RESUMO

Most children grow up in homes with easy access to multiple screens. Screen use by children between the ages of 0 to 5 has become a worldwide preoccupation. In the present narrative review, we examine child and parent screen use and its contribution to physical, cognitive, and social developmental outcomes. As research has mostly focused on the adverse consequences of screen media, we aim to depict both the negative and the positive influences of screen usage. To provide a more nuanced portrait of the potential benefits and harms of screen use, we examine how consequences of media use vary according to the content of media (ex., educational, violent), context (ex., using screens during mealtimes), and the nature (ex., passive vs active use) of child screen use. Our review supports existing screen time guidelines and recommendations and suggests that media content, the context of use, and the nature of child use, as well as the parent's own screen use, be considered clinically. Future research should seek to clarify how these dimensions jointly contribute to child screen use profiles and associated consequences. Finally, child sex, behavioral/temperamental difficulties, and family adversity appear to contribute to child screen use and its consequences and should be considered in future research. Suggestions for harm-reduction approaches are discussed.

RESUMO

PURPOSE: To evaluate the prevalence of sleep disorders in Brazilian preschool children and its associations with parental report of dental pain and discomfort. METHODS: This cross-sectional study involved 604 Brazilian preschoolers (4-5 years old). Sleep disorders (SD) and the parental report of dental pain and discomfort (DPD) were evaluated using the Brazilian versions of the Sleep Disturbance Scale for Children (SDSC) and the Dental Discomfort Questionnaire (DDQ-B), respectively. Bivariate and multivariate Poisson regression analyses with robust variance were performed to analyze the association between SDSC and DP. RESULTS: Prevalence of SD ranged from 7 to 21%. 7.9% of the children had DPD indicating the need for more invasive dental procedures (DDQ-B ≥ 5). Significant associations were found between DPD and the following SDSC domains: sleep hyperhidrosis (p = 0.024; PRa = 1.38; 95% CI: 1.04-1.83), disorders of initiating and maintaining sleep (p < 0.001; PRa = 1.41; 95% CI: 1.15-1.73), parasomnias (p < 0.001; PRa = 1.82; 95% CI: 1.39-2.37), and sleep-wake transition disorders (p = 0.018; PRa = 1.28; 95% CI: 1.04-1.58). Children with higher prevalence of DPD presented 20% higher prevalence of SD than children lower prevalence of DPD (p = 0.039; PRa = 1.20; 95% CI: 1.01-1.44). CONCLUSION: Preschool children with higher prevalence of DPD are more likely to have SD, such as hyperhidrosis, disorders of initiating and maintaining sleep, parasomnias, and sleep-wake transition.

Assuntos

RESUMO

RESUMEN El objetivo del estudio es analizar el discurso narrativo productivo de estudiantes de kínder en escuelas de lenguaje de Chile, considerando Trastorno Específico del Lenguaje (TEL) expresivo y mixto junto a la periodicidad de la lectura de cuentos en el hogar. Ambientes naturales enriquecidos en la familia aportan mayores oportunidades de desarrollo favoreciendo la literacidad, las habilidades lingüísticas y sociales. Los niños y niñas con TEL pueden mostrar dificultades en la narración, afectando el desempeño académico, social y en su calidad de vida. El discurso narrativo en una muestra de 150 preescolares es evaluado, utilizando un instrumento formal a través del recontado de 3 cuentos originales. Se examina la etapa del desarrollo narrativo y la lectura de cuentos realizada por padres en el hogar. Se aplica una ficha para recoger información demográfica de las familias. A través de un estudio descriptivo comparativo, se aplica estadística descriptiva e inferencial (ANOVA de dos factores) para analizar las variables. Los resultados muestran que ni el tipo de TEL, ni la frecuencia de lectura o la interacción de ambas, provocan cambios estadísticamente significativos en el discurso narrativo. Sin embargo, se observan hallazgos cualitativos en la cantidad de narración, en función de la lectura de cuentos.

ABSTRACT The study aimed to analyze the productive narrative discourse of students who attended kindergarten in special language schools in Chile, considering the expressive and mixed Specific Language Impairment (SLI) with the periodicity of reading stories at home. Enriched natural environments into the family provide better opportunities to develop early literacy, linguistic and social skills. Children with SLI may show difficulties in narration, affecting academic, social performance, and generally affecting their quality of life. The narrative discourse in a sample of 150 preschoolers was evaluated using a formal instrument that included the retelling of three original stories. The performance of narrative development and reading stories by parents at home were examined. A form was applied to collect demographic information from families. Through a comparative-descriptive study, descriptive and inferential statistics (two-way ANOVA) were used to analyze the variables. The results show that type of SLI, frequency of reading and the interaction of both variables did not cause statistically significant effects in the narrative discourse. However, qualitative findings were observed, in the quantity of oral discourse related to storytelling.

