Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2018-03-21T13:17:45Z No. of bitstreams: 1 WilmaMariaDaCostaMedeiros_TESE.pdf: 1291691 bytes, checksum: 21ca1efae5ecd551cf1c7041795af6af (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2018-03-26T18:11:28Z (GMT) No. of bitstreams: 1 WilmaMariaDaCostaMedeiros_TESE.pdf: 1291691 bytes, checksum: 21ca1efae5ecd551cf1c7041795af6af (MD5) / Made available in DSpace on 2018-03-26T18:11:28Z (GMT). No. of bitstreams: 1 WilmaMariaDaCostaMedeiros_TESE.pdf: 1291691 bytes, checksum: 21ca1efae5ecd551cf1c7041795af6af (MD5) Previous issue date: 2017-12-22 / Introdu??o: Os acidentes de transporte terrestre se constituem em relevante problema de sa?de p?blica mundial dada a sua magnitude e transcend?ncia, bem como ao alto custo humano e material que acarreta a sociedade. Em fun??o do aumento dos sobreviventes de acidentes de transporte terrestre com les?es leves e graves, nos ?ltimos anos, conhecer as v?timas sob o ponto de vista de caracter?sticas epidemiol?gicas e a percep??o do estado de sa?de, torna-se ?til para melhor monitorar as v?timas pelos sistemas de sa?de. Objetivo: Estimar a preval?ncia e identificar os fatores associados aos acidentes de transporte terrestre, bem como seus efeitos sobre a sa?de autorreferida da popula??o brasileira, segundo a Pesquisa Nacional de Sa?de, 2013. M?todo: Estudo de associa??o de fatores que utilizou dados da Pesquisa Nacional de Sa?de, realizada em 2013, atrav?s do inqu?rito populacional de base domiciliar, pelo Minist?rio da Sa?de e Funda??o Oswaldo Cruz, em parceria com Instituto Brasileiro de Geografia e Estat?stica, realizada no per?odo de agosto de 2013 a fevereiro de 2014. Para a an?lise dos dados foram calculadas as frequ?ncias relativas dos aspectos relacionados aos acidentes de transporte terrestre e da sa?de autorreferida, para fins de caracteriza??o da popula??o de estudo. As associa??es foram verificadas pelo teste Qui-Quadrado, considerando-se um n?vel de signific?ncia de 5%. Na sequ?ncia foram estimadas as raz?es de preval?ncia bruta e ajustadas, utilizando regress?o de Poisson com vari?ncia robusta, n?veis de signific?ncia de 0,05. Para estimar as raz?es de preval?ncia ajustadas, inicialmente foi realizada an?lise bivariada, que verificou associa??o dos acidentes de transporte terrestre com as vari?veis sociodemogr?ficas e as relacionadas aos aspectos da ocorr?ncia; da sa?de autorreferida com as vari?veis sociodemogr?ficas, socioecon?mica e aspecto inerente ? consequ?ncia do evento. As associa??es que apresentaram valor de p<0,05 foram inclu?das no modelo multivariado. Resultados: Do total de entrevistados na Pesquisa Nacional de Sa?de, 3,2% dos indiv?duos relataram ter sofrido acidentes de transporte terrestre no Brasil. Na an?lise de acidentes de transporte terrestre, vari?veis sociodemogr?ficas e aspectos envolvidos no evento, os indiv?duos do sexo masculino (RP=1,46 e IC95%: 1,22?1,75), que relataram n?o serem casados (RP=1,30 e IC95%: 1,12?1,52), dirigirem motocicleta (RP=2,41 e IC95%: 1,84?3,15) apresentaram maior probabilidade de referir envolvimento em acidente de transporte terrestre. As vari?veis idade e frequ?ncia com que anda de moto mostraram associa??o inversa com o desfecho. Na an?lise da sa?de autorreferida, vari?veis sociodemogr?ficas e socioecon?mica, os indiv?duos v?timas de acidentes de transporte terrestre que sofreram sequelas e/ou incapacidades (RP=1,51 e IC95%: 1,17?1,96), com mais de 40 anos (RP=1,75 e IC95%: 1,35?2,27), pertencentes tanto ? classe social D e E (RP=2,82 e IC95%: 1,58?5,00) quanto a C (RP=2,60 e IC95%: 1,49?4,54) apresentaram maior probabilidade de autoavaliar o estado de sa?de como prec?rio. Faz-se necess?rio destacar ainda, que sequela e/ou incapacidade ? a vari?vel independente principal e as demais s?o de ajuste. Conclus?es: Os acidentes de transporte terrestre no Brasil s?o mais prevalentes em motociclistas, do sexo masculino e n?o casado. J? os que sofreram sequelas nos acidentes, com idade mais avan?ada e das classes menos favorecidas economicamente possuem um estado de sa?de mais prec?rio. Tais resultados devem subsidiar pol?ticas p?blicas e programas de preven??o, de promo??o da sa?de e seguran?a no tr?nsito, com atua??o intersetorial, que vai muito al?m de medidas educativas e campanhas de m?dia. / Introduction: Land transport accidents constitute a significant global public health problem due to its magnitude and transcendence, as well as to the high human and material costs that society entails. Due to the increase in the number of land transport accidents survivors with mild and severe injuries in recent years, to know the victims from the point of view of their epidemiological characteristics and their perception of the state of health, it becomes useful to better monitor the health of the victims provided health systems. Objective: To estimate the prevalence and identify the factors associated with land transportation accidents, as well as the self-rated health of the Brazilian population affected by this event, according to the National Health Survey, 2013. Method: Association study of factors that used data of the National Health Survey, conducted in 2013, through a population-based household survey, by the Ministry of Health and the Oswaldo Cruz Foundation, in partnership with the Brazilian Institute of Geography and Statistics, conducted in August 2013 to February 2014. For the analysis of the data, the relative frequencies of the aspects related to land transportation accidents and self-rated health were calculated for the purposes of characterization of the study population. The associations were verified by the chi-square test, considering a level of significance of 5%. The crude and adjusted prevalence ratios were estimated using Poisson regression with robust variance, significance levels of 0.05. To estimate the adjusted prevalence ratios, we initially performed a bivariate analysis, which verified the association of land transport accidents with sociodemographic variables and those related to aspects of the occurrence; of precarious self-reported health with the sociodemographic, socioeconomic and inherent aspects of the consequence of the event. Associations that presented p value <0.05 were included in the multivariate model. Results: Of the total number of interviewees in the National Health Survey, 3.2% of the individuals reported having suffered land transportation accidents in Brazil. In the analysis of ground transportation accidents, sociodemographic variables and aspects involved in the event, male subjects (PR = 1.46 and 95% CI: 1.22-1.75), who reported not being married (PR = 1.30 and 95% CI: 1.12-1.52), motorcycle driving (PR = 2.41 and 95% CI: 1.84-3.15) were more likely to report involvement in ground transportation accidents. The variables age and frequency of motorcycle riding showed an inverse association with the outcome. In the analysis of self-rated health, socio-demographic variables and socioeconomic variables, individuals who were victims of road transport accidents that suffered sequels and/or disabilities (RP = 1.51 and 95% CI: 1.17-1.96), older than 40 (RP = 1.75 and 95% CI: 1.35-2.27), belonging to both social class D and E (RP = 2.82 and 95% CI: 1.58-5.00) and C (RP = 2.60 and 95% CI: 1.49-4.54) were more likely to self-assess health status as precarious. It is also necessary to highlight that sequela and/or incapacity is the main independent variable and the others are of adjustment. Conclusions: Land transportation accidents in Brazil are more prevalent in motorcyclists, male and unmarried. Those who have suffered sequels in accidents, with more advanced age and the economically disadvantaged classes, have a poorer health condition. Such results should support public policies and prevention programs, health promotion and traffic safety, with intersectoral action, which goes far beyond educational measures and media campaigns.