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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
171

Consumidores conscientes: um estudo sobre como a consciência sustentável se manifesta e influencia o comportamento de consumo

Bresolin, Ernani 26 April 2016 (has links)
Submitted by Silvana Teresinha Dornelles Studzinski (sstudzinski) on 2016-07-18T18:40:35Z No. of bitstreams: 1 Ernani Bresolin_.pdf: 6006969 bytes, checksum: e09eb45bc2de4bee44f66eb48d4b237d (MD5) / Made available in DSpace on 2016-07-18T18:40:35Z (GMT). No. of bitstreams: 1 Ernani Bresolin_.pdf: 6006969 bytes, checksum: e09eb45bc2de4bee44f66eb48d4b237d (MD5) Previous issue date: 2016-04-26 / Nenhuma / A sustentabilidade é um tema bastante amplo e largamente discutido por pesquisas e estudos da área. Dentre seus desdobramentos encontra-se também o consumo sustentável, neste contexto, este estudo pretende pesquisar como consumidores estão resistindo a lógica atual de consumo e adotando práticas guiadas por uma consciência sustentável. Assim, tem-se como objetivo analisar comportamento de consumo desses que serão denominados neste estudo como, consumidores conscientes. A metodologia utilizou-se de uma pesquisa exploratória com entrevistas qualitativas e uso de técnicas projetivas e interpretativas. Os resultados proporcionam informações relevantes quanto aos significados, motivadores e benefícios percebidos, bem como, eventuais contradições, exceções e demandas ainda não supridas pelo mercado, utilizando como lente a visão daquele que talvez possui o maior dos poderes de transformação do atual modelo de consumo; o próprio consumidor. / Sustainability is a very broad topic and it is widely discussed by researches and studies in the area. In its developments, sustainable consumption has also been addressed. In this context, this study aims to investigate how consumers are resisting the current logic of consumption and adopting practices that are guided by sustainable awareness. Hence, it is necessary to analyze the consumption behavior of those who will be called in this study conscious consumers. Regarding methodology, an exploratory research including qualitative interviews, as well as projective and interpretive techniques, were used. The results provide relevant information on meanings, motivating factors and perceived benefits, as well as on possible contradictions, exceptions and market still unmet demands, and it holds the perspective from the one that, perhaps, has the greatest current consumption model transformation power: the consumer himself.
172

De Robinson Crusoé a Vanity Fair : la figure de lecteur dans les romans britanniques de 1719 a 1847 / From Robinson Crusoe To Vanity Fair : the reader figure in british novels, 1719-1847

Dupuy, Sonia 04 December 2010 (has links)
La figure de lecteur, prégnante dans les romans britanniques des XVIIIe et XIXe siècles, est porteuse de sens pour l’histoire du roman. Intimement liée à l’histoire du livre et à la discontinuité de lecture qu’impose la publication des romans en plusieurs volumes ou épisodes, elle s’impose aussi comme une représentation plus ou moins fidèle du lectorat. La figure de lecteur reconstruit ainsi l’histoire complexe que le roman entretient avec ses lecteurs. Derrière une bienveillante volonté d’inviter le plus grand nombre à la lecture romanesque se cache en réalité une tendance à la définition du lectorat par exclusion. Pour aussi paradoxal que cela soit, le roman a peur de ses lecteurs. Mus par la volonté de dissocier le genre des vulgaires « romances », les auteurs ne vont avoir de cesse de repousser en marge de leur texte tant de lecteurs indésirables susceptibles de faire échouer l’édifice littéraire aux préceptes encore très classiques qui se met en place. Au-delà, la figure de lecteur ne saurait être qu’une simple affaire de représentation : elle est aussi un double narratif, une sorte de miroir érigé au narrateur-auteur qui met à profit ce reflet inversé pour construire l’instance narrative encore bien peu légitime qu’il représente. Figure de lecteur et narrateur-auteur sont indissociablement liés. Ainsi les variations d’apparition de la figure de lecteur dans le texte n’ont d’égal que la fragilité de la voix auctoriale et l’expression de l’angoisse de réception que trahit une très symptomatique rhétorique de dépréciation. / Pregnant as it is in 18th and 19thC British novels, the reader in the text is potent with meaning for the history of the novel. Related to the history of the book and the discontinuous act of reading imposed on readers by the publication of novels in different volumes or episodes, the reader figure may also be seen as a more or less faithful representation of actual readers. The reader figure thus retraces the complex history of the relationship between the novel and its readers. Behind what appears as a complacent will to invite the widest audience to the reading of novels, a more systematic tendency to define readership by exclusion can hardly be concealed. Paradoxical as this may be, the novel has much to fear from its readers. Moved by their will to have the genre clearly distinguished from vulgar romances, the authors will repeatedly push those unwelcome readers likely to lead the whole literary edifice to a collapse back to the margins of their texts. But the reader cannot just be a matter of representation: it also is a narrative double, a sort of mirror erected to the self-conscious narrator who uses it to build up the hardly legitimate literary authority he stands for. Thus the reader figure and the self-conscious narrator are linked by an indissolvable bond. The variations in number of reader figures only reverberate the frailty of the authorial voice and the anxiety of reception expressed in a highly symptomatic text-undermining rhetoric.
173

