Submitted by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-03-21T17:07:14Z No. of bitstreams: 1 TES_CLARISSA_AIRES_ROZA_PARCIAL.pdf: 507622 bytes, checksum: afb3f324ad1f25c628f444e32084d5b7 (MD5) / Made available in DSpace on 2017-03-21T17:07:14Z (GMT). No. of bitstreams: 1 TES_CLARISSA_AIRES_ROZA_PARCIAL.pdf: 507622 bytes, checksum: afb3f324ad1f25c628f444e32084d5b7 (MD5) Previous issue date: 2016-05-25 / Introduction: Acute bronchiolitis (AB) is the most common disease of the lower airways in infants. There is disagreement in the literature on the AB definition, especially in relation to age and recurrence of symptoms. As some children may develop post-bronchiolitis recurrent wheezing, it has been widely studied interventions to prevent recurrence wheezing. Methods: A systematic literature review was conducted in MEDLINE with filter for "clinical trial" and the search term was "acute bronchiolitis?. It was established two distinct groups of setting: 1-first episode of wheezing and 2-clinical presentation of AB below 24 months of age, regardless of recurrence. Furthermore, we conducted a double-blind randomized placebo-controlled trial with patients admitted for AB to test the hypothesis that use of azithromycin in the acute episode of AB may reduce the risk of recurrent wheezing. Results: The systematic review included 79 trials and showed that the majority (59.49%) defines AB as the first episode of wheezing in infants and 56.96% includes children under 12 months. The trial included 91 patients (51 in the azithromycin group and 40 in the placebo group). The risk of hospital readmission was not different between the groups studied 1, 3 and 6 months after AB. The risk of recurrent wheezing was significantly reduced up to 6 months after admission for AB (p = 0.022). Conclusion: AB definition used by most clinical trials was the first episodes of wheezing in children, and most of the studies included patients up to 12 months. Therefore, this should be the definition used in guidelines and documents ofrecommendations. The use of azithromycin in the first episode of AB reduces the risk of recurrent wheezing in infants. / Introdu??o: A bronquiolite aguda (BA) ? a doen?a mais comum das vias a?reas inferiores. H? diverg?ncias importantes na literatura sobre a defini??o de BA, principalmente em rela??o ? idade e ? recorr?ncia dos sintomas. Como algumas crian?as podem desenvolver sibil?ncia recorrente ap?s epis?dio agudo de BA, tratamentos t?m sido avaliados com o objetivo de prevenir tal recorr?ncia. M?todos: Foi realizada uma revis?o sistem?tica da literatura na base de dados MEDLINE com filtro ?clinical trial? e o termo de busca foi ?acute bronchiolitis?. Estabeleceram-se dois grupos distintos de defini??o: 1- primeiro epis?dio de sibil?ncia e 2- quadro cl?nico de BA abaixo de 24 meses de idade,independente da recorr?ncia. Al?m disso, foi realizado ensaio cl?nico randomizado (ECR) duplo-cego controlado por placebo com pacientes internados por BA para testar a hip?tese de que uso de azitromicina no epis?dio agudo de BA reduza o risco de sibil?ncia recorrente. Resultados: A revis?o sistem?tica incluiu 79 ensaios cl?nicos e mostrou que a maioria (59,49%) define BA como o primeiro epis?dio de sibil?ncia na inf?ncia e que 56,96% incluem crian?as abaixo de 12 meses de idade. O ensaio cl?nico incluiu 91 pacientes (51 no grupo azitromicina e 40 no grupo placebo). O risco de readmiss?o hospitalar n?o foi diferente entre os grupos estudados 1,3 e 6 meses ap?s a BA. O risco de sibil?ncia recorrente foi significativamente reduzido em um seguimento de 6 meses ap?s admiss?o por BA (p =0.022). Conclus?o: A defini??o de BA mais utilizada pelos ensaios cl?nicos foi o primeiro epis?dio de sibil?ncia na inf?ncia, sendo que a maioria dos estudos incluiu pacientes de no m?ximo 12 meses de idade. Portanto, recomenda-se a utiliza??o dessa defini??o em guidelines ou documentos de recomenda??es. Ainda, o ECR demonstrou que o uso de azitromicina no epis?dio agudo de BA reduz o risco de sibil?ncia recorrente em lactentes nos primeiros 6 meses ap?s o epis?dio agudo.

Submitted by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-05-26T17:56:11Z No. of bitstreams: 1 DIS_ALINE_AVILA_DOS_SANTOS_PARCIAL.pdf: 3240136 bytes, checksum: 5f913b56bff4b9c26fb64a893d75e2ce (MD5) / Made available in DSpace on 2017-05-26T17:56:11Z (GMT). No. of bitstreams: 1 DIS_ALINE_AVILA_DOS_SANTOS_PARCIAL.pdf: 3240136 bytes, checksum: 5f913b56bff4b9c26fb64a893d75e2ce (MD5) Previous issue date: 2016-09-29 / Introduction: The rate of premature births has been increasing at significant way and due to the better technical conditions of Neonatal Intensive Therapy Units, the survival of these children has also had a raise. Premature birth is a theme of global priority in terms of public health and corresponds to approximately 10% of all births worldwide. Several studies have approached behavioral issues, which occur during the first years of life in these children; however, studies which evaluate sleep in this group when they reach scholar age are still scarce, period in which behavioral difficulties may develop in their scholar and social relations, as a consequence of the association to sleep alterations. In view of that, this work has proposed evaluating this group. Goals: evaluating the prevalence of sleep disorders and behavioral alterations in patients born premature and with low weight at birth, currently at scholar age. Methodology: Transversal study which has evaluated 25 premature children with low weight at birth (<1500g), without neurological comorbities, born at Hospital S?o Lucas da PUCRS in the period of 2007 to 2009, today at scholar age and compared to 25 children at term, linked to pediatric ambulatory of the same hospital. Those with neurological comorbities were excluded, under use of psychotropic substances or those showing IQ<70 by WASI scale (Wechsler Abbreviated Scale of Intelligence). In order to evaluate sleep organization the Actigraph and the Sleep Diary were used in a 72-hour period. In actigraphy, the following variables were measured: Sleep Efficience, calculated automatically by the actigraphy; Total Sleep Time (TST), being calculated