Submitted by Cássio da Cruz Nogueira (cassionogueirakk@gmail.com) on 2017-10-17T13:43:55Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertacao_DoencasSexualmenteTransmissiveis.pdf: 892211 bytes, checksum: 4a2cd4ca3278ce0fb4c6722d6ae827b5 (MD5) / Approved for entry into archive by Irvana Coutinho (irvana@ufpa.br) on 2017-10-26T15:04:29Z (GMT) No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertacao_DoencasSexualmenteTransmissiveis.pdf: 892211 bytes, checksum: 4a2cd4ca3278ce0fb4c6722d6ae827b5 (MD5) / Made available in DSpace on 2017-10-26T15:04:29Z (GMT). No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Dissertacao_DoencasSexualmenteTransmissiveis.pdf: 892211 bytes, checksum: 4a2cd4ca3278ce0fb4c6722d6ae827b5 (MD5) Previous issue date: 2010 / O abuso sexual em menores tem se mostrado um problema de grande magnitude para a saúde pública. Atualmente presente na mídia, já havia sido descrito há vários anos, mas só começou a ser estudado nos séculos XVII e XVIII. Segundo dados da Organização mundial de Saúde ocorreram 223 milhões casos de vitimizações sexuais infantis no ano de 2002. O abuso sexual traz graves conseqüências à saúde, incluindo a aquisição de doenças sexualmente transmissíveis (DST). Foram avaliadas 164 crianças vítimas de abuso sexual no centro de referência do estado do Pará, no ano de 2007. Para tanto se utilizou uma ficha protocolar com informações clínicas e laboratoriais voltadas para diagnóstico de doença sexualmente transmissível durante o acompanhamento daqueles pacientes. A maioria das crianças que tiveram diagnóstico de DST era do sexo feminino. A idade foi, sobretudo, dos 10 aos 18 anos e procediam da capital do estado. A aquisição de uma DST esteve associada, principalmente, ao estupro e, na maioria das vezes, o abusador era conhecido da vítima. A principal DST foram as vulvovaginites (66,2%), seguido da condilomatose (21,5%), gonorréia (9,2%), herpes (6,2%), doença inflamatória pélvica (4,6%) e sífilis (3,1%). O desenvolvimento de moléstia de contágio sexual está relacionado com a prevalência adulta local. O presente trabalho está de acordo com a literatura em vários aspectos, como por exemplo, no que se refere à idade, sexo, agressor e tipo de abuso. Quanto à evolução para DST, neste trabalho, foi maior do que em países desenvolvidos, porém menor do que na África. A infecção por gonorréia foi menor que em outros países sul-americanos. A infecção por sífilis, vulvovaginites, vírus Herpes e HPV segue os parâmetros de países desenvolvidos e do restante do país. A clamídia não foi diagnosticada embora tenha grande presença em estudos nacionais e internacionais. Mais estudos seria adequado, sobretudo no que se refere ao diagnóstico das infecções por clamídia, que ainda são subdiagnosticadas em nosso meio. / Sexual abuse of minors has been a problem of great magnitude to public health. Currently in the media, it had been described several years ago but has only been studied in the seventeenth and eighteenth centuries. According to World Health Organization there were 223 million cases of child sexual victimization in 2002 year. Sexual abuse has serious health consequences, including the acquisition of sexually transmitted diseases (STDs). This research evaluated 164 children victims of sexual abuse in the reference center on the north of Brazil, in 2007. For such a protocol form was used with clinical and laboratorial data about sexually transmitted disease during follow-up of those patients. Most children who were diagnosed with STIs were female. The children’s age was mainly from 10 to 18 years and they were from the largest city. The acquisition of an STD was associated mainly to the rape and, in most cases, the abuser was known to the victim. The major STDs were vulvovaginitis (66.2%), followed by condylomatosis (21.5%), gonorrhea (9.2%), herpes (6.2%), pelvic inflammatory disease (4.6%) and syphilis (3.1%). The development of sexual disease contagion is related to the prevalence of adult site. This research is consistent with the literature in several aspects, such as age, sex, perpetrator and abuse. As regards the development of DST it was higher than in developed countries, but lower than in Africa. The infection with gonorrhea was lower than in other South American countries. The syphilis infection, vulvovaginitis, herpes and HPV follow the parameters of developed countries and the rest of the country. Chlamydia was not diagnosed but has great presence on national and international studies. Further studies would be appropriate, particularly with regard to the diagnosis of Chlamydia infection, which is underdiagnosed.

