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Doen?as cr?nicas n?o transmiss?veis e sinais e sintomas de depress?o e de decl?nio cognitivo em idosos na aten??o prim?ria ? sa?deSilva, Amanda Ramalho 30 March 2015 (has links)
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Previous issue date: 2015-03-30 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Objective: To investigate the non-communicable chronic diseases with symptoms of depression and of cognitive deficit in elders attended by family health strategy. Methods: It is conducted a cross-sectional, quantitative and descriptive study with 1.391 elders attended by 21 family health strategy under PUCRS jurisdiction, Porto Alegre. Data were collected from the formulary of PENCE. It was used for tracking of the symptoms of depression the geriatric depression scale (GDS15), and it was used the Vellore for the tracking of cognitive deficit symptoms. Results: Only 18,7% out of the analyzed did not present chronic disease and 47,5% presented 2 or more. It was noticed a greater frequency of chronic diseased with advanced age (P<0,001) and lower level of education (P=0,004) and lower frequency of chronic diseases among singles (P=0,001). The GDS result was normal in approximately 72% of the elder without chronic disease and 56% of those with some chronic disease (P<0,001). The Vellore result was normal in approximately 58% and 49% of the elders with or without chronic diseases respectively (P<0,001). The following diseases showed significant association (P<0,05) as the result of the depression symptoms scale as the cognitive symptoms scale: hypertension, diabetes, coronary disease, heart failure and cerebral vascular accident. Conclusion: The results suggest that, among the chronic diseases, cardiovascular and cerebrovascular have a clearer Independent association, both with depression as with cognitive decline, supporting the hypothesis of a possible relationship of depression as a risk factor for vascular disease and with this commitment brain associated with cognitive decline and perhaps also to depression. / Objetivos: Investigar as doen?as cr?nicas n?o transmiss?veis associadas com sintomas de depress?o e sinais de deficit cognitivo em idosos atendidos pela Estrat?gia Sa?de da Fam?lia. M?todos: Estudo transversal com 1.391 idosos atendidos no Programa de Envelhecimento Cerebral (PENCE) da Estrat?gia Sa?de da Fam?lia do Munic?pio de Porto Alegre (RS). Os dados foram coletados a partir do prontu?rio do PENCE, que cont?m informa??es sociodemogr?ficas e doen?as cr?nicas autorreferidas, al?m de instrumentos utilizados para triagem de depress?o e decl?nio cognitivo. Para o rastreio dos sintomas de depress?o, foi utilizada a Escala de Depress?o Geri?trica (GDS-15), e, para o rastreio dos sintomas de deficit cognitivo, foi utilizado o Vellore, que cont?m 10 quest?es para um informante e testagem breve realizada com o idoso. Resultados: Apenas 18,7% dos idosos n?o referiram doen?a cr?nica e 47,5% referiram duas ou mais. Foi observada maior frequ?ncia de doen?a cr?nica com idade avan?ada (P<0,001) e menor escolaridade (P=0,004); e menor frequ?ncia de doen?a cr?nica entre os solteiros (P=0,001). O resultado da GDS foi alterado em aproximadamente 28% dos idosos sem doen?a cr?nica e 44% daqueles com alguma doen?a cr?nica (P<0,001). J? o resultado do cognitivo foi alterado em aproximadamente 42% e 51% dos idosos sem e com doen?a cr?nica, respectivamente (P<0,001). A maior preval?ncia de sintomas depressivos foi no sexo feminino e nos idosos com doen?a coronariana, insufici?ncia card?aca e AVC; e menor preval?ncia naqueles com 1o grau completo, que vivem com parceiro e nos vi?vos. J? a presen?a de sinais de deficit cognitivo foi prevalente entre os que tinham 80 anos ou mais, nos idosos da ra?a negra e naqueles que apresentavam doen?a coronariana e acidente vascular encef?lico; e foi menos prevalente, quanto maior a escolaridade e entre os idosos que referiram reumatismo/artropatia. Conclus?o: Os resultados sugerem que, entre as doen?as cr?nicas, as cardiovasculares e as cerebrovasculares t?m associa??o independente mais evidente, tanto com depress?o quanto com decl?nio cognitivo, corroborando a hip?tese de uma poss?vel rela??o da depress?o como fator de risco para doen?a vascular e desta com comprometimento encef?lico associado ao decl?nio cognitivo e, talvez, tamb?m com a depress?o.
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Papel do sistema ubiquitina-proteassoma na forma??o da mem?ria e suas altera??es em um modelo de disfun??o cognitiva associada ao ac?mulo cerebral de ferroFigueiredo, Luciana Silva 07 August 2015 (has links)
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Previous issue date: 2015-08-07 / The healthy neuronal function and synaptic modification need both the synthesis and
degradation of proteins. Evidence indicates that the protein turnover mediated by proteasome
activity is involved in synaptic plasticity and long term memory. However, their role in different
stages of memory is still under discussion, and previous studies did not evaluate the possible
need of protein degradation in recognition memory. In this work, we have shown that
proteasome inhibitor, lactacystin, infused in the CA1 area of the hippocampus at two specific
time periods during consolidation affect the retention of the recognition memory in mice. The
administration of lactacystin did not affect the reconsolidation of memory. These findings
provide the first evidence for the importance of proteasome activity in memory
recognition, indicating that the protein breakdown in the hippocampus is required during two
specific time windows in memory consolidation, contributing to a better understanding of
protein turnover's role in memory formation. Changes of brain iron levels have been observed
in neurodegenerative diseases. It has been demonstrated by our research group, that iron
overload in the neonatal period results in severe and persistent memory deficits in adulthood.
