Embu Das Artes Research Articles

College Students’ Preference and Information Comprehension of Different Forms of Diabetes Education Materials Under Different Reading Scenarios

ABSTRACT Background There is a lack of research on diabetes education for healthy college students. Purpose To examine the effect of three different forms of diabetes education materials on college students’ information comprehension under focused and fragmented reading scenarios. Methods A total of 300 college students divided into six groups were enrolled in this study with a response rate of 91.45%, with each group representing different reading scenarios with different forms of education materials (text, icon, and illustration). A questionnaire survey was conducted to assess the understanding (information perception and memory retention) of participants. Results There was similar influence of different forms of education materials on college students’ perception and memory retention in the context of focused reading. In contrast, under the fragmented reading scenario, materials with illustrations were the most effective. Discussion The form of education materials is crucial for information comprehension of college students in the scenario of fragmented reading rather than focused reading. Translation to Health Education Practice It is necessary to design visually appealing health education materials to promote diabetes education among college students.

Teacher-Preschool Student Relationships and Their Associations with Child Mental Health Problems

ABSTRACT Background In low- and middle-income countries, despite increasing early childhood education opportunities, research on quality and monitoring systems remains limited. This includes a lack of validated tools for assessing teacher-student relationships, which are crucial for child development but often characterized by conflict and low closeness in poor settings. Purpose This study aims to validate the Student-Teacher Relationship Scale – Short Form (STRS-SF) in Brazilian preschools and examine its correlation with socioemotional development and mental health symptoms in children aged 4 to 5. Methods Conducted in public preschools in Embu das Artes, the study involved 489 children and used the STRS-SF to assess teacher-student relationships and their impact on children’s emotional and behavioral symptoms through univariate logistic regression analysis. Results Confirmatory factor analysis confirmed the scale’s construct validity for the “closeness” and “conflict” dimensions, with factor loadings over 0.40. Significant associations were found between the conflict dimension and externalizing symptoms and delays in socioemotional development among preschoolers. Discussion The findings validate the STRS-SF as an effective tool for evaluating teacher-student relationships in early education settings. Translation to Health Education Practice Regular assessment of teacher-student relationships is essential for early detection and intervention in developmental delays, mental health issues, and social performance challenges.

Internalizing problems can differ in boys and girls since early childhood: Findings from the Child Behavioral Checklist 1.5-5 (CBCL 1.5-5).

Globally, internalizing problems disproportionately affect females in adolescence and adulthood, with limited research at earlier ages due to a focus on disruptive behaviors. Our study addresses this gap by exploring the structure of internalizing problems and gender differences in Brazilian preschoolers. We analyzed data from the Child Behavioral Checklist 1.5-5 in the Preschool Mental Health Study, involving 1,292 children aged 4 to 5 in Embu das Artes, São Paulo, Brazil. Confirmatory factor analysis and mean comparisons explored internalizing problems and gender variations. A two-factor model best fit both internalizing and externalizing problems.The hierarchical model with four factors (Emotionally Reactive, Anxiety/Depression, Somatic Complaints, and Withdrawn) best fit internalizing problems, achieving partial invariance between boys and girls. Boys scored higher in Withdrawn Syndrome, while girls scored higher in Somatic Complaints Syndrome. Preschoolers' internalizing problems warrant attention beyond their link to externalizing problems. While the overall construct is similar in boys and girls, divergent syndrome scores indicate potential distinct risk patterns requiring further exploration.

Isolation, typing, and drug susceptibility of Leishmania (Leishmania) infantum isolates from dogs of the municipality of Embu das Artes, an endemic region for canine leishmaniasis in Brazil.

