996 resultados para Paralisia cerebral - Crianças - Avaliação
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Conselho Nacional de Desenvolvimento Científico e Tecnológico
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This study had as objective to identify to the perception of mothers and professionals of health on the attention to the health of HIV-Positive children/adolescents in the city of Natal-RN. It is a descriptive-exploratory study with quantitative and qualitative approach, carried through in the Giselda Trigueiro Hospital and in the State and Municipal Health Councils in Natal - RN, from march to december of 2005. The sample was composed by 56 participants, 33 mothers of children who use specialized assistance and 23 professionals. Data collection occurred with the application of a half-structuralized interview. Quantitative data were analyzed through descriptive statistics and qualitative data were submitted to content analysis. Prevailing categories in relation to the cartography of the attention to seropositive children and adolescents in Natal were: Organization and dynamics of the attention; Institutional management and human development; Control and prevention; other contexts of attention; relationship/communication team-patient and organization and functioning of the services. The profile epidemiologist of the children, adolescents and of the people/mothers, who take care of them with HIV/Aids, followed the evolution of the epidemic in the country and the world. It was verified that mothers need care and information; however they make a positive evaluation of the attendance they receive. It was also observed many gaps in the services of assistance, in which the researched group was attended, beyond imperfections in the communication between health professionals and users. The professionals recognize the advances that the politics represent for the assistance of people with Aids; however feel themselves limited by the precariousness of the system and the partner-economic conditions of the people. According to these data, it can be verified great challenges to go through in the context of integrality of the assistance to HIV positive children and adolescents in the city of Natal and in the improvement of the communication in the institution of reference
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Diabetes Mellitus (DM) and osteoposes are chronic diseases with great socioeconomic consequences, mainly due to the late complications and consequent disabilities. The potential effects of DM on bone metabolism remain a very conroversial issue, and disagreement exists with regard to the clinical implications of diabetic osteopenia and the mechanism of its ocurrence. The issue is further complicated by the contribuicion of the especific factors, such as duration of disease an dthe degree of metabolic control. The objective of this study is to identify the osteopathy in children and adolescents with DM 1 assisted in the hospital of pediatrics, UFRN, through biochemical markers of bone and mineral metabolism and the extent of bone mineral density. The study was composed by 74 diabetics type 1 patients (DM1) of both gender and aged 6 to 20 yars. Normoglicêmic group was composed by 97 healthy subjects of both genders, which showed the same age range of DM1, in addition to same socioeconomic class. These individuals qere students from the networks of public education in the city of Natal-RN, randomly invited to paticipate in our study. Both groups DM1 and NG were divided intofour subgroups, according to the classification of tanner , T1, T2, T3, T4 for achieving a benchmark. Diabetic individuals showed up with a poor glycemic control. the group DN1 T4 showed an incresead value for total protein, albumin, urea and microalbumiuria are predictors of grumelura injury in DM1 patients . The total alkaline phosphatase activitywas kept on high levels for both groups because they are in a stature development age. For osteocalcin there were decreased levels for groups Dm1 T1, T2, and T3 when compared to their NG (s), suggesting that this decrease could be associated with reduction in the number and/or differentiation os osteoblasts thereby contributing to reducing bone formation. There were no changes in the activity of TRAP. The serum concentrations of total and ionized calcium, phosphorus and magnesium were included within the RV. It was observed that the BMD (Z- SCORE ) has always been within the RV for both groups, despite to DM1 T4. Taking all together, our results support the hypothesis that children and adolescents with type 1 DM present the risk in the long run to suffer a reduction in the bone mass, associated to poor glicemic control and disease duration. It could limit the bone growth and increase the probality of development of osteopenia, as well as other complications surch as retinopathy and renal failure
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
