Background Despite therapeutic advances, asthma prevalence remains high. Psychosocial factors, including maternal mental disorders, may be involved. This study aims to evaluate the association of maternal common mental disorders (CMDs) and their change over time with asthma morbidity in the child and to observe the effect of social support on this association. Methods This prospective study involved 189 dyads of mothers and their asthmatic children aged between 2 and 14 years, assisted in specialized outpatient clinics. We measured the association of maternal CMD evolution (absent, maintained, or improved over time) with asthma control and visits to the emergency department (ED) due to asthma attacks through Poisson regression analysis. We further stratified the sample according to social support levels to identify a possible effect of this variable on the association of maternal psychological symptoms with asthma morbidity. Results Compared with mothers who maintained CMD over time, maternal CMD absence had a protective effect on the occurrence of visits to the ED (RR: 0.45; 95% CI: 0.26‐0.79) and maternal CMD improvement was associated with lower risk of uncontrolled asthma in the child (RR: 0.60; 95% CI: 0.37‐0.97). There was a stronger association of maternal CMD improvement with asthma control in the child only for the stratum of mothers with high social support in its three dimensions (affective‐social interaction, emotional‐informational, and material dimensions). Conclusions Maternal CMD absence and improvement over the study period were protective factors for uncontrolled asthma in the child, mainly in the presence of high social support.
Objective: To describe the management of acute diarrhea in emergency departments with emphasis on the type of hydration and exploring factors associated with prescription of oral rehydration therapy vs. intravenous rehydration therapy for children with dehydration that is not severe. Methods:This was a descriptive study conducted from January to May of 2008 observing case management of children with non-severe dehydration due to acute diarrhea at two emergency units (A and B) in Recife, Brazil. Emergency unit B is affiliated to a teaching hospital. The primary variables were: 1) type of hydration prescribed, 2) associations with the characteristics of the children and emergency department (A or B).Results: A total of 166 children took part in the study. The rates of prescription of oral rehydration therapy were similar at both services (32.2 vs. 31.6% for A and B, respectively, p = 0.93) and were lower for cases with moderate dehydration (17.6%) compared with mild dehydration (35.6%) (p = 0.07). Neither service had a dedicated oral rehydration room.Conclusions: Most children were given intravenous rehydration therapy, especially those with moderate dehydration, without differences according type of service: whether a teaching institution or healthcare provider only.J Pediatr (Rio J). 2011;87(2):175-179: Emergency medical services, fluid therapy, gastroenteritis, child. ResumoObjetivo: Descrever o manejo da diarreia aguda na emergência, explorando fatores associados à prescrição da terapia de reidratação oral (TRO) versus terapia de reidratação venosa (TRV) para crianças com desidratação não grave.Métodos: Estudo descritivo conduzido de janeiro a maio de 2008 em duas unidades de emergência em Recife (PE), A e B, sendo a emergência B vinculada a um hospital-escola, com observação do manejo de crianças com desidratação não grave por diarreia aguda. As principais variáveis foram: 1) tipo de hidratação prescrito; 2) associação com características das crianças e local.Resultados: Cento e sessenta e seis crianças participaram do estudo. A indicação de TRO foi semelhante nos dois serviços (32,2 versus 31,6% em A e B, respectivamente, p = 0,93) e menor para os casos com desidratação moderada (17,6%) em relação à forma leve (35,6%), p = 0,07. Não havia sala de reidratação oral nos serviços. Conclusões:A maioria das crianças não fez uso de TRO, principalmente aquelas com desidratação moderada, não havendo diferença em relação ao tipo de serviço, assistencial ou de ensino.J Pediatr (Rio J). 2011;87(2):175-179: Serviços médicos de emergência, terapia de reidratação oral, gastroenterite, criança.
Objective: the aim of our study was to assess the effect of a physical activity that uses active video games in body composition, physical fitness, cardiovascular and biochemical parameters with sedentary adolescents. Methods: a non-controlled clinical trial design with a convenience sample of adolescents, separately, from ages ten to 17, of both genders. The intervention protocol consisted of physical activity with active video games (AVG), lasting two months, in 24 sessions, evolving into three levels (basic, intermediate and advanced) according to the maximum heart rate of the individuals. The adolescents’ body composition, physical fitness, cardiovascular and biochemical parameters were assessed. Data analysis was performed with a 95% confidence interval. Results: among the 14 adolescents that completed the physical training, we observed a improvement of muscle resistance (Δ= 8.26; p= 0.02) and decrease in post-exercise heart rate and systolic blood pressure (p< 0.01). However, were found a non-significant decrease in body fat percentage (Δ= -3.83; p= 0.24) and strength (Δ= 4.26; p= 0.57). A high level of satisfaction with the proposed activity was identified. Conclusion: a physical activity program based on AVG can reduce cardiovascular risk factors and improve muscle resistance in sedentary adolescents.
We aimed to investigate prevalence and factors associated with Suicide ideation (SI) in mothers of asthmatic children. This cross-sectional study included 362 dyads of mothers and children with asthma aged 2 to 14 years who attended two pediatric outpatient clinics in Brazil. We assessed the presence of SI (Self-Report Questionnaire-20), the occurrence of stressful events and maternal social support. The prevalence of SI was 8.6%. Low maternal education, exposure to serious illness, and low perception of social support in its affective–social interaction dimension remained significantly associated with SI in the final model. Thus, life stressors, social support and low maternal education accounted for most of the variation in prevalence of maternal SI. There were no effects of child asthma severity on maternal SI in this study.
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