Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2018-03-13T12:59:15Z No. of bitstreams: 1 LucimarFernandesDeLima_DISSERT.pdf: 3667054 bytes, checksum: be4f9f2dbcf2b03cd194286f1b16b1bc (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2018-03-19T16:01:48Z (GMT) No. of bitstreams: 1 LucimarFernandesDeLima_DISSERT.pdf: 3667054 bytes, checksum: be4f9f2dbcf2b03cd194286f1b16b1bc (MD5) / Made available in DSpace on 2018-03-19T16:01:48Z (GMT). No. of bitstreams: 1 LucimarFernandesDeLima_DISSERT.pdf: 3667054 bytes, checksum: be4f9f2dbcf2b03cd194286f1b16b1bc (MD5) Previous issue date: 2017-11-17 / A pediculose ? caracterizada pela infesta??o por Pediculus humanus capitis no homem. Desde o ano de 1963 a pediculose vem crescendo significativamente, principalmente, no ambiente escolar e nos centros urbanos. Isso decorre da aglomera??o de pessoas, tendo em vista a facilidade com que ? transmitida. Os procedimentos terap?uticos atuais apresentam efeitos colaterais, oferecendo risco ? sa?de do hospedeiro e contribuindo para a resist?ncia do parasita aos f?rmacos utilizados, elevando os custos com o tratamento. Os autores se propuseram a desenvolver um produto alternativo at?xico, biocompat?vel, biodegrad?vel e que desfavore?a a muta??o gen?tica apresentada pelos piolhos aos tratamentos dispon?veis atualmente, tudo isso suportado na gest?o da inova??o. Para gerir o projeto foram preparadas amostras do hidrogel ? dispers?o de quitosana em solu??o aquosa de ?cido ac?tico com dissolu??o pr?via do metilparabeno e adi??o de ess?ncia e glicerina - para posterior uso no ensaio in vitro e caracteriza??o f?sico-qu?mica do produto. A caracteriza??o f?sico-qu?mica das amostras foi realizada atrav?s de an?lise organol?ptica, da an?lise reol?gica e aferi??o do pH. A valida??o metodol?gica do produto foi realizada atrav?s do ensaio in vitro, que envolveu a sele??o das amostras, a coleta e padroniza??o de mechas de cabelo, exame e classifica??o da pediculose e, por fim, a aplica??o e constata??o da efici?ncia do produto. A gest?o de custo foi realizada a partir dos c?lculos de custos fixos e vari?veis, necess?rios ? produ??o do hidrogel. Foi realizado o dep?sito do pedido de patente junto ao Instituto Nacional da Propriedade Industrial (INPI) sob o registro n? BR 1020150251793 para garantir o direito ? propriedade intelectual sobre o produto. Os resultados obtidos durante a caracteriza??o f?sico-qu?mica do hidrogel revelaram estabilidade na colora??o e no odor durante os 60 dias em que o hidrogel foi armazenado. Observou-se no estudo reol?gico o comportamento caracter?stico de fluidos pseudopl?sticos das dispers?es de quitosana preparadas, dada ? redu??o observada na viscosidade em fun??o da eleva??o da taxa de cisalhamento. O percentual de remo??o dos ovos na amostra tratada com o hidrogel foi maior (83% dos ovos na primeira aplica??o) do que o observado na exclusiva aplica??o de solu??o de ?cido ac?tico (32%). O tratamento utilizando o produto proposto, denominado hidrogel, pode ser disponibilizado a um pre?o competitivo, tendo em vista a m?dia de pre?os praticados pelos concorrentes. / Pediculosis is characterized by infestation by Pediculus humanus capitis in humans. Since 1963 pediculosis has been growing significantly, mainly in the school environment and in urban centers. This is due to the agglomeration of people, given the ease with which it is transmitted. The current therapeutic procedures present side effects, offering a risk to the health of the host and contributing to the resistance of the parasite to the drugs used, increasing costs with the treatment. The authors set out to develop an alternative, non-toxic, biocompatible, biodegradable product that would undermine the genetic mutation presented by lice to currently available treatments, all supported in the management of innovation. To manage the project, samples of the hydrogel - chitosan dispersion in aqueous solution of acetic acid were prepared with previous dissolution of methylparaben and addition of essence and glycerine - for later use in the in vitro test and physicochemical characterization of the product. The physico-chemical characterization of the samples was performed through organoleptic analysis, rheological analysis and pH measurement. The methodological validation of the product was performed through the in vitro test, which involved sample selection, collection and standardization of hair strands, examination and classification of pediculosis and, finally, application and verification of product efficiency. The cost management was carried out from the calculations of fixed and variable costs, necessary for the production of the hydrogel. The filing of the patent application was filed with the National Institute of Industrial Property (INPI) under registry number BR 1020150251793 to guarantee the right to intellectual property on the product. The results obtained during the physico-chemical characterization of the hydrogel revealed staining and odor stability during the 60 days in which the hydrogel was stored. It was observed in the rheological study the characteristic behavior of pseudoplastic fluids of the prepared chitosan dispersions, due to the observed reduction in viscosity as a function of the elevation of the shear rate. The percentage of egg removal in the hydrogel treated sample was higher (83% of the eggs in the first application) than that observed in the application of acetic acid solution (32%). The treatment using the proposed product, called hydrogel, can be made available at a competitive price, given the average prices of concurrents.

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

