regression were used in the statistical analysis, estimating the crude and adjusted prevalence ratio, with 95% confidence intervals. Results: The prevalence of daily ultra-processed food consumption was 69.6%. After adjusted analyses, the consumption of ultra-processed food was associated with the omission of breakfast, mid-afternoon snack, supper, low physical activity, and consumption of risk foods. On the other hand, consumption of in natura or minimally processed foods was associated with older age, the consumption of lunch, mid-afternoon snack, dinner, and protective foods. Conclusions: There is a high prevalence of ultra-processed foods consumption, associated with unhealthy dietary habits among schoolchildren. This highlights the need for nutritional counseling and educational actions, favoring healthy eating in childhood.
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Francisco, Anilsa Suraia Pedro Gaspar, Maylli Daiani Graciosa, Sheila Cristina da Silva Pacheco, Anelise Sonza, and Luciana Sayuri Sanada. "Does premature birth affect Brazilian parents’ practices related to infant positioning?" Revista Paulista de Pediatria 42 (2023). http://dx.doi.org/10.1590/1984-0462/2024/42/2022163.
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Abstract Objective: To verify whether the time spent in prone, supine, or seated positions differed between term and preterm infants; and to determine whether a single verbal guidance session for parents changed the time spent in different positions, and, consequently, the motor development scores, after one month in preterm infants. Methods: Sixty-one infants from a full-term and preterm group from Brazil were included. Motor development was assessed by the Alberta Infant Motor Scale (AIMS) and the parents registered the time spent in each position on a 24-hour schedule. A month after verbal guidance, a second assessment was performed only on the preterm infants. Results: The positioning times awake determined for the full-term and preterm parents were similar. Preterm infants spent more time in the prone sleeping position (2.1 vs. 0.8 h; p=0.037) than full-term infants. The AIMS percentile scores did not differ significantly between the groups. For preterm infants, the time spent in all positions did not change during the second assessment (n=18). Conclusions: The fact that some parents position their infants in the prone posture during sleeping periods reinforce the importance of parental education approaches for sudden infant death syndrome (SIDS) prevention during the first months of life. The verbal guidance provided to parents of preterm infants did not influence the AIMS percentile and time spent in various positions but increased preterm parents’ confidence in placing their infants in a prone position to play.
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Rodrigues Junior, José Israel, Victória Gabriella Fidelix de Mecenas, Márcia de Oliveira Lima, Risia Cristina Egito de Menezes, Priscilla Márcia Bezerra de Oliveira, and Giovana Longo-Silva. "Association between iron deficiency anemia and sleep duration in the first year of life." Revista Paulista de Pediatria 42 (2023). http://dx.doi.org/10.1590/1984-0462/2024/42/2022173.
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Abstract Objective: The aim of this study was to investigate the association between iron deficiency anemia and sleep duration in the first year of life. Methods: A total of 123 infants were investigated, with sleep being evaluated at 3, 6, and 12 months of age and anemia at birth and 6 months. The cutoff points for anemia and short sleep duration were hemoglobin <11 g/dL (at birth and/or 6 months) and <10 h (at 3, 6, and 12 months), respectively. The comparison of the average sleep time between infants with and without anemia was performed using the Student’s t-test, and logistic regression models were also used to verify differences in the sleep duration (short/not short) between the groups. Linear regression analyses were conducted to determine the association between sleep duration and hemoglobin values. The analyses were adjusted for potential confounders. Results: Children with anemia were more likely to be short sleepers [odds ratio (95% confidence interval (CI)): 4.02 (1.02–15.76); p≤0.05], and for each unit increase in hemoglobin values, the sleep duration increased by 16.2 min [β (95%CI): 0.27 (0.00–0.55); p≤0.05), regardless of family income, maternal schooling, gender, and body mass index at birth. Conclusions: Our results suggest that iron deficiency anemia is associated with short sleep duration in the first year of life and indicate the need for longitudinal investigations, with longer follow-up, to verify the impact of anemia on sleep duration at subsequent ages.
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Pons, Emilia da Silva, Tatiane da Silva Dal Pizzol, Daniela Riva Knauth, and Sotero Serrate Mengue. "Self-medication in children aged 0–12 years in Brazil: a population-based study." Revista Paulista de Pediatria 42 (2023). http://dx.doi.org/10.1590/1984-0462/2024/42/2022137.
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ABSTRACT Objetive: Studies have shown that the practice of self-medicating children occurs worldwide and is independent of the country’s economic level, medication policies, or access to health services. This study aimed to estimate and characterize the prevalence of self-medication in the Brazilian population of children aged up to 12 years. Methods: We analyzed the data of 7528 children aged up to 12 years whose primary caregivers responded to the National Survey on Access, Use and Promotion of Rational Use of Medicines in Brazil (PNAUM), a cross-sectional population-based study conducted in 245 Brazilian municipalities. The prevalence of self-medication was defined as the use of at least one medication without a doctor’s or dentist’s indication 15 days before the interview. Results: The prevalence of self-medication was 22.2% and was more frequent in older children belonging to poorer families and without health insurance. The acute conditions for which there was a higher frequency of self-medication were pain, fever, and cold/allergic rhinitis. Analgesics/antipyretics stood out among the most used medications for self-medication. Conclusions: The prevalence of self-medication to treat acute conditions was high in Brazilian children sampled in PNAUM, emphasizing the management of common symptoms such as pain, fever, and cold/allergic rhinitis in this age group. These findings reinforce the need for educational actions aimed at parents and caregivers.
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Diniz, Bárbara Portela, Sandra Josefina Ferraz Ellero Grisi, Danton Matheus de Souza, and Ana Paula Scoleze Ferrer. "Mother-infant bonding and postpartum depression during the COVID-19 pandemic — a risk for nurturing care and child development." Revista Paulista de Pediatria 42 (2023). http://dx.doi.org/10.1590/1984-0462/2024/42/2022151.
