Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2015-04-24T12:29:01Z No. of bitstreams: 1 467624 - Texto Completo.pdf: 849321 bytes, checksum: 4d7bfa11b11f24f27c071bc7123e3801 (MD5) / Made available in DSpace on 2015-04-24T12:29:01Z (GMT). No. of bitstreams: 1 467624 - Texto Completo.pdf: 849321 bytes, checksum: 4d7bfa11b11f24f27c071bc7123e3801 (MD5) Previous issue date: 2014-12-08 / Conselho Nacional de Pesquisa e Desenvolvimento Cient?fico e Tecnol?gico - CNPq / The objective of this dissertation was to analyze some aspects related to the Roux-en-Y gastric bypass (RYGB) surgery access routes such as health effects, costs and possible diffusion of laparoscopy to the Brazilian National Public Health System (BNPHS). So, two papers were presented, aiming the comparison of the economic evaluation of both surgical routes (laparoscopy and laparotomy) and the evaluation of a possible diffusion rate of laparoscopy in the BNPHS. Article 1 was entitled "Systematic Review of the Economic Evaluation of Laparotomy versus Laparoscopy for Patients Who Underwent Roux-en-Y gastric bypass (RYGB) surgery" and aimed to analyze the cost-effectiveness of laparoscopic and laparotomic routes. The electronic databases used were MEDLINE, Embase, Scopus, Cochrane and Lilacs. From the 494 articles found, 6 met the inclusion criteria. All studies were published between 2001 and 2008 in the United States (USA). Three studies met less than half of the items that assessed the quality of results; two met five of the necessary items, and only one study met seven of 10 items. Five studies considered laparoscopic surgery the dominant strategy, because they presented higher clinical benefits (less likelihood of postoperative complications, shorter hospitalization) and lower total cost. This evaluation indicates that laparoscopy is a safe and well tolerated technique, although surgery costs are higher compared to laparotomy. However, the additional costs are offset by lower probability of complications after surgery. Article 2 was entitled "Implementing Laparoscopy in Brazil?s National Public Health System (BNPHS) ? the Bariatric Surgeons? point of view? and aimed to estimate 1) whether bariatric surgeons would support eventual incorporation of laparoscopy to the BNPHS; 2) whether there would be an increase in the total number of operations in case of availability of this option of access route; and 3) how would the redistribution of these two operation routes be. Using the Delphi method, we enlisted a panel of bariatric surgeons who answered a questionnaire previously developed for this purpose. In order to get a better consensus, two rounds were held. Of the 45 surgeons who attended a national event, 30 (66.7%) answered the Delphi questionnaire, which corresponded to the first round of the study. In the second, the final, round, 22 (48.9%) out of the 30 surgeons answered the questionnaire. Considering the possibility of incorporating the laparoscopic route in the BNPHS, approximately 95% of surgeons have expressed interest in choosing it. If the operation by laparoscopy was incorporated into the BNPHS, there would be a total average increase of 25% in the number of surgeries performed. So, in this new configuration system, the distribution of surgical procedures would be as follow: 62.5% and 37.5% by laparoscopy and laparotomy respectively. In conclusion 1) there was preference for laparoscopic route; 2) there would be an increase in the number of surgeries performed; and 3) the distribution of surgical procedures would be 62.5% by laparoscopy and 37.5% by laparotomy. / O objetivo dessa tese foi analisar os aspectos relacionados ?s vias de acesso da cirurgia bari?trica Bypass Gastrointestinal em Y de Roux (RYGB) referentes a efeitos em sa?de, custos e eventual taxa de difus?o da laparoscopia no Sistema ?nico de Sa?de (SUS). Para tanto, dois artigos s?o apresentados, visando ? avalia??o econ?mica das vias de acesso por laparoscopia e laparotomia, e a estimativa de eventual taxa de difus?o da laparoscopia no SUS. O artigo 1 intitulou-se ? Revis?o Sistem?tica de Avalia??o Econ?mica da Laparotomia versus Laparoscopia para Pacientes Submetidos ao Bypass Gastrointestinal em Y de Roux (RYGB)? e teve como objetivo analisar o custo-efetividade da cirurgia por acesso laparosc?pico e laparot?mico. Foram utilizadas as bases de dados eletr?nicas MEDLINE, Embase, Scopus, Cochrane e Lilacs. De 494 artigos, 6 preencheram os crit?rios de inclus?o. Todos os estudos foram publicados entre 2001 e 2008 nos Estados Unidos (EUA). Tr?s estudos preencheram menos de metade dos ?tens que avaliaram a qualidade dos resultados; dois preencheram 5 dos ?tens necess?rios, e apenas um estudo preencheu sete dos 10 ?tens. Cinco estudos consideraram a cirurgia por laparoscopia a estrat?gia dominante, pois apresentaram maiores benef?cios cl?nicos (menos probabilidade de complica??es p?s-cir?rgicas, menor tempo de interna??o) e menor custo total. Esta avalia??o indica que a laparoscopia ? uma t?cnica segura e bem tolerada, apesar de os custos da cirurgia serem maiores quando comparados com a laparotomia. No entanto, os custos adicionais s?o compensados pela menor probabilidade de complica??es ap?s a cirurgia e, conseq?entemente, evitando os seus custos. No artigo 2 intitulou-se ?Ades?o dos Cirurgi?es Bari?tricos ? Laparoscopia no Sistema ?nico de Sa?de do Brasil? e teve como objetivos estimar se os cirurgi?es bari?tricos apoiariam eventual incorpora??o da opera??o por via laparosc?pica no SUS; se haveria incremento no n?mero total de opera??es caso houvesse esta nova op??o de via de acesso; e como seria a redistribui??o da oferta de opera??es pelas duas vias. Com o m?todo Delphi, foi constru?do um painel de especialistas, em que cirurgi?es bari?tricos responderam um question?rio previamente desenvolvido para esse fim. Foram realizadas duas rodadas, no intuito de melhor consenso. Dos 45 cirurgi?es que estiveram presentes no evento nacional, 30 (66,7%) participaram do question?rio Delphi, o que correspondeu ? primeira rodada do estudo. Na segunda, e ?ltima rodada, dos 30 respondentes da primeira etapa, 22 (48,9%) cirurgi?es responderam. Mediante a possibilidade de incorpora??o da via laparosc?pica no SUS, aproximadamente 95% dos cirurgi?es manifestaram interesse em realiz?-la. Caso a opera??o por laparoscopia fosse incorporada no SUS, haveria incremento m?dio no n?mero de opera??es na ordem de 25%; nesta nova configura??o, a oferta de procedimentos cir?rgicos estaria distribu?da da seguinte forma: 62,5% por laparoscopia e 37,5% por laparotomia. Concluiu-se que: 1) Houve prefer?ncia pela via laparosc?pica; 2) haveria incremento no n?mero de opera??es comparado ao modelo atual em que apenas a via laparot?mica est? dispon?vel aos usu?rios do sistema p?blico; e 3) a distribui??o em rela??o ao tipo de procedimento seria de 62,5% por laparoscopia e 37,5% por laparotomia.