Made available in DSpace on 2016-04-28T14:16:34Z (GMT). No. of bitstreams: 1 Martha San Juan Franca.pdf: 1361631 bytes, checksum: e5d6649463705b1407ade34e19f6dc43 (MD5) Previous issue date: 2008-10-10 / This thesis aims to show how and why Brazil developed its internationally acclaimed model for fighting Aids. This model is based on Latin America s pioneer program, created in the Brazilian state of São Paulo in 1983, two years after the epidemic officially began in the United States. Based on reports by doctors and other healthcare professionals who started the São Paulo program, this study aims to present the ethical, political, and scientific references that gave rise to the Brazilian model for fighting AIDS and to show how these references have influenced the majority of public positions adopted in Brazil. The reports and complimentary research have shown how the ideas of the sanitary reform movement of the 1980s influenced the São Paulo program for fighting AIDS. This movement proposed the expansion and improvement of health coverage in Brazil, and, above all, an increase of public participation in matters related to health and illness. Given the period of history in which the epidemic appeared, in São Paulo it was possible to carry out a constructive dialogue between medicine and society, that is to say, between the creation of knowledge and the application of knowledge. Should this dialogue be furthered, it can serve as a tool to evaluate the role of science in the politics of health, and vice-versa, thus incorporating important social considerations into the scientific process of identifying options and making decisions. In this thesis, we aim to follow the methodology of the Simão Mathias Center / History of Science Post-Graduation Studies Program (Cesima/PEPGHC) of PUCSP. According to this methodology, the History of Science represents an opportunity to reflect upon and give context to multiple areas of knowledge today Natural Sciences and Human Sciences among them. Considering that the interests of these two areas have become more integrated, we have been able to explore aspects formerly neglected by Science History, such as the various institutions that intermediate between knowledge and society with the goal of showing how knowledge is produced, organized, and measured / A presente tese pretende mostrar como e por que o Brasil desenvolveu um modelo de combate à Aids elogiado internacionalmente a partir do programa pioneiro na América Latina, criado no Estado de São Paulo em 1983, dois anos depois do início oficial da epidemia nos Estados Unidos. A partir do relato dos médicos e de outros profissionais de saúde que deram início ao programa em São Paulo, o estudo pretende apontar os referenciais éticos, políticos e científicos que deram origem ao modelo brasileiro de combate à Aids e como esses referenciais influenciaram a maioria das posições públicas assumidas pelo país. Esses relatos e as pesquisas complementares apontam para a influência das idéias do movimento da reforma sanitária, em andamento na década de 1980, no programa de Aids desenvolvido em São Paulo. O movimento propunha a expansão e melhoria da cobertura de saúde no país, mas principalmente uma ampliação do espaço de participação popular nas questões ligadas à saúde e doença. Em São Paulo, devido ao momento histórico em que a epidemia começou a se manifestar, foi possível realizar um diálogo profícuo entre medicina e sociedade, entre produção de conhecimento e sua aplicação. Esse diálogo, se for levado adiante, pode servir para avaliar o papel da ciência na política de saúde e, vice-versa, para a incorporação de importantes aspectos sociais no processo de opções e decisões em ciência. Para essa tese, procuramos seguir a metodologia do Centro Simão Mathias/Programa de Estudos Pós-Graduados em História da Ciência (Cesima/PEPGHC) da PUCSP, segundo a qual a História da Ciência representa hoje um espaço de reflexão e contextualização de múltiplas áreas do conhecimento, entre elas tanto as Ciências Naturais como as Humanas. Como as preocupações desses dois campos se tornaram mais integradas, foi possível explorar aspectos antes negligenciados da História da Ciência, como as várias instituições que fazem a mediação entre conhecimento e sociedade com o objetivo de mostrar como o conhecimento é produzido, organizado e dimensionado