subsequently the Average of Total Sleep Time, referring to the 72 hours of use of the device and the Night Awakenings with above 5 minutes lasting (WASO >5: wake after sleep onset), where the presence of 3 or more night awakenings lasting over 5 minutes configures sleep alteration. In order to evaluate the presence of sleep disorders it was used the Sleep Disturbance Scale for Children (SDSC), where values above cut point 39 indicate sleep alterations. The evaluation of behavior was performed by CBCL (Child Behavior Checklist), where the scoring is established by a software in which scores above 63 are classified as showing clinical manifestations of behavior alterations. Results: the total sleep time reported on SDSC for prematures ranged between 7 and 11 hours, for those at term 5 to 11 hours, where 60% of prematures and 68% of born at term showed sleep restriction (lasting below expected for age range). In this same scale, the total score of prematures ranged between 31 and 76 and neonates at term between 35 and 82, indicating the presence of sleep disorders in 88% of prematures and 76% of those at term. In actigraphy, the Average Sleep Time was 4,84 to 9,96 in prematures and 6,33 to 10,02 hours in those at term; ensuing 68% prematures and 76% of those at term. Sleep Efficiency ranged between 43,3 and 99,57 in prematures and 43,66 to 96,77 on those at term; where 60% of prematures and 72% of those at term showed improper sleep efficiency, which is, below 90. The average night awakenings lasting over 5 minutes ranged between 0 and 5,66 in prematures and 0 to 6,33 in those at term, where 56% prematures and 72% at term presented more than three night awakenings above 5 minutes duration, configuring sleep disorder. In CBCL behavioral variables there was a prevalence of behavioral alterations in 64% prematures and 56% in those at term. The comparison between groups has not highlighted a statistically significant difference to any variable. Conclusion: It was observed an elevated prevalence of sleep alterations in both groups of study, however, it was not possible to perform associations between these disorders and behavioral alterations. / Introdu??o: O n?mero de nascimentos prematuros vem aumentando de forma significativa e devido ?s melhores condi??es t?cnicas das Unidades de Terapia Intensiva Neonatal, a sobrevida destas crian?as tamb?m aumentou. O nascimento prematuro ? um tema de prioridade global em termos de sa?de p?blica e corresponde a cerca de 10% de todos os nascimentos no mundo todo. Diversos estudos abordaram quest?es comportamentais, que ocorrem durante os primeiros anos de vida nestas crian?as; entretanto, ainda s?o escassos os estudos que avaliam o sono nesse grupo quando atinge a idade escolar, per?odo em que podem se desenvolver dificuldades comportamentais nas suas rela??es sociais e escolares, em virtude da associa??o a altera??es de sono. Em virtude disso, o trabalho se prop?s a avaliar esse grupo. Objetivos: avaliar a preval?ncia de dist?rbios do sono e altera??es comportamentais em pacientes nascidos prematuros e com muito baixo peso, ao nascer, atualmente em idade escolar. Metodologia: Estudo transversal que avaliou 25 crian?as prematuras de muito baixo peso ao nascer (<1500g), sem comorbidades neurol?gicas, nascidas no Hospital S?o Lucas da PUCRS no per?odo de 2007 a 2009, hoje em idade escolar e comparadas com 25 crian?as ? termo, vinculadas ao ambulat?rio de pediatria do mesmo hospital. Foram exclu?dos aqueles com comorbidades neurol?gicas, em uso de psicotr?picos ou que apresentaram QI<70 pela escala WASI (Wechsler Abbreviated Scale of Intelligence). Para avaliar a organiza??o do sono foi utilizado o Actigrafo e o Di?rio de Sono pelo per?odo de 72 horas. Na actigrafia, foram medidas as seguintes vari?veis: Efici?ncia do sono (ES), calculado automaticamente pelo act?grafo; Tempo Total de Sono (TTS) , sendo calculado posteriormente a M?dia do Tempo de Sono Total , referente ?s 72 horas de uso do aparelho e os Despertares Noturnos com mais de 5 minutos de dura??o (WASO >5: wake after sleep onset), onde a presen?a de 3 ou mais despertares noturnos, com dura??o superior a 5 minutos configura altera??o do sono. Para avaliar a presen?a de dist?rbios do sono foi utilizada a Escala de Dist?rbios de Sono em Crian?as (EDSC), onde, valores acima do ponto de corte 39 indica altera??es do sono. A avalia??o do comportamento foi realizada pelo CBCL (CHild Behavior Checklist), onde a pontua??o ? estabelecida atrav?s de um software em que escores acima de 63 s?o classificadas como apresentando manifesta??es cl?nicas de altera??es de comportamento. Resultados: O tempo total de sono relatado na EDSC para os prematuros variou entre 7 e 11 horas e para os a termo, entre 5 e 11 horas, onde 60% dos prematuros e 68% dos nascidos a termo apresentaram restri??o de sono (dura??o inferior ao esperado pela faixa et?ria). Nesta mesma escala, o escore total dos prematuros variou entre 31 e 76 e o dos neonatos a termo variou entre 35 e 82, indicando a presen?a de dist?rbios do sono em 88% dos prematuros e 76% dos a termo. Na actigrafia, a M?dia de Tempo de Sono Total foi de 4,84 a 9,96 horas nos prematuros e de 6,33 a 10,02 horas nos a termo; resultando em 68% dos prematuros e 76% dos a termo. A Efici?ncia do Sono variou entre 43,3% e 99,57% nos prematuros e entre 43,66% a 96,77% nos a termo; onde, 60% dos prematuros e 72% dos a termo apresentaram efici?ncia do sono inadequada, ou seja, abaixo de 90%. A m?dia de despertares noturnos com dura??o maior que 5 minutos (WASO) variou entre 0 e 5,66 nos prematuros e 0 a 6,33 nos a termo, onde 56% dos prematuros e 72% dos a termo apresentaram mais que tr?s despertares noturnos com mais de 5 minutos de dura??o, configurando altera??o do sono. Nas vari?veis comportamentais da CBCL houve uma preval?ncia de altera??es comportamentais em 64% nos prematuros e 56% nos a termo. A compara??o entre os grupos n?o evidenciou diferen?a estatisticamente significativa para qualquer uma das vari?veis. Conclus?o: Foi observada uma elevada preval?ncia de altera??es de sono em ambos os grupos de estudo. Entretanto, n?o foi poss?vel realizar associa??es entre estes dist?rbios e altera??es comportamentais.