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ABSTRACT Objective: The COVID-19 pandemic Increased the risk of impairing the mother-infant bonding. The objectives of this study were to evaluate the early bond established between mother and infant and postpartum depression (PPD) in pregnancies that occurred during the pandemic period, to identify the factors that may have influenced these outcomes and to verify if there was an association between bonding and probable PPD. Methods: This is a cross-sectional study of postpartum women from a public maternity hospital in the city of São Paulo conducted from February to June 2021, involving 127 mother-baby dyads. The initial data were collected in the immediate postpartum period and between 21–45 days after birth, using a semi-structured questionnaire on sociodemographic characteristics, gestational and birth conditions, and baby characteristics; the Edinburgh Postnatal Depression Scale (EPDS) and Postpartum Bonding Questionnaire (PBQ) were used to evaluate PPD and bonding, respectively. Results: The presence of probable PPD and unplanned pregnancies were associated with higher PBQ score and risk to impaired bonding (p = 0.001 and p = 0.004, respectively). EPDS showed a high prevalence of PPD (29.1%) and was not associated with any Studied variable. Probably, this high prevalence of probable PPD was due to the context of insecurity secondary to the pandemic. Conclusions: We observed an increase in the prevalence of probable PPD and unplanned pregnancies during the first 18 months of the pandemic, which were associated with worse scores in mother-infant bonding. The impaired bond can affect the future development of children born during this period.
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Oliveira, Maria de Fatima de, Ariana Rodrigues da Silva Carvalho, Bruna Schumaker Siqueira, Bruna Emília Mareco de Almeida, Claudia Silveira Viera, Gicelle Galvan Machineski, Beatriz Rosana Gonsalves de Oliveira Toso, and Sabrina Grassiolli. "Body mass index and abdominal waist values are related to increased cardiometabolic risk in schoolchildren aged five to ten years." Revista Paulista de Pediatria 42 (2023). http://dx.doi.org/10.1590/1984-0462/2024/42/2022113.
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ABSTRACT Objective: To evaluate the frequency of obesity and cardiometabolic risk in schoolchildren under ten years old. Methods: This is a cross-sectional study with schoolchildren (n=639) aged five to ten years in a municipally of southern of Brazil. The cardiometabolic risk was calculated from values of body mass index (BMI), waist circumference (WC), diastolic (DBP) and systolic blood pressure (SBP), blood glucose levels, triglycerides and total cholesterol (TC). Odds ratio (OR), Spearman correlation and principal component analysis (PCA) were analyzed. Results: Independent of sex, elevated WC and BMI were related to higher values of SBP, DBP, and TC in schoolchildren. The frequency of cardiometabolic risk was 6.0% in girls and 9.9% in boys. Schoolchildren with elevated values of SBP, triglycerides and TC presented high OR for cardiometabolic risk. PCA indicated that schoolchildren with high WC (p>80) presented more frequently altered glucose levels, triglycerides, and TC. Conclusions: Obesity, especially when associated with elevated WC, is related to metabolic dysfunctions and cardiometabolic risk in schoolchildren under ten years of age. These findings indicate the urgency of stablishing metabolic risk for this age group, enabling early diagnosis and adequate treatment, to prevent the development of diabetes and cardiovascular dysfunction throughout life.
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Freitas, Alex Sander, Marise Fagundes Silveira, Desirée Sant Ana Haikal, Antônio Prates Caldeira, Vinícius Dias Rodrigues, and Renato Sobral Monteiro-Júnior. "Different criteria for body mass index classification for excess weight screening in children aged six to ten years." Revista Paulista de Pediatria 42 (2023). http://dx.doi.org/10.1590/1984-0462/2024/42/2022132.
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ABSTRACT Objective: To evaluate the agreement between body mass index (BMI) parameters applied to children aged six to ten years in the city of Montes Claros (MG), Brazil with national and international criteria, also calculating their sensitivity and specificity regarding excess weight screening. Methods: A sample comprising 4151 children aged six to ten years was assessed, with height and body mass determined for BMI calculation. The obtained values were classified according to cutoff points established by the World Health Organization (WHO), International Obesity Task Force (IOTF), Centers for Disease Control and Prevention (CDC), Conde & Monteiro, and a recent local proposal. The agreement index between the mentioned criteria was calculated and thereafter the sensitivity and specificity. Results: The local proposal was proven to be highly consistent in most combinations, especially concerning the excess weight criteria of the World Health Organization (WHO) (k=0.895). Regarding excess weight, the local proposal presented sensitivity and specificity values of 0.8680 and 0.9956, respectively, indicating high BMI discrimination power. Conclusions: The locally applied BMI parameters for children aged six to ten years represent a valid, highly viable and practical proposal for excess weight screening in this population group, improving professional decision-making in their follow-up.
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Sion, Julia Loureiro, Angelica Lucía Hidalgo Flores, Regina Aparecida Cardoso, and Marlene Pereira Garanito. "Human adenovirus associated with severe cold agglutinin syndrome: a rare complication in Pediatrics." Revista Paulista de Pediatria 42 (2023). http://dx.doi.org/10.1590/1984-0462/2024/42/2022174.
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ABSTRACT Objective: The objectives of this study were to describe the first pediatric case of cold agglutinin syndrome (CAS) triggered by human adenovirus and review the literature. Case description: This case report involves a previously healthy, 2½-year-old female child with human adenovirus isolated in a nasal swab. At 72 h after admission, the patient progressed to a severe episode of anemia (hemoglobin level: 2.6 g/dL). The laboratory findings were consistent with CAS. The patient received blood transfusion, vitamin supplementation, adequate hydration, and thermal protection. At her last follow-up, 1 year after her initial presentation, she remains clinically well without signs of hemolysis. Comments: While severe CAS is extremely uncommon in the pediatric emergency department, human adenovirus infection is a common illness in pediatrics. Recently, the adenovirus has been associated with new complications (acute hepatitis and fulminant liver failure). Pediatric physicians and hematologists should be aware of unusual evolution, signs, and symptoms of this infection that warrant more urgent medical attention. In this case, the hematologic complication suspicion was the key to early diagnosis and adequate management.
