Effects of Educational Interventions on Maternal Self-efficacy and Childhood Diarrhea: A Randomized Clinical Trial.

OBJECTIVE: Diarrhea still causes high morbidity and mortality in children under five, requiring constant interventions. Thus, the study aims to evaluate the effects of educational technologies on maternal self-efficacy to prevent childhood diarrhea. METHODS: Randomized clinical trial carried out in Fortaleza, Ceará, Brazil, with four randomized groups of mothers of children under 5 years of age, as follows: control group (n = 61), group A (booklet, n = 60), group B (video, n = 60), and group AB (booklet and video, n = 60). From June to October 2015, data collection was carried out in three moments (the first in person and the others by telephone monitoring). RESULTS: All groups improved their self-efficacy after the intervention, with higher scores in the group AB (booklet and video). A statistically significant association was found between the occurrence of diarrhea and maternal self-efficacy in groups A (booklet) (p = 0.023) and AB (booklet and video) (p = 0.042) at the second moment of data collection. From the second moment to the third moment, the risk of diarrhea decreased in group A, from 12.8 to 1.3, and in group AB, from 8.5 to 1.1. CONCLUSION: The technologies used, isolated or combined, were effective in improving maternal self-efficacy and decreasing the occurrence of childhood diarrhea; therefore, they can be used by nurses as health education tools.

Educational interventions using a primer and motivational interviewing: randomized clinical trial.

BACKGROUND: Many educational technologies have been used to promote the health of the population. Thus, the objective was to assess the effect of using an individual educational primer along with the Brief Motivational Interviewing (BMI) for increasing maternal self-efficacy for preventing childhood diarrhoea. METHODS: Randomized clinical trial, conducted in Fortaleza/Ceará-Brazil, composed of 181 mothers and/or guardians of children under five years, who were randomized into three groups: experimental group A (EG A)-who read the primer, experimental group B (EG B)-application of the primer and BMI and the control group (CG). The participants' assessment was based on the Maternal Self-Efficacy Scale for Preventing Childhood Diarrhoea and the diarrhoea Investigation Form at the beginning of the intervention and then 30 and 60 days after the first contact with the participants. RESULTS: There were 60 participants in EG A and CG and 61 in EG B. It was noted a greater incidence of participants with high self-efficacy in EG B after applying the technologies. All groups manifested diarrhoea among children after the interventions, although with a lower number in EG B, one-month post-intervention (P = 0.025). CONCLUSIONS: The combined use of the primer and the BMI contributed significantly over time to increase maternal self-efficacy in preventing childhood diarrhoea and reduce cases of this disease.

Application of a Bundle in the Prevention of Peri-Intraventricular Hemorrhage in Preterm Newborns.

The purpose of this study was to evaluate the impact of implementing a care bundle for preventing peri-intraventricular hemorrhage (PIVH) in preterm newborns. A longitudinal, quantitative, quasi-experimental study was conducted with preterm newborns from a neonatal unit. The study was divided into 2 stages: the first consisted of a retrospective cohort of newborns (control group) not exposed to the bundle, and the second consisted of 5 practical steps of implementing a care bundle for preventing PIVH in eligible newborns. The results show that a significant reduction in PIVH occurred, from 34.8% before the intervention to 26.3% after application of the bundle. Also, after implementation of the bundle, there was a reduction in the severe forms of PIVH in the newborns who presented with hemorrhage compared with the control group. The study shows how the use of a low-cost and easy operationalization tool can contribute to the health of preterm newborns. It was found that the bundle is directly related to the decrease in the incidence of PIVH. The results may contribute to the improvement in care quality, thus promoting safe care for premature newborns.

Factors Associated With Body Image Perception Among Brazilian Students From Low Human Development Index Areas.

This study aimed to evaluate sociodemographic, behavioral, and individual factors associated with body image perception in a sample of adolescents from schools in low Human Development Index areas in Brazil. This cross-sectional study included 609 boys and 573 girls (aged 11-17 years). Body image perception (nine-silhouettes scale) and sociodemographic, behavioral, and individual variables were included. Multinomial logistic regression analysis was used. Most boys (76.9%) and girls (77.5%) were dissatisfied with their body image. Body mass index status and healthy body image evaluation were significantly associated with body image dissatisfaction in both boys and girls ( p < .001), and daily fruit consumption was associated with body image dissatisfaction only in boys ( p = .035). Education and health care focused on body image can pay special attention to young people from vulnerable areas with unhealthy nutritional status and focus on strategies that enable improving the perception of a healthy body and a healthy diet.