Submitted by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-06-08T18:11:19Z No. of bitstreams: 1 DIS_ANA_BASSOA_DE_MORAES_PARCIAL.pdf: 936438 bytes, checksum: 5d58046075a23b25a285f8af5972b340 (MD5) / Made available in DSpace on 2017-06-08T18:11:19Z (GMT). No. of bitstreams: 1 DIS_ANA_BASSOA_DE_MORAES_PARCIAL.pdf: 936438 bytes, checksum: 5d58046075a23b25a285f8af5972b340 (MD5) Previous issue date: 2016-09-29 / Objectives: To develop and collect evidence of validity and reliability for a screening scale for reading and writing skills for children. Methods: 1) review of the literature; 2) evaluation by experts; 3) evaluation by teachers; 4) application of the instrument with 95 students and evaluation of the students with standard reading and writing tests. Data Analysis: We carried out factor analysis, Cronbach alpha r, Rash model, item response theory, Spearman correlation between scale scores and the reading and writing tasks, test-retest reliability coefficient. Results: the main results were (1) development of a 16-item Likert scale for 16 symptoms for reading and writing difficulties; (2) presence of one factor and high factor loads in the factor analysis of the scale; (3) strong internal consistency for the alpha r (0.968), and the item response theory showed greater precision in the evaluation of children with average or low performance; (4) moderate Spearman correlation for 11 of the 16 external variables; (5) temporal stability showed correlation of 0.80. Conclusion: The study shows evidence of validity and reliability for the scale, which indicates the scale is a reliable instrument for teachers and healthcare professionals involved with pediatric patients and interested in investigating language skills. / Objetivo: Construir e obter evid?ncias de validade e fidedignidade para uma escala de rastreio de leitura e escrita para crian?as. M?todo: 1) levantamento bibliogr?fico; 2) avalia??o da escala por ju?zes; 3) avalia??o dos itens por professores; 4) teste da escala com 95 alunos e testagem destes alunos com leitura e escrita. An?lise dos dados: an?lise fatorial; coeficiente alpha de Cronbach; modelo de Rash, pela Teoria de Resposta ao Item (TRI); correla??o de Spearman entre a pontua??o da escala e as tarefas de leitura e escrita; coeficiente de estabilidade para o reteste. Resultados: os principais resultados foram (1) elaborou- se uma escala de 16 itens que mensura a frequ?ncia da manifesta??o de 16 sintomas de dificuldades de leitura e escrita; (2) an?lise fatorial indicou a presen?a de um fator e altas cargas fatoriais na escala; (3) o coeficiente alpha apontou forte consist?ncia interna (0,968) e a an?lise da TRI, para este quesito, indicou maior precis?o na avalia??o de indiv?duos com desempenho m?dio ou baixo; (4) a correla??o de Spearman foi moderada para 11 das 16 vari?veis externas; (5) a estabilidade temporal apresentou valor de correla??o de 0,80. Conclus?o: O estudo mostra evid?ncias de validade e fidedignidade da escala, o que a torna uma ferramenta confi?vel para professores e profissionais envolvidos com pacientes pedi?tricos e preocupados com quest?es de linguagem.

Submitted by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-06-30T17:28:27Z No. of bitstreams: 1 TES_CRISTINE_RUVIARO_DE_OLIVEIRA_PARCIAL.pdf: 3979228 bytes, checksum: da264217bd5a33ffd8471f140d41c962 (MD5) / Approved for entry into archive by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-06-30T17:28:35Z (GMT) No. of bitstreams: 1 TES_CRISTINE_RUVIARO_DE_OLIVEIRA_PARCIAL.pdf: 3979228 bytes, checksum: da264217bd5a33ffd8471f140d41c962 (MD5) / Made available in DSpace on 2017-06-30T17:28:42Z (GMT). No. of bitstreams: 1 TES_CRISTINE_RUVIARO_DE_OLIVEIRA_PARCIAL.pdf: 3979228 bytes, checksum: da264217bd5a33ffd8471f140d41c962 (MD5) Previous issue date: 2017-03-03 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Introduction: The central peripheral insertion catheter (PICC) has been an imperative in the survival of smaller and smaller newborns, since it makes possible the administration of parenteral nutrition (NP) and concentrated solutions in deep access, through a border procedure Of the bed. Although there is a recommendation to use exclusive access for infusion of NP, in the perspective that its properties are preserved avoiding interaction with other intravenous (IV) solutions, this does not always occur in daily practice, due to the low availability of Neonatal double lumen catheters and also by the lack of knowledge in this area of knowledge. Thus, this study has as main objective to compare infection rates in infants hospitalized in a Neonatal Intensive Care Unit (NICU) associated to the use of mono-lumen PICC in relation to the double lumen, the latter being an exclusive route for infusion Of NP. In addition, it intends to: compare the frequency of the isolated germs, the occurrence of other complications, the time of permanence of the PICC for the infusion of NP; To determine the frequency of the need for peripheral accesses (veno-punctures in addition to the PICC), and the type of complication associated with the use of a peripheral catheter in relation to PICC in newborns (NB) using the mono-lumen catheter To the double lumen. Methodology: This was a randomized, comparative study with a NICU of a university hospital in the interior of the State of Rio Grande do Sul as the study scenario. Subjects of the study were NB interns who used PICC for infusion of NP and other IV infusions from July 2014 to May 2016. NBs from said NICU with NP prescription and indication of PICC insertion were included. NBs that at the time of insertion of the PICC were diagnosed with clinical or laboratory sepsis (ANVISA-2010 criteria) and / or hematological score> 3 were excluded; Those infants in whom the PICC was not centrally located; RN with permanence of umbilical catheter; Check-list of the PICC insertion procedure with a score lower than 10 and those in which the consent of the parents or guardians to participate in the study was not obtained. Continuous variables were expressed as mean and standard deviation or median and interquartile range, and the categorical variables were in absolute and relative frequency. Statistical tests were used: Student's t-test, Mann-Whitney test, Chi-square test and Fisher's exact test. For control of confounding factors, the Poisson Regression analysis was applied. All tests were considered bidirectional and the differences were considered significant with p <0.05. The study was approved by the Research Ethics Committee (CEP) and registered at the REBEC clinical trial registration site. Results: We included 156 RNs: 78 in the mono-lumen group and 78 in the double-lumen group. The RNs remained for about 8 days with parenteral nutrition (NP) and used the PICC for approximately 10 days in the groups. Almost half of the sample presented some complication, being the suspicion of infection more frequent. There was a significant predominance of disruption (p = 0.001) and a reduction in obstruction rate (0.008) in the mono-lumen catheter, when compared to double. In the double-lumen group, there was a significantly greater withdrawal of the catheter due to suspected infection only due to clinical worsening compared to the mono-lumen. The most frequent germ found in the cultures was Staphylococcus Epidermidis. Approximately 30% of the newborns presented clinical or laboratorial infection related to the catheter, presenting as clinical symptoms: hypoactivity or lethargy, followed by respiratory discomfort and hemodynamic instability. Even using PICC, many RNs required concomitant peripheral venous catheter (CVP), and this need is greater in the mono-lumen group. Approximately 75% of the sample that used CVP presented complications, being the edema, followed by the catheter obstruction the most frequent. The low weight, corrected gestational age at the time of catheter insertion and the need for the 2nd PICC were significantly associated with the proven infection. Conclusion: It was concluded that there was no difference regarding the occurrence of infection with the use of a mono-lumen or double-lumen catheter in the neonatal period. These findings contradict the hypothesis that infection rates would be lower