Made available in DSpace on 2014-12-17T15:03:22Z (GMT). No. of bitstreams: 1 JucaraRMpdf1-61.pdf: 2157479 bytes, checksum: 530d9910b960362ab6b98d5b3433665f (MD5) Previous issue date: 2009-08-19 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico / The Pirangi beach is located in the eastern coastline of Rio Grande do Norte state, in the municipality of Parnamirim and N?sia Floresta. In it flow into Pirangi Watershed (PW), whose water receives large amounts of pollutants, mainly domestic and industrial sewage from districts where pass the rivers that consist it, compromising, thus, the bathing water quality of the Pirangi beach. Bearing in mind the importance of water sanitary quality to ensure an environment that no present risk to the bathers s health, this work had as main objective to assess the influence of the PW s waters in the bathing water quality of the Pirangi beaches. To that end, were made collections of water in the beaches and in the rivers with the intention of quantify the fecal contamination indicators thermotolerant coliforms and enterococci, to then classify the conditions of bathing water quality according with the CONAMA Resolution number 274 of 2000. For the purposes greater knowledge about the health conditions of the Beaches Pirangi and about the influence the PW s waters exert on it, was done parallely to the study of the water quality, an investigation of the sand sanitary quality. Furthermore, it was made an evaluation of the PW s Water Quality through Water Quality Index (WQI). Starting from the results obtained in the research present was possible to verify, among other aspects, that the entry of the PW s waters in the Pirangi beaches exerts direct influence in the bathing water quality of the same ones, being the North Pirangi beach (point tracking PA-02) the most influenced. There was noticed also a significant reduction in the conditions of bathing water quality of the beaches in the rainy season. However, the precariousness do sewerage system of the Natal metropolitan region and the absence of a right system of treatment an final disposal of domestic sewage and industrial are the main factors responsi le for deterioration of the PW s Water Quality, and as a consequence, compromising the bathing water quality of the Pirangi beaches / A praia de Pirangi est? localizada no litoral oriental do Estado do Rio Grande do Norte, nos munic?pios de Parnamirim e N?sia Floresta. Nela des?gua a Bacia Hidrogr?fica Pirangi (BHP), cuja ?gua recebe grande quantidade de poluentes, principalmente esgotos dom?sticos e industriais dos munic?pios por onde passam os rios que a comp?em, comprometendo, dessa forma, a balneabilidade desta praia. Tendo em vista a import?ncia da qualidade sanit?ria da ?gua para se garantir um ambiente que n?o apresente riscos ? sa?de dos banhistas, o presente trabalho teve como objetivo principal avaliar a influ?ncia das ?guas da BHP na balneabilidade das praias de Pirangi. Para tanto, foram realizadas coletas de ?gua nas praias e nos rios com o intuito de quantificar os indicadores de contamina??o fecal Enterococos e Coliformes termotolerantes, para ent?o classificar as condi??es de balneabilidade de acordo com a resolu??o CONAMA n? 274 de 2000. Para efeito de maior embasamento sobre as condi??es sanit?rias das Praias de Pirangi e sobre a influ?ncia que as ?guas da BPH exercem sobre elas, foi realizada, paralelamente ao estudo da qualidade das ?guas, uma investiga??o da qualidade sanit?ria das areias. Al?m disso, foi feita uma avalia??o da qualidade da ?gua da BHP atrav?s do ?ndice de Qualidade da ?gua (IQA). A partir dos resultados obtidos na presente pesquisa foi poss?vel constatar, dentre outros aspectos, que a entrada das ?guas da BHP nas praias de Pirangi exerce influ?ncia direta na balneabilidade das mesmas, sendo a praia de Pirangi do Norte (ponto de monitoramento PA-02) a mais influenciada. Observou-se, tamb?m, redu??o significativa nas condi??es de balneabilidade das praias na esta??o chuvosa. Contudo, a precariedade do esgotamento sanit?rio da regi?o metropolitana de Natal e a aus?ncia de um sistema adequado de tratamento e disposi??o final dos esgotos dom sticos e industriais s?o os principais fatores respons?veis pela degrada??o da qualidade da ?gua da BHP, e como conseq??ncia, pelo comprometimento da balneabilidade das praias de Pirangi

Introdução: Devido à fatores hormonais e mecânicos, a gestação e o parto provocam alterações que podem gerar disfunções do assoalho pélvico (DAP). Os estudos sobre as DAP no puerpério a curto prazo são escassos e fazem uso assistemático de métodos avaliativos. Objetivo: Identificar e avaliar as DAP no pós-parto imediato, um mês e três meses após o parto, comparando parto vaginal (PV), cesárea eletiva (CE) e cesárea intraparto (CI). Métodos: Estudo observacional longitudinal que avaliou mulheres até 48 horas (fase 1); um mês (fase 2) e três meses após o parto (fase 3). Utilizou-se o International Consultation on Incontinence Questionnaire (ICIQ-SF); o Índice de Incontinência Anal (IA) de Jorge-Wexner; a Escala Análoga Visual (EVA) para dor pélvica; o Pelvic Organ Prolapse Quantification system (POP-Q) e a perineometria dos Músculos do Assoalho Pélvico (MAP), além de questionário estruturado. Resultados: Foram avaliadas 227 pacientes na fase 1 (141 realizaram PV; 28 realizaram CI e 58 realizaram CE); 79 na fase 2 e 41 na fase 3. O escore do ICIQ-SF, índice de IA, EVA e perineometria não apresentaram diferenças significativas em relação ao tipo de parto. O ponto distal do colo uterino apresentou-se mais prolapsado no grupo PV. Conclusão: O tipo de parto não foi um fator significante para o desenvolvimento das DAP