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2015-06-03T17:21:09Z No. of bitstreams: 1 469956 - Texto Parcial.pdf: 108495 bytes, checksum: b30cb1fb39e91dfd223ddaf3ce7c9496 (MD5) / Made available in DSpace on 2015-06-03T17:21:09Z (GMT). No. of bitstreams: 1 469956 - Texto Parcial.pdf: 108495 bytes, checksum: b30cb1fb39e91dfd223ddaf3ce7c9496 (MD5) Previous issue date: 2015-03-20 / In recent years, there have been significant changes in the socioeconomic and health conditions of the population and hence the demographic structure, resulting in a significant growth of the elderly population and causing an increased risk of acquiring neurological and psychiatric diseases. Among the psychiatric illness, bipolar disorder is responsible for a significant portion of the functional impairment around the world. However, international data show that affective disorders have a prevalence of approximately 11.3% of the population, or up to 25% of the elderly. Furthermore, it is one of the diseases that generates and social losses in family relationships, which can lead to suicide in approximately 15% of patients. The aim of this study was to evaluate the prevalence of Bipolar Affective Disorder (BD) in a random sample of elderly attended by the Family Health Strategy (Estrat?gia Sa?de da Fam?lia, ESF) in Porto Alegre. The study is cross-sectional with prospective data collection. The sample consisted of 550 randomly selected elderly 30 Family Health Teams in the Municipality of Porto Alegre (ESF / POA) randomized stratified mode for district. For diagnoses, psychiatrists with experience in assessment of older adults used the diagnostic criteria of DSM-5. Regarding the results: a total of 5.8% (n = 32) of the sample subjects presented the Bipolar Affective Disorder, 59.4% (n = 19) diagnosed with type I and 40.6% (n = 13 ) type II. Of this total, 1.5% (n = 8) have current frame TAB and 4.4% (n = 24) TAB board in the past. Among seniors who had the disorder, some significant associations can be highlighted: with suicide attempt in life (21.6%; p = 0.001) with the risk of suicide (15.7%; p = 0.001) and an association borderline between the elderly having a partner with TAB (8.3%; p = 0.053). Variables associated with THB are female, having a partner and suicide risk. In this study, there has been a significant prevalence of the disorder in the elderly and it was possible to identify predictors through analyzes.The findings of this study are worrisome, if need be replicated in other locations and samples. / Nos ?ltimos anos, ocorreram modifica??es significativas nas condi??es socioecon?micas e de sa?de da popula??o mundial e, consequentemente, na estrutura demogr?fica, acarretando um crescimento expressivo da popula??o idosa e provocando um aumento do risco de adquirir doen?as neurol?gicas e psiqui?tricas. Dentre as doen?as psiqui?tricas, o transtorno bipolar ? respons?vel por importante parcela do preju?zo funcional ao redor do mundo. Contudo, dados internacionais mostram que os transtornos afetivos t?m uma preval?ncia de, aproximadamente, 11,3% da popula??o, podendo atingir 25% dos idosos. Al?m disso, ? uma das doen?as que mais gera perdas sociais e nos relacionamentos familiares, podendo levar ao suic?dio em, aproximadamente, 15% dos pacientes. O objetivo do presente estudo foi avaliar a preval?ncia do Transtorno Afetivo Bipolar (TAB) em uma amostra aleat?ria de idosos atendidos pela Estrat?gia Sa?de da Fam?lia (ESF) de Porto Alegre. O estudo ? do tipo transversal com coleta prospectiva. A amostra constituiuse de 550 idosos randomicamente selecionados de 30 Equipes de Sa?de da Fam?lia do Munic?pio de Porto Alegre (ESF/POA) sorteadas de modo estratificado por Ger?ncia Distrital. Para os diagn?sticos, psiquiatras com experi?ncia na avalia??o de idosos utilizaram os crit?rios diagn?sticos de DSM-5. Em rela??o aos resultados: um total de 5,8% (n=32) dos idosos da amostra apresentaram o Transtorno Afetivo Bipolar, 59,4%( n= 19) com diagn?stico do tipo I e 40,6% (n=13) do tipo II. Desse total, 1,5% (n= 8) apresentam quadro atual de TAB e 4,4% (n= 24) quadro de TAB no passado. Dentre os idosos que apresentaram o transtorno, algumas associa??es significativas podem ser destacadas: entre tentativa de suic?dio na vida (21,6%; p=0,001), entre o risco de suic?dio (15,7%; p=0,001) e uma associa??o lim?trofe entre o idoso ter companheiro com TAB (8,3%; p= 0,053). Vari?veis associadas ao THB s?o sexo feminino, ter companheiro e risco de suic?dio. Neste estudo, notou-se uma significativa preval?ncia do transtorno no idoso e foi poss?vel identificar fatores preditores por meio das an?lises realizadas. Os achados do presente trabalho s?o preocupantes, sendo necess?rio serem reproduzidos em outras localidades e amostras.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2015-09-02T12:03:47Z No. of bitstreams: 1 474469 - Texto Completo.pdf: 3432327 bytes, checksum: ffa8e3ce80a3adb37d2f4a5a0e3105d3 (MD5) / Made available in DSpace on 2015-09-02T12:03:48Z (GMT). No. of bitstreams: 1 474469 - Texto Completo.pdf: 3432327 bytes, checksum: ffa8e3ce80a3adb37d2f4a5a0e3105d3 (MD5) Previous issue date: 2015-07-19 / Introduction : The elderly population is growing at a rapid pace and the number of people living in institutions of Long-term care (LTC) is increasing in a representative manner, inferring the quality of life of older people. Music therapy is the one health engaged in promotion and prevention, assisting in the treatment of disease and its comorbidities. Objective : To investigate the effect of music therapy intervention on quality of life in elderly residents in two ILPIs. We evaluated the quality of life and depressive and anxiety symptoms before and after the sessions of music therapy. A screening test was used to identify the elderly with cognitive impairment. Methods : We conducted a controlled trial, in which were allocated 48 seniors, 24 participants in the group who underwent music therapy intervention (IG) and 24 elderly control group without intervention (CG). The instruments applied for the two groups were the Mini Mental State Examination (MMSE), Beck Depression Inventory (BDI-II), Beck Anxiety Inventory (BAI) and Quality of Life Questionnaire (WHOQOL-BREF). For the IG, it applied the analysis protocol of the sessions during the group calls of music therapy. Results : When comparing the groups, the intervention of Music Therapy contributed to quality of life, especially in the physical domain (p=0.006) and in reducing depression levels (p=0.046). In the control group, there was a significant worsening of cognition (p=0.015). Conclusion : The results indicate that music therapy promoted improvement in depressive symptoms and quality of life and probably reduced the likelihood of cognitive decline in institutionalized elderly. / Introdu??o : A popula??o idosa vem crescendo a passos largos e o n?mero de pessoas residentes em Institui??es de Longa Perman?ncia (ILPIs) vem aumentando de maneira representativa, inferindo na qualidade de vida dos idosos. A Musicoterapia ? uma ?rea da sa?de