Recognition Of Self Conscious Emotions In Relation To Psychopathology

Motan, Irem 01 December 2007 (has links) (PDF)
The aim of this study is to discover nonverbal, bodily gesture and contextual cues indicating self-conscious emotions and use these clues to examine personal differences and psychopathological symptoms. Moreover, possible effects of cultural differences on self-conscious emotions&rsquo / recognition and their relation to psychopathology are meant to be discussed. To achieve aforementioned goals, the study is partitioned into three separate but interdependent phases. The aim of the study is scale adaptation for which the State Shame and Guilt Scale, Test of Self-Conscious Affect-3, Guilt- Shame Scale, State-Trait Anxiety Inventory, and Beck Depression Inventory are applied to a group of 250 university students. The second study&rsquo / s objective is to determine the nonverbal expressions used in recognition of self-conscious emotions. To meet this goal, 5 TAT cards, whose compatibility with the research questions is verified, are applied to 45 university students in separate sessions by using close ended questions. In the third part of the study, 9 TAT cards, which include clues about recognition and nonverbal expressions of self-conscious emotions, adapted corresponding scales, and a psychopathological symptoms measuring scale (SCL-90) in self-report format are applied on a group of 250 university students. Factor and correlation analyses done in the first part reveal that adapted scales are reliable and valid, while group comparisons and measurements of the second part indicate differences in emotions. Findings reveal that shame can be recognized by nonverbal expressions whereas for guilt contextual clues are facilitated. In the third part, group comparisons and regression analyses, which are done in order to reveal self-conscious emotions&rsquo / recognition and their significant relationships with psychopathology, display that state self-conscious emotions and shame-proneness have very important roles on psychopathology. All these findings are discussed in the light of cultural effects.
174

The Differentiation Of Emotions Of Shame And Guilt In Adolescents With Maternal Breast Cancer

Kacmaz, Belgu Lale 01 September 2011 (has links) (PDF)
This study aimed at revealing and differentiating the emotions of shame and guilt felt by the adolescents with maternal cancer. In order to reveal and differentiate these emotions, a sentence completion task and interviews were used. The study was conducted on 10 adolescents in age range of 16-20. With each participant, four private sessions were made. In the first session, the participant&rsquo / s knowledge of his/her mother&rsquo / s condition was evaluated through the Sentence Completion Test. In the second session, Pandora&rsquo / s Box, a film by Yesim Ustaoglu was watched with the participant to understand if the film evoked the targeted emotions and the second format of Sentence Completion Test was given. In the third session, 20 minute interviews were conducted with the participant, privately. These interviews were called &ldquo / interventions&rdquo / because they aimed to intervene to the process of feeling guilty and ashamed and replace them with a positive self-conscious emotion, pride. The fourth and final session was conducted after one week and aimed to check if the anticipated affect of film and interventions lasted. Only 3 participants out of 10 returned for the fourth session, so the fourth session was left out of the analysis. Two main analyses were conducted in the current study. The frequencies of shame and guilt were examined in the Sentence Completion Test analysis and the interviews were analysed qualitatively. The outcome resulted that in both Sentence Completion Test and interview analysis, the adolescents with maternal cancer revealed emotions of shame and guilt. Furthermore, in the Sentence Completion Test analysis, it was tested whether the frequency of emotions of shame and guilt increased or decreased by the intervention of the film and interviews and the outcome yielded that neither the film Pandora&rsquo / s Box nor the interventions made any significant effect. The results were evaluated and the implications were discussed. Finally, limitations of the study and recommendations for future research were explained. Keywords: Cancer, breast cancer, adolescents, self-conscious emotions, Cinematherapy, Interventions Technique, Qualitative Study.
175

