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[PMID]:28463455
[Au] Autor:Gros CP; Parr C; Wright DK; Montreuil M; Frechette J
[Ad] Endereço:Catherine Pugnaire Gros, RN, MSc(A), is Assistant Professor, Ingram School of Nursing, McGill University and Clinical Nurse Specialist, Douglas Mental Health University Institute, Montreal, Quebec, Canada.
[Ti] Título:Hospital rules and regulations: The perspectives of youth receiving psychiatric care.
[So] Source:J Child Adolesc Psychiatr Nurs;30(1):18-24, 2017 Feb.
[Is] ISSN:1744-6171
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Rules and regulations represent an aspect of psychiatric hospitalization about which little is known. STUDY PURPOSE: To explore the perceptions of rules from the perspective of youth receiving hospital-based psychiatric services. DESIGN: Qualitative descriptive. METHODS: Perceptions of rules were elicited through semi-structured interviews with a convenience sample of six youth. RESULTS: Rules were perceived as governing virtually all aspects of everyday living in the hospital environment. Rules were used to structure daily activities, routines, and social interactions, and were embedded within clinical protocols and treatment plans. For each participant, "making sense" or "not making sense" were central themes through which rules were interpreted as being either therapeutic or oppressive. Rules that made "no sense" negatively affected youth mood, behavior, treatment adherence, and engagement in a collaborative relationship. CONCLUSION: Working in partnership with youth in psychiatric care to establish, implement, and evaluate rules that "make sense" can promote positive health outcomes and prevent negative, unintended consequences.
[Mh] Termos MeSH primário: Adolescente Hospitalizado
Hospital Dia/organização & administração
Pacientes Internados
Serviços de Saúde Mental/organização & administração
Aceitação pelo Paciente de Cuidados de Saúde
Unidade Hospitalar de Psiquiatria/organização & administração
[Mh] Termos MeSH secundário: Adolescente
Feminino
Seres Humanos
Masculino
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.1111/jcap.12166


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[PMID]:28701090
[Au] Autor:Krischer M; Ponton-Rodriguez T; Gooran GR; Bender S
[Ad] Endereço:Klinik für Psychiatrie, Psychosomatik und Psychotherapie des Kindes- und Jugendalters der Universität zu Köln Robert-Koch-Str. 10 50931 Köln Deutschland Kinder- und Jugendpsychiatrie Köln.
[Ti] Título:[Transference Focused Psychotherapy for Borderline-Adolescents in a Day Clinic Treatment Program].
[Ti] Título:Übertragungsfokussierte Psychotherapie von Borderline-Jugendlichen im tagesklinischen Setting..
[So] Source:Prax Kinderpsychol Kinderpsychiatr;66(6):445-463, 2017 Jul.
[Is] ISSN:0032-7034
[Cp] País de publicação:Germany
[La] Idioma:ger
[Ab] Resumo:Transference Focused Psychotherapy for Borderline-Adolescents in a Day Clinic Treatment Program This paper focuses on the concept of transference focused psychotherapy (TFP) modified for juvenile borderline patients. Adolescents with borderline developmental personality disorder (bpd) have an essential deficit in their personality structure that leads to oscillations in their self-esteem and in a "split" perception of the world. They suffer from a variety of symptoms and severe impairments on their own and their families' quality of life. Their fragmented perception of themselves and others make relationships almost unbearable for them. Relationships are mostly marked by severe anxiety of resentment and rejection. For these patients this causes intolerable trouble at school where every day conflicts take place. Self-mutilation and suicidal thoughts often seem the only way out. By now, there is an agreement that an early specialized assessment and treatment is necessary in order to stop the typical consequences of their self-mutilative and dysfunctional behavior. Still, in contrast to adult age, empirical evidence is missing which proves the effectiveness of treating adolescent borderline patients. In this paper we present a research project on the effectiveness of transference focused psychotherapy with adolescent borderline patients (TFP-A) in a day clinic setting, combining TFP with group skills training as known from dialectic behavior therapy (DBT). Furthermore, we give first results on analyzing the effectiveness of our day clinic treatment program based on TFP-A, focusing on improving core symptoms such as affective problems, aggressive behavior against self and others and interpersonal problems.
