Made available in DSpace on 2016-04-04T18:27:30Z (GMT). No. of bitstreams: 1 Fabio P Nucci.pdf: 270630 bytes, checksum: 73a8894e8429815d670ae4c13d185fe8 (MD5) Previous issue date: 2007-02-07 / Nowadays, there are a large number of professionals from different areas using motricity or psychomotricity as a way of studying many contexts, implying that motricity is the interaction of several motor functions. The aim of this study was to characterize the psychomotor profile of children aging from 6 to 11 years old with an Attention Deficit Hyperactivity Disorder (ADHD) clinical diagnosis. Ten Children that were attending the Children s Psychiatric Department of a Hospital from a Sao Paulo State city, from April/ 2006 to June/ 2006 had participated on the present research. In order to be selected, children must have satisfied the inclusion criteria, and also they must not have any exclusion criteria. After obtaining parental consent, children were evaluated. The assessment tool was Motor Development Scale (MDS) developed by Francisco Rosa Neto (1996), focusing 5 psychomotor factors, including fine motricity, global motricity, equilibrium, body scheme, and space organization. With the applied tasks, it became possible to verify all kinds of variation on the psychomotor performance establishing, or not, a relationship with the ADHD. The results suggests that the ADHD children did not have a satisfying motor performance, however it is not possible to assume that the ADHD was the only cause of the low performance, it is necessary to consider other issues as environments, social end economic level, and others, though this study does not concerns this issues. / Na atualidade, existem in?meros profissionais que utilizam a motricidade ou a psicomotricidade como meio de estudos em diferentes contextos, sendo que a motricidade ? a intera??o de diversas fun??es motoras. O objetivo desta pesquisa foi caracterizar o perfil psicomotor de crian?as entre 6 e 11 anos de idade com diagn?stico cl?nico comprovado de transtorno do d?ficit de aten??o e hiperatividade. Participaram da presente pesquisa 10 crian?as que freq?entaram, entre abril de 2006 e junho de 2006, o Ambulat?rio de Psiquiatria Infantil de um Hospital de uma cidade do interior do estado de S?o Paulo. Foram selecionadas as crian?as que cumpriram os crit?rios de inclus?o, al?m de n?o possu?rem nenhum fator de exclus?o. A pesquisa foi realizada com a autoriza??o dos pais ou respons?veis, os quais assinaram o termo de consentimento. As crian?as foram submetidas a uma avalia??o por meio da Escala de Desenvolvimento Motor (EDM), estabelecida por Francisco Rosa Neto (1996). Referente ? EDM, a mesma enfoca 5 fatores psicomotores, sendo motricidade fina, motricidade global, equil?brio, esquema corporal e organiza??o espacial. Por meio das tarefas aplicadas, foi poss?vel constatar qualquer tipo de varia??o no desempenho dos fatores psicomotores citados, estabelecendo-se, ou n?o, uma rela??o com o transtorno do d?ficit de aten??o e hiperatividade. O resultado obtido constatou um perfil psicomotor com desempenho n?o satisfat?rio, por?m ? invi?vel afirmar que esse seja o ?nico fator para tal resultado, sendo necess?rio considerar outras vari?veis como meio ambiente, n?vel socioecon?mico, entre outras, as quais n?o s?o o objeto de discuss?o deste estudo.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2016-02-10T12:59:12Z No. of bitstreams: 1 TES_VERA_ELIZABETH_CLOSS_PARCIAL.pdf: 344877 bytes, checksum: 83c1713273477d9c1c0fb821d224a93c (MD5) / Made available in DSpace on 2016-02-10T12:59:12Z (GMT). No. of bitstreams: 1 TES_VERA_ELIZABETH_CLOSS_PARCIAL.pdf: 344877 bytes, checksum: 83c1713273477d9c1c0fb821d224a93c (MD5) Previous issue date: 2015-08-27 / Population ageing has been the focus of many studies as it reflects an important transformation of society that creates a reality with new challenges to be faced. The ageing process can be categorized in two forms: normal ageing or ageing per se or senescence (with associated molecular, anatomical and physiological alterations) and usual ageing or senility (associated with diseases and disabilities). The frailty syndrome is among the most discussed current themes. Frailty is a condition in which the individual presents increased vulnerability to the development of dependency, hospitalization, institutionalization, fall-risk and mortality, among other adverse outcomes, when exposed to a stressor. Various pathophysiological processes involved in frailty are closely related to nutritional and body composition aspects, and anthropometry presents as a useful technique for evaluating these conditions. Given that frailty in its early stages is commonly seen in the elderly community and that available instruments for its identification (such as the widely used Fried Phenotype) are complex and difficult to apply in primary care, the search for simple tools becomes important. In this thesis, three original articles are presented. In the first, article, AGING INDEX DEVELOPMENT IN BRAZIL, REGIONS, AND FEDERATIVE UNITS FROM 1970 TO 2010, we sought to address the ageing index, the parameter through which to evaluate the expansion process of the elderly segment of total population in relation to the relative change in young age group. To this end, data from the Demographic Census and Social Indicators of the Brazilian Institute of Geography and Statistics (IGBE) were analysed. It was evidenced that the Brazilian population is undergoing a rapid ageing process. For the second article, DESCRIPTION OF ANTHROPOMETRIC MEASUREMENTS AND ANALYSIS OF THEIR ASSOCIATION WITH GENDER, AGE, AND FRAILTY SYNDROME IN ELDERLY ASSISTED AT THE FAMILY HEALTH STRATEGY: DATA FROM THE EMI-SUS, data from 583 elderly participants of a cross-sectional study ?Clinical and Epidemiological Study of the Elderly Attended at the Family Health Strategy (FHS) in the City of Porto Alegre (EMI-SUS)?, were analyzed. The frequency of frailty (diagnosed by Fried Phenotype) was observed to be 21.5% and pre-frailty 51.1%, and that only one of the 41 evaluated anthropometric measures was not associated with at least one of the investigated dependent variables (gender, age group or frailty). In the third article, PERFORMANCE OF ANTHROPOMETRIC MEASURES