Submitted by Erika Demachki (erikademachki@gmail.com) on 2017-01-18T14:52:54Z No. of bitstreams: 2 Dissertação - Charlise Fortunato Pedroso - 2016.pdf: 1888405 bytes, checksum: 7e4406a4bbeeb6bce12caecdf06bb72b (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2017-01-19T10:30:24Z (GMT) No. of bitstreams: 2 Dissertação - Charlise Fortunato Pedroso - 2016.pdf: 1888405 bytes, checksum: 7e4406a4bbeeb6bce12caecdf06bb72b (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2017-01-19T10:30:24Z (GMT). No. of bitstreams: 2 Dissertação - Charlise Fortunato Pedroso - 2016.pdf: 1888405 bytes, checksum: 7e4406a4bbeeb6bce12caecdf06bb72b (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2016-04-14 / Fundação de Amparo à Pesquisa do Estado de Goiás - FAPEG / Reports of pain in the preoperative period are frequent and may be influenced by socioeconomic, clinical, psychological and behavioral factors and by health conditions. However, little is known about this pain in the preoperative period of cesarean section, one of the surgeries performed more frequently in the global surgical setting. The aim of the study was to identify the prevalence, characteristics and factors associated with pain in the preoperative period immediately prior to cesarean section. This was a cross-sectional analysis of data from the baseline of research matrix, cohort study, open and prospective, the data of which were collected in the wards and apartments of a private hospital, contracted to the Health Unic System (SUS), of the city of Goiânia, Brazil. The recruitment of women (n = 1082) was made between February 2014 and July 2015. The study sample consisted of 877 women. The outcome variable investigated was the report of any pain reported by women in the immediate preoperative period. The pain characteristics include intensity, measured by means of numeric pain scale of 11 points (END) which allows the intensity measured by numbers representing the amount of pain felt (zero (0) = no pain; 1 , 2.3 and 4 = mild pain; 5:06 = moderate pain, 7.8 and 9 = severe pain, and ten (10) = worst possible pain), location; onset and duration of painful episodes. The associated variables were: symptoms of anxiety and depression, assessed through the Hospital Anxiety and Depression Scale (HADS), as well as sociodemographic, clinical and behavioral variables and health related conditions. For the statistical analysis, logistic regression was used to identify factors associated with preoperative pain. In the multivariate analysis, variables that presented p-values <0,10 were included. For all tests p-values <.05 were considered significant. The prevalence of preoperative pain was 27.5% (CI: 95%:24.6-30.5). The locations most mentioned by the women included the lower back (29.9%), pelvic/genital region (22.4%) and head (12.9%). The pain appeared with more prevalence in the final trimester of pregnancy (37.8%), being considered by the majority of the participants as a daily complaint (68.5%). The intensity was classified as strong in 44.8% of cases. Preoperative pain was associated with pregnancyrelated pain (OR: 3.50; 2.23-5.252) and symptoms of anxiety (OR: 1.61; 1.14-2.28; p=.006). The evaluation of pain in the preoperative period should include negative aspects, such as anxiety, in order to use therapies for its management proper. In the prenatal care, it is essential to evaluate the characteristics of pain that arises after the confirmation of the pregnancy, in order to implement strategies to avoid prolonged contact with this experience and consequent impairments in the postoperative period. Nurses are responsible for part of this mission, together with obstetric nurses, who can and should fulfill their role as promoters of health / Relatos de dor no período pré-operatório são frequentes e podem sofrer influência de fatores socioeconômicos, clínicos, psicológicos e de comportamentos e condições de saúde. No entanto, pouco se conhece sobre a dor referida no período pré-operatório de cesariana, uma das cirurgias realizadas com maior frequência no cenário cirúrgico mundial. O objetivo da pesquisa foi identificar a prevalência, as características e os fatores associados à dor referida no período pré-operatório imediato de cesariana. Trata-se de análise transversal de dados da linha de base da pesquisa matriz, tipo coorte, aberta e prospectiva, cujos dados foram colhidos nas enfermarias e apartamentos de um hospital privado, conveniado ao Sistema único de Saúde, no município de Goiânia, Goiás, Brasil. O recrutamento das mulheres (n=1082) foi feito entre fevereiro de 2014 e julho de 2015. A amostra deste recorte compôsse de 877 mulheres. A variável de desfecho investigada foi o relato de qualquer dor referida pelas mulheres no período pré-operatório imediato. As características da dor incluíram a intensidade, mensurada por meio da Escala Numérica de Dor de 11 pontos (END), a qual permite a medida da intensidade por meio de números que representam a quantidade de dor sentida (0 (zero)=nenhuma dor; 1,2,3 e 4=dor leve; 5 e 6=dor moderada; 7,8 e 9=dor forte; e 10 (dez)=pior dor possível), localização; início e duração dos episódios dolorosos. As variáveis de associação foram: sintomas de ansiedade e depressão, avaliados por meio da Escala Hospitalar de Ansiedade e Depressão (HADS), além de variáveis sociodemográficas, clínicas, comportamentos e condições relacionados à saúde. Para análise estatística, foi utilizada a regressão logística a fim de identificar os fatores associados à dor pré-operatória. Na análise multivariada, as variáveis que apresentaram valores de p<0,10, foram incluídas. Valores de p<0,05 foram considerados significativos para todos os testes. A prevalência de dor pré-operatória foi de 27,5% (IC:95%:24,6-30,5). Os locais mais referidos pelas mulheres incluíram a região lombar (29,9%), pélvica/genital (22,4%) e cabeça (12,9%). A dor apareceu com maior prevalência no último trimestre de gestação (37,8%), sendo considerada pela maioria das participantes como uma queixa diária (68,5%). A intensidade foi classificada como forte em 44,8% dos casos. Dor pré-operatória esteve associada com dor relacionada à gestação (OR:3,50; 2,23-5,252) e sintomatologia para ansiedade (OR:1,61;1,14-2,28; p=0,006). A avaliação da dor no período pré-operatório inclui comportamentos negativos como a ansiedade, com vistas à utilização de terapêuticas para o adequado manejo. No pré- natal é fundamental a avaliação da dor que surgiu após a constatação da gravidez e suas características, a fim de implementar estratégias que contribuam na redução de convívio com essa experiência e, consequentemente, com os prejuízos no pós-operatório. Ao enfermeiro cabe parte dessa missão, juntamente com as enfermeiras obstetrizes, que podem e devem ocupar seu papel de promotoras da saúde.