The parasitic protozoa Leishmania (Leishmania) infantum is the etiological agent of human visceral leishmaniasis and canine leishmaniasis in South America, where Brazil is the most affected country. This zoonotic disease is transmitted by the bite of an infected phlebotomine sand fly and dogs constitute the main domestic reservoir of the parasite. In this study, we screened 2348 dogs of the municipality of Embu das Artes, Brazil, for antibodies against the parasite. Prevalence for canine leishmaniasis seropositivity was 2.81%, as assessed using a Dual-Path Platform rapid test for canine leishmaniasis. Twenty-five seropositive dogs were euthanized for parasite isolation and 14 isolates were successful obtained. Nucleotide sequencing of the internal transcribed spacer confirmed the isolates to be L. (L.) infantum, and very low sequence variability was observed among them. The in vitro susceptibility to miltefosine and paromomycin was assessed and moderate variation in paromomycin susceptibility was found among the isolates in the promastigote and intracellular amastigote stages. On the other hand, in vitro susceptibility to miltefosine of these isolates was homogenous, particularly in the amastigote stage (EC50 values from 0.69 to 2.07μM). In addition, the miltefosine sensitivity locus was deleted in all the isolates, which does not corroborate the hypothesis that the absence of this locus is correlated with a low in vitro susceptibility. Our findings confirm that the municipality of Embu das Artes is endemic for canine leishmaniasis and that isolates from this region are susceptible to paromomycin and miltefosine, indicating the potential of these drugs to be clinically evaluated in the treatment of human visceral leishmaniasis in Brazil.

Transcultural adaptation and psychometric properties of the International Development and Early Learning Assessment (IDELA) in Brazilian pre-school children

Early childhood is a sensitive period for development, and it is important to use psychometrically sound instruments to assess the child's developmental abilities. The International Development and Early Learning Assessment (IDELA) represents an innovative, feasible and low-cost assessment tool for preschool children that evaluates motor development, pre-numeracy, pre-literacy, and socioemotional development. These areas of development represent “key” skills for early development and school readiness. The objectives of this study were to translate the IDELA to Brazilian Portuguese, to conduct its cultural adaptation to the Brazilian population, to analyze its content validity, to assess its inter-rater reliability, to analyze the internal consistency of its sub-domains and to investigate associations between the child's IDELA scores and sociodemographic characteristics of the family. This was a descriptive, cross-sectional study, in which a sample of 565 preschool children were assessed with the IDELA in the city of Embu das Artes, São Paulo. Results indicated that the IDELA was successfully translated and culturally adapted to the Brazilian population, presenting adequate content validity, good internal consistency of its sub-domains and very high inter-rater reliability. Among the evaluated children, the girls' mean scores were higher than the boys' mean scores; 5-year-old children had higher scores than 4-year-old children; a positive correlation was observed between maternal education and the children's mean scores in the total IDELA, the pre-mathematics and the socioemotional subdomains. In conclusion, the Brazilian version of the IDELA proved to be feasible, adequate and reliable to assess early childhood development and school readiness of preschool age children in Brazil. Future studies could use the IDELA to provide relevant data about the children's development and school readiness in other Brazilian regions that will be useful in the planning of public health and education policies to improve children's integral development and their academic achievement.

Maternal Pregnancy Intention and Developmental Outcomes in Brazilian Preschool-Aged Children.

This study aims to characterize the association between maternal pregnancy intention and socioemotional developmental outcomes in a Brazilian sample of preschool-aged children. Data from children aged 4 to 5 years and their primary caregivers in Embu das Artes, a Brazilian municipality in the state of São Paulo, were collected in 2016. Maternal pregnancy intention was defined as intended or unintended, which was then further stratified as mistimed or unwanted. Outcomes included socioemotional developmental delay, internalizing and externalizing behaviors, and school readiness. We estimated risk ratios (RRs) for unadjusted and inverse-probability-weighted regression adjustment (IPWRA) analyses using 2-level (intended vs unintended) and 3-level (intended vs mistimed vs unwanted) exposure definitions. Of 1,034 total mothers, 40.7% reported their pregnancy as intended, 46.0% as mistimed, and 13.4% as unwanted. In both unadjusted and IPWRA analyses comparing intended and unintended pregnancies, all associations failed to reach statistical significance. In the IPWRA analysis using the 3-level exposure definition, unwanted pregnancies were associated with higher risk of socioemotional developmental delay (RR = 1.14; 95% confidence interval [CI], 1.01-1.28) and co-occurring internalizing and externalizing behaviors (RR = 1.11, 95% CI, 1.00-1.22), compared with intended pregnancies. There was higher risk of poor child outcomes among unwanted compared with intended pregnancies, whereas mistimed pregnancies were not associated with poor outcomes. Further research using standardized definitions of pregnancy intention along with targeted interventions that increase access to family planning services and counseling for parents of children born after unintended pregnancies is needed.