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2018-04-02T15:39:52Z No. of bitstreams: 1 IsraelAlexandreDeAraujoSena_DISSERT.pdf: 1066452 bytes, checksum: 0db686fe8e7a09cfb316d9c4ce792350 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2018-04-06T16:43:08Z (GMT) No. of bitstreams: 1 IsraelAlexandreDeAraujoSena_DISSERT.pdf: 1066452 bytes, checksum: 0db686fe8e7a09cfb316d9c4ce792350 (MD5) / Made available in DSpace on 2018-04-06T16:43:08Z (GMT). No. of bitstreams: 1 IsraelAlexandreDeAraujoSena_DISSERT.pdf: 1066452 bytes, checksum: 0db686fe8e7a09cfb316d9c4ce792350 (MD5) Previous issue date: 2017-12-19 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES) / A Cloro-alum?nio ftalocianina (AlClFc), como droga fotossensibilizadora, tem demonstrado resultados favor?veis em estudos cl?nicos e laboratoriais, no entanto ainda n?o h? ensaios cl?nicos que avaliem sua aplica??o na terapia fotodin?mica antimicrobiana (TFDA) em periodontite cr?nica (PC). Assim, o objetivo deste estudo foi avaliar o efeito da TFDA com AlClFc adjuvante ? raspagem e alisamento corono-radicular (RACR) nos par?metros cl?nicos periodontais de pacientes com PC. O estudo caracterizou-se por um ensaio cl?nico boca dividida, randomizado, duplo cego, longitudinal e prospectivo. Cinquenta e quatro s?tios periodontais foram randomicamente distribu?dos em dois grupos: 27 no grupo teste (RACR + TFDA) e 27 no controle (RACR). A RACR foi realizada em sess?o ?nica e os par?metros cl?nicos periodontais de ?ndice de placa vis?vel (IPV), ?ndice de sangramento ? sondagem (ISS), profundidade de sondagem (PS) e n?vel de inser??o cl?nica (NIC) foram avaliados na linha base (T0) e ap?s 3 meses (T3) da TFDA. Os dados foram submetidos ? an?lise estat?stica pelos testes n?o-param?tricos de Wilcoxon e Mann-Whitney, ao n?vel de signific?ncia de 5%. Observou-se redu??o do ISS em ambos os grupos de tratamento, com TFDA adjuvante (p = 0,003) e somente RACR (p = 0,001), entre T0 e T3. Na compara??o intergrupos n?o houve diferen?a estatisticamente significativa. Verificou-se redu??o da PS e ganho de inser??o cl?nica para ambos os grupos de tratamento (p<0,05) ap?s 3 meses da terapia. Na compara??o intergrupos n?o houve diferen?a estatisticamente significativa (p>0,05) em nenhum dos tempos analisados. A TFDA com AlClFc, adjuvante ? RACR, n?o proporcionou benef?cios adicionais na redu??o da profundidade de sondagem e ganho de inser??o cl?nica. / Chloro-aluminum phthalocyanine (AlClPc), as a photosensitizing drug, has shown favorable results in clinical and laboratory studies; however, there are no clinical trials evaluating its application in antimicrobial photodynamic therapy (PDTa) in chronic periodontitis (CP). Thus, the objective of this study was to evaluate the effect of adjuvant PDTa with AlClPc on scaling and root planing (SRP) in periodontal clinical parameters of patients with CP. The study was characterized as split-mouth randomized clinical trial, double-blind, longitudinal and prospective. Fifty-four periodontal sites were randomly distributed into two groups: 27 in the test group (SRP + PDTa) and 27 in the control group (SRP). The SRP was performed in a single session and clinical periodontal parameters of plaque index (PI), bleeding on probing (BOP), probing depth (PD) and clinical attachment level (CAL) were assessed at the baseline ( T0) and after 3 months (T3) of the PDTa. Data were submitted to statistical analysis by the non-parametric Wilcoxon and Mann-Whitney tests, at a significance level of 5%. There was a reduction in the BOP in both treatment groups, with adjuvant PDTa (p = 0.003) and only SRP (p = 0.001), between T0 and T3. In the inter-group comparison there was no statistically significant difference. PD reduction and clinical insertion gain were observed for both treatment groups (p <0.05) after 3 months of therapy. In the inter-group comparison there was no statistically significant difference (p> 0.05) in any of the times analyzed. PDTa with AlClPc, adjuvant to RACR, did not provide additional benefits in reducing depth of probing and gain of clinical insertion.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2018-04-02T15:39:52Z No. of bitstreams: 1 MarianaSilvaBezerra_DISSERT.pdf: 1777120 bytes, checksum: 807bcc2f61b63b6d332d28ec1f820f93 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2018-04-06T16:53:51Z (GMT) No. of bitstreams: 1 MarianaSilvaBezerra_DISSERT.pdf: 1777120 bytes, checksum: 807bcc2f61b63b6d332d28ec1f820f93 (MD5) / Made available in DSpace on 2018-04-06T16:53:51Z (GMT). No. of bitstreams: 1 MarianaSilvaBezerra_DISSERT.pdf: 1777120 bytes, checksum: 807bcc2f61b63b6d332d28ec1f820f93 (MD5) Previous issue date: 2017-12-08 / O objetivo foi analisar a distribui??o espa?o-temporal da inseguran?a alimentar e sua correla??o com indicadores de vulnerabilidade social, condi??es socioecon?micos e mortalidade infantil, no Brasil. Estudo ecol?gico, com dados de dois inqu?ritos nacionais, a Pesquisa Nacional Amostra de Domic?lios (2004, 2009 e 2013) do Instituto Brasileiro de Geografia e Estat?stica e o Altas Brasil do Instituto de Pesquisa Econ?mica Aplicada (2010). Foi realizada uma an?lise descritiva das vari?veis no software Statistical Package for the Social Science Statistics (SPSS) para c?lculo das preval?ncias de inseguran?a alimentar considerando os pesos amostrais e efeito do desenho. Para an?lise temporal da distribui??o espacial das preval?ncias de inseguran?a alimentar nos anos de 2004, 2009 e 2013, foi realizada a divis?o em quartis dos dados de 2004, por ser considerado o primeiro ano de an?lise e o que encontra-se com maiores preval?ncias e, utilizou-se esses valores como pontos de corte para distribui??o das preval?ncias nos tr?s anos. Na an?lise espacial bivariada, para analisar o padr?o de distribui??o espacial e a intensidade dos aglomerados (cluster, aleat?rio ou disperso), foi utilizado o ?ndice de Moran, considerando como signific?ncia estat?stica o valor de p<0,05. A ocorr?ncia de aglomerados e a signific?ncia estat?stica desses aglomerados foram demonstrados pelo MoranMap e pelo LisaMap. As preval?ncias de inseguran?a alimentar diminu?ram nos anos analisados e apresentaram correla??o espacial negativa e moderada com o IDH (-0,643; p<0,05); positiva e moderada com % de extremamente pobres (0,684; p<0,05), mortalidade infantil (0,572; p<0,05), ?ndice de vulnerabilidade social (0,654; p<0,05), ?ndice de vulnerabilidade social capital humano (0,636; p<0,05); positiva e forte com ?ndice de vulnerabilidade social renda e trabalho (0,716; p<0,05) e