Lyme disease is the most common tick-borne illness in North America. It can be hard to detect using blood tests, especially in the early stage. Due to the number of significant complications from untreated or undertreated Lyme disease, better methods need to be found to detect the disease. Some surface lipoproteins may be used to detect early disease due to their early expression. Others are maintained for the duration of the infection and can be used to detect chronic Lyme disease. Antibody responses to OspA, OspC and OspE were measured in sera from experimentally infected dogs. The response to OspA was only detectable in a few samples and did not appear to be sensitive for mammalian infections. A protein construct based on multiple epitopes of OspC was used to detect an antibody response starting three weeks after initial infection, and remained detectable for three months. As the response to OspC decreased, OspE could be used to detect an antibody response from three to six months after the initial infection. Because of the strength and the differences in timing of the antibody responses, OspC and OspE could be used to design an accurate blood test for Lyme disease that also indicates early and late stages of infection based on the results.

Lyme disease (LD) is the leading arthropod-borne disease in North America with 300-600,000 cases each year. There are currently no approved human LD vaccines. Outer surface protein C (OspC) has emerged as a leading vaccine candidate and an attractive diagnostic marker due to its antigenicity and expression early in infection. Several chimeric, epitope based OspC derived proteins were generated. The constructs were found to be highly immunogenic in mice and vaccination induced complement-dependent bactericidal antibodies. These results suggest that a broadly protective polyvalent OspC epitope based vaccine can be produced. Currently, LD diagnostic approaches are unreliable and unable to differentiate between early and late stage disease. An Ab response to OspE family proteins occurs later in infection. The two-Ag diagnostic assay using chimeric OspC proteins and a site-directed mutant of an OspE paralog, accurately differentiated between early and late infection in experimentally infected canines and humans.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-08-29T23:14:02Z No. of bitstreams: 1 RodrigoTrigueiroMoraisDePaiva_DISSERT.pdf: 947502 bytes, checksum: 46696e1ac3fa61305da439442086a02d (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-09-06T23:15:56Z (GMT) No. of bitstreams: 1 RodrigoTrigueiroMoraisDePaiva_DISSERT.pdf: 947502 bytes, checksum: 46696e1ac3fa61305da439442086a02d (MD5) / Made available in DSpace on 2016-09-06T23:15:56Z (GMT). No. of bitstreams: 1 RodrigoTrigueiroMoraisDePaiva_DISSERT.pdf: 947502 bytes, checksum: 46696e1ac3fa61305da439442086a02d (MD5) Previous issue date: 2015-12-30 / Introdu??o: Objective Structured Practical Examination (OSPE), ? um m?todo de avalia??o de habilidades pr?ticas que utiliza de ambiente simulado e controlado, de efici?ncia comprovada no processo ensino-aprendizagem. O internato de Cirurgia Geral do curso de medicina da UFRN ainda necessita de adequa??es quanto ? avalia??o de habilidades em ambiente simulado, sendo essa uma demanda dos estudantes. A UFRN disp?e de Laborat?rio de Habilidades Cl?nicas, contudo observa-se que ainda ? pouco utilizado por docentes e discentes e a avalia??o estruturada de habilidades ainda n?o est? devidamente estruturada nas ?reas cir?rgicas. Metodologia: foi proposta a elabora??o de 10 protocolos contendo as listas de materiais para montagem de cen?rios e checklists de 10 esta??es de OSPE. A seguir foram selecionadas 04 esta??es e aplicadas a 32 estudantes do internato de Cirurgia Geral, onde estes al?m de serem avaliados, desempenharam, em algum momento da atividade, os pap?is de estudante ?avaliador? e ator/figurante. Um question?rio foi aplicado para avaliar este tipo de atividade na perspectiva destes estudantes do internato. Resultados: os10 protocolos referentes ?s esta??es de I a X, foram elaborados e ficar?o sob a responsabilidade da coordena??o do Laborat?rio de Habilidades da UFRN. Na atividade realizada, as notas dos checklists dos