RESUMEN
La conciencia fonológica es un predictor importante del aprendizaje de la lectoescritura. Se han desarrollado y probado diferentes programas para su estimulación, sin embargo, el grado de variabilidad entre los métodos utilizados dificulta la comparación de resultados. Es necesaria una síntesis de la literatura para analizar la efectividad de programas de estimulación de la conciencia fonológica, que considere la variabilidad existente entre metodologías. Se planteó una revisión con los siguientes objetivos:1) sintetizar la literatura sobre estudios que investigan programas de estimulación de la conciencia fonológica en niños con desarrollo típico; 2) examinar la eficacia de dichos programas; 3) evaluar críticamente su metodología.Para esta investigación bibliográfica se utilizaron las siguientes bases de datos: Central, Medline, Pubmed, Scopus y Web of Knowledge. Diez artículos cumplieron con los criterios de elegibilidad establecidos y fueron incluidos en el presente estudio. En general, los resultados mostraron la efectividad de los programas de estimulación de conciencia fonológica utilizados. Sin embargo, la calidad metodológica es variable entre los estudios; esto incluye una falta de detalle en cuanto a los criterios de inclusión, capacitación limitada de los/las profesionales que llevaron a cabo los programas de CF, participación inconsistente de los padres y falta de seguimiento. Se discuten algunas pautas para futuras investigaciones con el objetivo de mejorar la calidad metodológica de los estudios y reducir el riesgo de sesgo.
Phonological awareness is a strong predictor of reading and writing skills development. Several programs have been developed and tested for the stimulation of phonological awareness, but the degree of variation among them makes it difficult to compare the different methods. A synthesis of the literature on phonological awareness stimulation programs is needed to examine the effectiveness of PA programs while considering the variability that exists between the methodologies used. This systematic review aimedto 1) synthesize the literature on PA stimulation programs in typically developing children; 2) examine the effectiveness of PA programs; 3) critically appraise the methodology of PA stimulation programs. Central, Medline, Pubmed, Scopus, and Web of Knowledge were used to conduct an extensive literature search. A total of 10 articles met the eligibility criteria and were included in the present study. Results showed that, in general, the phonological awareness stimulation programs carried out in the analyzed research were effective. However, the quality of the methodology varied significantly across studies, showing in some cases a lack of detail in the inclusion criteria, limited training of the professionals who carried out the PA programs, an inconsistency in parent involvement, and a lack of follow-up. Guidelines for future research are discussed to enhance the methodological quality of this line of research and reduce the risk of bias.
Asunto(s)
Humanos , Preescolar , Concienciación , FonéticaRESUMEN
Objetivo: Verificar a presença do farmacêutico nas Unidades Básicas de Saúde, identificando as classes terapêuticas mais dispensadas e suas condições de armazenamento. Métodos: Estudo de campo, com caráter descritivo e abordagem qualiquantitativa, utilizando Graphpad Prism®, versão 5.03, e o Microsoft Excel 2010. Resultados: O farmacêutico estava ausente nas 96 Unidades Básicas de Saúde estudadas. Por meio de checklist aplicado em 18 Unidades Básicas de Saúde, 8 tinham algum tipo de fonte de calor; 4, umidade; 14 não controlavam temperatura para produtos termolábeis; 8 tinham medicamentos próximos do piso, da parede e do teto; 1 tinha medicamentos sujeitos a controle especial fora de um armário com chave. Todas as Unidades Básicas de Saúde apresentaram descarte correto das medicações vencidas. As classes medicamentosas mais dispensadas foram anti-inflamatórios não esteroides, anti-hipertensivos, antidiabéticos, anticoncepcionais, anti-helmínticos, antibióticos, antifúngicos, inibidores da bomba de prótons e psicotrópicos. Conclusão: A ausência do farmacêutico nas Unidades Básicas de Saúde estudadas possivelmente foi responsável pelas inconformidades nas condições de armazenamento dos medicamentos, regulamentada inclusive por Resolução da Diretoria Colegiada. As classes terapêuticas dispensadas estavam de acordo com o padrão da Atenção Primária, porém a não participação do farmacêutico pode gerar riscos aos pacientes. As autoridades devem se conscientizar da importância da participação desse profissional no ciclo primário de saúde. (AU)
Objective: To verify the availability of pharmacists in the Basic Health Units, and to identify the most dispensed types of drugs, and their storage conditions. Methods: This is a descriptive field study with a qualitative/quantitative approach, using GraphpadPrism ® version 5.03 and Microsoft Excel 2010. Results: The pharmacist was absent in 96 Basic Health Units studied. A checklist applied to the 18 Basic Health Units showed that 8 of them had heat sources; 4, humidity; 14 lacked control of temperature for thermolabile products; 8 kept drugs near the floor, wall, and ceiling; 1 kept prescription drugs out of lockable cabinets; all of them presented correct disposal of expired medications. The most dispensed drug types were: non-steroidal anti-inflammatory drugs (NSAIDs), antihypertensives, antidiabetic drugs, contraceptives, anthelmintics, antibiotics, antifungals, proton pump inhibitors, and psychotropics. Conclusion: The absence of pharmacists in the Basic Health Units studied was possibly responsible for nonconformities in the drugs maintenance conditions, which are regulated by an ANVISA's Board Resolution. The dispensed therapeutic classes are in accordance with the Primary Care standard, but the absence of a pharmacist can lead to risks to the patients. The authorities shall be aware of the importance of the participation of this professional in the primary health cycle. (AU)