An epidemiological study of childhood development in an urban setting in Brazil.

Objective:Mental illness is an important public health concern, often starting early in life and particularly impacting children from low-and middle-income countries. Our aims were to 1) determine, in a representative sample of public preschool 4- to 5-year old children in Brazil, the prevalence of internalizing and externalizing disorders and socioemotional development delays; and 2) to identify modifiable risk factors associated with mental, behavioral, or developmental disorders (MBDD), such as microsystem (i.e., parent-child relationship), mesosystem (social support), and macrosystem contextual factors (neighborhood disadvantage).Methods:A random sample of public preschool children was recruited in the city of Embu das Artes (São Paulo metropolitan area) (n=1,292 from 30 public preschools). Six-month prevalence of MBDD was measured using the Child Behavior Checklist (CBCL) and the Ages and Stages Questionnaires: Social-Emotional (ASQ:SE).Results:Six-month prevalence estimates were 25.4% for internalizing disorders, 12.1% for externalizing disorders, and 30.3% for socioemotional development delays. MBDD prevalence estimates were higher in families with stressful relationships and parental depression or anxiety, and in families with lower social capital.Conclusion:At least 25% of preschool children living in an urban area in Brazil presented a mental health disorder. These mental disorder were associated with modifiable factors such as stressful family relationships and lower social capital. Prevention and intervention measures such as family therapy are needed to decrease such high prevalence.

Detection of Pintomyia fischeri (Diptera: Psychodidae) With Leishmania infantum (Trypanosomatida: Trypanosomatidae) Promastigotes in a Focus of Visceral Leishmaniasis in Brazil.

Visceral leishmaniasis is spreading in Brazil where the main vector of its agent, Leishmania infantum Nicolle, 1908, is the Lutzomyia longipalpis (Lutz & Neiva, 1912) species complex (Diptera: Psychodidae: Phlebotominae), on which many of the activities of the visceral leishmaniasis surveillance program are based. However, there are areas where canine, and/or human cases have been occurring without the presence of this species complex as in the western part of the Greater São Paulo Metropolitan region, where Embu das Artes municipality is situated. In this area, Pintomyia fischeri (Pinto, 1926) has been implicated as potential vector of Le. infantum but so far its natural infection with this parasite has not yet been ascertained. Therefore, the present study sought to investigate the natural infection in sand flies of a CVL focus in Embu das Artes. The sand fly collections were undertaken with Shannon and CDC traps, monthly, between 1800 and 2100 hours from November 2018 to October 2019, inclusive. A total of 951 sand flies (457 males and 494 females), belonging to 10 species, were captured. Pintomyia fischeri was the predominant species (89.5%); of which 426 females were dissected and one of them (0.23%) was found to be harboring flagellates in its midgut. A sample of these flagellates was isolated in culture and characterized by a 234 base pair fragment of Leishmania heat-shock protein 70 gene (hsp70) and restriction fragment length polymorphism with Hae III restriction enzyme as Le. infantum. This finding reinforces previous evidence of Pi. fischeri as a vector of Le. infantum in foci of visceral leishmaniasis and highlights the importance of vector surveillance in areas where this species occurs.

