As redes de proteção à criança e ao adolescente constituem uma política pública recente no contexto nacional. O Conselho Tutelar é uma instituição que aciona o funcionamento das redes, sob a égide jurídica do Estatuto da Criança e do Adolescente (ECA). Nesse campo problemático e complexo, quais os significados e representações da função social do Conselho Tutelar construídas pelos seus atores principais? Esta pesquisa teve como objetivo analisar o funcionamento dessa instituição, a partir das práticas discursivas de seus agentes. Trata-se de um estudo qualitativo, referenciado na Teoria das Representações Sociais, segundo Moscovici e Jodelet. A coleta de dados ocorreu em cinco sessões de grupo focal, análise de documentos, prontuários e observação participante da rotina institucional, num Conselho Tutelar que atua num município de pequeno porte (85 mil habitantes) no interior do país. Os dados foram analisados através da técnica denominada Análise de Conteúdo, que consiste na identificação dos temas recorrentes e emergentes, seja nas regularidades ou singularidades discursivas. As unidades de significado foram organizadas em categorias temáticas que explicitaram os aspectos cognitivos, afetivos e políticos do dispositivo grupal. Enquanto resultados, afirma-se que os discursos indicam posicionamentos defensivos, ambivalentes e paradoxais no que tange ao trabalho do Conselho Tutelar e a Doutrina de Proteção Integral. Os enunciados trazem à tona incompatibilidades entre a esfera pública e a esfera privada. As condições institucionais, concretas e subjetivas, contribuem efetivamente para o sofrimento psíquico dos conselheiros tutelares, com destaque para a impotência e regressão psicofamiliar frente às pressões da sociedade. As representações sociais, objetivadas na prática desses agentes públicos, desvelam que o dispositivo acabou tomando a forma do mal social que visa a combater. Conclui-se, enquanto tese, que o Conselho Tutelar, tal como está estruturado no país, funciona como um dispositivo ideológico e propagandístico, sendo pouco capaz de atender aos anseios sociais por promoção de direitos, inclusão e cidadania. Frente ao julgamento ético e moral, as vítimas tendem a ser culpabilizadas, incorrendo na amenização ou negação dos danos, justificando a violência para fins idealistas na educação exemplar. Diante da condição paradoxal, constatou-se um processo de estereotipia, discriminação e demonização da clientela. / The child and adolescent protection network is a recent public politics in the national context. The Guardianship Council is an institution that actuates the networks functioning, under the legal aegis of the Child and Adolescent Statute (CAS). In this complex field, what are the meanings and representations of the function of the Guardianship Council constituted by its main actors? This study aimed to analyze the functioning of this institution, from its agents discursive practices. Its a qualitative study, having as reference the Theory of the Social Representations, according to Moscovici and Jodelet. The data collection occurred in five sessions of focal group, analysis of documents, records and participating observation of the institutional routine, at a Guardianship Council that acts in a small city (85 thousand inhabitants) in the countrys interior. The data were analyzed through the Content Analyzed, which consists in identifying the recurrent and emerging themes, on the discursive regularity or uniqueness. The meaning units were organized into thematic categories that show the cognitive, affective and political aspects of the group device. While results, its affirmed that the speeches indicated defensive, ambivalent and paradox positions regarding the Guardianship Councils work and the Integral Protective Doctrine, findings revealed an incompatibilities between the public and private spheres. The institutional conditions, concrete and subjective, contribute to the psychic suffering of the guardianship counselors, highlighting the psych familiar impotence and regression. The social representations, objectified at these public agent practices, unveiling that the device, ended taking the shape of the social ill that aims to combat. Its concluded, as thesis, that the Guardianship Council, as it is organized in Brazil, works as an ideological and propagandistic device, it is incapable to attend the social expectations by rights, social inclusion and citizenship. In view of the ethical and moral judgment, the victims tend to be blamed, incurring mitigation or denial of the damage, justifying the violence to idealistic ends at the exemplary education. Concluding, it has been found a process of stereotyping, discrimination and demonizing of the communities.

