Famílias de portadores da síndrome de Down geralmente têm dificuldades para enfrentar a deficiência do filho e vivenciam um processo de luto que pode ser longo. Objetivos. Identificar as razões pelas quais os pais, em geral, não conseguem vencer o luto inicial após o nascimento da criança com síndrome, conhecer dados relativos aos portadores e suas famílias e verificar suas concepções sobre os portadores. Métodos. Para o levantamento de dados utilizaram-se formulários distintos e os resultados apresentados segundo a técnica de análise de conteúdo de Bardin. Resultados. Foram identificadas as principais características de 60 portadores e entrevistadas individualmente 127 pessoas de suas famílias, grande parte das quais vivia em situação de miséria. A maioria das mães/cuidadoras não possuía grandes conhecimentos sobre a síndrome de Down e nem sobre as necessidades dos portadores; tinha medo de morrer e deixar seus filhos desamparados. Os pais/cuidadores apresentaram baixa expectativa em relação à conquista de autonomia do filho e da melhoria da sua qualidade de vida. Conclusões. As famílias com concepções negativas em relação ao portador mantinham o luto inicial porque não elaboraram a “morte" do filho “perfeito", sentimento agravado pela maneira desastrosa com que receberam o diagnóstico, confirmando que grande parte dos profissionais da saúde estavam despreparados naquele momento para o enfrentamento desta problemática. Tudo isto indica a absoluta necessidade da capacitação dos profissionais para darem o diagnóstico e informações adequadas para que a família inicie precocemente os cuidados específicos que seus filhos necessitam / Families of Down’s syndrome sufferers generally have difficulties in facing the deficiency of the child and they experience a process of struggle which can be lengthy. Objectives. To identify the reasons for which the parents, in general, are unable to win the initial fight after the birth of a child with the syndrome, to find out data relative to the sufferers and their families and to check their concept of sufferers. Methods. For the gathering of data several forms were used and the results presented in accordance with Bardin’s contents analysis technique. Results. The principal characteristics of 60 sufferers were identified and 127 people from their families were interviewed individually, a large section of whom was living in a miserable situation. The majority of mothers/carers did not have much knowledge of Down’s syndrome or the needs of sufferers; they were afraid of dying and leaving their children abandoned. Fathers/carers presented low expectations with regard to achieving the child’s autonomy and improving their quality of life. Conclusions. Families with negative perceptions regarding the sufferer continued the initial struggle because they did not prepare the “death" of the “perfect" child, a sentiment aggravated by the disastrous way they had received the diagnosis, confirming that a significant sector of health professionals were unprepared at that time to confront this set of problems. All this indicates the absolute need to train professionals to give a diagnosis and appropriate information for the family to begin early the specific care that their children need.

Famílias de portadores da síndrome de Down geralmente têm dificuldades para enfrentar a deficiência do filho e vivenciam um processo de luto que pode ser longo. Objetivos. Identificar as razões pelas quais os pais, em geral, não conseguem vencer o luto inicial após o nascimento da criança com síndrome, conhecer dados relativos aos portadores e suas famílias e verificar suas concepções sobre os portadores. Métodos. Para o levantamento de dados utilizaram-se formulários distintos e os resultados apresentados segundo a técnica de análise de conteúdo de Bardin. Resultados. Foram identificadas as principais características de 60 portadores e entrevistadas individualmente 127 pessoas de suas famílias, grande parte das quais vivia em situação de miséria. A maioria das mães/cuidadoras não possuía grandes conhecimentos sobre a síndrome de Down e nem sobre as necessidades dos portadores; tinha medo de morrer e deixar seus filhos desamparados. Os pais/cuidadores apresentaram baixa expectativa em relação à conquista de autonomia do filho e da melhoria da sua qualidade de vida. Conclusões. As famílias com concepções negativas em relação ao portador mantinham o luto inicial porque não elaboraram a “morte” do filho “perfeito”, sentimento agravado pela maneira desastrosa com que receberam o diagnóstico, confirmando que grande parte dos profissionais da saúde estavam despreparados naquele momento para o enfrentamento desta problemática. Tudo isto indica a absoluta necessidade da capacitação dos profissionais para darem o diagnóstico e informações adequadas para que a família inicie precocemente os cuidados específicos que seus filhos necessitam / Families of Down’s syndrome sufferers generally have difficulties in facing the deficiency of the child and they experience a process of struggle which can be lengthy. Objectives. To identify the reasons for which the parents, in general, are unable to win the initial fight after the birth of a child with the syndrome, to find out data relative to the sufferers and their families and to check their concept of sufferers. Methods. For the gathering of data several forms were used and the results presented in accordance with Bardin’s contents analysis technique. Results. The principal characteristics of 60 sufferers were identified and 127 people from their families were interviewed individually, a large section of whom was living in a miserable situation. The majority of mothers/carers did not have much knowledge of Down’s syndrome or the needs of sufferers; they were afraid of dying and leaving their children abandoned. Fathers/carers presented low expectations with regard to achieving the child’s autonomy and improving their quality of life. Conclusions. Families with negative perceptions regarding the sufferer continued the initial struggle because they did not prepare the “death” of the “perfect” child, a sentiment aggravated by the disastrous way they had received the diagnosis, confirming that a significant sector of health professionals were unprepared at that time to confront this set of problems. All this indicates the absolute need to train professionals to give a diagnosis and appropriate information for the family to begin early the specific care that their children need.