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-01-04T13:19:42Z No. of bitstreams: 1 LeandroAntonioPasa_TESE.pdf: 2290404 bytes, checksum: 02409d9ddb38171fd363b99f26390d89 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-01-05T18:51:41Z (GMT) No. of bitstreams: 1 LeandroAntonioPasa_TESE.pdf: 2290404 bytes, checksum: 02409d9ddb38171fd363b99f26390d89 (MD5) / Made available in DSpace on 2017-01-05T18:51:41Z (GMT). No. of bitstreams: 1 LeandroAntonioPasa_TESE.pdf: 2290404 bytes, checksum: 02409d9ddb38171fd363b99f26390d89 (MD5) Previous issue date: 2016-02-19 / A quantidade de informa??es coletadas e armazenadas cresce a cada dia nas mais diversas ?reas do conhecimento e t?cnicas de minera??o de dados s?o aplicadas a estes conjuntos de dados com o objetivo de extrair conhecimento ?til. A utiliza??o de um ou outro algoritmo, ou o mesmo algoritmo com diferentes atributos pode levar a diferentes resultados, devido ? diversidade dos conjuntos de dados. Na busca por solu??es eficientes para este problema, foram desenvolvidos m?todos de comit?s de m?quinas. Um comit? de m?quinas ? um conjunto de redes neurais trabalhando independentemente cujos resultados s?o combinados em uma ?nica sa?da, alcan?ando uma melhor generaliza??o do que cada uma das redes trabalhando separadamente. A proposta deste trabalho ? desenvolver um novo m?todo para comit?s de mapas de Kohonen, em que a combina??o (fus?o) dos mapas seja ponderada por ?ndices de valida??o de agrupamentos, que seja v?lido para combina??o de mapas de tamanhos iguais e mapas de tamanhos diferentes. O algoritmo proposto foi testado em variados conjuntos de dados provenientes do reposit?rio UCI e do Conjunto de Problemas Fundamentais de Agrupamento. As simula??es computacionais demonstram que o m?todo proposto neste trabalho ? capaz de alcan?ar resultados promissores, conseguindo elevar a performance em compara??o com um ?nico mapa de Kohonen. / The amount of collected and stored information is growing every day in several areas of knowledge and data mining techniques are applied to these datasets in order to extract useful knowledge. One or another algorithm, or the same algorithm with different attributes, can lead to different results due to the dataset diversity. To solve this problem, machines committees methods were developed. A machine committee is a set of neural networks working independently and the results are combined into a single output, achieving a better generalization. The purpose of this work is to develop a new method for Kohonen maps ensemble, where the maps fusion is weighted by cluster validation indices and is suitable for equal size maps fusion and for different size maps fusion. The proposed algorithm has been tested in multiple data sets from the UCI Machine Learning Repository and Fundamental Clustering Problems Suite. Computer simulations show the proposed method is able to reach encouraging results, obtaining raising performance compared with a single Kohonen map.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-01-27T13:30:49Z No. of bitstreams: 1 AnaBeatrizDeAlmeidaMedeiros_TESE.pdf: 2411384 bytes, checksum: 92c650f6680920b2f593c10ef84b8ed7 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-01-31T13:24:12Z (GMT) No. of bitstreams: 1 AnaBeatrizDeAlmeidaMedeiros_TESE.pdf: 2411384 bytes, checksum: 92c650f6680920b2f593c10ef84b8ed7 (MD5) / Made available in DSpace on 2017-01-31T13:24:12Z (GMT). No. of bitstreams: 1 AnaBeatrizDeAlmeidaMedeiros_TESE.pdf: 2411384 bytes, checksum: 92c650f6680920b2f593c10ef84b8ed7 (MD5) Previous issue date: 2016-08-08 / Este estudo objetivou validar o diagn?stico de enfermagem Risco de ?lcera por press?o em pacientes internados na unidade de terapia intensiva. Diante da gravidade, complexidade e grau de depend?ncia dos pacientes cr?ticos, surge a necessidade da enfermagem avaliar a presen?a desse diagn?stico para atuar na preven??o dos fatores de risco e na manuten??o da qualidade nos servi?os ofertados. Tratou-se de um estudo metodol?gico, desenvolvido em tr?s etapas: an?lise de conceito, an?lise do conte?do por especialistas e valida??o cl?nica. A primeira etapa foi baseada no modelo de Walker e Avant e operacionalizada atrav?s de revis?o da literatura, que aconteceu nos meses de fevereiro e mar?o de 2015. Utilizaram-se as bases de dados: Scopus, Literatura Latino-Americana e do Caribe em Ci?ncias da Sa?de, Cumulative Index to Nursing and Allied Health Literature, National Library of Medicine and Nattional Institutes of Health e Web of Science, e os descritores: ?lcera por press?o, fatores de risco e unidades de terapia intensiva e suas respectivas sinon?mias em ingl?s. Obteve-se uma amostra de 22 artigos. Ap?s a an?lise do conceito, identificaram-se 42 antecedentes e os seguintes atributos essenciais: Press?o; Press?o em combina??o com cisalhamento; e Isquemia tecidual. Na segunda etapa, foram solicitadas as opini?es dos especialistas com rela??o ? an?lise de conceito e de conte?do, por meio de grupo focal, composto por sete enfermeiras, em quatro encontros, durante os meses de maio a julho de 2015. Ap?s a discuss?o no grupo focal, resultou-se um total de 29 antecedentes e na seguinte defini??o conceitual para o diagn?stico estudado: Vulnerabilidade de rompimento da integridade da pele como resultado da isquemia tecidual ocasionada por press?o ou press?o em combina??o com cisalhamento. Na terceira etapa, foi realizado um estudo de caso-controle, com intuito de avaliar, na pr?tica cl?nica, a precis?o dos fatores de risco do diagn?stico de enfermagem identificados e validados nas etapas anteriores. Esta etapa ocorreu na unidade de terapia intensiva do Hospital Universit?rio Onofre Lopes, atrav?s de um formul?rio. A amostra consistiu de 180 participantes, sendo 90 no grupo caso e 90 no grupo controle. O projeto de pesquisa foi submetido e aprovado pelo Comit? de ?tica em Pesquisa do referido hospital, sob n?mero de protocolo 848.997 e Certificado de Apresenta??o para Aprecia??o ?tica 36883714.5.0000.5292. Os resultados mostram que, atrav?s da aplica??o do modelo de regress?o log?stica hier?rquica, um conjunto de cinco fatores de risco e um aspecto cl?nico deve ser visto como um forte indicativo do aumento do risco para ?lcera por press?o. Os fatores de risco foram: Hist?ria de ?lcera por press?o, Tempo prolongado de perman?ncia na UTI; Fric??o, Desidrata??o e Temperatura elevada da pele em torno de 1 a 2 ?C. E o aspecto cl?nico foi: Tratamento das comorbidades. Conclui-se que o diagn?stico de enfermagem Risco de ?lcera por press?o p?de ser validado em seus aspectos de conceito, de conte?do e cl?nicos e que existe um conjunto de vari?veis que aumentam a chance da ocorr?ncia do diagn?stico de enfermagem Risco de ?lcera por press?o em pacientes internados em unidade de terapia intensiva. Assim, acredita-se que o estudo contribuiu para o aperfei?oamento da linguagem diagn?stica, com vistas a ado??o de medidas preventivas, aplica??o de interven??es mais eficazes, alcance de resultados positivos e melhoria da qualidade do cuidado prestado pelo enfermeiro. / The objective of this study was to validate the nursing diagnosis ?Pressure ulcer risk? in patients admitted to the intensive care unit. Faced with the severity, complexity and degree of dependence of the critical patients, nursing needs to assess the presence of this diagnosis to act in the