Percepções Sobre o Processo de Inclusão de Estudantes com Paralisia Cerebral no Ensino Regular de uma Cidade da Fronteira Oeste do RS

ResumoLevando em consideração o amparo estabelecido por lei no que diz respeito a inclusão no Ensino Regular, sabe-se que existem inúmeras barreiras para que, de fato, este processo inclusivo realmente aconteça. Diante disso, esta pesquisa teve o objetivo de analisar as percepções de responsáveis e professores de estudantes com Paralisia Cerebral sobre o processo de inclusão, em uma cidade da Fronteira Oeste do Rio Grande do Sul. A amostra foi composta por doze indivíduos, sendo eles responsáveis e professores dos seis estudantes do estudo. A coleta de dados ocorreu através de entrevista baseada no instrumento School Function Assessment. A análise foi realizada através da estatística descritiva por meio de medidas de frequência, médias e desvio padrão. Para analisar a concordância entre a percepção dos responsáveis e professores, foi realizado o teste Índice de Kappa. Os resultados se apresentam em três pilares: participação nos ambientes escolares, tarefas físicas e cognitivas. Na participação nos ambientes escolares se identificou uma relação inversa com o grau de comprometimento. Nas tarefas físicas e cognitivas, ficou evidenciado que a necessidade de assistência é maior que a de adaptação. Baseado nesse respaldo se pode inferir que as principais barreiras estão relacionadas aos recursos humanos, a falta de auxílio e de assistência para os estudantes desenvolverem suas tarefas. Constatou-se, também, que as adaptações arquitetônicas isoladamente não contribuem, de maneira significativa, mesmo sendo facilitadoras do processo, não garantem a inclusão. Palavras-chave: Educação Inclusiva. Paralisia Cerebral. Educação Básica. AbstractTaking into account the support established by law regarding the inclusion in regular education, it is known that there are numerous barriers for, in fact, this inclusive process to actually happen. Therefore, this research aimed to analyze the perceptions of representatives and teachers of students with Cerebral Palsy about the inclusion process in a city on the Western Frontier of Rio Grande do Sul. The sample was composed of twelve individuals, being representatives and teachers for the six students in the study. Data collection took place through an interview based on the School Function Assessment instrument. The analysis was carried out through descriptive statistics through measures of frequency, means and standard deviation. To analyze the concordance between the perception of those responsible and teachers, Kappa Index test was performed. The results are presented in three pillars: participation in school environments, physical and cognitive tasks. In the participation in school environments, an inverse relationship with the degree of commitment was identified. In physical and cognitive tasks, it became evident that the need for assistance is greater than that of adaptation. Based on this support, it can be inferred that the main barriers are related to human resources, the lack of help and assistance for students to develop their tasks. It was also found that architectural adaptations alone do not contribute significantly, even though they facilitate the process, they do not guarantee inclusion. Keywords: Inclusive Education. Cerebral Palsy. Basic Education.

Characteristic Quality of Life Children with Rheumatic Heart Disease

Background: Rheumatic heart disease is an acquired disease that has characterized damaged valve and it effects the quality of life in children. Aim: To asses quality of life in patient with rheumatic heart disease by using Pediatric Quality of Life Inventory (PedsQL) instrument at pediatric cardiologist. Methods: A descriptive study with cross sectional study conduct among children aged 5 to 18 years old attend the Pediatric Cardiology at Haji Adam Malik Hospital Medan, from 2016 to 2018. Result: A hundred children with rheumatic heart disease in this study who had affected quality of life-based on group age with 5 to 7 year old in physical function was 6 subjects (85.7%), social function was 1 subject (14.2%), and school function was 2 subjects (28.5%) (Table 3); group age with 8 to 12 year old in physical function was 100 subjects (100%), emotional function was 3 subjects (3%), social function was 1 subject (3%), and school function was 5 subjects (15.1%); group aged 13 to 18 year old in physical function was 60 subjects (100%), emotional function was 1 subject (16.7%), and school function was 51 subjects (85%). Conclusion: From 100 children with RHD dominant in group aged 13-18 years old and male, mal malnutrition status, using of erythromycin, high senior school of level parents’ education, and valve disorder was mitral regurgitation. The quality of life was affected in all age groups, especially in the domain of physical function, and school functions with RHD.

