Made available in DSpace on 2014-12-17T15:43:54Z (GMT). No. of bitstreams: 1 VanessaMAS_DISSERT.pdf: 1312665 bytes, checksum: c571f23a201e08178fefee625ed7591a (MD5) Previous issue date: 2012-09-25 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico / Em infec??es parasit?rias helm?nticas a eosinofilia ? um dos fatores essenciais ? resist?ncia do hospedeiro, entretanto, infec??es com protozo?rios raramente resultam em eosinofilia perif?rica. O objetivo deste estudo foi identificar infec??es por enteroparasitas em crian?as e associ?-las com eosin?filos sangu?neos e fecais. Os exames parasitol?gicos efetuados pelo m?todo de Blagg, a pesquisa de eosin?filos pelo tric?mio e colora??o por Leishman foram realizados em 346 crian?as. Amostras positivas para parasitas representaram 80,1% e negativas 19,9%. A eosinofilia absoluta perif?rica foi encontrada em 55,9% das crian?as, sendo 82,7% representado por crian?as parasitadas e destacando que 54,9% dos infectados por protozo?rios apresentaram eosin?filos acima de 500c?lulas/mm3. Das 62 crian?as com amostras fecais positivas para eosin?filos, 77,4% eram parasitadas por helmintos e/ou protozo?rios. A presen?a dos cristais de Charcot-Leyden nas fezes foi positiva em 39,1% das amostras, se mostrando estatisticamente significante nas crian?as parasitadas com helmintos (p=0,022). As crian?as s?o residentes em ?reas end?micas de parasitoses intestinais e como p?de ser observado a maior parte das crian?as que apresentaram eosinofilia e eosin?filos nas fezes eram parasitadas por helmintos e/ou protozo?rios

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2016-11-09T10:20:25Z No. of bitstreams: 1 DIS_KARLA_LOYOLA_DE_OLIVEIRA_ARANTES_PARCIAL.pdf: 498884 bytes, checksum: bb7c00542339d8c42d7f409e045abdf5 (MD5) / Made available in DSpace on 2016-11-09T10:20:25Z (GMT). No. of bitstreams: 1 DIS_KARLA_LOYOLA_DE_OLIVEIRA_ARANTES_PARCIAL.pdf: 498884 bytes, checksum: bb7c00542339d8c42d7f409e045abdf5 (MD5) Previous issue date: 2016-08-31 / Introduction: Prognostic scores are useful tools in assessing the effectiveness of treatments, mortality risk and quality of services, allowing the comparison between different Intensive Care Units as the implementation and improvement of treatment and public health policies and protocols. The PIM (Pediatric Index of Mortality) is one of the most widely used prognostic scores in pediatrics and has improved generating PIM 2 and PIM 3. The latest has not been validated in developing countries. Objectives: Validation of PIM 3 score in a tertiary pediatric hospital in southeastern Brazil, and comparison of its performance with the PIM 2, currently used. Methods: A contemporary cohort study undertaken between January 1 and December 31, 2014, at the Pediatric Intensive Care Unit of HEINSG (Hospital Estadual Infantil Nossa Senhora da Gl?ria). The sample characterization was performed using the observed frequency, percentage, measures of central tendency and variability. The calibration of the scores was analyzed by the Hosmer-Lemeshow test setting, while the Z statistic Flora was used to evaluate the similarity between overall mortality and the one observed through the standardized mortality rate (SMR - Standardized Mortality Rate). For Flora z test, it is considered critical values for the non-null hypothesis rejected the two standard deviations (SD) (or between <1.96 and> -1.96). The area under the ROC curve (Receiver Operating Characteristic) was used to analyze the discrimination capacity of PIM2 and PIM3 models among patients who were discharged or died, and the assessment of the concordance between the measures of PIM 2 and PIM3 was performed using the Student t test for independent samples. The agreement between the measures of PIM 2 and PIM3 was evaluated by Bland & Altman plot. The significance alpha level used in the analyzes was 5% and 95% confidence interval. Data were collected in an Excel table, confirmed on medical records and later transferred to IBM SPSS software to perform all analyzes. Results: 293 patients were admitted to the PICU during the studied period, 38 of whom presented exclusion criteria. 35 (13.7%) of the 255 patients studied died. The average score PIM2 was significantly higher than the PIM3, and Flora Z statistics showed no difference between the overall mortality observed and the expected one in PIM2, but this difference was found in PIM3. The PIM2 score got an excellent discrimination (AUC = 0.830) and its sensitivity was 85.7, and the specificity was 69.1. On the other hand, the PIM 3 score had an acceptable discrimination (AUC = 0.748), while its sensitivity was 74.3, and its specificity was 67.7. The comparison between the areas under the ROC curve of PIM2 and PIM3 was significant (p = 0.015), showing that there is a difference between their areas, with better performance for PIM2 compared to PIM 3 (Z Flora 2.427). The Bland-Altman diagramme indicated that the 95% limits of concordance between the two versions of PIM ranged from -1.2 to 2.3, indicating that the measures are inconsistent. There is discordance of 10.6% above and below the limit ? 