Crianças diagnosticadas em função de impasses na alfabetização: contribuições da psicanálise / Enfants diagnostiqués en fonction des impasses d'alphabétisation: apports de la psychanalyse / Children diagnosed due to literacy problems: contributions of psychoanalysis

O presente artigo descreve os resultados de uma pesquisa/intervenção de orientação psicanalítica por meio do relato de um estudo de caso de um aluno do ensino fundamental de uma escola pública de ensino da cidade de Itabira-MG. O estudante apresentava impasses na alfabetização e entraves na esfera escolar, enfrentados por meio do processo de patologização e medicalização. Contrapondo-se à medicalização, o caso visa demonstrar a contribuição de um dos procedimentos adotados nesta pesquisa: o diagnóstico Clínico-Pedagógico (DCP), cuja intervenção realiza a leitura daquilo que o aluno ensina ao educador sobre sua singularidade e sobre as particularidades que se repercutem na sua relação com o saber e com os laços sociais construídos na escola. Os resultados obtidos por meio do DCP permitiram perceber o impacto do fenômeno da nomeação advinda de um diagnóstico na aprendizagem acadêmica e a possibilidade de utilizar abordagens teóricas e práticas que permitam aos sujeitos agir sobre os seus problemas escolares.

Cet article décrit les résultats d'une recherche/intervention d'orientation psychanalytique à l'aide du rapport d'une étude de cas d'un élève du primaire d'une école publique de la ville d'Itabira-MG. L'étudiant avait des impasses en alphabétisation et des obstacles dans la sphère scolaire, confrontés à travers le processus de pathologisation et de médicalisation. Contrairement à la médicalisation, le cas vise démontrer l'apport d'une des procédures adoptées dans cette recherche: le Diagnostic clinico-pédagogique (DCP), dont l'intervention effectue la lecture de ce que l'élève enseigne à l'éducateur sur sa singularité et sur les particularités qui ont des répercussions sur leur rapport aux savoirs et aux liens sociaux construits à l'école. Les résultats obtenus par le biais du DCP ont permis de percevoir l'impact du phénomène de dénomination issu d'un diagnostic sur les apprentissages scolaires et la possibilité d'utiliser des approches théoriques et pratiques permettant aux sujets d'agir sur leurs problèmes scolaires.

This article describes the results of a psychoanalytically oriented research/intervention through the report of a case study of an elementary school student from a public school in the city of Itabira-MG. The student had impasses in literacy and obstacles in the school life, faced through the process of pathologization and medicalization. In contrast to medicalization, the case aims to demonstrate the contribution of one of the procedures adopted in this research: the Clinical- Pedagogical Diagnosis (DCP), whose intervention performs the evaluation of what the student teaches the educator about his singularity and about the particularities that have repercussions on their relationship with knowledge and with the social bonds built at school. The results obtained through the DCP made it possible to perceive the impact of the naming phenomenon arising from a diagnosis on academic learning and the possibility of using theoretical and practical approaches that allow subjects to act on their school problems.

Echocardiographic screening of 4107 Nigerian school children for rheumatic heart disease.

OBJECTIVE: Echocardiographic screening for Rheumatic Heart Disease (RHD) in Africa has revealed prevalence rates in the range of 0.5-7.4%. There are no recent large population-based studies in Nigeria. The objective of the study was to determine the prevalence of RHD in a large sample of Nigerian school children. METHODS: Using portable transthoracic echocardiography and auscultation, school children aged 5 years to 16 years in Lagos, Nigeria were screened for RHD. Diagnosis was based on the 2012 World Heart Federation echocardiographic criteria. RESULTS: The 4107 children screened had mean age of 11.3 years (SD = 2.6) and 2206 (53.7%) were females. There were 38 children with abnormal echocardiograms, of which 11 (0.27%) showed RHD including two cases of definite RHD giving a prevalence of 2.7/1000 [2.9/1000 in the peri-urban, 2.4/1000 in the urban area). Echocardiography detected RHD 10 times better than auscultation [echocardiography 11 (0.27%) vs. auscultation 1 (0.02%); P = 0.003]. The remaining 27 children with abnormal echocardiograms had congenital heart defects (CHD) giving a prevalence of 6.6/1000 for CHD, a yield higher than for RHD. CONCLUSION: Prevalence of RHD among school children in Lagos, South West Nigeria is low compared to other African countries, possibly due to better access to medical care and antibiotic treatment for infections. Our data provides evidence that RHD prevalence may vary substantially within sub-Saharan Africa, necessitating targeted population-based sampling to better understand disease burden and distribution. Further work is needed to compare within- and between-country RHD prevalence as a basis for programme planning and control efforts.