O estudo propõe, com base na escuta das histórias de vida de dez jovens, entre 19 e 25 anos, que vivem na prostituição em boates da cidade de Santo André-SP, realizar uma discussão a respeito da prevenção das DST/AIDS e da toxicomania. A partir da fala de cada entrevistada sob o enfoque da psicanálise, evidenciou-se o fato de que as jovens, embora disponham de informações sobre medidas preventivas das DST/aids, vivenciam um conflito de identidade expresso em vários níveis de seu discurso que contribui para a vulnerabilidade dessas doenças, sobretudo nas relações que envolvem afetividade. Apoiando-se nesses discursos, foi possível pontuar a implicação dessa ambiguidade no cuidado de si e na necessidade de políticas públicas que abordem a prostituição, levando em conta esse aspecto. / The purpose of this study is to discuss the prevention of STDs/AIDS and drug adiction, starting from listening to ten life stories from youngsters, between 19 and 25 years old, who are involved in prostitution at nightclubs from the city of Santo André-SP. Through the speech of each and every one of them, under the psychoanalysis approach, it was possible to notice that, although having information on the prevention methods against STDs/AIDS, the youngsters live an identity conflict shown in many levels of their discourse, which contributes to their vulnerability towards these diseases, mainly in their affective relationships. Based on these discourses, it was possible to identify the implications of this ambiguity while caring for themselves and the need of public policies that take prostitution into account, regarding this aspect, from a woman\'s point of view.

There is a significant comorbidity between anxiety/depression and functional gastrointestinal syndromes, such as irritable bowel syndrome (IBS) and functional dyspepsia. The pathophysiological link between emotions and the gut is not known. A model of an emotional motor system (EMS) which reacts to interoceptive and exteroceptive stress has been proposed. EMS consists of specific brain structures including anterior cingulate cortex (ACC), amygdala, hippocampus and hypothalamus and mediates their communication to the rest of the body (including the gastrointestinal tract) through the hypothalamus-pituitary-adrenal (HPA) axis, the autonomic nervous system (ANS) and by a pain modulation system. The aim of this thesis was to test the EMS model by studying the relationship between symptoms of anxiety and depression and IBS-like symptoms in patients with recurrent unipolar depression, in patients with IBS and in a sample of a normal Swedish population. The peripheral limb of EMS (ANS, HPA axis and the pain modulations system) was tested in patients with IBS and control subjects. Spectral heart rate variability was used to investigate ANS function in patients with refractory IBS and in healthy controls. The HPA axis function was tested by a weight adjusted low dose dexamethasone suppression test in control subjects. The influence of catecholamine degradation on pain modulation was tested by analyzing val158met catechol-o-methyl transferase (COMT) polymorphism in patients with IBS and in control subjects. We found a significant relationship between symptoms of anxiety/depression and IBS-like symptoms in patients with recurrent unipolar depression, in patients with IBS and in a sample of the normal population. Interestingly, patients with recurrent unipolar depression in remission had no more IBS-like symptoms than controls, indicating that the gastrointestinal symptoms may resolve when depression is treated to remission. Patients with IBS have an increased mid-frequency power in rest and in supine position (after tilt test) compared to healthy controls indicating an increased sympathetic ANS drive. The symptoms of diarrhea and early satiety has in the litterature been associated to the stimulation of corticotropin releasing hormone (CRH) receptors and was also in our study related to HPA axis function tested by a low dose dexamethasone test. Interestingly both hypo- and hyperfunction of the HPA axis was related to these symptoms in control subjects. The val158met COMT polymorphism was associated to IBS-like symptoms. Control subjects with IBS-like symptoms (defined by the upper quartile in total GSRS-IBS score) had a higher frequency of the met/met and a significantly lower frequency of the val/met genotype. Also patients with IBS tended to have a lower frequency of the heterozygous val/met genotype so we conclude that this genotype may be protective against IBS/IBS like symptoms. In addition, the val/val genotype in patients with IBS was associated to diarrhea symptoms. Conclusions: Our results support the model of an emotional motor system in the genesis of functional gastrointestinal symptoms by the finding of the association of IBS-like symptoms and mood disturbances, and by finding alterations in the peripheral limbs of EMS (ANS, HPA axis and catecholamines) in subjects with IBS and IBS-like symptoms.