1.96 standard deviations (SD) between the mentioned values, that is about twice the tolerable 5%. Conclusion: In our study, the PIM 2 shows better results to discriminate those patients who will die. We suggest, based on these results, that data collection should be maintained using the 2 versions of the score in this unit. Than, these data could be reanalyzed with a larger sample, and these results could be compared with new studies conducted in locations where population have similar characteristics. / Introdu??o: Escores progn?sticos s?o ferramentas ?teis na avalia??o da efic?cia de tratamentos, risco de mortalidade e qualidade de servi?os, possibilitando compara??o entre diferentes UTI (Unidade de Terapia Intensiva), al?m de implementa??o e melhorias de protocolos de tratamento e pol?ticas de sa?de p?blica. O PIM (Pediatric Index of Mortality) ? atualmente um dos escores progn?sticos mais utilizados na pediatria, tendo sido aperfei?oado gerando o PIM 2 e mais recentemente o PIM 3, este ?ltimo at? o momento n?o validado em pa?ses em desenvolvimento. Objetivos: Valida??o do PIM3 em um hospital pedi?trico terci?rio no sudeste do Brasil, e compara??o de sua performance com o PIM 2, escore atualmente utilizado. M?todos: Estudo de coorte hist?rico retrospectivo, realizado entre 1? de janeiro e 31 de dezembro de 2014 na Unidade de Terapia Intensiva Pedi?trica (UTIP) do HEINSG (Hospital Estadual Infantil Nossa Senhora da Gl?ria). A caracteriza??o da amostra foi realizada atrav?s da frequ?ncia observada, porcentagem, medidas de tend?ncia central e de variabilidade. A calibra??o dos escores foi analisada pelo teste de ajuste de Hosmer-Lemeshow, enquanto a estat?stica Z de Flora foi utilizada para avaliar a semelhan?a entre a mortalidade geral e observada atrav?s do ?ndice padronizado de mortalidade (SMR - Standardized Mortality Rate). Para o teste z de Flora, considerou-se valores cr?ticos para n?o-rejei??o da hip?tese nula o intervalo de dois desvios padr?o (DP) (ou entre < 1,96 e > -1,96). A ?rea sob a curva ROC (Receiver Operating Characteristic) foi utilizada para a an?lise da capacidade de discrimina??o dos modelos PIM2 e PIM3 entre os pacientes que teriam alta ou evoluiriam para o ?bito, e a avalia??o da semelhan?a entre as m?dias do PIM2 e PIM3 foi feita atrav?s do teste t de Student para amostras independentes. A concord?ncia entre as medidas do PIM2 e PIM3 foi avaliada pelo gr?fico de Bland & Altman. O n?vel alfa de signific?ncia utilizado nas an?lises foi de 5% e intervalo de confian?a de 95%. Os dados foram coletados em uma tabela Excel, conferidos em prontu?rios m?dicos e posteriormente transferidos para o software IBM SPSS para a realiza??o de todas as an?lises. Resultados: Foram admitidos 293 pacientes no per?odo estudado, sendo 38 exclu?dos por apresentarem um dos crit?rios de exclus?o. Dos 255 pacientes analisados, 35 (13,7%) foram a ?bito. O escore m?dio do PIM2 foi significativamente maior que o do PIM3, e a estat?stica Z de flora evidenciou n?o haver diferen?a entre a mortalidade geral observada e esperada no PIM2, mas h? diferen?a destas no PIM3. O PIM2 obteve uma discrimina??o excelente (AUC = 0.830) e sua sensibilidade foi de 85.7 e especificidade de 69.1. J? o PIM3 obteve uma discrimina??o aceit?vel (AUC = 0.748) e sua sensibilidade foi de 74.3 e especificidade de 67.7. A compara??o entre as ?reas sob a curva ROC do PIM2 e PIM3 foi significativa (p = 0.015), evidenciando que h? diferen?a entre as suas ?reas, com melhor desempenho do PIM2 em rela??o ao PIM 3 (Z de Flora 2.427). O gr?fico de Bland-Altman indicou que os limites de 95% de concord?ncia entre as 2 vers?es do PIM variaram de -1,2 a 2,3, indicando que as medidas s?o inconsistentes, havendo discord?ncia entre as mesmas que incluem 10,6% valores acima e abaixo do limite ? 1,96 DP, cerca do dobro do toler?vel de 5%. Conclus?es: Neste estudo, o PIM 2 apresentou melhores resultados para discriminar aqueles pacientes que ir?o a ?bito, se comparado ao PIM 3. Poderia se sugerir, partindo desses resultados, que fosse mantida a coleta de dados utilizando as 2 vers?es do escore nesta unidade, para que estes dados possam ser novamente analisados com uma amostra maior, e que esses resultados possam ser comparados com novos estudos que devem surgir em locais com popula??es com caracter?sticas semelhantes.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2016-11-09T10:23:59Z No. of bitstreams: 1 DIS_CAROLINA_MENNA_BARRETO_SILVEIRA_PARCIAL.pdf: 882195 bytes, checksum: 4e9eed2bd20f440884bd27fcba9fbdfd (MD5) / Made available in DSpace on 2016-11-09T10:23:59Z (GMT). No. of bitstreams: 1 DIS_CAROLINA_MENNA_BARRETO_SILVEIRA_PARCIAL.pdf: 882195 bytes, checksum: 4e9eed2bd20f440884bd27fcba9fbdfd (MD5) Previous issue date: 2016-08-29 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Recent data from scientific literature show low exclusive breastfeeding (EBF) rates in the world, and diversity in the factors that influence it. However, the number of studies about the power of pediatricians and their interventions on duration of EBF is still limited. Objective: To determine the influence of the pediatrician and their interventions on the success of EBF at 3 and 6 months of age in full-term newborns (FNT), undergoing elective cesarean delivery. Methods: A cohort study in a private hospital in Brazil. Questionnaires to mothers at discharge, at 7 days, 3 and 6 months of life were applied. At the day of discharge, the contact was in person, while the following steps was by phone calling. To evaluate the association between categorical variables, chi-squared tests or Fisher's exact were used. Results: The final