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din spaniolă în engleză: Secuelas del maltrato infantil General field: Ştiinţe Sociale
Text sursă - spaniolă Secuelas del maltrato infantil
Neurociencias - Psicobiología
Publicado: julio 22, 2016
Esperanza Cabrera Díaz Ph.D.
Psicóloga, Magister en Educación y Desarrollo Comunitario
Doctorado en Bioética de la Universidad El Bosque
Docente de la Facultad de Salud, Programa de Medicina, Universidad Surcolombiana
Neiva, Colombia.
Gilberto Mauricio Astaiza Arias Ph.D.
Médico, Magister en Educación y Desarrollo Comunitario
Doctorado en Salud Pública de la Universidad Nacional
Docente de la Facultad de Salud, Programa de Medicina, Universidad Surcolombiana
Neiva, Colombia.
Resumen
La violencia es un fenómeno que afecta la vida de las personas y su desarrollo psicológico. Colombia vive en los últimos años un grave fenómeno de violencia con múltiples manifestaciones y víctimas, entre ellas los niños, los cuales por su inmadurez neurológica presentan variados efectos en el desarrollo cerebral y psicológico expresados en la vida adulta, por lo que este artículo revisa las evidencias sobre el efecto crónico de la violencia en el desarrollo cerebral y conductual de los niños. Se realizó una investigación bibliográfica mediante la revisión de artículos con palabra como violencia y alteraciones neurológicas en niños, los artículos se revisaron y extrajeron las ideas centrales para responder el interrogante planteado.
Se encontró evidencia con alta correlación entre el momento y la intensidad de fenómenos violentos en los niños como abuso sexual y psicológico con efectos demostrados en la corteza cerebral prefrontal y respuestas conductuales anómalas en la vida adulta.
Palabras clave: Maltrato infantil, abuso infantil, secuelas violencia, estrés infantil.
El maltrato infantil es un problema mundial, en Colombia es un grave problema de salud pública. Dada la inmadurez del cerebro de los infantes, éste sufre por el fenómeno de la violencia alteraciones que afectarán su desarrollo estructural y funcional normal. El estrés temprano repetitivo emanado por la polivictimización de las diferentes formas de maltrato infantil está relacionado con alteraciones en las funciones neuroendocrinas, con diferencias estructurales y funcionales del cerebro.
Los daños permanentes de este fenómeno en las víctimas infantiles evolucionan en el denominado “efectos adversos de la infancia” (Cicchetti & Rizley, 1981; 2000), variedad de patologías físicas y mentales que se expresan en la edad adulta.
La relación entre edad de inicio del trauma y la duración o cronicidad, definen el tipo de déficit que presentará el niño. Además, el mayor déficit o daño neurológico sufrido está relacionado con la temprana edad de inicio del trauma y mayor duración de éste. Igualmente, el grado de trauma también depende del momento de desarrollo evolutivo y del proceso de mielinización que hacen al cerebro más o menos vulnerable al estrés.
MÉTODO
Se realizó una revisión documental sistemática de artículos, libros y fuentes primarias sobre maltrato infantil y sus efectos en el cerebro y mente del niño, así como en su salud física.
Las bases de datos bibliográficas consultadas fueron las siguientes:
• PubMed, palabra clave: “childhood abuse” (PubMed, 2015), se encontraron 3522 artículos, 177 páginas. Se revisaron los artículos relacionados con el tema en las 20 primeras páginas.
• The National Child Traumatic Stress Network (2015a), palabra clave: “Childhood abuse”, se revisaron los artículos relacionados con maltrato infantil.
• Epistemonikos (2015), palabras claves: “secuelas del maltrato infantil” y “maltrato infantil”. Como producto de los últimos cinco años, se encontraron 36 artículos de revisión.
Se leyeron y seleccionaron los artículos con las palabras definidas previamente. Con estos elegidos, se realizó la ficha bibliográfica que se retomó en el momento de organizar el artículo. Se ordenaron por categorías y subcategorías para determinar el posible contenido del artículo, se desecharon algunos y finalmente, con los definitivos se trabajó en la estructura y redacción del presente escrito.