by infusing NP in an exclusive pathway. / Introdu??o: O cateter central de inser??o perif?rica (PICC) tem representado um imperativo na sobreviv?ncia de rec?m-nascidos cada vez menores, por tornar poss?vel a administra??o de nutri??o parenteral (NP) e solu??es concentradas em acesso profundo, por meio de um procedimento a beira do leito. Apesar de existir a recomenda??o de utiliza??o de acesso exclusivo para infus?o de NP, na perspectiva que as propriedades desta sejam preservadas evitando a intera??o com as demais solu??es intra-venosas (IV), isso nem sempre ocorre na pr?tica di?ria, devido a pouca disponibilidade de cateteres duplo l?men neonatais e tamb?m pelo desconhecimento nesta ?rea do conhecimento. Deste modo este estudo tem como objetivo principal comparar as taxas de infec??o em rec?m-nascidos internados em Unidade de Terapia Intensiva Neonatal (UTIN) associadas ao uso de PICC mono l?men, em rela??o ao duplo l?men, sendo este ?ltimo, uma via exclusiva para infus?o de NP. Al?m disso, pretende: comparar a frequ?ncia dos germes isolados, a ocorr?ncia de demais complica??es, o tempo de perman?ncia do PICC para a infus?o de NP; determinar a frequ?ncia da necessidade de acessos perif?ricos (veno-pun??es al?m do PICC), e o tipo de complica??o associada ao uso de cateter perif?rico, em rela??o ao PICC, nos rec?m-nascidos (RN) que utilizaram o cateter mono l?men, em rela??o ao duplo l?men. Metodologia: Trata-se de um ensaio cl?nico randomizado, comparativo, tendo como cen?rio de estudo a UTIN de um hospital universit?rio do interior do Estado do Rio Grande do Sul. Os sujeitos da pesquisa foram os RNs internados na UTIN que utilizaram PICC para infus?o de NP e demais infus?es IV no per?odo de julho de 2014 a maio de 2016. Foram inclu?dos os RN da referida UTIN com prescri??o de NP e indica??o da inser??o de PICC. Foram exclu?dos os RN que no momento da inser??o do PICC tinham diagn?stico de sepse cl?nica ou laboratorial (crit?rios da ANVISA-2010), e/ou escore hematol?gico > 3; os RN nos quais o PICC n?o estava em localiza??o central; RN com perman?ncia de cateter umbilical; check-list do procedimento de inser??o do PICC com pontua??o inferior a 10 e aqueles em que n?o se obteve o consentimento dos pais ou respons?veis para a participa??o no estudo. As vari?veis cont?nuas foram expressas como m?dia e desvio padr?o ou mediana e intervalo interquartil, e as categ?ricas em frequ?ncia absoluta e relativa. Foram utilizados os testes estat?sticos: teste t-Student, teste de Mann-Whitney, Qui-quadrado e teste exato de Fisher. Para controle de fatores confundidores, a an?lise de Regress?o de Poisson foi aplicada. Todos os testes foram considerados bidirecionais e as diferen?as foram consideradas significativas com p < 0,05. O estudo foi aprovado pelo Comit? de ?tica em Pesquisa (CEP) e registrado no site para registro de ensaios cl?nicos ? REBEC. Resultados: Foram inclu?dos 156 RNs: 78 no grupo mono-l?men e 78 no duplo-l?men. Os RNs permaneceram cerca de 8 dias com nutri??o parenteral (NP) e utilizaram o PICC por aproximadamente 10 dias nos grupos. Quase metade da amostra apresentou alguma complica??o, sendo a suspeita de infec??o a mais frequente. Houve um predom?nio significativo de rompimento (p=0,001) e uma redu??o no ?ndice de obstru??o (0,008) no cateter mono-l?men, quando comparado ao duplo. No grupo duplo-l?men, houve uma retirada significativamente maior do cateter devido a suspeita de infec??o somente por piora cl?nica, em compara??o ao mono-l?men. O germe mais frequente encontrado nas culturas foi o Staphylococcus Epidermidis. Cerca de 30% dos RNs apresentaram infec??o cl?nica ou laboratorial relacionado ao cateter, apresentando como sintomas cl?nicos: hipoatividade ou letargia, seguido de desconforto respirat?rio e instabilidade hemodin?mica. Mesmo utilizando o PICC, muitos RNs necessitaram de cateter venoso perif?rico (CVP) concomitante, sendo essa necessidade maior no grupo mono-l?men. Aproximadamente 75% da amostra que utilizou CVP apresentou complica??es, sendo o edema, seguido da obstru??o do cateter as mais frequentes. O baixo peso, a idade gestacional corrigida no momento da inser??o do cateter e a necessidade do 2? PICC foram associados significativamente com a infec??o comprovada. Conclus?o: Conclui-se que n?o houve diferen?a quanto a ocorr?ncia de infec??o com o uso de cateter mono-l?men ou duplo-l?men, no per?odo neonatal. Estes achados contrariam a hip?tese de que os ?ndices de infec??o seriam menores infundindo a NP em via exclusiva.

Submitted by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-06-30T17:59:06Z No. of bitstreams: 1 DIS_MARIELE_CUNHA_RIBEIRO_PARCIAL.pdf: 672571 bytes, checksum: 27c2bd20182f999e450542417e172b4e (MD5) / Approved for entry into archive by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-06-30T17:59:13Z (GMT) No. of bitstreams: 1 DIS_MARIELE_CUNHA_RIBEIRO_PARCIAL.pdf: 672571 bytes, checksum: 27c2bd20182f999e450542417e172b4e (MD5) / Made available in DSpace on 2017-06-30T17:59:20Z (GMT). No. of bitstreams: 1 DIS_MARIELE_CUNHA_RIBEIRO_PARCIAL.pdf: 672571 bytes, checksum: 27c2bd20182f999e450542417e172b4e (MD5) Previous issue date: 2017-03-10 / Objective: to evaluate the theoretical and practical knowledge of the inhaled technique of asthmatic children and their parents, in an outpatient clinic setting, and the association with control of disease. Methods: a cross-sectional and prospective study was carried out to evaluate the knowledge of inhaled technique in children and adolescents with asthma and their parents, in two outpatient clinics from Southern Brazil. Questionnaires assessing control of the disease and adherence to treatment, and evaluation of inhaled technique were applied. Results: 119 children and their parents were included. Only 24/119 (20%) of the parents reached the expected levels of theoretical knowledge about inhaled technique. In the practical evaluation of the inhalation technique by metered-dose inhaler (MDI), 31/59 (53%) of the parents reached satisfactory knowledge levels, and, of the 57 children evaluated by ID technique, only 9/57 (16%) of the children evaluated with MDI reached satisfactory knowledge levels, and only 11/28 (39%) of the children assessed with dry powder devices scored satisfactorily. In general, the evaluation of inhaled technique reached satisfactory levels in only 44/119 (37%) of the patients. There was no significant association between asthma control and knowledge levels of inhaled technique. Conclusion: Our results demonstrate that children and their parents have reduced mastery of inhalation techniques. This basic problem of managing childhood asthma needs to be reviewed in the strategies used for disease education in real-life clinical settings. / Objetivo: avaliar o conhecimento te?rico-pr?tico da terapia inalat?ria de pais e pacientes com asma, em acompanhamento ambulatorial, e sua rela??o com controle da doen?a. M?todos: foi realizado um estudo transversal, para avaliar o dom?nio das t?cnicas inalat?rias em crian?as com asma e seus pais, em acompanhamento em dois centros ambulatoriais no sul do Brasil. Foram aplicados question?rios incluindo avalia??o do controle da doen?a e ades?o ao tratamento, e avalia??o te?rico-pr?tica da t?cnica inalat?ria. Resultados: foram inclu?das 119 crian?as e respectivos pais. Deste total, apenas 24 (20%) dos pais alcan?aram os n?veis esperados de conhecimento te?rico sobre inaloterapia. Na avalia??o pr?tica da t?cnica inalat?ria por inalador dosimetrado (ID), 31/59 (53%) dos pais alcan?aram n?veis satisfat?rios, e na avalia??o pr?tica aplicada ?s crian?as (ID e p? seco), 9/57 (16%) das crian?as usando ID alcan?aram n?veis satisfat?rios e 11/28 (39%) das crian?as usando p? seco obtiveram pontua??o satisfat?ria. No geral, apenas 44/119 (37%) dos pacientes pontuaram de forma satisfat?ria na avalia??o da t?cnica inalat?ria. N?o houve associa??o significativa entre o controle da asma e n?veis de conhecimento em inaloterapia. Conclus?o: nossos resultados demonstram que crian?as e seus pais apresentam reduzido dom?nio das t?cnicas inalat?rias. Este problema b?sico de manejo da asma infantil necessita ser revisado nas estrat?gias utilizadas para educa??o da doen?a em cen?rios cl?nicos de vida real.