[Mh] Termos MeSH primário: Transtorno da Personalidade Borderline/terapia
Hospital Dia
Terapia Psicanalítica/métodos
Transferência (Psicologia)
[Mh] Termos MeSH secundário: Adolescente
Agressão/psicologia
Terapia Comportamental/métodos
Transtorno da Personalidade Borderline/diagnóstico
Transtorno da Personalidade Borderline/psicologia
Terapia Combinada
Feminino
Alemanha
Seres Humanos
Relações Interpessoais
Masculino
Projetos Piloto
Autoimagem
Comportamento Autodestrutivo/diagnóstico
Comportamento Autodestrutivo/psicologia
Comportamento Autodestrutivo/terapia
Percepção Social
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170914
[Lr] Data última revisão:
170914
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170714
[St] Status:MEDLINE
[do] DOI:10.13109/prkk.2017.66.6.445


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[PMID]:28196489
[Au] Autor:Page K; Barnett AG; Graves N
[Ad] Endereço:Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Qld, 4059, Australia. katie.page@qut.edu.au.
[Ti] Título:What is a hospital bed day worth? A contingent valuation study of hospital Chief Executive Officers.
[So] Source:BMC Health Serv Res;17(1):137, 2017 Feb 14.
[Is] ISSN:1472-6963
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Decreasing hospital length of stay, and so freeing up hospital beds, represents an important cost saving which is often used in economic evaluations. The savings need to be accurately quantified in order to make optimal health care resource allocation decisions. Traditionally the accounting cost of a bed is used. We argue instead that the economic cost of a bed day is the better value for making resource decisions, and we describe our valuation method and estimations for costing this important resource. METHODS: We performed a contingent valuation using 37 Australian Chief Executive Officers' (CEOs) willingness to pay (WTP) to release bed days in their hospitals, both generally and using specific cases. We provide a succinct thematic analysis from qualitative interviews post survey completion, which provide insight into the decision making process. RESULTS: On average CEOs are willing to pay a marginal rate of $216 for a ward bed day and $436 for an Intensive Care Unit (ICU) bed day, with estimates of uncertainty being greater for ICU beds. These estimates are significantly lower (four times for ward beds and seven times for ICU beds) than the traditional accounting costs often used. Key themes to emerge from the interviews include the importance of national funding and targets, and their associated incentive structures, as well as the aversion to discuss bed days as an economic resource. CONCLUSIONS: This study highlights the importance for valuing bed days as an economic resource to inform cost effectiveness models and thus improve hospital decision making and resource allocation. Significantly under or over valuing the resource is very likely to result in sub-optimal decision making. We discuss the importance of recognising the opportunity costs of this resource and highlight areas for future research.
[Mh] Termos MeSH primário: Ocupação de Leitos/economia
Diretores de Hospitais
Cuidados Críticos/economia
[Mh] Termos MeSH secundário: Análise de Variância
Austrália
Análise Custo-Benefício
Hospital Dia/economia
Gastos em Saúde/estatística & dados numéricos
Recursos em Saúde/economia
Seres Humanos
Unidades de Terapia Intensiva/economia
Alocação de Recursos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170822
[Lr] Data última revisão:
170822
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170216
[St] Status:MEDLINE
[do] DOI:10.1186/s12913-017-2079-5


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[PMID]:28069663
[Au] Autor:Bowling A; Slavet J; Miller DP; Haneuse S; Beardslee W; Davison K
[Ad] Endereço:Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
[Ti] Título:Cybercycling Effects on Classroom Behavior in Children With Behavioral Health Disorders: An RCT.
[So] Source:Pediatrics;139(2), 2017 Feb.