Submitted by Daniella Santos (daniella.santos@ufma.br) on 2017-08-11T16:25:32Z No. of bitstreams: 1 Lilian Cavalcante.pdf: 2247557 bytes, checksum: 4945eb34fa27f507f7c034437b4eae18 (MD5) / Made available in DSpace on 2017-08-11T16:25:32Z (GMT). No. of bitstreams: 1 Lilian Cavalcante.pdf: 2247557 bytes, checksum: 4945eb34fa27f507f7c034437b4eae18 (MD5) Previous issue date: 2017-02-15 / Introduction: Obesity rates are rising significantly in the world. Cesarean delivery has been associated with increased obesity at all stages of life. Our objective was to evaluate the causal effect between cesarean delivery and body mass index in children. Methods: A cohort study was carried out, including 3,205 children between 1 and 3 years of age, born in 2010. After birth, 5,475 mothers and children were evaluated. Information on the type of delivery, maternal and child characteristics such as sociodemographic, morbidity and anthropometric conditions were collected. For the analysis of the causal effect a Directed Acyclic Graphs (DAG) was constructed to select the variables for minimum adjustment. Statistical analysis showed interchangeability between groups. Overweight in children by body mass index for age was defined by z> +2 score. Results: Of the 3,205 children evaluated (51.3% female), 48% were born by cesarean delivery, only 0.2% of the newborns were small for gestational age and 8.9% of the children were overweight. There was inadequacy of prenatal care in 37.8% of pregnancies. There is no causal relationship between cesarean delivery and body mass index in children between 1 and 3 years of age. Conclusion: The causal effect of cesarean section on the BMI of children was not observed. Through the methodology used, it was possible to attenuate possible biases of confounding and collision, and interchangeability between groups was observed. / Introdução: As taxas de obesidade estão aumentando significativamente no mundo. O parto cesáreo tem sido associado ao aumento de obesidade em todas as fases da vida. Nosso objetivo foi avaliar o efeito causal entre parto cesáreo e o índice de massa corporal em crianças. Métodos: Realizou-se um estudo do tipo coorte que incluiu 3.205 crianças entre 1 e 3 anos de idade, nascidas no ano de 2010. Após o nascimento, foram avaliados 5.475 mães e filhos. Informações sobre o tipo de parto, características maternas e do filho como condições sociodemográficas, morbidade e antropométricas foram coletadas. Para análise do efeito causal foi construído um Gráfico acíclico direcionado (DAG) para escolha das varáveis para ajuste mínimo. Após análise estatística foi verificado a permutabilidade entre os grupos. O excesso de peso nas crianças pelo índice de massa corporal para idade foi definido por escore z > +2. Resultado: Das 3.205 crianças avaliadas (51,3% do sexo feminino), 48% nasceram por parto cesáreo, apenas 0,2% dos recém nascidos foram pequenos para idade gestacional e 8,9% das crianças apresentaram excesso de peso .Houve inadequação do pré-natal em 37,8% das gestações. Não há relação de causa entre o parto cesáreo e índice de massa corporal em crianças entre 1 a 3 anos de idade. Conclusão: Não observou-se o efeito causal do parto cesáreo no IMC de crianças. Através da metodologia utilizada foi possível atenuar possíveis viéses de confundimento e colisão e foi observado permutabilidade entre os grupos.