Protein degradation mediated by the ubiquitin proteasome system plays an important role in
regulating various cellular processes and their involvement has been implicated in
pathogenesis of neurodegenerative diseases. So in this study was also evaluated the effects of
iron exposure in the neonatal period on the expression of proteasome subunits ?1, ?2, and ?5
and polyubiquitinated proteins in brains of rats at 15 days of life and adulthood. Two types of
hippocampal-dependent memory and recognition aversive were analyzed in adult animals. We
confirm earlier evidence that iron administered in the neonatal period affect both the aversive
memory and recognition memory. The levels of proteins polyubiquitinated found to be high in
the hippocampus, but not in the cortex of adult animals treated with iron. The gene expression
of the subunits ?1 and ?5 were affected by age in the hippocampus, which is higher in the
early stages of development, accompanied by a related increase with age polyubiquitinated protein levels in adult rats. In the cortex, the gene expression of all three subunits of the
proteasome was significantly higher in old adult than in neonatal age. Together, these results
suggest that the expression of the subunits of the proteasome and are regulated activity of
age-dependent manner. This was the first study to investigate the protein degradation system
in the brain of rats newborns and also the first to study the proteasome subunits comparing
neonatal and adult ages. Exposure to iron in the neonatal period produces long lasting harmful
effects on the functioning of the ubiquitin-proteasome system, which may be related to
deficiency of the iron induced memory, providing evidence that this system can be considered a target for the treatment of deficits memory. / A fun??o neuronal saud?vel e a modifica??o sin?ptica precisam tanto da s?ntese quanto da
degrada??o de prote?nas. Evid?ncias indicam que o turnover de prote?nas mediado pela
atividade do proteassoma est? envolvido na plasticidade sin?ptica e na mem?ria de longa
dura??o. No entanto, seu papel nas diferentes fases da mem?ria continua em discuss?o, e
estudos anteriores n?o avaliaram a poss?vel necessidade da degrada??o de prote?nas na
mem?ria de reconhecimento. Nesse trabalho, n?s mostramos que o inibidor de proteassoma,
lactacistina, infundido na ?rea de CA1 do hipocampo em dois per?odos de tempo espec?ficos
durante a consolida??o, prejudica a reten??o da mem?ria de reconhecimento em ratos. A
administra??o da lactacistina n?o afetou a reconsolida??o da mem?ria. Estas descobertas
fornecem a primeira evid?ncia para a import?ncia da atividade do proteassoma na mem?ria
de reconhecimento, indicando que a degrada??o de prote?nas no hipocampo ? necess?ria
durante duas janelas de tempo espec?ficas na consolida??o da mem?ria, contribuindo para a
melhor compreens?o do papel do turnover de prote?na na forma??o da mem?ria. Altera??es
dos n?veis de ferro cerebral t?m sido observadas em doen?as neurodegenerativas. J? foi
demonstrado pelo nosso grupo de pesquisa, que a sobrecarga de ferro no per?odo neonatal
resulta em graves e persistentes d?ficits de mem?ria na vida adulta. A degrada??o das
prote?nas mediada pelo sistema ubiquitina-proteassoma desempenha um importante papel na
regula??o de v?rios processos celulares e seu comprometimento tem sido implicado na
patog?nese de doen?as neurodegenerativas. Ent?o, nesse estudo, tamb?m foram avaliados os
efeitos da exposi??o de ferro no per?odo neonatal sobre a express?o das subunidades do
proteassoma ?1, ?2, e ?5 e das prote?nas poliubiquitinadas em c?rebros de ratos aos 15 dias
de vida e na idade adulta. Dois tipos de mem?ria dependente do hipocampo, aversiva e de
reconhecimento, foram analisados em animais adultos. Confirmamos as evid?ncias anteriores,
de que o ferro administrado no per?odo neonatal prejudica tanto a mem?ria aversiva quanto a
mem?ria de reconhecimento. Os n?veis de prote?nas poliubiquitinadas encontraram-se elevados no hipocampo, mas n?o no c?rtex, de animais adultos tratados com ferro. A
express?o g?nica das subunidades ?1 e ?5 foram afetadas pela idade no hipocampo, sendo
maior nos primeiros est?gios de desenvolvimento, acompanhado por um aumento relacionado
com a idade nos n?veis de prote?na poliubiquitinada em ratos adultos. No c?rtex, a express?o
g?nica das tr?s subunidades do proteassoma foi significativamente mais elevada na idade
adulta do que na idade neonatal. Em conjunto, esses resultados sugerem que a express?o das
subunidades e a atividade do proteassoma s?o regulados de forma dependente da idade. Este,
foi o primeiro estudo a investigar o sistema de degrada??o de prote?nas em c?rebros de ratos
neonatos e tamb?m, o primeiro a estudar as subunidades do proteassoma comparando as
idades neonatal e adulta. A exposi??o ao ferro no per?odo neonatal produz efeitos nocivos
duradouros sobre o funcionamento do sistema ubiquitina-proteassoma, que pode estar
relacionado com a defici?ncia de mem?ria induzida pelo ferro, fornecendo evid?ncias de que
esse sistema pode ser considerado um alvo para o tratamento dos d?ficits de mem?ria.