positiva e fraca com ?ndice de vulnerabilidade social infraestrutura (0,273; p<0,05). Conclui-se que houve diminui??o da preval?ncia de IA de 2004 a 2013 e que o territ?rio brasileiro apresentou dois padr?es distintos, um com territ?rios com maiores preval?ncias de IA e piores condi??es de renda, trabalho e sa?de infantil nas regi?es Norte e Nordeste e outro com menores preval?ncias de IA e menor vulnerabilidade de acordo com os indicadores analisados em UF nas regi?es Centro-Oeste, Sudeste e Sul. / This study aimed to evaluate the temporal and spatial distribution of food insecurity and its correlation with indicators of social vulnerability, socioeconomic conditions and infant mortality in Brazil. Ecological study, with data from two national surveys, the Brazilian National Household Survey (2004, 2009 and 2013) from the Brazilian Institute of Geography and Statistics, and Altas Brasil from the Institute of Applied Economic Research (2010). A descriptive analysis of the variables was performed in the software Statistical Package for the Social Science Statistics (SPSS) to calculate the prevalence of food insecurity considering sample weights and design effect. For the temporal analysis of the spatial distribution of food insecurity prevalence in 2004, 2009 and 2013, a division into quartiles of the 2004 data was performed, since it was considered the first year of the analysis and the one with the highest prevalence rates, thus these values were used as cut-off points for the distribution of prevalence rates in the three years. In the bivariate spatial analysis, to analyze the spatial distribution pattern and the intensity of the clusters (cluster, random or dispersed), Moran?s Index was used, considering p <0.05 as the statistical significance. The occurrence of clusters and their statistical significance were demonstrated by MoranMap and LisaMap. The prevalence of food insecurity decreased in the years analyzed and showed a negative and moderate spatial correlation with HDI (-0.643; p<0.05); positive and moderate with % of extremely poor (0.684; p<0.05), infant mortality (0.572; p<0.05), social vulnerability index (0.654; p<0.05), social vulnerability index - human capital (0.636; p<0.05); positive and strong with social vulnerability index ? income and labor (0.716; p<0.05) and positive and weak with social vulnerability index ? infrastructure (0.273; p<0.05). It is concluded that the Brazilian there was a decrease in the prevalence of FI from 2004 to 2013 and Brazilian territory presented two distinct patterns, one with territories with higher prevalence of FI and worse conditions of income, work and child health in the North and Northeast regions, and another one with a lower prevalence of FI and lower vulnerability according to the indicators analyzed in federative units of the Central-West, Southeast and South regions.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2018-04-03T14:49:52Z No. of bitstreams: 1 HaryelleNarymaConfessorFerreira_DISSERT.pdf: 903183 bytes, checksum: 512cec0622808aed442e5d8b7f4b59a6 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2018-04-10T20:46:08Z (GMT) No. of bitstreams: 1 HaryelleNarymaConfessorFerreira_DISSERT.pdf: 903183 bytes, checksum: 512cec0622808aed442e5d8b7f4b59a6 (MD5) / Made available in DSpace on 2018-04-10T20:46:08Z (GMT). No. of bitstreams: 1 HaryelleNarymaConfessorFerreira_DISSERT.pdf: 903183 bytes, checksum: 512cec0622808aed442e5d8b7f4b59a6 (MD5) Previous issue date: 2018-02-26 / Introduction: The increase in the number of cases of microcephaly in Brazil and its association with the Zika virus (ZIKV) is a global public health problem. The International Classification of Functioning Disability and Health (ICF) model is a powerful tool and extremely relevant in managing disability. Objective: Describe the functioning profile of children with microcephaly associated with ZIKV in two states of northeastern Brazil. Methods: This is a descriptive cross-sectional study. The sociodemographic characteristics, head circumference and other clinical data were collected from medical charts, physical examinations, measuring instruments and interviews with the children and their parents. The Brazilian Portuguese version of the ICF core set for cerebral palsy (CP) was used. Each ICF category was assigned a qualifier, which ranged from 0 to 4 (no disability, mild disability, moderate disability, severe disability and complete disability). For environmental factors, 0 represents no barrier and 4 total barrier; +0, no facilitator +4, total facilitator. Results: A total of 34 children with microcephaly caused by ZIKV were recruited (18 girls and 16 boys) at four rehabilitation facilities in Rio Grande do Norte and Para?ba states, Brazil. The average age of the participants was 21 months and head circumference z-scores ranged from 0.92 to -5.51. The functioning profile revealed complete disability in most of the body function categories (b). The activity and participation areas (d) were highly impacted, particularly in mobility-related categories. With respect to environmental factors (e), most of the sample reported a total facilitator for the nuclear family, friends and health services, systems and policies, as well as a total barrier to social attitudes. Conclusion: This is the first study that describes the functioning profile of children with microcephaly associated with ZIKV, using a tool based on the ICF in Brazil. Our findings reinforce the need to maximize health care and access to information ? based on the ICF ? for multiprofessional teams, administrators, family members and children.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2018-04-03T15:09:04Z No. of bitstreams: 1 LuanaCarolineDeAssuncaoCortezCorrea_DISSERT.pdf: 614120 bytes, checksum: d878ff5028c84be38cd3d51d841a4bc3 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2018-04-10T21:30:05Z (GMT) No. of bitstreams: 1 LuanaCarolineDeAssuncaoCortezCorrea_DISSERT.pdf: 614120 bytes, checksum: d878ff5028c84be38cd3d51d841a4bc3 (MD5) / Made available in DSpace on 2018-04-10T21:30:05Z (GMT). No. of bitstreams: 1 LuanaCarolineDeAssuncaoCortezCorrea_DISSERT.pdf: 614120 bytes, checksum: d878ff5028c84be38cd3d51d841a4bc3 (MD5) Previous issue date: 2018-02-26 / Introdu??o: Com o envelhecimento, mulheres apresentam pior desempenho f?sico quando comparadas aos homens em idades semelhantes, sugerindo que existem fatores relacionados ao sexo ou g?nero, como as vari?veis de hist?ria reprodutiva, que podem explicar tais diferen?as. A alta paridade e a idade materna precoce est?o relacionadas com a ocorr?ncia de altera??es uroginecol?gicas, tais como a Incontin?ncia Urin?ria (IU), e tamb?m ? conhecido que mulheres que tiveram muitos filhos e/ou foram m?es na adolesc?ncia apresentam piores condi??es de sa?de na velhice, incluindo pior desempenho f?sico. Hipotetiza-se que a mulheres que reportam IU apresentam pior desempenho f?sico e uma redu??o mais acentuada deste com o passar dos anos. No entanto, h? uma lacuna na literatura para comprovar tais hip?teses. Objetivos: Avaliar se h? uma rela??o entre a incontin?ncia urin?ria e o desempenho f?sico em mulheres idosas de cinco localidades com diferentes condi??es socioecon?micas e avaliar