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This study aims to verify the impact of the Bolsa Família Program (BFP) in income and school attendance of poor Brazilian families. It is intended to also check the existence of a possible negative effect of the program on the labor market, titled as sloth effect. For such, microdata from the IBGE Census sample in 2010 were used. Seeking to purge possible selection biases, methodology of Quantilic Treatment Effect (QTE) was applied, in particular the estimator proposed by Firpo (2007), which assumes an exogenous and non-conditional treatment. Moreover, Foster- Greer-Thorbecke (FGT) index was calculated to check if there are fewer households below the poverty line, as well as if the inequality among the poor decreases. Human Opportunity Index (HOI) was also calculated to measure the access of young people / children education. Results showed that BFP has positively influenced the family per capita income and education (number of children aged 5-17 years old attending school). As for the labor market (worked hours and labor income), the program showed a negative effect. Thus, when compared with not benefiting families, those families who receive the BFP have: a) a higher family income (due to the shock of the transfer budget money) b) more children attending school (due to the conditionality imposed by the program); c) less worked hours (due to sloth effect in certain family groups) and d) a lower income from work. All these effects were potentiated separating the sample in the five Brazilian regions, being observed that the BFP strongly influenced the Northeast, showing a greater decrease in income inequality and poverty, and at the same time, achieved a greater negative impact on the labor market
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The most recent data of the Brazilian Test (BRAZIL, 2005) and of the SAEB (BRAZIL, 2007) have reaffirmed the serious situation of the Brazilian public school, where great part of the students, after to conclude 4º year of basic education, does not present minimum knowledge of reading and writing. In this picture, the situation of the state of Rio Grande do Norte, whose students had presented, in the last evaluation is particularly difficult, the worse performances of the country, in this area. The data also discloses that the failure pertaining to school, closely tied with the failure in the literacy, not only remains, as takes other aspects. In consequence of this picture, the literacy, even so widely argued in the last few decades, still instigates inquiries, as it is the case of this work. Our study got shaped due to reflections, as much to the theorizations to which we had access, as of the emergent questions of ours pedagogical practice. Through the past three decades, the studies in the area of literacy with the purpose to understand the constituent nature of the process, its aspects and its determinative ones has been intensified. The produced knowledge has contributed for the overcoming of the reductionist form as if it thought/thinks, in some contexts - this process. Such statements impel them to reflect concerning what is happening in the school, limiting or making possible the pertaining to school success. With these concerns, we delimit, as focus of study, the teaching action, having the following stunning question: What to make professors, in the context of the public school, to propitiate or hinder the process of literacy of the children? In this direction, our object of study is to make them professors who can propitiate or hinder the process of literacy of the children, in the context of the public school. The objective work to investigate, from practical of professors the teachers, that to make professors related to the literacy process - they can propitiate or hinder the learning of the written language, for the pupils of the public school, at the beginning of the school process. The work if inscribes in the qualitative boarding of research and if it configures as a case study, with characteristics of Research-Action, inspired by the following principles: authenticity and commitment and systematic restitution. For the retraction of the data, they had been used: half-structuralized interview; participant comment; meeting of studies and reflection; register in daily of field. We define as locus of study, a school of public net and, more specifically, a group of the initial years of school process that integrates the cycle of literacy . Of the five invited teachers, only one demonstrated interest in participating of the work. Its group of first year of the First Cycle of basic education is composed for 34 children, with ages between six the nine years. The data constructed by means of the described procedures, as well as its analysis, make possible to identify, between the many aspects and to make that they compose the pedagogical dynamics in the context of classroom, the following categories to make articulated with the literacy process: 1. To make of practical the relative ones to the planning, understood as To make relative: 1,1 distribution of the time-space/routine; 1.2 to the didactic activities and/or sequences and teaching interventions; 1.3 to the organization/election of the contents; 1.4 to the materials/didactic resources and 1.5 to the evaluation. 2. To make relative to the interaction professor-pupil, systemize in: 2.1 attention to the diversity; 2.2 to the affectivity. These to make, in the form as if materialized in the practical one observed, had been reflected, jointly with the teacher, as constituting parts of obstacles to a perspective of literacy. By means of the sharing of the reflections, anchored in theoretical conceptions concerning the practical one of teach-learning and, more specifically, of literacy, we register indications of new meanings of these to make on the part of the teacher in conducting them as providers of learning of its pupils, first purpose of its teaching performance. This finishing, possible synthesis at this moment is, therefore, point of fond and departure for new studies