Effects of an educational technology on self-efficacy for breastfeeding and practice of exclusive breastfeeding. / Efeitos de uma tecnologia educativa na autoeficácia para amamentar e na prática do aleitamento materno exclusivo.

OBJECTIVE: To evaluate the effects of using a flipchart (serial album) on maternal self-efficacy in breastfeeding and its effects on exclusive breastfeeding (EBF) in children's first two months of life. METHOD: Clinical trial in Recife, Northeastern Brazil, with 112 women in the third trimester of gestation, randomly distributed in intervention group (IG) and control group (CG). The intervention was the use of the flipchart in IG. Data collection was performed through interviews in the prenatal period, and telephone contact at second, fourth and eighth weeks postpartum. The Breastfeeding Self-Efficacy Scale-Short-Form (BSES-SF) was used to measure self-efficacy scores. In the analysis, was used descriptive, bivariate statistics through tests of comparisons of proportions and means, and relative risk assessment. RESULTS: There was a statistically significant difference in mean values of self-efficacy scores between women in the IG and CG (p<0.001) and in EBF rates (p<0.001). The probability of exclusively breastfeeding in IG was twice as high than in CG (RR 2.2, CI 1.51-3.21). CONCLUSION: The use of a flipchart as an educational tool had positive effects on self-efficacy scores for breastfeeding and in maintenance of EBF in the IG. Brazilian Registry of Clinical Trials: RBR-5N7K99.

Physical accessibility in primary healthcare: a step towards the embracement. / Acessibilidade física na atenção primária à saúde: um passo para o acolhimento.

OBJECTIVE: To assess the physical accessibility from the front desk of primary healthcare units. METHOD: Descriptive and quantitative research to map the accessibility of the physical space in 157 health units, between August 2014 and May 2015, in the region of Baturité, Ceará, Brazil. The data were collected using a checklist instrument type, and absolute and relative frequencies, binomial and verisimilitude tests for statistical analysis, with statistical significance of p <0.05 were used. RESULTS: Of the analyzed items, stairs (24.8%), ramps (47.1%) and floors (75.8%) were inaccessible in most health units. Comparing urban and rural areas, circulation area (0.7x, p=0.293), counter (0.4x, p=0.010), seat (0.7x, p=0.758) and drinking fountain (0.7x, p=0.736) were more inaccessible in the urban area. CONCLUSION: The access of persons with physical disabilities to primary care should be seen as a priority. There are physical, architectural and furniture barriers that compromise the full embracement of the user.

Weight-Gain Velocity in Newborn Infants Managed with the Kangaroo Method and Associated Variables.

Objectives The Kangaroo method helps promote maternal breastfeeding and adequate growth of low birthweight preterm infants. The objective of this study was to analyze the association between weight-gain velocity during use of the Kangaroo method and maternal and infant variables. Methods A nested cross-sectional study in a cohort of newborn infants managed using the Kangaroo method was carried out at a reference center for the method in Brazil. Data on low birthweight and preterm infants managed using the Kangaroo Method (n = 78) and on their respective mothers (n = 70) was collected between January and July 2014. Maternal and infant variables were associated and correlated with weight-gain velocity (g/kg/day) at each phase of the method (p < 0.05). Results Mean weight-gain velocity increased from 0.12 ± 11.11 g/kg/day in the first phase to 13.47 ± 4.84 g/kg/day in the third phase (p < 0.001), and percentage of adequate weight increased at phase 3 (p < 0.001). Birthweight was inversely correlated with weight-gain velocity at phases 1 and 2 of the Kangaroo method. Birthweight of under 1500 g was associated with a lower likelihood of inadequate weight-gain velocity of the newborn at phase 1 (OR = 0.1; 95 % CI 0.01-0.78; p = 0.012). In phase 3, maternal age was directly correlated with weight-gain velocity. Conclusions Weight-gain velocity was associated with maternal (age) and infant (gestational age at birth, birthweight, weight for gestational age at birth, length of hospital stay and five-minute Apgar score) variables. Knowledge of the factors influencing weight-gain velocity and its behavior at each phase of the method can help guide conduct toward potentializing factors that promote adequate weight-gain.