a influ?ncia da incontin?ncia urin?ria na mudan?a de desempenho f?sico ao longo de um per?odo de dois anos. Metodologia: Trata-se de um estudo observacional longitudinal derivado do International Mobility in Aging Study (IMIAS), realizado nas cidades de Saint?Hyacinthe (Quebec, Canad?), Kingston (Ont?rio, Canad?), Manizales (Col?mbia), Tirana (Alb?nia) e em Natal (Brasil). Neste estudo, aproximadamente 200 mulheres idosas (65 e 74 anos) de cada localidade, residentes na comunidade, foram avaliadas nos anos de 2012, 2014 e 2016. A presente pesquisa apresenta os dados coletados em 2014 e 2016. Para avalia??o foram coletados dados socioecon?micos, medidas antropom?tricas e hist?ria reprodutiva. O desempenho f?sico foi avaliado atrav?s da Short Physical Performance Battery (SPPB) seguindo um protocolo padronizado que mede o equil?brio, a marcha e for?a dos membros inferiores. O escore final da SPPB ? uma soma dos pontos de cada teste, variando de 0 a 12 pontos (4 pontos para cada teste). A incontin?ncia urin?ria foi avaliada por meio de autorrelato de epis?dios de perda involunt?ria de urina na ?ltima semana, e classificada como ?nenhum nos ?ltimos 7 dias? e ?algum nos ?ltimos 7 dias?. A rela??o transversal entre IU e SPPB foi avaliada pela an?lise de regress?o linear m?ltipla. A avalia??o do efeito longitudinal da IU sobre o escore da SPPB ao longo de 2 anos foi avaliada por meio de an?lise de modelos lineares mistos. Em ambas as an?lises, foram consideradas como covari?veis: idade, local de estudo, educa??o, sufici?ncia de renda e paridade. Resultados: A amostra foi composta por 915 mulheres com m?dia de idade de 71,2 (?2,88). A preval?ncia da incontin?ncia urin?ria variou de 11,4% (Natal) e 30,7% (Kingston). As mulheres que relataram alguma perda de urina apresentam m?dia da SPPB significativamente inferior do que as demais, mesmo nos modelos completamente ajustados (?= -0,469; p= 0,009). Al?m disso, elas apresentam uma redu??o significativamente mais acentuada no escore da SPPB ao longo de dois anos que as mulheres que n?o reportaram IU (?=-0,533, p=0,001). Conclus?o: A IU est? associada com piores resultados na SPPB e influencia negativamente no desempenho f?sico ao longo de dois anos, uma vez que as mulheres com IU apresentam um decl?nio mais acentuado do desempenho f?sico neste per?odo. Esses achados servem de base para o planejamento e aplica??o de interven??es precoces para melhorar o perfil de envelhecimento das mulheres e a qualidade de vida dessa popula??o. / Introduction: With aging, women present worse physical performance when compared to men of similar ages, suggesting that there are factors related to sex or gender, such as variables of reproductive history that may explain these differences. High parity and early maternal age are related to the occurrence of urogynecological disorders, such as Urinary Incontinence (UI), and it is also known that women who had many children and / or were mothers in adolescence have worse health conditions in old ages, including worse physical performance. Hypothesize that women who report UI have worse physical performance and a more pronounced reduction of UI over the years. However, there is a gap in the literature to prove these hypotheses. Objectives: To evaluate if there is a relationship between urinary incontinence and physical performance in older women from five sites with different socioeconomic conditions and to evaluate the influence of urinary incontinence on the change in physical performance over a two-year period. Methodology: This is a longitudinal observational study derived from the International Mobility in Aging Study (IMIAS), conducted in Saint-Hyacinthe (Quebec, Canada), Kingston (Ontario, Canada), Manizales (Colombia), Tirana (Albania) and Natal (Brazil). In this study, approximately 200 older women (65 and 74 years old) from each locality, residents on community, were evaluated in the years of 2012, 2014 and 2016. The present study presents data collected in 2014 and 2016. For the evaluation, socioeconomic data, anthropometric measures and reproductive history were collected. Physical performance was assessed using the Short Physical Performance Battery (SPPB) following a standardized protocol that measures balance, gait and lower limbs strength. The SPPB final score is a sum of the points of each test, ranging from 0 to 12 points (4 points for each test). Urinary incontinence was assessed by self-report of episodes of involuntary loss of urine in the last week, classified as "none in the past 7 days" and "some in the last 7 days". The cross-sectional relationship between UI and SPPB was assessed by multiple linear regression analysis. The evaluation of the longitudinal effect of UI on the SPPB score over 2 years was evaluated by analysis of mixed linear models. In both analyzes, covariables were considered: age, study site, education, income sufficiency, and parity. Results: The sample was composed by 915 women with mean age of 71.2 (? 2.88). The prevalence of urinary incontinence ranged from 11.4% (Natal) and 30.7% (Kingston). The women who reported some loss of urine presented a significantly lower SPPB mean than the others, even in the fully adjusted models (? =-0.469, p= 0.009). In addition, they show a significantly greater reduction in SPPB scores over two years than women who did not report UI (? =-0.533, p=0.001). Conclusion: UI is associated with worse results in SPPB and negatively influences physical performance over two years, since women with UI have a more pronounced decline in physical performance in this period. These findings serve as the basis for the planning and implementation of early interventions to improve the aging profile of women and the quality of life of this population.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-10-27T00:21:29Z No. of bitstreams: 1 CamilaAlvesDosSantosSiqueira_DISSERT.pdf: 1495444 bytes, checksum: f91210bc45fac9bd21a5dcd79f503b4c (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-12-27T18:03:56Z (GMT) No. of bitstreams: 1 CamilaAlvesDosSantosSiqueira_DISSERT.pdf: 1495444 bytes, checksum: f91210bc45fac9bd21a5dcd79f503b4c (MD5) / Made available in DSpace on 2016-12-27T18:03:56Z (GMT). No. of bitstreams: 1 CamilaAlvesDosSantosSiqueira_DISSERT.pdf: 1495444 bytes, checksum: f91210bc45fac9bd21a5dcd79f503b4c (MD5) Previous issue date: 2016-06-03 / INTRODU??O: O melanoma maligno de pele ? um dos principais tipos de c?ncer de pele, com baixa incid?ncia, contudo, alta letalidade. OBJETIVO: Realizar proje??es e analisar as tend?ncias de mortalidade por melanoma, no per?odo de 1998 a 2032, no Brasil e em suas regi?es. METODOLOGIA: Estudo ecol?gico, com dados de mortalidade por melanoma maligno de pele, obtidos no Sistema de Informa??o sobre Mortalidade (SIM), e dados populacionais do Instituto Brasileiro de Geografia e Estat?stica (IBGE). A an?lise dos ?bitos compreendeu o per?odo de 1998 a 2012. Para proje??o dos dados, foi usado o software Nordpred, que consta no programa R, considerando-se o modelo idade-per?odo-coorte. Foram calculadas se as modifica??es ocorridas com o tempo resultam de mudan?as populacionais ou no risco de ?bito pela doen?a. Como m?todo de an?lise de tend?ncias, utilizou-se a Regress?o