The Differentiation Of Emotions Of Shame And Guilt In Adolescents With Maternal Breast Cancer

Kacmaz, Lale Belgu 01 September 2011 (has links) (PDF)
This study aimed at revealing and differentiating the emotions of shame and guilt felt by the adolescents with maternal cancer. In order to reveal and differentiate these emotions, a sentence completion task and interviews were used. The study was conducted on 10 adolescents in age range of 16-20. With each participant, four private sessions were made. In the first session, the participant&rsquo / s knowledge of his/her mother&rsquo / s condition was evaluated through the Sentence Completion Test. In the second session, Pandora&rsquo / s Box, a film by Yesim Ustaoglu was watched with the participant to understand if the film evoked the targeted emotions and the second format of Sentence Completion Test was given. In the third session, 20 minute interviews were conducted with the participant, privately. These interviews were called &ldquo / interventions&rdquo / because they aimed to intervene to the process of feeling guilty and ashamed and replace them with a positive self-conscious emotion pride. The fourth and final session was conducted after one week and aimed to check if the anticipated affect of film and interventions lasted. Only 3 participants out of 10 returned for the fourth session, so the fourth session was left out of the analysis. Two main analyses were conducted in the current study. The frequencies of shame and guilt were examined in the Sentence Completion Test analysis and the interviews were analysed qualitatively. The outcome resulted that in both Sentence Completion Test and interview analysis, the adolescents with maternal cancer revealed emotions of shame and guilt. Furthermore, in the Sentence Completion Test analysis, it was tested whether the frequency of emotions of shame and guilt increased or decreased by the intervention of the film and interviews and the outcome yielded that neither the film Pandora&rsquo / s Box nor the interventions made any significant effect. The results were evaluated and the implications were discussed. Finally, limitations of the study and recommendations for future research were explained.
176

Romantic Mediacy, Self-Consciousness and the Ideologies of Authorship

Jon, Bumsoo 2012 August 1900 (has links)
How did Romantic poets react to Wordsworth's preoccupation with immateriality, an illusion of poetic experiences in which the form of poetry itself becomes ironically unnecessary? To what extent is Romantic poetry involved with a counter-tradition of self-exposure, with an awareness of literary experience and meaning as essentially inseparable from its physical form? To address these questions, my dissertation looks in three directions: first, at the evidence of contradictions in Coleridge's lyric poems and, second, at Keats's reflexive alertness to the techniques that Wordsworth often uses to achieve the lyric effects of immediacy and, third, at the changing nature of the Romantic notions of the self and the materiality of text in the wake of Charlotte Smith's experiment with paratext. Chapter I explores the critical implications of Wordsworth?s emphasis on the mind and individual subjectivity, which involves a myth of Romanticism that genuine poetry can be attained when its production and existence in the material world become paradoxically invisible. Examining the publishing history of Coleridge's poems of poetic failure, and his conflicting motives for re-writing them, Chapter II argues that Coleridge's self-conscious poems have been considered, erroneously, in terms of a deeply private genre in which the poet describes a moment of personal crisis involved with the breakdown of his creative power. In Chapter III, I show how Keats debunks Wordsworthian notions of solitary authorship in the Hyperion poems via his persistent references to the act, artifice and materiality of writing. Reading Beachy Head as a challenge to the Romantic fiction of a unified self, Chapter IV argues that Smith's preoccupation with print apparatuses and discursive modes highlights her refusal to integrate the competing voices and styles she displays in the poem, preventing readers from easily associating the hybrid poetic persona with her earlier lyric ethos. Chapter V builds on the concept of hypermediacy, an awareness and artistic representation of mediation, in order to argue that the ways in which Coleridge, Keats and Smith represent the act, process and materiality of writing indicate a counter-tradition in Romantic literary culture that challenges the predominant Wordsworthian logic of immateriality.
177