RESUMO

Abstract Most children grow up in homes with easy access to multiple screens. Screen use by children between the ages of 0 to 5 has become a worldwide preoccupation. In the present narrative review, we examine child and parent screen use and its contribution to physical, cognitive, and social developmental outcomes. As research has mostly focused on the adverse consequences of screen media, we aim to depict both the negative and the positive influences of screen usage. To provide a more nuanced portrait of the potential benefits and harms of screen use, we examine how consequences of media use vary according to the content of media (ex., educational, violent), context (ex., using screens during mealtimes), and the nature (ex., passive vs active use) of child screen use. Our review supports existing screen time guidelines and recommendations and suggests that media content, the context of use, and the nature of child use, as well as the parent's own screen use, be considered clinically. Future research should seek to clarify how these dimensions jointly contribute to child screen use profiles and associated consequences. Finally, child sex, behavioral/temperamental difficulties, and family adversity appear to contribute to child screen use and its consequences and should be considered in future research. Suggestions for harm-reduction approaches are discussed.

RESUMO

This study investigates the occurrence of childhood cancer between the years 2015 and 2016 in the city of Cali, Colombia, with respect to: a) sociodemographic characteristics, b) type of cancer, c) epidemiological weeks of cancer and d) comparative survival according to health system affiliation by consolidating the records notified to the municipal health secretariat. Statistically significant differences were found between the groups analysed in relation to the variables related to the type of cancer (p = 0.006). With respect to the proportion of cancer mortality between the years 2015-2016 there was no significant change, even though survival increased in the year 2016. The implications for collective health and public policies in Latin America are discussed.

RESUMO

Introducción: La caries de infancia temprana severa es un problema de salud pública que afecta a los niños que la padecen y a sus familias. Objetivo: Determinar la asociación de variables sociodemográficas, de higiene y alimentación con la caries de infancia temprana severa en niños peruanos. Métodos: Se realizó un estudio observacional, analítico, de casos y controles, de octubre a diciembre del 2019. La muestra estuvo compuesta por 264 niños de 2-5 años de edad y sus acompañantes (100 del grupo sin caries y 164 del grupo con caries de infancia temprana severa) que asistieron al Departamento de Odontopediatría del Instituto Nacional de Salud del Niño en Lima, Perú. Se realizó una entrevista estructurada directa, con preguntas cerradas sobre variables sociodemográficas, de higiene, de alimentación y una evaluación clínica, utilizando el índice cpo-s. Se utilizaron las pruebas estadísticas de chi cuadrado, Kruskal-Wallis y el modelo de regresión logística binaria. Resultados: De las variables sociodemográficas, experiencia dental negativa y seguro de salud, tuvieron un valor p < 0,05. Igual resultado tuvo el uso de una pasta dental fluorada, alimentación por biberón, tiempo de alimentación por biberón y edad de inicio del cepillado dental. En el modelo de regresión logística binaria solo las variables uso de pasta dental fluorada (OR = 0,578; 95 por ciento IC: 0,495-0,674) y edad de inicio del cepillado dental (OR = 0,924; 95 por ciento IC: 0,850-0,938) tuvieron un p < 0,05. Conclusiones: Las variables edad de inicio del cepillado dental y uso de una pasta dental fluorada están asociadas con la aparición de caries de infancia temprana severa en niños peruanos. Las variables sociodemográficas y de alimentación no están asociadas(AU)

Introduction: Severe early childhood caries is a public health problem affecting sufferers and their families. Objective: Determine the association of sociodemographic, hygiene and food intake variables to severe early childhood caries in Peruvian children. Methods: An observational analytical case-control study was conducted from October to December 2019. The study sample was 264 children aged 2-5 years (100 from the group without caries and 164 from the group with severe early childhood caries) and their companions, who attended the Children's Dental Care Department at the National Children's Health Institute in Lima, Peru. Direct structured interviews were held based on closed-ended questions about sociodemographic, hygiene and food intake variables, and a clinical evaluation was performed using the cpo-s index. Use was made of the chi-square statistical test, the Kruskal-Wallis test and the binary logistic regression model. Results: Among the sociodemographic variables considered, a negative dental care experience and health insurance obtained a value of p < 0.05. The same result was obtained by use of fluoride toothpaste, bottle feeding, bottle feeding time and age at tooth brushing start. In the binary logistic regression model only the variables use of fluoride toothpaste (OR = 0.578; 95 por ciento CI: 0.495-0.674) and age at tooth brushing start (OR = 0.924; 95 por ciento CI: 0.850-0.938) obtained a value of p < 0.05. Conclusions: The variables age at tooth brushing start and use of fluoride toothpaste are associated to the appearance of severe early childhood caries in Peruvian children. Sociodemographic and food intake variables are not associated(AU)