BACKGROUND School‐based interventions hold promise for child obesity prevention. Implemented as a part of the Winning With Wellness obesity prevention project, the “Go Slow Whoa” meal pattern (GSW) was designed to promote healthier foods in school cafeterias. This investigation determined perceived program effectiveness and impact on student's food purchases. METHODS A mixed method design was used, including focus groups with cafeteria staff (CS), quantitative analysis of CS and teacher surveys, and pre‐post analysis of cafeteria sales. A total of 37 CS and 131 teachers from 7 schools in northeast Tennessee participated. RESULTS CS recognized the important role of school nutrition services in influencing student choices, yet perceived lack of administrative support for cafeteria‐based interventions and minimal interaction with teachers were barriers. CS also believed that students choose less nutritious options due to family influence. Cafeteria sales indicated that changes were made in menu planning and production, yet students' choices improved minimally. Teachers expressed moderate levels of confidence in GSW as influential in children's dietary habits. CONCLUSIONS Successful implementation of school‐based nutrition programs requires supportive policies, administrators, and teachers. CS should be included in program implementation efforts and the role of school nutrition services should be maximized.

<p><strong>Introduction: </strong>The Reading the Mind in the Eyes Test is a widely used test for measuring aspects of social cognition. The aim of the present study was to provide results from a group of typically developing Swedish children (age 9-12) and to compare these results with children and adults in other Swedish and English studies, as well as results from a group of children with Asperger syndrome. <strong>Method: </strong>A Swedish version of the child version of the test was completed by 83 controls and by six children with Asperger syndrome. Results were compared between the two groups and with data from other studies. <strong>Results: </strong>The children in the current study did not differ on scores compared to children in the same age group in other studies. The children in the current study scored significantly lower than adults in an earlier study. The results from the children with Asperger syndrome did not differ significantly to the results from the controls.</p>

<p>This study investigated a consecutive cohort of 88 youngsters with onset of a psychotic disorder at age 15.7 (sd 1.5) years and followed-up 10.6 (sd 3.6) years after first admission at the age of 26.5 (sd 3.7) years. A subsample of 15 subjects were assessed with the Five Minute Speech Sample for measuring Expressed Emotion and subsequent recording of relapses during a two year period.</p><p>A diagnostic split between schizophrenia spectrum psychosis and affective psychotic disorder was usually stable over time. The main diagnostic shift was an influx to schizophrenia spectrum disorder of subjects with a better premorbid function and less insidious onset as compared to those with a stable schizophrenia diagnosis.</p><p>Early onset schizophrenia spectrum disorder usually had a poor functional outcome. Most subjects needed support in the form of a disability pension. Early onset affective psychotic disorder usually had a good functional outcome. Most subjects worked and enjoyed regular friendships. The functional level before onset of illness was the best predictor of future functional level in psychotic disorders. A family history of non-affective psychosis predicted a worse function in schizophrenia. Frequent episodes and low intelligence predicted a worse function in affective disorders.</p><p>Four men (4.5% of the sample) committed suicide. The risk of suicide was increased about 30 times. Almost a third of subjects attempted suicide. Females made more attempts. Suicide attempts were related to more depressive symptoms but less negative symptoms at first episode, to readmissions and to dependence on nicotine. </p><p>Subjects with schizophrenia spectrum psychoses were less satisfied with life than those with affective psychotic disorder. Subjective satisfaction in schizophrenia was strongly associated to depressive mood while in affective disorders it was associated to degree of employment.</p><p>Adolescents with psychosis in families rated high or borderline high in Expressed Emotion either during first episode or after discharge had an increased risk of relapse.</p>

<p>A total population of 4,479 children (7-15 years of age) attended school in Ludvika & Smedjebacken in 2000. All the school children and their parents were asked to fill in a questionnaire concerning different tics A three-stage procedure was used: tic identification, interview, and clinical assessment.</p><p>Tourette syndrome, according to DSM IV criteria was found in 25 (0.6%) of the children, another 34 (0.8%) suffered from chronic motor tics (CMT), 24 (0.4%) from chronic vocal tics (CVT) and 214 (4.8%) children had had transient tics (TT) during the last year. Altogether 297 (6.6%) children had or had had some tic disorder. </p><p>Twenty-five controls without tics and 25 children with TT of the same age, sex and school as the TS children were randomly chosen. They were together with the 34 children with CMT and the 24 children with CVT examined with use of a broad battery of instruments. </p><p>The mean age of the first symptoms of TS was significantly lower than the onset of chronic motor/vocal tics. A younger age of onset of TS indicated more severe tics. Eighty per cent had a first-degree relative with a psychiatric disorder such as tic disorder, obsessive-compulsive behaviour, attentiondeficit/hyperactivity disorder (ADHD), or depression. A non-significant increase with regard to reduced optimality score in the pre-, peri-, or neonatal periods was found in children with TS compared to controls. No differences were found concerning socio-economic status. Psychiatric comorbid disorders were found in 92% of the children with TS. ADHD was most common. Patterns of psychiatric comorbidity were similar in children with TS and CVT. Children with TS perform poorer than the population in general with respect to cognitive functioning and self-perception.</p><p>The results are discussed as they relate to the need for case identification, diagnosis, intervention, and treatment. </p>