que atua na promo??o e preven??o, auxiliando no tratamento de doen?as e suas comorbidades. Objetivo : Investigar o efeito da interven??o musicoterap?utica na qualidade de vida em idosos residentes em duas ILPIs. Foram avaliados a qualidade de vida e os sintomas depressivos e ansiosos antes e ap?s as sess?es de Musicoterapia. Um teste de rastreio foi utilizado para identificar os idosos com d?ficit cognitivo. M?todos : Foi realizado um ensaio cl?nico controlado, no qual foram alocados 48 idosos, sendo 24 participantes do Grupo que se submeteu a interven??o musicoter?pica (GI) e 24 idosos do Grupo Controle sem interven??o (GC). Os instrumentos aplicados para os dois grupos, foram o Mini Exame do Estado Mental (MEEM), Invent?rio de Depress?o de Beck (BDI-II), Invent?rio de Ansiedade de Beck (BAI) e Question?rio de Qualidade de Vida (WHOQOL-bref). Para o GI, foi aplicado o Protocolo de An?lise das Sess?es durante os atendimentos grupais de musicoterapia. Resultados : Na compara??o entre os grupos, a interven??o da Musicoterapia contribuiu na qualidade de vida, principalmente no dom?nio f?sico (p=0,006) e na redu??o dos n?veis de depress?o (p=0,046). No grupo controle, houve uma piora significativa da cogni??o (p=0,015). Conclus?o : Os resultados indicam que a Musicoterapia promoveu melhora nos sintomas depressivos e qualidade de vida e provavelmente reduziu a probabilidade de decl?nio cognitivo em idosos institucionalizados.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2015-10-09T20:19:07Z No. of bitstreams: 1 475669 - Texto Completo.pdf: 1091552 bytes, checksum: 307191dfde957a03443a58cf35cbb904 (MD5) / Made available in DSpace on 2015-10-09T20:19:07Z (GMT). No. of bitstreams: 1 475669 - Texto Completo.pdf: 1091552 bytes, checksum: 307191dfde957a03443a58cf35cbb904 (MD5) Previous issue date: 2015-08-12 / This dissertation analyzes the relationship between the organization and division of labor and the worker's health-disease process, through the work profile mapping at the National Institute of Social Security (INSS), in the state of Rio Grande do Sul. The construction of this work took place through research, whose problem was initially designed to investigate how the Social Security in the state of Rio Grande do Sul is organized as its active workers. During the research, the data and analysis that emerged brought more complex findings and deepened the discussion on the relationship between work in the context of corporate restructuring resulting from the neoliberal advance from the 1980s to expand the understanding the categories of analysis, theoretical approach was needed on the concept of work, which was revealed in its centrality as construction mode and reproduction of human sociability of structural and cyclical changes in production methods, Social Security and its historic building within the various social protection concepts according to the state of existing models from the conservative models to the design of the Welfare State, and the process of construction and development of Occupational Health concept in Brazil, since the conventional hospital-centered model until its transformation from the Sanitary Reform Movement. The research, which aims to translate into support new studies and action plans on the subject of workers' health, used the approach of the socio-historical and dialectical view of social reality which provided bases to analyze, within the categories of the dialectical method of how the relationship between the state and the capital historically determined the design of social protection to the working class, the conflicting relations between the State of Social Welfare and the managerialist model of state, whose logic is transferred from the private to the public and that worsens the relationship between capital and work, and how this process of alienation constitutes a universal phenomenon among workers in the context of the flexible accumulation capitalism breakthrough that resulted in the movement of the state reform backset. The documentary research appreciated the expansion of understanding of the object in its historical and sociocultural context, making relevant source for concrete mapping to be performed. In the context of theoretical discussion and analysis of the data, mapping the capacity of the INSS servers in Rio Grande do Sul warned of a next scenario of shortage of workers, since the count of the number of servers by the Social Security Agency considers a large portion of which is in Permanence Allowance, and selection processes information are insufficient to assess whether the division of labor in the INSS is healthy, making it important to discuss the relationship between overload, or surplus, and the illness. The changes in the activity carried out Taylorization type undergo a process at the same time as the public service undergoes a Toyotist demand for flexibility, shows the scene of alienation and loss of meaning of work, compounded by the implementation of goals and performance evaluations, making the INSS server subject overload and physical and mental illness. This research also highlights the challenge of working class is fragmented by new management models and who cannot find space for reflection on the work as a determinant of health. / Esta disserta??o analisa a rela??o entre a organiza??o e divis?o do trabalho e o processo sa?de-doen?a do trabalhador, atrav?s do mapeamento do perfil do trabalho no Instituto Nacional do Seguro Social (INSS), no Estado do Rio Grande do Sul. A constru??o deste trabalho se realizou atrav?s de pesquisa, cujo problema foi inicialmente elaborado para investigar como a Previd?ncia Social no Estado no Rio Grande do Sul est? organizada quanto aos seus trabalhadores ativos. No decorrer da pesquisa, os dados encontrados e as an?lises que emergiram trouxeram achados mais complexos e que aprofundaram a discuss?o em torno da rela??o entre o trabalho, na conjuntura da reestrutura??o produtiva decorrente do avan?o neoliberal a partir da d?cada de 1980. Para ampliar a compreens?o das categorias de an?lise, foi necess?ria a abordagem te?rica sobre o trabalho, que se revelou em sua centralidade como modo de constru??o e reprodu??o da sociabilidade humana das transforma??es estruturais e conjunturais nos modos de produ??o, a Previd?ncia Social e a sua constru??o hist?rica dentro das diversas concep??es de prote??o social de acordo com os modelos de Estado vigentes, desde os modelos conservadores at? o a concep??o do Welfare State, e o processo de constru??o e evolu??o do conceito de sa?de do trabalhador no Brasil, desde o modelo convencional hospitaloc?ntrico at? a sua transforma??o a partir do Movimento de Reforma Sanit?ria. A pesquisa, cujo objetivo se traduziu em subsidiar novos estudos e planejamentos de a??es na tem?tica da sa?de do trabalhador, se utilizou do enfoque da vis?o s?cio-hist?rica e dial?tica da realidade social que forneceu bases para analisar, dentro das categorias do m?todo