Effectiveness of an educational manual to promote infant feeding practices in primary health care

Abstract Background Breastfeeding and adequate complementary feeding in the first years of life provide short- and long-term benefits for child health. However, breastfeeding and adequate complementary feeding prevalence's are low. In Brazil, the Estratégia Amamenta e Alimenta Brasil (EAAB) aims to improve the quality of the assistance provided by primary healthcare teams to ultimately improving infant feeding practices in the Brazilian population. In primary healthcare units, continuing education in breastfeeding and complementary feeding is facilitated by EAAB tutors. A Manual to Support EAAB Tutor (the Manual) was developed following a problem-based learning methodology. This study aimed to evaluate the effectiveness of using the Manual by analyzing exclusive breastfeeding and complementary feeding indicators. Methods A before and after study was conducted at primary healthcare units in Embu das Artes, Brazil. The intervention consisted in the use of the Manual by EAAB tutors who performed some comprehensive training activities with healthcare teams, in a period of 8 months. Subjects consisted of mothers of infants under one year of age attended at primary healthcare units. 561 mothers before and 598 mothers after intervention were interviewed about breastfeeding and complementary feeding practices. Multivariate analysis was performed using Poisson multilevel regression to test the hypothesis. Results Lack of minimum food diversity (before 62.9%; after 50.3%) and lack of food adequacy (before 77.5%; after 63.3%) decreased significantly. Regression analysis confirmed that infants after the intervention had lower prevalence of inadequacy of complementary feeding. While the intervention did not show significant association with exclusive breastfeeding, it showed association with the improvement of complementary feeding practices. Conclusions The Manual is a continuing educational strategy that improved complementary feeding practices in primary health care. Key messages The use of a continuing education strategy grounded on a problem-based learning methodology was effective to produce improvements in complementary feeding practices in primary health care. The 'Manual to Support EAAB Tutor' consists of a tool that has the potential to be adapted for different contexts and easy to disclose to all EAAB tutors in the country.

Maternal cigarette use during pregnancy and school readiness: An analysis of preschool age children in São Paulo, Brazil

BackgroundBarriers to early childhood development (ECD) are a global concern. Limited research exists on prenatal smoking and ECD in vulnerable populations, especially as it relates to school readiness (SR). AimsTo examine how maternal cigarette use during pregnancy is associated with SR in a sample of Brazilian preschool-age children. Study designWe used the Brazilian Preschool Mental Health Study, a cross-sectional, epidemiological study of preschool-age children in Embu das Artes, São Paulo. SR was assessed using the Engle Scale of Child Development (ESCD). We restricted analyses to biological mothers, who represented 81.9% (n = 591) of the total 722 with ESCD data. Logistic regression models, adjusting for birth and child characteristics (year of preschool, sex, race, history of head trauma, coma, convulsions or epilepsy), sociodemographic factors and school environment, were used to estimate odds ratios and 95% confidence intervals. ResultsPrenatal smoking was negatively associated with SR. Children of mothers who smoked during pregnancy were more likely to be in the lowest ESCD quartile (aOR = 1.26, 95%CI: [1.02–1.55]) compared to those of non-smoking mothers, and each cigarette resulted in additional risk (aOR = 1.03, 95%CI:[1.01–1.05]). Children of heavy smokers had worse ESCD scores compared to children of non-smokers (aOR = 1.69, 95%CI:[1.18–2.44]), as well as when compared to children of moderate and non-smokers combined (aOR = 1.77, 95%CI:[1.22–2.57]). This relationship was not seen when comparing children of moderate smokers to children of non-smokers. Inferences were robust when examining very heavy smoking. ConclusionMaternal tobacco use during pregnancy may affect child SR. Additional studies in other populations are needed to corroborate these results.

A cross-sectional study assessing the pharyngeal carriage of Neisseria meningitidis in subjects aged 1–24 years in the city of Embu das Artes, São Paulo, Brazil

Meningococcal carriage is a prerequisite for invasive infection. This cross-sectional study assessed the pharyngeal carriage prevalence in healthy subjects aged 1–24 years in Embu das Artes city, São Paulo, Brazil. Pharyngeal swabs were examined for the presence of Neisseria meningitidis. The isolates were tested for different serogroups using agglutination and polymerase chain reaction. A logistic regression model assessed any independent association between Neisseria meningitidis carriage and various risk factors. A total of 87/967 subjects (9%, 95% Confidence Interval (CI): 7.3–11.0) tested positive for N. meningitidis: 6.2% (95% CI: 3.8–9.4) in 1–4 years, 8.5% (95% CI: 5.1–13.0) in 5–9 years, 12.5% (95% CI: 7.8–18.6) in 10–14 years, 12.6% (95% CI: 7.4–19.7) in 15–19 years and 9% (95% CI: 4.9–14.9) in 20–24 years age groups. Highest carriage prevalence was observed in adolescents 10–19 years old. Serogroup C was predominant (18.4%) followed by serogroup B (12.6%). The 15–19 years age group showed a significant association between number of household members and carriers of N. meningitidis. This cross-sectional study is the first in Brazil to evaluate meningococcal carriage prevalence and associated factors in a wide age range.