prevention of risk factors and maintenance of quality in the services offered. This was a methodological study, conducted in three steps: concept analysis, content analysis by experts and clinical validation. The first step was based on the model of Walker and Avant and performed through literature review, which occurred in the months of February and March 2015. We used the databases: Scopus, Latin American and Caribbean Health Sciences Literature, Cumulative Index to Nursing and Allied Health Literature, National Library of Medicine and National Institutes of Health, and Web of Science, and the descriptors: pressure ulcer, risk factors and intensive care units, and their respective synonyms in the English language. We obtained a sample of 22 papers. After completing the concept and content analysis, we identified 42 backgrounds and the following essential attributes: Pressure; Pressure combined with shearing; and Tissue ischemia. In the second step, we asked the experts to give opinions about the concept analysis, by means of a focus group, composed of seven nurses, in four meetings, which were held from May to July 2015. After finishing the discussion in the focus group, we had a total of 29 backgrounds, besides the following conceptual definition for the diagnosis under study: Vulnerability of rupture of the skin integrity as a result of the tissue ischemia provoked by pressure or pressure combined with shearing. In the third step, we conducted a case-control study with the aim of assessing, in clinical practice, the accuracy of the risk factors of the nursing diagnosis identified and validated in the preceding steps. This step took place in the intensive care unit of the Onofre Lopes University Hospital, through a form. The sample was composed of 180 participants, with 90 in the case group and 90 in the control group. The research project was submitted and approved by the Research Ethics Committee of the aforementioned hospital, under Protocol number 848.997 and Presentation Certificate for Ethics Assessment number 36883714.5.0000.5292. The results show that, through the application of the hierarchical logistic regression model, a set of five risk factors and one clinical aspect must be regarded as a strong indicator of the increased risk for pressure ulcer. The risk factors were: History of pressure ulcer; Extended period of stay in the ICU; Friction, Dehydration and High skin temperature around 1 to 2 ? C. As for the clinical aspect, it was: Treatment of comorbidities. We conclude that the nursing diagnosis of pressure ulcer risk could be validated in aspects of concept, content and clinical and that there is a set of variables that increase the chance of occurrence of the nursing diagnosis ?Pressure ulcer risk? in patients admitted to the intensive care unit. Accordingly, we believe that this study has contributed to the improvement of the diagnostic parlance, with regard to adopting preventive measures, applying more effective interventions, achieving positive results and improving the quality of the health care provided by the nursing professional.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-02-13T19:44:49Z No. of bitstreams: 1 GrazieneLopesDeSouza_DISSERT.pdf: 1409638 bytes, checksum: b2258a2f626dcdfadfc00445de366ca7 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-02-14T21:07:25Z (GMT) No. of bitstreams: 1 GrazieneLopesDeSouza_DISSERT.pdf: 1409638 bytes, checksum: b2258a2f626dcdfadfc00445de366ca7 (MD5) / Made available in DSpace on 2017-02-14T21:07:26Z (GMT). No. of bitstreams: 1 GrazieneLopesDeSouza_DISSERT.pdf: 1409638 bytes, checksum: b2258a2f626dcdfadfc00445de366ca7 (MD5) Previous issue date: 2015-06-26 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES) / Anacardium occidentale Linn ? uma ?rvore nativa do Brasil, popularmente conhecida como cajueiro. Estudos mostram que a fra??o Acetato de Etila (AcOEt) obtida a partir do extrato acetona das cascas do caule de A. occidentale apresenta atividade anti-inflamat?ria, sugerindo-se os taninos como respons?veis por essa a??o. Sendo uma das 71 esp?cies da Rela??o Nacional de Plantas Medicinais de Interesse ao Sistema ?nico de Sa?de (RENISUS), ? importante que sejam desenvolvidas metodologias anal?ticas para o estudo dos seus constituintes. Nesse contexto, a Cromatografia L?quida de Alta Efici?ncia (CLAE) constitui uma metodologia de import?ncia para a an?lise de amostras de origem vegetal. Este estudo teve como objetivo desenvolver e validar uma metodologia anal?tica por CLAE para a an?lise da fra??o AcOEt do extrato acetona das cascas do caule de A. occidentale. As condi??es cromatogr?ficas foram estabelecidas utilizando como fase m?vel ?cido ac?tico a 0,3% e acetonitrila. Como ponto de partida para o desenvolvimento do m?todo cromatogr?fico, foi utilizado um gradiente explorat?rio, que permite analisar todas as faixas de polaridade. O gradiente de elui??o foi ent?o ajustado at? a obten??o de um cromatograma com adequada separa??o e par?metros cromatogr?ficos satisfat?rios. Para a identifica??o dos compostos, foi realizada a an?lise de padr?es e, pela observa??o dos tempos de reten??o e espectros de absor??o das subst?ncias, foi poss?vel eleger as que estariam presentes na amostra. Foi poss?vel sugerir a presen?a de catequina, epicatequina, epigalocatequina e ?cido g?lico na fra??o AcOEt de A. occidentale. Para a valida??o do m?todo, foram realizados os testes de linearidade, precis?o, exatid?o, robustez, limites de detec??o e quantifica??o. O m?todo foi avaliado como sendo linear, preciso e exato para os compostos estudados. Dentre as condi??es de an?lise alteradas para o estudo da robustez, o m?todo n?o apresentou robustez para a an?lise do ?cido g?lico, quando a temperatura da coluna foi de 35?C, mas as demais condi??es alteradas n?o promoveram mudan?as estatisticamente significativas para este analito. Conclui-se que o m?todo cromatogr?fico ? adequado para a an?lise da fra??o AcOEt do extrato acetona de A. occidentale. / Anacardium occidentale Linn is a tree native to Brazil, popularly known as cashew. Studies show that the Ethyl Acetate fraction (EtOAc) obtained from the acetone:water extract of the A. occidentale stem bark has anti-inflammatory activity, suggesting tannins as responsible for this action. As one of 71 species of the National List of Medicinal Plants of Interest to the Unified Health System (RENISUS), it is important that analytical methodologies for the study of its constituents are developed. In this context, the