RESULTADOS
El maltrato infantil es definido por la Organización Panamericana de la Salud como “toda forma de maltrato físico y/o emocional, abuso sexual, abandono o trato negligente, explotación comercial o de otro tipo, de la que resulte un daño real o potencial para la salud, la supervivencia, el desarrollo o la dignidad del niño en el contexto de una relación de responsabilidad, confianza o poder” (O.P.S., 2004). Las Naciones Unidas (Secretaría Regional para América Latina y del Caribe, 2006) consideran que el maltrato crea un síndrome que produce en la víctima lesiones físicas y emocionales indelebles, muerte o cualquier daño severo. Pinheiro (2006) reconoce el impacto del maltrato en la salud física y mental de niños y niñas, causando un daño que se extiende durante toda la vida de la persona.
En Colombia, de acuerdo con los datos de Medicina Legal (2015) para el 2014, se reportaron 10.402 casos de maltrato físico severo contra niños y niñas, es decir 28 casos diarios y más de uno cada hora en el país. Y de acuerdo con Medicina Legal, durante el 2014 se reportaron 18.116 casos de abuso sexual infantil, equivale a 49 casos diarios, es decir, cada hora dos niños fueron víctimas de abuso sexual infantil.
La Organización Mundial de la Salud (2014), en estudios internacionales realizados a diciembre de 2014 revela estas cifras: “Una cuarta parte de todos los adultos manifiestan haber sufrido maltratos físicos de niños. Una de cada 5 mujeres y 1 de cada 13 hombres declaran haber sufrido abusos sexuales en la infancia. Al año mueren 41.000 niños víctimas del maltrato infantil que se atribuyen erróneamente a caídas, quemaduras, ahogamientos y otras causas. Muchos niños son objeto de maltrato psicológico (también llamado maltrato emocional) y víctimas de desatención, este tipo de maltrato no queda en las estadísticas”.
Sin embargo, estos datos muestran las cifras sólo de casos extremos o que han sido denunciados. La OMS (2014) y autores como Montoya (1999) reconocen el inconveniente del subregistro del maltrato infantil y aclaran que se subestiman las cifras verdaderas. Estos autores lo consideran como un problema de salud pública. Pereda (2009) muestra que el abuso sexual infantil es un grave problema de salud pública, que deja a la víctima afectada física y psicológicamente, con un elevado grado de estrés y malestar. Este maltrato se presenta en todas las culturas y sociedades, en cualquier estrato social y constituye un problema universal muy complejo que puede desencadenar la muerte del niño o niña.
Secuelas del maltrato infantil en el cerebro del niño.
Las estructuras fundamentales implicadas en el procesamiento de una emoción son: el eje hipotálamo-hipófisis-adrenocortical (HPA), que se expresa a través del sistema endocrino y permite que el cuerpo actúe con la secreción de cortisol en la corteza de las glándulas suprarrenales y se genere el flujo de activación que va desde la amígdala hacia la corteza prefrontal.
De acuerdo con el DSM 5 el maltrato infantil en sus distintos tipos y el abuso sexual están asociados al trastorno de estrés postraumático (TEPT) (Asociación Americana de Psiquiatría, 2013).
Esperanza Cabrera Díaz Ph.D.
Psychologist, Master of Education and Community Development
Doctorate in Bioethics from the University El Bosque
Teacher in the Faculty of Health, Medicine Program, Surcolombiana University,
Neiva, Colombia.
Gilberto Mauricio Astaiza Arias Ph.D.
Doctor, Master of Education and Community Development
Doctorate in Public Health from the National University
Teacher in the Faculty of Health, Medicine Program, Surcolombiana University,
Neiva, Colombia.
SUMMARY
Violence is a phenomenon that affects the lives of people and their psychological development. In recent years, Colombia has experienced a serious phenomenon of violence with multiple manifestations and victims, including children. Due to neurological immaturity various effects on children’s psychological and brain development are manifested in adult life. This article reviews the evidence of the chronic effect of violence on children's behavioural development and brain. A bibliographic research was carried out by reviewing articles containing words such as violence and neurological alterations in children. The articles were reviewed, and the central ideas were extracted to answer the posed question.
Evidence was found of a high correlation between the timing and intensity of violent occurrences in children, such as sexual and psychological abuse, with effects displayed in the prefrontal cerebral cortex in conjunction with abnormal behavioral responses in adulthood.
Key words: Child abuse, child mistreatment, violence sequelae, child stress.