CONHECIMENTOS E OPINIÕES DE ADOLESCENTES SOBRE ABORTAMENTO

Introduction: The topic of abortion still allows multiple interpretations and represents diverse interests for social institutions, among which there is no consensus on the issue, even though it is considered a serious public health problem. Objective: To identify the knowledge and opinion of high school adolescents about abortion, observing which variables change according to the higher level of schooling. Method: This is a descriptive study involving 302 adolescents of both sexes, between the ages of 14 and 20 years old, who attended high school in three state schools in the city of Embu das Artes (Sao Paulo, Brazil). A semi-structured, multiple-choice, self-administered questionnaire was used as data collection tool in the classroom. Results: The obtained data showed that there is a strong influence of religious and moral concepts in the structuring of knowledge on the subject, which have modulated opinions about the legislation in force in the country. Regarding abortion methods, a higher percentage of adolescents know about minor surgeries (50.66%), followed by marijuana tea (34.43%) and pointed objects (27.48%). Regarding the sources of information on abortion, statistically significant results were detected only for magazine/newspaper (p=0.001) and TV (p=0.003). Concerning the opinion on the theme, 55.63% of the participants were against abortion and 82.45% were in favor in cases of pregnancy resulting from rape. Conclusion: The formulation of knowledge on the subject was based on legality, increasing its intensity according to the higher schooling of the respondents, while the opinion of the participants reflected the dominant social ideals on the subject.

Interpretation of ambiguities by schoolchildren with low birth weight from Embu das Artes, São Paulo state, Brazil.

To assess the development of language regarding the ability to recognize and interpret lexical ambiguity in low-birth-weight schoolchildren enrolled at the school system in the municipality of Embu das Artes, Sao Paulo state, compared with that of schoolchildren with normal birth weight. A case-control, retrospective, cross-sectional study conducted with 378 schoolchildren, both genders, aged 5 to 9.9 years, from the municipal schools of Embu das Artes. Study Group (SG) comprising 210 schoolchildren with birth weight < 2500 g. Control Group (CG) composed of 168 school children with birth weight ≥ 2500 g. Participants of both groups were compared with respect to the skills of recognition and verbal interpretation of sentences containing lexical ambiguity using the Test of Language Competence. Variables of interest: Age and gender of children; age and schooling of mothers. Statistical analysis: Descriptive analysis to characterize the sample and score per group; Student's t test for comparison between the total scores of each skill/subtest; Chi-square test to compare items within each subtest; multiple regression analysis for the intervening variables. Participants of the SG presented lower scores for ambiguous sentences compared with those of participants of the CG. Multiple regression analysis showed that child's current age was a predictor for all metalinguistic skills regarding interpretation of ambiguities in both groups. Participants of the SG presented lower specific and total scores than those of participants of the CG for ambiguity skills. The child's current age factor positively influenced the ambiguity skills in both groups.

PT027 Cigarette Smoking and the Determinants of Smoking Among Vilnius University Medical Students

Substance use among teenage students and factors associated were investigated through a survey using a questionnaire adapted from the WHO's Program on Research and Reporting on the Epidemiology of Drug Dependence, additional questions on family factors and personal risks, and the Coopersmith Self-Esteem Inventory, adapted to Brazil. The target population consisted of 3891 10–22-year-old students from the city of Embu das Artes, São Paulo, Brazil. The prevalence of lifetime substance use was 26.7%. Most commonly used substances were energy drinks combined with alcohol (19%), solvents (11.2%) and marijuana (4.8%). Almost 60% of the students had already tried alcohol and 18.2% had tried tobacco. Factors associated to lifetime substance use were: lower self-esteem, going to nightclubs at least twice a week, use of alcohol, trying tobacco, bad relationship with the mother, permissive mothers, practicing sports as an obligation, working, and higher socioeconomic level. Concerning frequent/heavy substance use, chances were found to be higher among students who had use tobacco and alcohol, going to nightclubs at least twice a week, and those with lower self-esteem. Preventive actions concerning drug use should focus on avoiding the first experimentation, approaching family relationships, and improving students' self-esteem.