Être et altérité : l'ontologie dans la pensée d'Emmanuel Lévinas / Being and alterity : The Ontology in the thought of Emmanuel Levinas

Sadikoglu, Ali Sait 07 September 2017 (has links)
La notion d’éthique apparaît chez Emmanuel Lévinas à travers la critique de l’ontologie de Martin Heidegger et de la phénoménologie d’Edmund Husserl. Dans cette dimension de l’éthique, deux catégories s’imposent : le Même et l’Autre. Elles jouent toutes deux un rôle primordial. Pourtant, chez Lévinas, apparaît une tendance ontologique, lorsqu’il doit penser la notion du Même et de l’Autre, puisque ces deux notions renvoient à une certaine appropriation de l’être et de l’étant. Ainsi, dans notre recherche sur la pensée de Lévinas, nous essaierons d’expliciter son ontologie. Pour cela, nous commencerons par décrire la conception lévinasienne du monde et du corps. Puis, sur le fondement du monde et du corps, nous décrirons la notion de la subjectivité par le biais d’autres notions comme « l’il y a », la sensibilité, le langage, le temps et Dieu. Nous expliquerons alors leur rapport fondateur en tant que celui-ci constitue la notion de la subjectivité. Ces notions, en effet, justifient notre intérêt porté à l’ontologie de Lévinas et à ses éléments canoniques que sont les ontologies du Même et de l’Autre. A la suite de notre interrogation sur ces deux ontologies, nous décrirons le rôle fondateur de l’ontologie de l’Autre dans le domaine de l’éthique. Enfin, nous expliciterons le sens de l’éthique grâce à l’analyse des notions de mauvaise conscience et de volonté qui permettent de comprendre plus avant l’ontologie de l’Autre. / In Emmanuel Levinas’s work, the concept of ethics appears through a critique of the ontology of Martin Heidegger and the phenomenology of Edmund Husserl. In the dimension of ethics the two categories of the Same (Même) and Other (Autre) play primordial roles. At the same time, we find in Levinas’s philosophical discourse an ontological tendency whenever he must consider the concepts of Same and Other, because they recourse to a certain appropriation of existence and the existent. Thus, in our research on Levinas’s thought, we have tried to clarify his ontology in all of its specificity. To bring this specificity to light, we start by describing the concepts of the world and the body. Then, based on these two notions, we describe the notion of subjectivity with other principal concepts such as “the there is” (“l’il y a”), sensitivity, language, time, and God. Their fundamental relationship is explained in a way such that they produce subjectivity. These considerations effectively build up to our principal interest, which is to focus directly upon the particular ontology of Levinas, with its constitutive parts of Same and Other. Drawing upon the philosophical outcomes of our interrogation of these notions, we describe the fundamental role of the ontology of the Other for the meaning of the ethics. The final sections of the text continue this theme by considering the concepts of the guilty conscious and the will.
178

Reoression, Defense Mechanisms and the Unreliability of Stevens' Narration in the Remains of the Day

Guo, Lulu January 2018 (has links)
This essay argues that repression and defense mechanisms contribute to the unreliability of Stevens’ narrationthrough three aspects: Stevens’ uncertainty of certain memories, his failure to report certain scenescorrectly and his defensive, self-contradictory discourse. There is no single best way to define what is consideredreliable and what is unreliable in narratology because the complexity of fictional characters will renderdifferent kinds of unreliability. This essay detects three kinds of unreliability of Stevens corresponding to thethree aspects mentIoned above: the first kind results from the untrustworthiness of our memory, the secondkind is the contradiction between the voice of the narrator and the other characters and the third kind lieswithin the narrative discourse. The unreliability of Stevens’ narration attributes to repression and defensemechanisms. The five kinds of defense mechanisms analyzed in the essay are selective memory, denial,projection, reaction formation and rationalization. In order to defend his self-image as a great butler, Stevenslies to or hides from himself and tries to avoid acknowledging certain undesirable thoughts or emotions. Eventhough Stevens becomes more reliable as he gains more self-realization during the road trip, his defensesare still on.
179