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Dans le scénario actuel marqué par l'insuccès de l'école publique en alphabétiser les enfants, l'objectif de cet étude est d'analyser, dans le cadre d'une école publique (dont les enfants, d'après les numéros officiels, deviennent lettrés au cours des trois premières années), des actions de gestion scolaire qui favorisent le processus d'alphabétisation. Pour cela nous suivons les principes de la méthode qualitative et adoptons l‟études de cas. Le terrain empirique est une école publique de la ville de Parnamirim (RN) et les sujets sont sa directrice, la vice-directrice, trois enseignantes des trois premières années de l'enseignement fondamental, deux coordinatrices pédagogiques, deux parents et six enfants. Pour la construction des données nous adoptons le questionnaire, l'analyse documentaire, des entretiens semi-dirigés et l'observation non-participante. Les fondements théoriques qui servirent de jalon à nos interprétations se retrouvent dans les conceptions actuelles de gestion éducationnelle et d'alphabétisation, ainsi que sur le processus d'apprentissage et de développement et pratique éducative. Dans cette étude, le concept de gestion est pris comme manière de dépasser la perspective bornée, bureaucratique, comme condition fondamentale de la qualité d'enseignement et de transformation de la propre identité des écoles, des systèmes d'enseignement et de l'éducation brésilienne; un concept déposé sur (et à partir de ) la mobilisation dynamique des sujets humains organisés collectivement. L'alphabétisation d'enfants est comprise en tant qu'enseignement-apprentissage du langage écrit dans une processus qui entoure deux dimensions indissociables: l'appropriation du système d'écriture alphabétique et le développement d'habilités/pratiques textuelles, dont les spécificités de développement impliquent systématisation et internationalité, caractéristiques de l'école en tant qu'institution éducative. A travers l'analyse des données fondé en quelques principes de l'analyse de contenu nous constatâmes que la gestion de l'école objet de la recherche, bien que marquée par des contradictions, développe des actions qui exercent un rôle fondamental dans les processus et résultats de l'apprentissage de l'écriture par les enfants. Ayant identifié les actions, nous construisîmes les catégories suivantes: 1) Actions relatives à l'organisation de l'école comme institution; 2) Actions relatives à organisation du processus enseignement-apprentissage; et sous-catégories: 1.1 Création et manutention d'infra-structure adéquate; 1.2 Promotion du travail collectif et autonome des professionnels; 1.3 Construction/formation permanente de l'équipe de professeurs; 1.4 Participation des parents dans la dynamique de l'école; 2.1 Disponibilité de ressources pour l'apprentissage; 2.2 Systématisation de la planification du processus enseignement-apprentissage e 2.2.1 Systématisation de l'évaluation de l'apprentissage. La catégorisation construite, bien que sa réflexion, signale que les actions qui favorisent l'alphabétisation des enfants s'approchent des conceptions d'une éducation de qualité sociale et de la démocratisation de l'éducation, bien que la propre institution de la gestion de l'école ne soit, pas encore, démocratisée. Notre étude réaffirme que la gestion de l'école, comme tout pratique humaine et sociale, a un caractère essentiellement contradictoire, inachevé et lacunaire, mais qui, jusqu'aux limites des contradiction, l'on trouve des possibilités, mises en évidence dans les actions de la gestion intimement articulées avec le succès de l'apprentissage et qui, par conséquent, peuvent construire une référence pour la réflexion sur les pratiques de gestion de l'école engagées engagée avec l'apprentissage et avec l'alphabétisation des enfants
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Unlike adult cancer, where cells usually originate from epithelial tissue and is linked to environmental factors, malignant tumors in childhood are mostly of embryonic origin and have a phase of rapid proliferation. When not started chemotherapy at this stage, the tumor increases in size, reducing their growth rate, thus reducing the response to chemotherapy. Childhood cancer is in Brazil, the second cause of mortality among children and adolescents from one to nineteen. His impact on the ranking of diseases becomes significantly important to public health since the first issue is related to accidents and violence. Many children are still sent to the centers of high complexity for cancer treatment with advanced stage disease. The delay in referral to diagnosis can be family, or the difficulty of access to the health sector, or the characteristics of the disease and lack of health staff regarding theme of childhood cancer. Before this problem, we aimed to assess the performance of health teams in the identification of child and