[Is] ISSN:1098-4275
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND OBJECTIVES: Exercise is linked with improved cognition and behavior in children in clinical and experimental settings. This translational study examined if an aerobic cybercycling intervention integrated into physical education (PE) resulted in improvements in behavioral self-regulation and classroom functioning among children with mental health disabilities attending a therapeutic day school. METHODS: Using a 14-week crossover design, students (N = 103) were randomly assigned by classroom (k = 14) to receive the 7-week aerobic cybercycling PE curriculum during fall 2014 or spring 2015. During the intervention, children used the bikes 2 times per week during 30- to 40-minute PE classes. During the control period, children participated in standard nonaerobic PE. Mixed effects logistic regression was used to assess relationships between intervention exposures and clinical thresholds of behavioral outcomes, accounting for both individual and classroom random effects. RESULTS: Children experienced 32% to 51% lower odds of poor self-regulation and learning-inhibiting disciplinary time out of class when participating in the intervention; this result is both clinically and statistically significant. Effects were appreciably more pronounced on days that children participated in the aerobic exercise, but carryover effects were also observed. CONCLUSIONS: Aerobic cybercycling PE shows promise for improving self-regulation and classroom functioning among children with complex behavioral health disorders. This school-based exercise intervention may significantly improve child behavioral health without increasing parental burden or health care costs, or disrupting academic schedules.
[Mh] Termos MeSH primário: Transtornos do Comportamento Infantil/psicologia
Transtornos do Comportamento Infantil/terapia
Exercício
Transtornos de Aprendizagem/psicologia
Transtornos de Aprendizagem/terapia
Educação Física e Treinamento
Interface Usuário-Computador
[Mh] Termos MeSH secundário: Adolescente
Criança
Estudos Cross-Over
Currículo
Hospital Dia
Feminino
Seres Humanos
Masculino
Transtornos Mentais/psicologia
Transtornos Mentais/terapia
Autocontrole/psicologia
Pesquisa Médica Translacional
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170627
[Lr] Data última revisão:
170627
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170111
[St] Status:MEDLINE


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[PMID]:28065290
[Au] Autor:Perrin-Niquet A
[Ad] Endereço:c/o Soins Psychiatrie, Elsevier Masson SAS, 65, rue Camille-Desmoulins, 92130 Issy-les-Moulineaux, France. Electronic address: annick.perrin-niquet@arhm.fr.
[Ti] Título:[A step-by-step recovery].
[Ti] Título:« Ça s'est fait au fil de l'eau ¼..
[So] Source:Soins Psychiatr;38(308):35-39, 2017 Jan - Feb.
[Is] ISSN:0241-6972
[Cp] País de publicação:France
[La] Idioma:fre
[Ab] Resumo:A patient retraces her care pathway with authenticity and emotion. While her memories of her time in hospital are still raw, her path towards recovery was built on constructive stages and encounters, from one structure to another, towards refound freedom. An interview with Marie-Paule Chanel.
[Mh] Termos MeSH primário: Hospitalização
Enfermagem Psiquiátrica
Esquizofrenia/diagnóstico
Esquizofrenia/enfermagem
Psicologia do Esquizofrênico
[Mh] Termos MeSH secundário: Adaptação Psicológica
Hospital Dia
Seres Humanos
Comunicação Interdisciplinar
Colaboração Intersetorial
Relações Enfermeiro-Paciente
Reabilitação Psiquiátrica
Qualidade de Vida/psicologia
Recidiva
Autoimagem
Grupos de Autoajuda
Apoio Social
Socialização
[Pt] Tipo de publicação:INTERVIEW
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170707
[Lr] Data última revisão:
170707
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170110
[St] Status:MEDLINE


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[PMID]:28061887
[Au] Autor:Moorhouse P; Theou O; Fay S; McMillan M; Moffatt H; Rockwood K
[Ad] Endereço:Division of Geriatric Medicine, Dalhousie University, Veterans' Memorial Building, 5955 Veterans memorial Lane, Halifax, Nova Scotia, B3H2E1, Canada. Paige.Moorhouse@nshealth.ca.
[Ti] Título:Treatment in a Geriatric Day Hospital improve individualized outcome measures using Goal Attainment Scaling.