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Efeitos do treinamento de Karate-Do na cogni??o de idosos : ensaio cl?nico randomizado e controladoLopes Filho, Brandel Jos? Pacheco 04 August 2015 (has links)
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Previous issue date: 2015-08-04 / Introduction : Physical activity and martial arts have a major influence on cognitive performance of elderly, and can be important tools for preventing the development of cognitive decline and improve intervention strategies. Martial arts, especially Karate-Do, our object of study, are considered forms of complete exercise, which besides bringing benefits to physical health, contribute to stimulate motor and cognitive skills, improved quality of life and emotional aspects of their practitioners. Objective : to determine the effectiveness of a Karate-Do training, Wado-ryu style, on cognition in healthy elderly. Methods : A randomized controlled clinical trial was conducted with 33 elderly divided into two groups: Karate group (n = 16) and Control group (n = 17). In the pre and post-intervention phases, the elderly answered a sociodemographic questionnaire, a battery of neuropsychological tests (evaluation of attention, memory, language, perception, visoconstruction abilities and executive functions), subjective cognitive complaints and mood scales (anxiety and depression). Intervention with Karate-Do was conducted twice a week, lasting 60 minutes each session, for 12 weeks. The exercises consisted of kihon, kata and kumite typical of Karate-Do. Control group did not perform any physical activity or cognitive stimulation during the intervention period. Data analysis was conducted using descriptive and inferences statistics. A comparison of performance neuropsychological tests and subjective complaints scales, within and between-groups in the pre- and post-intervention, was performed using the Mann-Whitney test and Wilcoxon test. Results : the groups showed no statistically significant differences in the sociodemographic and clinical data in the pre-intervention phase. In intra-group comparison, at the end of the intervention, Karate Group achieved better performance in visual memory (Mpre: 11,78; sdpre: 6,12 / Mpost: 14,38; sdpost: 5,35 / p: 0,041), alternating attention (Mpre: 146,98; sdpre: 92,74 / Mpost: 121,39; sdpost: 70,71; p: 0,017), episodic verbal memory (Mpre: 43,88; sdpre: 7,74 / Mpost: 49,06; sdpost: 8,06; p: ?0,001), executive functions tasks (Mpre: 21,88; sdpre: 15,07 / Mpost: 31,88; sdpost: 14,91; p: 0,024) and reduction of subjective memory complaints by relatives (Mpre: 24,63; sdpre: 3,12 / Mpost: 19,69; sdpost: 5,61; p: 0,003). Control Group showed no significant differences in cognitive performance between pre- and post-intervention. In between-groups analysis at post-intervention phase, Karate group had higher scores than the Control Group in visual memory task (MGK: 14,38; sdGK: 5,35 / MGC: 10,03; sdGC: 3,43; p: 0,019) and reduction of subjective memory complaints by relatives (MGK: 19,69; sdGK: 5,61 / MGC: 24,41; sdGC: 5,12; p: 0,008). Conclusions : The Karate-Do training, Wado-ryu style, was effective in cognitive stimulation in healthy elderly, especially in tasks of attention, memory and executive functions. / Introdu??o : a atividade f?sica e artes marciais possuem uma grande influ?ncia no desempenho cognitivo de idosos, e podem ser ferramentas importantes de preven??o do desenvolvimento de decl?nio cognitivo e incrementar estrat?gias de interven??o. As artes marciais, especialmente o Karate-Do, nosso objeto de estudo, s?o consideradas formas de exerc?cio completas, que al?m de trazerem benef?cios ? sa?de f?sica, contribuem para estimular habilidades motoras e cognitivas, melhora da qualidade de vida e de aspectos emocionais de seus praticantes. Objetivo : verificar a efic?cia de um treinamento de Karate-Do, estilo Wado-ryu, sobre a cogni??o de idosos saud?veis. M?todo : realizou-se um ensaio cl?nico controlado e randomizado com 33 idosos divididos em dois grupos: Grupo Karate (n = 16) e Grupo Controle (n = 17). Nas etapas pr? e p?s-interven??o os idosos responderam a um question?rio sociodemogr?fico, a uma bateria de testes neuropsicol?gicos (avalia??o de aten??o, mem?ria, linguagem, percep??o, habilidades visuoconstrutivas e fun??es executivas) e a escalas de queixas cognitivas subjetivas e de humor (ansiedade e depress?o). A interven??o foi conduzida duas vezes por semana, com dura??o de 60 minutos/aula, por 12 semanas. Os exerc?cios eram compostos de kihon, kata e kumite t?picos de Karate-Do. O Grupo Controle n?o realizou nenhuma atividade f?sica ou de estimula??o cognitiva durante o per?odo de interven??o. A an?lise dos dados foi realizada com estat?sticas descritivas e de infer?ncias. A compara??o de desempenho nos testes neuropsicol?gicos e nas escalas de queixas subjetivas intra e entre-grupos, nos per?odos pr? e p?s-interven??o, foi realizada atrav?s do Teste U de Mann-Whitney e Wilcoxon. Resultados : os grupos n?o apresentaram diferen?as estatisticamente significativas com rela??o aos dados sociodemogr?ficos e cl?nicos na etapa pr?-interven??o. Na compara??o intra-grupos, ap?s a interven??o, o Grupo Karate demonstrou diferen?a significativa nas tarefas de mem?ria visual (Mpr?: 11,78; dppr?: 6,12 / Mp?s: 14,38; dpp?s: 5,35 / p: 0,041), aten??o alternada (Mpr?: 146,98; dppr?: 92,74 / Mp?s: 121,39; dpp?s: 70,71; p: 0,017), mem?ria verbal epis?dica (Mpr?: 43,88; dppr?: 7,74 / Mp?s: 49,06; dpp?s: 8,06; p: ?0,001), fun??es executivas (Mpr?: 21,88; dppr?: 15,07 / Mp?s: 31,88; dpp?s: 14,91; p: 0,024) e queixas de mem?ria pelo familiar (Mpr?: 24,63; dppr?: 3,12 / Mp?s: 19,69; dpp?s: 5,61; p: 0,003). N?o foram encontradas diferen?as significativas de desempenho cognitivo do Grupo Controle entre os per?odos pr? e p?s-interven??o. Na compara??o entre-grupos no ap?s a interven??o, o Grupo Karate apresentou escores mais elevados nas tarefas de mem?ria visual (MGK: 14,38; dpGK: 5,35 / MGC: 10,03; dpGC: 3,43; p: 0,019) e redu??o nas queixas subjetivas de mem?ria pelo familiar em compara??o ao Grupo Controle (MGK: 19,69; dpGK: 5,61 / MGC: 24,41; dpGC: 5,12; p: 0,008). Conclus?o : O treinamento de Karate-Do estilo Wado-ryu mostrou-se eficaz na estimula??o cognitiva de idosos saud?veis, especialmente em tarefas de aten??o, mem?ria e fun??es executivas.