no pós-parto a curto prazo. Foi identificado que ocorreu recuperação fisiológica na funcionalidade dos MAP e piora na sustentação da parede vaginal anterior e no impacto da incontinência urinária na qualidade de vida ao longo dos três meses. / Introduction: Due to mechanical and hormonal factors, pregnancy and childbirth triggers changes that can lead to pelvic floor dysfunction (PFD). PFD studies in the immediate postpartum period are scarce and do unsystematic use of evaluation methods. Objective: To identify and evaluate the immediate, one month and three months postpartum PFD, comparing vaginal delivery (VD), elective cesarean (ECS) and cesarean indicating (ICS) during labor. Methods: This was a longitudinal observational study that assessed postpartum women after up to 48 hours (phase 1); one month (phase 2) and three months (phase 3). The study used the International Consultation on Incontinence Questionnaire (ICIQ-SF); Jorge-Wexner's Anal Incontinence (AI) score; the Visual Analogue Scale (VAS) for pelvic pain; the Pelvic Organ Prolapse Quantification System (POP-Q); and a Pelvic Floor Muscles (PFM) perineometer, as well as a structured questionnaire. Results: A total of 227 patients were assessed in phase 1 (141 had VD, 28 ICS and 58 ECS); 79 in phase 2 and 41 in phase 3. The ICIQ-SF, AI, VAS and perineometer index did not present significant differences in relation to the type of delivery. The distal point of the cervix presented more prolapse in VD. Conclusion: The type of delivery was not a significant factor for the development of postpartum PFD in the short term. The study found that there was physiological recovery of the functionality of PFM and worsening prolapse of the anterior vaginal wall and urinary incontinence over the three months.

Objetivo: Avaliar a segurança e eficácia da injeção transesfincteriana de silicone para o tratamento da incontinência anal, assim como correlacionar os resultados clínicos, ultra-sonográficos e manométricos. Métodos: Pacientes incontinentes foram submetidos à manometria e ultra-sonografia anorretal, índice de incontinência (II) e instrumento de qualidade de vida (FIQL), antes e após injeção do silicone (PTQ) sob anestesia local e profilaxia antibiótica. Os critérios de inclusão foram: incontinência anal, lesão isolada ou múltipla do músculo esfíncter interno do ânus, associada ou não à lesão isolada, em um quadrante, do músculo esfíncter externo do ânus. O instrumento FIQL utilizado inclui quatro domínios: estilo de vida, comportamento,depressão e constrangimento.Os parâmetros da manometria foram: pressão média de repouso (PMR), pressão média (PMCV) e máxima (PmaxCV) de contração voluntária, zona de alta pressão (ZAP) e índice de assimetria (IA). Após três meses de tratamento, os pacientes foram reavaliados através do II, FIQL, manometria e ultra-sonografia anorretal. Um grupo controle composto por 10 homens e 10 mulheres continentes e sem história prévia de cirurgia anorretal foi submetido à manometria após consentimento informado. Resultados: Foram estudados 35 pacientes, 28 mulheres e sete homens com idade média de 60,3 (19-80) anos, antes e após injeção do silicone anal. As complicações observadas incluíram dois hematomas (5,7%), um abscesso anal (2,8%), dor anal em dois pacientes (5,7%) e dificuldade evacuatória em um paciente (2,8%). Notou-se uma melhora do índice médio de incontinência de 11,3 para 4,3 (p < 0,001). Houve melhora de todos os domínios estudados no instumento FIQL (p<0,0001). Pacientes incontinentes apresentaram hipotonia esfincteriana quando comparados aos controles (p < 0,05). As pressões esfincterianas antes e após injeção foram respectivamente: PMR (29,4 mmHg x 35,1 mmHg; p = 0,07), PMCV (68,6 mmHg x 75,9 mmHg; p = 0,20) e PmaxCV (102,2 mmHg x 127,0 mmHg; p = 0,11). Houve aumento médio da ZAP de 1,0 para 1,7 cm (p = 0,002) Em relação aos resultados da manometria: o IA aos 3 e 2 cm apresentou redução significativa após injeção do silicone (p < 0.05 e 0,002). A ultra-sonografia de canal anal demonstrou a presença do silicone nos sítios de injeção em todos os pacientes. Conclusão: Em casos selecionados, a injeção transesfincteriana de silicone é um método seguro e proporciona uma melhora do quadro de incontinência anal, observada pela mudança significativa dos parâmetros de qualidade de vida e índice de incontinência. O provável mecanismo de ação pelo qual o agente estudado melhora o quadro de incontinência parece relacionar-se à correção da assimetria esfincteriana e aumento do comprimento da zona de alta pressão. / Aim: To evaluate safety and efficacy of trans-sphincteric silicone injection for the treatment of anal incontinence and to assess correlation between clinical and physiological results. Methods: Incontinent patients prospectively selected by clinical and physiological evaluation underwent trans-sphincteric silicone injection (PTQ) under local anesthesia. Eight channel manometry with asymmetry index and anal ultrasound were performed before and after injections. Incontinence scale (IS) and quality of life instrument (FIQL scale) were applied before and after injection.Inclusion criteria were: anal incontinence, isolated or multiple injury of the internal anal sphincter associated or not to small, restricted, external anal sphincter defect. FIQL scale included four domains: life-style, behavior, depression and embarrassment. Manometry evaluation included mean resting pressure (MRP), mean squeeze pressure (MSP), maximal squeeze pressure (MaxSP), high-pressure zone (HPZ) and asymmetry index (AI). After 3 months of treatment the patients had been reevaluated through the IS, FIQL scale, manometry and ultrasound. A