loglineal (Joinpoint regression), com taxas padronizadas pela popula??o mundial, para estimar a porcentagem anual de mudan?a, com o intervalo de confian?a de 95%. RESULTADOS: No per?odo de 1998 a 2012, estima-se que houve 21.706 mortes por melanoma (12.436 homens e 9.270 mulheres), cujas proje??es para per?odos futuros revelou, entre 2013 e 2032, um aumento para 46.245 mortes (27.112 homens e 19.133 mulheres), com taxas padronizadas pela popula??o mundial de 1,03 mortes/100.000 habitantes para homens e de 0,62 mortes/100.000 habitantes para mulheres no ?ltimo per?odo observado, ao passo que o ?ltimo per?odo projetado revelou taxas padronizadas de 0,92 mortes/100.000 habitantes para homens e de 0,51 mortes/100.000 habitantes para mulheres. A an?lise das tend?ncias de mortalidade resultou, no Brasil, em redu??o para homens (APC = -0,4; IC95%= -0,6; -0,1; p<0,01) e mulheres (APC = -0,8; IC95%= -0,9; -0,7; p<0,01). A regi?o Centro-oeste teve aumento para os dois sexos, em oposi??o ao Sudeste, com redu??o em ambos. O Norte apresentou estabilidade para homens e aumento para mulheres, enquanto o Sul teve redu??o em homens e estabilidade em mulheres; e, por fim, o Nordeste revelou um joinpoint para cada sexo. Nos homens, com o primeiro per?odo de aumento e outro de estabilidade; e, nas mulheres, com estabilidade seguida de redu??o. DISCUSS?O: A avalia??o das tend?ncias de mortalidade por melanoma permitiu identificar semelhan?as e diferen?as regionais quanto aos padr?es encontrados. Em todas as regi?es, houve maior quantitativo de morte em homens, fato justificado por comportamentos de maior exposi??o aos riscos, bem como ao diagn?stico mais tardio, o que eleva o risco de morte. A modifica??o no n?mero de mortes ao longo do tempo no pa?s decorreu, essencialmente, da mudan?a na estrutura e tamanho populacional, exceto em rela??o ? regi?o nordeste em homens e centro-oeste em homens e mulheres, cujo aumento est? tamb?m relacionado ao aumento no risco de morrer por melanoma. Taxas mais altas de mortalidade foram registradas em locais nos quais h? maior percentual de brancos, e naqueles em que h? melhores indicadores sociodemogr?ficos. O fato possivelmente est? associado a melhor qualidade no registro das informa??es, bem como a melhores condi??es diagn?sticas. Ressalta-se, tamb?m, a necessidade de uma aten??o para os trabalhadores expostos ao risco de c?ncer de pele, o que refor?a a necessidade de uma vigil?ncia em sa?de bem realizada e centrada na integralidade da aten??o. CONCLUS?ES: Os resultados encontrados revelaram a exist?ncia de regi?es de maiores taxas de mortalidade, o que pode estar associado a determinantes individuais, tais como o fen?tipo e o comportamento, bem como ao ambiente, no que tange ? exposi??o aos fatores de risco. Os achados foram condizentes com a literatura, que evidenciou maiores taxas em locais de maior poder aquisitivo, neste caso, Sul e Sudeste, acompanhadas de tend?ncias a redu??o ao longo do tempo. Ademais, a maior mortalidade em homens, merece aten??o de pol?ticas, visto que, normalmente o diagn?stico ocorre em fases mais avan?adas da doen?a para este grupo de pessoas. Para tanto, s?o essenciais a??es de promo??o da sa?de e aten??o para cria??o de pol?ticas preventivas no combate da doen?a, principalmente relacionadas ? educa??o em sa?de, voltada para a preven??o por meio da diminui??o da exposi??o a fatores de risco, al?m de h?bitos de vida saud?veis. / INTRODUCTION: Malignant skin melanoma is one of the main types of skin cancer, with low incidence but high lethality. OBJECTIVE: Carry out projections and analyze mortality trends for melanoma, in the period 1998-2032, in Brazil and its geographic regions. METHODOLOGY: An ecological study is presented herein, with mortality data for malignant skin melanoma obtained from the Mortality Information System (MIS) and from the Brazilian Institute of Geography and Statistics (BIGS). Death analysis comprehended the period 1998-2012. For data projection, the Nordpred software was utilized, within the R program, considering the model age-period-cohort. It was verified whether the modifications throughout time were a result of population changes or of death risk for the disease. Joinpoint regression and standardized rates based on the world population were utilized to estimate the annual percentage change, with a 95% confidence interval. RESULTS: Evaluation of mortality trends for melanoma enabled the identification of regional similarities and differences regarding the patterns encountered. In all regions, there was a higher number of deaths in men. In the period 1998-2012, there were 21,705 deaths by melanoma (12,436 men and 9270 women). The projections for future periods have revealed, between 2013 and 2032, an increase to 46,245 deaths (27,112 men and 19,133 women), with standardized rates of 1.03 deaths/100,000 inhabitants for men and 0.62 deaths/100,000 inhabitants for women in the last observed period. For the last projected period, the standardized rates were 0.92 deaths/100,000 inhabitants for men and 0.51 deaths/100,000 inhabitants for women. Mortality trend analysis resulted, in Brazil, in reductions for men (APC = -0.4; CI95%= -0.6; -0.1; p<0.01) and women (APC = -0.8; CI95%= -0.9; -0.7; p<0.01). The Midwest region presented increases for both sexes, in opposition to the Southeast, which presented reductions for both sexes. The North region presented stability for men and increases for women, while the South region presented reductions for men and stability for women. Finally, the Northeast region revealed one joinpoint for each sex: in men, there was initially an increasing period followed by stable rates, and in women, the initial stability period was followed by decreasing rates. CONCLUSIONS: The results obtained revealed the existence of regions with higher mortality rates, which could be associated with individual determinants, such as phenotype and behavior, as well as with the environment, regarding the exposure to risk factors. The findings were in line with scientific literature, which evidenced higher rates in locations with higher purchasing power, in this case, the South and Southeast regions, accompanied by reducing trends throughout time. Also, higher mortality rates in men deserve better attention of health policies, as normally the diagnosis occurs in more advances stages of the disease for this sex. For such, actions to promote health are essential. Also, special attention should be given to the creation of preventive policies to fight the disease, mainly related to health education, directed to prevention through the reduction of the exposure to risk factors, besides the adoption of healthy life habits.