Association Between Confidence in Smiling and Esthetic Characteristics.

OBJECTIVE: This study aimed to analyze which facial, gingival and dental characteristics are associated with confidence in smiling among 75 subjects seeking treatment in a northern Brazilian public dental university. MATERIALS AND METHODS: Clinical examinations and three standardized photographs of each subject were taken by one trained examiner. In addition, a questionnaire was applied to assess confidence in smiling. The subjects were dichotomized into two groups, non-confident (n = 36) and confident (n = 39) in smiling. Chi-square/Fischer exact test were used to associate the facial, gingival and dental characteristics between groups. RESULTS: The subjects that reported to be non-confident in smiling were statistically associated with smile type (p = 0.030) and wrongly positioned teeth (p = 0.047). On the other hand, gender (p = 0.491), marital status (p = 0.217), gum pigmentation (p = 0.930), midline (p = 0.176), volume of the upper (p = 0.380), and lower (p = 0.615) lips were not associated with self-reported confidence in smiling. CONCLUSION: In patients seeking dental treatment in a public dental university, non-confidence in smiling was associated only with some oral and intraoral characteristics and not with demographic characteristics. CLINICAL SIGNIFICANCE: This study showed that only smile type and wrongly positioned teeth were statistically associated with confidence in smiling. Dentists should pay attention to those intraoral characteristics, but the clinical decision making should always include the patients' perception. (J Esthet Restor Dent 29:E56-E66, 2017).

The use of educational video to promote maternal self-efficacy in preventing early childhood diarrhoea.

Diarrhoea is responsible for high rates of infant morbidity and mortality. It is multifactorial, manifested by socioeconomic, hygienic, and maternal factors. The aim of this study is to evaluate the effects of an educational video on maternal self-efficacy for the prevention of childhood diarrhoea. This was a randomized trial conducted in the state of Ceará, Brazil. Participants were 2 groups (comparison and intervention), composed of mothers of children under 5 years of age. Group membership was allocated by cluster randomization. Outcomes were maternal self-efficacy measured using the Maternal Self-efficacy Scale for Prevention of Early Childhood Diarrhoea; outcome data collectors were blinded to group allocation. Ninety participants were randomized to each group; 83 intervention group and 80 comparison group members were contained in the final analysis. Maternal self-efficacy in preventing childhood diarrhoea increased in both groups, but average scores of the intervention group were higher at all time than those of the comparison group. The educational video had a significant effect on maternal self-efficacy.

Construction and validation of educational video for the guidance of parents of children regarding clean intermittent catheterization. / Construção e validação de vídeo educativo para orientação de pais de crianças em cateterismo intermitente limpo.

OBJECTIVE: To construct and validate an educational video for the guidance of parents of children who require clean intermittent catheterization. METHOD: Methodological study, developed in two stages: construction and validation of the video was performed by experienced judges from March to December 2016. The construction of the technology had the Theory of Adaptation as theoretical reference. For the data analysis, the intraclass correlation index was used. RESULTS: The first version of the video was 12 minutes, after validation the replacement of technical terms by colloquial language, dynamism in dialogues and the mention of handwashing before assembling the material was recommended. With regard to total reliability, the intraclass correlation coefficient for all the categories evaluated was 0.768, considered reasonable. In the evaluation of language clarity, relevance to practice and theoretical relevance, the results were 0.745, 0.771 and 0.777, respectively, considered reasonable, with p<0.0001. CONCLUSION: The educational video was valid regarding appearance and content, with potential to mediate educational practices in hospital and outpatient settings.

Association of self-efficacy of parents/caregivers with childhood asthma control parameters.

Objective To verify the association between the self-efficacy of parents/caregivers and control parameters of childhood asthma. Method Cross-sectional study with parents/caregivers of asthmatic children. Data were collected through a sociodemographic questionnaire and the Self-efficacy and their child's level of asthma control scale: Brazilian version. Results Participation of 216 parents/caregivers in the study. There was a statistically significant association between self-efficacy scores and the following variables: unscheduled physician visit (p=0.001), visit to emergency department (p<0.001), hospital stays in the previous 12 months (p=0.005), physical activity limitation (p=0.003), school days missed (p<0.001), impaired sleep (p<0.001), ability to differentiate crisis medication from control medication (p=0.024), use of spacer (p=0.001), performing oral hygiene after use of inhaled corticosteroids (p=0.003), and knowledge of medication gratuity (p=0.004). Conclusion A significant relationship of the self-efficacy of parents/caregivers of asthmatic children with control parameters and training on the necessary skills to reach this control was demonstrated in the study.