IN PREDICTING FRAILTY IN THE ELDERLY: LOGISTIC REGRESSION AND ARTIFICIAL NEURAL NETWORK MODELS, we sought to investigate the performance of 26 anthropometric measurements in predicting frailty and to develop a tool for their identification. Data from 583 participants of the EMI-SUS were analyzed, randomly divided into a learning sample (n=439) and test sample (n=144). Logistic regression and artificial neural network models were used. The neural network demonstrated a superior predictive performance to the logistic regression model and resulted in a reliable tool for identifying frailty in the elderly. The anthropometric measures of weight, biceps skinfold, sagittal abdominal diameter and waist circumference, grouped, proved to be good predictors of frailty in the elderly. / O envelhecimento da popula??o tem sido foco de muitos estudos por se tratar de uma transforma??o importante da sociedade e que implica uma realidade com novos desafios a serem enfrentados. O processo de envelhecimento pode ser categorizado em dois padr?es: o envelhecimento normal ou envelhecimento per se ou senesc?ncia (com altera??es moleculares, anat?micas e fisiol?gicas associadas) e o envelhecimento usual ou senilidade (associado a doen?as e incapacidades). Dentre as tem?ticas mais abordadas atualmente, encontra-se a s?ndrome da fragilidade. Fragilidade ? uma condi??o na qual o indiv?duo apresenta uma maior vulnerabilidade para o desenvolvimento de depend?ncia, hospitaliza??o, institucionaliza??o, queda e mortalidade, dentre outros desfechos negativos, quando exposto a um estressor. V?rios processos fisiopatol?gicos envolvidos na fragilidade t?m estreita rela??o com aspectos nutricionais e de composi??o corporal e que, na avalia??o destas condi??es, a antropometria se apresenta como uma t?cnica ?til. Considerando que est?gios iniciais de fragilidade s?o comumente observados em idosos da comunidade e que instrumentos dispon?veis para a identifica??o de fragilidade (como o fen?tipo de Fried que ? amplamente utilizado) s?o complexos e de dif?cil aplica??o na aten??o b?sica, a busca por ferramentas simples torna-se importante. Na presente tese, s?o apresentados tr?s artigos originais. No primeiro artigo, A EVOLU??O DO ?NDICE DE ENVELHECIMENTO NO BRASIL, NAS SUAS REGI?ES E UNIDADES FEDERATIVAS NO PER?ODO DE 1970 A 2010, buscou-se abordar o ?ndice de envelhecimento, par?metro atrav?s do qual se avalia o processo de amplia??o do segmento idoso na popula??o total em rela??o ? varia??o relativa no grupo et?rio jovem. Para tanto, foram pesquisados dados dos Censos Demogr?ficos e dos Indicadores Sociais do IBGE. Evidenciou-se que a popula??o brasileira se encontra em franco processo de envelhecimento. Para o segundo artigo, DESCRI??O DE MEDIDAS ANTROPOM?TRICAS E AN?LISE DE SUA ASSOCIA??O COM G?NERO, IDADE E S?NDROME DA FRAGILIDADE EM IDOSOS ASSISTIDOS NA ESTRAT?GIA SA?DE DA FAM?LIA: DADOS DO EMI-SUS, foram analisados os dados de 583 idosos participantes de um estudo transversal denominado ?Estudo Epidemiol?gico e Cl?nico dos Idosos Atendidos na Estrat?gia Sa?de da Fam?lia (ESF) do Munic?pio de Porto Alegre (EMI-SUS)?. Observou-se que a frequ?ncia de fragilidade (diagnosticada pelo Fen?tipo de Fried) foi 21,5% e de pr?-fragilidade, 51,1% e que, das 41 medidas antropom?tricas avaliadas, somente uma n?o se mostrou associada com pelo menos uma das vari?veis dependentes investigadas (sexo, faixa et?ria ou fragilidade). No terceiro artigo, PERFORMANCE OF ANTHROPOMETRIC MEASURES IN PREDICTING FRAILTY IN ELDERLY: LOGISTIC REGRESSION AND ARTIFICIAL NEURAL NETWORK MODELS, buscou-se investigar a performance de 26 medidas antropom?tricas na predi??o de fragilidade e formular uma ferramenta para sua identifica??o. Foram analisados os dados de 583 idosos participantes do EMI-SUS, divididos randomicamente em uma amostra de aprendizado (n=439) e uma amostra teste (n=144). Foram utilizados modelos de regress?o log?stica e rede neural artificial. A rede neural mostrou performance preditiva superior ? regress?o log?stica e resultou em uma ferramenta confi?vel na identifica??o de fragilidade em idosos. As medidas antropom?tricas peso, dobra cut?nea bicipital, di?metro abdominal sagital e circunfer?ncia da cintura, agrupadas, mostraram-se bons preditores de fragilidade em idosos.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2016-05-03T15:55:01Z No. of bitstreams: 1 TES_JANAINA_ALVARENGA_ARAGAO_COMPLETO.pdf: 3180936 bytes, checksum: 8c2565ec49dcb5d8412b181769abe70c (MD5) / Made available in DSpace on 2016-05-03T15:55:01Z (GMT). No. of bitstreams: 1 TES_JANAINA_ALVARENGA_ARAGAO_COMPLETO.pdf: 3180936 bytes, checksum: 8c2565ec49dcb5d8412b181769abe70c (MD5) Previous issue date: 2014-03-31 / Several changes have occurred on humanity in the last decades, the aging of the world population and Brazilian population. Due to the drop in mortality rates and increased life expectancy at birth, it has also increased the prevalence of chronic diseases due to transmissible diseases in developing countries. The overall objective of the study was analyze the relation between the characteristics of access to health care and assistency provided in primary care to adults and seniors of remaining quilombola communities, associated to the epidemiological and socio-cultural profile of the community where they live. A census was conducted along with community health agents, and by the end 198 remnants of quilombola communities, adults and seniors, that is being 45 years old or more, residents of the quilombola communities of Piau?, between March and December 2011. It was performed an analysis (fasting peripheral blood, and analyzed it to test the levels of HDL-cholesterol, triglycerides and glucose), anthropometric data (height, weight, arterial pressure, waist circumference), completed questionnaires regarding sociodemographic data, lifestyle and access to healthcare. Data were scanned into a database developed by TeleForm and analyzed using the Epi Info software, version 3.5.1. The botanical material was collected to get to know the practices and natural and traditional health resources in their communities. The study was approved by the Pontifical Catholic University of Rio Grande do Sul Ethics Committee. The results of this study demonstrated