Made available in DSpace on 2016-03-15T19:40:25Z (GMT). No. of bitstreams: 1 Luciana Rodrigues Theodoro.pdf: 354671 bytes, checksum: 8abdf3d70eea7595d531fd01fb7896d6 (MD5) Previous issue date: 2007-08-07 / Fundo Mackenzie de Pesquisa / The obesity comes increasing too much in the last few decades and for this reason they are innumerable studies that dedicates to the treatment of this illness. However, the epidemic still little is studied in people with Down s syndrome, whose situation propitiates a bigger development of the illness due to the thyroid and growth hormones imbalance problems - that are the factors etiologies of the illness in the population without the syndrome. This study had as objective identify the existence of overweight and obesity in adolescents with Down s syndrome and establish relations with eating habits, hormonal alterations, practices of physical activities and emotional behavior. Had participated in this study 40 adolescents with Down s syndrome between 10 and 19 years of both sex and their respective mothers. The data had been collected in the clinic of a hospital in São Paulo city from a social demography fiche, a questionnaire applied to the mothers and interview with the adolescents and mothers. The results had indicated that, in relation to the weight, 60% had been considered with overweight and obesity, being classified 20% with overweight and 40% with obesity, of these 50% with moderate obesity and 50% with light obesity. The eating habits had demonstrated that 40% eat more than the majority of the people, in the opinion of their mothers. The compulsory search for foods was related by 65% of the interview. The overweight and the obesity had been took of alterations of thyroid in 50% of the cases, of cardiopathies in 57,5%, familiar historic of obesity of 27,5% in fathers and 31% in the mothers and the practical of physical activity in 62,5%. The mothers had chosen as predispositions factors of the overweight and obesity in their children the fact to have Down s syndrome and the adolescents demonstrated to have idea of what it is necessary to make to lose weight and make distinction between healthful and not healthful foods. That can be concluded that the combination of diverse factors can interfere with the presence of the excess of weight in the population with Down s syndrome as already studied in the population without the syndrome, kwon that the syndrome to have clinical alterations (hypothyroidism) that favor the increase of weight still more. / Sabe-se que o quadro de obesidade vem aumentando demasiadamente nas últimas décadas e por esse motivo são inúmeros os estudos que se dedicam ao tratamento desta doença. Porém, a epidemia ainda é pouco estudada em pessoas com Síndrome de Down, cujo quadro sindrômico propicia um maior desenvolvimento da doença devido aos problemas de tireóide e defasagem de hormônios de crescimento que são fatores etiológicos da doença na população sem a síndrome. Este estudo teve como objetivos identificar a existência de sobrepeso e obesidade em adolescentes com Síndrome de Down (SD) e estabelecer relações com hábitos alimentares, alterações hormonais, prática de atividades físicas e comportamento emocional. Participaram 40 adolescentes com SD entre 10 e 19 anos de ambos os sexos e suas respectivas mães. Os dados foram coletados no ambulatório de um hospital na cidade de São Paulo a partir de uma ficha sócio-demográfica, um questionário aplicado às mães, entrevista com os adolescentes e entrevista com as mães. Os resultados indicaram que, em relação ao peso, 60% foram considerados com sobrepeso e obesidade, sendo 20% classificados com sobrepeso e 40% com obesidade, destes 50% com obesidade moderada e 50% com obesidade leve. Os hábitos alimentares demonstraram que 40% comem mais que a maioria das pessoas, na opinião das mães. A busca compulsiva por alimentos foi relatada por 65% dos entrevistados. O sobrepeso e a obesidade foram acompanhados de alterações de tireóide em 50% dos casos, de cardiopatias em 57,5%, histórico familiar de obesidade de 27,5% nos pais e 31% nas mães e a prática de atividade física em 62,5%. As mães elegeram como fator predisponente do quadro de sobrepeso e obesidade em seus filhos o fato de terem SD e os adolescentes demonstram ter idéia do que é necessário fazer para perder peso e fazem distinção entre os alimentos saudáveis e não saudáveis. Pode-se concluir que a combinação de diversos fatores pode interferir na presença do excesso de peso na população com SD como já estudado na população sem a síndrome, tendo em vista que a síndrome possui alterações clínicas (hipotiroidismo) que favorecem ainda mais o ganho de peso.