Factors associated with illicit drugs' lifetime and frequent/heavy use among students results from a population survey

Substance use among teenage students and factors associated were investigated through a survey using a questionnaire adapted from the WHO's Program on Research and Reporting on the Epidemiology of Drug Dependence, additional questions on family factors and personal risks, and the Coopersmith Self-Esteem Inventory, adapted to Brazil. The target population consisted of 3891 10–22-year-old students from the city of Embu das Artes, São Paulo, Brazil. The prevalence of lifetime substance use was 26.7%. Most commonly used substances were energy drinks combined with alcohol (19%), solvents (11.2%) and marijuana (4.8%). Almost 60% of the students had already tried alcohol and 18.2% had tried tobacco. Factors associated to lifetime substance use were: lower self-esteem, going to nightclubs at least twice a week, use of alcohol, trying tobacco, bad relationship with the mother, permissive mothers, practicing sports as an obligation, working, and higher socioeconomic level. Concerning frequent/heavy substance use, chances were found to be higher among students who had use tobacco and alcohol, going to nightclubs at least twice a week, and those with lower self-esteem. Preventive actions concerning drug use should focus on avoiding the first experimentation, approaching family relationships, and improving students' self-esteem.

Community vegetable gardens as a health promotion activity: an experience in Primary Healthcare Units

Urban and peri-urban agriculture (UPA) is being practiced in different settings, contributing to the improvement of health in communities and healthier environments. In order to identify the meanings and implications of the practice of UPA in Primary Healthcare Units (PHU) as an activity of health promotion (HP), and to what extent its therapeutic dimension characterizes it as an activity aligned with complementary and integrative practices (CIP), a qualitative cross-sectional study was performed in Embu das Artes, State of São Paulo. From the analysis, the following main themes arose: health concept, health outcomes, the return to traditional practices and habits and the reorientation of health services. It was possible to identify the close link between the cultivation of vegetable gardens and HP guidelines and fields of action, such as creating healthier environments, boosting community actions, developing personal skills, stimulating autonomy and empowerment and demands for the reorientation of services. The garden activities, set up in PHU areas, proved to be an implementation strategy of CIP. The conclusion reached is that vegetable gardening activities in community gardens are seen to be health promotion practices that integrate key elements of CIP.

Clinical evolution and nutritional status in asthmatic children and adolescents enrolled in Primary Health Care

ObjectiveTo evaluate the clinical evolution and the association between nutritional status and severity of asthma in children and adolescents enrolled in Primary Health Care. MethodsA retrospective cohort study of 219 asthmatic patients (3–17 years old) enrolled in Primary Care Services (PCSs) in Embu das Artes (SP), from 2007 to 2011. Secondary data: gender, age, diagnosis of asthma severity, other atopic diseases, family history of atopy, and body mass index. To evaluate the clinical outcome of asthma, data were collected on number of asthma exacerbations, number of emergency room consultations and doses of inhaled corticosteroids at follow-up visits in the 6th and 12th months. The statistical analysis included chi-square and Kappa agreement index, with 5% set as the significance level. Results50.5% of patients started wheezing before the age of 2 years, 99.5% had allergic rhinitis and 65.2% had a positive family history of atopy. Regarding severity, intermittent asthma was more frequent (51.6%) and, in relation to nutritional status, 65.8% of patients had normal weight. There was no association between nutritional status and asthma severity (p=0.409). After 1 year of follow-up, 25.2% of patients showed reduction in exacerbations and emergency room consultations, and 16.2% reduced the amount of inhaled corticosteroids. ConclusionsThe monitoring of asthmatic patients in Primary Care Services showed improvement in clinical outcome, with a decreased number of exacerbations, emergency room consultations and doses of inhaled corticosteroids. No association between nutritional status and asthma severity was observed in this study.