that the prevalence of MS was 55.4% in the quilombolas surveyed, and more prevalent in females (p <0.001). the distance between home and the health unity greater than 5 km was significantly important for a smaller chance to prefer non-traditional health knowledge, the geographical distance interfered with the access to healthcare of these communities. Therefore, it is necessary to invest in the construction of social equipment designed to meet their needs based on the historical context and where these communities live, especially in public policies of preventive health education, professional qualification of the Family Health staff, since it is in this strategy that the government investment has had the highest concentration. / V?rias mudan?as aconteceram na humanidade nas ?ltimas d?cadas, o envelhecimento da popula??o mundial e popula??o brasileira. Devido ? queda da taxa de mortalidade, e aumento da esperan?a de vida ao nascer aumentou tamb?m a preval?ncia das enfermidades cr?nicas em detrimento das doen?as transmiss?veis nos pa?ses em desenvolvimento. O objetivo geral desse trabalho foi analisar a rela??o entre as caracter?sticas de acesso de sa?de e assist?ncia prestada na aten??o b?sica dirigida aos adultos e idosos de comunidades remanescentes quilombolas, associado ao perfil epidemiol?gico e sociocultural da comunidade onde vivem. Para metodologia realizou-se um censo junto com os agentes comunit?rios de sa?de, e ao final participaram 198 volunt?rios remanescentes de comunidades quilombolas, adultos e idosos, ou seja com idade de 45 anos ou mais residentes nas comunidades quilombolas no centro sul do Piau, entre mar?o e dezembro de 2011. Que realizaram an?lises (sangue perif?rico em jejum, e analisadas para testar os n?veis de colesterol-HDL, triglicer?deos e glicemia), dados antropom?tricos (altura, peso, press?o art?ria, circunfer?ncia abdominal), responderam question?rios sobre dados, s?cio demogr?ficos, h?bitos de e de acesso de sa?de. Os dados foram digitalizados em um banco de dados desenvolvido pelo programa TeleForm e analisados pelo programa Epi Info, vers?o 3.5.1. O material bot?nico foi coletado para conhecer as pr?ticas e recursos naturais e tradicionais de sa?de de suas comunidades. A pesquisa foi aprovada pela Comit? de ?tica da Pontif?cia Universidade Cat?lica do Rio Grande do Sul. Os resultados dessa pesquisa mostraram a preval?ncia da SM foi de 55.4% nos quilombolas pesquisados, e mais prevalente no sexo feminino (p < 0,001). A dist?ncia entre a resid?ncia e a UBS maior que 5 km foram um fator significativamente importante para a menor chance de preferir conhecimentos n?o tradicionais de sa?de, que a dist?ncia geogr?fica interferiu no acesso de sa?de dessas comunidades. Portanto ? necess?rio investir na constru??o de equipamentos sociais destinados a atender suas demandas tendo como base o contexto hist?rico e local onde vivem essas comunidades, principalmente em pol?ticas p?blicas de sa?de preventiva e na educa??o, qualifica??o dos profissionais das equipes de Sa?de da Fam?lia, pois ? nessa estrat?gia onde os investimentos governamentais tem tido maior concentra??o.

Submitted by Sara Ribeiro (sara.ribeiro@ucb.br) on 2017-08-15T12:47:41Z No. of bitstreams: 1 WaleskaMascarenhasdosSantosDissertacao2017.pdf: 1657834 bytes, checksum: 3001f35415661ff719736110022e5e50 (MD5) / Approved for entry into archive by Sara Ribeiro (sara.ribeiro@ucb.br) on 2017-08-15T12:47:45Z (GMT) No. of bitstreams: 1 WaleskaMascarenhasdosSantosDissertacao2017.pdf: 1657834 bytes, checksum: 3001f35415661ff719736110022e5e50 (MD5) / Made available in DSpace on 2017-08-15T12:47:45Z (GMT). No. of bitstreams: 1 WaleskaMascarenhasdosSantosDissertacao2017.pdf: 1657834 bytes, checksum: 3001f35415661ff719736110022e5e50 (MD5) Previous issue date: 2017-06-29 / There is an agreement in the contemporary literature that multimodal interventions are best indicated for attention-deficit/hyperactivity disorder (ADHD). On this perspective, interventions implemented in the school context, especially in the classroom, are relevant for the educational process from students with this diagnosis. In this context, typical ADHD behaviors are especially dysfunctional and also contributes on school failure and dropout. The aim of the present study was to analyze the effects of two teaching strategies on typical problem ADHD behaviors: ClassWide Peer Tutoring and Highlighted Words. Using a multiple baseline across participants design, three elementary school students from a public school, diagnosed with ADHD, were exposed to both strategies. Results showed reduction in typical hyperactivity/impulsivity and attention deficit repertoires from baseline levels for all participants. These data replicate and extend the results of prior studies which also showed interventions effects however in academic tasking behaviors. / H?? consenso na literatura contempor??nea de que interven????es multimodais s??o as mais indicadas para o Transtorno de D??ficit de Aten????o/Hiperatividade (TDAH). Nesta perspectiva, interven????es realizadas no contexto escolar e, principalmente, em sala de aula, s??o relevantes para o processo educacional dos estudantes que apresentam tal transtorno. ?? neste contexto que os comportamentos t??picos do TDAH s??o especialmente disruptivos e contribuem para altos ??ndices de fracasso e evas??o escolar. O presente estudo teve por objetivo analisar o efeito de diferentes estrat??gias interventivas, em sala de aula, sobre os repert??rios t??picos do transtorno, em tr??s meninos diagnosticados com TDAH, alunos da primeira fase do Ensino Fundamental (1?? ao 5?? ano) de uma escola p??blica. Para isso, foi utilizado um delineamento de linha de base m??ltipla, no qual as interven????es Palavras em Destaque e ClassWide Peer Tutoring, foram aplicadas com todos os participantes, um por vez. Observou-se que as duas interven????es tiveram efeitos sobre os repert??rios de hiperatividade/impulsividade e de d??ficit de aten????o dos participantes produzindo o enfraquecimento dos mesmos. Estes resultados replicam e ampliam os de pesquisas anteriores as quais tamb??m evidenciaram efeitos das interven????es investigadas, contudo em repert??rios acad??micos como acertar tarefas e compreender enunciados.

