Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-11-03T21:39:42Z No. of bitstreams: 1 KeivertonRonesGurgelPaiva_DISSERT.pdf: 1038992 bytes, checksum: 838139b553fcb29873b38407992a06de (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-11-18T00:06:45Z (GMT) No. of bitstreams: 1 KeivertonRonesGurgelPaiva_DISSERT.pdf: 1038992 bytes, checksum: 838139b553fcb29873b38407992a06de (MD5) / Made available in DSpace on 2017-11-18T00:06:45Z (GMT). No. of bitstreams: 1 KeivertonRonesGurgelPaiva_DISSERT.pdf: 1038992 bytes, checksum: 838139b553fcb29873b38407992a06de (MD5) Previous issue date: 2017-07-25 / Introdu??o: Os aspectos subjetivos e a opini?o do paciente devem ser considerados nas reabilita??es unit?rias sobre implante em ?rea est?tica. Proposi??o: Avaliar o efeito da reabilita??o unit?ria provis?ria implantossuportada sobre a satisfa??o e qualidade de vida dos indiv?duos. Metodologia: Estudo transversal que visa avaliar pacientes reabilitados com coroas unit?rias provis?rias sobre implantes em ?rea est?tica quanto ? qualidade de vida, atrav?s do uso de dois question?rios (OIDP e OHIP-14) e quanto ? satisfa??o, por meio de escala visual anal?gica. Ambas an?lises foram realizadas previamente e ap?s a reabilita??o com as coroas provis?rias. Bem como, determinar a partir da diferen?a m?nima a ser detectada de m?dias, igual a 2,00 para o OHIP-14 e para a Satisfa??o o tamanho amostral ideal para se encontrar uma diferen?a estatisticamente significante. Resultados: Obteve-se uma amostra de 10 pacientes para este estudo dos quais sete tinham a aus?ncia de um incisivo superior. O OIDP demonstrou que a qualidade de vida apresentou impacto positivo em todas as performances ap?s a reabilita??o, entretanto duas performances ainda permaneceram com impacto negativo (comer e limpeza da boca), por?m menores que anterior ? interven??o. O score m?dio do OHIP-14 demonstrou que houve melhora na qualidade de vida tendo uma redu??o no seu valor de 23,3%. Quanto ? satisfa??o houve uma melhora ap?s o procedimento em todos os aspectos. Realizando o c?lculo amostral com as diferen?as m?nimas a serem detectadas (igual a 2,00 para ambas as tem?ticas estudadas) encontrou-se uma amostra variando de 11 a 54, e de 16 a 62, para qualidade de vida e satisfa??o, respectivamente. Conclus?o: O tamanho amostral de 62 pacientes parece ser o ideal para se estabelecer uma diferen?a significativa ao longo do tempo, visando determinar o efeito da reabilita??o prot?tica provis?ria implantossuportada unit?ria sobre a qualidade de vida e satisfa??o dos pacientes. / Introduction: The subjective aspects and patient opinion should be considered in single-implant treatment in aesthetic area. Proposition: To evaluate the effect of provisional single-implant crowns on the satisfaction and quality of life of individuals. Methodology: a cross-sectional study aiming to evaluate patients who were rehabilitated with provisional single-implant crowns in the aesthetic area regarding quality of life, using two questionnaires (OHIP-14 and OIDP), and satisfaction, using a visual analog scale. The evaluation was performed before and after rehabilitation with the provisional crowns. As well as, to determine from the minimum difference to be detected of means, equal to 2.00 for the OHIP-14 and for Satisfaction the ideal sample size to find a statistically significant difference. Results: A sample of 10 patients was obtained for this study of which seven had the absence of a superior incisor. The OIDP shown that quality of life had a positive impact on all performances after rehabilitation, however two performances still remained with negative impact (eating and mouth cleaning), but smaller than before the intervention. The mean score of OHIP-14 showed that there was an improvement in quality of life having a reduction in its value of 23.3%. For the satisfaction there was an improvement after the procedure in all aspects. A sample ranging from 11 to 54 and from 16 to 62, for quality of life and satisfaction, respectively, was found to make the sample calculation with the minimum differences to be detected (equal to 2.00 for both subjects). Conclusion: The sample size of 62 patients seems to be the ideal to establish a significant difference over time, aiming to determine the effect of provisional implant-supported prosthetic rehabilitation on quality of life and patient satisfaction.

