Background: Talipes equinovarus, also termed club foot, is a congenital deformity of the ankle joint. Despite its prevalence of approximately 1 per 1000 live births, fetal talipes is relatively poorly studied since the introduction of percutaneous tendo Achilles tenotomies. Objectives: To document the associations, outcomes and prognosis of patients with antenatally diagnosed fetal talipes. The study aims to examine the association between, and prevalence of, fetal talipes and other abnormalities, structural and chromosomal, as well as the outcome in relation to postnatal surgery. The accuracy of prenatal ultrasound in diagnosing fetal talipes is also examined. Methods: A retrospective observational study was made of all cases presenting to the Fetal Medicine Unit between 1 January 2009 and 31 December 2014. All the identified cases were analysed to identify isolated talipes, associated abnormalities, and chromosomal abnormalities. The pregnancy outcomes were determined using the Astraia database as well as maternity records. When the outcome resulted in a live infant, these infants were followed up using the files at the referral hospital to determine the treatment method used and the number requiring surgery. Results: There were 155 cases, all referred to the Fetal Medicine Unit. Antenatal data included 75 who had other structural abnormalities and 75 who had isolated talipes. In five of the cases were no sufficient data could be found. Twenty-five cases were lost to follow-up, and 12 cases had no clubfoot at birth. Only one was labelled as having positional clubfoot. There were 91 live births. Of the cases of talipes with associated abnormalities, 21.19% were live births (excluding ENND). All terminations of pregnancy as well as 90.9% of intrauterine fetal deaths were complex talipes, and 94.52% of the cases of isolated talipes were live births. The most common associated abnormalities were of the central nervous system. Seventeen of the live births were lost to follow-up. Of the cases of isolated talipes, 53.19% had tenotomies and Ponseti treatment. The false positive rate of detecting fetal talipes on ultrasound was 7.74%. Conclusion: The study made it evident that complex talipes is associated with a poor pregnancy outcome defined as pregnancy loss, where isolated talipes is usually associated with a good pregnancy outcome. Ultrasound is a good diagnostic tool when diagnosing talipes antenatally but cannot diagnose the severity of the clubfoot. False negatives were not studied. The introduction of tenotomy can make a difference in the outcome of clubfoot in comparison with previous studies where tenotomies were not performed. Medical professionals need to address the importance of counselling, and a multidisciplinary team should be involved in cases involving prenatal counselling.

RAMOS, Jeannette Filomeno Pouchain. Projeto educativo e político-pedagógico da escola De ensino médio: tradições e contradições na gestão e na formação para o trabalho. 2009. 245f. Tese (Doutorado em Educação) – Universidade Federal do Ceará, Faculdade de Educação, Programa de Pós-Graduação em Educação Brasileira, Fortaleza-CE, 2009. / Submitted by Maria Josineide Góis (josineide@ufc.br) on 2012-07-09T11:46:49Z No. of bitstreams: 1 2009_Tese_JFPRamos.pdf: 2192405 bytes, checksum: 71c4d8335d8c1d60c3331ea87534ab26 (MD5) / Approved for entry into archive by Maria Josineide Góis(josineide@ufc.br) on 2012-07-13T11:18:44Z (GMT) No. of bitstreams: 1 2009_Tese_JFPRamos.pdf: 2192405 bytes, checksum: 71c4d8335d8c1d60c3331ea87534ab26 (MD5) / Made available in DSpace on 2012-07-13T11:18:44Z (GMT). No. of bitstreams: 1 2009_Tese_JFPRamos.pdf: 2192405 bytes, checksum: 71c4d8335d8c1d60c3331ea87534ab26 (MD5) Previous issue date: 2009 / The Brazilian education, founded by the logic submission of the educational project from the Jesuits, and the influences from the French, English and Americans, passed on to be considered a national problem with the proclamation of the republic in 1980. The attempt to regulate and to consolidate the social function propaedeutics, which denies the work, the industrialization who demanded the instrumental education for work and the reestablishment of the democracy in the state which reorganized the flexible production and impose the formation of a new type of worker (KUENZER, 1998) presents contradictories movements. In agreement with transformation the scientific technical conception of organization adopted participative democratic mechanism. Recognizing the contradiction in keeping distinct types of logic and the tendency of the liberal logic over the social logic, the challenger of the work management is to reverse this premise. As an alternative to the educational middle class project, the polytechnic education proposes to overcome the dual structure and history by omni lateral formation (SAVIANI, 2003). The elementary and middle school should be guided by the work as an excellent base for education (PISTRAK, 2005). The school, known as the work product of man, should be linked to school life as a social transformation combined with school education with material production and to promote self and social emancipation. In context, the general objective is to analyze the experience of reorganizing the educational work in creation of the politic pedagogic project of middle school, identifying perspectives, limits, possibilities, and resistances. The specifics objectives are to examine the evolution of the educational project in the social politic and economic history of Brazil, highlighting the management of school work and the formation of the young for work; analyze fundamentals, intentions and practices which guide the politic pedagogic project and identify and analyze the limits, possibilities and ways of group resistances