dial?tico, de que forma a rela??o entre o Estado e o capital determinou historicamente a concep??o de prote??o social ? classe trabalhadora, as rela??es contradit?rias entre o Estado de Bem-Estar Social e o modelo gerencial de Estado, cuja l?gica se transferiu do privado para o p?blico e que precariza a rela??o entre o capital e o trabalho, e como este processo de aliena??o se constitui em um fen?meno universal entre os trabalhadores na conjuntura do avan?o do capitalismo de acumula??o flex?vel que resultou no movimento de contrarreforma do Estado. A pesquisa documental valorizou a amplia??o da compreens?o do objeto na sua contextualiza??o hist?rica e sociocultural, se tornando fonte relevante para a concretude do mapeamento a ser realizado. No contexto da discuss?o te?rica e da an?lise dos dados, o mapeamento da lota??o dos servidores do INSS no Rio Grande do Sul alertou para um cen?rio pr?ximo de escassez de trabalhadores, uma vez que a contagem do n?mero de servidores por Ag?ncia da Previd?ncia Social considera uma grande parcela que se encontra em Abono de Perman?ncia, e as informa??es sobre processos seletivos se mostram insuficientes para avaliar se a divis?o do trabalho no INSS ? saud?vel, tornando relevante a discuss?o sobre a rela??o entre a sobrecarga, ou sobretrabalho, e o adoecimento. As transforma??es no tipo de atividade realizada sofrem um processo de tayloriza??o, ao mesmo tempo em que o servi?o p?blico sofre uma exig?ncia toyotista de flexibiliza??o, evidencia o cen?rio de aliena??o e perda de sentido do trabalho, agravado pela implementa??o de metas e avalia??es de desempenho, tornando o servidor do INSS sujeito ? sobrecarga e ao adoecimento f?sico e ps?quico. Esta pesquisa evidencia tamb?m o desafio da classe trabalhadora que se encontra fragmentada por novos modelos de gest?o e que n?o encontram espa?o para reflex?o sobre o trabalho enquanto determinante de sa?de.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2016-02-10T12:59:12Z No. of bitstreams: 1 TES_VERA_ELIZABETH_CLOSS_PARCIAL.pdf: 344877 bytes, checksum: 83c1713273477d9c1c0fb821d224a93c (MD5) / Made available in DSpace on 2016-02-10T12:59:12Z (GMT). No. of bitstreams: 1 TES_VERA_ELIZABETH_CLOSS_PARCIAL.pdf: 344877 bytes, checksum: 83c1713273477d9c1c0fb821d224a93c (MD5) Previous issue date: 2015-08-27 / Population ageing has been the focus of many studies as it reflects an important transformation of society that creates a reality with new challenges to be faced. The ageing process can be categorized in two forms: normal ageing or ageing per se or senescence (with associated molecular, anatomical and physiological alterations) and usual ageing or senility (associated with diseases and disabilities). The frailty syndrome is among the most discussed current themes. Frailty is a condition in which the individual presents increased vulnerability to the development of dependency, hospitalization, institutionalization, fall-risk and mortality, among other adverse outcomes, when exposed to a stressor. Various pathophysiological processes involved in frailty are closely related to nutritional and body composition aspects, and anthropometry presents as a useful technique for evaluating these conditions. Given that frailty in its early stages is commonly seen in the elderly community and that available instruments for its identification (such as the widely used Fried Phenotype) are complex and difficult to apply in primary care, the search for simple tools becomes important. In this thesis, three original articles are presented. In the first, article, AGING INDEX DEVELOPMENT IN BRAZIL, REGIONS, AND FEDERATIVE UNITS FROM 1970 TO 2010, we sought to address the ageing index, the parameter through which to evaluate the expansion process of the elderly segment of total population in relation to the relative change in young age group. To this end, data from the Demographic Census and Social Indicators of the Brazilian Institute of Geography and Statistics (IGBE) were analysed. It was evidenced that the Brazilian population is undergoing a rapid ageing process. For the second article, DESCRIPTION OF ANTHROPOMETRIC MEASUREMENTS AND ANALYSIS OF THEIR ASSOCIATION WITH GENDER, AGE, AND FRAILTY SYNDROME IN ELDERLY ASSISTED AT THE FAMILY HEALTH STRATEGY: DATA FROM THE EMI-SUS, data from 583 elderly participants of a cross-sectional study ?Clinical and Epidemiological Study of the Elderly Attended at the Family Health Strategy (FHS) in the City of Porto Alegre (EMI-SUS)?, were analyzed. The frequency of frailty (diagnosed by Fried Phenotype) was observed to be 21.5% and pre-frailty 51.1%, and that only one of the 41 evaluated anthropometric measures was not associated with at least one of the investigated dependent variables (gender, age group or frailty). In the third article, PERFORMANCE OF ANTHROPOMETRIC MEASURES IN PREDICTING FRAILTY IN THE ELDERLY: LOGISTIC REGRESSION AND ARTIFICIAL NEURAL NETWORK MODELS, we sought to investigate the performance of 26 anthropometric measurements in predicting frailty and to develop a tool for their identification. Data from 583 participants of the EMI-SUS were analyzed, randomly divided into a learning sample (n=439) and test sample (n=144). Logistic regression and artificial neural network models were used. The neural network demonstrated a superior predictive performance to the logistic regression model and resulted in a reliable tool for identifying frailty in the elderly. The anthropometric measures of weight, biceps skinfold, sagittal abdominal diameter and waist circumference, grouped, proved to be good predictors of frailty in the elderly. / O envelhecimento da popula??o tem sido foco de muitos estudos por se tratar de uma transforma??o importante da sociedade e que implica uma realidade com novos desafios a serem enfrentados. O processo de envelhecimento pode ser categorizado em dois padr?es: o envelhecimento normal ou envelhecimento per se ou senesc?ncia (com altera??es moleculares, anat?micas e fisiol?gicas associadas) e o envelhecimento usual ou senilidade (associado a doen?as e incapacidades). Dentre as tem?ticas mais abordadas atualmente, encontra-se a s?ndrome da fragilidade. Fragilidade ? uma condi??o na qual o indiv?duo apresenta uma maior vulnerabilidade para o desenvolvimento de depend?ncia, hospitaliza??o, institucionaliza??o, queda e mortalidade, dentre outros desfechos negativos, quando exposto a um estressor. V?rios processos fisiopatol?gicos envolvidos na fragilidade t?m estreita rela??o com aspectos nutricionais e de composi??o corporal e que, na avalia??o destas condi??es, a antropometria se apresenta como uma t?cnica ?til. Considerando que est?gios iniciais de fragilidade s?o comumente observados em idosos da comunidade e que instrumentos dispon?veis para a identifica??o de fragilidade (como o fen?tipo de Fried que ? amplamente utilizado) s?o complexos e de dif?cil aplica??o na aten??o b?sica, a busca por ferramentas simples torna-se importante. Na presente tese, s?o