Investigation of the impact of feeding Lactobacillus plantarum CRL 1815 encapsulated in microbially derived polymers on the rat faecal microbiota

AIMS: The aim of this study was to evaluate the impact of the administration of microencapsulated Lactobacillus plantarum CRL 1815 with two combinations of microbially derived polysaccharides, xanthan : gellan gum (1%:0·75%) and jamilan : gellan gum (1%:1%), on the rat faecal microbiota. METHODS AND RESULTS: A 10-day feeding study was performed for each polymer combination in groups of 16 rats fed either with placebo capsules, free or encapsulated Lact. plantarum or water. The composition of the faecal microbiota was analysed by fluorescence in situ hybridization and temporal temperature gradient gel electrophoresis. Degradation of placebo capsules was detected, with increased levels of polysaccharide-degrading bacteria. Xanthan : gellan gum capsules were shown to reduce the Bifidobacterium population and increase the Clostridium histolyticum group levels, but not jamilan : gellan gum capsules. Only after administration of jamilan : gellan gum-probiotic capsules was detected a significant increase in Lactobacillus-Enterococcus group levels compared to controls (capsules and probiotic) as well as two bands were identified as Lact. plantarum in two profiles of ileum samples. CONCLUSIONS: Exopolysaccharides constitute an interesting approach for colon-targeted delivery of probiotics, where jamilan : gellan gum capsules present better biocompatibility and promising results as a probiotic carrier. SIGNIFICANCE AND IMPACT OF STUDY: This study introduces and highlights the importance of biological compatibility in the encapsulating material election, as they can modulate the gut microbiota by themselves, and the use of bacterial exopolysaccharides as a powerful source of new targeted-delivery coating material.

Perceptions of informal safety nets: a case study from a South African informal settlement

The relevance and importance of informal safety nets that buffer poor households from livelihood hardships have been given little attention in South Africa’s development programmes to date. This article contributes to the understanding of informal safety nets by investigating local perceptions in a South African informal settlement. The main findings of the study are that families perform an important safety net function, but that these sources of assistance can be susceptible to social isolation. Immediate neighbours and friends also play an important safety net role, but these reciprocal-based sources of assistance may be difficult to secure. Community-wide threats can have a severe impact on people’s ability to engage in safety net transfers. Many of these difficulties stem from South Africa’s structural unemployment crisis. This factor is the greatest danger to the future of the informal safety net system in the informal settlement.

On the barrier properties of the cornea: a microscopy study of the penetration of fluorescently labeled nanoparticles, polymers, and sodium fluorescein

Overcoming the natural defensive barrier functions of the eye remains one of the greatest challenges of ocular drug delivery. Cornea is a chemical and mechanical barrier preventing the passage of any foreign bodies including drugs into the eye, but the factors limiting penetration of permeants and nanoparticulate drug delivery systems through the cornea are still not fully understood. In this study, we investigate these barrier properties of the cornea using thiolated and PEGylated (750 and 5000 Da) nanoparticles, sodium fluorescein, and two linear polymers (dextran and polyethylene glycol). Experiments used intact bovine cornea in addition to bovine cornea de-epithelialized or tissues pretreated with cyclodextrin. It was shown that corneal epithelium is the major barrier for permeation; pretreatment of the cornea with β-cyclodextrin provides higher permeation of low molecular weight compounds, such as sodium fluorescein, but does not enhance penetration of nanoparticles and larger molecules. Studying penetration of thiolated and PEGylated (750 and 5000 Da) nanoparticles into the de-epithelialized ocular tissue revealed that interactions between corneal surface and thiol groups of nanoparticles were more significant determinants of penetration than particle size (for the sizes used here). PEGylation with polyethylene glycol of a higher molecular weight (5000 Da) allows penetration of nanoparticles into the stroma, which proceeds gradually, after an initial 1 h lag phase.