Habilidades de interação social e o brincar de crianças com cegueira ou baixa visão em contexto escolar

O objetivo do presente estudo foi analisar as habilidades de interação social e o brincar de crianças com cegueira ou baixa visão em contexto escolar, na percepção de seus respectivos professores da classe regular. Trata-se de uma pesquisa quantitativa, descritiva, analítica e transversal realizada no período de abril a julho de 2019. Participaram 16 professoras que acompanhavam 18 crianças com cegueira ou baixa visão matriculadas em escolas da Rede Municipal de Ensino, nos Anos Iniciais do Ensino Fundamental, da Região Metropolitana do Recife/PE. Foi utilizado o instrumento School Function Assessment para a coleta de dados. Para comparação dos percentuais dos níveis dos fatores avaliados foi aplicado o teste Qui-quadrado para comparação de proporção. Para avaliar o nível de auxílio demandado pelos alunos foram calculadas as estatísticas medianas e amplitude interquartil das tarefas avaliadas. Os resultados apresentaram que as crianças com cegueira ou baixa visão apresentaram maior dificuldade em desempenhar atividades lúdicas. Quanto à participação social, observou-se que as mesmas crianças desenvolveram habilidades de interação social básicas e suficientes para o convívio em ambiente escolar. A comparação das tarefas de interação social e o brincar identificou, de acordo com a percepção dos professores, que o desempenho no brincar está mais prejudicado nas crianças com deficiência visual, bem como necessita de maiores adaptações e assistência.

M182. EFFECTIVENESS OF COORDINATED SPECIALTY CARE (CSC) DELIVERED VIA TELE-HEATH COMPARED TO THE STANDARD CSC CLINIC-BASED MODEL

Background There is a growing body of evidence suggesting that specialized early intervention (EI) programs deliver superior outcomes for individuals with early phase psychosis. Coordinated Specialty Care (CSC) is a recovery-oriented EI treatment program that employs multi-disciplinary team based care with high provider to patient staffing ratios and promotes shared decision making. CSC services are primarily provided in health care clinics. An alternative to “in clinic” service models is tele-health (TH) where clinical care and team interactions occur remotely through TH platforms. The advantages of this model may include reduced costs, bridging geographical distances, decreased stigma and increased flexibility for when and where therapeutic sessions occur. The purpose of this study is to compare the effectiveness of CSC delivered through TH (CSC-TH) versus the standard, clinic-based CSC model (CSC-Clinic). Methods A TH network was established in Indiana, USA to provide statewide CSC services. A “hub” team, comprised of a psychiatrist, therapist, team leader, nurse and data manger, was located in Indianapolis, IN and four “spoke” sites (Ft. Wayne, Anderson, Gary and Bloomington IN), were established across the State. All hub team services were delivered remotely through VIDYO, a leading, HIPPA compliant TH platform which was used on hand-held devices for care deliver in the subjects’ homes, as well as in local CMHCs. The standard clinical CSC program (CSC-Clinic), termed Prevention and Recovery Center (PARC), was located in Indianapolis, IN and all services were obtained through in-person clinic visits. Both the CSC-TH and CSC-Clinic programs employed identical inclusion criteria (16 – 30 years; within 3 years of psychosis onset; and non-substance induced psychotic disorder), assessment instruments, OnTrackNY training for all treatment staff, and outcome measures. Both programs conducted weekly team meetings where all patients were reviewed. Both programs were assessed for fidelity to the CSC model. All CSC patients were newly enrolled over the same treatment period. Data was collected at baseline, 3 months and 6 months. The outcome measures included engagement (drop outs), use of acute services (ER, hospitalization), illness severity (CGI-S), and MIRECC GAF symptoms, occupation/school function and social function. Ratings were independently determined through consensus of the respective treatment teams. Results Thirty-one early phase subjects were enrolled in the CSC-TH and 89 in the CSC-Clinic programs. Analyses demonstrates that CSC-TH was associated with significant and trend level superiority compared to CSC-Clinic for better engagement (3-month: X2=2.89, p=0.09; 6-month: X2=3.12, p=0.05); less use of acute services (3-month: X2= 6.62, p=0.01; 6-month: X2 =7.17, p=0.07); lower MIRECC GAF symptoms (3-month: t=3.2, p=0.002), improved occupation/school function (3-month: t=3.02, p=0.003) and social function (t=3.18, p=0.002). No group differences were found for CGI-S ratings. Discussion These results suggest that CSC-TH was associated with better outcomes compared to CSC-Clinic on key variables. Important caveats, including lack of randomization and blinded ratings, will be discussed. Future studies needed to further evaluate the role of TH in EI programs will be proposed.

Analysis of the commercialization from the Enem by the three schools better ranked in 2015 from the city of São Paulo. Abstract

This work discusses the use of the ENEM ranking by a group of private schools in the city of São Paulo for commercial purposes and explcity through the data obtained from Instituto Nacional de Estudos e Pesquisas Educacionais Anísio Teixeira (INEP), how the families are led to look for these schools because of the disclosure of results with criteria and deficit of information, starting an "intellectual auction" for the search for scholarships to attend high school. It is well-known that the students' dispute between private schools in São Paulo has been fierce over the years and the transitions made by them tend to happen at the end of the last grade of Elementary School II (9th Year), so, after having done all training in an institution, in the final portion of their preparation, students tend to look for specialized entrance schools and better ranked in the ENEM. We observed that these elements end up distorting the real breadth of the school function that starts to adopt measures to keep its students and just prepare for the entrance exam.