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-02-25T17:57:03Z No. of bitstreams: 1 mayseitagibarooke.pdf: 2048683 bytes, checksum: 817a8af5a2d2d9fe7eabc557e8f23a3e (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-03-03T13:32:55Z (GMT) No. of bitstreams: 1 mayseitagibarooke.pdf: 2048683 bytes, checksum: 817a8af5a2d2d9fe7eabc557e8f23a3e (MD5) / Made available in DSpace on 2016-03-03T13:32:55Z (GMT). No. of bitstreams: 1 mayseitagibarooke.pdf: 2048683 bytes, checksum: 817a8af5a2d2d9fe7eabc557e8f23a3e (MD5) Previous issue date: 2014-08-25 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / A síndrome de Down (SD) em crianças e adolescentes representa grandes desafios para as famílias já que o impacto do diagnóstico tem implicações no sistema familiar, afetando todos os membros e seus relacionamentos. Nesse sentido, as pesquisas revelam que frente à adversidade, o funcionamento da família tem uma maior probabilidade de desenvolver a resiliência, superando os desafios advindos da SD.Assim, este estudo tem como objetivos: caracterizar as famílias de crianças com SD, identificar fatores de risco e de proteção, descrever as estratégias de enfrentamento dos genitores e analisar a resiliência familiar. Cinco famílias compostas por pai, mãe e filhos, tendo um deles a SD, foram visitadas em suas residências. A mãe respondeu ao Questionário de caracterização do sistema familiar e ambos os genitores responderam, separadamente, à Escala de recursos da família, Escala de apoio da família, Inventário de Estratégias de Enfrentamento e entrevistas, sendo que o filho com desenvolvimento típico foi também entrevistado. Os resultados indicam que a renda familiar teve média de 11,7 salários mínimos e as mães constituem-se as cuidadoras principais de seus filhos com SD, bem como assumem a maior parte das atividades domésticas.A participação em missas/cultos foi a atividade social mais relatada pelos participantes. De forma geral, as famílias avaliam os recursos como disponíveis, principalmente, aqueles relacionados ao abrigo, saúde e cuidados com os filhos. A estratégia de enfrentamento mais utilizada é a reavaliação positiva, enquanto a menos utilizada é a fuga-esquiva. Diante de eventos ruins, principalmente, dos problemas de saúde relacionados à SD, as famílias apresentam capacidade de extrair sentido da adversidade, bem como organizam-se de forma cooperativa, com diálogo e estreitamento dos vínculos. Em todas as famílias identificam-se indicativos de resiliência familiar. / Down‟s syndrome (DS) in children and adolescents represents major challenges for families as the impact of the diagnosis has implications in the family system, affecting all members and their relationships. In this sense, the research reveals that the face of adversity, family functioning has a greater likelihood of developing resilience, overcoming the challenges posed DS. Thus, this study aims to characterize the families of children with DS, identify risk and protective factors, describe the coping strategies of parents and analyzing family resilience. Five families composed of father, mother and children, with one DS, were visited in their homes. The mother answered the Questionnaire characterization of the family system and both parents responded separately to the family resource Scale, family support Scale, the coping strategies Inventory and interviews, and the typically developing child was also interviewed. The results indicate that family income has averaged 11,7 minimum wages and mothers constitute the main DS caregivers with their children and assume most of the household activities. Participation in Mass/worship was the most social activity reported by participants. In general, families evaluate resources as available, mainly those related to shelter, health and child care. The most frequently used coping strategy is positive reappraisal, while the least used is escape-avoidance. Before bad events, mainly of health problems related to DS, families have the ability to make sense of adversity, as well as organize themselves cooperatively, with dialogue and closer ties. In all families identify themselves indicative of family resilience.