Made available in DSpace on 2016-08-03T16:34:43Z (GMT). No. of bitstreams: 1 VANIA APARECIDA DA SILVA FIGUEIREDO DO COUTO.pdf: 621638 bytes, checksum: 48fdc674878dcfd246d534d79dc3b632 (MD5) Previous issue date: 2004-09-15 / This work has for general objective to investigate the information regarding sexuality and STD/Aids among students in the city of Rondonópolis (Mato Grosso), observing the behavior of this public for concepts on sexuality and STD, use of condoms and behaviors faced in a virus HIV intense reality. The analysis involves the interpretations, beliefs, images or symbols shared and used for the people in its interaction with sexuality and STD. This manner, the analysis of literature demonstrated that the lack of information on the STD don t usually differs from a situation of salient social differences. The Structuration theory, theoretical framework of the present work, visualizes that the themes like sexuality and the STD s/Aids needs to be part of day-by-day of the young and the adolescents of all the societies, independent of the social or cultural class of the same ones. In this way, it is conceived that school is an important vehicle of information that must be used in all its amplitude, thus assisting in the maintenance of the public health through the prevention of the STD s/Aids. For in such a way, a collection of data was carried to get more details on questions as: Knowledge on sexuality and concept and use of condoms. Among others results founded, it has evidence of the necessity of the school, while privileged space of the information and knowledge, to insert itself in programs that oportunizes the debate and the reflection of the such themes.

p. 1-178 / Submitted by Santiago Fabio (fabio.ssantiago@hotmail.com) on 2013-05-06T18:09:24Z No. of bitstreams: 1 44444444444.pdf: 1267573 bytes, checksum: d19f36de8ef7dc34eafc3b727f404c33 (MD5) / Approved for entry into archive by Maria Creuza Silva(mariakreuza@yahoo.com.br) on 2013-05-13T13:48:57Z (GMT) No. of bitstreams: 1 44444444444.pdf: 1267573 bytes, checksum: d19f36de8ef7dc34eafc3b727f404c33 (MD5) / Made available in DSpace on 2013-05-13T13:48:57Z (GMT). No. of bitstreams: 1 44444444444.pdf: 1267573 bytes, checksum: d19f36de8ef7dc34eafc3b727f404c33 (MD5) Previous issue date: 2010 / Embora o trabalho de parto não seja o momento adequado para a realização do teste anti-HIV, o Ministério da Saúde considera indispensável disponibilizar o exame e tratamento quimoprofilático para mãe e bebê visando impedir a transmissão do HIV durante a gestação e parto. Assim, está preconizado que o teste rápido anti-HIV seja ofertado mediante aconselhamento em situações consideradas especiais, como em maternidades. Este trabalho teve por objetivo analisar a ação de aconselhamento em DST/AIDS para as parturientes e puérperas que são submetidas ao teste anti- HIV, na admissão para o parto, em Salvador-BA. Foi realizado um estudo qualitativo em uma maternidade com observação participante e entrevistas semi-estruturadas com 20 informantes, sendo 13 puérperas sem diagnóstico prévio para o HIV e 07 profissionais de saúde. Observou-se que a Unidade de saúde pesquisada não desenvolve ações específicas de aconselhamento para a oferta e comunicação do resultado do teste anti-HIV no trabalho de parto, limitando-se a solicitar o exame de forma compulsória e a informar o diagnóstico no pós-teste somente às usuárias, cujos resultados foram positivos para o HIV. A experiência das mulheres na passagem por maternidade de Salvador revela que não há diálogo entre profissional e paciente na triagem pelo teste anti-HIV na admissão para o parto. Muitas nem percebem que foram submetidas a esse tipo de testagem. A significação que permeia um diagnóstico positivo ou negativo para o HIV e o entendimento dos valores e sentidos dados por essas mulheres, principalmente quando se descobrem positivas para o HIV não são abordados pelos profissionais de saúde. Para estes, na dinâmica do hospital não há espaço para a escuta qualificada. Há dificuldade na capacitação desses profissionais para lidar com esse tipo de abordagem no seu cotidiano em que as atitudes e práticas hegemônicas pautada na biomedicina mecanicista e centrada na doença, muitas vezes, se contrapõem as experiências e necessidades dessas mulheres. / Salvador