sample consisted of 907 mother-baby pairs, assisted by 32 pediatricians. The influence of the pediatrician was significant in EBF at 3 months of age (p=0.001). The prevalence of complement in the first prescription varied significantly among pediatricians (31.6% to 100%, p <0.001) and was negatively associated with the EBF at 3 months (p=0.003). When comparing the prevalence of the use of bottles and pacifiers at the first 7 days of life, among the pediatricians, there was a significant difference (p=0.005). The use of pacifiers at 7 days and 3 months was negatively associated with the EBF at 3 months (p<0.001). FNTs who used a bottle at 7 days showed lower prevalence of EBF until sixth month of life. Conclusion: This study provides evidences about the influence of the pediatrician in the prevalence and duration of exclusive breastfeeding at third month of life. This reinforces the need to improve their knowledge, attitudes and practices on breastfeeding. / Dados recentes da literatura cient?fica mostram baixas taxas de aleitamento materno exclusivo (AME) no Brasil e no mundo, al?m de uma grande diversidade nos fatores que o influenciam. Contudo, o n?mero de estudos sobre o poder de atua??o do pediatra e suas interven??es na dura??o do AME ainda ? limitado. Objetivo: Verificar a influ?ncia do pediatra e suas interven??es no sucesso do AME aos tr?s e seis meses de vida, em rec?m-nascidos (RNs) a termo, submetidos ? cesariana eletiva. Me?todos: Estudo de coorte, em um hospital privado do Brasil. Foram aplicados question?rios ?s m?es na alta, aos 7 dias, 3 e 6 meses de vida. No dia da alta, o contato foi presencial, enquanto nas etapas seguintes foi telef?nico. Para avaliar a associa??o entre as vari?veis categ?ricas, foram utilizados os testes qui-quadrado de Pearson ou Exato de Fisher. Resultados: A amostra final foi composta por 907 duplas m?es-beb?s, assistidas por 32 pediatras. A influ?ncia do pediatra foi significativa no AME aos 3 meses de vida do beb? (p=0,001). A preval?ncia de complemento na 1? prescri??o variou significativamente entre os pediatras (de 31,6% a 100%; p<0,001) e esteve associada negativamente com o AME aos 3 meses (p=0,003). Quando comparadas as preval?ncias de uso de mamadeira e chupeta aos 7 dias, entre os pediatras, houve diferen?a significativa (p=0,005). O uso de chupeta aos 7 dias e 3 meses associou-se ao insucesso do AME no 3? m?s de vida (p<0,001). RNs que utilizaram mamadeira aos 7 dias apresentaram preval?ncias de AME mais baixas at? o 6? m?s de vida. Conclus?o: Este estudo fornece evid?ncias sobre a influ?ncia do pediatra e suas interven??es na preval?ncia e dura??o do AME no terceiro m?s de vida. Isso refor?a a necessidade de aprimorar seus conhecimentos, atitudes e pr?ticas sobre a amamenta??o.

Made available in DSpace on 2015-04-14T14:52:07Z (GMT). No. of bitstreams: 1 422276.pdf: 1366124 bytes, checksum: 2f960e44afb1f177c4ea79339325bcd6 (MD5) Previous issue date: 2010-03-15 / A presente disserta??o tem como objetivo ampliar o conhecimento sobre o significado cultural dos bens de consumo, tendo como objeto o fen?meno dos concursos de beleza infantil e suas candidatas. Primeiramente, descrevo os concursos de beleza (adulto e infantil) expondo as principais discuss?es j? geradas sobre o assunto, a fim de apresentar o contexto da pesquisa. Depois, realizo uma revis?o te?rica da tem?tica dos significados culturais dos bens de consumo, do modelo de movimenta??o destes significados, realizando a liga??o entre esta teoria com o p?blico infantil. No cap?tulo de m?todo, descrevo o campo de pesquisa, justificando a escolha pela etnografia. Al?m disso, descrevo mais especificamente as tr?s etapas observadas (municipal, nacional e internacional), nos estados do Paran? e Santa Catarina, no ano de 2009. Posteriormente, identifico os principais bens de consumo utilizados: os pr?mios (faixas, coroas e presentes); os trajes (t?pico e de gala); as maquiagens; as lembrancinhas; os materiais para emerg?ncias; e os uniformes. Depois, identifico os significados desses bens, que s?o de: posi??o (FOURNIER, 1991) ou comunica??o de status social (THARP; SCOTT, 1990); personalidade (FOURNIER, 1991) ou express?o do self (RICHINS, 1994b; THARP; SCOTT, 1990); potencializador de ritual (FOURNIER, 1991); e transi??o (FOURNIER, 1991). Esses significados, por estarem relacionados com o desempenho das candidatas no ritual, levaram a uma rean?lise das teorias que ligam significado cultural dos bens de consumo e ritual. Como contribui??o para o marketing, esta disserta??o traz um acr?scimo ?s pesquisas de significados culturais dos bens de consumo, a partir da rean?lise do modelo de movimento do significado de McCracken (1986), como tamb?m do modelo de vitalidade do ritual de consumo de Rook (1985). Tais contribui??es foram poss?veis, pelo menos em parte, pela escolha de um ritual de consumo diferenciado que ? o concurso de beleza infantil, t?o pouco explorado na academia. Outra contribui??o que cabe ser destacada se refere ? pesquisa de um p?blico ainda pouco explorado na ?rea do marketing: as crian?as. Essa escolha trouxe desafios metodol?gicos, uma vez que a pesquisa com crian?as exige cuidados, inclusive ?ticos. Por fim, o estudo de tal concurso se apresentou como um interessante exemplo de ritual da nossa sociedade, se apresentando tamb?m como um interessante espa?o de estudo das Ci?ncias Sociais.