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-01-10T16:02:22Z No. of bitstreams: 1 GeorgiaCostaDeAraujoSouza_TESE.pdf: 1915072 bytes, checksum: 643722b6293cdd4713fd95140a0f91b9 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-01-12T11:15:44Z (GMT) No. of bitstreams: 1 GeorgiaCostaDeAraujoSouza_TESE.pdf: 1915072 bytes, checksum: 643722b6293cdd4713fd95140a0f91b9 (MD5) / Made available in DSpace on 2017-01-12T11:15:44Z (GMT). No. of bitstreams: 1 GeorgiaCostaDeAraujoSouza_TESE.pdf: 1915072 bytes, checksum: 643722b6293cdd4713fd95140a0f91b9 (MD5) Previous issue date: 2015-08-03 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico (CNPq) / A Pol?tica Nacional de Sa?de Bucal (PNSB) incorpora diversos elementos inovadores que tiveram o objetivo de impactar sobre o quadro epidemiol?gico e a vigil?ncia em sa?de bucal. Ao mesmo tempo, as duas edi??es do mais abrangente inqu?rito de sa?de bucal do Pa?s, o SBBrasil, demonstraram uma importante tend?ncia de redu??o nos principais indicadores, particularmente aqueles relativos ? c?rie dent?ria, entre os anos de 2003 e 2010. Desta forma, objetiva-se analisar o efeito da implementa??o da PNSB sobre a tend?ncia nos principais indicadores de sa?de bucal em capitais brasileiras. Trata-se de um estudo de avalia??o de pol?ticas desenvolvido em tr?s fases: 1) An?lise de implanta??o da PNSB nas capitais; 2) An?lise da tend?ncia dos indicadores epidemiol?gicos entre 2003 e 2010; 3) An?lise do impacto da implanta??o sobre a tend?ncia dos indicadores de sa?de bucal. Para a realiza??o da fase 1, os dados de Sa?de Bucal dispon?veis nos Sistemas de Informa??o em Sa?de foram analisados, possibilitando a gera??o de 4 fatores de caracteriza??o da aten??o em sa?de bucal em cidades brasileiras com mais de 100.00 habitantes, a partir da qual foram selecionadas as capitais para uma an?lise mais aprofundada. A fase 2 consistiu na defini??o das capitais a serem investigadas in loco atrav?s da aplica??o de question?rio face a face com Coordenadores de Sa?de Bucal de 13 capitais selecionadas. A fase 3 foi realizada por meio dos dados do SBBrasil 2003 e 2010, dispon?veis pelo Minist?rio da Sa?de com avalia??o dos efeitos das vari?veis independentes, referentes ? caracteriza??o da Aten??o em Sa?de Bucal e vari?veis socioecon?micas de n?vel populacional, sobre as dependentes, modifica??o nos indicadores de sa?de bucal entre 2003 e 2010. Os resultados apontam para a n?o associa??o entre as caracter?sticas da Aten??o em Sa?de Bucal e a redu??o da morbidade bucal na maioria das capitais selecionadas. Observa-se que o Modelo de aten??o em sa?de bucal anda em conson?ncia com as estrat?gias de Promo??o da Sa?de Bucal, Organiza??o da oferta de servi?os em sa?de bucal e com a presen?a de fl?or nas ?guas de abastecimento p?blico. Contudo, isso n?o reflete na modifica??o dos indicadores de sa?de bucal entre 2003 e 2010. A condi??o socioecon?mica parece estar mais associada ao CPO-D satisfat?rio aos 12 anos em 2010 do que o reflexo do Modelo de aten??o em sa?de bucal. Conclui-se que a oferta de servi?os e a aten??o em sa?de bucal p?s PNSB n?o produzem uma resposta direta sobre a modifica??o nos indicadores de sa?de bucal entre 2003 e 2010. / The Brazilian National Policy on Oral Health (PNSB from Portuguese acronym) incorporates several innovative elements that were intended to impact on the epidemiological situation and the surveillance of oral health. At the same time, the two editions of the more comprehensive oral health survey of the country, SBBrazil showed a significant downward trend in key indicators, particularly those related to tooth decay, between the years 2003 and 2010. Thus, the objective is to analyze the effect of implementation of PNSB on the trend of the main oral health indicators in Brazilian capitals. It is a policy assessment study carried out in three steps: 1) Implementation analysis of PNSB in capitals; 2) Trend analysis of epidemiological indicators between 2003 and 2010; 3) The implementation effect analysis on the trend of oral health indicators. For step 1, the oral health data available in the Health Information Systems were analyzed, allowing the creation of 4 characterization factors of dental care from which the capitals were selected for further analysis. Step 2 was the definition of capitals to be investigated by applying questionnaire face to face with Oral Health Coordinators of 13 state capitals selected. Step 3 was performed using the SBBrazil data 2003 and 2010, to assess the effects of independent variables relating to the characterization of attention in oral health and socioeconomic variables of population level, on dependents, changes on oral health indicators between 2003 and 2010. Results pointed to the lack of association between characteristics of oral health attention and the reduction of oral morbidity in most state capitals. There was a link between oral health promoting characteristics, supply of services and the dental care model, which represents the dynamics of public services is entirely dependent on local management in health. These characteristics do not reflect the modification of oral health indicators between 2003 and 2010. Capital with the lowest poverty rates and better human development in 2010 are those that have lower DMFT this year. However, changes in socioeconomic conditions between the years analyzed does not influence directly on the trend in oral health indicators. It is concluded that the PNSB is implemented differently in Brazilian capitals and the conduction mode of its guidelines in each capital favors the development of the provision of oral health services and strategies to promote oral health. The influence of PNSB on change in oral health indicators is still barely noticeable, however, highlights the potential of this policy in establishing priorities and guidelines that contribute to increasing the supply of services and expanding access to oral health care especially where is needed more intensively.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-01-13T14:15:29Z No. of bitstreams: 1 EricoGurgelAmorim_DISSERT.pdf: 1036507 bytes, checksum: 76703b25fa3210d3c77c667f6c23d32e (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-01-26T12:00:56Z (GMT) No. of bitstreams: 1 EricoGurgelAmorim_DISSERT.pdf: 1036507 bytes, checksum: 76703b25fa3210d3c77c667f6c23d32e (MD5) / Made available in DSpace on 2017-01-26T12:00:56Z (GMT). No. of bitstreams: 1 EricoGurgelAmorim_DISSERT.pdf: 1036507 bytes, checksum: 76703b25fa3210d3c77c667f6c23d32e (MD5) Previous issue date: 2016-02-17 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES) / O movimento em favor da inclus?o de pessoas com defici?ncia, vivenciado atualmente, caracteriza um novo olhar sobre as possibilidades de vida outrora invisibilizadas. Entretanto, sobressai neste cen?rio um contexto lesivo, no tocante ao comprometimento da sa?de mental, no conv?vio com um d?ficit nas fun??es sensoriais, notadamente, na defici?ncia visual. Esta realidade infringe no sujeito sofrimento ps?quico e priva??o social, mutilando suas perspectivas de realiza??o pessoal, abarcadas em uma conjuntura micro e macrossocial em constante intera??o. Nesse sentido, na presente pesquisa objetivamos analisar a contribui??o dos determinantes sociais de sa?de no cotidiano de sujeitos com defici?ncia visual, com ?nfase na sa?de mental, identificando as dificuldades percebidas e as estrat?gias de enfrentamento utilizadas em rela??o ?s adversidades cotidianas. Trata-se, portanto, de uma pesquisa descritiva e explorat?ria com abordagem qualitativa. Para a coleta de dados, realizamos entrevistas semiestruturadas junto aos sujeitos deficientes visuais no ambulat?rio de oftalmologia do Hospital Universit?rio Onofre Lopes (HUOL), no per?odo de agosto a setembro de 2015. Os