O estudo propõe, com base na escuta das histórias de vida de dez jovens, entre 19 e 25 anos, que vivem na prostituição em boates da cidade de Santo André-SP, realizar uma discussão a respeito da prevenção das DST/AIDS e da toxicomania. A partir da fala de cada entrevistada sob o enfoque da psicanálise, evidenciou-se o fato de que as jovens, embora disponham de informações sobre medidas preventivas das DST/aids, vivenciam um conflito de identidade expresso em vários níveis de seu discurso que contribui para a vulnerabilidade dessas doenças, sobretudo nas relações que envolvem afetividade. Apoiando-se nesses discursos, foi possível pontuar a implicação dessa ambiguidade no cuidado de si e na necessidade de políticas públicas que abordem a prostituição, levando em conta esse aspecto. / The purpose of this study is to discuss the prevention of STDs/AIDS and drug adiction, starting from listening to ten life stories from youngsters, between 19 and 25 years old, who are involved in prostitution at nightclubs from the city of Santo André-SP. Through the speech of each and every one of them, under the psychoanalysis approach, it was possible to notice that, although having information on the prevention methods against STDs/AIDS, the youngsters live an identity conflict shown in many levels of their discourse, which contributes to their vulnerability towards these diseases, mainly in their affective relationships. Based on these discourses, it was possible to identify the implications of this ambiguity while caring for themselves and the need of public policies that take prostitution into account, regarding this aspect, from a woman\'s point of view.

Modified discrete cosine transform (MDCT) derived from DCT IV has emerged as the most suitable choice for transform domain audio coding applications due to its time domain alias cancellation property and de-correlation capability. In the present research work, we focus on MDCT domain analysis of audio signals for compression and other applications. We have derived algorithms for linear filtering in DCT IV and DST IV domains for symmetric and non-symmetric filter impulse responses. These results are also extended to MDCT and MDST domains which have the special property of time domain alias cancellation. We also derive filtering algorithms for the DCT II and DCT III domains. Comparison with other methods in the literature shows that, the new algorithm developed is computationally MAC efficient. These results are useful for MDCT domain audio processing such as reverb synthesis, without having to reconstruct the time domain signal and then perform the necessary filtering operations. In audio coding, the psychoacoustic model plays a crucial role and is used to estimate the masking thresholds for adaptive bit-allocation. Transparent quality audio coding is possible if the quantization noise is kept below the masking threshold for each frame. In the existing methods, the masking threshold is calculated using the DFT of the signal frame separately for MDCT domain adaptive quantization. We have extended the spectral integration based psychoacoustic model proposed for sinusoidal modeling of audio signals to the MDCT domain. This has been possible because of the detailed analysis of the relation between DFT and MDCT; we interpret the MDCT coefficients as co-sinusoids and then apply the sinusoidal masking model. The validity of the masking threshold so derived is verified through listening tests as well as objective measures. Parametric coding techniques are used for low bit rate encoding of multi-channel audio such as 5.1 format surround audio. In these techniques, the surround channels are synthesized at the receiver using the analysis parameters of the parametric model. We develop algorithms for MDCT domain analysis and synthesis of reverberation. Integrating these ideas, a parametric audio coder is developed in the MDCT domain. For the parameter estimation, we use a novel analysis by synthesis scheme in the MDCT domain which results in better modeling of the spatial audio. The resulting parametric stereo coder is able to synthesize acceptable quality stereo audio from the mono audio channel and a side information of approximately 11 kbps. Further, an experimental audio coder is developed in the MDCT domain incorporating the new psychoacoustic model and the parametric model.