Submitted by Biblioteca Digital de Teses e Disserta????es (sdi@ucb.br) on 2017-11-20T13:05:13Z No. of bitstreams: 1 IsabelaAlmeidaRamosTeseParcial2017.pdf: 1042461 bytes, checksum: f6949b777ee0947e83bb52979487d593 (MD5) / Approved for entry into archive by Biblioteca Digital de Teses e Disserta????es (sdi@ucb.br) on 2017-11-20T13:10:49Z (GMT) No. of bitstreams: 1 IsabelaAlmeidaRamosTeseParcial2017.pdf: 1042461 bytes, checksum: f6949b777ee0947e83bb52979487d593 (MD5) / Made available in DSpace on 2017-11-20T13:10:49Z (GMT). No. of bitstreams: 1 IsabelaAlmeidaRamosTeseParcial2017.pdf: 1042461 bytes, checksum: f6949b777ee0947e83bb52979487d593 (MD5) Previous issue date: 2017-06-21 / Learning difficulties and disturbs, socioeconomic conditions, could justify the high rate of brazilian educational system failure. Therefore, interdisciplinary Physical Education can ameliorate children learning. The purpose of this study was to verify the effects of an interdisciplinary physical education program on academic achievement and selective attention in children. 60 boys and girls from 4th grade of public elementary brazilian school, underwent a Education by Movement group (EduMove) (n=39, 9.7??yr; 31.6 ?? 6.2 kg; 1.4 ?? 0.1 m; 17.9 ?? 7.2 %G) with math, written and reading classes through physical education activities during a school journey (172.8??16.31bpm) (60min each class, twice a week), and a control group (Con) (n=21, 9.9??0.8yr; 30.0 ?? 5.1 kg; 1.4 ?? 0.1 m; 17.1 ?? 8.6 %G) which participated at traditional classes (92.4??8.9bpm). Thereafter children undertook anthropometric (weight, height, body fat), physical activity level, academic achievement, selective attention test (Stroop Go/NoGo), before and after three months. ANOVA revealed tricipital skinfold reduction for EduMove in comparison with CON at post test (11.8 ?? 5.6 vs 12.7 ?? 5.3; p=0.008), it was observed higher physical activity level for EduMovi vs CON (?? 23.3 vs 2.9 METs; p=0.09). Children showed better results at reading capacity for EduMovi vs CON (65.2 ?? 4.9 vs 64.7 ?? 3.0; p=0.038). Regarding selective attention EduMovi was faster and committed less mistakes in comparison with pre test (236.1 ?? 39.9 vs 327.9 ?? 45.88 ms/%, ?? -90ms e - 2% de erros p=0.09). A short term interdisciplinary physical education program can improve reading capacity, and selective attention in children. These results may suggest that activity breaks during a school journey could contributing to learning. / Dificuldades, problemas de aprendizagem, condi????es socioecon??micas, s??o fatores que justificam o alto ??ndice de repet??ncia escolar no sistema educacional brasileiro. Nesse sentido, a Educa????o F??sica interdisciplinar pode otimizar a aprendizagem da crian??a. O estudo teve por objetivo verificar os efeitos de um programa de educa????o f??sica interdisciplinar sobre o desempenho escolar e aten????o seletiva de crian??as. 60 meninos e meninas com desempenho escolar inferior, estudantes do 4?? ano do ensino fundamental foram divididos em grupo educa????o pelo movimento (EduMovi) (n=39, 9,7 ?? 1,0 anos; 31,6 ?? 6,2 kg; 1,4 ?? 0,1 m; 17,9 ?? 7,2 %G), que participou de aulas ativas com os conte??dos de portugu??s e durante o turno escolar (duas vezes por semana por tr??s meses) (172,8 ?? 16,31 bpm); e grupo controle (CON, n=21, 9,9??0,8 anos; 30,0 ?? 5,1 kg; 1,4 ?? 0,1 m; 17,1 ?? 8,6 %G) que permaneceu assistindo aulas tradicionais de portugu??s e matem??tica durante o mesmo per??odo (92,4 ?? 8,9 bpm). A ANOVA revelou redu????o na dobra cut??nea tricipital para EduMovi em compara????o com grupo CON no p??s teste (11,8 ?? 5,6 vs 12,7 ?? 5,3; p=0,008), houve ainda um aumento no NAF para EduMovi vs CON por??m n??o foi significativo (?? 23,3 vs 2,9 METs; p=0,09). Na capacidade de leitura foi observado um melhor escore para EduMovi no p??s teste comparado com CON (65,2 ?? 4,9 vs 64,7 3,0; p=0,038). Na etapa incongruente do teste de Stroop que avalia a aten????o seletiva, o grupo EduMovi foi mais r??pido e errou menos em compara????o com o pr?? teste, mas o resultado n??o foi significativo (236,1 ?? 39,9 vs 327,9 ?? 45,88 ms/%, ?? -90ms e -2% de erros p=0,09). Um programa de curto prazo de educa????o f??sica interdisciplinar pode melhorar a capacidade de leitura e aten????o seletiva de crian??as.