Submitted by PPG Direito (ppgdir@pucrs.br) on 2018-09-10T18:33:25Z No. of bitstreams: 1 ?SIS_BOLL_DE_ ARAUJO_BASTOS_TES.pdf: 2389583 bytes, checksum: 196cf75482cb924c1a1581c7e059967b (MD5) / Approved for entry into archive by Sheila Dias (sheila.dias@pucrs.br) on 2018-09-12T12:01:13Z (GMT) No. of bitstreams: 1 ?SIS_BOLL_DE_ ARAUJO_BASTOS_TES.pdf: 2389583 bytes, checksum: 196cf75482cb924c1a1581c7e059967b (MD5) / Made available in DSpace on 2018-09-12T12:07:53Z (GMT). No. of bitstreams: 1 ?SIS_BOLL_DE_ ARAUJO_BASTOS_TES.pdf: 2389583 bytes, checksum: 196cf75482cb924c1a1581c7e059967b (MD5) Previous issue date: 2018-07-30 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / The effectiveness of the constitutional provision of integral protection of children and adolescents with the use of mediation as a proper procedure in the transformation of conjugalparental disputes is the theme to be here developed. The general objective is to analyze the procedural adequation of mediation as a means of transformation of conjugal-parental conflicts with juridical effects. The specific objectives have been unfolded in identifying the conceptual content of integral protection and verifying the suitable procedural construction of mediation by considering the Child and Youth Law. The central issue involves assessing whether mediation is a suitable means to actualize and materialize the integral protection of children and adolescents, as well as the procedures required to achieve this goal. It is understood that, in the face of a specific and associated procedural commitment of mediation of conflicts, by means of collaborative and committed behaviors of integral protection agents (family, society and State), the materialization of the integral protection is a real possibility in the sphere of mediation. By following three sequential paths, the procedure is suitable to attain the intended result. The first one is the moment of pre-judicial mediation, i.e. before any judicial or litigation proceeding. The second one is the action of society, in the person of both the mediator, on the grounds of their training and accountability, and the lawyer, through their collaborative and committed action. The third one is the function of the State as an agent of planning and taking actions intended for increasing and providing judicial and managerial settings for implementation of mediation. Thus, if the previous procedural sequence is followed, mediation becomes a proper procedure for transformation of conjugal-parental disputes, and it materializes the integral protection of children and adolescents. / A efetividade da previs?o constitucional de prote??o integral de crian?as e adolescentes a partir do uso da media??o como procedimento adequado ? transforma??o dos conflitos conjuparentais ? o tema a ser desenvolvido. O objetivo geral ? analisar a aptid?o procedimental da media??o como meio de transforma??o de conflitos conjuparentais com reflexos jur?dicos. Os objetivos espec?ficos desdobram-se em identificar o conte?do conceitual de prote??o integral e verificar a constru??o procedimental adequada da media??o a partir do Direito da Crian?a e do Adolescente. A problem?tica central implica aferir se a media??o ? um meio adequado para efetivar e concretizar a prote??o integral de crian?as e adolescentes e o que precisa ser realizado em termos procedimentais para atingir este fim. Entende-se que, diante de um comprometimento procedimental espec?fico e vinculado da media??o de conflitos, mediante comportamentos colaborativos e comprometidos dos agentes de prote??o integral (fam?lia, sociedade e Estado), o resultado de concretiza??o da prote??o integral ? uma possibilidade real no ?mbito da media??o. O procedimento, ao obedecer a tr?s caminhos sequenciais, ? apto a atingir o resultado pretendido. O primeiro ? o momento de ocorr?ncia da media??o de forma pr?-judicial, antes de qualquer procedimento judicial ou processual. O segundo ? a a??o da sociedade, nas figuras do mediador, a partir dos pilares da capacita??o e responsabiliza??o, e do advogado, por meio de uma atua??o colaborativa e comprometida. O terceiro ? a fun??o do Estado como ator de planejamento e a??es direcionadas ? amplia??o e facilita??o de espa?os administrativos e judiciais para implementa??o da media??o. Logo, a media??o, observada a sequ?ncia procedimental exposta, ? procedimento adequado ? transforma??o dos conflitos conjuparentais e concretiza a prote??o integral de crian?as e adolescentes.