Made available in DSpace on 2016-07-27T14:20:29Z (GMT). No. of bitstreams: 1 Savanah Borges Araujo Fleury.pdf: 1029037 bytes, checksum: 1b40e7cbbc77de5f46012aa65c865b35 (MD5) Previous issue date: 2014-08-19 / This dissertation has as the objective of study, the caretaker (mother or father) of children with the Down´s Syndrome. The main objective of this work is to understand the subjective sense which this caretaker (father or mother) develops concerning the buccal health of their child with the Down´s Syndrome and general health. The child Down´s Syndrome is seen within their biological, odontological and psychological limits. To understand the human development of such a person with the Down´s Syndrome, the dissertation applies to Vygotsky s Human Development Theory. For this author, the human development of a handicap child follows the same principles of a normal child, the only thing about the indirect ways. On the other hand, the caretaker will be analyzed while the senses of buccal health are developed with their interaction with the handicap child, together with a professional team, their family and society in general. The author who will be employed to accomplish such analysis will be Gonzalez Rey, who, for twenty years, has been constructing the subjective theory within the parameters of the Vygotskian historic cultural school, and which has one of its main pillar the subjective sense. The qualitative methodology has been used for such study, while a whole set of epistemological rules defend the constructive interpretative knowledge character. The instrument which was used to collect the data was the conversational system, of which,the thematic dialog is accomplished as a complement. The main conclusion of the work is that the caretaker of a child with the Down Syndrome, living with their child s syndrome, transformed or is transforming, their subjective feelings as to the buccal health to the child s general health. / Esta dissertação tem como objeto de estudo o cuidador (pai ou mãe) de crianças com Síndrome de Down. O objetivo principal do trabalho é compreender os sentidos subjetivos que este cuidador (pai ou mãe) gera em relação à saúde bucal de seu filho com Síndrome de Down e à saúde em geral. A criança com Síndrome de Down é vista em seus limites biológicos, odontológicos e psicológicos. Para compreender o desenvolvimento humano de tal sujeito com Síndrome de Down, a dissertação recorre à Teoria do Desenvolvimento Humano de Vygotski. Para este autor o desenvolvimento humano de uma criança especial segue os mesmos princípios que o de uma criança comum, só que a criança especial atinge seu desenvolvimento por caminhos indiretos. Por outro lado, o cuidador será analisado enquanto gera sentidos da saúde bucal em sua interação com a criança especial, com a equipe profissional, com sua família e sociedade em geral. O autor usado para se concretizar tal análise será González Rey, que há vinte anos, esta construindo a teoria da subjetividade dentro dos parâmetros da escola históricocultural vygotskiana, e que tem como um de seus pilares o sentido subjetivo. A metodologia usada para tal tipo de estudo é a qualitativa, enquanto um conjunto de regras epistemológicas que defende o caráter construtivo interpretativo do conhecimento. O instrumento utilizado para coleta de dados foi o dos sistemas conversacionais, nos quais o diálogo temático é realizado como complemento. A principal conclusão do trabalho é que a cuidadora da criança com Síndrome de Down, na vivência com a síndrome de seu filho, transformou e está transformando, seus sentidos subjetivos tanto da saúde bucal, quanto da saúde geral de sua criança.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / This work has been developed in the graduated curse in Education of the graduated program in Federal University of Santa Maria. This research has the aim of investigating the social rules of teachers that deal with students with Down s syndrome (DS). These students have been enrolled in the first years of elementary education program with the goal to understand how their involvement in class takes place. Although the challenge that this represents the outcomes is very significant since the regular elementary schools can become environments for DS students. Once, just a small fraction of elementary school admits DS students, there is a challenge as well as need of transformation of the system to have this practice wide spread. In this scenario it is imperative to hear teachers to know they think, feel and their ideas that is their social representations. It is known that a social representation