Assuntos

RESUMO

BACKGROUND/AIM: Obese children are more prone to accidents due to poorer motor skills which increase the likelihood of falls and the occurrence of traumatic dental injuries (TDIs). The aim of this study was to determine the association between overweight/obesity and TDI in pre-school children. MATERIAL AND METHODS: The case group was formed by children with TDI identified during a clinical examination (n = 262). Each pre-school child identified as a case was matched by a peer of the same age, gender and pre-school but without TDI to form the control group (n = 262). TDI was evaluated using the criteria proposed by Andreasen. The weight and height of the children were measured for the calculation of the body mass index which was plotted on the growth curve established by the World Health Organization. Socio-demographic variables were collected through questionnaires sent to the parents/guardians. Data analysis involved the determination of frequency distribution, the chi-square test and logistic regression analysis. RESULTS: The sample was composed of 253 children in each group. Among the children in the case group, 15.4% (n = 39) were overweight and 15.8% (n = 40) were obese. In the control group, 13.8% (n = 35) were overweight and 8.3% (n = 21) were obese. Children with trauma were more likely to be obese than children without trauma (OR = 2.05; 95%CI: 1.14 to 3.67; p = .016). In contrast, TDI was not associated with being overweight. A greater odds of TDI was also associated with an open bite (OR = 3.61; 95% CI: 1.64 to 7.96; p = .001) and accentuated overjet (OR = 2.19; 95% CI: 1.37 to 3.50; p = .001). CONCLUSIONS: Pre-school children with a history of dental trauma were more likely to be obese than those without a history of dental trauma whereas being overweight was not associated with TDI.

Assuntos

RESUMO

A primeiríssima infância é o período que vai desde a gestação até os três anos de vida, sendo um período importante para o desenvolvimento e que tem como característica a ausência da dentição completa e consequente instabilidade mandibular, podendo levar ao comportamento bruxômano. Assim, os objetivos deste estudo foram verificar a influência do número de dentes decíduos presentes da arcada dentária na severidade do possível bruxismo do sono (PBS) ou possível bruxismo em vigília (PBV) em crianças menores de três anos, assim como identificar a prevalência desses comportamentos e seus fatores associados. Para isso, foi realizado um estudo transversal com 144 crianças entre quatro e 36 meses de idade participantes do programa preventivo e educativo do Núcleo de Odontologia para Bebês (Bebê Clínica) da Universidade Estadual de Londrina, Londrina-Brasil, saudáveis, não sindrômicos e que não fizessem uso de anticonvulsivantes contínuos. Os responsáveis por essas crianças responderam a um questionário sociodemográfico, relataram a presença e a frequência do PBS e PBV, características do sono, perfil cronotipo, nível de energia, hábitos bucais e tipo de aleitamento materno que as crianças receberam até os seis meses de vida. O número de dentes foi verificado através de exame clínico por um cirurgião-dentista residente calibrado. Os relatos de PBS e PBV foram baseados no formato da versão brasileira do Pittsburg Sleep Quality Index. A escala brasileira Circadian Energy Scale foi utilizada para mensurar o perfil cronotipo e nível de energia do dia das crianças. As variáveis numéricas foram descritas através da mediana e do intervalo interquartil, enquanto as variáveis categóricas foram descritas através da frequência e porcentagem. As análises bivariadas foram realizadas através dos testes de Mann-Whitney e Kruskal-Wallis e um modelo de Regressão Logística Multinomial foi construído e ajustado para avaliar as chances de as crianças apresentarem bruxismo com base no número de dentes erupcionados com nível de significância estatística de 95%. A mediana da idade da amostra foi de 26,0 (14,5-32,0) meses, sendo 56,3% meninas. As prevalências de PBS e PBV foram, respectivamente, de 19,5% e 16,7%. A severidade de PBS foi maior naquelas crianças que roncavam (p = 0,004), dormiam de boca aberta (p = 0,006) e tinham sono agitado (p = 0,010), enquanto as crianças que roncavam e babavam no travesseiro apresentaram maior severidade de PBV (p = 0,001 e p = 0,006, respectivamente). A distribuição do total de dentes foi maior nas crianças com PBS moderado em relação àquelas sem PBS (p=0,012) e com PBS grave (p=0,006). Aquelas com PBV moderado também apresentaram mais dentes que as com PBV grave (p=0,046). A cada dente erupcionado, as chances de PBS moderado aumentaram em 3,3 vezes e de PBV grave diminuíram em 11,4%. Conclusão: o número de dentes erupcionados influenciou na severidade do bruxismo.