adolescent symptoms of cancer in primary care, through the action research methodology, which includes the teaching-learning, seminars, describing the actions of the group and discussing the activities after the training. This study involved thirty-seven health professionals who provide care for children and adolescents in the USF Felipe Shrimp II, the Support Center for Children with Cancer and the pediatric hospital UFRN during the period from March to December 2010. The data were analyzed simultaneously to evaluate actions, following the direction of the analysis of ideas Freires, having as theoretical reference the primary health care. The diagnosis of current reality, as knowledge of the health team targeted for early identification of signs and symptoms raised through questioning, presented as generative themes: resistance to change, awareness of the need for apprehension of knowledge; prior knowledge through the media, fragmentation of the healthcare network, interfering with the operation of the reference and counter, the stigma of death, among others. The selected themes enabled the choice of content for the preparation of four seminars, such as implementation of collective action for discussion problematical. The teaching-learning process has allowed the study participants awareness of the problem and work through the knowledge acquired by interfering in decreasing the time interval between the identification of signs and symptoms of cancer and early specialist treatment. Their difficulties we are faced with a diagnosis of terminal cancer and associated with delayed access to laboratory tests and imaging necessary for the diagnosis of neoplasms. Thus, we find that when the team is consciously involved in the education process from identification of the problem situation, there may be significant changes in daily activities through awareness of being. However, we also realize that acquisition of knowledge and interest of the team are not enough, since to be efficiency of our service, we need an organization of cancer care network operating in the state of Rio Grande do Norte
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The objective was measured by surface electromyography (EMGs), the activity of inspiratory muscles during incremental test in subjects with hemiparesis and show its correlation with the Functional Independence Measure (FIM). Were included in the study 32 individuals hemiparetics and 14 healthy as control group. We performed an evaluation of lung function and anthropometric data. The EMGs were performed during the incremental test with Threshold ® (15, 30, 45 and 60% of MIP) and during maximal inspiratory pressure (MIP). The electromyographic findings were calculated by the signal amplitude (RMS). All data were initially analyzed by Kolmogorov-Smirnov, the anthropometric characteristics of both groups were tested with the Levene and then intra-subject analysis (hemiparetic hemithorax and healthy hemithorax) and inter-group analysis (experimental group and control group) by paired and non-paired Student t tests and Pearson correlation. In intra-subject comparison was observed less activation (p <0.01) of the sternocleidomastoid muscle, scalene and diaphragm paretic side in both sexes - for the Threshold ® incremental test (15, 30, 45 and 60% of the MIP) and during maximal inspiratory pressure (MIP). In inter-group comparison, there was reduced activity in the diaphragm and the scalene, in hemiparetics males and females, respectivelly, during the same test. Our results demonstrate the existence of reduced electromyographic activity of inspiratory muscles in hemiparetics, including changes between different genders and suggests the need of further studies to assess the effects of specific training of inspiratory muscles.
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Background: Down syndrome (DS) is a genetic alteration characterized by being a nonprogressive congenital encephalopathy. Children with DS have hypotonia and developmental delays that interfere in the movement`s acquisition for these children. Objective: Analyze the effects of treadmill inclination on angle and spatiotemporal gait characteristics of these individuals. Methodology: We studied 23 subjects of both sexes, with ages ranged between 05 and 11 years, they presented ability to walk on level 5 classified according to the Functional Ambulation Category (FAC). Initially held a subjective evaluation of balance through a questionnaire (Berg Balance Scale-BBS) then the kinematic gait analysis was realized on a treadmill first, without inclination and then, with inclination of 10%, using the motion system analysis Qualisys System. Data analysis was done using BioStat 5.0 attributing significance level of 5%. Normality of data was verified using D'Agostino test and later was applied paired t-test to compare data in two experimental conditions. Results: There was a statistically significant difference in the spatiotemporal variables: reduction in the cadence (from 108.92 ± 39.07 to 99.11 ± 27.51, p <0.04), increase in cycle time (from 1.24 ± 0.27 to 1.36 ± 0.34, p = 0.03 ) and increase in time to take stock (from 0.77 ± 0.15 to 0.82 ± 0.18, p <0.001). Angular variables that showed statistically significant increasing were: the hip in the initial contact (12.23 ± 4.63 to 18.49 ± 5.17, p <0.0001) and max. flexion in balance (12.96±4:32 to 19.50 ± 4.51, p <0.0001 ), knee in the initial contact (15.59 to ± 6.71 to 21.63 ± 6.48, p <0.0001), the ankle in the initial contact (-2.79 ± 9.8 to 2.25 ± 8.79, p <0.0001), max dorsiflexion in stance (4.41 ± 10.07 to 7.13 ± 11.58, p <0.0009), maximum plantar flexion in the pre-assessment of the ankle joint (increase of -6.33 ± 8.77 to -2.69 ± 8.62, p <0.0004).Conclusions: The inclination acts in a positive way for angular and spatiotemporal features gait of children with Down syndrome, demonstrating possible benefit of using this surface in the gait rehabilitation of children with Down Syndrome