Made available in DSpace on 2015-07-15T13:31:40Z (GMT). No. of bitstreams: 1 Marcio Costa - Saude Coletiva.pdf: 637539 bytes, checksum: a8ce63b902dc8a24ea2835901e9d4286 (MD5) Previous issue date: 2006-07-21 / This is a study about a model of health-centered attention at the Parque Floresta Health Center in Alagoinhas Bahia. Its objective is to analyze the public-private relationship in producing health actions and to discuss the relations of the welcoming, bonding, and responsibility aspects between the health care workers and those who receive care at the Parque Floresta Health Center in order to meet the health needs of this population. This unit is a reference center on basic attention given in this municipality for the areas discovered by the Family Health strategy and for actions of average complexity. The methodological path is founded on the social-historical context, by way of a dialectic approach. The data production analysis sought to bring the ermeneutic-dialectic sides closer together. The results of the model of health-centered attention show that it is still that of the liberal, privatepractice professional (of the biologist, mechanical and hospital-centered, and centered around the figure of the doctor); however, although the difficulty exists in allocating resources, the municipality has invested to change this relationship. There is also a compelling participation from the private sector in the municipal system, beyond the fragmented worker-receiver relationship, mainly occurring from encountering individualized and healing-based attention. Thus, it is necessary to institute the welcoming, bonding, and responsibility aspects as tools to (re) orient in the model of health-centered attention in force in Alagoinhas, as well as stimulate the decentralization of attention to health at the Parque Floresta Health Center. / Estudo sobre o modelo de aten??o ? sa?de no Centro de Sa?de Parque Floresta em Alagoinhas Bahia, com o objetivo de analisar s rela??o p?blico-privado para a produ??o de a??es de sa?de e de discutir as rela??es de acolhimento, v?nculo, responsabiliza??o entre os trabalhadores de sa?de e usu?rios no Centro de Sa?de Parque Floresta para atender as necessidades de sa?de dessa popula??o. Esta unidade ? refer?ncia em aten??o b?sica deste munic?pio pra ?reas descobertas pela estrat?gia Sa?de da Fam?lia e de a??es de m?dia complexidade. O caminho metodol?gico ? fundamentado no contexto hist?rico-social, atrav?s de uma abordagem dial?tica. A an?lise da produ??o dos dados buscou a aproxima??o da hermen?utica-dial?tica. Nos resultados o modelo de aten??o ? sa?de ? ainda o liberalprivatista (biologicista, mecanicista, hospitaloc?ntrico, centrado na figura do m?dico), por?m, apesar de existir uma dificuldade de aloca??o de recursos, o munic?pio tem investido para mudar esta rela??o. H? tamb?m uma forte participa??o do setor privado nos sistema municipal, al?m de uma rela??o entre trabalhador e usu?rio fragmentada, ocorrida principalmente por encontrar uma aten??o individualizada e curativista. Sendo necess?rio instituir o acolhimento, v?nculo e responsabiliza??o como ferramenta de (re) orienta??o do modelo de aten??o vigente em Alagoinhas, assim como estimular a descentraliza??o da aten??o ? sa?de no Centro de Sa?de Parque Floresta.

Made available in DSpace on 2015-04-14T13:35:47Z (GMT). No. of bitstreams: 1 450585.PDF: 3679647 bytes, checksum: 449520a022e29d4951604d60809e331f (MD5) Previous issue date: 2013-08-09 / Attention deficit/hyperactivity disorder (ADHD) is one of the most prevalent neuropsychiatric disorders among children. Although the clinical presentation and treatment of ADHD are well established, its etiology is not yet known. Recent functional neuroimaging techniques may help increase knowledge about the pathophysiology of the disorder, allowing for the empirical testing of theoretical hypotheses on brain networks in ADHD. In this study, we analyzed a group of 23 treatment na?ve boys with ADHD, aged between 8 and 10 years old, who underwent a protocol of resting-state functional magnetic imaging before and after six months of treatment with methylphenidate. Analyses of functional connectivity were performed between regions of interest (seeds) placed within the default mode network (DMN). Subsequently, changes in the DMN connectivity before and after treatment were investigated with an independent component analysis (ICA). Results of the seeds analysis showed no significant changes in connectivity between regions of the DMN following treatment, with a relatively small increase in the anterior-posterior connectivity of the network. The ICA revealed a significant increase in the connectivity between the left putamen and the DMN (p <0.01, corrected). There was also a positive correlation between the decrease of symptoms and the connectivity between the putamen and the DMN after treatment (rho = 0.65, p = 0.17). These findings indicate that treatment with methylphenidate modifies the connectivity between the DMN and subcortical nuclei. Dysfunctions in corticalsubcortical circuits have often been associated with the pathophysiology of ADHD. The effect of treatment with methylphenidate may in part be associated with elevated dopamine levels in subcortical nuclei, modulating its connectivity with the DMN. / O transtorno de d?ficit de aten??o/hiperatividade (TDAH) ? um dos transtornos neuropsiqui?tricos mais prevalentes entre crian?as. Embora a apresenta??o cl?nica e o tratamento do TDAH estejam bem estabelecidos, suas causas ainda n?o s?o conhecidas. T?cnicas recentes de neuroimagem funcional podem ampliar o conhecimento acerca da fisiopatologia do transtorno, permitindo a testagem emp?rica de hip?teses conceituais sobre o funcionamento de redes cerebrais no TDAH. Neste trabalho, analisamos um grupo de 23 meninos com diagn?stico de TDAH, com idades entre 8 e 10 anos, virgens de tratamento, que foram submetidos a um protocolo de resson?ncia funcional de repouso antes e ap?s seis meses de tratamento com metilfenidato. Foram realizadas an?lises de conectividade funcional entre regi?es de interesse (seeds) demarcadas