Submitted by PPG Pediatria e Sa?de da Crian?a (pediatria-pg@pucrs.br) on 2018-09-11T11:29:41Z No. of bitstreams: 1 Tese VFC 09-07-18 Lisi Vers?o Final.pdf: 2404794 bytes, checksum: cc151e819fe2b2d350e28543f9ab9cbf (MD5) / Approved for entry into archive by Sheila Dias (sheila.dias@pucrs.br) on 2018-09-12T13:08:07Z (GMT) No. of bitstreams: 1 Tese VFC 09-07-18 Lisi Vers?o Final.pdf: 2404794 bytes, checksum: cc151e819fe2b2d350e28543f9ab9cbf (MD5) / Made available in DSpace on 2018-09-12T13:12:17Z (GMT). No. of bitstreams: 1 Tese VFC 09-07-18 Lisi Vers?o Final.pdf: 2404794 bytes, checksum: cc151e819fe2b2d350e28543f9ab9cbf (MD5) Previous issue date: 2018-06-14 / Introduction: The analysis of body composition is fundamental, since it is associated with the general health of individuals. Objective: To evaluate the association between socioeconomic and clinical variables with body composition in children and adolescents. Methods: Were included for convenience, participants between 5 and 19 years. Socioeconomic and clinical variables were assessed by a standardized questionnaire and corporal bioimpedance by Biospace, model InBodyS10, from Ottoboni. The variables studied were compared in relation to sex by t-test for independent and chi-square samples. The outcome variables (body mass index, skeletal mass, fat free mass and fat percentage )and predictor variables (age, sex, race, place of residence, father's schooling, physical activity, birth weight and breastfeeding )were analyzed using the quantile regression model (percentile 5, 50 and 95). The testes were bidirectional and were compared in comparison with p <0.05. Results: Among the 529 participants included, 284 (53.6%) were female and mean age was 11.41 ? 3.9 years. The body mass index was the only one to be dissociated from the majority of the sexes (p = 0.753). The decrease in weight was associated with lower skeletal muscle mass (Difference = -8.51, 95% CI -11.12 to -5.90, p <0.001), lower fat-free mass (Difference = -13.80, 95% CI (P <0.001) and lower body mass index (Difference = -2.88, 95% CI - 4.42 to - 1.33, p <0.001) when adjusted for birth weight and breastfeeding. The lowest percentage of fat was associated with an inexpensive relative (Difference = -5.01, 95% CI -9.45 to -0.56, p = 0.027) only in the crude analyzes. Conclusion: Muscle mass,fat free mass, skeletal muscle mass and body mass index are associated with family income. / Introdu??o: A an?lise da composi??o corporal ? fundamental, pois est? fortemente associada com sa?de geral dos indiv?duos. Objetivo: Avaliar as associa??es entre fatores socioecon?micos e cl?nicos na composi??o corporal em crian?as e adolescentes. M?todos: Foram inclu?das por conveni?ncia, participantes com idades entre 5 e 19 anos. Crit?rios socioecon?micos e cl?nicos foram analisados por um question?rio padronizado e a composi??o corporal por bioimped?ncia el?trica (Biospace, modelo InBodyS10, da Ottoboni). As vari?veis estudadas foram comparadas em rela??o ao sexo por meio do teste t para amostras independentes e Qui-quadrado. As rela??es das vari?veis de desfecho (?ndice de massa corporal, massa livre de gordura, massa muscular esquel?tica e percentual de gordura) e as vari?veis preditoras (renda familiar, idade, sexo, ra?a, local de moradia, escolaridade do pai, atividade f?sica, peso ao nascimento e amamenta??o) foram analisadas mediante o modelo de regress?o quant?lica (percentil 5, 50 e 95). Os testes foram bidirecionais e as diferen?as foram consideradas significativas com p<0,05. Resultados: Entre os 529 participantes inclu?dos, 284 (53,6%) eram do sexo feminino e m?dia de idade foi de 11,41? 3,9 anos. O ?ndice de massa corporal foi o ?nico desfecho que n?o mostrou diferen?a significativa entre os sexos (p=0,753). A menor renda familiar foi associada com a menor massa muscular esquel?tica (Diferen?a= -8,51; IC95% -11,12 a -5,90, p<0,001), menor massa livre de gordura (Diferen?a= -13,80; IC95% -18,70 a -8,89, p<0,001) e menor ?ndice de massa corporal (Diferen?a= -2,88; IC95% - 4,42 a - 1,33, p<0,001) quando ajustado para peso ao nascimento e amamenta??o. O menor percentual de gordura associou-se a menor renda familiar (Diferen?a= -5,01; CI95% -9,45 a - 0,56, p=0,027) apenas nas an?lises brutas. Conclus?o: A renda familiar est? associada com a menor massa livre de gordura, massa muscular esquel?tica e ?ndice de massa corporal.

Submitted by PPG Medicina e Ci?ncias da Sa?de (medicina-pg@pucrs.br) on 2018-12-04T19:14:23Z No. of bitstreams: 1 RAFAEL_MORENO_FERRO_DE_ARAUJO.pdf: 2490432 bytes, checksum: 00a75e2fcaf58b1136209930cfb617bf (MD5) / Approved for entry into archive by Sheila Dias (sheila.dias@pucrs.br) on 2018-12-06T11:50:19Z (GMT) No. of bitstreams: 1 RAFAEL_MORENO_FERRO_DE_ARAUJO.pdf: 2490432 bytes, checksum: 00a75e2fcaf58b1136209930cfb617bf (MD5) / Made available in DSpace on 2018-12-06T11:56:09Z (GMT). No. of bitstreams: 1 RAFAEL_MORENO_FERRO_DE_ARAUJO.pdf: 2490432 bytes, checksum: 00a75e2fcaf58b1136209930cfb617bf (MD5) Previous issue date: 2018-08-07 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Os maus-tratos infantis (abuso e neglig?ncia) s?o considerados como problemas de sa?de p?blica globais, com graves consequ?ncias para a sa?de mental de quem sofre. A maioria dos estudos sobre abuso n?o faz distin??o entre os diferentes tipos de puni??o f?sica (abuso f?sico, palmadas), a intera??o com os outros tipos de abuso (emocional e sexual), se a crian?a sabia sobre o motivo por estarem sendo punidas, ou o impacto subjetivo a longo prazo na vida de quem sofreu algum tipo de abuso. O objetivo deste estudo ? descrever o impacto subjetivo na idade adulta do abuso ocorrido na inf?ncia e/ou na adolesc?ncia, analisar a associa??o de experi?ncias abusivas na inf?ncia e/o na adolesc?ncia com o uso de medica??es psicotr?picas ao longo da vida. Para este fim, analisamos os dados de uma grande pesquisa an?nima on-line (BRAINSTEP, Brazilian Internet Study on Temperament and Psychopathology). Para avaliar a hist?ria de abuso