professores e estudantes ?avaliadores? mostraram uma associa??o moderada em duas esta??es (R = 0,70 e p=0,012) e (R = 0,44 e p=0,152) e uma ssocia??o forte nas outras duas esta??es (R = 0,79 e p=0,002) e (R = 0,78 e p=0,003). Os estudantes avaliaram positivamente a atividade nos tr?s blocos do question?rio: grau de satisfa??o em rela??o ? avalia??o, avalia??o com rela??o ?s esta??es e avalia??o sobre sua participa??o na atividade. Conclus?o: a realiza??o de avalia??o pelo m?todo OSPE apresenta requisitos estruturais favor?veis para sua implanta??o na avalia??o dos estudantes do curso de medicina da UFRN, reestruturando a avalia??o de habilidades no internato de cirurgia geral. / Introduction: Objective Structured Practical Examination (OSPE) is a method of assessment of practical skills using simulated and controlled environment, widely used in the teaching-learning worldwide. UFRN has Clinical Skills Laboratory, however the skills assessment is not yet properly structured in surgical areas, this is a demand of the students. Objectives: The general objective of this study is to implement the method Objective Structured Practical Examination (OSPE) as an evaluation tool in General Surgery of medical school UFRN, and to evaluate the use of the method from the perspective of students of the boarding school. Methodology: The strategy was divided into two stages: the first were prepared and / or revised 10 stations OSPE, including lists of material for assembly of each scenario and their checklists. A test with some stations was carried out with the boarding school teachers of general surgery, residents of surgical areas for adjustments. In the second stage, four stations were selected and applied to two groups of 16 students of General Surgery internship, on two separate occasions, where they were evaluated, also playing the role of evaluator of colleagues. At the end of the activity a questionnaire was used to evaluate the activity from the perspective of students. Results: 10 stations drawn up the list of materials will be under the responsibility of coordination of the Skills Laboratory of UFRN. In the seasons application stage, the marks awarded by teachers and students "evaluators" have shown a strong association in two seasons: intubation (R = 0.79 and p = 0.002) and exchange gastrostomy tube (R = 0.78 p = 0.003). This association was also observed, although moderate, in the thoracic puncture stations for decompression of tension pneumothorax (R = 0.70 and p = 0.012) and suture face and knowledge of materials needed for its realization. (R = 0.44 and p = 0.152). Students positively evaluated the activity questionnaire in the three blocks: degree of satisfaction with the assessment, as the seasons and evaluation of their participation in the activity. Conclusion: The use of OSPE, as proposed, has structural and technical favorable conditions and a faculty qualified for its implementation in the evaluation of skills in General Surgery of students of medical school UFRN, thereby qualifying the evaluation system in this area.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-07-26T20:50:39Z No. of bitstreams: 1 AdemarAlexandreDeMorais_DISSERT.pdf: 3935521 bytes, checksum: 00b3deb50f3fbc802c3f664e7d1ba391 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-08-08T22:41:20Z (GMT) No. of bitstreams: 1 AdemarAlexandreDeMorais_DISSERT.pdf: 3935521 bytes, checksum: 00b3deb50f3fbc802c3f664e7d1ba391 (MD5) / Made available in DSpace on 2016-08-08T22:41:20Z (GMT). No. of bitstreams: 1 AdemarAlexandreDeMorais_DISSERT.pdf: 3935521 bytes, checksum: 00b3deb50f3fbc802c3f664e7d1ba391 (MD5) Previous issue date: 2015-12-15 / Diversos estudos t?m demonstrado que o residente exerce informalmente o papel de docente. Estima-se que at? 25 % do tempo dos residentes ? dedicado ao ensino, contribuindo principalmente como facilitador. Apesar dessa contribui??o, a quase totalidade dos programas de resid?ncia m?dica do Brasil n?o oferecem capacita??o docente, justamente o inverso que ocorre em programas de demais pa?ses, sobretudo Am?rica do Norte e Europa. Este trabalho tem como objetivo elaborar uma estrat?gia de capacita??o pedag?gica do residente que possa ser inserida formalmente na estrutura curricular