sobre ?reas da rede default mode network (DMN). Posteriormente, a conectividade da DMN antes e ap?s o tratamento foi mapeada atrav?s de uma an?lise de componentes independentes (ICA, independent component analysis). Os resultados da an?lise de seeds n?o demonstraram modifica??es significativas na conectividade entre regi?es da DMN com o tratamento, havendo apenas um pequeno aumento da conectividade ?ntero-posterior da rede. A an?lise por ICA revelou um aumento significativo de conectividade da DMN com o put?men esquerdo (p<0,01 corrigido). Observou-se ainda uma correla??o positiva entre a redu??o dos sintomas e a conectividade entre o put?men e a DMN ap?s o tratamento (rho=0,65, p=0,17). Esses achados indicam que o tratamento com metilfenidato modifica a conectividade entre a DMN e n?cleos subcorticais. Disfun??es em circuitos corticosubcorticais foram frequentemente associados ? fisiopatologia do TDAH. O efeito do tratamento com metilfenidato pode, em parte, estar associado ? eleva??o dos n?veis dopamin?rgicos em n?cleos subcorticais, modulando a sua conectividade com a DMN.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2016-08-29T14:06:36Z No. of bitstreams: 1 DIS_JOEL_HIRTZ_DO_NASCIMENTO_NAVARRO_PARCIAL.pdf: 326191 bytes, checksum: b4a1a4a965e905f18947117bd092e4c7 (MD5) / Made available in DSpace on 2016-08-29T14:06:36Z (GMT). No. of bitstreams: 1 DIS_JOEL_HIRTZ_DO_NASCIMENTO_NAVARRO_PARCIAL.pdf: 326191 bytes, checksum: b4a1a4a965e905f18947117bd092e4c7 (MD5) Previous issue date: 2016-03-23 / The Primary Health Care (PHC) constitutes preferably as the first level of contact of an individual with the Unified Health System and the Family Health Strategy (FHS) is the means by which the reorganization is sought in Brazil. The Ministry of Health considers relevant to assessing the PHC through the presence and extent of the essential attributes and derivatives proposed by the Primary Care Assessment Tool (PCATool-Brazil). In this sense, the present study aimed to compare the health care of the oldest in Basic Health Units (BHU) with and without ESF. It characterized by being observational, cross-sectional and quantitative approach. Fifity elderly were interviewed, aged 80 or more, users of BHU with and without FHS in the city of Porto Alegre, Rio Grande do Sul. When comparing the BHU models only services without Family Health demonstrated a high degree of orientation to the PHC for the Essential Attributes Score and the General Score of PCATool-Brazil. It was found that although the FHS be the means by which the PHC reorganizes in the country, this model does not have the intended effectiveness for the health care of the elderly. It is understood that the findings of this study contribute to new strategies in the PHC work process is designed so that receive more universality the older people and their different capacities, including those longer-lived. / A Aten??o Prim?ria ? Sa?de (APS) constitui-se preferencialmente como o primeiro n?vel de contatode um indiv?duo com o Sistema ?nico de Sa?de e, a Estrat?gia de Sa?de da Fam?lia (ESF) ? o meio pelo qual busca-se a sua reorganiza??o no Brasil. O Minist?rio da Sa?de considera relevante a avalia??o da APS atrav?s da presen?a e extens?o dos atributos essenciais e derivados propostos pelo Instrumento de Avalia??o da Aten??o Prim?ria (PCATool-Brasil). Nesse sentido, o presente estudo teve como objetivo comparar a aten??o ? sa?de de longevos em Unidades B?sicas de Sa?de (UBS) com e sem ESF. Caracterizou-se por ser observacional, transversal e com abordagem quantitativa. Foram entrevistados 50 pessoas idosas com 80 anos ou mais, usu?rias de UBS com e sem ESF do munic?pio de Porto Alegre, Rio Grande do Sul. Quando comparados os modelos de UBS apenas os servi?os sem Sa?de da Fam?lia demonstraram alto grau de orienta??o ? APS para o Escore dos Atributos Essenciais e para o Escore Geral do PCATool-Brasil. Verificou-se que apesar de a ESF ser o meio pelo qual a APS reorganiza-se no Pa?s, esse modelo ainda n?o possui a efetividade planejada para a aten??o ? sa?de das pessoas idosas. Entende-se que os achados deste estudo contribuem para que novas estrat?gias no processo de trabalho da APS sejam pensadas de forma que acolham com mais universalidade as pessoas idosas e suas diferentes capacidades, incluindo aquelas mais longevas.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2017-02-06T13:35:50Z No. of bitstreams: 1 DIS_RAQUEL_SEIBEL_PARCIAL.pdf: 457430 bytes, checksum: 6c0764371d25783fd26367cb421a27b3 (MD5) / Made available in DSpace on 2017-02-06T13:35:50Z (GMT). No. of bitstreams: 1 DIS_RAQUEL_SEIBEL_PARCIAL.pdf: 457430 bytes, checksum: 6c0764371d25783fd26367cb421a27b3 (MD5) Previous issue date: 2016-05-31 / The Mini Nutritional Assessment Short Form (MNA?-SF) is a nutritional status-screening tool in the elderly including body mass index or calf circumference as anthropometric parameter. However, it is not always possible to obtain these parameters. Thus, it is important to search for alternative parameters such as the circumference of the arm that is also used in the evaluation of nutritional status. This dissertation presents an original article entitled ACCURACY OF ARM CIRCUMFERENCE IN THE MINI NUTRITIONAL ASSESSMENT SHORT FORM whose objectives were to describe the nutritional status of elderly patients in primary health care and determine the accuracy of the use of the arm circumference in MNA?-SF for screening of nutritional status. Therefore, a cross-sectional, descriptive and analytical study was conducted, with a sample of 539 individuals aged 60 years or more, registered in the Family Healthcare in Porto Alegre-RS and were evaluated in the Epidemiological and Clinical Study Seniors Attended by the Family Healthcare in the City of Porto Alegre (EMI-SUS). Variables were investigated, such as Socio-demographic (genre, age, race, marital status, family income and education); Anthropometric [body mass index (BMI), calf circumference (CC) and arm circumference (AC)] and nutritional status (MNA? and MNA?