dados foram tratados ? luz do m?todo de an?lise tem?tica descrito por Minayo (2008); e os conte?dos das unidades de registro elencadas, inspirados no modelo de Determina??o social da sa?de, proposto por Dahlgren e Whitehead (1991). Assim sendo, organizamos as seguintes categorias tem?ticas: sa?de e sofrimento ps?quico no encontro com o n?o ver e seus modos de andar a vida; a autonomia e seus desafios cotidianos; intera??o social e suas redes de pertencimento; os valores e a cultura no processo de normaliza??o e estigmatiza??o; a educa??o, seus limites e possibilidades; e o trabalho nos contextos de exclus?o e inclus?o social vivenciados. A reflex?o das informa??es analisadas suscita discuss?es a respeito da persist?ncia de fatores sociais adversos ao processo de inclus?o plena e efetiva, geradores de atitudes normalizadoras. Destarte, a pesquisa revela desafios ?s inst?ncias gestoras e a toda a sociedade, no sentido de promover a aten??o ?s demandas da participa??o social e o respeito ?s diferen?as, a fim de concretizar o princ?pio da dignidade da pessoa humana, corol?rio da diversidade social, refletida nos modos de andar a vida, pr?prios de cada um. / The movement in favor of the inclusion of people with disabilities experienced nowadays features a new look at the possibilities of life once made invisible. However, stands out in this setting one harmful context that regards to mental health endanger about living with a deficit in sensorial functions, especially the visually impaired. This situation breaches to the person psychical suffering and social deprivation, mangling their prospects for personal fulfillment, embraced, on a micro and macro-environment, constant interaction. In this sense, this research aims to analyze the contribution of social determinants of health in the daily lives of individuals with visual impairment, emphasizing an emphasis on mental health, identifying the difficulties perceived and coping strategies used in relation to their daily hardships. It is a descriptive and exploratory research that deals with a qualitative approach. To collect data, semi-structured interviews were guided with the visually handicapped people in the Ophthalmology Clinic of the University Hospital Onofre Lopes (HUOL), between August and September 2015. The data were analyzed in the perspective of the thematic analysis method described by Minayo (2008). The matter of the chosen registration units have been inspired by the social health determination model, proposed by Dahlgren and Whitehead (1991). Thus, the following themes were organized: health and psychological suffering in the encounter with the action of ?no-see? in ways of living life; Autonomy and their daily challenges; Social interaction and their belonging networks; Values and culture in the standardization and stigmatization process; Education, its limits and possibilities; The work in contexts of experienced exclusion and social inclusion actions. The reflection of the information analyzed raises discussions about the persistence of adverse social factors to the full and effective inclusion process of normalizing attitudes generators. Therefore, the research reveals challenges to the management levels and to the whole society, to promote attention to the demands of social participation and respect for differences, in order to implement the principle of human dignity, a corollary of social diversity, reflected in ways of living life, proper to each one.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-01-13T14:15:30Z No. of bitstreams: 1 RayanneKarinaSilvaCruz_DISSERT.pdf: 1955808 bytes, checksum: 1cc736dc0e02ab36c0cbcd4d339407c3 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-01-26T12:55:35Z (GMT) No. of bitstreams: 1 RayanneKarinaSilvaCruz_DISSERT.pdf: 1955808 bytes, checksum: 1cc736dc0e02ab36c0cbcd4d339407c3 (MD5) / Made available in DSpace on 2017-01-26T12:55:35Z (GMT). No. of bitstreams: 1 RayanneKarinaSilvaCruz_DISSERT.pdf: 1955808 bytes, checksum: 1cc736dc0e02ab36c0cbcd4d339407c3 (MD5) Previous issue date: 2016-08-01 / O levantamento nacional de sa?de bucal, ?Projeto SB Brasil?, destaca-se enquanto principal estrat?gia de vigil?ncia em sa?de bucal no eixo da produ??o de dados prim?rios, cooperando para a constru??o de uma pol?tica baseada em modelos de base epidemiol?gica. Em situa??es de baixa preval?ncia de c?rie, os ?ndices utilizados atualmente podem perder poder discriminat?rio no sentido de refletir a severidade da c?rie dent?ria. Objetivo: construir e validar de um ?ndice de severidade da c?rie dent?ria, atrav?s de um conjunto arbitr?rio de pontua??es de acordo com o perfil de c?rie dent?ria e necessidades de tratamento. M?todos: a pesquisa se apropriou dos dados do SB Brasil 2003 e 2010 para a constru??o e valida??o de um ?ndice de Severidade de C?rie Dent?ria. A pesquisa ? do tipo individuado com base em dados secund?rios, tendo, como unidade de an?lise, a popula??o brasileira nos grupos et?rios de 12 anos, 15-19 anos e 35-44 anos. Os m?todos foram divididos em etapas, onde a primeira foi a formula??o das propostas com diferentes escores para a progress?o da c?rie atrav?s da atribui??o espec?fica de pontua??es para as condi??es de dente h?gido at? dente com necessidade de extra??o, a partir da associa??o dos ?ndices CPO-D e Necessidade de Tratamento. A segunda etapa foi a an?lise dos coeficientes de varia??o e a terceira foi a valida??o de constructo do indicador. Resultados: n?o houveram diferen?as entre as propostas, ao se analisar os coeficientes de varia??o. O constructo foi analisado e validado a partir da rela??o com as vari?veis regi?o, capital/interior, grupo ?tnico, renda e anos de estudo. Observou-se que o novo ?ndice conseguiu discriminar os diferentes est?gios do componente cariado. Conclus?es: o produto do estudo ser? ?til para atividades de planejamento em Sa?de Bucal Coletiva, na perspectiva de priorizar o acesso ao servi?o para os grupos com maior severidade, acrescentando maior poder discriminat?rio aos ?ndices de c?rie e necessidade de tratamento. / The oral health national survey, known as "SB Brazil Project," is considered as the main oral health surveillance strategy in the production of primary data, cooperating to build a policy based on epidemiologically-orientend assistance models in Brazil. In a low caries prevalence scenario, sometimes the current indices used nowadays can reduce their discriminatory power. Objective: To create and validate a caries severity index, through an arbitrary set of scores according to dental caries and treatment needs. Methods: This study worked with data from SB Brazil 2003 and 2010 for the construction and validation of a Severity Index Dental Caries. The research is individual-based using secondary data having, as unit of analysis, the Brazilian population in the age groups of 12 years, 15-19 years and 35-44 years. The methods were divided into stages, the first was the formulation of proposals with different scores for the progression of caries through the specific assignment of scores for tooth conditions, from sound teeth to those requiring extraction, from the association between the DMFT index and Treatment Need conditions. The second step was the analysis of the coefficients of variation and the third was the construct validation. Results: There were no differences between the proposals, when the variation where analyzed. The construct validation was made considering the variables: region, type of city (capital/ non-capital), ethnic group, family income and years of schooling. It was observed that the new index could discriminate the different stages of decayed teeth. Conclusions: the study product will be useful for planning activities in public health dentistry, as it will be possible prioritizing access to the service for the group with greater severity, adding a more discriminatory power to both caries and treatment needs indexes.