Submitted by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-06-30T18:01:01Z No. of bitstreams: 1 DIS_VANESSA_FEY_PASCOAL_PARCIAL.pdf: 876481 bytes, checksum: 0b2728fa712aaf8f7a7a02a0d8066035 (MD5) / Approved for entry into archive by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-06-30T18:01:09Z (GMT) No. of bitstreams: 1 DIS_VANESSA_FEY_PASCOAL_PARCIAL.pdf: 876481 bytes, checksum: 0b2728fa712aaf8f7a7a02a0d8066035 (MD5) / Made available in DSpace on 2017-06-30T18:01:17Z (GMT). No. of bitstreams: 1 DIS_VANESSA_FEY_PASCOAL_PARCIAL.pdf: 876481 bytes, checksum: 0b2728fa712aaf8f7a7a02a0d8066035 (MD5) Previous issue date: 2017-03-31 / Asthma is a chronic inflammatory disease of the airways, associated with genetic and environmental factors. Exposure to helminths appears to exert a protective effect on some chronic diseases, such as asthma. The objective of this study was to evaluate the immunomodulatory effect of different extracts of Angiostrongylus cantonensis (A. cantonensis) on the development of allergic pulmonary response by ovalbumin (OVA) in mice. The animals were divided into 6 groups: negative control (PBS), positive control (OVA), animals with asthma immunized with total soluble extract of A. cantonensis (Ac/OVA), animals with proteins from the digestive tract (AcD/OVA), animals with proteins from the reproductive tract (AcR /OVA), and animals with proteins from the cuticle (AcC / OVA). At the end of the OVA protocol, the animals were euthanized for blood collection, bronchoalveolar lavage and lung tissue. OVA-specific IgE was analyzed in blood, and cell counts, IL-4, IL-5, IL-10, INF- ? and eotaxin in bronchoalveolar lavage. Histological analysis of the lung was also performed. A significant reduction in the total cell count was observed in the groups that were immunized with the total soluble extract (TE) and with the soluble extract of the systems (SE) of A. cantonensis, compared to the OVA group (p <0.001). We found a significant reduction of eosinophils, macrophages and lymphocytes in the group immunized with TE, as in the SE groups, in relation to the OVA group. However, intraperitoneal immunization with TE and SE did not alter the levels of OVA-specific IgE and cytokines, except for an increase in IL-10 and IFN-? (p <0.01) in the group immunized with TE. In conclusion, the different worm extracts from A. cantonensis, especially TE, when administered early intraperitoneally, result in a modulation of the OVA-induced allergic lung response in mice, with a distinct response of IL-10 and e INF-? in the TE group. / A asma ? uma doen?a inflamat?ria cr?nica das vias a?reas, associada ? fatores gen?ticos e ambientais. A exposi??o a helmintos parece exercer um efeito protetor sobre algumas doen?as cr?nicas, como a asma. O objetivo deste estudo foi avaliar o efeito imunomodulador de diferentes extratos de Angiostrongylus cantonensis (A. cantonensis) no desenvolvimento da resposta pulmonar al?rgica por ovalbumina (OVA) em camundongos. Os animais foram divididos em 6 grupos: controle negativo (PBS), controle positivo (OVA), animais com asma imunizados com extrato total sol?vel de A. cantonensis (Ac/OVA), com prote?nas do aparelho digestivo (AcD/OVA), com prote?nas do aparelho reprodutor (AcR/OVA), e de prote?nas da cut?cula (AcC/OVA). No final do protocolo de OVA, os animais foram eutanasiados para coleta de sangue, lavado broncoalveolar e tecido pulmonar. Foram dosados IgE espec?fica para OVA no sangue, e contagem de c?lulas, IL-4, IL-5, IL-10, INF- ? e eotaxina (no lavado broncoalveolar) e realizada an?lise histol?gica do pulm?o. Foi observada significativa redu??o na contagem total de c?lulas nos grupos que foram imunizados com o extrato total sol?vel (ET) e com o extrato sol?vel dos sistemas (ES) de A. cantonensis, em rela??o ao grupo OVA (p<0,001). Verificamos uma redu??o significativa de eosin?filos, macr?fagos e linf?citos no grupo imunizado com ET, bem como nos grupos com ES, em rela??o ao grupo OVA. No entanto, a imuniza??o por via intraperitoneal com ET e ES n?o promoveu altera??o significativa nos n?veis de IgE espec?fica para OVA e citocinas avaliadas, exceto aumento de IL-10 e IFN- ? (p<0,01) no grupo imunizado com o ET. Concluindo, os diferentes extratos de vermes de A. cantonensis, em especial o ET, quando administrado precocemente por via intraperitoneal, resulta em uma modula??o na resposta pulmonar al?rgica induzida por OVA em camundongos, com uma resposta distinta de IL-10 e INF- ? no grupo ET.