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de Oliveira, Bianca Gabriella, Fabrício Negreiros Holtz, Matheus Pedroso Cavalcanti de Souza, and Nattan Santos Rozendo de Oliveira. "Analysis of the epidemiological profile of congenital hip deformities, 2011–2021." Revista Paulista de Pediatria 42 (2023). http://dx.doi.org/10.1590/1984-0462/2024/42/2022167.
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ABSTRACT Objective: This study aimed to identify the relevance of hospitalizations for congenital hip deformities in Bahia. Methods: This is a retrospective epidemiological study in public databases. Descriptors in health sciences: “congenital hip dysplasia”, “congenital hip dislocation”, and “congenital dislocation hip”. This is qualitative-quantitative research with the analysis of secondary data and cross-sectional typologies in the databases of the Ministry of Health – Health Information (TABNET), made available by the Department of Informatics of the Unified Health System (DATASUS). Results: Bahia was the third Brazilian state with the highest number of hospitalizations, registering 1481 cases. The municipalities in Bahia with the highest prevalence were Itanhém, Salvador, and Barreiras, with 912, 445, and 20 cases, respectively. Conclusions: The elevated number of congenital hip deformities reflects a public health problem, requiring investments in public policies.
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Pico, María, Ximena Prado, Gonzalo Germán Guiñazú, Sofía Diana Menéndez, Julia Dvorkin, María Victoria López, Carolina Pascual, Christian Elias Costa, and Diego Enríquez. "Communication of medical errors in a simulated clinical scenario. Experience with a pediatric residency group." Revista Paulista de Pediatria 42 (2023). http://dx.doi.org/10.1590/1984-0462/2024/42/2022109.
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ABSTRACT Objective: To determine the performance of groups of pediatric residents from a Buenos Aires hospital, in terms of correct recognition and communication of a medical error (ME), in a high-fidelity simulation scenario. To describe the reactions and communication attempts following the ME and the self-perception by the trainees before and after a debriefing. Methods: Quasi-experimental uncontrolled study conducted in a simulation center. First- and third-year pediatric residents participated. We designed a simulation case in which an ME occurred and the patient deteriorated. During the simulation, participants had to provide information on communicating the ME to the patient’s father. We assessed communication performance and, additionally, participants completed a self-perception survey about ME management before and after a debriefing. Results: Eleven groups of residents participated. Ten (90.9%) identified the ME correctly, but only 27.3% (n=3) of them reported that a ME had occurred. None of the groups told the father they were going to give him important news concerning his son’s health. All 18 residents who actively participated in this communication completed the self-perception survey, with an average score before and after debriefing of 5.00 and 5.05 (out of 10) (p=0.88). Conclusions: We observed a high number of groups that recognized the presence of a ME, but the communication action was substantially low. Communication skills were insufficient and residents’ self-perception of error management was regular and not modified by the debriefing.
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Bigio, Juliana Zoboli Del, Ana Cristina Aoun Tannuri, Mário Cícero Falcão, Felipe Yu Matsushita, and Werther Brunow de Carvalho. "Factors associated with cholestasis in newborns with gastroschisis." Revista Paulista de Pediatria 42 (2023). http://dx.doi.org/10.1590/1984-0462/2024/42/2022152.
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ABSTRACT Objective: To describe the incidence and to analyze risk factors associated with cholestasis in neonates with gastroschisis. Methods: This is a retrospective cohort study in a tertiary single center analyzing 181 newborns with gastroschisis between 2009 and 2020. The following risk factors associated with cholestasis were analyzed: gestational age, birth weight, type of gastroschisis, silo closure or immediate closure, days of parenteral nutrition, type of lipid emulsion, days of fasting, days to reach a full diet, days with central venous catheter, presence of infections, and outcomes. Results: Among the 176 patients evaluated, 41 (23.3%) evolved with cholestasis. In the univariate analysis, low birth weight (p=0.023), prematurity (p<0.001), lipid emulsion with medium-chain triglycerides and long-chain triglycerides (p=0.001) and death (p<0.001) were associated with cholestasis. In the multivariate analysis, patients who received lipid emulsion with fish oil instead of medium chain triglycerides/long chain triglycerides (MCT/LCT) emulsion had a lower risk of cholestasis. Conclusions: Our study shows that lipid emulsion with fish oil is associated with a lower risk of cholestasis in neonates with gastroschisis. However, this is a retrospective study and a prospective study should be performed to confirm the results.
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Silva, Danielle Cristina Guimarães da, Marcela de Sá Barreto da Cunha, Amanda de Oliveira Santana, Augusto Matheus dos Santos Alves, and Marcos Pereira Santos. "Nutritional interventions in children and adolescents with cerebral palsy: systematic review." Revista Paulista de Pediatria 42 (2023). http://dx.doi.org/10.1590/1984-0462/2024/42/2022107.