Memo test: standardisation of computerised assessment of auditory verbal short-term memory

Short-term memory (STM) impairments are prevalent in adults with acquired brain injuries. While there are several published tests to assess these impairments, the majority require speech production, e.g. digit span (Wechsler, 1987). This feature may make them unsuitable for people with aphasia and motor speech disorders because of word finding difficulties and speech demands respectively. If patients perceive the speech demands of the test to be high, the may not engage with testing. Furthermore, existing STM tests are mainly ‘pen-and-paper’ tests, which can jeopardise accuracy. To address these shortcomings, we designed and standardised a novel computerised test that does not require speech output and because of the computerised delivery it would enable clinicians identify STM impairments with greater precision than current tests. The matching listening span tasks, similar to the non-normed PALPA 13 (Kay, Lesser & Coltheart, 1992) is used to test short-term memory for serial order of spoken items. Sequences of digits are presented in pairs. The person hears the first sequence, followed by the second sequence and s/he decides whether the two sequences are the same or different. In the computerised test, the sequences are presented in live voice recordings on a portable computer through a software application (Molero Martin, Laird, Hwang & Salis 2013). We collected normative data from healthy older adults (N=22-24) using digits, real words (one- and two-syllables) and non-words (one- and two- syllables). Their performance was scored following two systems. The Highest Span system was the highest span length (e.g. 2-8) at which a participant correctly responded to over 7 out of 10 trials at the highest sequence length. Test re-test reliability was also tested in a subgroup of participants. The test will be available as free of charge for clinicians and researchers to use.

Geography, skills and careers patterns at the boundary of creativity & innovation: digital technology and creative arts graduates in the UK

In the last decades, research on knowledge economies has taken central stage. Within this broader research field, research on the role of digital technologies and the creative industries has become increasingly important for researchers, academics and policy makers with particular focus on their development, supply-chains and models of production. Furthermore, many have recognised that, despite the important role played by digital technologies and innovation in the development of the creative industries, these dynamics are hard to capture and quantify. Digital technologies are embedded in the production and market structures of the creative industries and are also partially distinct and discernible from it. They also seem to play a key role in innovation of access and delivery of creative content. This chapter tries to assess the role played by digital technologies focusing on a key element of their implementation and application: human capital. Using student micro-data collected by the Higher Education Statistical Agency (HESA) in the United Kingdom, we explore the characteristics and location patterns of graduates who entered the creative industries, specifically comparing graduates in the creative arts and graduates from digital technology subjects. We highlight patterns of geographical specialisation but also how different context are able to better integrate creativity and innovation in their workforce. The chapter deals specifically with understanding whether these skills are uniformly embedded across the creative sector or are concentrated in specific sub-sectors of the creative industries. Furthermore, it explores the role that these graduates play in different sub-sector of the creative economy, their economic rewards and their geographical determinants.

Impact of socioeconomic and clinical factors on child oral health-related quality of life (COHRQoL)

Child oral health-related quality of life (COHRQoL) has been increasingly assessed; however, few studies appraised the influence of socioeconomic status on COHRQoL in developing countries. This study assessed the relationship of COHRQoL with socioeconomic backgrounds and clinical factors. This study followed a cross-sectional design, with a multistage random sample of 792 schoolchildren aged 12 years, representative of Santa Maria, a southern city in Brazil. Participants completed the Brazilian version of the Child Perceptions Questionnaire (CPQ(11-14)), their parents or guardians answered questions on socioeconomic status, and a dental examination provided information on the prevalence of caries, dental trauma and occlusion. The assessment of association used hierarchically adjusted Poisson regression models. Higher impacts on COHRQoL were observed for children presenting with untreated dental caries (RR 1.20; 95% CI 1.07-1.35) and maxillary overjet (RR 1.19; 95% CI 1.02-1.40). Socioeconomic factors also associated with COHRQoL; poorer scores were reported by children whose mothers have not completed primary education (RR 1.30; 95% CI 1.17-1.44) and those with lower household income (RR 1.13; 95% CI 1.02-1.26). Poor socioeconomic standings and poor dental status have a negative impact on COHRQoL; reducing health inequalities may demand dental programmes and policies targeting deprived population.