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I ntroduction: The assessment of respiratory muscle strength is important in the diagnosis and monitoring of the respiratory muscles weakness of respiratory and neuromuscular diseases. However, there are still no studies that provide predictive equations and reference values for maximal respiratory pressures for children in our population. Aim: The purpose of this study was to propose predictive equations for maximal respiratory pressures in healthy school children. Method: This is an observational cross-sectional study. 144 healthy children were assessed. They were students from public and private schools in the city of Natal /RN (63 boys and 81 girls), subdivided in age groups of 7-8 and 9-11 years. The students presented the BMI, for age and sex, between 5 and 85 percentile. Maximal respiratory pressures were measured with the digital manometer MVD300 (Globalmed ®). The maximal inspiratory pressure (MIP) and maximal expiratory pressures (MEP) were measured from residual volume and total lung capacity, respectively. The data were analyzed using the SPSS Statistics 15.0 software (Statistical Package for Social Science) by assigning the significance level of 5%. Descriptive analysis was expressed as mean and standard deviation. T'Student test was used for unpaired comparison of averages of the variables. The comparison of measurements obtained with the predicted values in previous studies was performed using the paired t'Student test. The Pearson correlation test was used to verify the correlation of MRP's with the independent variables (age, sex, weight and height). For the equations analysis the stepwise linear regression was used. Results: By analyzing the data, we observed that in the age range studied MIP was significantly higher in boys. The MEP did not differ between boys and girls aged 7 to 8 years, the reverse occurred in the age between 9 and 11 years. The boys had a significant increase in respiratory muscle strength with advancing age. Regardless sex and age, MEP was always higher than the MIP. The reference values found in this study are similar to a sample of Spanish and Canadian children. The two models proposed in previous studies with children from other countries were not able to consistently predict the values observed in this studied population. The variables sex, age and weight correlated with MIP, whereas the MEP was also correlated with height. However, in the regression models proposed in this study, only gender and age were kept exerting influence on the variability of maximal inspiratory and expiratory pressures. Conclusion: This study provides reference values, lower limits of normality and proposes two models that allow predicting, through the independent variables, sex and age, the value of maximal static respiratory pressures in healthy children aged between 7 and 11 years old
Desempenho motor de pacientes com acidente vascular cerebral em um jogo baseado em realidade virtual
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The Cerebral Vascular Accident (CVA) is the leading cause of motor disability in adults and elderly and that is why it still needs effective interventions that contribute to motor recovery. Objective: This study was aimed to evaluate the performance of stroke patients in chronic stage using a virtual reality game. Method: 20 patients (10 with injury to the left and 10 to the right side), right-handed, average age 50.6 ± 9.2 years, and 20 healthy subjects with average age of 50.9 ± 8.8, also right-handed participated. The patients had a motor (Fugl-Meyer) and muscle tone assessment (Ashworth). All participants made a kinematic evaluation of the drinking water activity and then underwent training with the table tennis game on XBOX 360 Kinect®, 2 sets of 10 attempts for 45 seconds, 15 minutes rest between sets, giving a total of 30 minutes session. After training the subjects underwent another kinematic evaluation. The patients trained with the right and left hemiparect upper limb and the healthy ones with the right and left upper limb. Data were analyzed by ANOVA, t Student test and Pearson correlation. Results: There was significant difference in the number of hits between the patients and healthy groups, in which patients had a lower performance in all the attempts (p = 0.008), this performance was related to a higher level of spasticity (r = - 0.44, p = 0.04) and greater motor impairment (r = 0.59, p = 0.001). After training, patients with left hemiparesis had improved shoulder and elbow angles during the activity of drinking water, approaching the pattern of motion of the left arm of healthy subjects (p < 0.05), especially when returning the glass to the table, and patients with right hemiparesis did not obtain improved pattern of movement (p > 0.05). Conclusion: The stroke patients improved their performance over the game attempts, however, only patients with left hemiparesis were able to increase the angle of the shoulder and elbow during the functional activity execution, better responding to virtual reality game, which should be taken into consideration in motor rehabilitation