sexual, f?sico e emocional na inf?ncia e/ou adolesc?ncia, utilizamos o QUESI (Question?rio Sobre Traumas na Inf?ncia). Para aqueles que n?o sofreram abusos f?sicos com objetos, perguntamos sobre frequ?ncia de palmadas. Al?m disso, para aqueles que reportaram algum tipo de puni??o f?sica (com objetos ou palmadas), avaliamos se ele sabia o motivo da puni??o. O impacto subjetivo foi avaliado em todos os participantes que sofreram algum tipo de abuso. O desfecho foi avaliado, o uso de medica??es psicotr?picas ao longo da vida. Encontramos que o abuso emocional e sexual estava associado a um impacto subjetivo negativo, independentemente da intensidade. Por sua vez, a puni??o f?sica nem sempre esteve associada a um impacto subjetivo negativo, sendo que foi maior para aqueles indiv?duos que n?o sabiam o motivo da puni??o. O abuso emocional mostrou a maior associa??o com o uso de medica??es psiqui?tricas ao longo da vida. Os participantes que reportaram um impacto subjetivo positivo da puni??o f?sica utilizaram menos frequentemente medica??es psiqui?tricas ao longo da vida. Esses achados sugerem que os mecanismos, que associam abuso a consequ?ncias negativas, s?o mais complexos do que os descritos anteriormente; seu impacto subjetivo e a coocorr?ncia de abuso emocional tamb?m devem ser levados em considera??o. / Child maltreatment (abuse and neglect) is a global public health problem, with serious consequences to the mental health of those who suffer it. Most studies on abuse have not accounted for the different types of physical punishment (physical abuse, spanking), the interaction between different types of abuse (emotional and sexual), awareness of the children on the motivation for being punished, or their long-term subjective impact in the life of those abused. This study aim is to describe the subjective impact in adulthood of abuse occurred in childhood and adolescence, and to analyze the association of abuse experiences in childhood and adolescence, and the use of psychoactive medication as adults. We analyzed data from a large and anonymous online survey (BRAINSTEP). To assess the history of childhood sexual, physical and emotional abuse, we used the CTQ (Childhood Trauma Questionnaire). For those who did not suffer physical abuse from objects, we asked about spanking frequency. Also, for those with any physical punishment history, we assessed if he/she knew the reason for being punished. The subjective impact was assessed in all participants that suffered any abuse. The outcome was assessed, inquiring on their lifetime psychiatric medication use. We found that emotional and sexual abuse were associated with a negative subjective impact, regardless of intensity. In turn, physical punishment not always was associated with a negative subjective impact, and this was greater for those individuals that did not know the reason for being punished. Emotional abuse showed the highest association with increased psychiatric medication use. Subjects that stated a positive subjective impact from physical punishment used less psychiatric medication. These findings suggest that the mechanisms, which associate abuse to negative consequences, are more complex than previously described; its subjective impact and the simultaneous occurrence of emotional abuse must also be taken into consideration.

Submitted by Sara Ribeiro (sara.ribeiro@ucb.br) on 2017-05-05T18:58:57Z No. of bitstreams: 1 StephanyVieiraBritoDissertacao2017.pdf: 1138647 bytes, checksum: 67411fc8bc6f6a991f7f6f64103b0e6d (MD5) / Approved for entry into archive by Sara Ribeiro (sara.ribeiro@ucb.br) on 2017-05-05T18:59:26Z (GMT) No. of bitstreams: 1 StephanyVieiraBritoDissertacao2017.pdf: 1138647 bytes, checksum: 67411fc8bc6f6a991f7f6f64103b0e6d (MD5) / Made available in DSpace on 2017-05-05T18:59:26Z (GMT). No. of bitstreams: 1 StephanyVieiraBritoDissertacao2017.pdf: 1138647 bytes, checksum: 67411fc8bc6f6a991f7f6f64103b0e6d (MD5) Previous issue date: 2017-02-23 / Event-related brain potentials (ERPs) have been instrumental for discerning the relationship between physical activity and aspects of cognition in children. We aimed to verify and compare the waveform of N450 ERP component in Stroop task between active play, passive play and control sessions in children. 13 girls and boys (9.5??0.8yr; 32.05??5.9kg; 1.38??0.1m; 16.36??4.2%body fat) participated on this study. Firstly, they were performed anthropometric evaluations. Thereafter, three sessions lasting 30min were performed in randomized order: 1) Control ??? seated watching a documentary (92.4??8.9bpm); 2) Active Play ??? games with movement, eg. jumping jacks, running, jumping (152.8??16.31bpm); 3) Passive Play ??? playing games seated, eg. puzzles of colors, animals and numbers (99.6??28.2bpm). Subsequently, they completed a Stroop task (GO/No-go) while brain electrical activity was recorded with EEG. ERPs were recorded and calculated from electrodes at Fz, F3, F4, Fp1 and Fp2. Mean peak amplitude of N450 component were used to compare the electrical brain responses between sessions. The ANOVA of N450 mean amplitudes revealed a significant main effect for interaction of factor frontal anterior in control sessionF(2,36) = 3.63, p = 0.04 (fig 1). The N450 amplitude in the incongruent condition was less negative in active play than in control session in the frontal sites (p=0.11). In the Stroop test, no significant differences in reaction time between sessions were observed (F (1.92) = 0.05, p = 0.94). The control differed in congruent Go responses between the passive and active sessions (p = 0.01), and the results of the active session also differed from the passive (p = 0.04). The comparison of total errors per session also presented a significant difference (p = 0.02) between control and passive (F (1,71) = 8.8, p <0.05). In conclusion, 30 minutes of active play promoted a lesser response conflict in the incongruent stimuli in the Stroop test, in the N450 component, in addition to a greater activation of the prefrontal cortex. / A atividade f??sica e cogni????o s??o ??reas que est??o cada vez mais correlacionadas. O estudo objetivou verificar e comparar os efeitos agudos de brincadeiras ativas, passivas e controle na modula????o da onda N450 em escolares. 