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ABSTRACT Objective: To systematically review the literature in search of the most suitable and effective nutritional interventions and indications for the nutritional treatment of children and adolescents with cerebral palsy (CP). Data source: This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The articles were selected from seven databases (Cochrane, Literatura Latino-Americana e do Caribe em Ciências da Saúde — Lilacs, Embase, United States National Library of Medicine — PubMed, Scientific Electronic Library Online — SciELO, Scopus, and Web of Science). Studies from a pediatric group (0 to 18 years old) diagnosed with CP were included and the search strategy included the descriptors: “children” OR “childhood” AND “nutritional therapy” OR “nutritional intervention” OR “nutrition” OR “nutritional support” OR “diet” AND “cerebral palsy” OR “cerebral injury”. Methodological quality was assessed using the checklist for cross-sectional analytical studies, the Newcastle-Ottawa scale or the Cochrane Collaboration tool for clinical trials. Data synthesis: Fifteen studies (n=658) published from 1990 to 2020 met the inclusion criteria. All of them had a low risk of bias. The data showed that children and adolescents with CP have worse nutritional status than those normally developed. Those who received hypercaloric and hyperprotein nutritional supplementation benefited from its use. Studies indicate that enteral nutrition should be considered when nutritional needs are not met by the oral diet, especially in cases where oral motor functions are impaired. In addition, there was a direct relationship between the consistency of food, the level of motor function and nutritional status. Conclusions: Children and adolescents with CP have a greater risk of malnutrition. The use of nutritional supplementation may help with weight gain. In addition, enteral nutrition and modification of food texture have been used to improve the nutritional status of this group.
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Dantas, Lorena Dias, Ricardo Queiroz Gurgel, Verena Pimenta Santos, Debora Fontes Leite, and Ikaro Daniel de Carvalho Barreto. "Impact of the Koala Project on clinical outcomes of preterm infants in two maternity hospitals." Revista Paulista de Pediatria 42 (2023). http://dx.doi.org/10.1590/1984-0462/2024/42/2022106.
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ABSTRACT Objective: To describe the impact of the Koala project (Actively Controlling Target Oxygen) on clinical outcomes in patients born with less than 36 weeks of gestation, in two maternity hospitals, comparing before and after the strategy implementation. Methods: This is an intervention study with 100 preterm infants with gestational age ≤36 weeks, who used oxygen in two maternity hospitals between January 2020 and August 2021. One of the hospitals was a private institution and the other was philanthropic. The goal for the target oxygen saturation with this project was 91–95%. Comparisons between the two stages (before and after the implementation of the project) were made evaluating the outcomes of retinopathy of prematurity, bronchopulmonary dysplasia, necrotizing enterocolitis, and deaths. The continuous variables were described using mean, median, standard deviation and interquartile interval. The significance level adopted was 5% and the software used was R Core Team 2021 (version 4.1.0). Results: After oxygen control use according to the Koala protocol, there was a significant reduction in the cases of retinopathy of prematurity (p<0.001) and bronchopulmonary dysplasia (p<0.001). There were no deaths in the second stage, and there was a non-significant increase in the absolute number of necrotizing enterocolitis cases. Conclusions: The Koala project seems to be an effective and feasible strategy to reduce adverse situations in the management of premature children, but research with a greater sample is needed.
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Brock, Karoliny, Gabriel Oscar Cremona Parma, Alessandra de Sá Soares, and Fabiana Schuelter-Trevisol. "Analysis of notified drug poisoning among children in Santa Catarina state, 2016–2020." Revista Paulista de Pediatria 42 (2023). http://dx.doi.org/10.1590/1984-0462/2024/42/2022155.
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ABSTRACT Objective: The aim of this study was to analyze the incidence of drug poisoning in children registered in the Santa Catarina Information and Toxicological Assistance Center between 2016 and 2020. Methods: This observational epidemiological study, with a historical cohort design, was carried out from reported cases of drug poisoning in children aged 0–12 years. Census sampling was used to collect data. Results: There were 4839 reported cases of drug poisoning among children in the State of Santa Catarina in the surveyed period, with an average annual incidence rate of 6 cases/1000 live births. The median age was 3 years. Most cases of poisoning occurred among girls aged 0–3 years by accidental ingestion of drugs at home. There was a predominance of signs and symptoms affecting the nervous system; only a small portion required hospitalization. Most cases were considered mild poisoning with a favorable outcome. No deaths were recorded. There was a tendency of increasing cases over time, however not significant. There is a predominance of incident cases in the Great West of the state, followed by the Midwest and Serra Catarinense regions. Conclusions: Drug poisoning in children is predominant in early childhood, mainly caused by accidental ingestion of drugs at home. These findings highlight the importance of preventive and educational measures among family members and caregivers.
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Lima, Lenita de Melo, Rafaela Baroni Aurilio, Adriana Rodrigues Fonseca, Ana Alice Amaral Ibiapina Parente, Maria de Fátima Bazhuni Pombo Sant’Anna, and Clemax Couto Sant’Anna. "Tuberculosis in children and adolescents with rheumatic diseases using biologic agents: an integrative review." Revista Paulista de Pediatria 42 (2023). http://dx.doi.org/10.1590/1984-0462/2024/42/2022084.
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ABSTRACT Objective: To conduct a bibliographic review on tuberculosis (TB) disease in children and adolescents with rheumatic diseases, being managed with biologic therapy. Data source: An integrative review with a search in the U.S. National Library of Medicine and the National Institutes of Health (PubMed) using the following descriptors and Boolean operators: ([“tuberculosis”] AND ([“children”] OR [“adolescent”]) AND [“rheumatic diseases”] AND ([“tumor necrosis factor-alpha”] OR [“etanercept”] OR [“adalimumab”] OR [“infliximab”] OR [“biological drugs”] OR [“rituximab”] OR [“belimumab”] OR [“tocilizumab”] OR [“canakinumab”] OR [“golimumab”] OR [“secukinumab”] OR [“ustekinumab”] OR [“tofacitinib”] OR [“baricitinib”] OR [“anakinra”] OR [“rilonacept”] OR [“abatacept”]), between January 2010 and October 2021. Data synthesis: Thirty-seven articles were included, with the total number of 36,198 patients. There were 81 cases of latent tuberculosis infection (LTBI), 80 cases of pulmonary tuberculosis (PTB), and four of extrapulmonary tuberculosis (EPTB). The main rheumatic disease was juvenile idiopathic arthritis. Among LTBI cases, most were diagnosed at screening and none progressed to TB disease during follow-up. Of the TB cases using biologics, most used tumor necrosis factor-alpha inhibitors (anti-TNFα) drugs. There was only one death. Conclusions: The study revealed a low rate of active TB in pediatric patients using biologic therapy. Screening for LTBI before initiating biologics should be done in all patients, and treatment, in cases of positive screening, plays a critical role in preventing progression to TB disease.