Análise das ações e práticas de um programa de Educação Ambiental e a perspectiva dos sujeitos sociais atendidos / Analysis of actions and practices of an environmental education program and the prospecto of social subjects served

Vieira, Tamara de Barros 29 May 2012 (has links)
Made available in DSpace on 2015-03-26T13:19:51Z (GMT). No. of bitstreams: 1 texto completo.pdf: 3393820 bytes, checksum: cb0615fe62c5579b9d749caf56bd096f (MD5) Previous issue date: 2012-05-29 / This study was based on the need to analyze the actions and practices of a socioenvironmental education program in order to investigate the level of involvement of social subjects treated, and identify if they are taking environmentally friendly actions at home, involving those who live with them, and consider whether the program provides improved quality of life for employees. We also intend to investigate the consumption indicators and targets proposed by the program. It is noteworthy that little is known about how the program is influencing social life (family) and institutional (at work) of the people involved in it, in which case, are the employees of public buildings. Thus, there is no research to show its impact on social subjects involved, emphasizing even more the importance of this study. Main objective was to analyze a program of socioenvironmental education from the perspective of users, as well as consumption indicators and proposed targets are being achieved. In order to achieve the proposed objectives, we used the method of exploratory research that aims to engage the literature and interviews with people who have had practical experience with the problem studied. Also adopt a descriptive, since this is the primary objective description of the characteristics of a given population. Are included in this group research that aims to raise their opinions, attitudes and beliefs of civil servants in the city of Belo Horizonte working in the State System Environment. The research approach was qualitative and quantitative since the data collection and analysis were carried out from social interactions between the researcher and the phenomenon under study. The data from the Integrated Management System Ambiance were systematized and subjected to statistical analysis, using graphs and tables, being prepared / compiled statistical models most suitable for the analysis of consumption indicators in the institution. In the first stage, an exploratory phase, data were collected, documents, photographs, and reports in order to build the history of the Atmosphere Program. This step consisted in the organization, description and analysis of all information obtained in order to characterize the trajectory of experience of the Program. Next, we applied a structured interview to verify the expectations, perceptions, involvement and satisfaction of social subjects covered by the Program Atmosphere. / Este estudo pautou-se na necessidade de analisar as ações e práticas de um programa de educação socioambiental, de forma a investigar o nível de envolvimento dos sujeitos sociais atendidos, além de identificar se eles estão tendo atitudes ambientalmente corretas no ambiente doméstico, envolvendo aqueles com quem convivem, além de analisar se o Programa proporciona a melhoria da qualidade de vida aos funcionários. Também pretendeu-se investigar os indicadores de consumo e as metas propostas pelo Programa. Vale ressaltar, que pouco se sabe a respeito de como o Programa está influenciando a vida social (ambiente familiar) e institucional (no trabalho) das pessoas envolvidas, que, no caso, são os funcionários dos prédios públicos. Assim sendo, não existem pesquisas que comprovem seu impacto para os sujeitos sociais envolvidos, ressaltando-se, ainda, mais, a importância deste estudo. Como objetivo geral teve-se a análise de um Programa de educação socioambiental na perspectiva dos usuários, bem como se os indicadores de consumo e as metas propostas estão sendo alcançados. Com o intuito de alcançar os objetivos propostos, utilizou-se o método de pesquisa exploratória que visa envolver o levantamento bibliográfico e entrevistas com pessoas que tiveram experiências práticas com o problema pesquisado. Também foi adotada a pesquisa descritiva, uma vez que esta tem como objetivo primordial a descrição das características de determinada população. São incluídas neste grupo as pesquisas que têm por objetivo levantar as opiniões, atitudes e crenças dos funcionários públicos da cidade de Belo Horizonte, MG, que trabalham no Sistema Estadual de Meio Ambiente. A abordagem da pesquisa foi qualitativa e quantitativa, uma vez que a coleta e análise de dados foram realizadas a partir de interações sociais entre o pesquisador e o fenômeno de objeto de estudo. Os dados provenientes do Sistema Integrado de Gestão AmbientAÇÃO foram sistematizados e submetidos à análise estatística descritiva, por meio de gráficos e tabelas, sendo elaborados/compilados modelos estatísticos mais adequados para a análise dos indicadores de consumo na instituição. Na primeira etapa, em uma fase de caráter exploratório, foram levantados dados, documentos, registros fotográficos, além de relatos para construir a história do Programa AmbientAÇÃO. Esta etapa consistiu na rganização, descrição e análise de todas as informações obtidas, visando caracterizar a trajetória de experiências do Programa. Em seguida, aplicou-se uma entrevista estruturada para constatar as expectativas, as percepções, o envolvimento e a satisfação dos sujeitos sociais atendidos pelo Programa AmbientAÇÃO.
180