Design of a Modern Liposome and Bee Venom Formulation for the Traditional VIT-Venom Immunotherapy

Traditional venom immunotherapy uses injections of whole bee venom in buffer or adsorbed in Al (OH)(3) in an expensive, time-consuming way. New strategies to improve the safety and efficacy of this treatment with a reduction of injections would, therefore, be of general interest. It would improve patient compliance and provide socio-economic benefits. Liposomes have a long tradition in drug delivery because they increase the therapeutic index and avoid drug degradation and secondary effects. However, bee venom melittin (Mel) and phospholipase (PLA(2)) destroy the phospholipid membranes. Our central idea was to inhibit the PLA(2) and Mel activities through histidine alkylation and or tryptophan oxidation (with pbb, para-bromo-phenacyl bromide, and/or NBSN-bromosuccinimide, respectively) to make their encapsulations possible within stabilized liposomes. We strongly believe that this formulation will be nontoxic but immunogenic. In this paper, we present the whole bee venom conformation characterization during and after chemical modification and after interaction with liposome by ultraviolet, circular dichroism, and fluorescence spectroscopies. The PLA(2) and Mel activities were, measured indirectly by changes in turbidity at 400(nm), rhodamine leak-out, and hemolysis. The native whole bee venom (BV) presented 78.06% of alpha-helical content. The alkylation (A-BV) and succynilation (S-BV) of BV increased 0.44 and 0.20% of its alpha-helical content. The double-modified venom (S-A-BV) had a 0.74% increase of alpha-helical content. The BV chemical modification induced another change on protein conformations observed by Trp that became buried with respect to the native whole BV. It was demonstrated that the liposomal membranes must contain pbb (SPC:Cho:pbb, 26:7:1) as a component to protect them from aggregation and/or fusion. The membranes containing pbb maintained the same turbidity (100%) after incubation with modified venom, in contrast with pbb-free membranes that showed a 15% size decrease. This size decrease was interpreted as membrane degradation and was corroborated by a 50% rhodamine leak-out. Another fact that confirmed our interpretation was the observed 100% inhibition of the hemolytic activity after venom modification with pbb and NBS (S-A-BV). When S-A-BV interacted with liposomes, other protein conformational changes were observed and characterized by the increase of 1.93% on S-A-BV alpha-helical content and the presence of tryptophan residues in a more hydrophobic environment. In other words, the S-A-BV interacted with liposomal membranes, but this interaction was not effective to cause aggregation, leak-out, or fusion. A stable formulation composed by S-A-BV encapsulated within liposomes composed by SPC:Cho:pbb, at a ratio of 26:7:1, was devised. Large unilamellar vesicles of 202.5 nm with a negative surface charge (-24.29 mV) encapsulated 95% of S-A-BV. This formulation can, now, be assayed on VIT.

Effects of starch gelatinization and oxidation on the rheological behavior of chitosan/starch blends

Chitosan/starchblends represent an interesting alternative for the preparation of biocompatible drug delivery systems, packing materials and edible films. This paper reports on the effects of starch gelatinization and oxidation on the rheological behavior of chitosan/starch blends. The results show that the modifications in the starch structure cause changes in G` (storage modulus) and G `` (lossmodulus) as a function of frequency. For chitosan/starch, G `` is higher than G`, showing a viscous behavior. However, for chitosan/gelatinized starch and chitosan/oxidized starch, an increase in the angular frequency promotes a modulus crossover at omega = 0.02 and 0.04 rad s(-1), respectively. The viscosity curves as a function of shear rate show that both modifications cause an increase in viscosity, and all blends show a non-Newtonian behavior. (C) 2011 Society of Chemical Industry

Reactions of Persons with Dementia to Caregivers Singing in Morning Care Situations

Music therapeutic caregiving', when caregivers sing for or together with persons with severe dementia during care situations, has been suggested as a way to reduce problematic behaviors in dementia care. The present study implemented this technique as an intervention in dementia care. Six caregivers participated in group interviews about their experiences of morning care situations without and with'Music therapeutic caregiving'. Through a qualitative content analysis two themes emerged.'Being in a different reality' was based on'usual' morning care situations. The caregivers' experienced the persons with dementia as absent-minded; communication and cooperation were difficult. The second theme,'Being present', was based on morning care situations with the intervention. The caregivers described communication as enhanced; the persons with dementia expressed themselves more appropriately, making cooperation possible. The results indicate that'Music therapeutic caregiving' might lead to a more positive experience of the person with dementia and seems to increase receptivity to caregiving.  