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O diferimento e a eventualidade do contradit?rio e a garantia constitucional da ampla defesa : um olhar sobre a a??o monit?riaFischmann, Gerson 31 August 2015 (has links)
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Previous issue date: 2015-08-31 / This study focused the examination of acceleration techniques of legal protection through the cuts in cognitive activity, both in extent and in depth. For this, the small claims court was used, reintroduced in Brazilian law in 1995 by Law n. 9079/95 and maintained in the new Civil Procedure Code in Articles 700-?702 with some notes to the new institute of stabilization of interim protection provided for in articles 303 and 304 of the CPC/2015, which previous decision also lends itself to analysis in the context of this work. Before that, there was a brief foray with summarized references, into the study of the history of civil procedure as an autonomous and detached science of substantive law, progressing to the understanding of constitutional procedural law as now conceived. The migration of the procedural science, seen as civilized and democratic driving technique of social conflicts, in interpreting permeated with constitutional rules and principles, demanded an investigation into the most recurring doctrines, especially the study Ronald Dworkin and Robert Alexy, whose works both influenced and still influences the understanding of the rules and principles and their roles in the various legal systems. The central idea of the work was to examine the scientific basis for allowing the legislator and the law enforcer, without violation of constitutional rules and principles which ensure the wide defense and the contradictory, working with ways in which the defense is deferred or postponed or even with reduced cognition field, all understood as legitimate ways to better mold the instrument to the content of the claimed right equipment. / O presente estudo tem como foco o exame das t?cnicas de acelera??o da tutela jurisdicional atrav?s dos cortes na atividade cognitiva, tanto na extens?o quanto na profundidade. Para isso, trabalhou-?se com a a??o monit?ria, reintroduzida no direito brasileiro em 1995, pela Lei n? 9.079/95 e mantida no novo C?digo de Processo Civil/2015, nos artigos 700 a 702 com algumas notas ao novo instituto da estabiliza??o da tutela provis?ria prevista nos artigos 303 e 304 do mesmo diploma legal, cuja sumariedade tamb?m se presta para an?lise no contexto deste trabalho. Antes disso, fez-?se uma breve incurs?o, com sint?ticas e abreviad?ssimas refer?ncias, ao estudo do hist?rico do processo civil como ci?ncia aut?noma e desapegada do direito material, evoluindo-?se ao entendimento do direito processual constitucional tal como hoje concebido. A migra??o da ci?ncia processual, vista como t?cnica de condu??o civilizada e democr?tica dos conflitos sociais, para a interpreta??o permeada de regras e princ?pios constitucionais, exigiu uma investiga??o acerca das mais recorrentes doutrinas, com destaque aos estudos de Ronald Dworkin e Robert Alexy, cujas obras tanto influenciaram e ainda hoje influenciam a compreens?o das regras e princ?pios e seus pap?is nos diversos ordenamentos jur?dicos. A ideia central do trabalho ? examinar as bases cient?ficas que permitem ao legislador e ao aplicador da lei, sem viola??o ?s regras e princ?pios constitucionais que asseguram a ampla defesa e o contradit?rio, trabalhar com formas em que a defesa fica diferida ou postergada, ou ainda com campo de cogni??o reduzido, tudo bem compreendido como formas leg?timas de melhor afei?oar o instrumento ao conte?do do direito material reclamado.
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Perfil neuropsicol?gico de idosos com e sem depress?o maiorBeckert , Michele 30 June 2015 (has links)
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Previous issue date: 2015-06-30 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Depression, along with cognitive disorders, has been a concern among mental health services due to the high injury rate in functionality and quality of life of this population. However, still remains open understanding of cognitive changes due to depression and difficult differential diagnosis with mild cognitive impairment (MCI). It is known that the performance on cognitive tests are strongly influenced by education, however, few studies have been conducted on very low education populations. Objective: To evaluate the performance Addenbrooke's Cognitive Examination-Revised (ACE-R) and his cognitive domains in low schooling elderly, without dementia, and compare those with a diagnosis of Major Current Depression Episode (MCDE) with those without depression.Method: analytical, retrospective cross-sectional study using the medical records of patients treated at the Brain Aging Clinic (BAC) of the Hospital S?o Lucas. It included 116 individuals with low education (<8 years of study) and aged between 60 and 84 years (69.6 ? 6.7) with MCDE (N = 41) and controls (N = 75). Results: When comparing the means of ACE-R, MMSE and from the five cognitive domains, between the control group and the group with MCDE, there was no significant difference. There was no difference between groups when analyzed separately the results of the clock drawing test, the categorical and phonological verbal fluency and naming test. Discussion: Unlike what happens with the more educated elderly, depressive symptoms do not change the values of the tests performed on ACE-R of older people with low education. / Depress?o, juntamente com os transtornos cognitivos, tem sido uma preocupa??o entre os servi?os de sa?de mental, devido ao alto ?ndice de preju?zo na funcionalidade e qualidade de vida desta popula??o. Contudo, ainda permanece em aberto a compreens?o das altera??es cognitivas decorrentes da depress?o e de dif?cil diagn?stico diferencial com o comprometimento cognitivo leve (CCL). Sabe-se que o desempenho nos testes cognitivos s?o fortemente influenciados pela escolaridade, no entanto, poucos estudos tem sido realizados em popula??es de muito baixa escolaridade. O presente trabalho teve como objetivo avaliar o desempenho no Addenbrooke?s Cognitive Examination-Revised (ACE-R) e seus dom?nios cognitivos em idosos de baixa escolaridade, sem dem?ncia, e comparar aqueles que possuem diagn?stico de Epis?dio de Depress?o Maior Atual (EDMA), com os que n?o apresentam tal diagn?stico.M?todo: Estudo transversal anal?tico, retrospectivo, atrav?s dos prontu?rios dos pacientes atendidos no Ambulat?rio de Envelhecimento Cerebral (AMBEC) do Hospital S?o Lucas da PUCRS. Foram inclu?dos 116 idosos com baixa escolaridade (< 8 anos de estudo) e idade entre 60 e 84 anos (69,6?6,7), 41 com EDMA e 75 controles. Na compara??o das m?dias do ACE-R e dos cinco dom?nios cognitivos e do MEEM, entre o grupo controle e o grupo com EDMA, n?o foi observada diferen?a significativa. Tamb?m n?o houve diferen?a entre os grupos quando analisado separadamente os resultados do teste do rel?gio, da flu?ncia verbal categ?rica e fonol?gica e do teste de nomea??o. Diferente do que acontece com os idosos mais escolarizados, os sintomas depressivos n?o modificam os valores dos testes realizados no ACE-R de idosos com baixa escolaridade.