High Performance Liquid Chromatography (HPLC) is a method of importance to the analysis of samples of plant origin. This study aimed to develop and validate an analytical methodology by HPLC for analysis of EtOAc fraction of acetone:water extract from the stem bark of A. occidentale. The chromatographic conditions were established using acetic acid 0.3% (v/v in water) and acetonitrile as the mobile phase. As a starting point for the development of chromatographic procedures, exploratory gradient was used, which allows to analyze all polarity groups. The gradient elution was then adjusted to obtain a chromatogram with adequate separation and satisfactory chromatographic parameters. For identification of the compounds, the pattern analysis was carried out, and by observing the retention times and absorption spectra of the substances was possible to choose those which would be present in the sample. It could suggest the presence of catechin, epicatechin, epigallocatechin and gallic acid in the EtOAc fraction of A. occidentale. To validate the method, linearity tests were performed, precision, accuracy, robustness, limits of detection and quantification. According to Resolution 899/2003 (ANVISA), the method was assessed to be linear, precise and accurate for the studied compounds. Among the changed analysis conditions for studying the robustness of the method, when the column temperature was 35?C analysis did not present robustness for gallic acid, but when other conditions were changed it did not promote statistically significant changes to this analyte. It follows that the chromatographic method is suitable for analysis of gallic acid, catechin and epicatechin in EtOAc fraction of the acetone:water extract of the A. occidentale.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-04-17T23:08:14Z No. of bitstreams: 1 CileneNunesDantas_TESE.pdf: 2563015 bytes, checksum: b3aa845befddb2f6863a7e2507250995 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-04-20T20:01:01Z (GMT) No. of bitstreams: 1 CileneNunesDantas_TESE.pdf: 2563015 bytes, checksum: b3aa845befddb2f6863a7e2507250995 (MD5) / Made available in DSpace on 2017-04-20T20:01:01Z (GMT). No. of bitstreams: 1 CileneNunesDantas_TESE.pdf: 2563015 bytes, checksum: b3aa845befddb2f6863a7e2507250995 (MD5) Previous issue date: 2016-12-05 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES) / Este estudo teve como objetivo desenvolver um software (prot?tipo) para consulta de enfermagem aplicada ao acompanhamento do crescimento e desenvolvimento infantil na Aten??o Prim?ria ? Sa?de, cujos objetivos espec?ficos foram construir e validar o conte?do de um instrumento de hist?rico de enfermagem para a primeira consulta e subsequente aplicada ao acompanhamento do crescimento e desenvolvimento infantil, fundamentado na Teoria das Necessidades Humanas B?sicas e na Classifica??o Internacional para as Pr?ticas de Enfermagem; propor um software (prot?tipo) para a consulta de enfermagem aplicada ao acompanhamento do crescimento e desenvolvimento infantil. Trata-se de um estudo metodol?gico para elabora??o do instrumento de consulta de enfermagem que constou de cinco fases: revis?o da literatura; estrutura??o dos instrumentos para valida??o do conte?do da consulta de enfermagem para o acompanhamento do crescimento e desenvolvimento infantil; sele??o dos ju?zes para participa??o no estudo; valida??o de conte?do do Hist?rico de Enfermagem: T?cnica de Delphi; e desenvolvimento do ambiente do Telenfermagem (software-prot?tipo) para o acompanhamento do crescimento e desenvolvimento infantil. A pesquisa seguiu os preceitos ?ticos que regem a pesquisa cient?fica com seres humanos do Conselho Nacional de Sa?de, aprovada pelo Comit? de ?tica e Pesquisa, por meio do Parecer Consubstanciado n? 925.408, de 18/12/2014, sob o n?mero CAAE 39640914.8.0000.5537. A an?lise dos dados ocorreu por estat?stica descritiva simples, atrav?s de frequ?ncias absolutas e relativa, m?dia, desvio padr?o, teste binomial e ?ndice de validade de conte?do. Os resultados foram apresentados em tr?s manuscritos: 1. Consulta de enfermagem para acompanhamento do crescimento e desenvolvimento infantil na Aten??o Prim?ria ? Sa?de: revis?o integrativa; 2. Valida??o de instrumento de hist?rico de enfermagem para o acompanhamento do crescimento e desenvolvimento infantil; 3. Software-prot?tipo para o acompanhamento do crescimento e desenvolvimento infantil na Aten??o Prim?ria ? Sa?de. O primeiro artigo, est? relacionado aos achados para caracteriza??o da consulta ? crian?a, que revelaram lacunas nesssa para o acompanhamento do crescimento e desenvolvimento infantil em virtude das limita??es relacionadas ao conhecimento te?rico e/ou pr?tico do enfermeiro na Aten??o Prim?ria ? Sa?de. O segundo artigo revela a valida??o de conte?do dos instrumentos para a primeira consulta e subsequente aplicada ? crian?a. Faz refer?ncia a utiliza??o da etapa Delphi 1, na qual oito ju?zes avaliaram os instrumentos de hist?rico de enfermagem, das etapas Delphi 2 e 3, seis. O hist?rico de enfermagem para primeira consulta e subsequente foram avaliados pelos ju?zes de acordo com o crit?rio de concord?ncia. Considerou-se v?lido em seu conte?do os instrumentos que obtiveram consenso de 80% entre os experts. O artigo 3 est? relacionado ao software, desenvolvido sobre plataforma web e apresenta os requisitos previamente estabelecidos que est?o relacionados ao sistema, resultando em atividades que est?o acess?veis para os usu?rios (administrador e enfermeiro usu?rio) cadastrados no sistema. Destarte, as conclus?es apontam que os instrumentos de hist?rico de enfermagem e software elaborados e validados possuem potencialidades e limita??es, poder?o nortear a pr?tica do enfermeiro da Estrat?gia de Sa?de da Fam?lia, oportunizar uma comunica??o mais efetiva, o empoderamento e autonomia do enfermeiro na Aten??o Prim?ria ? Sa?de. / This study aimed to develop a software (prototype) for nursing consultation applied to the monitoring of child growth and development in Primary Health Care, whose specific objectives were to build and validate the content of a nursing history instrument for the first consultation and Applied to the monitoring of child growth and development, based on the Basic Human Needs Theory and the International Classification for Nursing Practices; Propose a software (prototype) for the nursing consultation applied to the monitoring of child growth and development. This is a methodological study for the elaboration of the nursing