[So] Source:BMC Geriatr;17(1):9, 2017 Jan 07.
[Is] ISSN:1471-2318
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Evidence regarding outcomes in the Geriatric Day Hospital (GDH) model of care has been largely inconclusive, possibly due to measurement issues. This prospective cohort study aims to determine whether treatment in a GDH could improve individualized outcome measures using goal attainment scaling (GAS) and whether improvements are maintained 6-months post-discharge. METHODS: A total of 469 outpatients admitted to a Canadian Geriatric Day Hospital, between December 2008 and June 2011, were included in the analysis (81.1 ± 6.7 years, 66.3% females); a smaller cohort of 121 patients received a follow-up phone call 6 months following discharge. Baseline, discharge and 6 month post-discharge observer-rated measures of mobility, cognition, and function were completed using GAS. Traditional psychometric measures were also captured. RESULTS: The mean number of goals set was 1.6 (SD 0.8) and patients set goals in the following domains: 88% mobility or falls reduction; 18% optimization of home supports; 17% medication optimization;12% cognition; 8% increasing social engagement; and 5% optimization of function. Total GAS was the most responsive measure to change with 86% of patients improving at discharge; mobility goals were the most likely to be achieved. Six-month GAS scores remained significantly higher than GAS scores on admission. Those who had more goals were more likely to improve during GDH admission (OR 1.49, CI 1.02-2.19) but this association was not seen 6 months after discharge. CONCLUSIONS: This study demonstrated short- and long-term effectiveness of GDH in helping patients achieve individualized outcome measures using GAS.
[Mh] Termos MeSH primário: Hospital Dia
Avaliação de Resultados (Cuidados de Saúde)
Planejamento de Assistência ao Paciente
[Mh] Termos MeSH secundário: Atividades Cotidianas
Centros-Dia de Assistência à Saúde para Adultos
Idoso
Idoso de 80 Anos ou mais
Canadá
Feminino
Metas
Seres Humanos
Masculino
Alta do Paciente
Estudos Prospectivos
Psicometria
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170707
[Lr] Data última revisão:
170707
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170108
[St] Status:MEDLINE
[do] DOI:10.1186/s12877-016-0397-9


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[PMID]:28056843
[Au] Autor:Tretteteig S; Vatne S; Rokstad AM
[Ad] Endereço:Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway. signe.tretteteig@aldringoghelse.no.
[Ti] Título:The influence of day care centres designed for people with dementia on family caregivers - a qualitative study.
[So] Source:BMC Geriatr;17(1):5, 2017 Jan 05.
[Is] ISSN:1471-2318
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Dementia is one of the most challenging age-related illnesses for family caregivers, whose care-related burden is well known. Research indicates that day care centres (DCCs) can reduce the caregiver burden and help family caregivers to cope with demands; however, the current body of knowledge is still tentative and inconsistent, and more research is recommended. The aim of this study is to provide an extended understanding of the situation of family caregivers and to examine to what extent DCCs can meet their need for support and respite. METHODS: This study has a qualitative descriptive design using in-depth interviews with 17 family caregivers of people with dementia attending DCCs. The data analysis was undertaken using systematic text condensation. RESULTS: Caregivers experience a complex role, with added responsibilities, new tasks, and emotional and relational challenges that are expressed through distressing emotions and demands for interaction. Additionally, the caregiving role leads to positive experiences, such as acceptance and adaptation, support and help, and positive changes in the relationship. Day care relieves family caregivers by meeting the person with dementia's needs for social community, nutrition, physical activity, and structure and variety in everyday life. Using a DCC led to a higher quality of time spent together and easier cooperation, but it also produced some hard feelings and challenging situations. DCCs gave the caregivers a feeling of freedom and increased the time available to be spent on their own needs, to be social and to work or do practical tasks undisturbed. CONCLUSIONS: DCCs for people with dementia can give family caregivers support and relief and have a positive impact on the relationship between the family caregiver and the person with dementia. A more individualized program, in addition to flexible opening hours, would make DCCs even more effective as a respite service, positively influencing the family caregiver's motivation and ability to care and postponing the need for nursing home placement.