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Preval?ncia de dist?rbios do sono em adolescentes em situa??o de vulnerabilidade social e sua rela??o com transtornos cognitivos e comportamentaisRomanzini, Lisie Polita 29 May 2015 (has links)
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Previous issue date: 2015-05-29 / Title: Prevalence of Sleep Disorders in Socially Vulnerable Teenagers and its Relation with Cognitive and Behavioral Disorder. Introduction: Sleep complaints are frequent in adolecents and can be associated with personal, behavioral and environmental problems. Sleep deprivation in this age group may affect school performance and results in behavioral changes. Insomnia, sleep phase delay and excessive daytime sleepiness are amongst the most common sleep problems in an adolescent population. Psychiatric diseases like anxiety disorder, depression and ADHD have also strong relation with sleep disorders at this age. The aim of this study is to investigate the prevalence of sleep disorders in socially vulnerable teenagers, to correlate such observations with cognitive problems and to verify the effectiveness of an educational intervention and of sleep hygiene. Methods: A cross and interventional study in which the sample was composed of 125 high school students in a school in Porto Alegre, that serves a highly vulnerable population. The tools used to evaluate sleep were two scales, Pittsburg Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). In the cognitive evaluation the Wechsler Abbreviated Scale of Intelligence (WASI) was used, which evaluates IQ, and the SNAP-V for ADHD diagnosis. An educational intervention and sleep hygiene routines were applied in order to access a possible improvement in students with sleep disorders. Results: From the 125 students included, 80% showed sleep alterations. From these, 44% presented excessive daytime sleepiness and 69,6% a poor sleep quality, this findings were associated to use of electronic media , noise and emotional issues as the main factors. The average time of sleep of the studied subjects was of approximately 6h30min, that being less than the recommended. No association was found between sleep problems and behavioral and cognitive disfunctions. Regarding the intervention study, there was a 17% (n = 53) improvement in sleep of the students who participated in the activities, however, there was no statistically significant difference between the different interventions. Conclusion: Data showed a high prevalence of sleep alterations in the studied population studied, however, this findings were not associated with cognitive and/or behavioral disfunctions. Environmental factors seem to have an influence in this poor quality of sleep. Educational interventions or sleep hygiene can be a way to address these problems. / T?tulo: Preval?ncia de Dist?rbios do Sono em Adolescentes em Situa??o de Vulnerabilidade Social e sua Rela??o com Transtornos Cognitivos e Comportamentais. Introdu??o: Queixas de sono s?o frequentes na adolesc?ncia e podem estar associadas a problemas intr?nsecos, comportamentais e ambientais. Restri??o de sono nesta faixa et?ria pode resultar em piora do desempenho escolar e altera??es comportamentais. A ins?nia, o atraso de fase e a sonol?ncia diurna excessiva est?o entre os mais frequentes. Doen?as psiqui?tricas como transtorno de ansiedade, depress?o e TDAH possuem importante rela??o com dist?rbios do sono. O objetivo deste estudo ? investigar a preval?ncia dos dist?rbios do sono em adolescentes em situa??es de vulnerabilidade social, correlacionar tais observa??es com problemas cognitivos e comportamentais e verificar a efetividade de uma interven??o educativa e de higiene do sono. M?todo: Estudo transversal e de interven??o em que a amostra foi composta por 125 estudantes do ensino m?dio de uma escola na cidade de Porto Alegre, que atende uma popula??o com grande vulnerabilidade social. Os instrumentos utilizados para avaliar o sono foram duas escalas, Pittsburgh Sleep Quality Index (PSQI) e a Epworth Sleepiness Scale (ESS). Na avalia??o cognitiva foi utilizado a Wechsler Abbreviated Scale of Intelligence (WASI), que avalia QI, e o SNAP-IV para diagn?stico de TDAH. Uma interven??o educativa e de higiene do sono foi realizada para avaliar poss?vel melhora em alunos com altera??es do sono. Resultados: Dos 125 estudantes inclu?dos, 80% apresentaram altera??es no sono. Destes 44% apresentaram sonol?ncia diurna excessiva e 69,6% sono de m? qualidade relatando uso de m?dia eletr?nica, barulho e quest?es emocionais como principais fatores que interferem no sono. O tempo m?dio de sono dos sujeitos do estudo foi aproximadamente de 6h30min, sendo inferior ao recomendado. N?o foram encontradas associa??es entre problemas do sono e problemas comportamentais e cognitivos. Em rela??o ao estudo de interven??o ocorreu uma melhora no sono de 17% (n=53) dos estudantes que participaram das atividades, por?m n?o houve diferen?a estatisticamente significativa entre as diferentes interven??es.
Conclus?o: Foi observada uma alta preval?ncia de altera??es do sono na popula??o estudada, n?o havendo associa??o entre problemas cognitivos e/ou comportamentais. Entretanto, fatores ambientais externos parecem ter influ?ncia nesta m? qualidade de sono. Interven??es educativas ou de higiene do sono podem ser um meio para abordar estes problemas.