The very first childhood is the period from pregnancy to three years of life, being an important period for development and characterized by the absence of a complete dentition and consequent mandibular instability, which can lead to bruxism behavior. Thus, the aim of this study was to verify the influence of the number of teeth present in the dental arch on the severity of possible sleep bruxism (PSB) or awake bruxism (PAB) in children under three years, as well as identify their prevalence and its associated factors. A cross-sectional study was carried out with 144 children from four to 36 months of age participating in the preventive and educational program of the pediatric dentistry center (Bebê Clínica) of Universidade Estadual de Londrina, Londrina-Brazil, health and non-syndromic and who did not use continuous anticonvulsants. Responsibles answered a sociodemographic questionnaire, reported the presence and frequency of PBS and PBV, sleep characteristics, chronotype, energy level, oral habits and type of breastfeeding that the children received until six months of age. The number of teeth was verified through clinical examination by a previously calibrated resident dentist and recorded on an odontogram. The presence of PSB and PAB was recorded by the Brazilian version of the Pittsburgh Sleep quality Index. Brazilian scale Circadian Eneegy Scale was used to measure the chronotype profile and energy levels through the day. Numerical variables were described using median and interquartile range and categorical variables were described using frequency and percentage. Bivariate analyzes were performed using the MannWhitney and Kruskal-Wallis tests and a multinomial logistic regression model was constructed and adjusted to describe the chances of children having bruxism based on the number of erupted teeth with significance level of 95%. The median age was 26.0 (14,5-32,0) months, with the majority being girls (56.3%). The prevalence of PSB was 19.5% and 16.7% of PAB. The severity of PSB was higher in those children who snored (p = 0,004), sleeped with mouth open (p = 0,006) and had restless sleep (p = 0,010), while children that snored and drooled in their sleep presented higher severity of PAB (p = 0,001 and p = 0,006, respetivelly). The distribution of total teeth was greater in children with moderate PSB than in those without PSB (p=0.012) and with severe PSB (p=0.006). Those with moderate PAB also had more teeth than those with severe PAB (p=0.046). For each erupted tooth, the odds of moderate PSB increased by 3.3 times and of severe PAB decreased by 11.4%. Conclusion: the number of erupted teeth influenced the severity of bruxism.

Assuntos

RESUMO

Introducción: La atención primaria de salud aporta la resolución de la mayoría de los problemas de salud de la población, proporciona el acceso primario al servicio, la continuidad e integralidad de la atención y la coordinación de los cuidados. Objetivo: Evaluar la relación entre la calidad de los cuidados primarios y la caries dental en preescolares. Métodos: Se realizó un estudio descriptivo de corte transversal en una muestra de 515 preescolares. La selección de las escuelas tuvo lugar a partir de un muestreo aleatorio estratificado, seguido por muestreo aleatorio simple para la selección de los participantes. Se realizó un examen bucal para evaluar caries dental y se aplicó a los padres/responsables un cuestionario de calidad de los servicios primarios utilizados por los niños. Se emplearon chi cuadrado, Wilcoxon y el coeficiente de Spearman (95 por ciento de confianza) para el cálculo de los datos. Resultados: La calidad de la atención primaria tuvo relación con el índice ceod de preescolares (p = -0,19; p < 0,05). Se observó diferencias significativas entre la prevalencia de caries dental cuando comparados servicios de calidad (ceod = 0,50) con el grupo baja calidad (ceod = 1,13). También, la calidad fue asociada con la modalidad del servicio (p < 0,001), obteniéndose en los servicios privado y la estrategia de salud de la familia puntajes mayores (55,31 por ciento y 69,48 por ciento de calidad, respectivamente). Conclusiones: La calidad de la atención primaria está estrechamente relacionada con salud bucal, de esta forma, cuando la calidad de los servicios de atención primaria no es buena, repercute en un mayor índice de caries dental en los preescolares.