[Mh] Termos MeSH primário: Adaptação Psicológica
Cuidadores/psicologia
Efeitos Psicossociais da Doença
Hospital Dia
Demência
[Mh] Termos MeSH secundário: Idoso
Hospital Dia/métodos
Hospital Dia/organização & administração
Demência/psicologia
Demência/terapia
Emoções
Feminino
Seres Humanos
Masculino
Casas de Saúde
Pesquisa Qualitativa
Apoio Social
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170620
[Lr] Data última revisão:
170620
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170107
[St] Status:MEDLINE
[do] DOI:10.1186/s12877-016-0403-2


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[PMID]:28045721
[Au] Autor:Caroline P; Marie-Cécile N; Demet Y; Francis V
[Ad] Endereço:*Departments of Anesthesiology, Paediatric Neurology and Ophtalmology, Cliniques Universitaires Saint-Luc, Brussels, Belgium; and †Department of Anesthesiology, Hôpital Jeanne de Flandre, Lille, France.
[Ti] Título:Case Report: Red Urine After Day Care Strabismus Surgery.
[So] Source:A A Case Rep;8(4):75-77, 2017 Feb 15.
[Is] ISSN:2325-7237
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:In the absence of surgery on the urinary tract, the emission of red urine after anesthesia should be considered as a diagnostic emergency because it can be a sign of hematuria, hemoglobinuria, blood transfusion reaction, significant myoglobinuria, or porphyria.This case describes the management of a 12-year-old boy who presented red urine at the day care unit after strabismus surgery.
[Mh] Termos MeSH primário: Procedimentos Cirúrgicos Ambulatórios/efeitos adversos
Hospital Dia
Mioglobinúria/diagnóstico
Rabdomiólise/diagnóstico
Estrabismo/cirurgia
[Mh] Termos MeSH secundário: Criança
Hospital Dia/tendências
Seres Humanos
Masculino
Mioglobinúria/etiologia
Mioglobinúria/terapia
Complicações Pós-Operatórias/diagnóstico
Complicações Pós-Operatórias/etiologia
Complicações Pós-Operatórias/terapia
Rabdomiólise/terapia
Estrabismo/diagnóstico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170220
[Lr] Data última revisão:
170220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170104
[St] Status:MEDLINE
[do] DOI:10.1213/XAA.0000000000000430


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[PMID]:27978580
[Au] Autor:Wagner C; Niemczyk J; von Gontard A
[Ad] Endereço:Universitatsklinikum des Saarlandes und Medizinische Fakultat der Universitat des Saarlandes, Child and Adolescent Psychiatry, Homburg, Germany.
[Ti] Título:Toilet Phobia and Toilet Refusal In Children.
[Ti] Título:Toilettenphobie und Toilettenverweigerung bei Kindern..
[So] Source:Klin Padiatr;229(1):27-31, 2017 Jan.
[Is] ISSN:1439-3824
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Toilet refusal syndrome (TRS) is a common disorder in toddlers, defined by use of diapers and refusal of toilet for defecation, while toilet phobia (TP) is a rare disorder in which toilets are avoided completely. Both disorders have not been described systematically in children, yet. Therefore, the aim was to present typical case vignettes illustrating different clinical presentations of TP and TRS. 5 typical cases were selected from all patients presented at a specialized outpatient clinic for incontinence at a tertiary university hospital during the last 3 years. The first case is a girl with incontinence and no behavioral comorbidities, for whom treatment was more complicated than expected because of her TP. Second, a boy with an IQ on the border to mild intellectual disability will be presented, who revealed phobias regarding the toilet. Case 3 is exemplary for a group of patients with TRS, who also have ODD and show oppositional behavior in different situations. Cases 4 and 5 show "classical" TRS with constipation following painful defecation. Similarities and differences of TRS and TP, the current state of research, diagnostic and management recommendations are presented in detail. TRS in preschool children is a common condition, associated with high rates of constipation and behavioral problems. In contrast, TP is rarer and harder to recognize for pediatricians, but is often accompanied with somatic and behavioral problems, as well. Although there is a paucity of studies on these pediatric disorders, pediatricians should keep them in mind.