Child abuse is a global problem. In Colombia it is a serious public health problem. Given the immaturity of an infant's brain, violence causes modifications that will affect its normal structural and functional development. The repetitive early stress emerging from the poly-victimization in different forms of child abuse is related to changes in neuroendocrine function along structural and functional differences in the brain.
The permanent damage in victims of child violence progresses in what is referred to as "adverse effects of childhood" (Cicchetti & Rizley, 1981, 2000), a number of physical and mental pathologies that manifest in adulthood.
The relationship between the age of onset of the trauma and the duration or continuity, define the type of deficit that the child will present. In addition, the highest deficit or neurological damage suffered is related to the early age of onset of the trauma and its longer duration. Similarly, the degree of trauma also depends on the moment of evolutionary development as well as the process of myelinization, determining the brain´s vulnerability to stress.
METHOD
A systematic literature review of articles, books and primary sources on child maltreatment and its effects on the child's brain and mind, as well as on their physical health, was conducted.
The bibliographic databases consulted were the following:
• PubMed, keyword: "childhood abuse" (PubMed, 2015), 3522 articles, 177 pages were found. The first 20 pages of articles related to the topic were reviewed.
• The National Child Traumatic Stress Network (2015a), keyword: "Childhood abuse", the articles related to child abuse were reviewed.
• Epistemonikos (2015), keywords: "sequels of child abuse" and "child abuse". For the last five years 36 articles were found and reviewed.
The articles containing the previously established keywords were selected and read. A bibliography was created so that the elected articles could be referred to at the time of organizing the article. They were ordered by categories and subcategories to determine the possible content of the article, some were discarded and finally, with the definitive ones, the structure and writing of this article was worked on.
RESULTS
Child maltreatment is defined by the Pan American Health Organization as "any form of physical and/or emotional abuse, sexual abuse, neglect or negligent treatment, commercial or other kind of exploitation, which results in an actual or potential harm to the child´s health, survival, development or dignity of the child in the context of responsibility, trust or power relationships"(PAHO, 2004). The United Nations (Regional Office for Latin America and the Caribbean, 2006) consider that the mistreatment creates a syndrome that produces in the victim indelible physical and emotional injuries, death or any other severe damage. Pinheiro (2006) acknowledges that the impact of abuse on the physical and mental health of children causes damage that extends throughout the person's life.
In Colombia, according to the data of Legal Medicine (2015) for 2014, 10,402 cases of severe physical abuse against children were reported, that is 28 cases daily and more than one per hour in the country. Moreover, according to Legal Medicine, during 2014 18,116 cases of child sexual abuse were reported, equivalent to 49 cases per day, that is, each hour two children were victims of child sexual abuse.
The figures of the World Health Organization (2014) international studies conducted until December of 2014 reveal that: "A quarter of all adults report having suffered physical abuse as children. One in 5 women and 1 in 13 men report having suffered sexual abuse in childhood. Each year, 41,000 children die as a consequence of child abuse, deaths that are mistakenly attributed to falls, burns, drowning and other causes. Many children are subject to psychological abuse (also called emotional abuse) and victims of neglect, this type of abuse is not in the statistics”.
However, this data shows figures of only extreme cases or cases that have been reported. The WHO (2014) and authors such as Montoya (1999) point out the problem of under-reporting of child maltreatment and explain that the true figures are underestimated. These authors consider it a public health problem. Pereda (2009) demonstrates that child sexual abuse is a serious public health problem, which leaves the physically and psychologically affected victim with a high degree of stress and discomfort. This abuse occurs in all cultures and societies, in any social stratum and constitutes a very complex universal problem that can trigger the death of the child.
Sequelae of child abuse in the child's brain
The fundamental structure involved in the processing of emotion is the hypothalamic-pituitary-adrenocortical (HPA) axis, which manifests through the endocrine system and permits the body to act by secreting cortisol in the adrenal glands’ cortex, which in turn activates the flow between the amygdala and the prefrontal cortex.
According to the DSM 5, the different forms of child maltreatment and sexual abuse are associated with post-traumatic stress disorder (PTSD) (American Psychiatric Association, 2013).
din spaniolă în engleză: Aspiradora General field: Tehnică/Inginerie Detailed field: Mobilă/Aparate electrocasnice
Text sursă - spaniolă ASPIRADORA
Características
• Tamaño compacto
• Indicador de carga de la bolsa
• Bolsa de tela
• Sistema de filtro secundario
• Cable de alimentación de 5 mts.
