Effects of a Preventive Intervention of Emotional Regulation in the School Context / Efeitos de uma Intervenção Preventiva em Regulação Emocional no Contexto Escolar

Abstract In early childhood education, socio-emotional learning is not always considered with appropriate planning nor based on scientific evidence. Aiming to analyze impact of an Emotional Regulation (ER) Intervention in school achievement and social skills (SS), fifty-five children from public schools were evaluated by Raven's Coloured Progressive Matrices (CPM), School Achievement Test (TDE) and Social Skills Rating System (SSRS-BR). After nine 50-minute meetings addressing ER strategies, evaluation of SS by the teacher indicated improvement in all aspects of SS in Intervention Group (IG) and worsening of the self-control in Comparison Group (CG). Self-evaluation of SS showed that IG overcame the initial difference in assertiveness and problem avoidance. Results suggest that ER programs can bring benefits to the development of SS.

Resumo Aprendizagem socioemocional nem sempre é contemplada, com devido planejamento e embasamento científico, na educação infantil. Avaliou-se impacto de intervenção de Regulação Emocional (RE) no desempenho escolar e Habilidades Sociais (HS) de 55 crianças de escolas públicas, utilizando-se Matrizes Progressivas Coloridas de Raven (CPM), Teste de Desempenho Escolar e Sistema de Avaliação de Habilidades Sociais (SSRS-BR).Após nove encontros de 50 minutos abordando estratégias de RE, avaliação de HS pelo professor indicou melhora em todos os aspectos de HS noGrupo Intervenção (GI) e piora no autocontrole no GrupoComparação (GC). Autoavaliação de HS mostrou que GI superou diferença inicial na assertividadee evitação de problemas. Os resultados sugerem que programas de RE podem trazer benefícios para o desenvolvimento das HS.

Adverse drug reactions in children: a ten-year review of reporting to the Portuguese Pharmacovigilance System.

OBJECTIVE: Adverse drug reactions (ADR) are a public health problem. They cause significant morbidity, mortality and health costs. Less is known about pediatric ADR. Our goal was to characterize a pediatric case series of ADR reported to the Portuguese Pharmacovigilance System (PPS) during the past 10 years. RESEARCH DESIGN AND METHODS: Retrospective analysis of ADR reports concerning patients till 17 years old received by the PPS between 2003 and 2012. We evaluated patients' demographic data and involved drugs, as well as characteristics and seriousness of reactions, stratified by age groups. RESULTS: We found 1742 reports (50% females) corresponding to 9.7% of the total received. The age of the patients varied from 0 to 17 years (median: 5 years, interquartile range: 10.6), with 566 cases (32%) occurring in patients younger than 2y. Among the 1195 serious cases, 31% (370) episodes led to hospitalization. In 32 cases (2%) there was a fatal outcome. Most of the ADR reported referred to general disorders and administration site conditions, followed by skin and subcutaneous tissue reactions. Vaccines were the most represented group (42%) followed by antibacterials for systemic use (17%). CONCLUSIONS: Pediatric ADR represents about 10% of the reports received by the PPS. Most ADR were considered serious. Major findings varied according to age groups.

Hepatotoxicity related to agomelatine and other new antidepressants: a case/noncase approach with information from the Portuguese, French, Spanish, and Italian pharmacovigilance systems.