has an impact in the daily activities as well as in the decision making and practicing. The representation make possible to draw a relationship between the dynamics that involve the language, thought and action. To carryout this research we have used the methodology of content analyses with allows to have a wide perspective of social representations on the school context. Analyzing the speech of teachers we pursuit the understanding of the representation that they have of the DS students. Where special attention has been spend to the following items:1) the phenotype; 2) the myths; 3)the terminology; 4) the feelings; 5) the attitudes. By analyzing the obtained data it is possible to conclude that the teacher s representations of DS students are separated from the inclusive practice. In addition, it has been verified that is important to have a specific continuing education for the teachers. With the inclusion teachers are learning to see that which student has his own particularities and a history of life and family that is the student is no longer more than one in class. In this way, the study of teacher s social representation of DS students is away to review the differences in the classroom. Leading to reflections and opening doors to new view, new paths in a process of active participations it is worth to mention that the result that we pursue is a comprehension and description of the process and not the definitive truth. Finally, we have highlighted what Moscovici (1978) states; the study is provisory and open and must be argued and studied with depth. / O presente trabalho foi desenvolvido durante o Curso de Mestrado em Educação, do Programa de Pós-Graduação em Educação, linha de pesquisa Educação Especial, da Universidade Federal de Santa Maria. Desenvolvemos essa pesquisa com o objetivo de investigar as representações sociais dos professores de alunos com síndrome de Down (SD), incluídos nas séries iniciais do ensino fundamental, a fim de compreender como está acontecendo a inclusão desses alunos nas classes comuns do ensino regular. Isso porque, mais que um desafio, a educação inclusiva é uma realidade, que permite que as escolas comuns do ensino regular tornem-se ambientes onde todos possam exercer seu direito à educação, onde as diferenças sejam atendidas (e respeitadas) de forma plena, onde todos os alunos, independente de terem ou não deficiências, tenham respeitados o seu desenvolvimento e o seu ritmo de aprendizagem. Sabemos, no entanto, que em muitas escolas isso não acontece, assim, pensar em inclusão significa pensar na transformação do sistema educacional. É neste contexto que se faz imperativo escutar os professores, saber o que eles pensam, sentem, suas idéias, enfim, suas representações. Sabe-se que as representações sociais influenciam no cotidiano, nas atitudes, nas tomadas de decisão e nas práticas. Pensando nas práticas educativas dos professores, as representações possibilitam fazer a relação entre a dinâmica que envolve linguagem, pensamento e ação. Para a realização da pesquisa, utilizamos a análise de conteúdo como abordagem metodológica, o que nos permitiu ter uma visão ampla das representações sociais e do contexto escolar. Através dos discursos dos professores, buscamos compreender as representações que eles têm de seus alunos com SD, dando atenção maior a alguns pressupostos, tais como: o fenótipo, os mitos, as terminologias, os sentimentos, as atitudes. Com a análise dos dados, podemos observar claramente que ainda está muito dividida a representação que os professores fazem de seus alunos com SD e da sua prática inclusiva. Também, verifica-se que é fundamental a formação continuada específica. Da mesma forma que acreditamos nas inúmeras possibilidades das pessoas com SD, cremos que é imprescindível a dedicação e o preparo dos professores. Com a inclusão os professores estão aprendendo a ver que cada aluno possui as suas particularidades, a sua história de vida: que o aluno não é somente mais um em sala, e sim outro , com outra história, outra família. Assim, o estudo das representações sociais dos professores, de seus alunos com SD, é uma forma de (re)ver a diferença na sala de aula, provocando reflexões e abrindo portas para novos olhares, novos caminhos num processo de participação ativa. É necessário destacar que o resultado que se busca é a compreensão e descrição do processo, não respostas e verdades definitivas, levando em conta que as representações sociais estão em constante (re)formulação. Sublinhamos, finalmente, o que Moscovici (1978) afirma, o estudado é provisório e aberto e deve ser questionado e aprofundado.