• Enrollacable automático
• Manguera flexible
• Práctica manija de transporte, en parte superior
Compruebe que la bolsa esté colocada
Abra la cubierta del compartimiento de la bolsa y tire hacia arriba la parte frontal del compartimiento. Levante la cubierta y verifique que la bolsa esté colocada.
Cierre la cubierta del compartimiento suavemente hasta que trabe.
Tubos de extensión y manguera
Si Ud. desea utilizar el o los tubos de extensión, inserte en la empuñadura de la manguera el extremo de mayor diámetro del tubo. En el otro extremo del tubo inserte el segundo tubo o el accesorio más conveniente. En caso de no utilizar los tubos de extensión inserte el accesorio a utilizar directamente en la empuñadura de la manguera.
Instalación de la manguera
Tome el extremo opuesto a la empuñadura de la manguera y suavemente insértelo en la boca de entrada de la aspiradora hasta que trabe. Para retirar la manguera presione firmemente la traba y tire.
Cable de alimentación
Para extraer el cable de alimentación tómelo de la ficha y tire suavemente. Su aspiradora está equipada con un enrollacable automático. Para guardar el cable, apague la aspiradora, desconecte el cable de la red y presione el botón del enrollacable. El cable se rebobinará automáticamente.
Botón de encendido
Con el cable de alimentación conectado a un tomacorriente, Ud. puede activar o desactivar la aspiradora presionando el botón de encendido.
Traducere - engleză VACUUM CLEANER
Features
• Compact size
• Dustbag load indicator
• Cloth bag
• Secondary filter system
• Power cable (5 m)
• Automatic cord rewind
• Flexible hose
• Practical transport handle, at the top
Check that the dustbag is in its place
Open the bag compartment cover and pull up on the front end of the compartment. Lift the cover and verify that the bag is in its place.
Close the compartment cover gently until it locks.
Extension tubes and hose
If you wish to use the extension tube (s), insert the larger diameter end of the tube into the hose opening. At the other end of the tube insert the second tube or the most convenient accessory. If you are not using the extension tubes, insert the accessory to be used directly on the opening of the hose.
Installation of the hose
Take the opposite end to the opening of the hose and gently insert it into the socket of the vacuum cleaner until it locks. To remove the hose press the latch firmly and pull.
Power cord
To remove the power cord, take it from the holder and pull gently. Your vacuum is equipped with an automatic cable winding system. To store the cable, turn off the vacuum, unplug it and press on the cable winding button. The cable will automatically rewind.
Power button
With the power cord connected to an outlet, you can turn on or turn off the vacuum by pressing the power button.
din engleză în română: Air Polllution and Your Health General field: Ştiinţă Detailed field: Mediu şi ecologie
Text sursă - engleză Air Pollution and Your Health
Urban air pollution is made up of a complex mix of hundreds of substances including toxic air pollutants and criteria air contaminants such as nitrogen oxides (NOx), sulphur oxides (SOx), and particulate matter (PM).
What is smog?
Sometimes people talk about "smog", a mixture of pollutants in the air that can affect our health. Smog can occur any time of year, but it is most common in the summer. It sometimes appears as a brownish haze. Smog is made up of ground-level ozone, fine particles and other pollutants. Smog can affect outlying suburbs and rural areas as well as big cities.
Where does smog come from?
The air pollutants that make up smog mainly come from burning fossil fuels. Every day we burn gasoline, diesel fuel, natural gas and coal in our cars, trucks, home furnaces, industries and power plants, we are sending pollutants into the air. Ozone, the main ingredient in smog, is formed when two pollutants (nitrogen oxides and volatile organic compounds) combine in the presence of sun light. Toronto's smog comes from sources in Toronto and beyond.
Retrieved from http://www1.toronto.ca/wps/portal/contentonly?vgnextoid=4e9febfc2bb31410VgnVCM10000071d60f89RCRD
Traducere - română Poluarea aerului și sănătatea dumneavoastră
Poluarea atmosferică urbană este compusă dintr-o combinație complexă de sute de substanțe, inclusiv poluanți toxici ai aerului și contaminanți ce produc smog și ploi acide, cum ar fi oxizii de azot (NOx), oxizii de sulf (SOx) și particulele de pulberi (PM).