Antidepressants have been associated with a low incidence of idiosyncratic hepatic injury. Some of them, nefazodone or amineptine, were observed to induce severe hepatic injury and withdrawn from the market. Recently, some cases of this severe condition have been reported in association with agomelatine use. Therefore, the objective of this study is to learn the risk of hepatic damage with agomelatine as compared with other new antidepressants. We took data from the Spanish, French, Italian, and Portuguese pharmacovigilance system databases. A case/noncase approach to assess the strength of the association between whichever antidepressant and hepatotoxicity was performed; cases were defined as reports of hepatotoxicity; noncases were reports of all reactions other than hepatotoxicity. Exposure was the recording of a new antidepressant in a report, whether or not it was suspected of causing the reaction. During the period surveyed, 3300 cases of hepatotoxicity were collected for the antidepressants assessed. They represent 10.3% of all cases collected for these drugs; the corresponding figure for all drugs was 6.0%. Meanwhile, 63 cases of hepatotoxicity associated with agomelatine were collected since its introduction until the end of the period studied; they account for a percentage of 14.6. Agomelatine was statistically associated with hepatotoxicity in Spain [reporting odds ratio (ROR), 4.9 (95% confidence interval [CI], 2.4-9.7)], France (ROR, 2.4 [95% CI, 1.5-3.7]), and Italy (ROR, 5.1 [95% CI, 1.7-14.0]). Current results support the idea of agomelatine to be related to a higher hepatotoxicity risk. Physicians should consider early discontinuation if the condition is suspected; health authorities should promptly explore the best regulatory actions to be taken.

O desenvolvimento da consciência fonológica em crianças com Síndrome de Down pode facilitar a alfabetização e contribuir para a inclusão no ensino regular? / Can the development of phonological awareness in children with Down Syndrome facilitate literacy and contribute to the inclusion in mainstream education?

As leis educacionais asseguram o direito das crianças ao ensino fundamental a partir dos seis anos, propiciando a elas a exposição antecipada a estratégias pedagógicas que visam à alfabetização. A inclusão escolar de crianças com Síndrome de Down (SD) acontece já na educação infantil e se torna cada vez mais frequente, possibilitando oportunidades ímpares para o desenvolvimento cognitivo dessas, o que inclui a alfabetização. A diversidade de aprendizes com necessidades educacionais individuais, sem o devido apoio de uma equipe interdisciplinar, dificulta a aquisição da leitura e escrita de forma igualitária. O desconhecimento, por parte dos educadores, dos pré-requisitos cognitivos mínimos necessários à alfabetização, também contribui para o seu insucesso. Um desses pré-requisitos é a consciência fonológica, pouco trabalhada intencionalmente já na educação infantil. Estratégias que visam orientar educadores no desenvolvimento objetivo da consciência fonológica em crianças com SD podem facilitar a alfabetização e contribuir para a inclusão escolar. Ou será possível incluir pedagogicamente essa população sem que ocorram adaptações curriculares e um trabalho interdisciplinar efetivo?.

There are laws that ensure the educational rights for children to basic education since they are six years-old, providing early exposure to teaching strategies aiming literacy. Educational inclusion of children with Down syndrome (DS) occurs in early childhood education and has become increasingly common, providing unique opportunities for cognitive development, including literacy. The diversity of learners with individual educational needs, without proper support from an interdisciplinary team, hinders the acquisition of reading and writing equally. The educators' misunderstanding about minimum prerequisites necessary for literacy also contributes to their failure. One of these prerequisites is phonological awareness, ability that usually is not intentionally developed in early childhood education. Strategies that aim to guide educators in the objective development of phonological awareness in children with Down syndrome may contribute to the educational inclusion. Or would it be possible to educationally include this population without any curricular adaptations or an interdisciplinary effective work?.

Perception of discomfort during orthodontic treatment with tongue spurs.

AIM: To evaluate patients' and parents' reactions to the orthodontic treatment of open bite patients with a mandibular lingual arch and spurs (MASP) and to compare any changes in anxiety and discomfort during treatment in different age groups and sexes. METHODS: Seventy-two patients completed a baseline questionnaire to assess their levels of discomfort and reaction to this appliance. The patients were divided into two groups: Group 1 consisted of 33 patients up to 14 years of age, and group 2 comprised 39 patients 15 years of age and older. A random group of 72 parents composed a special group. Parents' reactions were assessed through analysis of data gathered from an additional questionnaire with specific questions on their children's reactions. RESULTS: Ninety-eight percent of the patients accepted treatment with an MASP. The discomfort time was up to 10 days in the majority of patients. The younger group and the female group seemed to show higher tolerance to an MASP. Speech and chewing impairments were the most common functional problems associated with an MASP. Seventy-six percent of subjects did not feel a lack of confidence when wearing an MASP. CONCLUSION: This treatment was well accepted by patients and parents. This positive result seems to be closely related to how informed they were. Speech and chewing impairments, the most common functional problems, were temporary.