apresentados tr?s artigos originais. No primeiro artigo, A EVOLU??O DO ?NDICE DE ENVELHECIMENTO NO BRASIL, NAS SUAS REGI?ES E UNIDADES FEDERATIVAS NO PER?ODO DE 1970 A 2010, buscou-se abordar o ?ndice de envelhecimento, par?metro atrav?s do qual se avalia o processo de amplia??o do segmento idoso na popula??o total em rela??o ? varia??o relativa no grupo et?rio jovem. Para tanto, foram pesquisados dados dos Censos Demogr?ficos e dos Indicadores Sociais do IBGE. Evidenciou-se que a popula??o brasileira se encontra em franco processo de envelhecimento. Para o segundo artigo, DESCRI??O DE MEDIDAS ANTROPOM?TRICAS E AN?LISE DE SUA ASSOCIA??O COM G?NERO, IDADE E S?NDROME DA FRAGILIDADE EM IDOSOS ASSISTIDOS NA ESTRAT?GIA SA?DE DA FAM?LIA: DADOS DO EMI-SUS, foram analisados os dados de 583 idosos participantes de um estudo transversal denominado ?Estudo Epidemiol?gico e Cl?nico dos Idosos Atendidos na Estrat?gia Sa?de da Fam?lia (ESF) do Munic?pio de Porto Alegre (EMI-SUS)?. Observou-se que a frequ?ncia de fragilidade (diagnosticada pelo Fen?tipo de Fried) foi 21,5% e de pr?-fragilidade, 51,1% e que, das 41 medidas antropom?tricas avaliadas, somente uma n?o se mostrou associada com pelo menos uma das vari?veis dependentes investigadas (sexo, faixa et?ria ou fragilidade). No terceiro artigo, PERFORMANCE OF ANTHROPOMETRIC MEASURES IN PREDICTING FRAILTY IN ELDERLY: LOGISTIC REGRESSION AND ARTIFICIAL NEURAL NETWORK MODELS, buscou-se investigar a performance de 26 medidas antropom?tricas na predi??o de fragilidade e formular uma ferramenta para sua identifica??o. Foram analisados os dados de 583 idosos participantes do EMI-SUS, divididos randomicamente em uma amostra de aprendizado (n=439) e uma amostra teste (n=144). Foram utilizados modelos de regress?o log?stica e rede neural artificial. A rede neural mostrou performance preditiva superior ? regress?o log?stica e resultou em uma ferramenta confi?vel na identifica??o de fragilidade em idosos. As medidas antropom?tricas peso, dobra cut?nea bicipital, di?metro abdominal sagital e circunfer?ncia da cintura, agrupadas, mostraram-se bons preditores de fragilidade em idosos.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2016-04-19T17:56:30Z No. of bitstreams: 1 DIS_AUGUSTO_FRANKE_DAHINTEN_PARCIAL.pdf: 226215 bytes, checksum: 9d69e11431beee4d1ac3ea29ddc29657 (MD5) / Made available in DSpace on 2016-04-19T17:56:30Z (GMT). No. of bitstreams: 1 DIS_AUGUSTO_FRANKE_DAHINTEN_PARCIAL.pdf: 226215 bytes, checksum: 9d69e11431beee4d1ac3ea29ddc29657 (MD5) Previous issue date: 2015-12-01 / Conselho Nacional de Pesquisa e Desenvolvimento Cient?fico e Tecnol?gico - CNPq / This essay aims to analyze the incidence of consumer law in the insurance contracts, mainly regarding the discussion between the limitative and abusive clauses, in light of the jurisprudence. With this goal, it starts, in the first half, with the analysis of the theoretical fundamentals that underlie the objective of this research. It begins with the presentation of the consumer protection as a fundamental right and its insertion in the Brazilian legislative context. Next, it exams the insurance contracts, its concept, its purpose and importance, its characteristics and features, as well as the actors that figure in the domestic insurance market. Following, are commented some of the most important contractual aspects, including the evolution and the transformations that the Contract Law suffered, the principles that govern the contractual bonds and the main rules related to consumer contractual protection. In the second part, it?s worked on some of the major coverage negatives involving insurance contracts in the light of the national jurisprudence, which is done three stages, subdivided according to the insurance modalities. In each part, it?s worked on the general aspects of each controversy, including the arguments summoned by the parties, followed by the jurisprudential understandings. All with the end goal of analyzing which understandings and fundaments are presented in these kinds of demands. / Este trabalho tem como objetivo analisar a incid?ncia do direito do consumidor nos contratos de natureza securit?ria, principalmente no ?mbito da discuss?o entre as cl?usulas limitativas e abusivas, ? luz da jurisprud?ncia. Com esta meta, inicia-se, na primeira parte, com a an?lise dos fundamentos te?ricos que subjazem ao objetivo desta pesquisa. Come?a-se com a apresenta??o da prote??o do consumidor como direito fundamental, analisando-se a sua evolu??o e o seu enquadramento no contexto legislativo brasileiro. Na sequ?ncia, examinam-se os contratos de seguros, seu conceito, sua finalidade e sua import?ncia, seus elementos e caracter?sticas, bem como os atores que comp?em o mercado de seguros nacional. Ap?s, s?o comentados alguns dos mais importantes aspectos contratuais, incluindo a evolu??o e as transforma??es que sofreu o direito dos contratos, os princ?pios que regulam as rela??es contratuais e as principais normas de prote??o contratual dos consumidores. Na segunda parte, s?o trabalhadas algumas das principais negativas de cobertura, envolvendo contratos de seguro, ? luz da jurisprud?ncia p?tria, o que se faz em tr?s etapas, subdivididas conforme as modalidades securit?rias. Em cada parte, s?o trabalhados os aspectos gerais de cada controv?rsia, inclusive com os argumentos invocados em lit?gio pelas partes, seguidos dos entendimentos jurisprudenciais. Tudo com o objetivo final de se analisar quais os entendimentos e fundamentos que s?o apresentados nestas esp?cies de demandas.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2016-05-03T15:55:01Z No. of bitstreams: 1 TES_JANAINA_ALVARENGA_ARAGAO_COMPLETO.pdf: 3180936 bytes, checksum: 8c2565ec49dcb5d8412b181769abe70c (MD5) / Made available in DSpace on 2016-05-03T15:55:01Z (GMT). No. of bitstreams: 1 TES_JANAINA_ALVARENGA_ARAGAO_COMPLETO.pdf: 3180936 bytes, checksum: 8c2565ec49dcb5d8412b181769abe70c (MD5) Previous issue date: 2014-03-31 / Several changes have occurred on humanity in the last decades, the aging of the world population and Brazilian population. Due to the drop in mortality rates and increased life expectancy at birth, it has also increased the prevalence of chronic diseases due to transmissible diseases in developing countries. The overall objective of the study was analyze the relation between the characteristics of access to health care and assistency provided in primary care to adults and seniors of remaining quilombola communities, associated to the epidemiological and socio-cultural profile of the community where they live. A census was conducted along with community health agents, and by the end 198 remnants of quilombola communities, adults and seniors, that is being 45 years old or more, residents of the quilombola communities of Piau?, between March and December 2011. It was performed an analysis (fasting peripheral blood, and analyzed it to test the levels of HDL-cholesterol, triglycerides and glucose), anthropometric