Quality of life in liver transplant recipients and the influence of sociodemographic factors.

OBJECTIVE: To verify the influence of sociodemographic factors on the quality of life of patients after liver transplant. METHOD: Cross-sectional study with 150 patients who underwent liver transplant at a referral center. A sociodemographic instrument and the Liver Disease Quality of Life questionnaire were applied. The analysis of variance (ANOVA) was performed, as well as multiple comparisons by the Tukey test and Games-Howell tests when p <0.05. RESULTS: Old age had influence on domains of symptoms of liver disease (p = 0.049), sleep (p = 0.023) and sexual function (p = 0.03). Men showed better significant mean values than women for the loneliness dimension (p = 0.037). Patients with higher educational level had higher values for the domain of stigma of liver disease (p = 0.014). There was interference of income in the domains of quality of social interaction (p = 0.033) and stigma of the disease (p = 0.046). CONCLUSION: In half of the quality of life domains, there was influence of some sociodemographic variable. OBJETIVO: Verificar a influência dos fatores sociodemográficos na qualidade de vida dos pacientes depois do transplante de fígado. MÉTODO: Estudo transversal, com 150 pacientes submetidos ao transplante de fígado em um centro de referência. Aplicou-se um instrumento sociodemográfico e o questionário Liver Disease Quality of Life. Foi realizada Análise de Variância (ANOVA) e comparações múltiplas pelo teste de Tukey e Games-Howell, quando p<0,05. RESULTADOS: A idade avançada apresentou influência nos domínios: sintomas da doença hepática (p=0,049), sono (p=0,023) e função sexual (p =0,03). Os homens apresentaram melhores médias significativas do que as mulheres na dimensão isolamento (p=0,037). Pacientes com nível de instrução mais alto apresentaram maiores valores no domínio estigma da doença hepática (p=0,014). Houve interferência da renda nos domínios qualidade da interação social (p=0,033) e estigma da doença (p=0,046). CONCLUSÃO: Em metade dos domínios de qualidade de vida, houve influência de alguma variável sociodemográfica.

Factors associated with asthma in adolescents in the city of Fortaleza, Brazil.

OBJECTIVE: Asthma is a chronic inflammatory airway disease. In Brazil, little is known about factors associated with this disease. This study aimed to identify factors associated with asthma in 13- to 14-year-old adolescents in Fortaleza, Ceará, Brazil. METHODS: It is a cross-sectional population-based study, with a probability sample of 3015 students in 2006-2007. We used the questionnaires about asthma, rhinitis and socio-demographic/environmental factors from the International Study for Asthma and Allergies in Childhood (ISAAC) protocol. Current asthma was defined as physician-diagnosed asthma and wheezing in the previous 12 months. Bivariate analysis was performed between asthma and factors included in the study, using prevalence ratio and Chi-square test. Confidence intervals (95%) and odds ratio (OR) were also calculated. Factors associated with asthma in bivariate analysis were then assessed using logistic regression. RESULTS: Final sample was composed by 694 adolescents, 179 with asthma. Rhinoconjunctivitis and consumption of stuffed biscuits and fried snacks three or more times per week were independently and positively associated with asthma; consumption of fruits three or more times per week was negatively associated with asthma. CONCLUSIONS: Dietary factors were the most associated with asthma in this study. Besides rhinoconjunctivitis, consumption of stuffed biscuits and fried snacks (foods with high content of saturated fat) three or more times per week were independently associated with asthma as aggravating factors, while the consumption of fruits three or more times per week was associated with asthma as protective factor. Interventions acting on these factors may decrease the occurrence of asthma in this population.

[Assistive technology for visually impaired women for use of the female condom: a validation study]. / Tecnologia assistiva para mulheres com deficiência visual acerca do preservativo feminino: estudo de validação.

OBJECTIVE: To validate assistive technology for visually impaired women to learn how to use the female condom. METHOD: a methodological development study conducted on a web page, with data collection between May and October 2012. Participants were 14 judges; seven judges in sexual and reproductive health (1st stage) and seven in special education (2nd stage). RESULTS: All items have reached the adopted parameter of 70% agreement. In Stage 1 new materials were added to represent the cervix, and instructions that must be heard twice were included in the 2nd stage. CONCLUSION: The technology has been validated and is appropriate for its objectives, structure / presentation and relevance. It is an innovative, low cost and valid instrument for promoting health and one which may help women with visual disabilities to use the female condom.