consultation instrument that consisted of five phases: literature review; Structuring of the instruments for validation of EC content for the monitoring of children's CD; Selection of judges for participation in the study; Validation of Nursing History content: Delphi Technique; And development of the Telenfermagem environment (software-prototype) for the follow-up of the children's CD. The research followed the ethical precepts that govern the scientific research with human beings of the National Health Council, approved by the Committee of Ethics and Research, through Opinion No 925.408, of 12/18/2014, under the number CAAE 39640914.8.0000.5537 . The data analysis was performed by simple descriptive statistics, using absolute and relative frequencies, mean, standard deviation, binomial test and IVC. The results were presented in three manuscripts: 1. Nursing consultation to monitor child growth and development in Primary Health Care: integrative review; 2. Validation of a nursing history instrument for monitoring child growth and development; 3. Software-prototype for the follow-up of children's growth and development in Primary Health Care. The first article is related to the findings to characterize the child's consultation, which revealed gaps in the monitoring of children's CD due to limitations related to Theoretical and / or practical knowledge of the nurse in PHC. The second article reveals the validation of content of the instruments for the first and subsequent consultation applied to the child. It refers to the use of the Delphi 1 stage, in which eight judges evaluated the nursing history instruments of Delphi 2 and 3, 6 stages. The nursing history for the first and subsequent consultations were evaluated by the judges according to the criterion of agreement. The instruments that obtained a consensus of 80% among experts were considered valid in their content. Article 3 is related to software, developed on web platform and presents the previously established requirements that are related to the system, resulting in activities that are accessible to the users (administrator and nurse user) registered in the system. Thus, the conclusions point out that the elaborated and validated nursing and software tools have potentialities and limitations, could guide the practice of the nurse in the Family Health Strategy, provide more effective communication, nurse empowerment and autonomy in Primary Care the health.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-04-17T23:08:15Z No. of bitstreams: 1 FabianeRochaBotareli_TESE.pdf: 2442381 bytes, checksum: 41d6068d7d112e405810a025b8ac5066 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-04-20T21:10:14Z (GMT) No. of bitstreams: 1 FabianeRochaBotareli_TESE.pdf: 2442381 bytes, checksum: 41d6068d7d112e405810a025b8ac5066 (MD5) / Made available in DSpace on 2017-04-20T21:10:14Z (GMT). No. of bitstreams: 1 FabianeRochaBotareli_TESE.pdf: 2442381 bytes, checksum: 41d6068d7d112e405810a025b8ac5066 (MD5) Previous issue date: 2016-12-12 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico (CNPq) / Objetivou-se validar o diagn?stico de enfermagem Risco de olho seco em pacientes internados em Unidade de Terapia Intensiva. Trata de um e 1) Constru??o das defini??es conceituais e operacionais dos fatores de risco do olho seco; 2) Valida??o cl?nica do diagn?stico de enfermagem Risco de olho seco. A primeira etapa foi operacionalizada por meio de revis?o integrativa para constru??o das defini??es conceituais e operacionais dos fatores de risco para o olho seco e subsidiou a etapa de valida??o cl?nica. Esta foi operacionalizada por meio de um estudo de coorte prospectivo Definiu-se a amostra de 69 pacientes com tempo de coleta de 7 meses. Crit?rios de inclus?o: pacientes sem olho seco na admiss?o, idade maior ou igual de 18 anos e tempo de interna??o maior que 24 horas. Crit?rios de exclus?o: diagn?stico pr?vio de doen?as da superf?cie ocular, cirurgias faciais e uso de qualquer tipo de medicamento ocular t?pico. A avalia??o aconteceu diariamente e com tempo de seguimento de at? cinco dias. O desfecho de olho seco foi estabelecido por crit?rios cl?nicos e teste de Schirmer. Os dados descritivos foram analisados por meio de frequ?ncias simples, m?dia, mediana, desvio padr?o e coeficiente de varia??o. As medidas de associa??o entre as vari?veis de desfecho e preditoras foram calculadas pelo teste qui-quadrado e teste exato de Fisher. O n?vel de signific?ncia adotado foi de 5%. A medida de associa??o entre exposi??o e desfecho utilizada foi o Risco Relativo. Esta pesquisa foi submetida e aprovada pelo Comit? de ?tica em Pesquisa da Universidade Federal do Rio Grande do Norte. 75,36% dos pacientes tiveram olho seco e 24,64% o diagn?stico de enfermagem Risco de olho seco. A etapa 1 do estudo permitiu o refinamento dos fatores de risco para os pacientes internados em UTI e construiu as defini??es constitutivas e operacionais para padroniza??o da valida??o cl?nica. Os fatores de risco validados na etapa 2 foram: lagoftalmia (p <0,041; RR=3,51); ventila??o mec?nica invasiva (p<0,002; RR=2,18), quemose (<0,06; RR=4,94), aus?ncia ou redu??o do reflexo espont?neo de piscar (p<0,037; RR=0,60); analg?sicos opi?ides (p< 0,001; RR=17,50); sedativos (p<0,001; RR=10,83); antibi?ticos (p< 0,029; RR=7,69); vasodilatadores (p< 0,019; RR=0,19). Os resultados possibilitaram a revis?o do diagn?stico de enfermagem e sugeriu a mudan?a do termo olho seco para ressecamento ocular. Al?m disso, baseados nas evid?ncias apresentadas dos crit?rios definidos para o desfecho de ressecamento ocular (hiperemia conjuntival: RR=18,37; secre??o mucosa: RR=12; teste de Schirmer: RR=0,35; todos com p <0,001) foi proposto um novo diagn?stico de enfermagem Ressecamento ocular. Portanto, acredita-se que este estudo ? inovador para o avan?o do conhecimento sobre a tem?tica e para o aperfei?oamento e valida??o do uso da taxonomia da NANDA-I por enfermeiros que atuam neste cen?rio, com vistas a proporcionar subs?dio para avalia??o ocular precisa, acur?cia na infer?ncia do diagn?stico em quest?o, predi??o de risco como ado??o de medidas de preven??o e monitoramento de complica??es. / The objective of this study was to validate the nursing diagnosis of dry eye risk in patients admitted to the Intensive Care Unit. It is a methodological study developed in two stages of validation of nursing diagnoses: 1) Construction of the conceptual and operational definitions of dry eye risk factors; 2) Clinical validation of the nursing