Avaliação do papel da ultra-sonografia obstétrica de rotina, no rastreamento pré-natal das anormalidades cardíacas

A ultra-sonografia obstétrica é um método diagnóstico tradicionalmente utilizado na rotina do atendimento pré-natal, tendo sido estudados de forma ampla suas vantagens e limitações. O advento do diagnóstico intra-uterino de cardiopatias congênitas e de arritmias através da ecocardiografia fetal modificou completamente o prognóstico perinatal dessas afecções, por permitir planejar o adequado manejo cardiológico no período neonatal imediato e, em algumas situações, o tratamento e sua resolução in utero. Sendo muito elevada a prevalência de cardiopatias congênitas durante a vida fetal, sua detecção torna-se fundamental. Considerando a inviabilidade operacional de realizar rotineiramente ecocardiografia fetal em todas as gestações, levando-se em conta as condições locais do sistema de saúde, o encaminhamento para exame por especialista passa a ser otimizado com a possibilidade da suspeita de alterações estruturais ou funcionais do coração e do sistema circulatório durante o exame ultra-sonográfico obstétrico de rotina. Não são conhecidos, em nosso meio, dados que avaliem de forma sistemática a acurácia da ultra-sonografia obstétrica no que se refere à suspeita pré-natal de cardiopatias. A partir deste questionamento, este trabalho foi delineado com o objetivo de avaliar o papel da ultra-sonografia obstétrica de rotina na suspeita pré-natal de cardiopatias congênitas ou arritmias graves e os fatores envolvidos na sua efetividade. A amostra foi constituída de 77 neonatos ou lactentes internados no Instituto de Cardiologia do Rio Grande do Sul / Fundação Universitária de Cardiologia (IC/FUC) no período de maio a outubro de 2000, com diagnóstico pós-natal confirmado de cardiopatia estrutural ou arritmia grave, que tenham sido submetidos, durante a vida fetal, a pelo menos uma ultra-sonografia obstétrica após a 18a semana de gestação. Para a coleta de dados, foi utilizado um questionário padronizado, respondido pelos pais ou responsáveis, após consentimento informado. As variáveis categóricas foram comparadas pelo teste do qui-quadrado ou pelo teste de Fisher, com um alfa crítico de 0,05. Um modelo de regressão logística foi utilizado para determinar variáveis independentes eventualmente envolvidas na suspeita pré-natal de cardiopatia. Em 19 pacientes (24,7%), a ultra-sonografia obstétrica foi capaz de levantar suspeita de anormalidades estruturais ou de arritmias. Ao serem consideradas apenas as cardiopatias congênitas, esta prevalência foi de 19,2% (14/73). Em 73,7% destes, as cardiopatias suspeitadas eram acessíveis ao corte de 4-câmaras isolado. Observou-se que 26,3% das crianças com suspeita pré-natal de cardiopatia apresentaram arritmias durante o estudo ecográfico, enquanto apenas 3,4% dos pacientes sem suspeita pré-natal apresentaram alterações do ritmo (P=0,009). Constituiram-se em fatores comparativos significantes entre o grupo com suspeita pré-natal e o sem suspeita a paridade (P=0,029), o parto cesáreo (P=0,006), a internação em unidade de tratamento intensivo (P=0,046) e a escolaridade paterna (P=0,014). Não se mostraram significativos o número de gestações, a história de abortos prévios, o estado civil, o sexo dos pacientes, o tipo de serviço e a localidade em que foram realizados o pré-natal e a ultra-sonografia obstétrica, a indicação da ecografia, o número de ultra-sonografias realizadas, a renda familiar e a escolaridade materna. À análise multivariada, apenas a presença de alteração do ritmo cardíaco durante a ultra-sonografia obstétrica mostrou-se como variável independente associada à suspeita pré-natal de anormalidade cardíaca. Este trabalho demonstra que a ultra-sonografia obstétrica de rotina ainda tem sido subutilizada no rastreamento pré-natal de cardiopatias congênitas, levantando a suspeita de anormalidades estruturais em apenas um quinto dos casos. Considerando a importância prognóstica do diagnóstico intra-uterino de cardiopatias congênitas e arritmias graves, todos os esforços devem ser mobilizados no sentido de aumentar a eficácia da ecografia obstétrica de rotina para a suspeita de anormalidades cardíacas fetais. O treinamento dirigido dos ultra-sonografistas e a conscientização do meio obstétrico e da própria população são instrumentos para esta ação.