data (height, weight, arterial pressure, waist circumference), completed questionnaires regarding sociodemographic data, lifestyle and access to healthcare. Data were scanned into a database developed by TeleForm and analyzed using the Epi Info software, version 3.5.1. The botanical material was collected to get to know the practices and natural and traditional health resources in their communities. The study was approved by the Pontifical Catholic University of Rio Grande do Sul Ethics Committee. The results of this study demonstrated that the prevalence of MS was 55.4% in the quilombolas surveyed, and more prevalent in females (p <0.001). the distance between home and the health unity greater than 5 km was significantly important for a smaller chance to prefer non-traditional health knowledge, the geographical distance interfered with the access to healthcare of these communities. Therefore, it is necessary to invest in the construction of social equipment designed to meet their needs based on the historical context and where these communities live, especially in public policies of preventive health education, professional qualification of the Family Health staff, since it is in this strategy that the government investment has had the highest concentration. / V?rias mudan?as aconteceram na humanidade nas ?ltimas d?cadas, o envelhecimento da popula??o mundial e popula??o brasileira. Devido ? queda da taxa de mortalidade, e aumento da esperan?a de vida ao nascer aumentou tamb?m a preval?ncia das enfermidades cr?nicas em detrimento das doen?as transmiss?veis nos pa?ses em desenvolvimento. O objetivo geral desse trabalho foi analisar a rela??o entre as caracter?sticas de acesso de sa?de e assist?ncia prestada na aten??o b?sica dirigida aos adultos e idosos de comunidades remanescentes quilombolas, associado ao perfil epidemiol?gico e sociocultural da comunidade onde vivem. Para metodologia realizou-se um censo junto com os agentes comunit?rios de sa?de, e ao final participaram 198 volunt?rios remanescentes de comunidades quilombolas, adultos e idosos, ou seja com idade de 45 anos ou mais residentes nas comunidades quilombolas no centro sul do Piau, entre mar?o e dezembro de 2011. Que realizaram an?lises (sangue perif?rico em jejum, e analisadas para testar os n?veis de colesterol-HDL, triglicer?deos e glicemia), dados antropom?tricos (altura, peso, press?o art?ria, circunfer?ncia abdominal), responderam question?rios sobre dados, s?cio demogr?ficos, h?bitos de e de acesso de sa?de. Os dados foram digitalizados em um banco de dados desenvolvido pelo programa TeleForm e analisados pelo programa Epi Info, vers?o 3.5.1. O material bot?nico foi coletado para conhecer as pr?ticas e recursos naturais e tradicionais de sa?de de suas comunidades. A pesquisa foi aprovada pela Comit? de ?tica da Pontif?cia Universidade Cat?lica do Rio Grande do Sul. Os resultados dessa pesquisa mostraram a preval?ncia da SM foi de 55.4% nos quilombolas pesquisados, e mais prevalente no sexo feminino (p < 0,001). A dist?ncia entre a resid?ncia e a UBS maior que 5 km foram um fator significativamente importante para a menor chance de preferir conhecimentos n?o tradicionais de sa?de, que a dist?ncia geogr?fica interferiu no acesso de sa?de dessas comunidades. Portanto ? necess?rio investir na constru??o de equipamentos sociais destinados a atender suas demandas tendo como base o contexto hist?rico e local onde vivem essas comunidades, principalmente em pol?ticas p?blicas de sa?de preventiva e na educa??o, qualifica??o dos profissionais das equipes de Sa?de da Fam?lia, pois ? nessa estrat?gia onde os investimentos governamentais tem tido maior concentra??o.

Submitted by Sara Ribeiro (sara.ribeiro@ucb.br) on 2017-08-16T18:25:55Z No. of bitstreams: 1 MayaraCandidaPereiraDissertacao2017.pdf: 1645657 bytes, checksum: d6f53ba624ef817d635292c906de59f1 (MD5) / Approved for entry into archive by Sara Ribeiro (sara.ribeiro@ucb.br) on 2017-08-16T18:26:12Z (GMT) No. of bitstreams: 1 MayaraCandidaPereiraDissertacao2017.pdf: 1645657 bytes, checksum: d6f53ba624ef817d635292c906de59f1 (MD5) / Made available in DSpace on 2017-08-16T18:26:12Z (GMT). No. of bitstreams: 1 MayaraCandidaPereiraDissertacao2017.pdf: 1645657 bytes, checksum: d6f53ba624ef817d635292c906de59f1 (MD5) Previous issue date: 2017-01-01 / Population aging is associated with important social and economic transformations, as well as changes in the demographic and epidemiological profile. Such changes and transformations demand more from nursing and health services, opening new fields of work. Nursing professionals are currently the largest workforce in the healthcare area, having Resolution 311/2007 ruling their activities and they have COREN as a regulatory institution in all the states and the federal district in Brazil. Because of this scenario, the interest for this study arose. It aimed to describe ethical nursing occurrences involving elderly in the ethical processes judged by the Regional Nursing Council (COREN/DF), from 2005 to 2015. This work regards the profile of professionals involved, the denunciations and whistleblowers involved. Besides, it intended to analyze the main articles violated in the code of ethics, the penalties applied, the locations, and types of health institution with the greatest number of ethical occurrences. Method: A literature review was carried out addressing topics such as aging, vulnerability, the development of nursing, codes of ethics, nursing mistakes and their reflect in the field of civil and criminal law. Then, an active search was done in the finalized ethical processes involving elderly at COREN-DF from 2005 to 2015. They were collected through a data collection instrument. The results were worked out using descriptive statistics. Results: A total of 144 completed cases were found at COREN-DF and only 18 involved elderly patients, which were the ones that entered this study. Among the most relevant results, there was a high number of licensed practical nurses (LPN), with 12 offenders. In this percentage, there is a prevalence of professionals with short enrollment period at COREN-DF, who were 9 people. The majority of complaints were made by the elderly???s relatives, 8 of the total. The most evidenced iatrogenesis were negligence(8), followed by maltreatment(7). The most common place where the abuses took place was elderlies??? houses, standing out with 10 cases. Conclusion: It is understood from the data analysis that, fortunately, people are becoming more likely to report the ethical infractions they suffer. It is necessary to think, however, about the quantity of these infractions that are not reported. Through denunciations and studies like this, the nursing service can be improved and that???s why it???s important. Being LPN the most reported category, it is concluded that more work is needed in order to recycle learning and humanization. This work, of course, must be done not only with these