Eficácia da sedação intranasal com midazolam e cetamina no controle comportamental de crianças submetidas a tratamento odontológico: ensaio clínico randomizado / Effectiveness of intranasal sedation with midazolam and ketamine in the behavior management control of children undergoing dental treatment: randomized clinical trial

Sado Filho, Joji 13 March 2017 (has links)
Submitted by Erika Demachki (erikademachki@gmail.com) on 2017-04-05T21:16:41Z No. of bitstreams: 2 Dissertação - Joji Sado Filho - 2017.pdf: 5994690 bytes, checksum: 2a60faf14b700ecba0cd47970099e8f8 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2017-04-06T15:04:55Z (GMT) No. of bitstreams: 2 Dissertação - Joji Sado Filho - 2017.pdf: 5994690 bytes, checksum: 2a60faf14b700ecba0cd47970099e8f8 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2017-04-06T15:04:55Z (GMT). No. of bitstreams: 2 Dissertação - Joji Sado Filho - 2017.pdf: 5994690 bytes, checksum: 2a60faf14b700ecba0cd47970099e8f8 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2017-03-13 / Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq / During dental treatment of children, basic or advanced behavior guidance techniques can be used. Advanced techniques, non-pharmacological (protective stabilization) or pharmacological (sedation and general anesthesia), are indicated when there is no success with the basic techniques. Regarding advanced techniques, sedation has been increasingly widespread in pediatric dentistry, although the evidence is still weak about which sedative regime provides the greatest comfort and the lowest risk. In view of this need to identify the best sedative regimen, the objective of this randomized, masked, controlled, parallel-design trial was to evaluate the effectiveness of intranasal sedation with Midazolam and Ketamine in behavioral control of preschool children undergoing dental treatment. Eighty-four preschoolers, aged between 1.5 and 6 years old, with dental caries and non-cooperative behavior in previous dental treatment, were randomized into three groups: (1) Midazolam and Ketamine intranasally (MKI); (2) Midazolam and oral ketamine (MKO); (3) Oral midazolam. In all groups, the sedative was administered by a pediatrician or anesthesiologist, and the children received restorative treatment under local anesthesia and rubber dam isolation. Dental treatment was performed by pediatric dentists who, in the end, classified child behavior through the Frankl scale. The training sessions were videotaped, and the videos were then analyzed by trained and calibrated researchers to assess behavior using the Ohio State University Behavioral Rating Scale (OSUBRS) scale. The need to discontinue care and to use protective stabilization was recorded. The data obtained were organized and analyzed in the software Statistical Package for Social Sciences (SPSS). The statistical analysis involved the description of the data and bivariate tests, considering a level of significance of 5%. Considering as a parameter for sedation success the "positive" or "definitely positive" behavior verified with the Frankl scale, the following rates were observed: MKI - 50.0%; MKO - 64.3% and MO - 28.6%. Success rates differed significantly between MKO compared to MKI and MO (P = 0.03). When comparing the groups in relation to the behavior evaluated by the OSUBRS scale, no statistically significant difference was observed in the frequency of "quiet" (P = 0.22), "movement without crying" (P = 0.69) and "combative (P = 0.30). The groups did not differ in assessing the number of cases in which there was a "quiet" behavior in at least 51.7% (median) of the session duration (P = 0.27) and in the number of cases in which the child was "combative" "In at least 24.5% (median) of the session duration (P = 0.65). The need to suspend treatment (P = 0.69) and use protective stabilization (P = 0.14) did not differ significantly among the three groups. The results of behavior evaluation using the Frankl and OSUBRS scale were strongly correlated (rho = -0.84, P0.01). From these results, it was concluded that the sedative protocol MKO presented a higher success rate in