This study investigated a consecutive cohort of 88 youngsters with onset of a psychotic disorder at age 15.7 (sd 1.5) years and followed-up 10.6 (sd 3.6) years after first admission at the age of 26.5 (sd 3.7) years. A subsample of 15 subjects were assessed with the Five Minute Speech Sample for measuring Expressed Emotion and subsequent recording of relapses during a two year period. A diagnostic split between schizophrenia spectrum psychosis and affective psychotic disorder was usually stable over time. The main diagnostic shift was an influx to schizophrenia spectrum disorder of subjects with a better premorbid function and less insidious onset as compared to those with a stable schizophrenia diagnosis. Early onset schizophrenia spectrum disorder usually had a poor functional outcome. Most subjects needed support in the form of a disability pension. Early onset affective psychotic disorder usually had a good functional outcome. Most subjects worked and enjoyed regular friendships. The functional level before onset of illness was the best predictor of future functional level in psychotic disorders. A family history of non-affective psychosis predicted a worse function in schizophrenia. Frequent episodes and low intelligence predicted a worse function in affective disorders. Four men (4.5% of the sample) committed suicide. The risk of suicide was increased about 30 times. Almost a third of subjects attempted suicide. Females made more attempts. Suicide attempts were related to more depressive symptoms but less negative symptoms at first episode, to readmissions and to dependence on nicotine. Subjects with schizophrenia spectrum psychoses were less satisfied with life than those with affective psychotic disorder. Subjective satisfaction in schizophrenia was strongly associated to depressive mood while in affective disorders it was associated to degree of employment. Adolescents with psychosis in families rated high or borderline high in Expressed Emotion either during first episode or after discharge had an increased risk of relapse.

The negative impact of war on child mental health has been repeatedly documented. Still, the majority of children exposed to ethnic and political violence show no signs of clinical disorder. In Western countries of exile, these findings have prompted a variety of attempts to evaluate refugee children, in the hope of identifying and offering support to those children “at risk”. This study critically examines one such attempt. The aims are fourfold: 1. to describe the range and pattern of child trauma-stress exposure and mental health reactions as captured on clinician semi-structured interview; 2. to critically compare clinician assessment with independent parent, child and teacher reports; 3. to identify factors of potential risk or protective import for child mental health; 4. to draw clinical implications: from whom and by what means can children at risk be reasonably identified? The target of our study was the entire population of Bosnian-Serbian-Croatian speaking child refugee families assigned to Umeå and surrounding municipalities during 1994-95. Fifty families, containing 90 children aged one month to 20 years, were included in the study. Assessment occurred in two phases. First, a semi-structured interview was conducted that inquired broadly as to the child’s family background, trauma-stress exposure, emotional-behavioral problems, patterns of family functioning, and future hopes. Second, standardized self-report questionnaires were administered, separately to parent and child, to provide alternative appraisal of the child’s war exposure, mental health symptoms, coping strategies, and social network. Teacher evaluation of child cognitive-social functioning as well as emotional-behavioral problems was also obtained. Clinician semi-structured interview revealed the child’s pre-war period as preponderantly good, and provided richly detailed narratives of child exposure during war and resettlement that clustered into a limited number of type-stories. Independent parent assessment captured the same broad strokes of child war exposure; but both approaches – fixed questionnaire and semi-structured interview – showed specific areas of blindness. Teenage self-report offered a disparate but equally rich account of war exposure, while that of primary school child was significantly less detailed. Nearly half of the study children (48%) were identified on clinician interview with one or more mental health problem “demanding further attention”. Depressiveness was the single most prevalent symptom (31%), followed by posttraumatic reactions (23%) and anxiety-regressiveness (15%). Independent symptom appraisal by parent and primary school child was largely concordant with that of clinician, while teenagers made similar assessment as to who was in distress, but defined the nature of that distress differently. Teacher report stood apart, identifying fewer inward emotional problems and asserting the cognitive-social competence of the vast majority of study children. Trauma-stress exposure during both war and resettlement presented as an unequivocal risk to mental health, but accounted for only part of outcome variance. Additional factors of strong import related broadly to “living in the present”. Parent impairment of daily routines, child dissatisfaction with school and an ongoing quarrelsome relationship presented as risk factors. Protection was associated with parent maintenance of a warm family climate and of concrete physical-emotional caring, child social ties to physically present others, including teacher; and above all, a family sense of hope for the future. Results support the general robustness of our semi-structured approach. Exploring the child’s present well-being in narrative relation to past and future, our assessment captured and gave meaning to the complexity of child exposure and behavior. At the same time, independent parent and child appraisals provided an additional richness to the retelling and evaluation of child experience. Particularly the apartness of teacher report underscores the need to incorporate an outside-world vantage point in the process of risk assessment.