diagnosis Dry eye risk. The first step was operationalized through an integrative review to construct the conceptual and operational definitions of risk factors for dry eye and subsidized the clinical validation stage. This was performed using a prospective cohort study. A sample of 69 patients with a collection time of 7 months was defined. Inclusion criteria: patients without dry eye at admission, age greater than or equal to 18 years and length of hospital stay longer than 24 hours. Exclusion criteria: prior diagnosis of ocular surface diseases, facial surgeries and use of any topical ocular medication. The evaluation took place daily and with a follow-up time of up to five days. The dry eye outcome was established by clinical criteria and Schirmer's test. Descriptive data were analyzed using simple frequencies, mean, median, standard deviation and coefficient of variation. The measures of association between the outcome variables and predictors were calculated using the chi-square test and Fisher's exact test. The level of significance was 5%. The measure of association between exposure and outcome used was Relative Risk. This research was submitted and approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte. 75.36% of the patients had dry eye and 24.64% the nursing diagnosis Dry eye risk. Stage 1 of the study allowed the refinement of risk factors for ICU patients and constructed the constitutive and operational definitions for the standardization of clinical validation. The risk factors validated in stage 2 were: lagoftalmia (p <0.041; RR = 3.51); (P <0.001, RR = 0.60), absence or reduction of the spontaneous flashing reflex (p <0.037, RR = 0.60); Opioid analgesics (p <0.001, RR = 17.50); Sedatives (p <0.001, RR = 10.83); Antibiotics (p <0.029, RR = 7.69); Vasodilators (p <0.019, RR = 0.19). The results allowed the revision of the nursing diagnosis and suggested the change of dry eye term for ocular dryness. In addition, based on the evidence presented from the criteria defined for the outcome with p <0.001 for ocular dryness (conjunctival hyperemia: RR = 18.37; mucus secretion: RR = 12; Schirmer test: RR = 0.35) was possible propose a new nursing diagnosis Eye dryness. Therefore, it is believed that this study is innovative for the advancement of knowledge on the subject and for the improvement and validation of the use of NANDA-I taxonomy by nurses working in this scenario, in order to provide support for precise ocular evaluation, accuracy In the inference of the diagnosis in question, prediction of risk as adoption of measures of prevention and monitoring of complications.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-10-18T19:26:56Z No. of bitstreams: 1 IsabelKarolyneFernandesCosta_TESE.pdf: 2181357 bytes, checksum: 8d98e8818bf89e0f537997a189865771 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-10-18T22:25:08Z (GMT) No. of bitstreams: 1 IsabelKarolyneFernandesCosta_TESE.pdf: 2181357 bytes, checksum: 8d98e8818bf89e0f537997a189865771 (MD5) / Made available in DSpace on 2017-10-18T22:25:08Z (GMT). No. of bitstreams: 1 IsabelKarolyneFernandesCosta_TESE.pdf: 2181357 bytes, checksum: 8d98e8818bf89e0f537997a189865771 (MD5) Previous issue date: 2017-07-07 / O objetivo dessa investiga??o foi analisar as evid?ncias de valida??o de um curso de Suporte B?sico de Vida (SBV) na modalidade de ensino a dist?ncia (EAD) para acad?micos e profissionais de sa?de de um Hospital Universit?rio. Trata-se de uma pesquisa metodol?gica, quantitativa, utilizando enquanto referencial te?rico a teoria psicom?trica de Pasquali. O estudo desenvolveu-se em duas etapas: constru??o e valida??o do conte?do de tr?s ferramentas: instrumento de avalia??o de conhecimento em suporte b?sico de vida (ACSBV); conte?do do curso de Suporte B?sico de Vida (CSBV) e roteiro do jogo educativo simulado de Suporte B?sico de Vida (JESBV). A amostra para valida??o do instrumento de avalia??o do conhecimento foi composta por 29 ju?zes e seis ju?zes para o curso e roteiro do jogo. A coleta de dados foi realizada entre agosto e setembro de 2016. O estudo foi aprovado (Parecer n? 1.709.004 e CAAE: 58511516.0.0000.5292) pelo Comit? de ?tica em Pesquisa do Hospital Universit?rio Onofre Lopes. Os dados foram analisados por meio de estat?stica descritiva e inferencial, utilizando os programas Microsoft-Excel e SPSS 20.0, com uso do ?ndice Kappa (K) e ?ndice de Validade de Conte?do (IVC), considerando aceit?vel K ?0,65 e IVC>0,80. O n?vel de signific?ncia estat?stica estabelecido para o valor de ? foi < 0,05. O ACSBV continha inicialmente 13 quest?es. Na valida??o do ACSBV, verificou-se que das 33 sugest?es realizadas, 18 foram acatadas, 3 rejeitadas e 12, ap?s an?lise de valores de IVC e Kappa, serviram de orienta??o para a exclus?o de tr?s quest?es. Assim, ao final foram removidas as quest?es (5, 6 e 13) com ?ndice K ou IVC menores que o estabelecido nesse estudo, sendo a clareza o requisito com menores valores de adequa??o. Na avalia??o global, ap?s retirada das tr?s quest?es, o instrumento final ficou com 10 quest?es e obteve IVC de 0,95 e K de 0,81. Quanto ao processo de valida??o do CSBV, verificou-se que das 16 sugest?es realizadas, 14 foram acatadas e apenas 2 rejeitadas. A maioria das sugest?es esteve relacionada aos requisitos avalia??o geral do conte?do, utilidade, clareza, objetividade e vocabul?rio. Desse modo, o CSBV foi validado com ?ndices satisfat?rios pelos ju?zes (IVC = 0,94; K = 0,87; nota m?dia 9,50). Quanto ao JESBV, esse foi desenvolvido em 13 telas, das quais 9 apresentaram conte?dos de SBV, e as demais orienta??es gerais para o avan?ar do jogo. A elabora??o do roteiro priorizou a complexidade gradativa dos conhecimentos em SBV com cuidados minuciosos na organiza??o dos textos e na proposta das anima??es. Das cinco sugest?es realizadas, todas foram acatadas, sendo a maioria relacionada aos requisitos de organiza??o, clareza e vocabul?rio. Nenhum item foi considerado inadequado, apresentando o jogo um valor m?dio de 0,95 de IVC; 0,81 de Kappa e nota m?dia de 9,67. O desenvolvimento de todas as ferramentas que comp?e o Curso de Suporte B?sico de Vida (CSBV) em EAD apesar de ter se mostrado um processo complexo e desafiador ? v?lido para apoiar o ensino de urg?ncia (nessa tem?tica) para acad?micos e profissionais de sa?de. / The objective of this research was to analyze the evidences of validation of a Basic Life Support (BLS) course in distance education for academics and health professionals of a University Hospital. It