Submitted by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-06-12T17:44:48Z No. of bitstreams: 1 DIS_ROBERTO_FERREIRA_ZANIN_PARCIAL.pdf: 733158 bytes, checksum: a7a7b4d0022ccc0b36fa8657b48ad0ff (MD5) / Made available in DSpace on 2017-06-12T17:44:48Z (GMT). No. of bitstreams: 1 DIS_ROBERTO_FERREIRA_ZANIN_PARCIAL.pdf: 733158 bytes, checksum: a7a7b4d0022ccc0b36fa8657b48ad0ff (MD5) Previous issue date: 2017-01-19 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Temporomandibular disorders (TMD) and their treatment have a physical and psychological impact on quality of life (QOL). This study aimed to assess the impact of oral health on QOL by evaluating 50 patients with bilateral anterior disc displacement without reduction preoperatively (T0) and 3?6 months after surgery for anterior disc repositioning and anchoring (T1). Oral health-related QOL was assessed using the short form of the Oral Health Impact Profile (OHIP-14). There was a statistically significant reduction in the mean total OHIP-14 score between T0 (12.48 ? 5.81) and T1 (3.84 ? 3.00). In addition, there was a significant decrease in all 7 OHIP-14 domains (P<0.001). Younger patients (aged 28?38 years, n=26) had benefits in all domains, while older patients (aged 50?60 years, n=5) showed a significant improvement only in the physical pain domain (P=0.049). The results suggest that TMD affect individuals in many aspects of their lives and that general or condition-specific oral health-related QOL measures are valuable tools for determining the impact of joint disorders on patients? QOL. Surgical treatment for articular disc repositioning and anchoring had a positive impact on patients? QOL. / As desordens da articula??o temporomandibular (ATM) e seu tratamento possuem repercuss?es f?sicas e psicol?gicas na qualidade de vida (QOL). Este estudo avaliou o pr?-operat?rio (T0) e de 3-6 meses de p?s-operat?rio (T1) em 50 pacientes (100 discos articulares) com deslocamento anterior do disco, sem redu??o bilateral, submetidos ? cirurgia para o reposicionamento do disco articular atrav?s de ?ncoras. A QOL relacionada com a sa?de bucal foi avaliada usando a vers?o reduzida do oral health impact profile (OHIP-14). Houve uma redu??o estatisticamente significante na m?dia geral das pontua??es OHIP-14 entre T0 (12.48 ? 5.81) e T1 (3.84 ? 3.00). Em adi??o, houve uma redu??o significativa em todos os 7 dom?nios OHIP-14 (P<0,001). Pacientes mais jovens, na faixa et?ria entre 28-38 anos (n=26), foram beneficiados em todos os dom?nios avaliados, enquanto que uma melhora significativa pode ser observada apenas no dom?nio dor f?sica (P > 0.05) para os pacientes mais idosos na faixa et?ria entre 50-60 anos (n=5). Os resultados sugerem que as desordens da ATM afetam os indiv?duos em diversos aspectos de suas vidas e que as abordagens das condi??es espec?ficas e gerais de sa?de oral para avaliar a QOL possuem valor em determinar o impacto das desordens articulares na qualidade de vida destes pacientes. O tratamento cir?rgico para a ancoragem de disco da ATM teve um impacto positivo na qualidade nos pacientes avaliados.