Evolução clínica e estado nutricional de crianças e adolescentes asmáticos acompanhados em Unidade Básica de Saúde

ObjectiveTo evaluate the clinical evolution and the association between nutritional status and severity of asthma in children and adolescents enrolled in Primary Health Care. MethodsA retrospective cohort study of 219 asthmatic patients (3 to 17 years old) enrolled in primary care services (PCSs) in Embu das Artes (SP), from 2007 to 2011. Secondary data: gender, age, diagnosis of asthma severity, other atopic diseases, family history of atopy, and body mass index. To evaluate the clinical outcome of asthma, data were collected on number of asthma exacerbations, number of emergency room consultations and doses of inhaled corticosteroids at follow‐up visits in the 6th and 12th months. The statistical analysis included chi‐square and Kappa agreement index, with 5% set as the significance level. Results50.5% of patients started wheezing before the age of two years, 99.5% had allergic rhinitis and 65.2% had a positive family history of atopy. Regarding severity, intermittent asthma was more frequent (51.6%) and, in relation to nutritional status, 65.8% of patients had normal weight. There was no association between nutritional status and asthma severity (p=0,409). After one year of follow‐up, 25.2% of patients showed reduction in exacerbations and emergency room consultations, and 16.2% reduced the amount of inhaled corticosteroids. ConclusionsThe monitoring of asthmatic patients in PCSs showed improvement in clinical outcome, with a decreased number of exacerbations, emergency room consultations and doses of inhaled corticosteroids. No association between nutritional status and asthma severity was observed in this study.

School children with low birth weight inserted in system of Embu's education: construction of sentences.

To characterize the construction of sentences in schoolchildren born with low weight. We selected 413 students from Embu das Artes (SP), Brazil. Application of Recreating Speech Acts of Test of Language Competence sub-test. We analyzed the number of words and the holistic score. Age group of 6-10 years old, female/male, with low birth weight (<2,500 g) in Study Group (SG; n=238), and birth weight above or equal to 2,500 g composing the Control Group (CG; n=175). Children with anomalies were excluded. The both groups' responses were considered as well as the association of the responses with variables birth weight, gender, age of child and maternal age and education, through Student's t-test, χ2test and linear regression. The SG scored less on the total number of words and had worst performance in items that involved prepositions with a sense of temporality and place, with adverb functions. There was no difference between groups regarding the holistic score. It was found positive impact of the variables birth weight (p=0.002), age of child, age of mother and maternal education on standard test scores in both groups. The SG had fewer words compared to CG. The higher the birth weight, the higher the score test pattern. It was evident the age-related changes in morpho-syntactic skills addressed in the study, and protection factors mother's schooling and age had a positive impact on language performance.

Prevalence of juvenile idiopathic arthritis in children aged 6 to 12 years in Embu das Artes, state of São Paulo, Brazil

The aim of the study was to study the prevalence of juvenile idiopathic arthritis (JIA) in school children in the city of Embu das Artes in São Paulo State. 2880 school children from seven public schools, aged between 6 and 12 years, were evaluated (clinical findings) by a pediatric rheumatologist. A board certified Pediatric Rheumatologist evaluated the subjects with sus- pected inflammatory arthropathy. Children with higher suspicion were referred to a special- ized service. One hundred and forty-one children have presented abnormalities on examina- tion of musculoskeletal system, with isolated pain on palpation the most common finding in the first evaluation (60.9%), with improvement in almost all cases in the second examination. Most of the abnormalities were related to recent injuries or congenital malformations. Six chil- dren have clinical findings suggestive of chronic arthropathy and were referred to a specialized pediatric rheumatology clinic. Of these, a 12 year-old girl fulfilled the criteria for JIA. The other diagnoses were aseptic necrosis of the hip (P = 1) of and post-trauma synovitis (P = 4). The prevalence of JIA in children aged between 6 and 12 years was 1/2.880 (or 0.34/1.000).