controlled group of 20 healthy volunteers (10 men and 10 women) underwent anal manometry. Results: 35 patients (28 women and seven men) with a mean age of 60.3 (19-80) years were evaluated. Complications observed were two anal hematomas (5,7%), one perianal abscess (2.8%), two patients complained of anal pain (5,7%) and one patient required assistance for defecation (2,8%). Mean incontinence score improved significantly after injection: 11, 3 to 4,3 (p < 0.001). Significant improvement in the FIQL scale was noticed in all domains (p < 0.0001). Incontinent patients had significantly lower anal pressures when compared to controls (p < 0.05). Manometric pressures before and after injection did not change: MRP (29,4 mmHg x 35,1 mmHg; p = 0.07), MSP (68,6 mmHg x 75,9 mmHg; p = 0.20) e MaxSP (102.2 mmHg x 127.0 mmHg; p = 0.11) The HPZ changed from 1 to 1,7 cm after injection (p = 0.002) AI at 3 and 2 cm showed a significantly change (p < 0.05 and p = 0.001, respectively). Ultrasound images demonstrated the presence of silicone in all sites of injection. Conclusion: In selected cases, trans-sphincteric silicone injection is an effective treatment for anal incontinence, as significant changes in quality of life and incontinence scales can be observed. The mechanism of action for which the studied agent improves anal incontinence seems to be related to improvement in the asymmetry index as well as a change in the HPZ.

The bacterium Escherichia coli is internationally recognized for being the only exact environmental indicator for fecal contamination. In the decades of 2000 and 2010, research found this bacterium does not live only in intestines habitat, losing its exactitude as a fecal indicator. Some important questions were not answered, for instance, soil types and under what physic, chemical and geological conditions, E. coli grows in the environment; how its concentrations in river bank interferes in the water column concentration; why the concentration is so high in soil and sediments in relation to water column; what is its validity as a fecal indicator. This research aimed to answer these questions, more specifically, (1) to verify the occurrence and growth of this bacterium in river bank soil in tropical rivers in Brazil; (2) to evaluate if it is a natural soil specie; (3) to establish some of its ecological relations; (4) to identify techniques to potentialize its use as a fecal indicator. Mathematical models were utilized for E. coli dispersion simulation in river considering the sediments ressuspension and the bank erosion. The E. coli concentration was measured with membrane filtration method using the culture medium Endo at 37° C. The results show a natural E. coli occurrence in soil with concentrations such as 104 CFU/g dry soil, identified as an E. coli source. This work also concluded that the population persistence and growth depend on the clay properties to maintain the temperature and humidity and to adsorb the bacterium, decreasing its lateral flux in the water column. The E. coli adhesion is an evolution adaptation to fix it into its habitat. River bank E. coli goes to water column through erosion and ressuspension, being associated to suspended sediment concentration. The relation between soil and water concentration was 26.762 times more in soil at low velocities of the river, and 266 times in high velocities, showing a direct relation with bank erosion rate and sediment ressuspension. / A bactéria Escherichia coli é reconhecida internacionalmente como o único indicador ambiental exato para contaminação fecal. Nas décadas de 2000 e 2010, pesquisas constataram que essa bactéria não tem habitat exclusivamente intestinos, perdendo sua exatidão. Algumas questões importantes não foram respondidas, como quais tipos de solo e sob quais condições físicas, químicas e geológicas E. coli cresce no meio ambiente; como sua concentração nas margens de rios interfere na sua concentração na coluna d água; porque a concentração é alta no solo das margens e sedimento dos rios em relação a coluna d água; qual sua validade como indicador de contaminação fecal. Essa pesquisa objetivou responder essas questões, mais especificamente, (1) verificar a ocorrência e crescimento desta bactéria no solo das margens em rios tropicais no Brasil; (2) avaliar se faz parte da microbiota natural do solo; (3) estabelecer algumas de suas relações ecológicas; (4) identificar técnicas de potencializar seu uso como indicador de contaminação fecal. Foram utilizados modelos matemáticos para simulação da dispersão de E. coli na água considerando a ressuspensão de sedimentos e erosão das margens. A concentração de E. coli foi medida através do método de filtração em membrana e cultivo em meio de cultura Endo a 37° C. Os resultados mostram ocorrência natural de E. coli no solo com concentrações de 104 UFC/ g de solo seco, que foi identificada como a fonte de entrada de E. coli na coluna d água. Concluiu-se também a sobrevivência e crescimento da população dependente das propriedades da argila de manter a temperatura e umidade relativamente constantes, e de fixar a bactéria no solo diminuindo seu arraste para a coluna d água. A adesão de E. coli ambiental ao solo é uma adaptação evolutiva de fixação no habitat, tem forte adsorção à partícula de sedimento. E. coli das margens somente entra na coluna d água através da erosão e ressuspensão, estando associada à concentração de sedimento suspenso. A relação da concentração no solo e na água foi de 26.762 vezes maior no solo em baixas velocidades do rio, e 266 maior no solo em altas velocidades, apresentando relação direta com a taxa de erosão das margens e de ressuspensão de sedimentos.