Submitted by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-06-30T18:30:41Z No. of bitstreams: 1 TES_PATRICIA_MORSCH_COMPLETO.pdf: 7843957 bytes, checksum: 0fa475ed4c0a81b093704f1a73f0fd0f (MD5) / Approved for entry into archive by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-06-30T18:30:48Z (GMT) No. of bitstreams: 1 TES_PATRICIA_MORSCH_COMPLETO.pdf: 7843957 bytes, checksum: 0fa475ed4c0a81b093704f1a73f0fd0f (MD5) / Made available in DSpace on 2017-06-30T18:30:56Z (GMT). No. of bitstreams: 1 TES_PATRICIA_MORSCH_COMPLETO.pdf: 7843957 bytes, checksum: 0fa475ed4c0a81b093704f1a73f0fd0f (MD5) Previous issue date: 2017-03-29 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Introduction: Falling is an important public health problem for older adults. The literature suggests that 30% to 40% of them are preventable through management of risk factors. These factors have been extensively studied by epidemiology. However, adherence to preventive programs depends on older adults? perception in relation to falling and its risk factors. Thus, it is important to face the subjectivity and older adults? perception related to this problem. Objective: The objective of the present study was to develop a questionnaire to evaluate older adults? perception about the risk of falls. Methods: This is a qualitative and descriptive research with a methodological approach, carried out in three phases. Phase one, aiming to verifying older adults? perceptions about falls and risk factors, was carried out by content analysis. The sample consisted of individuals aged 60 years and over, from the city of Porto Alegre. In phase two the questionnaire was developed, based on the main categories resulted from the previous phase. The questionnaire was then sent to content validity analysis, through evaluation of the judges. In the third phase of the study, questionnaire?s face validity was verified through focal groups constituted by older adults. Results: Regarding the first phase of the study, codification and interpretation of data resulted in two thematic categories: the problematization of falls and the perception of risk factors. The first category highlights that many older adults do not perceive falls as a problem, and the second category demonstrates that older adults perceive risk factors for falls, but often they are not avoided. Extrinsic risk factors seem to be the most remembered by the elderly as causes of falls. In the second phase of the study, the 36-question research tool was sent for content validity analysis through the evaluation of judges, in three aspects: language clarity, importance and theoretical relevance. With these results, the Validity Coefficient (VC) was calculated. All questions with VC <0.7 were excluded. The new questionnaire, with 24 questions, after being tested for facial validity (phase 3), reached 14 questions. Conclusion: according to preliminary results, the questionnaire seems to be relevant to identify if older adults perceive falling as a problem to be prevented and their perception regarding risk factors. This knowledge can help develop more effective methods for fall prevention. Extrinsic risk factors should be addressed differently, as risks at home and on the street are perceived differently. A less objective approach, understanding the meanings attributed to each risk factor is important in order to prevent falls more effectively. / Introdu??o: A queda ? um importante problema de sa?de p?blica para a popula??o idosa. A literatura sugere que 30% a 40% delas s?o pass?veis de preven??o atrav?s do manejo adequado dos fatores de risco. Esses t?m sido extensivamente estudados pela epidemiologia. No entanto, a ades?o aos programas de preven??o depende da percep??o dos idosos em rela??o ? queda e seus fatores de risco. Dessa forma, ? importante encarar a subjetividade e a percep??o do idoso relacionada a esse problema. Objetivo: O objetivo do presente estudo foi desenvolver um instrumento para avaliar a percep??o do risco de quedas em idosos. M?todos: Trata-se de uma pesquisa descritiva qualitativa com abordagem metodol?gica, realizada em tr?s fases. A fase um, com objetivo de verificar as percep??es dos idosos acerca das quedas e seus fatores de risco, foi realizada pela an?lise de conte?do. A amostra foi composta por indiv?duos com 60 anos ou mais de idade, da cidade de Porto Alegre. Na fase dois o instrumento foi elaborado embasado nas categorias principais resultantes da fase anterior. O instrumento desenvolvido foi ent?o encaminhado para a