Avaliação do desenvolvimento neuropsicomotor em crianças na rede básica de saúde utilizando o teste de Denver II: identificação de fatores de risco materno

Alterations in the neuropsychomotor development of children are not rare and can manifest themselves with varying intensity at different stages of their development. In this context, maternal risk factors may contribute to the appearance of these alterations. A number of studies have reported that neuropsychomotor development diagnosis is not an easy task, especially in the basic public health network. Diagnosis requires effective, low-cost, and easy - to-apply procedures. The Denver Developmental Screening Test, first published in 1967, is currently used in several countries. It has been revised and renamed as the Denver II Test and meets the aforementioned criteria. Accordingly, the aim of this study was to apply the Denver II Test in order to verify the prevalence of suspected neuropsychomotor development delay in children between the ages of 0 and 12 months and correlate it with the following maternal risk factors: family income, schooling, age at pregnancy, drug use during pregnancy, gestational age, gestational problems, type of delivery and the desire to have children. For data collection, performed during the first 6 months of 2004, a clinical assessment was made of 398 children selected by pediatricians and the nursing team of each public health unit. Later, the parents or guardians were asked to complete a structured questionnaire to determine possible risk indicators of neuropsychomotor development delay. Finally the Denver II Developmental Screening Test (DDST) was applied. The data were analyzed together, using Statistical Package for Social Science (SPSS) software, version 6.1. The confidence interval was set at 95%. The Denver II Test yielded normal and questionable results. This suggests compromised neuropsychomotor development in the children examined and deserves further investigation. The correlation of the results with preestablished maternal risk variables (family income, mother s schooling, age at pregnancy, drug use during the pregnancy and gestational age) was strongly significant. The other maternal risk variables (gestational problems, type of delivery and desire to have children) were not significant. Using an adjusted logistic regression model, we obtained the estimate of the greater likelihood of a child having suspected neuropsychomotor development delay: a mother with _75 4 years of schooling, chronological age less than 20 years and a drug user during pregnancy. This study produced two manuscripts, one published in Acta Cirúrgica Brasileira , in which an analysis was performed of children with suspected neuropsychomotor development delay in the city of Natal, Brazil. The other paper (to be published) analyzed the magnitude of the independent variable maternal schooling associated to neuropsychomotor development delay, every 3 months during the first twelve months of life of the children selected.. The results of the present study reinforce the multifactorial characteristic of development and the cumulative effect of maternal risk factors, and show the need for a regional policy that promotes low-cost programs for the community, involving children at risk of neuropsychomotor development delay. Moreover, they suggest the need for better qualified health professionals in terms of monitoring child development. This was an inter- and multidisciplinary study with the integrated participation of doctors, nurses, nursing assistants and professionals from other areas, such as statisticians and information technology professionals, who met all the requirements of the Postgraduate Program in Health Sciences of the Federal University of Rio Grande do Norte

Visual IMML: um perfil UML para a modelagem de interfaces de usuário

The software development processes proposed by the most recent approaches in Software Engineering make use old models. UML was proposed as the standard language for modeling. The user interface is an important part of the software and has a fundamental importance to improve its usability. Unfortunately the standard UML does not offer appropriate resources to model user interfaces. Some proposals have already been proposed to solve this problem: some authors have been using models in the development of interfaces (Model Based Development) and some proposals to extend UML have been elaborated. But none of them considers the theoretical perspective presented by the semiotic engineering, that considers that, through the system, the designer should be able to communicate to the user what he can do, and how to use the system itself. This work presents Visual IMML, an UML Profile that emphasizes the aspects of the semiotic engineering. This Profile is based on IMML, that is a declarative textual language. The Visual IMML is a proposal that aims to improve the specification process by using a visual modeling (using diagrams) language. It proposes a new set of modeling elements (stereotypes) specifically designed to the specification and documentation of user interfaces, considering the aspects of communication, interaction and functionality in an integrated manner

Model-Driven requirements engineering process aided by ontologies and natural controlled languages

Researches in Requirements Engineering have been growing in the latest few years. Researchers are concerned with a set of open issues such as: communication between several user profiles involved in software engineering; scope definition; volatility and traceability issues. To cope with these issues a set of works are concentrated in (i) defining processes to collect client s specifications in order to solve scope issues; (ii) defining models to represent requirements to address communication and traceability issues; and (iii) working on mechanisms and processes to be applied to requirements modeling in order to facilitate requirements evolution and maintenance, addressing volatility and traceability issues. We propose an iterative Model-Driven process to solve these issues, based on a double layered CIM to communicate requirements related knowledge to a wider amount of stakeholders. We also present a tool to help requirements engineer through the RE process. Finally we present a case study to illustrate the process and tool s benefits and usage