Submitted by Erika Demachki (erikademachki@gmail.com) on 2017-03-29T20:09:57Z No. of bitstreams: 2 Dissertação - Eni Liudmiliza Leite Buma - 2017.pdf: 1928297 bytes, checksum: 00dfb2987c7dc920fba208a5861948fe (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2017-03-31T10:28:49Z (GMT) No. of bitstreams: 2 Dissertação - Eni Liudmiliza Leite Buma - 2017.pdf: 1928297 bytes, checksum: 00dfb2987c7dc920fba208a5861948fe (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2017-03-31T10:28:49Z (GMT). No. of bitstreams: 2 Dissertação - Eni Liudmiliza Leite Buma - 2017.pdf: 1928297 bytes, checksum: 00dfb2987c7dc920fba208a5861948fe (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2017-03-07 / Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq / Water courses that pass through areas of production, whether agricultural, pasture or housing, are subject to discharge of municipal and industrial sewage systems. These waters can be directed to river basins and redistributed to networks of water treatment and public supply. Normally, surface raw water has high concentrations of total coliforms, thermotolerant coliforms and E. coli. However, the microbiological indicator of fecal contamination, E. coli, does not present specificity, limiting, therefore, the host identification causing fecal pollution in water stream. As an alternative, bacteria of the genus Bacteroides have been suggested as potential alternative indicators of fecal pollution. Bacteroides are strictly anaerobic, exclusive and specific to the human gastrointestinal tract, and are also present in homeothermic animals. Because its inability to withstand aerobic environments, Bacteroides are considered as promising indicators of recent fecal pollution. Their identification in water bodies is usually performed by the presence of the 16S rRNA genetic marker of the order Bacteroidales. The objective of this study was to evaluate the microbiological and physico-chemical quality of the water of the Ribeirão João Leite Basin, responsible to supply 50% of water to the city of Goiânia, as well as the evaluation of the 16S rRNA Bacteroidales marker as an indicator of human and / or animal fecal pollution in waters of this basin. For this purpose, 91 samples of surface freshwater were collected from 13 points located along the Ribeirão João Leite Hydrographic Basin extension. Also, human and animal fecal samples were collected to test the sensitivity and specificity of primers to trace the 16S rRNA Bacteroidales marker. Based on the CONAMA Resolution 357/2005 Class II for fresh water, 5.5% (5/91) of the samples had a turbidity level above > 100 NTU (119-180 NTU), while 33% presented values below <103 CFU / 100 mL for thermotolerant E. coli. The mean values were found to be between 1.24 x 103-5.03 x 104 CFU / 100 mL. The 16S rRNA Bacteroidales ruminant host marker was identified in points with high agricultural and cattle influence, on the other hand, the presence of the 16S rRNA Bacteroidales marker as an indicator of human fecal pollution was not detected in the 5 analyzed points. The results obtained will be able to collaborate with sanitary measures to reduce the level of turbidity and also to identify the source of the fecal contamination in these bodies of water, thus minimizing the risk of dissemination of waterborne diseases. / Cursos de água que atravessam áreas de produção, sejam elas agrícolas, de pastagens ou habitacional, estão sujeitos à captação de sistemas de esgoto municipais e industriais. Essas águas podem ser direcionadas a bacias hidrográficas e redistribuídas a redes de estação de tratamento de água e abastecimento público. Normalmente, águas de mananciais apresentam elevados níveis de concentrações de coliformes totais, coliformes termotolerantes e E. coli. Entretanto, o indicador microbiológico de poluição fecal E. coli, não apresenta especificidade, limitando, portanto, a identificação do hospedeiro causador da poluição fecal em determinada corrente de água. Como alternativa, as bactérias do gênero Bacteroides vêm sendo sugeridas como potenciais indicadores alternativos de poluição fecal. Bacteroides são estritamente anaeróbicas, exclusivas e específicas ao trato gastrointestinal humano, apresentando especificidade a animais homeotérmicos. Por serem incapazes de resistir a ambientes aeróbios são consideradas como promissores indicadores de poluição fecal recente. A sua identificação em corpos de água é geralmente realizada pela presença do marcador genético 16S rRNA da ordem Bacteroidales. Este estudo teve como objetivos