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Lunardelli, Sandra Espíndola, Abelardo Nunes Lunardelli, Luiz Gustavo Teixeira Martins, Eliane Traebert, and Jefferson Traebert. "Prenatal, neonatal and postnatal factors and the developmental defects of dental enamel." Revista Paulista de Pediatria 42 (2024). http://dx.doi.org/10.1590/1984-0462/2024/42/2022226.
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ABSTRACT Objective: To estimate the prevalence of developmental defects in dental enamel and its possible association with prenatal, neonatal and postnatal conditions in six-year-old schoolchildren in a southern Brazilian municipality. Methods: A cross-sectional study was conducted involving 655 six-year-old schoolchildren. Sociodemographic and health data were collected through interviews with mothers and children’s oral examinations at schools. Multivariate analyses were performed using Poisson regression with robust estimator. Results: The prevalence of developmental defects of enamel was 44.0%. Demarcated opacities were the most prevalent, followed by diffuse opacities. Late pregnancy, maternal schooling less than eight years, female gender and child’s white skin color were independently associated with the prevalence of demarcated opacities. Conclusions: The prevalence of developmental defects in dental enamel was 44.0%. Late pregnancy, maternal schooling less than eight years, female gender and child’s white skin color were associated with the prevalences.
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Costa, Roseli Divino, Maria de Fátima de Carvalho Ferreira, Thaís de Almeida Rocha, and Marcial Francis Galera. "Evaluation of newborn screening in the state of Mato Grosso from 2005 to 2019." Revista Paulista de Pediatria 42 (2024). http://dx.doi.org/10.1590/1984-0462/2024/42/2022161.
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ABSTRACT Objective: To evaluate quality indicators of the Neonatal Screening Referral Service of the state of Mato Grosso (NSRS-MT) from 2005 to 2019. Methods: Cross-sectional, retrospective, exploratory, descriptive, and observational study from 2005 to 2019. The following parameters were analyzed: age of newborns at the first collection, time between sample collection and arrival at the laboratory, time between the arrival and release of results and time between requesting the second sample and arrival at the NSRS. The population coverage of the program and the incidence of each clinical situation screened were also analyzed. Results: NSRS-MT coverage was analyzed and recorded as 76%. The incidence was analyzed for congenital hypothyroidism (CH) 1:1867, phenylketonuria (PKU) 1:33,311, sickle cell disease (SCD) 1:2004, cystic fibrosis (CF) 1:12,663, congenital adrenal hyperplasia (CAH) 1:15,843, and biotinidase deficiency (DB) 1:25,349. The median age (days) at the first consultation was: 44 for HC, 22 for PKU, 60 for DF, 52 for FC, 79 for HAC and 79 for DB. The mean time between exam collection and delivery to the NSRS was 8.4 days; between the arrival and release of results, 9 days; and for the return of recalls, 59 days. Conclusions: Regarding the coverage of the target population and collection at the ideal age, the NSRS-MT presents values below the national average. However, regarding the mean age at the time of the first consultation, the state's performance is better than the national.
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Oliveira, Suelen Rosa de, Ana Carolina Cabral de Paula Machado, Lívia de Castro Magalhães, Débora Marques de Miranda, Jonas Jardim de Paula, and Maria Cândida Ferrrez Bouzada. "Cognitive assessment in preterms by Bayley-III: development in the first year and associated factors." Revista Paulista de Pediatria 42 (2024). http://dx.doi.org/10.1590/1984-0462/2024/42/2022164.
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ABSTRACT Objective: To analyze the cognitive development of preterm infants at six and 12 months of corrected age and the associations with perinatal and socioeconomic factors. Methods: Cognitive development of 40 infants (20 preterm and 20 full-term) at six and 12 months of age was evaluated using the Bayley-III scale. Correlations between cognitive outcome and associated factors were assessed using Spearman correlation. Stepwise multiple linear regression analysis with covariance was applied to identify changes on cognitive score between six and 12 months. Results: Bayley-III cognitive score in preterm group was significantly lower than in full-term group at both six and 12 months of age. Birth weight correlated with cognitive performance at six months and head circumference at birth at 12 months, in full-terms infants. The occurrence of necrotizing enterocolitis was inversely associated with cognitive score in preterms at 12 months. An increase in cognitive score was observed between six and 12 months in both groups, but the gain was more pronounced in preterms. Conclusions: These findings suggest some cognitive recovery capacity in the first year despite the restrictions imposed by premature birth and emphasize the importance of early interventions in this population.
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Fuentes, Alejandro Donoso, Gianfranco Tomarelli Rubio, Camila Ampuero Acuña, Franco Díaz Rubio, Fernando Bracho Milic, and Pamela Carrasco Troncoso. "Near-fatal cocaine intoxication in an infant with thrombotic microangiopathy associated with multiple organ failure." Revista Paulista de Pediatria 42 (2024). http://dx.doi.org/10.1590/1984-0462/2024/42/2022159.