13 escolares de ambos os sexos (9,5??0,8anos; 32,05??5,9kg; 1,38??0,1m; 16,36??4,2%G) participaram de tr??s sess??es com dura????o de 30min em ordem randomizada: 1) Controle ??? sentadas assistindo um document??rio (92,4??8,9bpm); 2) Brincadeiras Ativas ??? brincadeiras com saltos, polichinelos e corrida (152,8??16,31bpm); 3) Brincadeira Passiva ??? brincando sentados com jogos pedag??gicos. Ap??s isso, realizaram o teste de Stroop (GO/No-go) enquanto era adquirida a atividade el??trica cerebral atrav??s de um eletroencefalograma (EEG) e registrado o potencial relacionado a evento (PRE), calculado pelos eletrodos Fz, F3, F4, Cz, Fp1 e Fp2. A ANOVA apresentou signific??ncia na m??dia do pico de amplitude da N450, com rela????o a intera????o do fator frontal anterior na sess??o controle F(2,36)= 3,63, p= 0,04. Na condi????o incongruente a amplitude da N450 foi menos negativa nos eletrodos frontais nas brincadeiras ativas comparada com controle (p=0,11). J?? no teste de Stroop, n??o foram observadas diferen??as significativas do tempo de rea????o entre as sess??es (F(1,92)=0,05, p=0,94). O controle diferiu nas respostas congruentes Go entre as sess??es passiva e ativa (p=0,01), e os resultados da sess??o ativa tamb??m diferiram da passiva (p=0,04). A compara????o do total de erros por sess??o tamb??m apresentou diferen??a significativa (p=0,02) entre controle e passiva (F(1,71)=8,8,p<0,05). Em conclus??o, 30 min de brincadeiras ativas promoveram menor conflito de resposta no teste de Stroop, no componente N450, com isso menor conflito de resposta no teste de Stroop nos est??mulos incongruentes, al??m de maior ativa????o do c??rtex pr??-frontal.

Submitted by Sara Ribeiro (sara.ribeiro@ucb.br) on 2017-05-10T14:01:11Z No. of bitstreams: 1 SandradeOliveiraDissertacao2016.pdf: 3477170 bytes, checksum: f9dcd58f0f92b370b721060e6d4c3ead (MD5) / Approved for entry into archive by Sara Ribeiro (sara.ribeiro@ucb.br) on 2017-05-10T14:01:29Z (GMT) No. of bitstreams: 1 SandradeOliveiraDissertacao2016.pdf: 3477170 bytes, checksum: f9dcd58f0f92b370b721060e6d4c3ead (MD5) / Made available in DSpace on 2017-05-10T14:01:29Z (GMT). No. of bitstreams: 1 SandradeOliveiraDissertacao2016.pdf: 3477170 bytes, checksum: f9dcd58f0f92b370b721060e6d4c3ead (MD5) Previous issue date: 2016-02-29 / This was a cross-sectional study with the objective to correlate the elevated glycated hemoglobin levels (HbA1) with blood pressure, handgrip strength and the risk of cardiovascular disease in children and adolescents with type 1 diabetes mellitus (T1DM). The sample was composed by approximately 135 volunteers, children and adolescents aged 12 to 16 years, registered in the specialized research center in diabetes mellitus, from the Regional Hospital of Taguatinga of the Health Secretary of Federal District. The anthropometric measures such as: body mass, height and body mass index (BMI) were done in each appointment by using the growing graph from the National Center for Health Statistics (NCHS, 2000). Blood pressure and heart rate were measured by the oscillometric device (Microlife 3AC1-1, Widnau, Switzerland), according to the recommendations of the The Fourth Report on The Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents of 2004. To analyze the handgrip strength the mechanic dynamometer Jamar?? (Sammons Preston Jamar Hand Dynamometer) was used, according to the protocol of Espa??a- Romero and co-workers (2012). The HbA1 and glucose were mesured by high performance liquid chromatography (BioRad, Brazil). The lipid profile was determined by the enzymatic colorimetric method, and the high density lipoproteins were determined by ionic exchange, followed by colorimetric reaction with the Linco Research Inc. kit (St. Louis, EUA). The results demonstrated a correlation between elevated HbA1 levels with alterations in blood pressure, handgrip strength and time of diagnosis in children and adolescents with T1DM. / Esta pesquisa foi do tipo transversal, com o objetivo de comparar os n??veis elevados da hemoglobina glicada (HbA1c) com a press??o arterial, for??a de preens??o manual e o risco de doen??as cardiovasculares em crian??as e adolescentes com diabetes melitos tipo 1 (DM1) . A amostra foi composta de aproximadamente de 135 volunt??rios, crian??as e adolescentes com idade entre 12 a 16 anos, atendidos no polo de pesquisa, especializado em diabetes melitos, do Hospital Regional de Taguatinga, da Secretaria de Sa??de do Distrito Federal. As medidas antropom??tricas como: peso, estatura e ??ndice de massa muscular (IMC) foram realizadas em cada consulta, usando o gr??fico de crescimento da National Center for Health Stattistics (NCHS,2000). A press??o arterial e a frequ??ncia card??aca foram aferidas pelo aparelho oscilom??trico (Microlife 3AC1-1, Widnau, Switzerland), de acordo com as recomenda????es da (The Fourth Report on The Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents, 2004). Para a an??lise da for??a de preens??o manual foi utilizado dinam??metro mec??nico Jamar?? (Sammons Preston Jamar Hand Dynamometer), respeitando o protocolo de Espa??a-Romero e colaboradores Para as an??lises sangu??neas todos pacientes forneceram amostras de sangue, a glicose e a hemoglobina glicada foram medidas por cromatografia l??quida de alta performance (BioRad, Brasil). O perfil lip??dico foi medido por m??todo colorim??trico enzim??tico, equipament, para as lipoprote??nas de alta densidade foram determinadas por troca i??nica, seguidas por rea????o colorim??trica com kit de Linco Research Inc.(St. Louis, EUA). Os resultados demonstram a associa????o das concentra????es elevadas da HbA1c com altera????es na press??o arterial diast??lica, for??a de preens??o manual e tempo de diagn??stico de crian??as e adolescentes DM1.