Children and parents who visited child and adolescent psychiatry (CAP) for the first time were interviewed in the presence of their therapists about the first meeting. The interview was intended to make the attendants describe in their own words what the meeting was like for them. The interview was repeated after six months to get complementary information. Research assistants, reflectors, helped the interviewer to prevent from bias and to hold on to the theme. The grounded theory approach was utilised in papers I, II, and III, and qualitative content analysis was used in paper IV. Children appreciated the therapist being in an active as well as in a more passive but alert position, moving between asking adjusted questions and including the parents. The therapists’ skill of listening was also important to them. For the parents, it was important what happened between their child and the therapists. They questioned their own role and presence. Also, they focused on the plan for the meeting and for the coming process. Certain things that happened in the dialogue were useful after the meeting. The results indicate that what was helpful was connected to family therapy matters rather than psychiatric ones. The therapists balanced between a psychiatric and a family therapeutic position, and it was a dilemma for them how to best fulfil their assignment in the organisation as they perceived it. Two competing discourses were found in the first meeting; Structuring, which stood for structure, planning and expertise, while Collaboration represented negotiations of how to work together, empowerment and emotional aspects. The Structuring discourse tended to dominate. Both discourses consisted of valuable elements that needed to be included to ensure that the atmosphere would not be too strict or too flexible. The findings are tentative because of the lack of studies to compare to, and because of the few interviews made. / Det första möte som sker mellan familjemedlemmar och personal antas ha stor betydelse för hur den fortsatta kontakten artar sig. Det är ett tillfälle när var och en kan vara öppen för intryck och nyfiken på hur kommunikationen utvecklas och vilken hjälp som ska till. Förutsättningarna för mötet är etablerade på många plan. Föräldrarna och barnen har tidigare erfarenheter av både personliga och professionella kontakter, och de har förväntningar på vad som ska eller bör ske under det första samtalet. Personalen befinner sig i ett sammanhang där de har förväntningar på sig från organisationen. De har utbildning och erfarenhet och har anammat organisationens kultur och vanor i större eller mindre utsträckning. Både inom det psykiatriska eller det psykoterapeutiska området har det varit brist på studier som rör det första samtalet mellan professionell och patient/klient. Detta väckte ett intresse att studera området närmare. Syftet med studien var därför att försöka ta reda på mer om det första mötet ansikte mot ansikte mellan personal och familjemedlemmar. Vad händer där och hur upplevs det här mötet av dem som deltar? Ytterligare ett syfte var att försöka ta reda på vilka diskurser som påverkar det som sker mellan deltagarna. Vilka underliggande meningar har deltagarnas tankar och sätt att bete sig, och som har förankring i allmänna föreställningar om hur ett möte av det här slaget går till? Hur framträder det i deltagarnas kommunikation med varandra? För att finna svar på dessa frågor gjordes forskningsintervjuer inom två veckor respektive sex månader efter det första mötet på BUP (barn- och ungdomspsykiatrin). Vid intervjuerna deltog de som varit närvarande vid det första samtalet, d v s personal, föräldrar och barn. Intervjuaren hade till sin hjälp forskningsassistenter, reflektörer, vars uppgift var att bidra till att alla fick komma till tals och att man höll fokus på hur det var under det första samtalet. Fyra delstudier genomfördes. I de tre första användes analysmetoden grundad teori, och i den fjärde kvalitativ innehållsanalys. Den första delstudien lyfte fram barnens perspektiv. Barnen uppskattade om behandlarna befann sig ömsom i en aktiv ömsom i en passiv position, där de samtidigt var alerta i förhållande till barnen. De gillade att behandlarna å ena sidan anpassade sig och sina frågor till barnen och å andra sidan tog med föräldrarna i samtalet. Behandlarnas förmåga att lyssna och att hjälpa barnen att uttrycka sig var viktig för barnen. De tog också upp vikten av att behandlarna höll reda på tiden, så att samtalet inte blev för långt för dem. För föräldrarna, i delstudie II, visade det sig vara avgörande vad som skedde mellan deras barn och behandlarna. De ifrågasatte sin egen roll i mötet, och var tveksamma till om de borde vara närvarande eller inte. Dessutom var de inriktade på hur upplägget av samtalet såg ut och hur den fortsatta planeringen skulle bli. Vissa teman och yttranden i dialogen kunde vara till nytta för samspelet därhemma. Fynden i delstudien antyder att det som var till hjälp snarare låg på ett familjeterapeutiskt plan än ett psykiatriskt. I delstudie III framkom att behandlarna nedtonade sin egen insats och lyfte fram det viktiga i familjemedlemmarnas bidrag till hur mötet blev. Behandlarna balanserade mellan ett psykiatriskt och ett familjeterapeutiskt förhållningssätt. De mest tillfredsställande arbetsuppgifterna rörde att lyssna på barns och föräldrars berättelser och att hitta sätt att uppmuntra och stödja deras vägar till att må och fungera bättre. De önskade möta familjemedlemmarna på deras villkor, men hade också att samla information för bedömning och fortsatt planering. Det innebar ett dilemma för dem hur de bäst skulle kunna uppfylla de uppgifter som de uppfattade att BUP-organisationen gett dem. Två konkurrerande diskurser framträdde i delstudie IV. De var inflätade i varandra och stod att finna hos var och en av parterna barn, föräldrar och behandlare. Det syntes pågå balanserande eller konkurrens mellan de sociala röster som ingick i diskurserna. Diskursen Strukturering innehöll sociala röster som rörde exempelvis inramning av mötet, expertis och kategoriseringar medan diskursen Samarbete inriktades mot aspekter som öppenhet, sam-skapande och en utvidgad dialog. Om diskursen Strukturering skulle överväga blev följden antingen ett undertryckande och okänsligt förhållningssätt och diskursen Samarbete skulle om den övervägde kunna skapa ett otydligt eller alltför flexibelt förhållningssätt. Den förra diskursen tycktes dominera, men båda diskurserna syntes innehålla delar som behövdes för att det första mötet skulle uppfattas som givande. Fynden i studien är preliminära av två skäl. Dels finns få eller inga studier att jämföra med; dels var antalet intervjuer begränsat.