professionals, but with everyone involved. It is believed that this study may instigate nursing professionals to think about their professional practice and about the possible ethical and legal implications of assisting the elderly, thus contributing to a more cautious and ethically responsible nursing practice. / O envelhecimento da popula????o ?? associado a importantes transforma????es sociais e econ??micas, bem como mudan??as no perfil demogr??fico e epidemiol??gico. Tais mudan??as e transforma????es refletem em demandas nos servi??os da enfermagem e sa??de por essa popula????o crescente, abrindo novos campos de trabalho para a enfermagem. Frente ao exposto, surgiu o interesse em se realizar este estudo, que teve como objetivo analisar os processos ??ticos de enfermagem envolvendo idosos no Conselho Regional de Enfermagem (COREN-DF), no per??odo de 2005 a 2015, quanto ao perfil dos profissionais envolvidos, as den??ncias e os denunciantes envolvidos. Al??m disso, pretendeu analisar os principais artigos violados do c??digo de ??tica, as penalidades aplicadas, os locais e tipos de institui????o de sa??de com maior n??mero de ocorr??ncias ??ticas. M??todo: Foi realizada uma revis??o de literatura abordando temas como envelhecimento, vulnerabilidade, o desenvolvimento da enfermagem, os c??digos de ??tica, os erros de enfermagem e seu reflexo no campo do direito civil e penal. Em seguida, foi realizada uma busca ativa nos processos ??ticos finalizados envolvendo idosos do COREN-DF, no per??odo de 2005 a 2015. Estes foram coletados por meio de instrumento de coleta de dados. Os resultados foram trabalhados em estat??stica descritiva. Resultado: Foram localizados 144 processos conclusos pelo COREN-DF e, destes, apenas 18 envolviam idosos e somente estes que entraram neste estudo. Dentre os mais relevantes resultados, destaca-se o elevado n??mero de t??cnicos de enfermagem, com 12 dos infratores. H??, nesse n??mero, preval??ncia de profissionais com menor tempo de inscri????o no COREN-DF, com 9. As den??ncias, em sua maioria, foram realizadas pelos familiares, em 8 dos casos. Os erros mais evidenciados foram: neglig??ncia, 8, seguidos de maus tratos, 7. Como local de ocorr??ncia da infra????o, destaca-se a resid??ncia dos idosos, 10. Conclus??o: Entende-se, a partir da an??lise dos dados, que, felizmente, a popula????o est?? come??ando a denunciar as infra????es ??ticas as quais s??o expostas. Deve-se pensar, entretanto, em quantas dessas infra????es n??o s??o reportadas. Atrav??s das den??ncias e de estudos como esse, o servi??o de enfermagem pode ser aperfei??oado, da?? sua import??ncia. Sendo t??cnicos de enfermagem a categoria mais denunciada, conclui-se que ?? necess??rio que sejam realizados mais trabalhos de educa????o continuada e humaniza????o. Trabalho esse que, claro, deve ser feito n??o s?? com esses profissionais, mas com todos os envolvidos. Acredita-se que este estudo possa instigar os profissionais de enfermagem a pensar acerca da sua pr??tica profissional e a respeito das poss??veis implica????es ??ticas e legais decorrentes da assist??ncia aos idosos, contribuindo para que a pr??tica de enfermagem seja mais cautelosa e eticamente respons??vel.

Submitted by Biblioteca Digital de Teses e Disserta????es (sdi@ucb.br) on 2017-11-08T19:13:17Z No. of bitstreams: 1 JulianaAlencardeSouzaDissertacaoParcial2013.pdf: 522492 bytes, checksum: 3add79c8e4db9a321776c5910544a0ff (MD5) / Approved for entry into archive by Biblioteca Digital de Teses e Disserta????es (sdi@ucb.br) on 2017-11-08T19:13:25Z (GMT) No. of bitstreams: 1 JulianaAlencardeSouzaDissertacaoParcial2013.pdf: 522492 bytes, checksum: 3add79c8e4db9a321776c5910544a0ff (MD5) / Made available in DSpace on 2017-11-08T19:13:25Z (GMT). No. of bitstreams: 1 JulianaAlencardeSouzaDissertacaoParcial2013.pdf: 522492 bytes, checksum: 3add79c8e4db9a321776c5910544a0ff (MD5) Previous issue date: 2013-08-30 / According to the World Health Organization obesity is one of the most serious public health problems in the world today . It is a chronic disease characterized by excessive accumulation of adipose tissue in the body , with etymology multifactorial and numerous associated complications. With high rates of morbidity and mortality , obesity is considered an epidemic of the XXI century global . More than 56 % of the population suffers from being overweight . Obesity treatment is done by various approaches being multimethodological . There is a great difficulty for most people to lose weight and maintain a healthy weight . This study aimed to construct a proposal for inclusion of families of obese adults in the treatment of the same . From working with a Group Weight Control what happens for several years in a public health institution in the Federal District , coordinated by a team of health professionals , the study had two phases : the first was a detailed description of the procedures used by that group, and the second based on this description and in the theoretical framework , was developed a proposal for inclusion of families in the program that had only the share of obese adults . In the first part of an interview was conducted with each participant 's professional team, focusing on the functions of each and the procedures in which they participate . The interviews were conducted in the premises of the facility and were made by the researcher . It was suggested the name of Program Quality of Life for Obese Adults , replacing the previous Group Weight control , understanding that the proposal is a change in lifestyle and in family and social relationships , and not just related to weight control . The inclusion of the family in the program is based on the theoretical framework of systemic approach and research that has shown the importance of the family in prevention, treatment and care of both children and adolescents and adults with obesity problems . The proposal includes the use of the methodology of Multifamily Groups - GM , recognized as an important tool for working with families in different contexts . 