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Desenvolvimento e propriedades psicom?tricas da ECO-RV : tarefa ecol?gica em realidade virtual para avalia??o neuropsicol?gica de idososOliveira, Camila Rosa de 03 December 2015 (has links)
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Previous issue date: 2015-12-03 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / The use of virtual reality technology in clinical neuropsychology has received emphasis in the areas of assessment and rehabilitation in recent decades. Thereby, this doctoral thesis consisted of four studies with the objective of developing an ecological task in virtual reality for neuropsychological assessment in elderly (the ECO-VR), and provide evidence of its validity and reliability. Overall, the studies were characterized by cross-sectional, quasi-experimental, correlational, and between participants comparison design. At the development stage, the sample included 29 non-specialist judges, who analyzed the representativeness degree of the ECO-VR scene and three-dimensional stimuli, five expert judges have verified the apparent validity of the tasks, and six elderly who responded to the pilot studies. In other thesis studies, initial overall sample included 169 community dwelling elderly, recruited by convenience and snowball technique. In addition, 141 informants were included to respond questionnaires of cognitive complaints and functional capacity in relation to the elderly. After considering the exclusion criteria, final overall sample consisted of 149 elderly, 38 identified with mild cognitive decline, according to international criteria. In addition to the ECO-VR, the instruments used were a socio-demographic and clinical questionnaire, the CAGE questionnaire, the Mini Mental State Examination, the Geriatric Depression Scale-short form, a battery of neuropsychological tests, questionnaires of cognitive complaints and functional capacity. Data distribution was investigated by Kolmogorov-Smirnov, and associations between the scores of ECO-RV and other variables were investigated by Pearson correlation and stepwise multiple linear regression analysis. In the reliability tests, we used the Cronbach's coefficient alpha and the halves method (half-split), by adjusting the value according to the Spearman-Brown formula. Comparisons between groups were performed using chi-square test, Student's t test for independent samples, Mann-Whitney test and univariate analysis, and the effect magnitude was assessed by the Cohen?s d. A discriminant analysis was also carried out with enter method, and variance-covariance homogeneity was investigated with the Shapiro-Wilk test and Box?s M. Results were considered significant when p ? 0.05 and the SPSS 22 version for Windows was used for data analysis. According to the results, the ECO-VR has shown evidence for apparent, criterion, construct, and ecological validity, as well as adequate reliability indices. Correlations between ECO-TV scores and demographic data, neuropsychological performance and functional capacity were found. The inclusion of technological tools in the clinical neuropsychology field seeks to enhance the evaluation methods, particulary in the diagnosis of cognitive disorders associated with aging process. / O uso da tecnologia de realidade virtual na neuropsicologia cl?nica tem recebido destaque tanto nos contextos de avalia??o quanto de reabilita??o nas ?ltimas d?cadas. Assim, a presente tese de doutorado foi composta por quatro estudos com o objetivo de desenvolver uma tarefa ecol?gica em realidade virtual para avalia??o neuropsicol?gica de idosos (a ECO-RV), bem como prover evid?ncias de validade e de fidedignidade desta. De maneira geral, os estudos caracterizaram-se por um delineamento transversal, quase-experimental, correlacional e entre participantes. Durante a etapa de desenvolvimento da ECO-RV, a amostra incluiu 29 ju?zes n?o especialistas, os quais analisaram o grau de representatividade do cen?rio e est?mulos tridimensionais, cinco ju?zes especialistas que verificaram a validade aparente das tarefas, e seis idosos que responderam aos estudos pilotos. Na realiza??o dos demais estudos da tese, a amostra geral inicial incluiu 169 idosos residentes da comunidade, recrutados por conveni?ncia e pela t?cnica de snowball. Ademais, foram inclu?dos 141 informantes que responderam a question?rios de queixas cognitivas e de capacidade funcional em rela??o aos idosos. Ap?s considerar os crit?rios de exclus?o, a amostra geral final foi composta por 149 idosos, sendo 38 identificados com decl?nio cognitivo leve conforme crit?rios internacionais. Al?m da ECO-RV, os instrumentos utilizados foram uma ficha de dados sociodemogr?ficos e cl?nicos, question?rio CAGE, Mini Exame do Estado Mental, Escala de Depress?o Geri?trica de 15 itens, uma bateria de testes neuropsicol?gicos, question?rios de queixas cognitivas e de capacidade funcional. A distribui??o dos dados foi verificada pelo teste de Kolmogotov-Smirnov, e associa??es entre os escores da ECO-RV e demais vari?veis foram investigadas por correla??o de Pearson e an?lises de regress?o linear m?ltiplas com m?todo stepwise. Nas an?lises de fidedignidade, utilizou-se o coeficiente de alfa de Cronbach e o m?todo das metades (split-half), cujo valor foi corrigido de acordo com a f?rmula de Spearman-Brown. Compara??es entre grupos foram realizadas atrav?s do teste qui-quadrado, teste t de Student para amostras independentes, teste U de Mann-Withney e an?lise univariada, e a magnitude de efeito foi verificada pelo d de Cohen. Realizou-se tamb?m uma an?lise discriminante com m?todo enter e a homogeneidade das vari?ncias-covari?ncias foi investigada com os testes de Shapiro-Wilk e M de Box. Resultados significativos foram considerados quando p ? 0,05 e utilizou-se o software SPSS vers?o 22 para Windows para a an?lise dos dados. De acordo com os resultados, a ECO-RV demonstrou evid?ncias de validade aparente, crit?rio, construto e ecol?gica, al?m de adequados ?ndices de confiabilidade. Encontraram-se correla??es entre os escores da ECO-RV e dados sociodemogr?ficos, desempenho neuropsicol?gico e capacidade funcional. A inclus?o de ferramentas tecnol?gicas no campo da neuropsicologia cl?nica busca incrementar os m?todos de avalia??o, principalmente na investiga??o de transtornos cognitivos associados ao processo de envelhecimento.
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O impacto dos maus-tratos na cogni??o e na emo??o durante a inf?nciaN??ez Carvalho, Jana?na Castro 04 March 2016 (has links)
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Previous issue date: 2016-03-04 / Conselho Nacional de Pesquisa e Desenvolvimento Cient?fico e Tecnol?gico - CNPq / The occurrence of maltreatment in childhood is a phenomenon with high prevalence around the world and is associated to a series of neurobiological, emotional and cognitive impairments in victims. A body of evidence already exists regarding its consequences for adolescent and adult samples, suggesting deleterious medium and long-term impacts; however, impairments in childhood have not been sufficiently studied. Thus, the aim of this study is to assess the impact of maltreatment on cognition during childhood, as well as the presence of associated clinical symptoms. This thesis is composed of three papers: one theoretical and two empirical. The theoretical article entitled "Cognitive, neurobiological and psychopathological alterations associated with child maltreatment: a review of systematic reviews" aims to review the association between maltreatment and neurobiological, cognitive and lifetime comorbid psychiatric alterations. Important neurobiological alterations were found to be associated with maltreatment, as changes in levels of cortisol, dopamine, norepinephrine and serotonin. Structural impairments were found in regions such as the frontal cortex and hippocampus in adult victims of childhood maltreatment. The most consistent finding was the association between childhood maltreatment and presence of psychiatric conditions in adulthood. Regarding the impact