Gestão associada de prestação de serviço público jurisdicional nos juizados especiais federais

Por mais que a informatização esteja avançada (interligação por melO da rede internet de computadores entre os órgãos e entidades públicas pelo Estado), máquina alguma substituirá os dramas do homem contemporâneo, principalmente aqueles que sempre estiveram alijados da cidadania. Os problemas do homem, principalmente os hiposuficientes, dentro do caso concreto, nem sempre podem ser solucionados por máquinas distantes uma da outra e, o pior, em locais distantes, sem permitir o acesso direto ao ser humano que comanda a máquina. Esse cidadão, que tem no princípio da dignidade da pessoa humana sua maior proteção e garantia outorgada pelo Estado de Direito, tem o direito de ser tratado com dignidade pelo Estado que monopoliza a pacificação social através da jurisdição, principalmente quando o réu é o próprio Estado, como é o caso do subsistema dos Juizados Especiais Federais (os réus são a União, ou suas entidades autárquicas, ou empresas públicas federais). A humanização no atendimento do cidadão, que busca e deposita no Estado Judiciário (Federal), no subsistema do Juizado Especial Federal, sua última esperança na resposta de seus direitos violados pelo próprio Estado Administração (Federal), se materializará por uma nova proposta de prestação de serviço público - a unitariedade (concentração de todos os partícipes desse subsistema em um único local - Judiciário e Executivo juntos) - de forma permanente e estática, nas cidades de maior demanda social, pela gestão associada de prestação de serviço público jurisdicional entre o Judiciário e Executivo (Legislativo eventualmente) onde a entrega do bem da vida litigioso ou a pacificação (meios alternativos de solução do conflito, como a conciliação) se dê dentro de um ambiente de respeito ao ser humano, ou seja, dentro de um prazo razoável, com padrões de atendimento de eficiência compatíveis com a contemporaneidade e principalmente de forma efetiva (com efetividade plena). Os Juizados Especiais, que foram criados para serem rápidos, ágeis e efetivos, não podem se banalizar e terem os mesmos estigmas da morosidade, da não efetividade e do desapego a qualidade no atendimento ao usuário. Tal humanização, como proposta na dissertação, desse subsistema judiciário - Juizado Especial Federal - com a unitariedade desse serviço público, atende e concretiza os valores e princípios constitucionais, sem necessidade de mudança legislativa, além de reforçar a legitimidade do Estado e solidificar a cidadania. O que se quer nessa dissertação é retirar o Judiciário do isolamento, o que é fundamental sobretudo no plano da efetividade (execução de suas decisões e prevenção e postergação de litígios criando uma mecanismos de conciliação prévia permanente). A dissertação propõe um novo desenho institucional entre Poderes da República para prestação de serviço público jurisdicional buscando contribuir para o aperfeiçoamento das atividades judiciárias em sentido amplo, ou seja, atividades administrativas ou não jurisdicionais (função atípica do Poder Judiciário). O paradigma proposto, além da valorização do consensualismo, implica a efetividade das normas jurídicas e a eficiência do sistema.