In situ assessment of effects of the bromide- and fluoride-incorporating adhesive systems on biofilm and secondary caries.

AIM: This in situ study assessed the effects of adhesive systems containing or not fluoride and/or the antibacterial monomer 12-methacryloyloxydodecylpyridinium bromide (MDPB) on the microbiological composition of dental biofilm and enamel demineralization. MATERIALS AND METHODS: During two phases of 14 days, ten volunteers wore intraoral palatal appliances containing two slabs of human enamel according to a double-blind, crossover design. The slabs were randomly restored using a composite resin and one of the following adhesive systems: All-Bond SE(TM) (self-etch, fluoride/MDPB free adhesive, AB) and Clearfl Protect Bond (self-etch containing fluoride and MDPB adhesive, CB). The biofilm formed on the slabs was analyzed with regard to total and mutans streptococci and lactobacilli counts. Demineralization represented by integrated area of hardness × lesion depth Delta S ( ΔS) was determined on enamel by analysis of cross-sectional microhardness, at 20 and 70 µm from the restoration margin. Data were analyzed by ANOVA. RESULTS: No statistically significant difference was found either in enamel demineralization or in the microbiological composition of dental biofilm. CONCLUSION: All adhesive systems containing or not fluoride and/or MDPB tested were unable to inhibit secondary caries in the in situ model used in the present research.

[Knowledge, attitudes and practices for the prevention of diabetic foot]. / Conhecimento, atitudes e práticas de medidas preventivas sobre pé diabético.

The purpose of this study was to identify the knowledge, attitudes and practices for the prevention of diabetic foot in patients with diabetes mellitus type 2. This study was based on a cross-sectional survey conducted in two Family Health Units, in the city of Picos--PI, Brazil, with 85 diabetics of both sexes, by means of a semi-structured Knowledge, Attitude and Practice questionnaire. There was a predominance of females in the study (62.4%). On the topic of foot care, 49.4% had no knowledge on hygiene or what to observe in their feet. In relation to nail care, 56.5% were unaware of the correct way to cut nails. Regarding attitudes, 80% were willing to engage in self-care. In terms of practice, results showed that activities such as washing, drying, moisturizing and massaging were not executed together. It is therefore necessary to develop educational strategies to create awareness, both for diabetics and health professionals, on the effective prevention of diabetic foot.

Social determinants and access to health services in patients with COVID-19: a cross-sectional study.

OBJECTIVE: To verify the association between social determinants of health and access to health services for COVID-19 patients. METHOD: Analytical, cross-sectional study, carried out in three states in the Northeast of Brazil (Ceará, Maranhão and Pernambuco), with 968 patients, using questionnaires with sociodemographic data, determinants and the Primary Care Assessment Tool, adapted to the reality of COVID-19, with 58 items, classified as high (score ≥ 6.6) and low (score < 6.6), whose high value reveals better standards of access to health services. The Chi-square test was used for comparative analysis. RESULTS: There was a significant difference (p < 0.05) between the domains of the instrument and the following determinants: age, skin color, body mass index, origin, schooling, employment, services close to home, first service, income and means of transport. CONCLUSION: Access to health services for people with COVID-19 was associated with various determinants, including individual, behavioural and social ones, correlated with the structural and organizational aspects of the health services offered by the three states of Northeastern Brazil.

Prevalence of the metabolic syndrome and its individual components in Brazilian college students.

AIMS AND OBJECTIVES: To identify the prevalence of the metabolic syndrome and its individual components in a population of college students at a public higher education institution in Fortaleza, Brazil. BACKGROUND: Scientific evidence has demonstrated the ascent of the metabolic syndrome in the young population. DESIGN: Cross-sectional study of 702 Brazilian college students between January-July 2011. METHODS: Socio-demographic indicators, life habits and the components of the metabolic syndrome were assessed. anova statistical tests were used to associate gender with the metabolic syndrome components, and the chi-square test to associate the number of metabolic syndrome components with gender and body mass index. RESULTS: High fasting venous glucose, triglyceride, total cholesterol and LDL-C levels were found in 12·3, 23·0, 9·7 and 5·9% of the sample, respectively. The prevalence of the metabolic syndrome amounted to 1·7%. Nevertheless, 30·4% of students manifested at least one and 12·4% at least two individual components. The prevalence of the metabolic syndrome was higher in men (58·3%) and in people who were overweight (33·3%) and obese (41·7%). It is important to implement public health policies to reduce college students' vulnerability to the metabolic syndrome. CONCLUSIONS: Most college students who displayed ≥3 metabolic syndrome components were men and already indicated being overweight and/or obesity. RELEVANCE TO CLINICAL PRACTICE: It is important that nurses assess the frequency of metabolic syndrome in college students as a predictor of cardiovascular health.