-SF). For the classification of the AC, two variations were used, one with three categories (AC3= <21cm: 0 points; ?21 or ?22cm: 1.5 points; >22cm: 3 points) and one with two categories (AC2= < 21cm: 0 points and ?21: 3 points), taking into account the minimum and maximum values established for categories of BMI of MNA? due to its replacement by AC2, AC3. For CC, the cutoff points used were already determined to MNA?-SF (<31cm: 0 points; ?31cm: 3 points). To determine the accuracy, MNA? was considered the gold standard for nutritional risk. The mean age was 68.7 ? 6.8 years (60-100 years). Most seniors were female (63.1%). Regarding nutritional status, they were classified as being at nutritional risk or undernourished, 24.1% of the elderly by MNA? and 33.4% by MNA?-SF. Regarding the socio-demographic variables, association only between nutritional status and marital status and education was observed. Separate individuals were more often eutrophic and widowers and illiterates were more often malnourished. Correlation analysis between BMI, CC and AC was significant, positive and strong (r> 0.750, P <0.001). The agreement between the MNA?-SF with IMC and MNA?-SF with CC, MNA?-SF with IMC and MNA?-SF with AC2, MNA?-SF with IMC and MNA?-SF with AC3 was excellent (?>0.90; P<0.001). The accuracy of the four instruments showed that they all had high accuracy [MNA?-SF with IMC (aucROC= 0.940), MNA?-SF with CP (aucROC = 0.932), MNA?-SF with CB2 (aucROC = 0.926) and MNA?-SF with CB3 (aucROC = 0.927)], with good sensitivity. Thus, it can be concluded that the use of the arm circumference in MNA?-SF proved accurate for tracking the nutritional status of elderly assisted in the Family Healthcare. / A Mini Avalia??o Nutricional Vers?o Reduzida (MNA?-SF) ? um instrumento de rastreio do estado nutricional de idosos que inclui o ?ndice de massa corporal ou a circunfer?ncia da panturrilha como par?metro antropom?trico. Contudo, nem sempre ? poss?vel obter esses par?metros. Dessa forma, torna-se importante a busca por par?metros alternativos, como a circunfer?ncia do bra?o que tamb?m ? utilizada na avalia??o do estado nutricional. Nesta disserta??o ? apresentado um artigo original intitulado ACUR?CIA DA CIRCUNFER?NCIA DO BRA?O NA MINI AVALIA??O NUTRICIONAL VERS?O REDUZIDA cujos objetivos foram descrever o estado nutricional de idosos atendidos na aten??o b?sica ? sa?de e determinar a acur?cia da utiliza??o da circunfer?ncia do bra?o na MNA?-SF para rastreio do estado nutricional. Para tanto, foi realizado um estudo transversal, descritivo-anal?tico, com uma amostra constitu?da por 539 individuos, com 60 anos ou mais, cadastrados na Estrat?gia Sa?de da Fam?lia de Porto Alegre-RS e que foram avaliados no Estudo Epidemiol?gico e Cl?nico dos Idosos Atendidos pela Estrat?gia Sa?de da Fam?lia do Munic?pio de Porto Alegre (EMI-SUS). Foram investigadas vari?veis sociodemograficas (g?nero, idade, faixa et?ria, ra?a, estado civil, renda familiar e escolaridade); antropom?tricas [?ndice de massa corporal (IMC), circunfer?ncia da panturrilha (CP) e circunfer?ncia do bra?o (CB)] e do estado nutricional (MNA? e MNA?-SF). Para a classifica??o da CB, foram usadas duas varia??es, uma com tr?s categorias (CB3= <21cm: 0 pontos; ?21 ou ?22cm: 1,5 pontos; >22cm: 3 pontos) e outra com duas categorias (CB2= <21cm: 0 pontos e ?21: 3 pontos), levando-se em considera??o os valores m?nimos e m?ximos estabelecidos para as categorias do IMC da MNA? em fun??o de sua substitui??o por CB2, CB3. Para a CP, foram utilizados os pontos de corte j? determinados para a MNA?-SF (<31cm: 0 pontos; ?31cm: 3 pontos). Para determina??o da acur?cia, a MNA? foi considerada padr?o-ouro para risco nutricional. A m?dia da idade foi de 68,7?6,8 anos, (60-100 anos). A maioria dos idosos era do sexo feminino (63,1%). Quanto ao estado nutricional, foram classificados como sob risco nutricional ou desnutridos 24,1% dos idosos pela MNA? e 33,4% pela MNA?-SF. Em rela??o ?s vari?veis sociodemograficas, observou-se associa??o somente entre estado nutricional e estado civil e escolaridade. ?ndividuos separados eram mais frequentemente eutr?ficos e vi?vos e analfabetos eram mais frequentemente desnutridos. A an?lise de correla??o entre IMC, CP e CB mostrou-se significativa, positiva e forte (r>0,750; P<0,001). A concord?ncia entre os instrumentos MNA?-SF com IMC e MNA?-SF com CP, MNA?-SF com IMC e MNA?-SF com CB2, MNA?-SF com IMC e MNA?-SF com CB3 foi excelente (?>0,90; P<0,001). A acur?cia dos quatro instrumentos mostrou que todos tinham alta precis?o [MNA?-SF com IMC (aucROC= 0,940), MNA?-SF com CP (aucROC= 0,932), MNA?-SF com CB2 (aucROC= 0,926) e MNA?-SF com CB3 (aucROC= 0,927)], com boa sensibilidade. Dessa forma, pode-se concluir que a utiliza??o da circunfer?ncia do bra?o na MNA?-SF mostrou-se acurada para rastreio do estado nutricional de idosos atendidos na Estrat?gia Sa?de da Fam?lia.

Submitted by PPG Gerontologia Biom?dica (geronbio@pucrs.br) on 2018-11-26T10:29:25Z No. of bitstreams: 1 CEOLIN_JAMILE_DIS.pdf: 5734789 bytes, checksum: a5fc91e4d004e1c48342aa425f83a4e8 (MD5) / Approved for entry into archive by Sheila Dias (sheila.dias@pucrs.br) on 2018-11-28T11:06:54Z (GMT) No. of bitstreams: 1 CEOLIN_JAMILE_DIS.pdf: 5734789 bytes, checksum: a5fc91e4d004e1c48342aa425f83a4e8 (MD5) / Made available in DSpace on 2018-11-28T11:14:21Z (GMT). No. of bitstreams: 1 CEOLIN_JAMILE_DIS.pdf: 5734789 bytes, checksum: a5fc91e4d004e1c48342aa425f83a4e8 (MD5) Previous issue date: 2018-03-28 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Performance of anthropometric indicators in the prediction of metabolic syndrome in elderly people attended basic care. 2018. 