do programa de resid?ncia m?dica do HUOL. Trata-se de estudo explorat?rio, prospectivo e descritivo, realizado HUOL da Universidade Federal do Rio Grande do Norte. Tr?s etapas foram idealizadas: (1) elabora??o e planejamento de um workshop de capacita??o pedag?gica para o residente, associado a um conte?do t?cnico motivador (suporte b?sico e a avan?ado ? vida); (2) primeira interven??o com estudantes do curso de medicina e residentes, para testagem do modelo pedag?gico escolhido, proporcionando ajustes no planejamento para a interven??o com residentes; e (3) segunda interven??o com replica??o do curso para residentes. Nas interven??es foram feitas duas esta??es de pr?tica de suporte ? vida com a avalia??o do desempenho em atividade pr?tica atrav?s do OSPE (Objective and Structured Practical Examination). A capacita??o pedag?gica foi pautada na t?cnica de ensino preceptoria minuto e feedback. A avalia??o de desempenho nas esta??es foi feita atrav?s de um checklist e das demais atividades da capacita??o, atrav?s de uma ficha de avalia??o preenchida no final do curso. As esta??es de suporte ? vida foram bem avaliadas pelos participantes nas duas interven??es e permitiu o ensino da t?cnica de feedback positivo e corretivo. A t?cnica de preceptoria minuto foi feita atrav?s de dramatiza??o, aula expositiva dialogada e v?deos. As duas t?cnicas de ensino foram avaliadas como importante para o aprendizado e ensino. Aspectos positivos citados pelos participantes foram mais relacionados a interven??o pedag?gica, do que ao conte?do t?cnico. Assim acreditamos que a estrat?gia de workshop de capacita??o pedag?gica elaborada para os residentes foi fact?vel e bem aceita pelos participantes. Assim, tais conte?dos pedag?gicos representam uma op??o para inser??o pioneira no curr?culo formal dos programas de resid?ncia m?dica do HUOL. / Studies have shown that resident informally plays the role of teacher. It is estimated that up to 25% of the residents of the time is devoted to teaching, mainly contributing as a facilitator, however, almost the entire medical residency programs in Brazil did not offer teacher training during residency education. This paper aims to introduce educational content initiation to teaching as part of the training of resident physician inserted in residency program of the University Hospital Onofre Lopes (HUOL). It is an exploratory, descriptive and prospective study in HUOL the Federal University of Rio Grande do Norte. Three steps were developed: preparation and planning of a pedagogic course, associated with a motivating technical content (basic and advanced life support); second stage, testing of pedagogical model for medical students; and finally, replication to residents. The interventions were made two practice stations life support with performance evaluation in practical activity through OSPE (Objective Structured Practical Examination). The techniques presented teachings were one-minute preceptor and feedback. Data collection was conducted through a structured evaluation form during the life support stations and at the end of the course, and analyzed using descriptive statistics. The results showed that the feedback and one minute preceptor were considered important for teaching and learning for more than 85% of participants. The feedback from evaluators practices stations added information about the performance and were held appreciatively way, according to 100% of the participants. Positive aspects highlighted by the participants were related to educational content, especially the participants of the first intervention. The time of the lectures of motivating technical content was the most repeated negative. Based on the good acceptance of pedagogical contents, this pioneer teacher training strategy was included in the formal residency program in Cardiology of our institution. It is considered therefore that the educational training model with motivating technical content was feasible and had a good evaluation and acceptance by most participants in both interventions. Thus, we believe that the educational content can be inserted in the formal curriculum of medical residency of other programs at HUOL through the training model developed in this study.