OBJECTIF: Le dépistage échocardiographique de la cardiopathie rhumatismale (CR) en Afrique a révélé des taux de prévalence compris entre 0,5 et 7,4%. Il n'existe pas de grande étude récente de population au Nigéria. L'objectif de l'étude était de déterminer la prévalence de la CR dans un grand échantillon d'écoliers nigérians. MÉTHODES: A l'aide d'une échocardiographie et d'une auscultation trans-thoraciques portables, des écoliers âgés de 5 à 16 ans de Lagos, au Nigeria, ont été soumis à un dépistage de la CR. Le diagnostic reposait sur les critères échocardiographiques de la Fédération Mondiale du Cœur de 2012. RÉSULTATS: Les 4.107 enfants testés avaient un âge moyen de 11,3 ans (DS = 2,6) et 2.206 (53,7%) étaient de sexe féminin. Il y avait des échocardiogrammes anormaux chez 38 enfants, dont 11 (0,27%) présentaient une CR, y compris deux cas de CR bien définie, donnant une prévalence de 2,7/1000 [2,9/1000 dans les zones périurbaines, 2,4/1000 dans les zones urbaines). L'échocardiographie a détecté une CR 10 fois mieux que l'auscultation [échocardiographie 11 (0,27%) contre auscultation 1 (0,02%); p = 0,003]. Les 27 enfants restants dont les échocardiogrammes étaient anormaux avaient une cardiopathie congénitale (CHD), ce qui donnait une prévalence de 6,6/1.000 pour les cardiopathies congénitales, donnant une prévalence de 6,6/1000, un rendement supérieur à celui de la CR. CONCLUSION: La prévalence de la CR parmi les écoliers à Lagos, dans le sud-ouest du Nigéria, est faible comparée à celle d'autres pays africains, probablement en raison d'un meilleur accès aux soins médicaux et au traitement antibiotique contre les infections. Nos données fournissent des preuves que la prévalence de la CR peut varier considérablement en Afrique subsaharienne, nécessitant un échantillonnage ciblé de la population pour mieux comprendre la charge et la répartition de la maladie. Des études supplémentaires sont nécessaires pour comparer la prévalence de la CR intra- et inter pays en tant que base des efforts de planification et de lutte des programmes.

Conducta y hábitos alimentarios en estudiantes escolares / Behavior and eating habits in school students / Comportamento e hábitos alimentares em alunos do ensino básico / Conduites et habitudes alimentaires chez les écoliers

Resumen Objetivo: Determinar la clasificación de conductas y hábitos alimentarios de estudiantes en etapa escolar mediante la exploración de once dimensiones. Materiales y métodos: Diseño cuantitativo, no experimental y transversal, población de interés 590 escolares de 6 a 12 años de edad, de la primaria Francisco Zarco, residentes de la ciudad de H. Matamoros, Tamaulipas México. Muestreo probabilístico aleatorio simple, la muestra constituida por 243 participantes de 1° a 6° grado. Se utilizó el cuestionario para evaluar conductas y hábitos alimentarios en usuarios de la atención primaria de salud formado por 11 dimensiones, se clasificaron tres puntos de corte de acuerdo a percentiles, 1) <P25= Conducta y hábitos alimentarios deficientes; 2) P25 - P75= Conducta y hábitos alimentarios suficientes, y 3) >P75= Conducta y hábitos alimentarios saludables. Se utilizó estadística descriptiva (frecuencias y porcentajes) e inferencial (asociaciones). Resultados: 52.7% fueron de sexo masculino, 48.6% presentaron conducta y hábitos alimentarios suficientes. El sexo masculino presentó una relación con la conducta y los hábitos alimentarios (X2=11.11, p=.004), así como efecto predictivo (β= .307, F[1-241]= 11.516, p< .01). Conclusiones: Los hábitos alimentarios de los escolares representan una oportunidad para identificar conductas que puedan generar factores de riesgo para el desarrollo de complicaciones relacionadas con nutrición inadecuada. Los participantes masculinos demostraron tener las conductas menos saludables y esto indica que son ellos los que representan mayor riesgo en el futuro.

Abstract Objective: To determine the classification of behaviors and eating habits of students in school stage through eleven dimensions. Materials and methods: Quantitative, non-experimental and transversal design, population of interest 590 schoolchildren aged from 6 to 12, Francisco Zarco elementary school, residents of the city of H. Matamoros, Tamaulipas, Mexico. Simple random probabilistic sampling, the sample consisting of 243 participants from 1st to 6th grade. The questionnaire was used to evaluate behaviors and eating habits in users of primary health care formed by 11 dimensions, three cutoff points were classified according to percentiles, 1) <P25 = Poor behavior and eating habits; 2) P25 - P75 = Sufficient behavior and eating habits, and 3)> P75 = Healthy behavior and eating habits. Descriptive statistics (frequencies and percentages) and inferential statistics (associations) were used. Results: 52.7% were male, 48.6% showed sufficient behavior and eating habits. Male sex presented a relationship with behavior and eating habits (X2 = 11.11, p= .004), as well as predictive effect (β= .307, F[1-241] = 11,516, p<.01). Conclusions: The eating habits of schoolchildren represent an opportunity to identify behaviors that may generate risk factors for the development of complications related to inadequate nutrition. Male participants were shown to have less healthy behavior and this indicates that they represent the most risk in the future.