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ABSTRACT Objective: To report a pediatric case of drug-induced thrombotic microangiopathy caused by cocaine Case description: We report a nine-month-old patient who developed thrombotic microangiopathies after extreme cocaine intoxication, multiple organ dysfunction syndrome with hemodynamic dysfunction, anuric renal failure, liver failure, encephalopathy, and myocardial injury, corresponding phenotypically to thrombocytopenia-associated multiple organ failure. The patient received continuous venous hemofiltration and therapeutic plasma exchange, recovering satisfactorily. She was discharged after 30 days of hospitalization under the guidance of the childcare service, and was healthy after one year of follow-up. Toxicological samples confirmed high levels of cocaine and derivatives in blood, urine and hair. Comments: To our knowledge, this is the first reported pediatric case. There are particularities of cocaine intoxication pathophysiology that can trigger thrombotic microangiopathies because of vasoconstriction, direct endothelial injury, platelet activation, and increasing von Willebrand factor and fibrinogen levels. All of which results in a prothrombotic state, inflammatory dysregulation, and microvascular thrombi. The increasing use of cocaine, especially among young adults, puts children at high risk of toxicity, either by passive unintentional exposure, or abuse due to the increased availability in homes.
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Freitas, Felipe Teixeira de Mello, Cíntia Costa Pereira Pimentel, Pedro Ribeiro Bianchini, Rafaela Moreira de Carvalho, Alexandre Peixoto Serafim, and Cira Ferreira Antunes Costa. "Evaluation of Severe Acute Respiratory Syndrome surveillance caused by respiratory viruses in a pediatric unit, 2013 to 2019." Revista Paulista de Pediatria 42 (2024). http://dx.doi.org/10.1590/1984-0462/2024/42/2022215.
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ABSTRACT Objective: To evaluate severe acute respiratory syndrome surveillance in a pediatric unit. Methods: Descriptive study of reported severe acute respiratory syndrome cases with the detection of respiratory viruses in the nasopharyngeal sample of patients hospitalized between 2013 and 2019, in a reference hospital in the Federal District, Brazil. Results: A total of 269 children had one or more viruses detected, resulting in 280 viruses, of which 152 (54%) were respiratory syncytial virus. The detection of respiratory syncytial virus was higher during the autumn-winter period. Children´s median age was 6.9 months, 156 (58%) were male, 104 (39%) had comorbidity, 197 (73%) required mechanical ventilation, 241 (90%) received antibiotics, and 146 (54%) oseltamivir. There were 19 (7%) deaths. The median time from symptom onset to sample collection was 5 days and the median time from sample collection to final results was 6 days. Conclusions: The system needs to reduce the time to deliver results so that inappropriate use of antibiotics and antivirals can be avoided. Moreover, the burden of viral pneumonia was relevant and the system must be flexible enough to include emerging viruses in order to be useful in responding to public health emergencies caused by respiratory viruses.
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Coelho, Rachel Mocelin Dias, Sandra Josefina Ferraz Ellero Grisi, Alexandra Valéria Maria Brentani, and Ana Paula Scoleze Ferrer. "Assessment of school readiness and the importance of executive functions for learning." Revista Paulista de Pediatria 42 (2024). http://dx.doi.org/10.1590/1984-0462/2024/42/2022196.
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ABSTRACT Objective: Considering the importance of the beginning of the academic trajectory for children to reach their full development, this work aims to evaluate the school readiness of preschool-age children and identify which factors influence these results, in order to contribute to the proposition of strategies that allow improving the teaching-learning process and child development. Methods: This is a cross-sectional, descriptive and analytical study with 443 preschool children belonging to the West Region Cohort (ROC Cohort), from the public school system of the city of São Paulo. School readiness was assessed by the International Development and Early Learning Assessment (IDELA) tool. Non-parametric techniques were used for the correlation analysis between IDELA scores and sociodemographic and socioeconomic conditions: Spearman's parametric correlation, Mann-Whitney and Kruskal-Wallis tests. Results: The children's mean age was 69 months (standard deviation — SD=2.8; ranging from 55 to 72 months) and most of them came from families with low socioeconomic level. Most children showed adequate readiness in the overall score (65%) and in most domains, except for emergent literacy, in which most (56.9%) were classified as “emergent”. The highest percentage of insufficiency was identified in executive functions (4.1%), which showed a correlation only with the caregiver's education. Conclusions: Children had adequate school readiness scores, except for emergent literacy, but the insufficiency in executive functions may compromise the future schooling of these children. Thus, pedagogical proposals should consider these aspects for learning and pediatricians need to reinforce the habit of reading and playing games to stimulate child development.
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Bagatini, Maria Amélia, João Paulo Heinzmann-Filho, Fernanda Maria Vendrusculo, Leonardo Araújo Pinto, and Márcio Vinícius Fagundes Donadio. "Impact of COVID-19 social distancing recommendations on pulmonary function, nutritional status, and morbidity in patients with cystic fibrosis." Revista Paulista de Pediatria 42 (2024). http://dx.doi.org/10.1590/1984-0462/2024/42/2022198.
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ABSTRACT Objective: To evaluate the impact of COVID-19 social distancing recommendations on nutritional status, pulmonary function, and morbidity in patients with cystic fibrosis (CF). Methods: A retrospective cohort study including patients older than six years with a diagnosis of CF was performed. Demographic and clinical data, anthropometric measurements, pulmonary function, days of antibiotic use, and length of hospital stay were recorded. Variables were recorded at three time points relative to the baseline for implementation of social distancing measures: T-1 (14 months before implementation), T0 (baseline), and T1 (14 months after implementation). Delta (Δ) was calculated for each period: Δ1 (pre-pandemic T0-T-1) and Δ2 (pandemic T1-T0). Results: The study included 25 patients, with a mean age of 11.7±4.3 years. The mean forced expiratory volume in the first second (FEV1) was 85.6±23.6%, and body mass index (BMI) was 17.5±3.0 kg/m2. When comparing the two periods (Δ1 and Δ2), there was a significant increase in the FEV1/forced vital capacity (FVC) ratio (p=0.013) and in the forced expiratory flow between 25 and 75% of vital capacity (FEF25–75%) (p=0.037) in the pandemic period. There was also a significant reduction (p=0.005) in the use of antibiotics in the pandemic period compared with the pre-pandemic period. The Δ1 and Δ2 values did not differ significantly for BMI, FEV1, or length of hospital stay. Conclusions: COVID-19 social distancing recommendations had a positive impact (decrease) on morbidity (use of antibiotics) and small airway obstruction (FEF25–75%) in patients with CF.