Made available in DSpace on 2015-04-14T13:22:09Z (GMT). No. of bitstreams: 1 445400.pdf: 1464113 bytes, checksum: 39b5263a5de8c40bc2664527dcce4db1 (MD5) Previous issue date: 2013-01-07 / In the past years, there has been a considerable raise in the number of child sexual abuse complaints. Thereat, several studies have been developed about investigative interviewing of children with alleged abuse. The present dissertation has two sections about the topic of investigative interviewing of children with allegations of having been sexual abused. The first section presents a literature review on the peculiarities of the investigative interviews of pre-school age. Some of the most used investigative interviewing techniques around the globe are presented. Also, some elements that could compromise the child s report during the investigative interview are discussed, such as the use of artifacts (toys and drawings), repetitive interviewing, as well as the type of questions used by the interviewer. In the second section, an empirical study is described focusing on the structure of children s investigative interview, emphasizing the dynamics of questions and answers. The study was based over the document analysis (videos or audio) of a sample 49 real interviews with children aged between six and eleven years old, with allegations of having been sexual abused. The audio-tape or video-tape of the interviews were analyzed and both the questions placed by the interviewer and the answers given by the child were coded. The categories of questions and answers were adapted from pre-existent categories.Only the pre-substantive phase (rapport) and substantive phase (report) of the interviews were considered for the coding of questions and answers, since they are the most relevant phases to the interview. The frequencies of types of questions and types of answers were analyzed, as well as the frequency of each association between type of question and its respective type of answer. The results yielded that the interviewers tended to use few open questions. Most of the interviewers questions were considered appropriate, although more directive (closed question and probing).Therefore children s answers were frequently shorter, which means, with fewer information about what was being investigated. In the concluding section, the results were discussed in terms of the importance of the interviewers training. In addition, results also highlighted the importance of developing need assessment techniques for training investigative interviewers / Nos ?ltimos anos, tem havido um aumento consider?vel no n?mero de den?ncias de abuso sexual infantil. Com isso, diversos estudos vem sendo desenvolvidos sobre as t?cnicas de investiga??o, no que tange ? oitiva de crian?as com suspeita de terem vivenciado situa??es de abuso. A presente disserta??o aborda como tema a entrevista investigativa com crian?as, especialmente aquelas com suspeita de terem sofrido abuso sexual. A disserta??o ? apresentado em dois m?dulos. O primeiro m?dulo trata das peculiaridades da entrevista investigativa com crian?as em idade pr?-escolar, ou seja, menores de seis anos. S?o apresentadas as t?cnicas de entrevista investigativa mais utilizadas ao redor do mundo. Tamb?m s?o discutidos alguns fatores que podem comprometer o relato da crian?a durante a entrevista investigativa, tais como o uso de artefatos (p.ex., brinquedos e desenhos), a repeti??o de entrevistas, bem como o tipo de pergunta utilizada pelo entrevistador. No segundo m?dulo, ? descrito um estudo sobre a avalia??o da estrutura da entrevista investigativa com crian?as, com ?nfase na din?mica de perguntas e respostas. O estudo foi feito atrav?s da an?lise documental de uma amostra de 49 entrevistas reais realizadas com crian?as entre seis e onze anos de idade, com suspeita de terem sofrido abuso sexual. Foram analisados os ?udios ou v?deos das entrevistas e foram categorizadas as perguntas dos entrevistadores e as respostas das crian?as. A classifica??o das perguntas e das respostas foi adaptada a partir de categoriza??es j? existentes.Apenas as fases pr?substantiva (rapport) e substantiva (relato) das entrevistas foram consideradas para a classifica??o de perguntas e respostas, j? que s?o as fases de maior relev?ncia para a din?mica da entrevista. Foram analisadas as freq??ncias de perguntas e de respostas de toda a amostra, bem como a frequ?ncia da associa??o entre pergunta e sua respectiva resposta. Os resultados obtidos neste estudo mostram que os entrevistadores usam poucas perguntas abertas. A maioria das perguntas dos entrevistadores foram consideradas apropriadas, embora tenham sido mais diretivas (fechadas e de sondagem). Em fun??o disso, as respostas das crian?as foram mais frequentemente curtas, ou seja, com poucas informa??es acerca do que ? questionado. A conclus?o dos estudos apresentados destaca a import?ncia do treinamento dos entrevistadores. Ressalta, ainda, a necessidade de t?cnicas de avalia??o das entrevistas investigativas para constante manuten??o do treinamento e aprendizado dos entrevistadores