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Stroke is a neurological dysfunction of vascular origin that causes physical impairments and disabilities. Brazil leads the statistics stroke mortality among Latin American countries, demonstrating still be a neglected disease in this country. The incidence is related to risk factors and still is great misinformation in our country about stroke, treatment and prophylaxis. The aim of this study was to assess the degree of knowledge about stroke and patients need to use educational booklet for physiotherapy. The sample consisted of 53 patients, 22 females and 31 males, mean age 56.2 ± 10.9 years. Patients were evaluated by completing questionnaires, observing the socio-demographic and clinical aspects, neurological assessment, functional assessment, knowledge of pathology and presenting educational booklet. The data were analyzed using the chi-square test. According to the results, it was observed that the patients had not enough knowledge about the terminology, complications and warning signs of stroke, were not aware and did not perform the proper positioning of the limb and transfers, however, were aware and performed the stretching maneuvers. This reveals the need to implement policies that lead to information about stroke population. Following discharge from outpatient physical therapy using educational booklets with guidelines on positioning, stretching exercises and transfer is important in functional rehabilitation and encouraging independence of the individual affected by stroke
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The association of Virtual Reality (VR) to clinical practice has become common in the recent years, showing to be an additional tool on health care, especially for elderly. Its use has been related to higher therapeutic adhesion levels and well being sensation. Such emotional based aspects are often observed by subjective tools of relative validity. This study analyzed the immediate effects of varied VR contexts balance training over emotional behavior, which was observed under peaks of maximum expression of EEG waves. Methodology: 40 individuals, divided in two groups, both gender, 20 young and 20 elderly, were submitted to a 60 minutes intervention, including balance training under VR. The first 25 minutes referred to initial evaluation, general orientation and cognitive assessment by the use of Mini Mental. The next ten minutes were designated to the avatar creation and tutorial video presentation. Through the following 20 minutes, the individuals from both groups were exposed to the exact same sequence of games under virtual contexts, while submitted to electroencephalography by Emotiv EPOC® focusing Adhesion, Frustration and Meditation states. The virtual interface was provided by the Nintendo® game, Wii Fit Plus, with the scenarios Balance Bubble (1), Penguin (2), Soccer (3), Tight Rope (4) and Table Tilt (5). Finally, a questionnaire of personal impressions was applied on the 5 minutes left. Results: data collected showed 64,7% of individuals from both groups presented higher concentration of adhesion peaks on Balance Bubble game. Both groups also presented similar behavior regarding meditation state, with marks close to 40%, each, on the same game, Table Tilt. There was divergence related to the frustration state, being the maximum concentration for the young group on the Soccer game (29,3%), whilst the elderly group referred highest marks to Tight Rope game (35,2%). Conclusion: Findings suggest virtual contexts can be favorable to adhesion and meditation emotional patterns induction, regardless age and for both sexes, whilst frustration seems to be more related to cognitive motor affordance, likely to be influenced by age. This information is relevant and contributes to the orientation for the best choice of games applied in clinical practice, as for other studies regarding this topic
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O estudo teve como objetivo avaliar o desenvolvimento de crianças indicadas por suas professoras na Educação Infantil (EI) como apresentando problemas de comportamento (Grupo IPC) ou comportamentos socialmente habilidosos (Grupo ICSH), em dois momentos: quando tinham cinco anos e quando tinham 10 anos. Participaram 48 professoras de 62 crianças de ambos os sexos. Os instrumentos utilizados foram Questionário de Respostas Socialmente Habilidosas para Professores e Escala Comportamental Infantil B. Os resultados indicaram diminuição dos problemas de comportamento e aumento dos comportamentos socialmente adequados no grupo IPC; os grupos eram bastante diferentes na primeira avaliação, quando na EI, mas as mudanças se atenuaram no ensino fundamental. em ambas as avaliações, as crianças do Grupo ICSH foram avaliadas como mais habilidosas.