of maltreatment on cognition, there are few studies to date and they report contrasting results. A need for further studies with child samples was evidenced through the literature review, in order to assess the immediate or short-term impact of maltreatment in cognition, as well as the presence of clinical symptoms. Thus, the first empirical article entitled "Cognitive Performance and Clinical Symptoms in Maltreatment Victims: Intellectual Impairment Evidence in a Child Sample in Brazil" aims to assess global cognitive profile and the prevalence of intellectual impairment of a sample of child victims of maltreatment between 6 and 12 years of age. A further objective is to assess the presence of internalizing and externalizing symptoms and their relation to the cognitive profile of the sample. Group differences were found across all assessed functions, with the presence of important intellectual impairment in the maltreatment group. More clinical symptoms, especially externalizing symptoms, were found in the maltreatment group. Few associations were found between clinical symptoms and cognitive profile. The second empirical article, "Executive Function and clinical symptoms in children exposed to maltreatment", sought to assess in a more specific manner the executive functioning of a group of child victims of maltreatment aged 8 to 12 years. Furthermore, clinical symptoms were more broadly investigated in the sample, through the assessment of depression, anxiety and post-traumatic stress symptoms. Evidence of an important executive impairment was found in the maltreatment group. Inhibitory control remained impaired even when controlling for intelligence. More clinical symptoms were found in the maltreatment group, with no association between most of the cognitive and clinical measures. Lastly, final considerations about the work are drawn. In view of the findings of a high prevalence of intellectual impairments in the maltreatment group and the dissociation between cognitive impairments and clinical profile, the discussion revolves around preventive and cognitive stimulation interventions for victims. / A ocorr?ncia de maus-tratos na inf?ncia ? um fen?meno com alta preval?ncia ao redor do mundo e est? associado a uma s?rie de preju?zos neurobiol?gicos, emocionais e cognitivos nas v?timas. Ainda que j? exista um corpo de evid?ncias sobre as suas sequelas em amostras de adolescentes e adultos, sugerindo um impacto delet?rio a m?dio e longo prazo, os preju?zos na inf?ncia ainda n?o foram suficientemente estudados. Dessa forma, o objetivo geral deste trabalho foi avaliar o impacto dos maus-tratos na cogni??o durante a inf?ncia, bem como a presen?a de sintomatologia cl?nica associada. A presente tese ? composta de 3 artigos, sendo um artigo te?rico e dois artigos emp?ricos. O primeiro artigo te?rico denominado ?Cognitive, neurobiological and psychopathological alterations associated with child maltreatment: a review of systematic reviews? teve como objetivo revisar a associa??o entre maus-tratos e altera??es neurobiol?gicas, cognitivas e comorbidades psiqui?tricas ao longo da vida. Foram encontradas importantes altera??es neurobiol?gicas associadas aos maus-tratos com modifica??es nos n?veis de cortisol, dopamina, noradrenalina e serotonina. Em n?vel estrutural foram encontradas diminui??es em regi?es como c?rtex frontal e hipocampo em adultos v?timas de maus-tratos na inf?ncia. O achado mais consistente foi a associa??o entre maus-tratos na inf?ncia e presen?a de quadros psiqui?tricos na vida adulta. Em rela??o ao impacto dos maus-tratos na cogni??o, existem poucos estudos at? o momento e estes encontraram resultados contrastantes. A partir da revis?o da literatura evidenciou-se a necessidade de mais estudos com amostras de crian?as, para avaliar o impacto imediato, ou de curto prazo, dos maus-tratos na cogni??o, bem como a presen?a de sintomatologia cl?nica. Dessa forma, o primeiro artigo emp?rico denominado ?Desempenho Cognitivo e Sintomas Cl?nicos em V?timas de Maus-tratos: Evid?ncias de Preju?zo Intelectual em uma Amostra de Crian?as no Brasil? teve como objetivo avaliar o perfil cognitivo global, bem como a preval?ncia de preju?zo intelectual de uma amostra de crian?as v?timas de maus-tratos de 6 a 12 anos. Teve como objetivo ainda avaliar a presen?a de sintomas internalizantes e externalizantes na amostra e sua rela??o com o perfil cognitivo. Foram encontradas diferen?as entre os grupos em todas as fun??es avaliadas, com a presen?a de importante preju?zo intelectual no grupo maus-tratos. Foi encontrada, ainda, maior sintomatologia cl?nica, sobretudo de sintomas externalizantes, no grupo maus-tratos. Foram encontradas poucas associa??es entre a sintomatologia cl?nica e o perfil cognitivo encontrado. O segundo artigo emp?rico, ?Fun??es Executivas e sintomatologia cl?nica em crian?as expostas a maus-tratos?, buscou avaliar de uma forma mais espec?fica as fun??es executivas de um grupo de crian?as de 8 a 12 anos v?timas de maus-tratos bem como investigar de forma mais ampla a sintomatologia cl?nica na amostra, avaliando sintomas de depress?o, ansiedade e sintomatologia de estresse p?s-traum?tico. Foram encontradas evid?ncias de importante preju?zo executivo no grupo maus-tratos. O controle inibit?rio manteve-se prejudicado, mesmo quando a intelig?ncia foi controlada. Houve maior presen?a de sintomatologia cl?nica no grupo maus-tratos, sem associa??o entre a maior parte das medidas cognitivas e cl?nicas. Por ?ltimo, foram tra?adas considera??es finais sobre o trabalho. Tendo em vista os achados de alta preval?ncia de preju?zos intelectuais no grupo maus-tratos e dissocia??o entre os preju?zos cognitivos e o perfil cl?nico, foram discutidas, a partir da literatura, interven??es preventivas e de estimula??o cognitiva para as v?timas.
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A influ?ncia da indu??o de estere?tipo e desaprova??o na mem?ria de crian?as pr?-escolares e escolaresPante, Marina 04 March 2016 (has links)
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Previous issue date: 2016-03-04 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / This Master's thesis consists of two studies, one theoretical and one empirical. The theoretical session consists of a non-systematic literature review in order to investigate the cognitive and social consequences of child suggestibility and false memory phenomenon, seeking to advance the debate on the development of memory during childhood and its impact on testimonials. This discussion is important to precisely determining practical implications of the child suggestibility. Empirical session proposes a new experimental paradigm for methodological purposes of the study of child suggestibility, aiming to investigate the impact stereotype induction and disapproval influence in preschoolers and schoolchildren memory. Thereunto, 40 preschoolers (23 girls) aged from 4 to 6 years (M = 62.7 months, SD = 8.03) and 36 schoolchildren (17 girls) aged from 7 to 8 years (M = 95.4 months, SD = 6.21) were visited in their classrooms by an adult (Samuel, the scientist), who held a brief demonstration of science to children. The stereotype induction and disapproval were made through videos containing information about the scientist. Two weeks later, we accessed the memory of all children about the scientist's visit by an interview and we categorized their responses into different types of information (accurate, stereotype-related and confabulations). The main results indicate that older children (schoolchildren) remember more accurate information than younger (preschoolers) do. In addition, there is a positive relationship between the recall of accurate memories and stereotype-related information. The age of participants moderates this relation. The main contribution of this study is the empirical investigation of the impact of age on the accuracy of children's memory reports about a target event, and the relationship between accurate memory and false memories. / A presente disserta??o de Mestrado ? constitu?da por dois estudos, um te?rico e um emp?rico.