Avaliando o avaliador: evidências de um experimento de campo sobre as auditorias da CGU

O Brasil praticamente alcançou a provisão universal dos serviços públicos de educação, saúde e assistência social nos últimos anos, mas a qualidade desses serviços ainda está bem atrás da maioria dos países desenvolvidos. As instituições de controle são atores relevantes nesse contexto, pois é seu dever avaliar a efetividade e a eficiência da provisão desses serviços públicos. Entretanto, pouco se sabe sobre a efetividade dessas instituições, especialmente no Brasil. Os artigos de Olken (2007), Reinikka e Svensson (2004) e Di Tella & Schargrodsky (2000) trazem alguns elementos para essa discussão, ao mostrar como e onde políticas de boas práticas podem funcionar em outros países. No Brasil, estudos empíricos sobre essas políticas são escassos. Nesta tese, meu principal objetivo é trazer evidências sobre a efetividade da auditoria pública no Brasil. Utilizando um experimento de campo, eu avalio a efetividade do trabalho de auditoria da Controladoria-Geral da União (CGU) no âmbito do Programa de Fiscalização a partir de Sorteios Públicos. Os principais tópicos discutidos aqui são relativos à gestão de programas em nível local e aos processos licitatórios a eles associados. Os municípios no grupo de tratamento são submetidos a um aumento na probabilidade de receber uma auditoria, enquanto os de controle permanecem com probabilidade inalterada. Os resultados sugerem que os gestores locais são sensíveis ao tratamento quando focamos as licitações, mas não quando a questão é a gestão de programas. Em seguida ao experimento, utilizo um modelo "Fora da Amostra" para sugerir um mecanismo de alocação de recursos financeiros e humanos, para melhorar os níveis de eficiência do trabalho de campo da CGU

Cell-responsive nanogels for anticancer drug delivery

One of the main goals in Nanomedicine is to create innovative drug delivery systems (DDS) capable of delivering drugs into a specific location with high efficiency. In the development of DDS, some essential properties are desired, such as biocompatibility and biodegradability. Furthermore, an ideal DDS should be able to deliver a drug in a controlled manner and minimize its side effects. These two objectives are still a challenge for researchers all around the world. Nanogels are an excellent vehicle to use in drug delivery and several other applications due to their biocompatibility. They are polymer-based networks, chemically or physically crosslinked, with at least 80-90% water in their composition. Their properties can be tuned, like the nanogel size, multifunctionality and degradability. Nanogels are capable of carrying in their interior bioactive molecules and deliver them into cells. The main objective of this project was to produce nanogels for the delivery of anticancer drugs with the ability of responding to existent stimuli inside cells (cellresponsiveness nanogels) and/or of controlled drug delivery. The nanogels were mainly based on alginate (AG), a natural biopolymer, and prepared using emulsion approaches. After their synthesis, they were used to encapsulate doxorubicin (Dox) which was chosen as a model drug. In the first part of the experimental work, disulfide-linked AG nanogels were prepared and, as expected, were redox-sensitive to a reducing environment like the intracellular medium. In the second part, AG nanogels crosslinked with both calcium ions and cationic poly(amidoamine) dendrimers were developed with improved sustained drug delivery. The prepared nanogels were characterized in terms of size, chemical composition, morphology, and drug delivery behavior (under redox/pH stimuli). The in vitro cytotoxicity of the nanogels was also tested against CAL-72 cells (an osteosarcoma cell line).

Humanização do atendimento à criança na atenção básica: visão dos profissionais

Objetivou-se compreender a humanização do atendimento à criança na Atenção Básica na visão dos profissionais. Estudo qualitativo, realizado em uma Unidade de Saúde da Família de Natal-RN, Brasil. Dezesseis profissionais responderam a um formulário contendo questões referentes ao atendimento à criança, à humanização e às práticas realizadas para humanizar o atendimento. Os dados foram categorizados por temas e analisados a partir dos princípios da Política Nacional de Humanização. Para os profissionais, humanizar o atendimento envolve acolher, escutar, aconselhar sobre o que está sendo realizado com a criança, valorizar a família, e tornar o sujeito ativo no atendimento, mesmo que de forma incipiente. A maioria dos profissionais descreveu atendimento que valorizava parte dos princípios da política de humanização, mesmo com dificuldades para implementá-los na rotina. Requer, portanto, estímulos e atualização dos profissionais para uma postura autocrítica sobre o atendimento

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