valida??o de conte?do, atrav?s da t?cnica dos ju?zes. Na fase tr?s do estudo foi verificada a validade de face do instrumento por meio de grupos focais compostos por idosos. Resultados: Em rela??o ? primeira fase do estudo, a codifica??o e a interpreta??o dos dados resultaram em duas categorias tem?ticas: a problematiza??o das quedas e a percep??o dos fatores de risco. A primeira categoria destaca que muitos idosos n?o percebem as quedas como um problema e, a segunda demonstra que os idosos percebem os fatores de risco para as quedas, mas muitas vezes, eles n?o s?o evitados. Os fatores de risco extr?nsecos parecem ser os mais lembrados pelos idosos como causadores de quedas. Na segunda fase do estudo, o instrumento de pesquisa elaborado, com 36 quest?es, foi enviado para an?lise de validade de conte?do por meio da avalia??o de "ju?zes", em tr?s aspectos: clareza de linguagem, import?ncia e relev?ncia te?rica. Com estes resultados, foi calculado o Coeficiente de Validade de Conte?do (CVC). Todas as perguntas com CVC <0,7 foram exclu?das. O novo question?rio, com 24 perguntas, depois de testado quanto ? validade de face (fase 3), totalizou 14 quest?es. Conclus?o: De acordo com os resultados preliminares, o question?rio parece ser relevante para identificar se os idosos percebem a queda como um problema a ser prevenido e a sua percep??o em rela??o aos fatores de risco. Esse conhecimento pode ajudar a desenvolver m?todos mais eficazes para a preven??o de quedas. Os fatores de risco extr?nsecos devem ser abordados de maneira diferenciada j? que os riscos em casa e na rua s?o percebidos de maneiras diferentes. Uma abordagem menos objetiva, entendendo os significados atribu?dos a cada fator de risco ? importante para conseguir prevenir as quedas de forma mais eficaz.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2018-03-21T13:17:44Z No. of bitstreams: 1 MarcelloBarbosaOtoniGoncalvesGuedes_TESE.pdf: 1792670 bytes, checksum: bd8d59181fb4a99aef7df509936105d5 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2018-03-26T17:16:55Z (GMT) No. of bitstreams: 1 MarcelloBarbosaOtoniGoncalvesGuedes_TESE.pdf: 1792670 bytes, checksum: bd8d59181fb4a99aef7df509936105d5 (MD5) / Made available in DSpace on 2018-03-26T17:16:55Z (GMT). No. of bitstreams: 1 MarcelloBarbosaOtoniGoncalvesGuedes_TESE.pdf: 1792670 bytes, checksum: bd8d59181fb4a99aef7df509936105d5 (MD5) Previous issue date: 2017-11-28 / O envelhecimento populacional ? uma realidade no Brasil e no mundo, evidenciando al?m de uma transi??o demogr?fica, uma transi??o epidemiol?gica. Novas demandas para o cuidado integral da pessoa idosa se fazem presentes e, para que seja contemplada, a multidimensionalidade da sa?de, seus aspectos sociais tamb?m devem ser considerados na avalia??o em sa?de. Dentre fatores sociais importantes para a avalia??o do idoso, merece destaque o Apoio Social, sobretudo o informal. Assim, os objetivos deste trabalho foram construir e validar um question?rio para avalia??o do apoio social informal para idosos. Trata-se de uma pesquisa descritiva, observacional, do tipo quantitativa. O projeto foi aprovado pelo comit? de ?tica em pesquisa do Hospital Universit?rio Onofre Lopes, sendo executado entre os meses de janeiro a dezembro de 2016 no munic?pio do Natal-RN e em outras localidades do Brasil por entrevistas presenciais com os idosos e question?rio autorrespondido virtualmente com os especialistas. Os crit?rios de inclus?o foram: experi?ncia comprovada na ?rea de apoio social (para especialistas) ou ter 60 anos ou mais e ter capacidade cognitiva preservada (para os idosos). Na etapa de Validade de Conte?do (VC), avaliou-se a relev?ncia dos itens segundo ?ndice de Validade de Conte?do (IVC) geral e por item e montagem de painel com as observa??es feitas pelos especialistas. Na etapa de Validade do Processo de Respostas (VPR), avaliou-se o entendimento referente aos itens pelo p?blico alvo. Para validade fatorial procedeu-se com An?lise Fatorial Explorat?ria (AFE). Para realiza??o da AFE foi usado o programa estat?stico M PLUS Vers?o 7?. Foi realizado agrupamento de vari?veis (tipo R) e extra??o de fatores com an?lise de fatores comuns, a partir de rota??o obl?qua Geomin. Como crit?rio de exclus?o dos itens foi adotado o valor de refer?ncia maior ou igual a 0,35 de carga fatorial e maior ou igual a 0,5 de comunalidade por item. Para determina??o da quantidade de fatores retidos, foram observados os crit?rios de valores pr?prios >1, vari?ncia explicada acumulada m?nima de 60% e an?lise paralela de Horn. Na etapa de VC com especialistas, obteve-se um total de 40 entrevistados, 90% eram Doutores, 7,5% Mestres e 2,5% Especialistas. O IVC geral foi de 0,88 e apenas um item teve IVC considerado pobre. Ap?s avalia??o do painel, dois itens foram inclu?dos e os demais aprimorados. Na etapa de VPR com os idosos, obteve-se um total de 41 entrevistados. Ap?s an?lise do painel de observa??es feitas pelos idosos, as quest?es passaram por modifica??es para seu aperfei?oamento. 