A se??o te?rica consiste em uma revis?o n?o sistem?tica da literatura com o objetivo de
investigar os consequentes cognitivos e sociais da sugestionabilidade infantil e do fen?meno
de falsas mem?rias, buscando avan?ar o debate sobre o desenvolvimento da mem?ria durante
a inf?ncia e o seu impacto em depoimentos. Esta discuss?o ? importante para determinar
implica??es pr?ticas mais precisas sobre a sugestionabilidade infantil. A se??o emp?rica prop?e
um novo paradigma experimental para fins metodol?gicos do estudo da sugestionabilidade
infantil, com o objetivo principal de investigar o impacto da indu??o de um estere?tipo e a
influ?ncia da desaprova??o na mem?ria de crian?as em idade pr?-escolar e crian?as escolares.
Para tanto, 40 pr?-escolares (sendo 23 meninas) com idades de 4 a 6 anos (M= 62,7 meses,
DP=8,03) e 36 escolares (sendo 17 meninas), com idades de 7 a 8 anos (M=95,4 meses, DP=
6,21), receberam a visita de um homem adulto denominado Cientista Samuel, o qual realizou
uma breve demonstra??o de ci?ncias com as crian?as. A transmiss?o do estere?tipo e a
desaprova??o foram realizadas por meio de v?deos contendo informa??es a respeito do cientista
Samuel. Duas semanas depois, a mem?ria de todas as crian?as acerca da visita do cientista foi
testada por meio de uma entrevista e suas respostas foram categorizadas em diferentes tipos de
informa??es acuradas, relativas ao estere?tipo e confabula??es. Os principais resultados
indicam que as crian?as mais velhas (escolares) recordam mais informa??es acuradas que as
mais novas (pr?-escolares). Ademais, existe uma rela??o positiva entre a recorda??o de
mem?rias acuradas e a produ??o de mem?rias relativas ao estere?tipo. Esta rela??o ? moderada
pela idade dos participantes. A principal contribui??o do presente estudo ? a investiga??o
emp?rica do impacto que a faixa et?ria exerce na acur?cia dos relatos de mem?ria de crian?as
sobre um evento alvo, e na rela??o entre mem?ria acurada e falsas mem?rias.
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O impacto do ambiente virtual na metamem??ria e nos estados de humor na terceira idadeAlvim, Kelly Cristina Barbosa Levi 05 February 2018 (has links)
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Previous issue date: 2018-02-05 / Knowledge about the use of technologies has become necessary in contemporary culture, regardless of age, influencing self-worth and developing daily activities and relationships. The objective of this study was to analyze the impact of the virtual environment on the improvement of the perception of cognitive ability and on the improvement of the mood states of the elderly. The methodology used was quantitative, quasi-experimental and cross-sectional, with pre and post intervention measures. The application was in a group and had an average duration of 40 minutes in each moment, the final sample being composed of 25 elderly people with mean age equal to 64.92 (?? 3.74).A structured questionnaire was applied with the sociodemographic measures, the states of anxiety (BAI-II) and depression (BDI), the WHOQOL-bref, which evaluates the quality of life and the MIAr, which investigates the metamemory. Descriptive statistics and distribution measures, correlation analysis and regression were used in the analyzes. The results showed a higher concentration of females (60%). As for mood states, there was no significant difference between pre- and post-intervention data. With regard to the quality of life added to the mood state there was a trend of improvement in the psychological domain (p???0.07). The t test paired showed significant differences in the social relations domains (p ???0,0001), total quality of life (p???0.01) and trend in the environmental domain (p???0.07). MIAr revealed an increase in the perception of those with poor memory (20-32%) and those who had a good memory (16-32%). It was concluded that there were important changes in some domains related to quality of life and in the metamemory of the evaluated elderly. / O conhecimento sobre o uso de tecnologias passou a ser necess??rio na cultura contempor??nea, independentemente da faixa et??ria, influenciando na autovaloriza????o e no desenvolvimento das atividades e rela????es di??rias. Este trabalho teve por objetivo geral analisar o impacto do ambiente virtual na melhora da percep????o da capacidade cognitiva e na melhora nos estados de humor dos idosos. A metodologia utilizada foi do tipo quantitativa, quase-experimental e transversal, com medidas pr?? e p??s-interven????o. A aplica????o deu-se em grupo e teve dura????o m??dia de 40 minutos em cada momento, sendo a amostra final composta por 25 idosos com m??dia de idade: 64,92 (??3,74). Foram aplicados um question??rio estruturado com as medidas sociodemogr??ficas, os estados de ansiedade (BAI-II) e depress??o (BDI), o WHOQOL-bref, que avalia a qualidade de vida, e o MIAr, que investiga a metamem??ria. Nas an??lises, foram utilizadas estat??sticas descritivas e medidas de distribui????o, an??lise de correla????o e de regress??o. Os resultados apresentaram uma maior concentra????o do sexo feminino (60%). Quanto aos estados de humor, n??o houve diferen??a significativa entre os dados pr?? e p??s-interven????o. No que se refere a qualidade de vida somada ao estado de humor, houve uma tend??ncia de melhora no dom??nio psicol??gico (p???0,07). O teste t pareado apresentou diferen??as significativas nos dom??nios rela????es sociais (p ???0,0001), qualidade de vida total (p???0,01) e tend??ncia no dom??nio do meio ambiente (p???0,07). O MIAr revelou um aumento na percep????o de quem se percebia com mem??ria ruim (20-32%) e quem se achava com boa mem??ria (16-32%), concluindo-se que houve altera????es importantes em alguns dom??nios referentes a qualidade de vida e na metamem??ria dos idosos avaliados.
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