behavioral control when compared to the other groups (MKI and MO). The combination of Midazolam and Ketamine, regardless of route of administration, was more effective in controlling behavior than Midazolam given alone. Therefore, the use of the combination of Midazolam and Ketamine, both orally and intranasally, is an effective alternative for controlling the behavior of non-collaborating preschoolers. / Durante o atendimento odontológico de crianças, podem ser utilizadas técnicas básicas ou avançadas de controle do comportamento. As técnicas avançadas, não farmacológicas (estabilização protetora) ou farmacológicas (sedação e anestesia geral), são indicadas quando não há sucesso com as técnicas básicas. Em relação às técnicas avançadas, a sedação tem sido cada vez mais difundida na odontopediatria, embora as evidências ainda sejam fracas sobre qual regime sedativo proporciona o maior conforto e menor risco. Diante dessa necessidade de se identificar o melhor regime sedativo, o objetivo deste ensaio clínico randomizado, mascarado, controlado e de delineamento paralelo foi avaliar a eficácia da sedação intranasal com Midazolam e Cetamina no controle comportamental de crianças pré-escolares submetidas a atendimento odontológico. Oitenta e quatro pré-escolares, com idade entre 1,5 e 6 anos, com cárie dentária e comportamento não colaborador em atendimentos odontológicos anteriores, foram randomizados em três grupos: (1) Midazolam e Cetamina por via intranasal (MKI); (2) Midazolam e Cetamina por via oral (MKO); (3) Midazolam por via oral. Em todos os grupos, o sedativo foi administrado por um médico pediatra ou anestesiologista, e as crianças receberam tratamento restaurador sob anestesia local e isolamento absoluto. O tratamento odontológico foi realizado por odontopediatras que, ao final, classificaram o comportamento infantil por meio da escala de Frankl. As sessões de atendimento foram filmadas e, posteriormente, os vídeos foram analisados por pesquisadores treinados e calibrados a fim de se avaliar o comportamento usando a escala Ohio State University Behavioral Rating Scale (OSUBRS). A necessidade de suspender o atendimento e de utilizar estabilização protetora foi registrada. Os dados obtidos foram organizados e analisados no software Statistical Package for Social Sciences (SPSS). A análise estatística envolveu a descrição dos dados e testes bivariados, considerando-se um nível de significância de 5%. Considerando-se como parâmetro para sucesso da sedação o comportamento “positivo” ou “definitivamente positivo” verificado com a escala de Frankl, foram observadas as seguintes taxas: MKI – 50,0%; MKO – 64,3% e MO – 28,6%. As taxas de sucesso diferiram significativamente entre MKO em comparação com MKI e MO (P = 0,03). Ao se comparar os grupos em relação ao comportamento avaliado pela escala OSUBRS, não foi observada diferença estatisticamente significativa na frequência de comportamentos “quieto” (P=0,22), “movimento sem choro” (P=0,69) e “combativo” (P=0,30). Os grupos não diferiram ao se avaliar o número de casos em que houve comportamento “quieto” em pelo menos 51,7% (mediana) da duração da sessão (P=0,27) e número de casos em que a criança ficou “combativa” em, pelo menos, 24,5% (mediana) da duração da sessão (P=0,65). A necessidade de suspender o atendimento (P=0,69) e de utilizar estabilização protetora (P=0,14) não diferiu significativamente entre os três grupos. Os resultados da avaliação do comportamento por meio da escala de Frankl e da OSUBRS foram fortemente correlacionados (rho = -0,84, P≤0,01). A partir destes resultados conclui-se que o protocolo sedativo MKO apresentou maior taxa de sucesso no controle comportamental, quando comparado aos outros grupos (MKI e MO). A combinação de Midazolam e Cetamina, independentemente da via de administração, foi mais eficaz para o controle do comportamento que o Midazolam administrado isoladamente. Sendo assim, o uso da associação Midazolam e Cetamina, tanto por via oral, quanto intranasal, é uma alternativa eficaz para o controle do comportamento de pré-escolares não colaboradores.

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