118f. Dissertation (Master in Biomedical Gerontology) - Escola de Medicina da Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Porto Alegre, 2018. Introduction: Metabolic syndrome (MetS) is frequent among the elderly and is associated with negative outcomes such as cardiovascular morbidity, cancer and mortality. Studies have demonstrated the performance of anthropometric indicators in the prediction of metabolic syndrome, however, studies involving the elderly population in general and Brazilian in particular are insipient. Objectives: To describe the frequency of MetS and its components in elderly patients assisted in basic care and to determine the performance of anthropometric indicators in the prediction of metabolic syndrome. Methods: This is a cross-sectional study with 479 elderly people who were evaluated in the Epidemiological and Clinical Study of the Elderly Attended by the Family Health Strategy of the Municipality of Porto Alegre (EMI-SUS). For the diagnosis of MetS, the revised NCEP-ATPIII criterion was used. The variables under investigation were: MetS and its components (central obesity, decreased HDL-c and triglycerides, high blood pressure and glucose); (age, sex and age) and five anthropometric indicators (neck circumference, sagittal abdominal diameter (SAD), SAD/height ratio, sagittal index and conicity index]. The predictive power and cut-off points of the anthropometric indicators were determined using Receiver Operating Characteristic (ROC) curves. The anthropometric indicators that presented area under the curve (auROC)> 0.70 were considered as adequate performance. Results: The majority of the sample was female (63.5%) and had MetS (60.5%). The most frequent MetS was high blood pressure (69.5%) and the least frequent was decreased HDL cholesterol (34.9%). In the total sample, the anthropometric indicators that demonstrated adequate performance were SAD/height (cutoff point: 0.14, auROC: 0.810, 95% CI: 0.771-0.850), SAD (cut-off point: 24.65 cm, 0.777, 95% CI: 0.734-0.820) and conicity index (cut-off point: 1.57, aROC: 0.706, 95% CI: 0.660-0.753). In females, anthropometric indicators with adequate performance were the SAD (cut-off point: 23.34 cm, auROC: 0.820, 95% CI: 0.766-0.875), SAD/height (cutoff point: 0.13, auROC: 0.810 , 95% CI: 0.755-0.865), neck circumference (cutoff point: 34.09 cm, auROC: 0.782, 95% CI: 0.727-0.838), and conicity index (cutoff point: 1.56, auROC: 0.727; 95% CI: 0.666-0.788). In males, the indicators with adequate performance were SAD/height (cutoff point: 0.14, auROC: 0.768, 95% CI: 0.695-0.841), SAD (cutoff point: 25.04 cm, auROC: 0.760; %: 0.685-0.835), and conicity index (cutoff point: 1.61, auROC: 0.724, 95% CI: 0.649-0.799). Conclusions: The elderly attending the Family Health Strategy had a high frequency of metabolic syndrome (60.5%). It was observed that, of the five anthropometric indicators investigated, three (SAD/height, SAD, and conicity index) performed well in the total sample, four (SAD, SAD/height, neck circumference and conicity index) in women and three in men (SAD/height, SAD and conicity index). That is, SAD, SAD/height and conicity index were adequate in all three segments. / Desempenho de indicadores antropom?tricos na predi??o de s?ndrome metab?lica em idosos assistidos na aten??o b?sica. 2018. 118f. Disserta??o (Mestrado em Gerontologia Biom?dica) ? Escola de Medicina da Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Porto Alegre, 2018. Introdu??o: A s?ndrome metab?lica (SM) ? frequente entre idosos e associa-se a desfechos negativos como morbidades cardiovasculares, c?ncer e mortalidade. Estudos t?m demonstrado o desempenho de indicadores antropom?tricos na predi??o de s?ndrome metab?lica, contudo, estudos envolvendo a popula??o idosa em geral e brasileira em particular s?o insipientes. Objetivos: Descrever a frequ?ncia de SM e de seus componentes em idosos assistidos na aten??o b?sica e determinar o desempenho de indicadores antropom?tricos na predi??o de s?ndrome metab?lica. M?todos: Trata-se de um estudo com delineamento transversal, com 479 idosos que foram avaliados no Estudo Epidemiol?gico e Cl?nico dos Idosos Atendidos pela Estrat?gia Sa?de da Fam?lia do Munic?pio de Porto Alegre (EMI-SUS). Para o diagn?stico de SM foi utilizado o crit?rio NCEP-ATPIII revisado. As vari?veis em investiga??o foram: SM e seus componentes (obesidade central, HDL-c diminu?do e triglicer?dios, press?o arterial e glicose elevados); vari?veis demogr?ficas (idade, sexo e faixa et?ria) e cinco indicadores antropom?tricos [circunfer?ncia do pesco?o, di?metro abdominal sagital (DAS), rela??o DAS/estatura (DAS/estatura), ?ndice sagital e ?ndice de conicidade]. O poder preditivo e os pontos de corte dos indicadores antropom?tricos foram determinados por meio de curvas Receiver Operating Characteristic (ROC). Os indicadores antropom?tricos que apresentaram ?rea sob a curva (auROC) >0,70 foram considerados como desempenho adequado. Resultados: A maioria da amostra era do sexo feminino (63,5%) e apresentava SM (60,5%). O componente da SM mais frequente foi press?o arterial elevada (69,5%) e o menos frequente foi HDL-colesterol diminu?do (34,9%). Na amostra total, os indicadores antropom?tricos que demonstraram desempenho adequado foram o DAS/estatura (ponto de corte:0,14; auROC:0,810; IC95%:0,771-0,850), DAS (ponto de corte:24,65 cm; auROC:0,777; IC95%:0,734-0,820) e ?ndice de conicidade (ponto de corte:1,57; auROC:0,706; IC95%:0,660-0,753). No sexo feminino, os indicadores antropom?tricos com desempenho adequado foram o DAS (ponto de corte:23,34 cm; auROC:0,820; IC95%:0,766-0,875), DAS/estatura (ponto de corte:0,13; auROC:0,810; IC95%:0,755-0,865), circunfer?ncia do pesco?o (ponto de corte:34,09 cm; auROC:0,782; IC95%:0,727-0,838) e ?ndice de conicidade (ponto de corte:1,56; auROC:0,727; IC95%:0,666-0,788). No sexo masculino, os indicadores com desempenho adequado foram DAS/estatura (ponto de corte:0,14; auROC:0,768; IC95%:0,695-0,841), DAS (ponto de corte:25,04 cm; auROC:0,760; IC95%:0,685-0,835), e ?ndice de conicidade (ponto de corte:1,61; auROC:0,724; IC95%:0,649-0,799). Conclus?es: Os idosos atendidos na Estrat?gia Sa?de da Fam?lia apresentaram elevada frequ?ncia de s?ndrome metab?lica (60,5%). Observou-se que, dos cinco indicadores antropom?tricos investigados, tr?s (DAS/estatura, DAS, e ?ndice de conicidade) apresentaram bom desempenho na amostra total, quatro (DAS, DAS/estatura, circunfer?ncia do pesco?o e ?ndice de conicidade) nas mulheres e tr?s nos homens (DAS/estatura, DAS e ?ndice de conicidade). Ou seja, DAS, DAS/estatura e ?ndice de conicidade mostraram-se adequados nos tr?s segmentos.