is a methodological and quantitative research that used as theoretical reference the psychometric theory of Pasquali. The study was developed in two stages: construction and validity of the content of three tools: tool for knowledge assessment in BLS; contents of the BLS course and simulated educational game on BLS. The sample for validation of the knowledge assessment instrument was composed by 29 judges and six judges for the course and script of the game. Data collection was performed between August and September 2016. The study was approved (Opinion No. 1.709.004 and CAAE: 58511516.0.0000.5292) by the Research Ethics Committee of Onofre Lopes University Hospital. The data were analyzed using descriptive and inferential statistics, using Microsoft Excel and SPSS 20.0 softwares, using Kappa (K) index and Content Validity Index (CVI), being considering acceptable K?0,65 and CVI>0,80. The level of statistical significance established for the value of ? was <0,05. The knowledge assessment on BLS initially contained 13 questions. In the validation of the knowledge assessment on BLS, it was verified that of the 33 suggestions made, 18 were accepted, 3 were rejected and 12, after analysis of values of CVI and Kappa, served as guidance for the exclusion of three questions. Thus, it were removed the questions (5, 6 and 13) with a K or CVI values lower than the one established in this study, being clarity the requirement with lower values of adequacy. In the overall evaluation, after the removal of the three questions, the final instrument had 10 questions and obtained a CVI of 0,95 and K of 0,81. As for the BLS course validation process, it was verified that of the 16 suggestions made, 14 were accepted and only 2 rejected. Most suggestions were related to the general evaluation requirements of content, usefulness, clarity, objectivity and vocabulary. Thus, the BLS course was validated with satisfactory indexes by the judges (CVI 0,94, K 0,87, mean score 9,50). As for the educational game on BLS, it was developed in 13 screens, of which 9 presented BLS contents, and the other, general orientations for the advancement in the game. The elaboration of the script prioritized the gradual complexity of the BLS knowledge with meticulous care in the organization of the texts and the proposal of the animations. Of the five suggestions made, all were followed, most of them related to the requirements of organization, clarity and vocabulary. No item was considered inappropriate, with the game presenting an average value of 0,95 of CVI, 0,81 of Kappa and a mean score of 9,67. The development of all the tools that composed the BLS course in distance education, despite having proved to be a complex and challenging process, is valid to support emergency education (in this theme) for academics and health professionals.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-10-18T21:24:04Z No. of bitstreams: 1 RosimeryCruzDeOliveiraDantas_TESE.pdf: 5591036 bytes, checksum: 13fb6a2c807443a41da890082aa5eb7e (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-10-30T20:44:00Z (GMT) No. of bitstreams: 1 RosimeryCruzDeOliveiraDantas_TESE.pdf: 5591036 bytes, checksum: 13fb6a2c807443a41da890082aa5eb7e (MD5) / Made available in DSpace on 2017-10-30T20:44:00Z (GMT). No. of bitstreams: 1 RosimeryCruzDeOliveiraDantas_TESE.pdf: 5591036 bytes, checksum: 13fb6a2c807443a41da890082aa5eb7e (MD5) Previous issue date: 2017-08-16 / A Aten??o Prim?ria ? Sa?de (APS) configura-se como o primeiro contato do usu?rio com o sistema de sa?de, destacando-se com tr?s fun??es essenciais: resolutividade, comunica??o e responsabiliza??o. Apesar do seu fortalecimento, interna??es por agravos que sob sua a??o poderiam ser controlados, continuam ocorrendo, a exemplo da hipertens?o. Da? justifica-se a constru??o de um protocolo para atendimento interprofissional a hipertensos na APS. Objetivou-se construir uma estrat?gia que oriente a gest?o de um cuidado integral ao usu?rio com hipertens?o arterial assistido na APS. Para tanto realizou-se uma revis?o de integrativa, um estudo ecol?gico, um estudo de valida??o e um estudo transversal. Adotou-se, para o estudo ecol?gico e transversal, estat?stica anal?tica com regress?o linear e multivariada; para a valida??o adotou-se o m?todo Delphi, desenvolvido em 4 fases: 1. Leitura pr?via dos referenciais te?ricos, 2. Constru??o do instrumento e apresenta??o a banca de ju?zes, 3. Valida??o por Experts, 4. Reprodutibilidade. A valida??o foi analisada, utilizando uma escala de Likert, pelo ?ndice de concord?ncia (IC) entre os experts, ?ndice de Validade de Conte?do (IVC), Correla??o de Pearson; a an?lise da reprodutibilidade se deu pelos Coeficientes Kappa (?) e o de Correla??o Intraclasse (CCI). A pesquisa envolveu 20 experts (nove m?dicos e 11 enfermeiros) e 160 usu?rios hipertensos alocados por conveni?ncia. A coleta ocorreu de julho/2015 a agosto/2016. O estudo seguiu ?s recomenda??es da Resolu??o 466/2012 que trata de pesquisa com seres humanos, aprovado pelo Comit? de ?tica da Universidade Federal do Rio Grande do Norte, sob n? 1.144.406. Protocolos s?o ferramentas utilizadas para verificar ades?o ao tratamento, sua utiliza??o na gest?o de doen?as cr?nicas, seu impacto no controle da hipertens?o e a satisfa??o do usu?rio com o servi?o. As interna??es por hipertens?o se associam com o percentual de condi??es sens?veis as a??es da APS, renda e ?ndice de desenvolvimento humano. O protocolo revelou-se muito importante - Escala de Likert >4 -, O IC entre os experts foi de 98,1%, o IVC > 0,90, a correla??o de Pearson se mostrou de moderada a forte (p <0,001). Kappa de > 75 e o CCI >0,80; os fatores determinantes para o controle da press?o foram dieta hiposs?dica e interrup??o do tratamento; para a interrup??o do tratamento foram risco metab?lico, estresse e controle da press?o. Apesar da alta cobertura e resolutividade da APS as interna??es por hipertens?o continuam ocorrendo, principalmente na popula??o com vulnerabilidade social. O instrumento mostrou evid?ncias robustas de validade e confiabilidade, bem como de reprodutibilidade. Isso o torna prop?cio para sua utiliza??o na APS. Al?m de constituir-se um guia para a consulta e acompanhamento do usu?rio hipertenso, permite maior di?logo entre o profissional e o paciente. Tamb?m ? um espa?o para que os registros aconte?am de forma mais efetiva, garantindo atendimento mais personalizado, voltado para as necessidades individuais de cada um. O conhecimento dos determinantes do controle