Introduction: The Reading the Mind in the Eyes Test is a widely used test for measuring aspects of social cognition. The aim of the present study was to provide results from a group of typically developing Swedish children (age 9-12) and to compare these results with children and adults in other Swedish and English studies, as well as results from a group of children with Asperger syndrome. Method: A Swedish version of the child version of the test was completed by 83 controls and by six children with Asperger syndrome. Results were compared between the two groups and with data from other studies. Results: The children in the current study did not differ on scores compared to children in the same age group in other studies. The children in the current study scored significantly lower than adults in an earlier study. The results from the children with Asperger syndrome did not differ significantly to the results from the controls.

A total population of 4,479 children (7-15 years of age) attended school in Ludvika &amp; Smedjebacken in 2000. All the school children and their parents were asked to fill in a questionnaire concerning different tics A three-stage procedure was used: tic identification, interview, and clinical assessment. Tourette syndrome, according to DSM IV criteria was found in 25 (0.6%) of the children, another 34 (0.8%) suffered from chronic motor tics (CMT), 24 (0.4%) from chronic vocal tics (CVT) and 214 (4.8%) children had had transient tics (TT) during the last year. Altogether 297 (6.6%) children had or had had some tic disorder. Twenty-five controls without tics and 25 children with TT of the same age, sex and school as the TS children were randomly chosen. They were together with the 34 children with CMT and the 24 children with CVT examined with use of a broad battery of instruments. The mean age of the first symptoms of TS was significantly lower than the onset of chronic motor/vocal tics. A younger age of onset of TS indicated more severe tics. Eighty per cent had a first-degree relative with a psychiatric disorder such as tic disorder, obsessive-compulsive behaviour, attentiondeficit/hyperactivity disorder (ADHD), or depression. A non-significant increase with regard to reduced optimality score in the pre-, peri-, or neonatal periods was found in children with TS compared to controls. No differences were found concerning socio-economic status. Psychiatric comorbid disorders were found in 92% of the children with TS. ADHD was most common. Patterns of psychiatric comorbidity were similar in children with TS and CVT. Children with TS perform poorer than the population in general with respect to cognitive functioning and self-perception. The results are discussed as they relate to the need for case identification, diagnosis, intervention, and treatment.