Submitted by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-06-30T18:50:43Z No. of bitstreams: 1 DIS_THIAGO_DE_ARAUJO_CARDOSO_PARCIAL.pdf: 433423 bytes, checksum: d92b2b78aff1d6d8d7d70ef28db3ccef (MD5) / Approved for entry into archive by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-06-30T18:50:50Z (GMT) No. of bitstreams: 1 DIS_THIAGO_DE_ARAUJO_CARDOSO_PARCIAL.pdf: 433423 bytes, checksum: d92b2b78aff1d6d8d7d70ef28db3ccef (MD5) / Made available in DSpace on 2017-06-30T18:50:59Z (GMT). No. of bitstreams: 1 DIS_THIAGO_DE_ARAUJO_CARDOSO_PARCIAL.pdf: 433423 bytes, checksum: d92b2b78aff1d6d8d7d70ef28db3ccef (MD5) Previous issue date: 2016-08-31 / Conselho Nacional de Pesquisa e Desenvolvimento Cient?fico e Tecnol?gico - CNPq / Introduction: asthma is a chronic disease that affects about of 20,000,000 people in Brazil, representing the third cause of hospitalization in the country. Disease impact data are scarce in the country, but are essential for better management in public health with consequent better control of the disease in the population. Objective: The aim of our study is to present a longitudinal official data about the impact of asthma in Brazil from 2008 to 2013. Methods: We performed a descriptive study from a Brazilian government database (DATASUS), analyzing hospitalizations, the number of deaths from asthma (between 2008 and 2013), and cost of admissions, with a geographical sub-analysis. Results: In the last year analyzed, 2047 people died from asthma in Brazil (5 deaths/day), with more than 120 000 hospitalizations/year. In the whole period analyzed, the absolute number of deaths and hospitalizations decreased 10% and 36%, respectively. However, the mortality rate in hospitalized patients increased by approximately 25% in this period. Analyzing the different regions of the country, the North/Northeast and Southeast regions have the highest rates of hospitalizations for asthma and deaths of hospitalized patients, respectively. When we evaluated representative states of the regions, we also observed discrepancies in hospitalization numbers and percentage of deaths among patients hospitalized. Finally, in the studied period, hospitalizations cost US$ 170 million to the public health system. Conclusions: Although the number of hospitalizations for asthma has decreased in Brazil since 2009, mortality rates have increased, with high budget costs, showing the importance of the burden of asthma in middle-income countries. / Introdu??o: a asma ? uma doen?a cr?nica que acomete cerca de 20 milh?es de pessoas no Brasil, representando a terceira causa de hospitaliza??es no pa?s. Dados de impacto da doen?a s?o escassos no pa?s, mas s?o essenciais para melhor gest?o em sa?de p?blica com consequente melhor controle da doen?a na popula??o. Com isso, o objetivo deste estudo ? apresentar os dados oficiais longitudinais sobre o impacto da asma no Brasil a partir de 2008 a 2013. M?todos: Realizamos um estudo descritivo de um banco de dados do governo brasileiro (DATASUS), analisando as hospitaliza??es, o n?mero de mortes por asma (entre 2008 e 2013) e custo de admiss?es, com uma sub-an?lise geogr?fica. Resultados: No ?ltimo ano analisado, 2047 pessoas morreram de asma no Brasil (5 mortes/dia), com mais de 120 000 hospitaliza??es/ano. Em todo o per?odo analisado, o n?mero absoluto de mortes e interna??es diminuiu 10% e 36%, respectivamente. No entanto, a taxa de mortalidade de pacientes hospitalizados aumentou cerca de 25% neste per?odo. Analisando as diferentes regi?es do pa?s, as regi?es norte/nordeste e sudeste apresentam as maiores taxas de hospitaliza??es por asma e mortes de pacientes hospitalizados, respectivamente. Quando avaliamos os estados, das regi?es, observou-se tamb?m discrep?ncias nos n?meros de hospitaliza??o e a porcentagem de mortes entre pacientes hospitalizados. Finalmente, no per?odo estudado, as interna??es custaram US$ 170 milh?es para o Sistema de Sa?de P?blica. Conclus?es: Embora o n?mero de interna??es por asma tem diminu?do no Brasil desde 2009, as taxas de mortalidade aumentaram, com elevados custos no or?amento, mostrando a import?ncia da carga da asma em pa?ses em desenvolvimento.

Submitted by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-07-07T18:18:20Z No. of bitstreams: 1 TES_NICOLE_MAINERI_STEIBEL_COMPLETO.pdf: 1741072 bytes, checksum: 6fdb03743861be77ecb592b0211a1038 (MD5) / Approved for entry into archive by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-07-07T18:18:28Z (GMT) No. of bitstreams: 1 TES_NICOLE_MAINERI_STEIBEL_COMPLETO.pdf: 1741072 bytes, checksum: 6fdb03743861be77ecb592b0211a1038 (MD5) / Made available in DSpace on 2017-07-07T18:18:35Z (GMT). No. of bitstreams: 1 TES_NICOLE_MAINERI_STEIBEL_COMPLETO.pdf: 1741072 bytes, checksum: 6fdb03743861be77ecb592b0211a1038 (MD5) Previous issue date: 2016-11-30 / Background: Along with increased longevity elderly are accompanied by diseases such as cognitive decline. Despite the increase in scientific research on cognitive aging, there are few adapted and validated for the American Latin countries. Thus, there is need for greater availability of valid instruments, reliable, standardized and standardized for use with the Brazilian population. Studies also show that education has a significant impact on cognitive performance, which may confound interpretation of the test results. It is noteworthy that low education with elderly performed worse on memory tests which can be seen in the ecological test and thus modify regulation standards is necessary because the test complements the traditional procedures of formal assessment of memory. The behavioral test Rivermead memory differs by being a functional and ecological test, widely used for memory assessment in aging may be of great value for the diagnosis and the use of formal cognitive batteries. Objective: Thus, these works has the main objective suggest normative data for the elderly, stratified by age and education to the Behavioral Test Rivermead Memory (RBMT) and evaluates the effect of these variables in a sample of elderly with preserved cognition, as well as comparatively analyze the results of normal and depressed elderly people with low education. Methods: A cross-sectional study involving a sample of 233 healthy elderly from a third-age group in Porto Alegre with an average age of 70 (SD 7.9) years and 10.7 (SD 4.8) years of education was carried out. The sample was stratified into the following age groups: 60-69 years, 70-79 years and > 80 years. The sample was also divided into individuals with < 8 years and ? 8 years of education. Pearson?s Chi-squared test and Spearman correlations were used. Results: The elderly participants with low educational level had worse performance on all sub-tests, except the Pictures, Messages, Belongings and Orientation. Older elderly performed worse for total RBMT score and on the Face Recognition, Immediate and Delayed Route, Messages and Belongings subtests (p ? 0.005). Conclusion: Mean scores for age and schooling were suggested in ecological tasks, which is an aspect to be taken into account in the context of the neuropsychological evaluation of cognitively normal elderly. / Introdu??o: Juntamente com o aumento da longevidade os idosos est?o sendo acompanhados por patologias, como o decl?nio cognitivo. Apesar do aumento das pesquisas cientificas sobre o envelhecimento cognitivo, ainda existem poucos instrumentos adaptados e validados para os pa?ses latinos americanos. Sendo assim, existe a necessidade de instrumentos v?lidos, fidedignos, padronizados e normatizados para serem utilizados com a popula??o brasileira. Estudos mostram tamb?m que a escolaridade exerce um impacto significativo no desempenho cognitivo, podendo confundir a interpreta??o dos resultados nos testes. Idosos com baixa escolaridade apresentam pior desempenho em testes de mem?ria o que pode ser verificado no teste ecol?gico e desta forma modificar padr?es de normatiza??o se faz necess?rio, pois o teste complementa os procedimentos tradicionais de avalia??o formal da mem?ria. O Teste Comportamental de Mem?ria de Rivermead, ? um teste funcional e ecol?gico, amplamente utilizado para avalia??o de mem?ria no envelhecimento podendo ser de grande valia para o diagn?stico bem como na utiliza??o em baterias cognitivas formais. Objetivo: Esse trabalho teve por objetivo principal sugerir dados normativos para idosos, estratificados por idade e escolaridade para o Teste de Comportamental de Mem?ria Rivermead (RBMT) e avaliar o efeito dessas vari?veis em amostra de idosos com cogni??o preservada, assim como analisar comparativamente os resultados de idosos normais e deprimidos com baixa escolaridade. M?todos: Estudo transversal com uma amostra de 233 idosos saud?veis, provenientes de um grupo de terceira idade do Munic?pio de Porto alegre, com m?dia de idade de 70 anos (7,9 DP) e 10,7 (4,8 DP) anos de escolaridade. A amostra foi dividida em idosos entre 60-69 anos, 70-79 anos e acima de 80 anos. A escolaridade foi dividida entre idosos abaixo de 8 anos e maior ou igual a 8 anos de estudo. Foram utilizados os testes Qui-Quadrado de Pearson e teste de correla??o de Spearman. Resultados: Os idosos com baixa escolaridade apresentaram pior desempenho em todas as tarefas, exceto no reconhecimento, na mem?ria prospectiva e na orienta??o (p?0,001). Idosos mais velhos tiveram desempenho inferior no escore total do RBMT e nas tarefas de reconhecimento, no caminho imediato e recente, na mem?ria prospectiva (p?0,005). Conclus?o: Foram sugeridos escores m?dios para a idade e escolaridade, em tarefas ecol?gicas, sendo esse um aspecto a ser levado em conta no contexto da avalia??o neuropsicol?gica de idosos cognitivamente normais.