Resumo Objetivo: Determinar a classificação dos comportamentos alimentares e hábitos em alunos do ensino básico através de onze dimensões. Materiais e métodos: Desenho quantitativo, náo experimental e transversal, sendo a população de 590 alunos dos 6 aos 12 anos, da Escola Francisco Zarco, da cidade de H. Matamoros, Tamaulipas, México. A amostragem é probabilística aleatória simples, sendo a amostra constituída por 243 alunos do 1° ao 6° ano. Utilizou-se um questionário para avaliar os comportamentos e hábitos alimentares, em utentes dos cuidados de saúde primários, formado por 11 dimensoes e tres pontos de corte foram classificados de acordo com os percentis: 1) <P25 = Comportamento e hábitos alimentares pobres; 2) P25 - P75 = comportamento e hábitos alimentares suficientes e 3)> P75 = comportamento e hábitos alimentares saudáveis. Aplicou-se as estatísticas descritivas (frequências e percentagens) e estatísticas inferenciais (associações). Resultados: 52,7% dos inqueridos eram do sexo masculino, 48,6% apresentavam um comportamento e hábitos alimentares suficientes. Existe uma relação significativa entre o sexo masculino e os comportamentos e hábitos alimentares (X2= 11,11, p= 0,004), bem como um efeito preditivo (β= 0,307, F[1-241]= 11,516, p< 0,01). Conclusões: os hábitos alimentares dos alunos representam uma oportunidade para identificar comportamentos geradores de fatores de risco no desenvolvimento de complicações relacionadas com uma alimentação nutrição inadequada. Os inqueridos do sexo masculino demonstraram ter comportamentos menos saudáveis, sendo estes a população de maior risco no futuro.

Résumé Objectif: Déterminer la classification des conduites et des habitudes alimentaires des écoliers selon onze dimensions. Matériaux et méthodes: La conception de l'étude est quantitative, non expérimentale et transversale. La population cible est constituée de 590 éleves de l'école primaire Francisco Zarco, agés de 6 a 12 ans et résidents dans la ville de H. Matamoros, Tamaulipas, au Mexico. Un échantillonnage probabiliste aléatoire simple a permis de sélectionner 243 participants de la 1ere a la 6eme année. L'instrument utilisé a été le questionnaire pour évaluer les conduites et les habitudes alimentaires des utilisateurs de soins de santé primaires, composé de 11 dimensions. Trois points de coupures ont été établis en fonction des percentiles: 1) <P25 = conduite et habitudes alimentaires malsaines; 2) P25 - P75 = conduites et habitudes alimentaires suffisamment saines, et 3) > P75 = conduites et habitudes alimentaires particulierement saines. Des statistiques descriptives (fréquences et pourcentages) et inférentielles (associations) ont été utilisées. Résultats: Parmi les personnes interrogées, 52,7% étaient de sexe masculin et 48,6% ont indiqué une conduite et des habitudes alimentaires suffisamment saines. Une relation entre le sexe masculin et la conduite et les habitudes alimentaires a été établie (X2= 11,11; p= 0,004) ainsi qu'un effet prédictif (β = 0,307, F[1-241] = 11,516, p<0,01). Conclusions: L'étude des habitudes alimentaires des écoliers représentent une opportunité pour identifier les comportements qui peuvent constituer des facteurs de risque de complications liées a une alimentation inadéquate. Les participants masculins se sont avérés avoir des conduites moins saines, ce qui indique un plus grand risque pour l'avenir.

Impact of periodic selective mebendazole treatment on soil-transmitted helminth infections in Cuban schoolchildren.

OBJECTIVE: To evaluate the impact of periodic selective treatment with 500 mg mebendazole on soil-transmitted helminth (STH) infections in Cuban schoolchildren. METHODS: We followed up a cohort of 268 STH-positive schoolchildren, aged 5-14 years at baseline, at six-month intervals for two years and a final follow-up after three years. Kato-Katz stool examination was used to detect infections with Ascaris lumbricoides, Trichuris trichiura and hookworm. Common risk factors related to STHs were assessed by parental questionnaire. RESULTS: A significant reduction in the number of STH infections was obtained after three years with the highest reduction for T. trichiura (87.8%) and the lowest for hookworm (57.9%). After six months, cure rates (CRs) were 76.9% for A. lumbricoides, 67.4% for T. trichiura and 44.4% for hookworm. After two treatment rounds, more than 75% of all STH-positive children at baseline were cured, but with important differences between STH species (95.2% for A. lumbricoides, 80.5% for T. trichiura and 76.5% for hookworm). At the end of the study, these cumulative CRs were almost 100% for all three STHs. Risk factors for STHs were sex, sanitary disposal and habit of playing in the soil. CONCLUSIONS: Our results indicate that periodic selective treatment with 500 mg mebendazole is effective in reducing the number of STH infections in Cuban schoolchildren. Although important differences were found between helminth species, two rounds of treatment appeared sufficient to obtain substantial reductions.