This study explores how five teachers from five different special schools work with their students´ speech disorders in a way that stimulates the students to develop their speech. The study is based on interviews as a qualitative method of investigation. An analysis was performed from a sociocultural perspective, where artefacts, the proximal zone of development, as well as the students' opportunities for interaction, were examined. The result of the study shows that teachers use many different types of artefacts. The most common artefacts used by these teachers are pictures and signs as means of support. When the teachers lack knowledge as to how the students would be stimulated to develop their speech, they engage speech therapists who are trained in speech development. There is an awareness with the teachers concerning how the students could take yet another step in their speech development. The teachers also think that the students need to experience contexts where they learn how to interact with each other. Special school students with additional functional disabilities who have extensive speech disorders are those with Down's syndrome or states within the autistic spectrum. Motivation is a key concept for these teachers. To find the motivation within the students, means that they work based on the various areas of interest that the children have. Finding the key to motivation is crucial, in order for the students to develop their speech. / Sammanfattning Denna studie undersöker hur fem pedagoger från fem olika grundsärskolor arbetar med grundsärskoleelevers talsvårigheter på ett sätt som stimulerar eleverna till talutveckling. Studien är baserad på intervjuer som är en kvalitativ undersökningsmetod. En analys gjordes utifrån ett sociokulturellt perspektiv där artefakter, den proximala utvecklingszonen samt elevernas möjligheter till samspel synades. Resultatet av studien visar att pedagoger använder sig av många olika slags artefakter. De vanligaste artefakter som pedagogerna använder sig av är bilder och tecken som stöd. Om pedagogerna känner att de brister i kunskap om hur eleverna ska få stimulans till att utvecklas i sitt tal så anlitar de talpedagoger eller logopeder som har utbildning i tal. En medvetenhet finns hos pedagogerna om hur eleverna ska ta ett steg till i sin talutveckling. Pedagogerna anser även att eleverna ska få uppleva miljöer där de ska lära sig att samspela med varandra. Grundsärskoleelever med flerfunktionsnedsättningar som har stora svårigheter med sitt tal är de med Downs syndrom och autismspektrumtillstånd. Motivation är ett ledord hos pedagogerna. Att hitta motivationen hos eleverna är detsamma som att pedagoger arbetar utifrån elevernas olika intresseområden. Nyckeln till motivationen är viktig att hitta om eleverna ska utvecklas i sitt tal.

Made available in DSpace on 2016-04-04T18:32:50Z (GMT). No. of bitstreams: 1 Juliana Mantelatto.pdf: 894055 bytes, checksum: bacc6bbddee3ddcb652f2d9bb6e06bdb (MD5) Previous issue date: 2009-02-02 / This research has as objective to reflect on the school years of Let?cia, a teenager with Down s syndrome, regularly registered in basic education initial grades, of a regular private school in the metropolitan area of Campinas. The theoretical basis is based on the historical-cultural perspective. This view opposes the traditional conceptions of mental deficiency and is supported, especially, in the contributions of Vygotsky, who built his theory basing on the individual development as a result of a social-historical process, focusing the role of the language and the learning in the development. The central question is the knowledge application through the person interaction with the culture. As methodological procedure I used participant observation, field record, documentary analysis and semi-structured interviews. I made semi-structured interviews with Let?cia, her parents, professionals and teachers who work at the school she attends nowadays. I made some comments at the school from August to December, during the second term of 2007. I also made documentary analysis: since the school pedagogical project, school planning, its rules, didactic material, academic activities and tests, done by this student. The final results show that the biological factor Down s syndrome does not constitute as determinant for the exclusion of school trajectories. It is also necessary the effectiveness of public policies related to the training of teachers, the access to knowledge produced by humanity, effective participation and social mobilization of the people with Down s syndrome. / Esta pesquisa tem como objetivo refletir sobre a trajet?ria escolar de Let?cia, uma adolescente com s?ndrome de Down regularmente matriculada no ensino fundamental s?ries iniciais, de uma escola regular, particular, situada na Regi?o Metropolitana de Campinas. A fundamenta??o te?rica est? baseada na perspectiva hist?rico-cultural. Esta vis?o contraria as concep??es tradicionais de defici?ncia mental e ap?ia-se, especialmente, nas contribui??es de Vygotsky, que construiu sua teoria tendo por base o desenvolvimento do indiv?duo como resultado de um processo s?cio-hist?rico, enfatizando o papel da linguagem e da aprendizagem nesse desenvolvimento. Sua quest?o central ? a apropria??o de conhecimentos pela intera??o do sujeito com a cultura. Como procedimento metodol?gico utilizei observa??o participante, registro de campo, an?lise documental e entrevistas semiestruturadas. Realizei entrevistas semi-estruturadas com Let?cia, com seus pais e com profissionais e professores que atuam na escola em que Let?cia estuda atualmente. Fiz observa??es na escola, durante o 2? semestre de 2007, nos meses de agosto a dezembro. Tamb?m realizei an?lise documental: desde o projeto pedag?gico da escola, plano escolar, regimento escolar, material did?tico, atividades acad?micas e avalia??es realizadas pela aluna. Os resultados finais revelam que o fator biol?gico s?ndrome de Down n?o se constitui como determinante para a exclus?o de trajet?rias escolares. Faz-se necess?rio, tamb?m, ? efetiva??o de pol?ticas p?blicas voltadas ? forma??o de professores; acesso aos conhecimentos produzidos historicamente pela humanidade e efetiva participa??o e mobiliza??o social das pessoas com s?ndrome de Down.