Ce este smogul?
Uneori oamenii vorbesc despre "smog", un amestec de poluanți în aer ce ne pot afecta sănătatea. Smogul poate fi prezent în orice timp al anului, dar este mai predominant vara. Arată uneori ca o ceață maronie. Smogul este alcătuit din ozon troposferic, particule fine și alți poluanți. Smogul poate afecta suburbiile periferice și zonele rurale, precum și orașele mari.
De unde vine smogul?
Poluanții atmosferici care alcătuiesc smogul provin în principal din arderea combustibililor fosili. În fiecare zi ardem benzină, combustibil diesel, gaze naturale și cărbune în mașinile noastre, camioane, încălzitoare casnice, industrii și centrale electrice, trimitem poluanți în aer. Ozonul, principalul ingredient al smogului, se formează atunci când doi poluanți (oxizi de azot și compuși organici volatili) se combină în prezența luminii soarelui. Smogul din Toronto provine de la surse din Toronto și din afară.
din română în engleză: Testament cu dispoziție de desemnare a tutorelui General field: Legislaţie/Brevete Detailed field: Juridic (general)
Text sursă - română Model de testament care cuprinde o dispoziție de desemnare a tutorelui[1]
Subsemnatul ...........[2]în calitate de ..........[3]al minorului/minorilor............[4] desemnez[5]pentru cazul în care va fi necesară instituirea tutelei minorului/minorilor, in conformitate cu art.114 Cod civil, pe .............[6] să exercite sarcina tutelei pentru minorul/minorii susmenționați.
Am luat la cunoştinţă că prezenta desemnare poate fi revocată, conform art.114 alin. (3) Cod civil.
Prezentul testament se înregistrează pe cheltuiala subsemnatului în Registrul National notarial privind capacitatea persoanelor(RNCP)[7].
Tehnoredactat la .............., în ...... exemplare, din care un exemplar pentru arhiva biroului notarial, un exemplar pentru RNCP și ...... exemplare s-au eliberat testatorului.
Testator, Semnătura........
[1]Această dispoziție poate face obiectul unui testament de sine stătător sau poate fi inserată într-un testament conținând și alte dispoziții testamentare.
[2]Se va completa numele, prenumele, codul numeric personal și domiciliul testatorului.
[3]Se va completa calitatea: tată sau mamă.
[4]Se va completa numele, prenumele, codul numeric personal și domiciliul.
[5]Dacă revocarea privește numai dispoziția testamentară cu privire la desemnarea tutorelui, aceasta se va înscrie numai în Registrul național privind capacitatea persoanelor.
[6]Se va completa numele, prenumele, codul numeric personal și domiciliul tutorelui. Pot fi desemnate mai multe persoane ca tutore fără vreo preferință, urmând ca instanța de tutelă să hotărască. Tutori pot fi și doi soți.
Traducere - engleză Testament model that includes a guardian designation provision [1]
I, the undersigned ........... [2] as .......... [3] of the minor/minors ............ [4] I will designate [5] in the event that the minor/minors guardianship is to be established in accordance with Art.114 of the Civil Code, ............. [6] to exercise the custody of the minor/minors mentioned.
I have noted that this designation may be revoked, according to Art. 114 paragraph (3) Civil Code.
This will is being recorded at the expense of the undersigned in the National Notary Registry to regard the legal capacity (RNCP) (National Registry of Private Copy) [7].
Drawn up at .............., in ...... copies, of which one copy for the archive of the notary office, one copy for RNCP (National Registry of Private Copy) and ...... copies were released to the testator.
Testator,
Signature ........
[1] This provision may be the subject of a will or may be included in as part of a testament containing other provisions.
[2] To be completed: the name, surname, personal numeric code and testator's domicile.
[3] To be completed the capacity of: father or mother.
[4] To be completed: name, surname, personal numeric code and home address.
[5] If the revocation refers only to the testamentary provision regarding the appointment of the guardian, it will be entered only in the National Notary Registry to regard the legal capacity (RNCP) (National Registry of Private Copy).
[6] To be completed: name, surname, personal numeric code and guardian's domicile. Several people may be appointed as guardians, without any preference, and the guardianship court will decide. Guardians may also be two spouses.
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