avaliar a qualidade microbiológica e físico-química da água bruta superficial da Bacia Hidrográfica do Ribeirão João Leite, responsável por 50% de abastecimento da cidade de Goiânia, e também, a avaliação do marcador 16S rRNA Bacteroidales como indicador da fonte de poluição fecal humana e/ou animal em águas desta bacia. Para tal, foram coletadas 91 amostras de água bruta superficial de 13 pontos localizados ao longo da extensão da Bacia Hidrográfica do Ribeirão João Leite, assim como, amostras de matéria fecal humana e animal de modo a testar a sensibilidade e especificidade de oligonucleotídeos iniciadores para o rastreamento do marcador 16S rRNA Bacteroidales. Baseado na Resolução CONAMA 357/2005 Classe II para águas doces, 5,5% (5/91) das amostras apresentaram nível de turbidez acima de >100 NTU (119-180 NTU), enquanto que 33% apresentaram valores inferiores a <103 CFU/100 mL para E. coli termotolerante, sendo os valores médios encontrados entre 1,24 x 103–5,03 x 104 CFU/100 mL. O marcador 16S rRNA Bacteroidales hospedeiro bovino (ruminante) foi identificado em água bruta superficial dos pontos coletados com alta influência agropecuária, em contrapartida, dos 5 pontos analisados não foi detectado a presença do marcador 16S rRNA Bacteroidales como indicador de poluição fecal humana. Os resultados obtidos poderão colaborar com medidas sanitárias que visam a redução do nível da turbidez e na identificação da origem da contaminação microbiológica fecal nesses corpos d’água minimizando, desta forma, o risco de disseminação das doenças de veiculação hídrica

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-01-06T16:37:02Z No. of bitstreams: 1 lucienecarnevaledesouza.pdf: 2592161 bytes, checksum: e9e57d465b2f129869598beed3f3bc72 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-01-25T16:36:51Z (GMT) No. of bitstreams: 1 lucienecarnevaledesouza.pdf: 2592161 bytes, checksum: e9e57d465b2f129869598beed3f3bc72 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-01-25T16:37:08Z (GMT) No. of bitstreams: 1 lucienecarnevaledesouza.pdf: 2592161 bytes, checksum: e9e57d465b2f129869598beed3f3bc72 (MD5) / Made available in DSpace on 2016-01-25T16:37:08Z (GMT). No. of bitstreams: 1 lucienecarnevaledesouza.pdf: 2592161 bytes, checksum: e9e57d465b2f129869598beed3f3bc72 (MD5) Previous issue date: 2015-01-27 / Objetivou-se analisar os determinantes do processo de envelhecimento, a prevalência de incontinência anal e as representações sociais que pessoas com idade ≥65 anos fazem sobre a incontinência anal com vista a identificar os diagnósticos de enfermagem nesta área em um grupo socialmente contextualizado. Pesquisa delineada no método misto composta por survey e Teoria das Representações Sociais com abordagem estrutural e processual. Participaram pessoas com idade ≥65 anos, de ambos os gêneros e moradoras de uma área atendida por uma Unidade de Atenção Primária à Saúde de Minas Gerais. A entrevista individual foi o instrumento de coleta de dados aplicado, contendo: determinantes do envelhecimento, escalas de incontinência de Wexner, St Mark, Revised Fecal Incontinence Score (RFIS) e Fecal Incontinence Quality Life (FIQL), evocações a partir de termo indutor e entrevista gravada para obter discurso sobre a incontinência anal. Utilizou-se suporte dos programas SPSS®, EVOC® e Nvivo® para consolidação e tratamento dos dados. Atenderam-se todos requisitos éticos e legais de pesquisa envolvendo seres humanos. Participaram 110 pessoas, destes 70,9% possuíam idade entre 65-75 anos; 62,7% eram mulheres; 67,3% eram naturais de cidades mineiras; 49,1% eram casados; 12,7% tinham profissão do lar, 19,1% eram doméstica; 24,5% nunca frequentaram escola e a média de anos de estudo foi de 7,59 anos. Prevalência de 9,9% de incontinência anal em diferentes graus, de acordo com as escalas utilizadas. Entre os determinantes do processo do envelhecimento identificaram-se: famílias numerosas, de baixa renda, presentes no cotidiano dos participantes, com convivência intergeracional, vínculos afetivos e fornecedores de apoio financeiro para o núcleo familiar; com hábitos de assistir à televisão, ouvir rádio, transferir tradição entre o grupo intergeracional; presença de doenças crônico-degenerativas e em uso de carga medicamentosa diária. Na Representação Social Estrutural, os cognemas alocados no núcleo central (cheiro-ruim, vergonha, pior-que-xixi e ruim) retrataram dimensões valorativas de caráter negativo, sendo que os mesmos foram corroborados com fragmentos de discurso dos participantes na abordagem processual da