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

Avaliação do desenvolvimento infantil e a influência dos fatores biopsicossociais em crianças com cardiopatia congênita

Child development is the result of the interaction of biological, psychological and social factors. Hostile environment, income, offered stimuli, as well as the presence of a chronic illness are issues that may interfere significantly. Considering the chronic diseases, we can identify congenital heart disease (CHD) is characterized by anatomical heart defects and functional and currently has presented an incidence of up to 1% of the population of live births. This research aimed to evaluate child development and verify an association with the commitment by biopsychosocial factors of children with and without CHD. Study participants were children from zero to six years, divided into three groups: Group1- 29 children pre-surgical congenital heart disease, Group2- 43 children post-surgical cardiac patients and Group3- 56 healthy children. The instruments used were a biopsychosocial questionnaire and the Screening Test Denver II. Of the total of 128 children evaluated, 66 (51.56%) are girls, and ages ranged from two months to six years (median 24.5 months). In G1 and G2 predominated acyanotic heart disease (55.2% and 58.1%). Regarding the Denver II reviews, children with heart disease had more development ratings "suspicious" and "suspect/abnormal", and 41.9% of children who have gone through surgery had characterized its development as "suspect/abnormal" . In the group of healthy children 53.6% were classified as developmental profile "normal" (p = ˂0,0001). On the areas of Denver II, among children with heart disease was greatest change in motor areas (p = 0.016, p = ˂0,001). The biopsychosocial variables that were related to a possible developmental delay were gender (p = 0.042), child's age (p = 0.0001) and income per capita (p = 0.019). There were no associations between the variables related to the treatment of disease, information, understanding of the disease and the way parents treat their children. In the group of healthy children showed that children who underwent hospitalization rates were more changes in development (p = 0.025) and the higher the number of admissions over these changes have intensified (p = 0.023). The results suggest that children with congenital heart disease have likely delayed development. It was also observed that there is a significant difference between the children who have gone through surgery, those who are still waiting for surgery only doing clinical follow-up. Changes in the development are more connected motor areas can be explained by the characteristic features of the disease and treatment, such as dyspnea, fatigue, care and limitations in daily activities. The gender and age appear to be decisive in the development as well as healthy children go through hospitalization experience. Already in children with heart disease, it was realized that social variables involved in the disease and the treatment did not affect the development. This question can be understood by means of protective factors and resiliency, as this population receives family and social support.

Gravidade do olho seco em pacientes internados em unidade de terapia intensiva: análise de conceito e construção de definições

Dry eye syndrome is a multifactorial disease of the tear film, resulting from the instability of the lacrimal functional unit that produces volume change, up or tear distribution. In patients in intensive care the cause is enhanced due to various risk factors, such as mechanical ventilation, sedation, lagophthalmos, low temperatures, among others. The study's purpose is to build an assessment tool of Dry Eye Severity in patients in intensive care units based on the systematization of nursing care and their classification systems. The aim of this study is to build an assessment tool of Dry Eye Severity in hospitalized patients in Care Unit Intensiva.Trata is a methodological study conducted in three stages, namely: context analysis, concept analysis, construction of operational definitions and magnitudes of nursing outcome. For the first step we used the methodological framework for Hinds, Chaves and Cypress (1992). For the second step we used the model of Walker and Avant and an integrative review Whitemore seconds, Knalf (2005). This step enabled the identification of the concept of attributes, background and consequent ground and the construction of the settings for the result of nursing severity of dry eye. For the construction of settings and operational magnitudes, it was used Psicometria proposed by Pasquali (1999). As a result of context analysis, visualized from the reflection that the matter should be discussed and that nursing needs to pay attention to the problem of eye injury, so minimizing strategies are created this event with a high prevalence. With the integrative review were located from the crosses 19 853 titles, selected 215, and from the abstracts 96 articles were read in full. From reading 10 were excluded culminating in the sample of 86 articles that were used to analyze the concept and construction of settings. Selected articles were found in greater numbers in the Scopus database (55.82%), performed in the United States (39.53%), and published mainly in the last five years (48.82). Regarding the concept of analysis were identified as antecedents: age, lagophthalmos, environmental factors, medication use, systemic diseases, mechanical ventilation and ophthalmic surgery. As attributes: TBUT <10s, Schimer I test <5 mm in Schimer II test <10mm, reduced osmolarity. As consequential: the ocular surface damage, ocular discomfort, visual instability. The settings were built and added indicators such as: decreased blink mechanism and eyestrain.