[Mh] Termos MeSH primário: Transtornos Fóbicos/diagnóstico
Transtornos Fóbicos/psicologia
Treinamento no Uso de Toaletes
[Mh] Termos MeSH secundário: Transtornos de Deficit da Atenção e do Comportamento Disruptivo/diagnóstico
Transtornos de Deficit da Atenção e do Comportamento Disruptivo/psicologia
Transtornos de Deficit da Atenção e do Comportamento Disruptivo/terapia
Aprendizagem da Esquiva
Terapia Comportamental/métodos
Criança
Pré-Escolar
Terapia Combinada
Constipação Intestinal/etiologia
Constipação Intestinal/psicologia
Constipação Intestinal/terapia
Hospital Dia
Feminino
Seres Humanos
Lactente
Deficiência Intelectual/diagnóstico
Deficiência Intelectual/psicologia
Deficiência Intelectual/terapia
Masculino
Enurese Noturna/diagnóstico
Enurese Noturna/psicologia
Enurese Noturna/terapia
Transtornos Fóbicos/complicações
Transtornos Fóbicos/terapia
Fatores de Risco
Incontinência Urinária/diagnóstico
Incontinência Urinária/psicologia
Incontinência Urinária/terapia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171006
[Lr] Data última revisão:
171006
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161216
[St] Status:MEDLINE
[do] DOI:10.1055/s-0042-121607


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[PMID]:27870813
[Au] Autor:Prins-van Ginkel AC; Bruijning-Verhagen PC; Uiterwaal CS; van der Ent CK; Smit HA; de Hoog ML
[Ad] Endereço:From the *Julius Center for Health Sciences and Primary Care, and †Department of Pediatric Pulmonology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands.
[Ti] Título:Acute Otitis Media During Infancy: Parent-reported Incidence and Modifiable Risk Factors.
[So] Source:Pediatr Infect Dis J;36(3):245-249, 2017 Mar.
[Is] ISSN:1532-0987
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Age at exposure to acute otitis media (AOM) risk factors such as day care attendance, lack of breastfeeding and tobacco smoke is little studied but important for targeting AOM prevention strategies. Moreover, studies are typically restricted to clinically diagnosed AOM, while a significant subset can occur outside the health care system, depending on the country setting. This study aims to determine risk factor exposure and effect of its timing within the first year of life on parent-reported AOM symptom episodes. METHODS: In the WHeezing and Illnesses STudy LEidsche Rijn birth-cohort study, 1056 children were prospectively followed during their first year of life. Group day care attendance, breastfeeding and tobacco smoke exposure were recorded monthly and parent-reported AOM symptoms daily. Generalized estimating equations were used to estimate the association between the time-varying risk factors and AOM symptom episodes, while correcting for confounding by indication. RESULTS: The first-year incidence rate of parent-reported AOM was 569/1000 child-years [95% confidence interval (CI): 523-618]. Children who attended day care had higher odds of developing AOM symptom episodes compared with those not attending (odds ratio: 5.0; 95% CI: 2.6-9.6). Tobacco smoke exposure and (a history of) breastfeeding were not associated with AOM. Test for interaction revealed that the effect of day care increased with each month younger in age. CONCLUSIONS: First-year day care attendance is a major risk factor for AOM symptom episodes among infants in the community. This adjusted effect estimate is higher than previously reported and is age-dependent. AOM prevention strategies in day care facilities should therefore focus in particular on the youngest age groups.
[Mh] Termos MeSH primário: Doença Aguda/epidemiologia
Otite Média/epidemiologia
[Mh] Termos MeSH secundário: Hospital Dia
Feminino
Seres Humanos
Lactente
Recém-Nascido
Masculino
Pais
Estudos Prospectivos
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170626
[Lr] Data última revisão:
170626
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161122
[St] Status:MEDLINE
[do] DOI:10.1097/INF.0000000000001412



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