representação social. A reunião de todas as informações subsidiou a identificação de diagnósticos de enfermagem segundo a taxonomia da NANDA I como estando vinculados à respostas dos participantes diante da incontinência anal. Deles 11 são do tipo real, oito de risco e quatro de promoção de saúde. Concluiu-se que o caráter valorativo negativo para a incontinência anal retrata a necessidade de condutas terapêuticas que auxiliem aos participantes a enfrentarem esta síndrome geriátrica com vistas ao envelhecimento ativo. A contribuição desta investigação está no fato de ela: 1) possibilitar a elaboração de um diagnóstico sobre o processo do envelhecimento, a prevalência da incontinência anal em grupo socialmente contextualizado na abordagem de atenção primária à saúde e a identificação de diagnósticos de enfermagem segundo a taxonomia da NANDA I; 2) conhecer as concepções de pessoas com idade ≥65 anos sobre uma das síndromes geriátricas que possuem impacto social, econômico, relacional e pessoal no processo de envelhecimento ativo e 3) elencar subsídios para reflexões do profissional enfermeiro para as condutas terapêuticas passíveis de ser operacionalizadas na atenção primária à saúde com vistas a contribuir para que o processo do envelhecimento ocorra com autonomia, saúde, segurança e participação social. / This study aimed to analyze the determinants of the aging process, the prevalence of anal incontinence and social representations that people aged ≥65 years are about anal incontinence to identify nursing diagnoses in this area in a socially contextualized group. Research outlined by the mixed method composed by survey and Theory of Social Representations structural and procedural approach. Participated peoples aged with ≥65 years, of both genders and residents of an area covered by a unit of Primary Health Care of Minas Gerais. Instrument of Data collection applied by individual interviews containing: Aging determinants, Wexner incontinence scales, St Mark, Fecal Incontinence Score Revised (RFIS) Fecal Incontinence Quality and Life (FIQL), evocations from inductive term and recorded interview for get discourse on anal incontinence. Used statistical support of SPSS, EVOC® and Nvivo® programs for consolidation and processing of data. Catered all legal and ethical requirements for research involving humans. Participated 110 people, with 70.9% aged 65-75 years; 62.7% women; 67.3% was borned in the state of Minas Gerais; 49.1% were married; home of the profession (12.7%), domestic (19.1%), and 24.5% never attended school and the average years of schooling was 7.59 years. Prevalence of anal incontinence was 9.9% in different levels according to the scale used. Among the determinants of the aging process was identified: many low-income families present in the daily lives of participants with intergenerational families, and bonds and with financial support for the family; habits of watching television, listening to the radio and transfer between tradition intergenerational group, presence of chronic degenerative diseases and drug charges in everyday use. Social Representation in the Structural words allocated in the central core (smell-bad, shame, worse-than-pee and bad), portrayed evaluative dimensions of negative character, and they were strengthened with speech fragments of the participants in the procedural approach to representation social. The combination of all the information supported the identification of nursing diagnoses according to the taxonomy NANDA I to be linked to the participants' responses on the anal incontinence. 11 of them are the real kind, eight-four risk of health promotion. It was concluded that the negative evaluative character for anal incontinence portrays the need for therapeutic approaches that help participants to handle such a geriatric syndrome with a view to active aging. The contribution of this research is the fact that it: 1) enable the development of a diagnosis of the aging process, the prevalence of anal incontinence in socially contextualized group in addressing primary health care and to identify nursing diagnoses according to the taxonomy NANDA I; 2) know the conceptions of people aged ≥65 years about one of the geriatric syndromes that have effect social, economic, relational and personal in active aging process and 3) to list grants for nursing professional reflections for therapeutic approaches that can be operationalized in primary health care in order to contribute to the aging process to occurs with autonomy, health, safety and social participation.