Nesta dissertação, tratamos do espalhamento de partículas (elétrons e éxcitons) em sistemas nos quais o potencial espalhador está acoplado a modos vibracionais. Os efeitos do acoplamento, no espalhamento das partículas, são estudados em dois problemas particularmente interessantes, a saber: o tunelamento de elétrons em heterojunções e o espelhamento de excitações em sólidos. Em ambos há a possibilidade de ocorrência de espalhamento inelástico/ressonante assistido por fônons. Verifica-se que a interação com modos vibracionais induz o aparecimento de estruturas bastante peculiares nos coeficientes de transmissão e seções de choque. Tais estruturas decorrem da existência de espalhamento inelástico (abertura de novos canais) e de efeitos de interferência, construtiva destrutiva, característicos de sistemas nos quais se tem acoplamento entre um nível discreto e o contínuo. / In this work we consider the scattering of excitations in systems in which a local scatterer center is coupled to single vibrational mode. The effects of the coupling are studied in two particular systems, namely, the tunneling of electrons in heterojunctions and the scattering of excitations by impurities in solids. In both cases inelastic scattering is observed and peculiar structures in transmission amplitudes and cross sections are observed. Such structures are a direct consequence from the newly open scattering channels and from interference effects resulting from the coupling of the discret with the continuum.

A tese teve como objetivo demonstrar a contribuição para o jornalismo brasileiro dos textos de Clarice Lispector escritos para o Caderno B do Jornal do Brasil entre 1967 e 1973, na relação com outros textos do jornal e na relação com os acontecimentos políticos, sociais e culturais da época. Para realização da leitura dos textos, embasamo-nos na concepção de Mikhail Bakhtin sobre o enunciado concreto e nas peculiaridades constitutivas desta noção. A leitura demonstrou traços do olhar jornalístico de Clarice Lispector quando escrevia sobre situações político-sociais vividas pelos cidadãos brasileiros diante dos fatos que aconteceram no cotidiano, num período marcado pela censura, a que se instalou após o golpe militar de 1964 e a posterior ao decreto do Ato Institucional n.º5, em 1968. Seus textos reportavam os sentimentos de medo, de insegurança, de coragem, de covardia que se relacionavam com as questões de injustiça social, da perda de liberdade e outras questões ligadas à conjuntura político-econômica do País, acontecimentos exteriores com os quais Clarice Lispector enquanto intelectual e cidadã que conviveu e compartilhou com os outros cidadãos. / The thesis had the goal to demonstrate the contribution to the Brazilian journalism of the texts of Clarice Lispector written for Section B of Jornal do Brasil between 1967 and 1973 in relation to other newspaper texts regarding the political, social and cultural events from the period. For the fulfillment of text reading, we based ourselves on Mikhail Bakhtin conception about the utterance and constituent features of this notion. The reading has shown evidences of Clarice Lispector journalistic view when she wrote about political and social situations, experienced by Brazilian citizens facing facts that took place in daily life in a period imprinted by censorship, established after the 1964 military coup and subsequent decree of Institutional Act No 5 in 1968. Her texts reported the feelings of dread, insecurity and fearlessness related to social injustice matters, loss of freedom and other issues linked to the country political and economic state of affairs, external happenings with which Clarice Lispector as an intellectual and denizen coexisted and shared with other citizens.

L'anomalie isotopique de l'ozone observée au début des années 1980 a été la première manifestation de fractionnement isotopique indépendant de la masse d'origine chimique. Attribuée au départ, essentiellement au processus de formation de l'ozone, les travaux récents mettent en évidence d'autres contributions telles que la photodissociation. Cette thèse utilise une approche théorique basée sur des calculs ab initio de chimie et dynamique quantique pour déterminer les sections efficaces d'absorption et leurs variations isotopiques. Ces sections efficaces permettent d'étudier la photodissociation de l'ozone par irradiation du soleil (flux actinique) ; ce qui permet une évaluation précise du processus de photodissociation à l'enrichissement isotopique de l'ozone. Ces résultats pourront être intégrés dans un modèle global prenant en compte à la fois les processus de formation et de destruction de l'ozone. / The ozone isotopic anomaly observed in early 1980s has been the first occurance of mass independent fractionation of chemical origin. Assigned first, essentially to the ozone formation process, recent works show additional contributions such as the photolysis process. This thesis uses a theoretical approach based on ab initio quantum chemistry and dynamics computations to obtain the absorption cross sections and their isotopic variations. The absorption cross sections allow to study ozone's photodissociation by solar irradiation (actinic flux) ; which enables an accurate evaluation of the photodissociation process in ozone's isotopic enrichment. Obtained results could be integrated in a global model that takes into account both ozone's formation and destruction processes.