Discurso médico e discurso pedagógico: interfaces e suas implicações para a prática pedagógica / Medical and pedagogic discourse: interfaces and implications for pedagogic practices

O estudo investigou os efeitos do discurso médico no processo de ensino-aprendizagem escolar, particularmente, como ele tem sido apropriado pelo corpo docente e os seus efeitos nas práticas pedagógicas dos educadores. Trata-se de um estudo qualitativo realizado ao longo do período letivo de 2008. Participaram do estudo 17 educadores que trabalham com crianças com paralisia cerebral, com idade entre 6 e 12 anos e acompanhadas pela equipe de reabilitação da Rede Sarah de Hospitais, em Belém. Foram realizadas entrevistas gravadas em áudio no início e no final do período letivo, seguindo o mesmo roteiro. Ao longo do ano, foram realizadas visitas escolares, pela equipe do Sarah, com intervalos de aproximadamente dois meses e com o objetivo de dialogar com os educadores e esclarecer sobre o diagnóstico da criança, seus potenciais, limites e adaptações que favorecessem o processo de inclusão e de aprendizagem. A análise dos dados iniciais revelou a inconsistência teórica dos educadores sobre os conceitos de inclusão e de paralisia cerebral. Indicou o desconhecimento sobre o diagnóstico da criança e a elaboração de práticas pedagógicas orientadas por discursos médicos baseados no senso comum. Ao final do processo, identificou-se que as percepções, as concepções, as práticas e o discurso pedagógico dos educadores haviam se modificado. Foram observadas reelaborações de ações pedagógicas considerando o diagnóstico, aspectos individuais e coletivos da aprendizagem, além dos limites e potenciais de cada criança. Constatou-se assim, o processo de subjetivação discursiva, como resultado da interlocução entre campos de saberes diferentes, no caso, Saúde e Educação, resultando em reelaboração do discurso e das práticas pedagógicas no processo de ensino-aprendizagem das crianças com paralisia cerebral.

This study investigated the effects of medical discourse in the teaching-learning process, particularly as it has been appropriated by educators in schools and its effects on these educators' pedagogical practices. The study in question is a qualitative study undertaken during the 2008 school year. Seventeen teachers participated in this study of children diagnosed with cerebral palsy, aged between 6 and 12 years old. The children were observed by the rehabilitation team of the Sarah Hospitals Network in Belém. Using the same guidelines, audio recorded interviews were conducted at the beginning and at the end of the school year. Over the year, there were school visits by Sarah staff, at two month intervals, approximately, in order to talk to the teachers regarding the children's diagnoses, their potentials and limitations, and possible adaptations that could facilitate their inclusion and learning processes. Analysis of the initial data has shown the theoretical inconsistency of educators concerning concepts of inclusion and cerebral palsy. In addition, the analysis pointed out that teachers lacked knowledge about the children's diagnoses; they seemed to prepare pedagogical practices according to medical discourse based on common sense. Changes in perceptions, concepts, practices and pedagogical discourse of the educators were observed at the end of the study. Renewed pedagogical strategies were observed that considered the child's diagnosis, as well as individual and group learning situations, besides the limitations and potential of each child. The study demonstrated that the process of discursive subjectification can come about as a result of exchanges between fields of knowledge, in this case, Health and Education, in order to redraft discourse as well as renewed elaboration of pedagogical practices in the teaching-learning process of children with cerebral palsy.