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Furtado, Michelle Alexandrina dos Santos, Hércules Ribeiro Leite, Matheus Rocha Pereira Klettenberg, Victor Alves Rodrigues, Lisiane Seguti Ferreira, Melina Rodero Marques, Isadora de Oliveira Cavalcante, et al. "Translation and measurement properties of the Portuguese-Brazil version of the Hammersmith Infant Neurological Examination (HINE-Br)." Revista Paulista de Pediatria 42 (2024). http://dx.doi.org/10.1590/1984-0462/2024/42/2023105.
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ABSTRACT Objective: The current study aimed to translate the Hammersmith Infant Neurological Examination (HINE) into Brazilian Portuguese and analyze the reliability of the translated version for a population of Brazilian infants. Methods: This was a methodological study, approved by the Ethics Committee, carried out between June 2020 and May 2021. HINE is a standardized clinical neurological examination used for the early detection of cerebral palsy. The quantitative section, “neurological examination”, contains 26 items scored from 0 to 3 points, divided into five categories: cranial nerve function, posture, movements, muscle tone and reflexes, and reactions. The HINE translation followed four steps: translation, synthesis, back-translation, and evaluation by an expert committee. To verify the reliability of the HINE-Br (Portuguese-Brazil version) two independent examiners evaluated 43 infants, between 3 and 22 months of age. Internal consistency was verified by Cronbach’s Alpha coefficient and interrater reliability by the intraclass correlation coefficient (ICC). Results: The translated version was similar to the original version and a few semantic and idiomatic adjustments were necessary. Appropriate internal consistency (Alpha=0.91) was found for the 26 items of the HINE-Br, as well as strong interrater reliability for the total score (ICC2.1=0.95), and also for the five categories (ICC2.1=0.83–0.95). Conclusions: The HINE-Br presents adequate rates of internal consistency and interrater reliability, and can be used for the evaluation of children at risk for cerebral palsy, between 3 and 24 months of age, by pediatricians and pediatric physical therapists.
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Dorf, Sandro Rachevsky, Adriana Rodrigues Fonseca, Flávio Roberto Sztajnbok, Thiffany Rodrigues Delfino de Oliveira, and Linamara Rizzo Basttistella. "The state of the art in therapeutic administration of botulinum toxin in children with cerebral palsy: an integrative review." Revista Paulista de Pediatria 42 (2024). http://dx.doi.org/10.1590/1984-0462/2024/42/2023093.
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ABSTRACT Objective: To describe the current state of the art in the therapeutic administration of botulinum toxin with indications, efficacy, and safety profile for children and adolescents with cerebral palsy. Data source: An integrative review was conducted. The MEDLINE/PubMed database was searched twice within the last decade using distinct terms, and only studies written in the English language were included. The study population was limited to those aged 0–18 years. Articles that were duplicates or lacked sufficient methodology information were excluded. Data synthesis: We found 256 articles, of which 105 were included. Among the included studies, most were conducted in developed countries. Botulinum toxin demonstrated good safety and efficacy in reducing spasticity, particularly when administered by a multidisciplinary rehabilitation team. It is primarily utilized to improve gait and upper limb function, facilitate hygiene care, reduce pain, prevent musculoskeletal deformities, and even decrease sialorrhea in patients without a functional prognosis for walking. Conclusions: The administration of botulinum toxin is safe and efficacious, especially when combined with a multi-professional rehabilitation team approach, which increases the probability of functional improvement. It can also be beneficial for patients with significant functional impairments to help with daily care tasks, such as hygiene, dressing, and reducing sialorrhea. Pediatricians must be familiar with this treatment and its indications to attend to and refer patients promptly when necessary, and to exploit their neuroplasticity. Further research on this topic is required in developing countries.
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Cortez, Mariela Valentina, Ana Veronica Scotta, Agustín Ramiro Miranda, and Elio Andrés Soria. "Polyphenol analysis in human milk by a rapid, cost-effective, and accurate micromethod: translational development." Revista Paulista de Pediatria 42 (2024). http://dx.doi.org/10.1590/1984-0462/2024/42/2023186.
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ABSTRACT Objective: To develop a rapid method for analysing polyphenols, which are potentially active antioxidants against neonatal oxidative stress, from small human milk (HM) volumes. Methods: Acid and alkaline extractions were compared using two dyes: Folin-Ciocalteu and Fast Blue BB. Linearity, sensitivity, recovery percentage, polyphenol content, precision, and stability were assessed in 14 HM samples and compared using the Kruskal-Wallis H test (p<0.05). The best technique was applied to 284 HM samples to determine their polyphenolic content and its association with maternal diet by multifactorial linear regression. Results: Acidic extraction successfully recovered the gallic acid reference standard, whereas alkaline extraction overestimated it. Calibration curves for all methods were linear (R2>0.96) up to 500 mg/L. All bicarbonate-based Folin-Ciocalteu methods assayed were stable and repeatable, whereas Fast Blue BB-based variants were not. HM polyphenols (mean=94.68 mg/L) positively correlated to the dietary intake of hydroxycinnamic acids, the most consumed polyphenolic family in this population. Conclusions: A bicarbonate-based Folin-Ciocalteu micromethod allowed the accurate determination of polyphenols in HM, which might be useful for translational research settings and HM banks.