Introdução: Devido à fatores hormonais e mecânicos, a gestação e o parto provocam alterações que podem gerar disfunções do assoalho pélvico (DAP). Os estudos sobre as DAP no puerpério a curto prazo são escassos e fazem uso assistemático de métodos avaliativos. Objetivo: Identificar e avaliar as DAP no pós-parto imediato, um mês e três meses após o parto, comparando parto vaginal (PV), cesárea eletiva (CE) e cesárea intraparto (CI). Métodos: Estudo observacional longitudinal que avaliou mulheres até 48 horas (fase 1); um mês (fase 2) e três meses após o parto (fase 3). Utilizou-se o International Consultation on Incontinence Questionnaire (ICIQ-SF); o Índice de Incontinência Anal (IA) de Jorge-Wexner; a Escala Análoga Visual (EVA) para dor pélvica; o Pelvic Organ Prolapse Quantification system (POP-Q) e a perineometria dos Músculos do Assoalho Pélvico (MAP), além de questionário estruturado. Resultados: Foram avaliadas 227 pacientes na fase 1 (141 realizaram PV; 28 realizaram CI e 58 realizaram CE); 79 na fase 2 e 41 na fase 3. O escore do ICIQ-SF, índice de IA, EVA e perineometria não apresentaram diferenças significativas em relação ao tipo de parto. O ponto distal do colo uterino apresentou-se mais prolapsado no grupo PV. Conclusão: O tipo de parto não foi um fator significante para o desenvolvimento das DAP no pós-parto a curto prazo. Foi identificado que ocorreu recuperação fisiológica na funcionalidade dos MAP e piora na sustentação da parede vaginal anterior e no impacto da incontinência urinária na qualidade de vida ao longo dos três meses. / Introduction: Due to mechanical and hormonal factors, pregnancy and childbirth triggers changes that can lead to pelvic floor dysfunction (PFD). PFD studies in the immediate postpartum period are scarce and do unsystematic use of evaluation methods. Objective: To identify and evaluate the immediate, one month and three months postpartum PFD, comparing vaginal delivery (VD), elective cesarean (ECS) and cesarean indicating (ICS) during labor. Methods: This was a longitudinal observational study that assessed postpartum women after up to 48 hours (phase 1); one month (phase 2) and three months (phase 3). The study used the International Consultation on Incontinence Questionnaire (ICIQ-SF); Jorge-Wexner's Anal Incontinence (AI) score; the Visual Analogue Scale (VAS) for pelvic pain; the Pelvic Organ Prolapse Quantification System (POP-Q); and a Pelvic Floor Muscles (PFM) perineometer, as well as a structured questionnaire. Results: A total of 227 patients were assessed in phase 1 (141 had VD, 28 ICS and 58 ECS); 79 in phase 2 and 41 in phase 3. The ICIQ-SF, AI, VAS and perineometer index did not present significant differences in relation to the type of delivery. The distal point of the cervix presented more prolapse in VD. Conclusion: The type of delivery was not a significant factor for the development of postpartum PFD in the short term. The study found that there was physiological recovery of the functionality of PFM and worsening prolapse of the anterior vaginal wall and urinary incontinence over the three months.

In the development of the watershed, hydrodynamic, and water quality models for Back Bay of Biloxi in Mississippi, the Better Assessment Science Integrating Point and Nonpoint Sources (BASINS 2.0) - Nonpoint Source Model (NPSM) was selected as the watershed model. The hydrodynamic and water quality models DNYHYD5 and EUTRO5 were selected as the tidally influenced bay models. The watershed model simulated nonpoint source flow and pollutant loadings for all sub-watersheds, routed flow and water quality, and accounted for all major point source discharges in the Back Bay of Biloxi watershed. Time varying output from the watershed model was applied directly to the Back Bay of Biloxi model. The Bay models, in turn simulated hydrodynamics and water quality, including water depth, velocities, and fecal coliform concentrations. Both watershed and Bay models were calibrated and verified against observed data. The calibrated/verified model was used as a planning tool to assess the water quality in the Watershed and the Bay as well as for calculating Total Maximum Daily Load (TMDL) and Waste Load Allocation (WLA).

Antibiotic resistance is a global threat that can severely imperil public health. To curb the spread of antibiotic resistance, it is imperative that efforts commensurate with a “One Health” approach are undertaken. Given that interconnectivities among ecosystems can serve as conduits for the proliferation and dissemination of antibiotic resistance, it is increasingly being recognized that a robust global environmental surveillance framework is required to promote One Health. The ideal aim would be to develop approaches that inform global distribution of antibiotic resistance, help prioritize monitoring targets, present robust data analysis frameworks to profile resistance, and ultimately help build strategies to curb the dissemination of antibiotic resistance. The work described in this dissertation was aimed at evaluating and developing different data analysis paradigms and their applications in investigating and characterizing antibiotic resistance across different resistomes. The applications presented in Chapter 2 illustrate challenges associated with various environmental data types (especially metagenomics data) and present a path to advance incorporation of data analytics approaches in Environmental Science and Engineering research and applications. Chapter 3 presents a novel approach, ExtrARG, that identifies discriminatory ARGs among resistomes based on factors of interest. The results in Chapter 4 provide insight into the global distribution of ARGs across human fecal and sewage resistomes across different socioeconomics. Chapter 5 demonstrates a data analysis paradigm using machine learning algorithms that helps bridge the gap between information obtained via culturing and metagenomic sequencing. Lastly, the results of Chapter 6 illustrates the contribution of phages to antibiotic resistance. Overall, the findings provide guidance and approaches for profiling antibiotic resistance using metagenomics and machine learning. The results reported further expand the knowledge on the distribution of antibiotic resistance across different resistomes. / Antibiotic resistance is a global threat that can severely imperil public health. To curb the spread of antibiotic resistance, it is imperative that efforts commensurate with a "One Health" approach are undertaken. Given that interconnectivities among ecosystems can serve as conduits for the proliferation and dissemination of antibiotic resistance, it is increasingly being recognized that a robust global environmental surveillance framework is required to promote One Health. The ideal aim would