[Quality of life in patients with spinal cord injury]. / Qualidade de vida em pacientes com lesão medular.

It was aimed to measure the quality of life of adults with spinal cord injury and identify domains that affect the quality of life of these individuals. Epidemiological study, conducted in 2007-2008 in Health Basic Units of Campina Grande/PB. There were 47 participants. It was used a questionnaire composed by: sociodemographic variables, etiology of injury; validated instrument to measure quality of life containing four domains: Physical Health, Environmental, Social Relationships and Psychological with their respective facets. The data collected were processed using descriptive and statistical analysis. The domains with lowest scores were: Environmental (55.20 points), Physical health (58.59 points). The facets that compromise the domains: mobility (55.3%), work capacity (55.3%), Financial resources (80.9%), Opportunities for acquiring new information and skills (51%), Participation in and opportunities for recreation/leisure activities (68.1%) and Sexual activity (34%). Results express the dissatisfaction of participants with quality of life. Nurses should contribute to rehabilitation and social reinsertion of those people, respecting their limitations, emphasizing the remaining potential and capacity for self-care.

Pesticide exposure and risk of Central Nervous System tumors in children: a systematic review with meta-analysis. / Exposição a agrotóxicos e o risco de tumores do Sistema Nervoso Central em crianças: revisão sistemática com metanálise.

Central Nervous System (CNS) tumors represent more than half of all childhood malignant neoplasms. The aim of this study was to determine the relationship between environmental exposure to pesticides and the development of CNS tumors in children. We conducted a systematic review of the literature in the PubMed/MEDILINE, Embase, Web of Science, Scopus, and CINAHL databases. The inclusion criteria were cohort and case-control studies investigating the association between exposure to pesticides and CNS tumors (all histological types included in group III of the WHO Classification of Childhood Cancer) in children aged 0-14 years. The meta-analysis was performed using a random effects model and the Mantel-Haenszel method. Strength of association was measured using odds ratios (OR). The review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) under identification number CRD42021209354. The search identified 1,158 studies, 14 of which were included in the review. There was evidence of an association between the development of astrocytomas and exposure to all classes of pesticides (OR 1.50; 95%CI 1.15-1.96; p=0.03). The synthesis of the evidence pointed to a relationship between exposure to pesticides and some histological types of CNS tumors in childhood.

Os tumores do Sistema Nervoso Central (SNC) representam mais da metade das neoplasias infantis malignas que acometem crianças. Objetivou-se analisar o risco de exposição a agrotóxicos relacionado com o desenvolvimento de tumores do SNC em crianças. Realizou-se uma revisão sistemática da literatura nas bases de dados PubMed/MEDILINE, Embase, Web of Science, Scopus e CINAHL. Foram incluídos estudos de coorte e caso-controle sobre o desenvolvimento de tumores do SNC (todos os tipos histológicos do grupo III Classificação de Câncer Infantil) decorrentes da exposição a agrotóxicos em crianças de 0-14 anos. Na metanálise utilizou-se o modelo de efeito aleatório e o método estatístico de Mantel-Haenszel. A Razão de Chances (RC) ou Odds Ratio (OR) foi a medida de associação aplicada. A revisão foi registrada no International Prospective Register of Systematic Reviews (PROSPERO) sob o número CRD42021209354. A busca identificou 1.158 estudos, dos quais 14 compuseram a revisão. Verificou-se evidência de associação entre o desenvolvimento de astrocitomas e a exposição a todas as classes de pesticidas (OR 1,50; IC95% 1,15-1,96; p=0,03). A síntese dos resultados apontou para uma relação da exposição aos agrotóxicos com o desfecho de alguns tipos histológicos de tumores do SNC na infância.