No Brasil, a saúde, como direito do cidadão e dever do Estado, é garantida pela constituição de 1998. Em 1983 foi criado o PAISM, propondo a perspectiva de atendimento integral à saúde da mulher, com o objetivo de considerar, no âmbito da saúde, também o entorno social, emo cional e psicológico da mulher, bem co mo as questões relacionadas à contra cepção. No entanto, sua implantação ainda não se realizou efetivamente até o momento atual, o que pode ser observa do pela alta prevalência de gestações indesejadas, dificuldade de acesso a informações sobre planejamento familiar, predomínio da esterilização cirúrgica feminina como método contraceptivo e da cesárea como via de parto, aspectos que ferem os direitos sexuais e reprodu tivos das mulheres. Um novo contexto tem se desenhado a partir da implanta ção da Lei 9 263, que regulamenta o planejamento familiar, e pela qual a este rilização cirúrgica é aprovada e passa a ser ofertada pelo sistema público de saúde, o que,por sua vez, permite a desvinculação da esterilização com o parto. O presente estudo tem por objeti vo conhecer as características das mu lheres que se esterilizaram pelo SUS, em Ribeirão Preto, entre 2000 e 2004, segun do o tipo de parto, cesárea e parto vagi nal. A amostra foi composta por 235 mulheres esterilizadas nos primeiros cinco anos de oferta da esterilização cirúrgica (2000-2004). Os dados foram coletados através de entrevistas domici liares, utilizando-se questionário estrutu rado. Os resultados demonstraram que a maioria das mulheres esterilizadas era branca, casada, com escolaridade até o ensino fundamental e pertencia à catego ria socioeconômica C e D. A maioria foi esterilizada entre 30 e 39 anos de ida de, com média de 33,3 e mediana de 33 anos, 52,3% faziam uso da pílula como método contraceptivo antes da esteriliza ção. Elas têm, em média, 3,2 filhos e 51,7% teve o primeiro filho entre 13 e 19 anos de idade. Este estudo indicou que as mulheres esterilizadas, em sua maioria, têm mais filhos, começaram a ter filhos mais cedo, usaram mais contra ceptivos enquanto esperavam pela cirurgia e se esterilizaram mais tarde quando comparadas aos resultados de outros estudos. Em relação ao tipo de parto, 71,2% dos partos ao longo da trajetória reprodutiva dessas mulheres foram vaginais, enquanto 28,8% cesáre as, o que aponta para o importante aspecto da desvinculação da esteriliza ção com a cesárea, como objetiva a Lei, e que essas mulheres que tiveram, em sua maioria, partos vaginais, estão tendo melhor acesso à esterilização. / The Brazilian Constitution of 1998 guarantees that health is a citizen right and a duty of the State. The PAISM (Women Health Comprehensive Program) was created emphasizing a comprehensive approach aiming to consi der the social, emotional and psychologi cal issues as part of health condition as well as contraception. However its imple mentation has not been completed up to now. This can be observed by the high prevalence of unwanted pregnancies, difficult access to family planning information, predominance of female surgical sterilization as a contraceptive method and the cesarean section. All these aspects are obstacles to sexual and reproductive rights. Since the implementation of the Federal Legal Act 9263 which regulates Family Planning Provision and approves surgical steriliza tion offering it in the public health system it is possible a disconnection between birth delivery and the surgical procedu re of sterilization. The objective of this study is to know the characteristics of women sterilized by SUS (Unified Health System) in Ribeirão Preto, betwen 2000 and 2004, according to the type of delive ry, cesarean or vaginal. The sample in cludes 235 sterilized women during the first five years of the surgical sterilizati on provision (2000-2004) Data was col lected through household interviews using a structured questionnaire. The results showed that the most sterilized women were white, married, with 8 years of schooling or less and belonged to socioeconomic category C or D. They were sterilized between 30 and 39 years old, with the average of 33.3 years old and median age of 33, 52.3% were using oral contraceptives before sterilization. They were found to have an average of 3,2 children and 51.7% had the first child between 13 and 19 years old. This study indicated that steri lized women had more children, started giving birth earlier and used contracepti ves while they waited for the surgery, and were sterilized later when compa red to the results of other studies. As to delivery types, 71,2% of deliveries along the reproductive history of these women were vaginal while 28% were cesarean what points out the important aspect of the disconnection between sterilization and the cesarean, as deter mined by law, and that these women who had mostly vaginal deliveries are having a better access to sterilization.