Um sistema para estimação da vazão de gás de poços produzindo por Plunger Lift para vaso separador de teste em plataformas de petróleo

This work intends to analyze the behavior of the gas flow of plunger lift wells producing to well testing separators in offshore production platforms to aim a technical procedure to estimate the gas flow during the slug production period. The motivation for this work appeared from the expectation of some wells equipped with plunger lift method by PETROBRAS in Ubarana sea field located at Rio Grande do Norte State coast where the produced fluids measurement is made in well testing separators at the platform. The oil artificial lift method called plunger lift is used when the available energy of the reservoir is not high enough to overcome all the necessary load losses to lift the oil from the bottom of the well to the surface continuously. This method consists, basically, in one free piston acting as a mechanical interface between the formation gas and the produced liquids, greatly increasing the well s lifting efficiency. A pneumatic control valve is mounted at the flow line to control the cycles. When this valve opens, the plunger starts to move from the bottom to the surface of the well lifting all the oil and gas that are above it until to reach the well test separator where the fluids are measured. The well test separator is used to measure all the volumes produced by the well during a certain period of time called production test. In most cases, the separators are designed to measure stabilized flow, in other words, reasonably constant flow by the use of level and pressure electronic controllers (PLC) and by assumption of a steady pressure inside the separator. With plunger lift wells the liquid and gas flow at the surface are cyclical and unstable what causes the appearance of slugs inside the separator, mainly in the gas phase, because introduce significant errors in the measurement system (e.g.: overrange error). The flow gas analysis proposed in this work is based on two mathematical models used together: i) a plunger lift well model proposed by Baruzzi [1] with later modifications made by Bolonhini [2] to built a plunger lift simulator; ii) a two-phase separator model (gas + liquid) based from a three-phase separator model (gas + oil + water) proposed by Nunes [3]. Based on the models above and with field data collected from the well test separator of PUB-02 platform (Ubarana sea field) it was possible to demonstrate that the output gas flow of the separator can be estimate, with a reasonable precision, from the control signal of the Pressure Control Valve (PCV). Several models of the System Identification Toolbox from MATLAB® were analyzed to evaluate which one better fit to the data collected from the field. For validation of the models, it was used the AIC criterion, as well as a variant of the cross validation criterion. The ARX model performance was the best one to fit to the data and, this way, we decided to evaluate a recursive algorithm (RARX) also with real time data. The results were quite promising that indicating the viability to estimate the output gas flow rate from a plunger lift well producing to a well test separator, with the built-in information of the control signal to the PCV

Dados normativos do teste de atenção por cancelamento em estudantes de Natal/RN

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Resposta clínica periodontal e controle glicêmico em pacientes com e sem diabetes tipo II portadores de periodontite crônica ao tratamento periodontal “full mouth desinfection”

There is a bidirectional association between periodontal disease (PD) and diabetes mellitus, in which diabetes favors the development of PD and PD, if left untreated, can worsen the metabolic control of diabetes. Thus, periodontal disease should be treated to restore periodontal health and reduce the complications of diabetes. Therefore, the objective is assess the effect of full mouth periodontal therapy decontamination (Full Mouth Desinfection - FMD) in diabetic type II patients with chronic periodontitis during 12 months. Thirty-one patients in group one (G1) and 12 in group two (G2) were followed at baseline, 03, 06 09 and 12 months. There following clinical parameters were accessed: probing on bleeding (BOP), visible plaque index (PI), probing depth (PD), clinical attachment level (CAL) and gingival recession (GR). For diabetic patients, there were also made laboratory tests to evaluate blood parameters: fasting glucose and glycated hemoglobin. The results had been analyzed in two ways: all sites in the mouth and another with diseased sites. The Mann-Whitney, Friedman and Wilcoxon tests were used with 5% significance. Intergroup analysis of all sites it is clear that there was no significant difference over time concerning PD, BOP, PI, CAL and RG. However, when evaluating the diseased sites, we observed significant difference for CAL and PD, with higher values in G1. The intragroup analysis for all sites showed a statistically significant reduction at PD, PI and BOP in both groups. Intragroup analysis of periodontal affected sites showed a statistically significant reduction in PD, BOP and CAL in both groups. There was also a statistically significant increase in RG values. There was no significant change concerning glycated hemoglobin and fasting glucose in the G1. Therefore, it can be concluded that there were improvements in periodontal parameters over the 12 months of research, but without changes in glycemic levels of diabetic patients. Thus, periodontal therapy proved effective in maintaining oral health.