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-02-02T14:33:25Z No. of bitstreams: 1 DanielleLorenCosta_DISSERT.pdf: 2734236 bytes, checksum: 355977e38196f1658804cb9d453b575e (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-02-09T16:30:12Z (GMT) No. of bitstreams: 1 DanielleLorenCosta_DISSERT.pdf: 2734236 bytes, checksum: 355977e38196f1658804cb9d453b575e (MD5) / Made available in DSpace on 2017-02-09T16:30:12Z (GMT). No. of bitstreams: 1 DanielleLorenCosta_DISSERT.pdf: 2734236 bytes, checksum: 355977e38196f1658804cb9d453b575e (MD5) Previous issue date: 2016-08-26 / A sa?de mental e o trabalho t?m sido temas de grande relev?ncia em estudos e pesquisas, uma vez que o adoecimento mental do trabalhador est? cada vez mais presente no cotidiano laboral, gera afastamentos por longos per?odos, e causa preju?zos tanto para o empregador, quanto para o pr?prio trabalhador e a sua rede de rela??es. A doc?ncia ? considerada uma profiss?o com risco f?sico e mental, e que merece uma aten??o especial voltada ? sa?de desses profissionais. Ent?o, pretendese com esse estudo analisar a rela??o entre o trabalho e a sa?de mental de docentes de uma institui??o p?blica federal de ensino superior. Trata-se de um estudo de car?ter descritivo explorat?rio com abordagem qualitativa, que foi dividido em duas fases. Na primeira fase, foi realizada uma pesquisa documental com o levantamento dos afastamentos por licen?a para tratamento da pr?pria sa?de dos servidores da UFRN, por CID F (Transtornos Mentais e Comportamentais) no per?odo de 2010-2014, atrav?s de relat?rio gerencial obtido do Sistema da Administra??o P?blica Federal (SIAPE SA?DE). Na segunda fase do estudo, foi realizada uma pesquisa de campo, junto aos docentes, atrav?s de uma entrevista semiestruturada com quest?es norteadoras acerca de prazer e sofrimento no trabalho. Para a an?lise das entrevistas, foi utilizada a t?cnica de an?lise de conte?do, do tipo an?lise tem?tica, proposta por Minayo (2013), e a teoria da Psicodin?mica do Trabalho segundo Dejours (1992), como referencial te?rico. O per?odo de coleta de dados compreendeu entre novembro/2015 a junho/2016. Os resultados da primeira fase demonstraram que os transtornos mentais e comportamentais t?m ocupado os primeiros lugares das causas de afastamento do trabalho por motivo de sa?de dos servidores da UFRN (t?cnicosadministrativos e docentes), e chegou a ser em 2014, 25% das ocorr?ncias de licen?a para tratamento da sa?de. Os diagn?sticos mais frequentes nos afastamentos foram o transtorno misto ansioso e depressivo (F 41.2), o epis?dio depressivo grave sem sintomas psic?ticos (F 32.2) e o transtorno depressivo recorrente, epis?dio atual grave sem sintomas psic?ticos (F 33.2). Quanto ? segunda fase, foram extra?das duas categorias de an?lise: o sofrimento e o prazer no trabalho docente, com tr?s subcategorias correspondentes a cada uma, quais foram: Produtivismo acad?mico ? ?Publicar ou perecer?; Professor: um ser onipresente?; Desgastes nas rela??es de trabalho; O encanto da sala de aula; O reconhecimento e Viv?ncias que promovem qualidade de vida no trabalho. Diante dos resultados, pode ser percebido que os docentes, apesar do sofrimento vivenciado no trabalho, das condi??es de desconforto, de mal-estar, por vezes culminando at? em adoecimento, reconhecem o seu trabalho como estimulante, como uma mola propulsora, que d? sentido ? sua exist?ncia, e que o simples fato do ser professor e do exerc?cio da doc?ncia puderam ser considerados por eles, como promotores do prazer e da qualidade de vida no trabalho. / Mental health and work have been issues of great relevance in studies and research, since the mental illness of the worker is increasingly present in the everyday life of work, entails withdrawals for long periods and provokes losses to both the employer and to the worker itself and its network of relationships. The teaching practice is regarded as a profession with mental and physical risk and therefore deserves a special attention geared towards the health of these professionals. Accordingly, this study is intended to analyze the relationship between the work and the mental health of teachers of a federal public institution of higher education. It is an exploratory and descriptive study, with a qualitative approach, which was divided into two stages. In the first stage, we performed a documentary research with the survey of withdrawals due to leave for health treatment in the UFRN servants, by ICD-F (mental and behavioral disorders), between 2010 and 2014, through a management report obtained from the Federal Public Administration System (SIAPE-SA?DE, as per its acronym in Portuguese). In the second stage of this study, we performed a field research with the teachers, through a semi-structured interview with guiding questions about pleasure and suffering at work. In order to analyze the interviews, we used the content analysis technique, in its thematic analysis modality, proposed by Minayo (2013), and the theory of Psychodynamics of Work, according to Dejours (1992), as theoretical benchmarks. The data collection period encompassed between November/2015 and June/2016. The results of the first stage showed that mental and behavioral disorders have filled the first places of causes for withdrawing the work because of health reasons in UFRN servants (technical-administrative and teaching staff), and even reached, in 2014, 25% of occurrences of leave for health treatment. The most frequent diagnoses in the withdrawals were the mixed anxiety and depressive disorder (F 41.2), the severe depressive episode without psychotic symptoms (F 32.2) and the recurrent depressive disorder, current episode severe without psychotic symptoms (F 33.2). Regarding the second stage, we extracted two of analytical categories: suffering and pleasure in the teaching work, with three subcategories corresponding to each, namely: Academic productivism ? ?Publishing or perishing?; Teacher: is it an omnipresent being?; Wear in work relationships; The enchantment of the classroom; The recognition and Experiences that promote quality of life in the work place. Faced with the results, one can realize that teachers, despite the suffering experienced at work, the uncomfortable conditions, malaise, which occasionally even culminates in illness, recognize their work as a stimulant, as a propelling force, that gives their existence a meaning, and that the simple fact of being a teacher and the exercise of teaching could be considered by them as promoters of pleasure and quality of life in the work place.