<p>The aims of the studies described in this thesis were to investigate the pharmacokinetics of and cellular resistance to chemotherapy as causes of treatment failure in childhood acute lymphoblastic leukemia (ALL).</p><p>Leukemic cells from 370 children with newly diagnosed ALL were tested by the Fluorometric Microculture Cytotoxicity Assay to measure their resistance to each of ten standard cytotoxic drugs. In the high-risk group, increased in vitro resistance to each of the drugs dexamethasone, etoposide and doxorubicin was associated with a worse clinical outcome. Combining the results for these drugs yielded a drug resistance score, showing a relative risk of relapse in the most resistant group that was 9.8 times higher than in the most sensitive group. In the standard-risk and intermediate-risk groups, final evaluation must await longer follow-up.</p><p>The new cytotoxic agent CHS 828 was equally active in vitro in samples from children with acute myeloblastic leukemia (AML) and ALL, with 50% cell kill at concentrations achievable in vivo. In AML samples CHS 828 also displayed high frequencies of synergistic interactions with four standard drugs. The well-known differences in clinical outcome between Down´s syndrome (DS) and non-DS children with acute leukemia may partly be explained by our finding of differences in drug resistance at the cellular level.</p><p>Pharmacokinetic studies were performed at the start of induction treatment of ALL. Doxorubicin was assayed by reversed-phase liquid chromatography with fluorometric detection, and vincristine by high performance liquid chromatography with electrochemical detection. Plasma doxorubicin concentrations were measured in 107 children after 23 h of a 24-h infusion. The median steady-state concentration in children 4-6 years old, a group known to have a favorable outcome of treatment, was about 50% higher than in those 1-2 and >6 years old Vincristine pharmacokinetics was evaluated in 98 children. There was no correlation between age and total body clearance or any other pharmacokinetic parameters.</p><p>In vitro testing of cellular drug resistance might be useful in predicting the outcome in high-risk ALL. The further exploration of CHS 828 in childhood leukemia seems warranted. There is no pharmacokinetic rationale for the common practice of administering relatively lower doses of vincristine to adolescents than to younger children.</p>

The aims of the studies described in this thesis were to investigate the pharmacokinetics of and cellular resistance to chemotherapy as causes of treatment failure in childhood acute lymphoblastic leukemia (ALL). Leukemic cells from 370 children with newly diagnosed ALL were tested by the Fluorometric Microculture Cytotoxicity Assay to measure their resistance to each of ten standard cytotoxic drugs. In the high-risk group, increased in vitro resistance to each of the drugs dexamethasone, etoposide and doxorubicin was associated with a worse clinical outcome. Combining the results for these drugs yielded a drug resistance score, showing a relative risk of relapse in the most resistant group that was 9.8 times higher than in the most sensitive group. In the standard-risk and intermediate-risk groups, final evaluation must await longer follow-up. The new cytotoxic agent CHS 828 was equally active in vitro in samples from children with acute myeloblastic leukemia (AML) and ALL, with 50% cell kill at concentrations achievable in vivo. In AML samples CHS 828 also displayed high frequencies of synergistic interactions with four standard drugs. The well-known differences in clinical outcome between Down´s syndrome (DS) and non-DS children with acute leukemia may partly be explained by our finding of differences in drug resistance at the cellular level. Pharmacokinetic studies were performed at the start of induction treatment of ALL. Doxorubicin was assayed by reversed-phase liquid chromatography with fluorometric detection, and vincristine by high performance liquid chromatography with electrochemical detection. Plasma doxorubicin concentrations were measured in 107 children after 23 h of a 24-h infusion. The median steady-state concentration in children 4-6 years old, a group known to have a favorable outcome of treatment, was about 50% higher than in those 1-2 and &gt;6 years old Vincristine pharmacokinetics was evaluated in 98 children. There was no correlation between age and total body clearance or any other pharmacokinetic parameters. In vitro testing of cellular drug resistance might be useful in predicting the outcome in high-risk ALL. The further exploration of CHS 828 in childhood leukemia seems warranted. There is no pharmacokinetic rationale for the common practice of administering relatively lower doses of vincristine to adolescents than to younger children.