259 idosos, das cinco regi?es do Brasil responderam ao question?rio. Ap?s AFE, 4 itens foram exclu?dos devido a pobreza de suas cargas fatoriais e 4 fatores foram identificados: ?composi??o e extens?o da rede social?, ? apoio instrumental e disponibilidade?, ?reciprocidade e longitudinalidade? e ?apoio emocional e participa??o social?. O question?rio demonstrou uma boa relev?ncia dos itens propostos e as observa??es feitas pelos entrevistados permitiram uma aproxima??o da linguagem utilizada no instrumento, ? linguagem usada pelos idosos. O instrumento com 20 itens e 4 fatores retidos, apresentou boas propriedades psicom?tricas, tais como: cargas fatoriais aceit?veis e comunalidades excelentes. Sugere-se 42 como pontua??o geral de corte ?tima. / Population aging is a reality in Brazil and in the world, evidencing, besides a demographic transition, an epidemiological transition. New demands for the integral care of the elderly are present and to be considered, the multidimensionality of health, its social aspects should also be considered in health assessment. Among important social factors for the assessment of the elderly, Social Support, especially the informal one, deserves special mention. Thus, the objectives of this study were to construct and validate a questionnaire to evaluate informal social support for the elderly. It is a descriptive, observational and quantitative research. The project was approved by the research ethics committee of the Onofre Lopes University Hospital, and was performed between January and December 2016 in the city of Natal-RN and other locations in Brazil through face-to-face interviews with the elderly and a questionnaire virtually answered by the specialists. Inclusion criteria were: proven experience in the social support area (for specialists) or 60 years of age or older and have preserved cognitive ability (for the elderly). In the Content Validity (CV) stage, was evaluated by relevance of the items according to the General Content Validity Index (CVI) and per item and panel assembly were evaluated with the observations made by the specialists. In the Validity of Process Responses (VPR) stage, the understanding of the items by the target audience was evaluated. For factorial validity we proceeded with Exploratory Factor Analysis (EFA). Using the statistical program M PLUS Version 7? was used. Variable grouping (type R) and factor extraction were performed with analysis of common factors, using oblique rotation Geomin. As exclusion criterion of the items was adopted a reference value greater than or equal to 0.35 of factorial load and greater or equal to 0.5 of commonality per item. To determine the amount of retained factors, the criteria of own values> 1, minimum cumulative explained variance of 60% and parallel Horn analysis were observed. In the CV stage with specialists, a total of 40 interviewees were obtained, 90% were PhD, 7.5% Masters and 2.5% Specialists. The general CVI was 0.88 and only one item had considered poor. After panel evaluation, two items were included and the others modified. In the VPR stage with the elderly, a total of 41 interviewees were obtained. After analyzing the panel of observations made by the elderly, the issues went through modifications for their improvement. A sample of 259 elderly people from the five regions of Brazil answered the questionnaire. After EFA, 4 items were excluded due to the poverty of their factorial loads and 4 factors were identified: "composition and extension of the social network", "support instrumental and availability", "reciprocity and longitudinality" and "support emotional support and social participation". The questionnaire showed a good relevance of the proposed items and the observations made by the interviewees allowed an approximation of the language used in the instrument, to the language used by the elderly. The instrument with 20 items and 4 retained factors presented good psychometric properties, such as: acceptable factor loads and excellent commonalities. We suggest 42 as the overall optimal cut score.