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Felipe, Marcelle Di Angelis Ambar, Maria Angelica Sorgini Peterlini, Amanda Ullman, and Mavilde da Luz Gonçalves Pedreira. "Michigan appropriateness guide for intravenous catheters in pediatrics — miniMAGIC-Brasil: translation into Brazilian portuguese." Revista Paulista de Pediatria 42 (2024). http://dx.doi.org/10.1590/1984-0462/2024/42/2023159.
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ABSTRACT Objective: To perform the translation and adaptation of the Michigan Appropriateness Guide for Intravenous Catheters in Pediatrics (miniMAGIC) into Brazilian Portuguese. Methods: Methodological study performed in five recommended stages: initial translations; synthesis of the translations; back translations; assessment of the back translations; expert committee assessment. The expert committee was composed of three registered nurses and two doctors who had a Master’s and/or PhD degree, and an expertise in intravenous therapy and pediatric and neonatal care. To assess the semantic, idiomatic, experiential and conceptual adequacy, a Likert scale was applied, in which 1, “not equivalent”; 2, “inequivalent”; 3, “cannot assess”; 4, “quite equivalent”; 5, “totally equivalent”. The terms mostly analyzed as negative in equivalence and with a lower than 20 score were reviewed and submitted to a new assessment, with the Delphi Technique until consensus was obtained. The results were stored in electronic spreadsheets and treated with concordance index, with a minimum acceptable result of 0.80. Results: The content of all recommendations, named as miniMAGIC-Brasil, was validated by the expert committee after two stages of evaluation. All recommendations had an overall agreement index of 0.91. Conclusions: The miniMAGIC-Brazil guide was validated in respect to the adequacy of the translation after two steps.
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Lederman, Vivian Renne Gerber, Ana Lucia Goulart, Juliana Gioia Negrão, and José Salomão Schwartzman. "Visual scanning of social stimuli in preterm and autism spectrum disorder children." Revista Paulista de Pediatria 42 (2024). http://dx.doi.org/10.1590/1984-0462/2024/42/2023017.
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ABSTRACT Objective: To evaluate the pattern of eye-gaze of preterm (PT), autism spectrum disorder (ASD) and neurotypical (Ty) children. Methods: A cross-sectional study with eight preterm (born with ≤2000 g weight), nine ASD and five Ty male children, between six and nine years old, was performed. The eye gaze was evaluated presenting a board with a couple in social interaction, and a video with four children playing with blocks, projected in a screen computer, successively, evaluating the time that the children looked at each stimulus. Results: Although all the groups focus on the central social figure with no significant differences, ASD presented significant differences in time fixation of the objects (p=0.021), while premature children fixated more time in the central social interaction than in the whole scene than typical children. Conclusions: Although this study found noteworthy differences in the eye-gaze patterns among the three groups, additional research with a more extensive participant pool is necessary to validate these preliminary results.
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Gifalli, Marina, Camila Trettene Antonio, Verônica Aparecida Pezzato da Silva, Francine Aroteia Capone, Priscila Capelato Prado, and Armando dos Santos Trettene. "Adolescents with orofacial clefts: understanding their experiences." Revista Paulista de Pediatria 42 (2024). http://dx.doi.org/10.1590/1984-0462/2024/42/2023131.
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ABSTRACT Objective: To understand the experience of young people with orofacial clefts regarding life as an adolescent. Methods: Descriptive, qualitative study, developed in a Brazilian public and tertiary hospital, a reference center in the care of patients with craniofacial anomalies and related syndromes, between February and April 2019. The sample was defined by theoretical saturation. The following inclusion criteria were established: age between ten and 19 years old and having previously operated on orofacial cleft (lip and/or palate). Individuals with fissure associated with syndromes or other malformations were excluded. Data collection was performed through semi-structured interviews, which were audio recorded and transcribed in full. The trigger element was: how has it been for you to experience your adolescence? For the construction of the results, content analysis was used in the thematic modality. Results: Seventeen adolescents participated. From the speeches, three categories were revealed: interacting socially, feeling supported, and experiencing and facing prejudice. Conclusions: The biopsychosocial and conflicting complexity that adolescents with orofacial clefts experience was noticed, as well as the importance of receiving support and establishing modalities of situational coping.
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Canto, Gabrielle Mascarenhas, and Katia de Miranda Avena. "Early stimulation for neuropsychomotor development in children with microcephaly: a systematic review." Revista Paulista de Pediatria 42 (2024). http://dx.doi.org/10.1590/1984-0462/2024/42/2023063.
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ABSTRACT Objective: To systematically review studies on the effects of early stimulation on the neuropsychomotor development of children with microcephaly. Data source: A systematic review was conducted in PubMed/MEDLINE, Virtual Health Library, and Cochrane Library databases. Studies that addressed the use of early stimulation in playful and interactive environments in children with microcephaly were included. There were no restrictions on the publication date or language of the studies. The outcomes assessed were muscle tone, social interaction, fine and gross motor skills, intelligence quotient, socioemotional and adaptive behavior of the child. The methodological quality and the scientific evidence level were assessed using the Risk of Bias in Non-randomized Studies of Interventions, the Revised Cochrane risk of bias tool for randomized trials and the Grading of Recommendations Assessment, Development and Evaluation. Data synthesis: 264 articles were identified, but only 7 met the eligibility criteria. The included studies had a total population of 125 individuals, with sample sizes ranging from 1 to 71 participants. Conclusions: The studies showed low evidence of an effect of early intervention on the outcomes muscle tone, social interaction, fine and gross motor skills, intelligence quotient, and socioemotional and adaptive behavior in children with microcephaly. However, further randomized clinical trials are needed.
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Jacobs, Jeremy, Garrett Booth, and Brian David Adkins. "All that hemolyzes with complement is not cold agglutinin syndrome." Revista Paulista de Pediatria 42 (2024). http://dx.doi.org/10.1590/1984-0462/2024/42/2023144.
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