Submitted by PPG Gerontologia Biom?dica (geronbio@pucrs.br) on 2017-08-02T12:18:10Z No. of bitstreams: 1 NOVELO_MARTA-DIS.pdf: 2074958 bytes, checksum: c9b854808e52443fe75a7a2e961a5d89 (MD5) / Approved for entry into archive by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-08-03T19:57:56Z (GMT) No. of bitstreams: 1 NOVELO_MARTA-DIS.pdf: 2074958 bytes, checksum: c9b854808e52443fe75a7a2e961a5d89 (MD5) / Made available in DSpace on 2017-08-03T20:07:08Z (GMT). No. of bitstreams: 1 NOVELO_MARTA-DIS.pdf: 2074958 bytes, checksum: c9b854808e52443fe75a7a2e961a5d89 (MD5) Previous issue date: 2017-03-14 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Introduction: Depression is a highly prevalent disease in the elderly, warranting further investigation of the factors associated with its occurrence. In addition, exposure to adverse conditions, especially in childhood, would appear to have an important influence on the manifestation of this disease. Objective: A cross-sectional study aimed to examine the relationship between maltreatment in childhood with depression in the elderly, based on data originating from the research, Epidemiological and Clinical Study of the Elderly, enrolled in the health strategy of Porto Alegre (EMI-SUS). Methods: A random sample comprised of 449 elderly participants, living in low socioeconomic conditions, and enrolled in the Family Health Strategy (FHS) program in the city of Porto Alegre. The prevalence of adverse childhood experiences was estimated, as reported by the elderly and measured using the Childhood Trauma Questionnaire (CTQ), with the aim of examining associations with sociodemographic factors and current geriatric depression, obtained from the 15-item Geriatric Depression Scale (GDS-15). Results: The sample was predominantly white/Caucasian (67.2%), female (64.1%), and aged 65-75 years (46.1%). The majority had a personal income of less than one minimum salary (57.7%) or had no income (8%), and had a very low formal education level of 4 years or less (35.4%), with a significant number being illiterate (25.8%). Depression was more prevalent in the elderly of a more advanced age (31.6%), divorced (33.2%), black (33.9%), illiterate (39.7%), and with no income (44.1%). Many participants reported experiences of maltreatment during childhood, having suffered some form of abuse or neglect (35.7%). Higher frequencies of emotional neglect (47.3%) and emotional abuse (43.5%) were observed in the reports. The odds ratios with 95% confidence intervals for the maltreatment subtypes were: Emotional Neglect [2.822 (1.698-4.692)], Emotional Abuse [2.252 (1.351-3.754)], Physical Neglect [1.912 (1.179-3.103)], and Physical Abuse [1.754 (1.076-2.861)], all of which were independently associated with current geriatric depression. Severe depression was significantly associated with Emotional Abuse [4.193 (1.752-10.036)], Emotional Neglect [3.543 (1.489-8.429)], and Physical Abuse [3.014 (1.245-7.296)]. In the adjusted model considering the overlapping of maltreatment, a rising odds ratio was found for current geriatric depression in which it was significantly associated with two [3.298 (1.600-6.796)], three 3.108 (1.359-7.111), four [3.813 (1.643-8.933)] and five [4.394 (1.300-14.853)] types of maltreatment experience. Conclusion: The main findings revealed that individuals presenting current geriatric depression more frequently reported having suffered physical and emotional abuse and/or neglect. Moreover, there is evidence that emotional abuse and neglect, coupled with an overlapping experience of maltreatment, contributed to the severity of depression. It is important to note that these elements were found within the context of a low-income, low-education level, homogeneous and multiethnic population. / Introdu??o: examinar os fatores que est?o associados ? manifesta??o da depress?o ampara-se no fato de ela ser uma doen?a de alta preval?ncia em idosos. Al?m disso, a exposi??o ?s situa??es adversas, principalmente no per?odo da inf?ncia, parece ter importante influ?ncia na manifesta??o da depress?o. Objetivo: estudo transversal que visa examinar a rela??o entre maus-tratos na inf?ncia com depress?o em idosos, a partir do banco de dados originado pelo Estudo Epidemiol?gico e Cl?nico dos Idosos cadastrados na estrat?gia de sa?de de Porto Alegre (EMI-SUS). M?todo: a amostra ? aleat?ria e composta por 449 idosos cadastrados na Estrat?gia Sa?de da Fam?lia (ESF) do munic?pio de Porto Alegre e que vivem em baixa condi??o socioecon?mica. Foi estimada a preval?ncia de situa??es adversas sofridas na inf?ncia, reportada por idosos e medida atrav?s do Question?rio de Traumas Infantis (CTQ), com o intuito de examinar associa??es com fatores sociodemogr?ficos e depress?o geri?trica atual, obtida atrav?s da Escala de Depress?o Geri?trica de 15 itens (GDS-15). Resultados: a amostra foi prevalentemente feminina (64,1%), com idade entre 65 e 75 anos (46,1%), de brancos/caucasianos (67,2%). A maioria detinha n?vel de educa??o formal muito baixa, de 4 anos ou menos (35,4%), com uma parcela significativa de analfabetos (25,8%). Quanto ? renda, 57,7% da amostra recebia valor menor do que 1 (um) sal?rio m?nimo ou n?o tinha nenhuma renda (8%). A depress?o foi mais prevalente em idades mais avan?adas (31,6%), negros (33,9%), analfabetos (39,7%), sem renda (44,1%) e divorciados (33,2%). Em rela??o ?s experi?ncias de maus-tratos, muitos sujeitos relataram ter sofrido algum tipo abuso ou neglig?ncia durante a inf?ncia (35,7%). Observaram-se frequ?ncias mais altas nos relatos de Neglig?ncia Emocional (47,3%) e Abuso Emocional (43,5%). Os subtipos de maus-tratos apresentaram odds ratio e IC 95%: Neglig?ncia Emocional [2.822 (1.698-4.692)], Abuso Emocional [2.252 (1.351-3.754)], Neglig?ncia F?sica [1.912 (1.179-3.103)], Abuso F?sico [1.754 (1.076-2.861)], sendo que todos foram associados independentemente com a depress?o geri?trica atual. A depress?o grave foi associada de forma significativa com Abuso Emocional [4.193 (1.752-10.036)], Neglig?ncia Emocional [3.543 (1.489-8.429)] e Abuso F?sico [3.014 (1.245-7.296)]. Na sobreposi??o de maus-tratos, no modelo ajustado, uma raz?o de chance crescente de depress?o geri?trica atual foi encontrada, em que foram associadas de forma significativa para dois [3.298 (1.600-6.796)], tr?s 3.108 (1.359-7.111), quatro [3.813 (1.643- 8.933)] e cinco [4.394 (1.300-14.853)] experi?ncias de maus-tratos. Uma rela??o crescente entre sobreposi??o de maus-tratos e depress?o foi observada nos grupos com depress?o grave, sendo significativos os resultados da sobreposi??o de tr?s [4.570 (1.286-16.235)] e de quatro [5.666 (1.602-20.034)] tipos de experi?ncias de maus-tratos Conclus?es: os principais achados mostram que indiv?duos que apresentaram depress?o geri?trica atual relataram ter sofrido mais abuso e/ou neglig?ncia f?sica e emocional. Ademais, h? ind?cios que abuso e neglig?ncia emocional em conjunto com a sobreposi??o de experi?ncia de maus-tratos t?m contribu?do para a severidade da depress?o. Ressalta-se que esses elementos foram encontrados dentro de um contexto relevante, de uma popula??o homog?nea, multi?tnica, de baixa renda e de baixa escolaridade

Submitted by PPG Gerontologia Biom?dica (geronbio@pucrs.br) on 2017-07-18T17:23:10Z No. of bitstreams: 1 KATIANA_ SPINELLI_ DA_VEIGA_DIS.pdf: 1583473 bytes, checksum: c5f5a3c85d3e909cc91ca1f90de55e2a (MD5) / Rejected by Caroline Xavier (caroline.xavier@pucrs.br), reason: Devolvido devido a falta de capa institucional. on 2017-07-28T19:51:38Z (GMT) / Submitted by PPG Gerontologia Biom?dica (geronbio@pucrs.br) on 2017-08-07T11:38:13Z No. of bitstreams: 1 KATIANA_ SPINELLI_ DA_VEIGA_DIS.pdf: 1397375 bytes, checksum: d0305e6a8ed276e776c77256e0d10428 (MD5) / Approved for entry into archive by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-08-08T11:58:07Z (GMT) No. of bitstreams: 1 KATIANA_ SPINELLI_ DA_VEIGA_DIS.pdf: 1397375 bytes, checksum: d0305e6a8ed276e776c77256e0d10428 (MD5) / Made available in DSpace on 2017-08-08T12:01:01Z (GMT). No. of bitstreams: 1 KATIANA_ SPINELLI_ DA_VEIGA_DIS.pdf: 1397375 bytes, checksum: d0305e6a8ed276e776c77256e0d10428 (MD5) Previous issue date: 2017-03-30 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Introduction: With the increase in the number of elderly people, evidence is an increase in the number of professionals dedicated to caring for these people, the so-called elderly caregivers. Objective: To study the main reasons and care perspectives of students seeking caregiver courses for the elderly. Methodology: A quantitative, cross - sectional and descriptive study was conducted with 109 students from caregivers courses for the elderly of educational institutions in Porto Alegre - RS. These students answered a questionnaire with sociodemographic and economic variables. The perspective of caring for the elderly was evaluated through the adaptation of the Instrument for the Evaluation of the Elderly Family Caregiver. Results: The results showed that the majority of the interviewees for this study are female, married, aged 40 to 60 years, studied until the end of high school and are currently unemployed. The reasons described for entering the course are the search for new occupations, financial return, new knowledge, respect for the elderly, for the desire to do more for the human being, for will, love and care for the elderly. Final Considerations: Students enrolled in caregiver courses for the elderly are willing to perform the functions assigned to them regarding primary care with the elderly as well as moments of leisure. But activities such as cleaning and housekeeping, washing and ironing, and small repairs at home are no longer activities recommended to the caregiver, being cared for by another person indicated by the family. / Introdu??o: Com o aumento do n?mero de idosos, fica evidente que ocorra uma eleva??o do n?mero de profissionais que se dedicam a cuidar destas pessoas, os chamados popularmente de cuidadores de idosos. Objetivo: Estudar os principais motivos e as perspectivas de cuidado dos alunos que buscam cursos de cuidadores de idosos. Metodologia: Foi conduzido um estudo quantitativo, transversal e descritivo com 109 estudantes de cursos de cuidadores de idosos de institui??es de ensino de Porto Alegre - RS. Estes estudantes responderam um question?rio com vari?veis sociodemogr?ficas e econ?micas. A perspectiva do cuidado com o idoso foi avaliada atrav?s da adapta??o do Instrumento para Avalia??o do Cuidador Familiar do Idoso. Resultados: Os resultados mostraram que a maioria dos entrevistados para este estudo s?o do g?nero feminino, casado, com idade entre 40 a 60 anos, estudaram at? o final do ensino m?dio e est?o, atualmente, desempregados. Os motivos descritos para ingressarem no curso s?o a busca de novas ocupa??es, retorno financeiro, novos conhecimentos, respeito ao idoso, pelo desejo de fazer mais pelo ser humano, por vontade, amor e gosto de cuidar de pessoas idosas. Considera??es finais: Os alunos ingressos nos cursos de cuidadores de idosos est?o dispostos a exercer as fun??es a eles concedidas referentes aos cuidados prim?rios com o idoso como tamb?m momentos de lazer. Por?m atividades como limpeza e arruma??o da casa, lavar e passar roupa e pequenos consertos em casa j? n?o s?o atividades preconizadas ao cuidador, ficando aos cuidados de outra pessoa indicada pela fam?lia.