be to develop approaches that inform global distribution of antibiotic resistance, help prioritize monitoring targets, present robust data analysis frameworks to profile resistance, and ultimately help build strategies to curb the dissemination of antibiotic resistance. The work described in this dissertation was aimed at evaluating and developing different data analysis paradigms and their applications in investigating and characterizing antibiotic resistance across different resistomes. The applications presented in Chapter 2 illustrate challenges associated with various environmental data types (especially metagenomics data) and present a path to advance incorporation of data analytics approaches in Environmental Science and Engineering research and applications. Chapter 3 presents a novel approach, ExtrARG, that identifies discriminatory ARGs among resistomes based on factors of interest. The results in Chapter 4 provide insight into the global distribution of ARGs across human fecal and sewage resistomes across different socioeconomics. Chapter 5 demonstrates a data analysis paradigm using machine learning algorithms that helps bridge the gap between information obtained via culturing and metagenomic sequencing. Lastly, the results of Chapter 6 illustrates the contribution of phages to antibiotic resistance. Overall, the findings provide guidance and approaches for profiling antibiotic resistance using metagenomics and machine learning. The results reported further expand the knowledge on the distribution of antibiotic resistance across different resistomes. / Doctor of Philosophy / Antibiotic resistance is ability of bacteria to withstand an antibiotic to which they were once sensitive. Antibiotic resistance is a global threat that can pose a serious threat to public health. In order to curb the spread of antibiotic resistance, it is imperative that efforts commensurate with the "One Health" approach. Since ecosystem networks can act as channels for the spread and spread of antibiotic resistance, there is growing recognition that a robust global environmental monitoring framework is required to promote a true one-health approach. The ideal goal would be to develop approaches that can inform the global spread of antibiotic resistance, help prioritize monitoring objectives and present robust data analysis frameworks for resistance profiling, and ultimately help develop strategies to contain the spread of antibiotic resistance. The objective of the work described in this thesis was to evaluate and develop different data analysis paradigms and their applications in the study and characterization of antibiotic resistance in different resistomes. The applications presented in Chapter 2 illustrate challenges associated with various environmental data types (especially metagenomics data) and present a path to advance incorporation of data analytics approaches in Environmental Science and Engineering research and applications. The Chapter 3 presents a novel approach, ExtrARG, that identifies discriminatory ARGs among resistomes based on factors of interest. The chapter 5 demonstrates a data analysis paradigm using machine learning algorithms that helps bridge the gap between information obtained via culturing and metagenomic sequencing. The results of Chapters 4 provide insight into the global distribution of ARGs across human fecal and sewage resistomes across different socioeconomics. Lastly, the results of Chapter 6 illustrates the contribution of phages to antibiotic resistance. Overall, the findings provide guidance and approaches for profiling antibiotic resistance using metagenomics and machine learning. The results reported further expand the knowledge on the distribution of antibiotic resistance across different resistomes.

Syftet med studien var att belysa upplevelser av att leva med fekal inkontinens. Fekal inkontinens, även kallat FI, är ett symtom som uppemot 15 % av den globala befolkningen lider av. Symtomet är fysiskt men kan även ha negativ inverkan på livskvaliteten, både på ett emotionellt och ett socialt plan. Stigmatiseringen av FI gör att många individer lider i det tysta. Litteraturstudiens resultat grundar sig på elva vetenskapliga artiklar, där resultatet av studien utföll i sju kategorier: Förlust av kontroll, Social isolering, Kroppsbild och självkänsla, Längtan efter bekräftelse, Livsbegränsningar, Bristande bemötande av hälso-och sjukvården, Känslor av skam, Förnedring samt Att hemlighålla fekal inkontinens. Resultatet visade att tabun kring FI ledde till skam hos de som levde med symtomet. Vidare framkom det i studien att individer med FI vanligtvis begränsade sitt sociala liv, vilket medförde en försämrad livskvalitet och självkänsla. Den skamfulla upplevelsen av FI korrelerar med bristande kunskap om symtomet. Mer kunskap medför i regel att skamkänslorna minskar. Hälso- och sjukvården kan tillhandahålla individen information och insikt om sina symtom. För att fler individer ska få hjälp att hantera känslan av skam som symtomet kan orsaka, är det av vikt att hälso- och sjukvårdspersonal har adekvat utbildning om uppkomsten av negativa känslor. På så vis kan de bemöta och stötta individerna på en individanpassad nivå. Därav behövs vidare forskning bedrivas i ämnet. / The purpose of this study was to illustrate experiences of living with fecal incontinence. Fecal incontinence, also known as FI, is a symptom that up to 15% of the population suffers from. The symptom is physical, but can also have a negative impact on quality of life, both on an emotional and social level. The stigmatization of FI makes many individuals suffer in silence. The results from the literature study is based on eleven scientific articles, and resulted into seven categories: Loss of control, Social isolation, Body image and self-esteem, Desire for affirmation, Life limitations, Inadequate treatment of health care, Feelings of shame, humiliation and To keep fecal incontinence a secret. The results showed that the taboo surrounding FI led to feelings of shame of those who lives with the symptom. The results also showed that individuals with FI usually limited their social life, resulting in a reduced quality of life and self-esteem. The shameful experience of FI correlates with lack of knowledge about the symptom. More knowledge generally leads to reduced feelings of shame. The health care may provide the individual with information and insight about their symptoms. It is important for the health professionals to have adequate education about the appearance of negative feelings, in order to help individuals with FI managing their feelings of shame. In this way, the health professionals can treat and support individuals on an individualized level. Hence the need for further research conducted on the subject.