Quandles, which are algebraic structures related to knots, can be used to color knot diagrams, and the number of these colorings is called the quandle coloring invariant. We strengthen the quandle coloring invariant by considering a graph structure on the space of quandle colorings of a knot, and we call our graph the quandle coloring quiver. This structure is a categorification of the quandle coloring invariant. Then, we strengthen the quiver by decorating it with Boltzmann weights. Explicit examples of links that show that our enhancements are proper are provided, as well as background information in quandle theory.

In 2003 Cohn and Umans introduced a new group-theoretic framework for doing fast matrix multiplications, with several conjectures that would imply the matrix multiplication exponent $\omega$ is 2. Their methods have been used to match one of the fastest known algorithms by Coppersmith and Winograd, which runs in $O(n^{2.376})$ time and implies that $\omega \leq 2.376$. This thesis discusses the framework that Cohn and Umans came up with and presents some new results in constructing combinatorial objects called uniquely solvable puzzles that were introduced in a 2005 follow-up paper, and which play a crucial role in one of the $\omega = 2$ conjectures.

This dissertation presents muon charge asymmetry, fiducial differential cross section and CMS single muon trigger efficiency measurements as a function of muon pseudorapidity for inclusive W→μν events produced in proton-proton collisions at the LHC. The data were recorded by the CMS detector at a center-of-mass energy of 8 TeV and correspond to an integrated luminosity of 18.8 fb-1. Several comparisons are performed to cross-check the experimental results. Muon efficiency measurements are compared to estimated values from Monte Carlo simulations and reference values recommended by CMS physics object groups. The differential cross section and the charge asymmetry measurements are compared to theoretical predictions based on next-to-leading order and next-to-next-to-leading order QCD calculations with different PDF models. Inputs from the charge asymmetry and the differential cross section measurements for the determination of the next generation of PDF sets are expected to bring different predictions closer together and aid in reducing PDF uncertainties. The impact of the charge asymmetry on PDFs has been investigated by putting the asymmetry results into a QCD analysis at next-to-leading order and next-to-next-leading order with inclusive deep-inelastic scattering data from HERA. Significant improvement of the accuracy on the valence-quark distributions is observed. This measurement is recommended for more accurate constraints in future PDF determinations. More precise measurements of PDFs will improve LHC predictions.

Two-way left-turn lane (TWLTL) is one of the common median treatments on the roadway. It is found that a number of crashes reported in Florida State are related to TWLTLs. This research focused on evaluating the effect of TWLTLs on these crashes by using the statistical crash prediction model that can estimate the expected number of crashes on TWLTLs. The crash database for analysis was extracted from the Florida Traffic Crash Database based on the TWLTL section list provided by FDOT and combined with some traffic characteristics. It consisted of totally 1688 sample sections within a three-year period from 1996 to 1998. Based on the crash database, distribution fittings for Poisson, Negative Binomial and Lognormal regression were conducted for average number of crashes. According to the results, statistical crash predictive model was developed to estimate the average number of crashes. Negative Binomial regression was applied with four variables, ADT, access density, posted speed and number of lanes for the TWLTL sections. The regression parameters were estimated by using maximum likelihood method with statistical software. The findings of the analysis indicated that all of the variables adopted in the predictive model significantly affect the occurrence of crashes. And the average number of crashes increases with the increase of ADT, access density and number of lanes, while with the decrease of posted speed. After that, the goodness-of-fit of developed model was performed in term of Pearson's R-square and likelihood ratio index. The results showed that the Negative Binomial regression model could explain the relationship between the variables and the crash occurrence In the third part, an approach was developed to identify the TWLTL sections with safety concern. For an undivided roadway, the approach can be carried out to judge if the TWLTL is appropriate to be selected as the median treatment. During the process, the whole database was divided into six categories according to the posted speed and number of lanes. By adopting the selected percentile value from the distribution of average number of crashes for each category in the predictive model, the critical ADT values according to specific access density, number of lane and posted speed level for each category were calculated and tabulated. With the comparison of the actual ADT value and the critical ADT value, if the actual ADT is higher than the critical value, the TWLTL section is determined as the critical section, which means the TWLTL is not appropriate to be selected as the median treatment in this roadway section.