in the management project. We choose as a theoretical methodological referential the Critic Theory and the method with materialistic history base. As instruments of qualitative and quantitative data collection we applied questionnaires, semi-structures interviews and focal groups. Among hypothesis should public school follow the educational project of middle class or should it follow the lines of vocational extent, instrumental; to attend to middle class project of the popular sector? The hard format of school has accomplished changes in the lines of directions? The politic pedagogic project working at Liceu do Maracanaú establish four pillars which reorganize the work in the school bearing in mind the full formation of the young. This school thinks, conceives and evaluates opposition to the others schools; it breaks with the traditional format of the work organization. The multiples intelligences are understood as principles, the project of work is the means to transformation of popular knowledge to the scientific knowledge with practice and social application of ideas in development of competencies and abilities, as means an half-yearly organizational and the evaluation as the learning observation. Scientific initiation in middle level education attends the interests of the school, highlighting the talents, improving the indicators and presenting results. This project is contradictory because the fundamentals and practice pedagogic reassures the principles of the traditional format and the process of schooling. This way the study confirms that is possible reorganize the work and this is done by the politic pedagogic project (PPP). Faced with the new demands the schools find themselves in a cross road and their functionality is placed at doubt. As a result of this, we point out the crises of education, formation of young and the society. It is necessary to invest in the contradictions of the system and take possession of them to construct another, the opposite and reverse. It is up to the intellectuals and educators to do their job. / A educação brasileira, permeada pela lógica da submissão do projeto educativo dos jesuítas, das influências francesas, inglesas e dos Estados Unidos da América, passa a ser considerada como problema nacional com a Proclamação da República em 1890. As tentativas de regulamentação e consolidação da função social propedêutica, que nega o trabalho, a industrialização que demandou a educação instrumental para o trabalho e a redemocratização do Estado que reorganizou a produção em flexível e impõe a formação do novo tipo de trabalhador (KUENZER, 1998) apresentam movimentos contraditórios. Em consonância com estas transformações a concepção técnico-científica de organização adota mecanismos democráticos-participativos. Como alternativa ao projeto educativo burguês, a educação politécnica propõe superar a dualidade estrutural e histórica por meio da formação omnilateral (SAVIANI, 2003). A escola fundamental e média deve guiar-se pelo trabalho como base excelente da educação (PISTRAK, 2005), portanto, deve vincular a vida escolar com a transformação social combinando educação escolar com produção material e promover a auto-emancipação e a emancipação social. Neste contexto, o objetivo geral é analisar a experiência de reorganização do trabalho educativo na constituição do projeto político-pedagógico da escola de ensino médio, identificando perspectivas, limites, possibilidades e resistências. Os objetivos específicos são examinar a evolução do projeto educativo na história sociopolítica e econômica do Brasil, destacando a gestão do trabalho escolar e a formação do jovem para o trabalho; analisar os fundamentos, intencionalidades e práticas que norteiam o projeto político-pedagógico e identificar e analisar os limites, possibilidades e formas de resistência coletiva na gestão do projeto. Optamos como referencial teórico-metodológico pela Teoria Crítica e pelo método de base materialista-histórica. Como instrumento de coleta de dados quantitativos e qualitativos foram aplicados questionários, grupos focais e entrevistas semiestruturadas. Entre os questões levantadas destacamos se escola pública deve seguir o projeto educativo da burguesia – propedêutica – ou deve se pautar na dimensão profissionalizante, instrumental, por atender ao projeto burguês para o setor popular? A escola mineralizada tem conseguido ressignificar diretrizes? O projeto político-pedagógico (PPP) em curso no Liceu do Maracanaú estabelece quatro pilares que reorganizam o trabalho na escola tendo em vista a formação integral do jovem. Esta escola pensa concebe e avalia e na contramão da maioria das escolas, rompe com o formato tradicional de organização do trabalho. As inteligências múltiplas são compreendidas como princípio, os projetos de trabalho como meio para a transformação do saber popular para o saber científico com aplicação prática e social dos conteúdos no desenvolvimento de competências e habilidades, a organização semestral como meio e a avaliação como monitoramento da aprendizagem. A iniciação cientifica destaca os talentos, melhora os indicadores e apresenta resultados. Este projeto é contraditório, pois os fundamentos e a prática pedagógica reafirmam os princípios liberais e o processo de escolarização excludente. Deste modo, o estudo confirma que é possível reorganizar o trabalho e este se concretiza por intermédio do PPP. Diante destas novas demandas, as escolas se encontram numa encruzilhada e sua funcionalidade é colocada em dúvida. Como prognóstico, apontamos o aprofundamento da crise da educação, da formação do jovem e da sociedade. Urge investir nas contradições inerentes ao sistema, apropriar-se delas para construção do outro, do contrário. Cabe, portanto, aos intelectuais e educadores cumprirem com a sua tarefa.