No description available.

<p>I collected two types of data throughout Weeks 1-14, with the original purpose of enhancing teaching and learning in ENGL620. The data included weekly assignment recordings and weekly surveys.</p><p>The primary data were students' speech data, which were collected through 14 weekly timed speaking assessments conducted from Week 1 to Week 14. These assignments were made available on Monday at midnight and were required to be completed and submitted by Sunday at midnight). The assignments were delivered, and responses were collected using Extempore (<a href="http://www.extemporeapp.com/" target="_blank">www.extemporeapp.com</a>), a website specifically designed to support oral English assessment and practice.</p><p>To conduct more comprehensive assessments of students’ performances, I incorporated two OEPT item types into the weekly assignments, including PROS and CONS (referred to as “PC”) and LINE GRAPH (referred to as “LG”). See Appendix B for the assignment items. The PC item presented challenging scenarios ITAs may encounter and required the test-takers to make a decision and discuss the pros and cons associated with the decision. An example item is “<i>Imagine you have a student who likes to come to your office hours but often talks about something irrelevant to the course. What would you do in this situation? What are the pros and cons associated with the decision?</i>”. The LG item asked students to describe a line graph illustrating two or three lines and provide possible reasons behind those trends. It can be argued that the two tasks targeted slightly different language abilities and background knowledge. The two item types were selected because they represented two key skills that the OEPT tests. The PC task focused on stating one’s decision and presenting an argument within a personal context, while the LG item assessed students’ ability to describe visual information and engage in discussions about broader topics such as gender equality, employment, economic growth, college policy. The PC and LG items are the most difficult items in the test (Yan et al., 2019). Therefore, progress in the two tasks can be a good indicator of improvement in the speaking skills required in this context. All the items were either taken from retired OEPT items or developed by the researcher following the specifications for OEPT item development. In particular, the design of the items aimed to avoid assuming prior specific knowledge and to ensure that students could discuss them without excessive cognitive load.</p><p>For each task, the students were allocated 2 minutes for preparation and a maximum of 2 minutes to deliver their response to the assigned topic. The responses were monologic, resembling short classroom presentations. During the preparation time, the participants were permitted to take notes. Each item only allowed for one attempt, which aimed to capture students’ online production of speech and their utilization of language resources. Table 2 presents the descriptive statistics of the responses.</p><p>The PC prompt was deliberately kept consistent for Week 2 and Week 12 randomly selected as time points at the beginning and end of the semester. This deliberate choice of using the same prompt at these two distinct stages serves multiple purposes. Firstly, it provides a valuable perspective for analyzing growth over time. This approach adds depth to the study results and conclusions by providing additional evidence and triangulation. Second, this approach addresses one of the specific challenges identified by Ortega and Iberr-Shea (2005) in studies involving multiple data collection points, as maintaining consistency in the prompt can minimize potential variations in task difficulty or topic-related factors.</p><p>After completing each speaking assignment, the students were requested to rate the level of difficulty for each item on a scale of 1 (Very Easy) to 5 (Very difficult). Additionally, they were asked to fill out a weekly survey using Qualtrics. The Qualtrics survey contained six questions related to the frequency of their English language use outside of the classroom and their focus on language skills in the previous and upcoming week. These questions were considered interesting as potential contributing factors to changes in their performances throughout the semester. Refer to Appendix C for the survey questions.</p>