ABSTRACT Introduction: Primary health care solves most of the health problems of the population, provides primary access to the service, ensures the continuity and comprehensiveness of health care, and coordinates its different forms. Objective: Evaluate the relationship between primary health care quality and dental caries in preschoolers. Methods: A cross-sectional descriptive study was conducted of a sample of 515 preschoolers. Participant schools were selected by stratified random sampling, followed by simple random sampling for the selection of participant children. Oral examination was performed to evaluate dental caries, and parents / guardians were given a questionnaire about the quality of the primary services attended by their children. Data were estimated with the chi-squared test, the Wilcoxon test and Spearman's coefficient (95 percent confidence). Results: A relationship was found between primary health care quality and the ceod index of preschoolers (p = -0.19; p < 0.05). Significant differences were observed in the prevalence of dental caries when quality services (ceod = 0.50) were compared with the low quality group (ceod = 1.13). Quality was also associated to the service mode (p < 0.001). Private services and the family health strategy obtained higher quality scores (55.31 percent and 69.48 percent, respectively). Conclusions: Primary health care quality is closely related to oral health, in such a way that when the quality of primary health care services is not good, a higher dental caries rate is observed among preschoolers(AU)

Assuntos

RESUMO

Abstract Background: Exhaled nitric oxide (eNO) is a noninvasive marker of airway inflammation that has been used in children, using the "offline" technique. To the extent of our knowledge, no article reported in literature compares the concordance and correlation between the two different technologies used to measure eNO at tidal volume offline. This study aimed to report the concordance and correlation of the eNO measured "offline" at tidal volume, using chemioluminiscence (cl) vs electrochemical devices (eq). Methods: A cross-sectional, observational, and prospective study was conducted in the National Institute of Respiratory Diseases (Instituto Nacional de Enfermedades Respiratorias), Mexico City. Healthy children and those with a lung disease between 1 and 11 years of age were included. The exhaled air sample at tidal volume was obtained by attaching a mask connected to a Mylar® bag. Results: We studied 36 children. The mean ± standard deviation (SD) age of the study population was 6 ± 2.6 years; 25% of the subjects included were healthy, and the rest had a lung disease. The concordance correlation coefficient between the two measuring devices was 0.98 (p < 0.001), with a mean difference of 1.46 ± 3.5 ppb and 95% limits of agreement from -5.3 ppb to 8.3 ppb. The linear regression model equation for the estimation of eNO was eNOcl = (eNOeq·1.0718) - 0.1343 (r2 = 0.97). Conclusions: The measurement of eNO at tidal volume by the offline method can be analyzed by electrochemical devices, and the results are interchangeable with those analyzed by chemiluminescence technology.

Resumen Introducción: El óxido nítrico exhalado (eNO) es un marcador no invasivo de inflamación de la vía aérea que se ha utilizado en niños mediante técnica «fuera de línea¼. Por lo que sabemos, en la literatura no existen reportes que comparen la concordancia y la correlación entre dos técnicas diferentes a volumen corriente. El objetivo de este trabajo es informar la concordancia y la correlación del eNO obtenido por la técnica fuera de línea a volumen corriente en los equipos de quimioluminiscencia (cl) y electroquímico (eq). Métodos: Se realizó un estudio transversal, observacional y prospectivo en el Instituto Nacional de Enfermedades Respiratorias, en Ciudad de México. Se incluyeron niños sanos y con enfermedad pulmonar de 1-11 años de edad. La muestra de aire exhalado se obtuvo a volumen corriente mediante una máscara con conexión a una bolsa de Mylar®. Resultados: Se estudiaron 36 niños. La edad promedio con su desviación estándar de la población de estudio fue de 6 ± 2.6 años. El 25% de los sujetos incluidos estaban sanos y el resto tenían alguna enfermedad pulmonar. El coeficiente de correlación de concordancia entre los dos equipos fue de 0.98 (p < 0.001), con una diferencia media de 1.46 ± 3.5 ppb y unos límites de concordancia del 95% de −5.3 a 8.3 ppb. La ecuación del modelo de regresión lineal del eNO fue eNOcl = (eNOeq·1,0718) − 0.1343 (r2 = 0.97). Conclusiones: La medición del eNO por el método fuera de línea a volumen corriente puede analizarse en dispositivos electroquímicos. Los resultados son intercambiables con los de quimioluminiscencia.