4 are proposed GM meetings , each with specific objectives and theme . The suggested topics are: feeding the family , family dynamics , communication and expression of affection among family members , diagnosis and treatment of obesity and support networks . The proposal should be discussed with the transdisciplinary team that coordinated the program and may undergo changes . The central and most important point , however , is the inclusion of the family in the treatment of obese adults , not only to support the family in treatment , but also as a patient , because we consider the disease as a family problem , not an individual. / Segundo a Organiza????o Mundial da Sa??de a obesidade ?? um dos mais graves problemas de sa??de p??blica mundial na atualidade. Trata-se de uma doen??a cr??nica, caracterizada pelo ac??mulo excessivo de tecido adiposo no organismo, com etimologia multifatorial e in??meras complica????es associadas. Com altas taxas de mortalidade e morbidade, a obesidade ?? considerada uma doen??a epid??mica global do s??culo XXI. Mais de 56% da popula????o brasileira sofre com o excesso de peso. O tratamento da obesidade ?? feito por v??rias abordagens, sendo multimetodol??gica. Observa-se uma grande dificuldade da maioria das pessoas em perder peso e conservar um peso saud??vel. O presente trabalho teve como objetivo construir uma proposta de inclus??o das fam??lias de adultos obesos no tratamento dos mesmos. A partir do trabalho com um Grupo de Controle de Peso que acontece h?? v??rios anos em uma institui????o de sa??de p??blica do Distrito Federal, coordenado por uma equipe de profissionais de sa??de, o estudo teve duas etapas: na primeira foi feita uma descri????o detalhada dos procedimentos utilizados pelo referido grupo e, em segunda com base nessa descri????o e no referencial te??rico, foi desenvolvida uma proposta de inclus??o das fam??lias no programa que contava apenas com a participa????o dos adultos obesos. Na primeira parte foi realizada uma entrevista com cada profissional participante da equipe, enfocando as fun????es de cada um e os procedimentos dos quais participam. As entrevistas foram realizadas nas instala????es da institui????o de sa??de e foram feitas pela pesquisadora. Foi sugerido o nome de Programa de Qualidade de Vida para Adultos Obesos, em substitui????o ao anterior Grupo de controle de Peso, por entender que a proposta ?? de uma mudan??a no estilo de vida e nas rela????es familiares e sociais, e n??o est?? relacionado apenas ao controle de peso. A inclus??o da fam??lia no Programa se baseia no referencial te??rico da abordagem sist??mica e em pesquisas que t??m mostrado a import??ncia da fam??lia na preven????o, tratamento e acompanhamento tanto de crian??as e adolescentes quanto de adultos com problemas de obesidade. A proposta inclui a utiliza????o da metodologia dos Grupos Multifamiliares - GM, reconhecida como importante instrumento para se trabalhar com fam??lias em diferentes contextos. S??o propostos 4 encontros do GM, cada um com tema e objetivos espec??ficos. Os temas sugeridos s??o: a alimenta????o na fam??lia, a din??mica familiar, comunica????o e express??o de afeto entre os membros da fam??lia, diagn??stico e tratamento da obesidade e as redes de apoio. A proposta dever?? ser discutida com a equipe transdisciplinar que coordenado o Programa e poder?? sofrer mudan??as. O ponto mais importante e central, no entanto, ?? a inser????o da fam??lia no tratamento de adultos obesos, n??o apenas para apoiar o familiar em tratamento, mas tamb??m como paciente, pois consideramos a doen??a como um problema familiar e n??o individual.

Submitted by Sara Ribeiro (sara.ribeiro@ucb.br) on 2017-11-22T13:14:09Z No. of bitstreams: 1 RaymundoLimaRibeiroJ??niorDissertacao2017.pdf: 11719941 bytes, checksum: d428806cc0b355a170dee285a8263844 (MD5) / Approved for entry into archive by Sara Ribeiro (sara.ribeiro@ucb.br) on 2017-11-22T13:14:23Z (GMT) No. of bitstreams: 1 RaymundoLimaRibeiroJ??niorDissertacao2017.pdf: 11719941 bytes, checksum: d428806cc0b355a170dee285a8263844 (MD5) / Made available in DSpace on 2017-11-22T13:14:23Z (GMT). No. of bitstreams: 1 RaymundoLimaRibeiroJ??niorDissertacao2017.pdf: 11719941 bytes, checksum: d428806cc0b355a170dee285a8263844 (MD5) Previous issue date: 2017-10-25 / This dissertation addresses the lack of effectiveness of health and safety of labour standards according to the Critical Theory of Human Rights, the approach of Social Psychology regarding the public invisibility of some categories of human beings, of the position adopted by the capitalist state in relation to the rights of the working class and of the Theory of Pressure Groups, answering the central question about the explanation for the lack of effectiveness of these norms in Brazil, especially when one observes its centrality in the legal order. The category of waster collectors was chosen for study because of the symbolism it represents, since noncompliance with health and safety standards by companies performing public cleaning and garbage collection is anachronistic. It has gone into the issue of illegal transportation of waste compactors because, although it is an unsafe and unlawful practice in various aspects and bases, it is widely adopted by companies in the sector and tolerated by society and the State. In addition to its legal nature, the dissertation uses concepts from Social Psychology and Sociology, reaching the conclusion that human and fundamental rights, including the rights to health and safety of workers, remain ineffective in Brazil, and there is a long way to be taken by society and the Brazilian State to overcome the labor incivility framework. In the end, it is argued that the prohibition of transport in the stirrups is already based on multiple normative sources in force, and the Labor Prosecution Office should demand, independently of the regulatory norm in the stage of tripartite discussion in the Ministry of Labor, the end of the transport of the waster collectors in the stirrups and in the external areas of the vehicles. / Esta disserta????o aborda a falta de efetividade das normas de sa??de e seguran??a do trabalho ?? luz da Teoria Cr??tica dos Direitos Humanos, da abordagem da Psicologia Social atinente ?? invisibilidade p??blica de algumas categorias de seres humanos, da postura adotada pelo Estado capitalista em rela????o aos direitos da classe trabalhadora e da Teoria dos Grupos de Press??o, respondendo ?? quest??o central sobre a explica????o para a falta de efetividade das referidas normas no Brasil, especialmente quando se observa a sua centralidade no ordenamento jur??dico. Escolheu-se a categoria dos garis para estudo pelo simbolismo que representa, pois o descumprimento das normas de sa??de e seguran??a do trabalho pelas empresas que executam a limpeza p??blica e a coleta de lixo ?? anacr??nico. Aprofundou-se no aspecto relativo ao transporte ilegal nos estribos dos compactadores de lixo, porque, embora seja uma pr??tica insegura e il??cita sob v??rios aspectos e fundamentos, ?? amplamente adotada pelas empresas do setor e tolerada pela sociedade e pelo Estado. Al??m do seu car??ter jur??dico, a disserta????o utiliza conceitos da Psicologia Social e da Sociologia, chegando-se ?? conclus??o no sentido de que os direitos humanos e fundamentais, inclu??dos os direitos ?? sa??de e ?? seguran??a do trabalhador, continuam sem efetividade no Brasil, havendo um longo caminho a ser trilhado pela sociedade e pelo Estado brasileiro para supera????o do quadro de incivilidade trabalhista. Defende-se, ao final, que a proibi????o do transporte nos estribos j?? se encontra fundamentada em m??ltiplas fontes normativas em vigor, devendo o Minist??rio P??blico do Trabalho exigir, independentemente da norma regulamentadora em fase de discuss??o tripartite no Minist??rio do Trabalho, o fim do transporte dos garis nos estribos e nas ??reas externas dos ve??culos.