da press?o e da interrup??o do tratamento favorece o planejamento das a??es da APS. / Primary Health Care (PHC) is the first contact with the health system, highlighting three essential functions: resolution, communication and accountability. Despite its strengthening, hospitalizations for diseases that could be controlled under its action, continue to occur, such as hypertension. Hence the construction of a protocol for interprofessional care for hypertensive patients in PHC is justified. The objective was to build a strategy that guides the management of comprehensive care to the user with arterial hypertension assisted in PHC. For the ecological and cross-sectional study, we used analytical statistics with linear and multivariate regression. For the validation, the Delphi method was developed in four phases: 1. Preliminary reading of the theoretical references 2. Construction of the instrument and presentation to the judge's bench 3. Validation by Experts 4. Reproducibility. The validation was analyzed using a Likert scale, by the Index of concordance (CI) among experts, Content Validity Index (IVC), Pearson's Correlation; The reproducibility analysis was performed by Kappa (?) and Intraclass Correlation (ICC) coefficients. The research involved 20 specialists (nine physicians and 11 nurses) and 160 hypertensive users allocated for convenience. The collection occurred from July / 2015 to August / 2016. The study followed the recommendations of Resolution 466/2012 that deals with research with human beings, approved by the Ethics Committee of the Federal University of Rio Grande do Norte, under No. 1.144.406. Protocols are tools used to verify adherence to treatment, its use in the management of chronic diseases, its impact on the control of hypertension, and user satisfaction with the service. Hypertension hospitalizations are associated with the percentage of conditions that are sensitive to the actions of Primary Care, income and human development index. The protocol was very important - Likert scale> 4 -, CI among experts was 98.1%, CVI> 0.90, Pearson's correlation was moderate to strong (p <0.001). Kappa of> 75 and CCI> 0.80; The determinant factors for the control of the pressure were hyposodic diet and treatment interruption; For treatment interruption were metabolic risk, stress and pressure control. Despite the high coverage and resolution of PHC, hospitalizations for hypertension continue to occur, especially in the population with social vulnerability. The instrument showed robust evidence of validity and reliability as well as reproducibility. This makes it suitable for use in APS. In addition to constituting a guide for consultation and follow-up of the hypertensive user, it allows a greater dialogue between the professional and the patient. It is also a space for records to happen more effectively, ensuring a more personalized service, focused on the individual needs of each one. Knowledge of the determinants of pressure control and discontinuation of treatment favors the planning of PHC actions

Submitted by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-06-30T13:19:50Z No. of bitstreams: 1 TES_VIRGINIA_CARLA_DE_ALMEIDA_FALCAO_COMPLETO.pdf: 3588046 bytes, checksum: 337be6be89fea4ea58787c070a072a51 (MD5) / Approved for entry into archive by Caroline Xavier (caroline.xavier@pucrs.br) on 2017-06-30T13:19:59Z (GMT) No. of bitstreams: 1 TES_VIRGINIA_CARLA_DE_ALMEIDA_FALCAO_COMPLETO.pdf: 3588046 bytes, checksum: 337be6be89fea4ea58787c070a072a51 (MD5) / Made available in DSpace on 2017-06-30T13:20:08Z (GMT). No. of bitstreams: 1 TES_VIRGINIA_CARLA_DE_ALMEIDA_FALCAO_COMPLETO.pdf: 3588046 bytes, checksum: 337be6be89fea4ea58787c070a072a51 (MD5) Previous issue date: 2017-03-30 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Funda??o de Amparo ? Pesquisa do Estado do Rio Grande do Sul (FAPERGS) / Tuberculosis (TB) has become the leading global cause of death from infectious diseases. In 2015, according to WHO, 10.4 million new cases of tuberculosis worldwide have emerged. Currently the commonly used treatments are not effective against the forms of disease resistant to the most effective anti-TB drugs, and drugs with new mechanisms of action are needed. Mycobacterium tuberculosis dihydroneopterin aldolase (MtDHNA /FolB) is a folate enzyme encoded by the folB gene, which has important properties that make it a potential target for the synthesis of new antimicrobial agents. As a first step for target validation in the antimicrobial drug development pipeline, it is important to prove that the gene encoding a putative target is essential for pathogen?s viability. In this study, using site directed mutagenesis, biochemical analyzes and gene knockout experiments, we demonstrated that the folB gene is essential for the survival of Mtb, and furthermore we prove that this essentiality depends on the aldolase/epimerase activities of the MtFolB protein. The wild-type gene (wt) and the point mutants K99A and Y54F were cloned and expressed, and the corresponding recombinant proteins were purified and monitored for the activities of aldolase, epimerase and oxygenase using HPLC. In contrast to the wild-type MtFolB (wt) enzyme, both mutants had neither aldolase nor epimerase activities under the conditions tested. The Y54F mutant maintained oxygenase activity, whereas for the K99A mutant it was possible to detect oxygenase activity only in the presence of HP and GA as substrates. Knockout experiments showed that the folB gene is essential for the survival of Mtb under the conditions tested. However, unlike the wild-type copy, when the sequences encoding the K99A or Y54F mutants were used for complementation, no viable colonies were obtained, indicating that these point mutants could not rescue the cells after the folB knockout. These results indicate that aldolase and/or epimerase activities are crucial for the survival of Mtb. The construction of Mycobacterium tuberculosis folB-GFP fusion (Mtb) strains containing wild-type folB gene sequence or a deleted C-terminal mutant (folB?C), devoid of the sequence presumably necessary for anchoring the enzyme within nanocage compartments, were performed and together with other cell biology methods described in this work will be used for a better understanding of MtDHNA/FolB cellular functions and for the validation of this enzyme as a therapeutic target. / A tuberculose (TB) tornou-se a principal causa mundial de morte por doen?as infecciosas. Em 2015, de acordo com a OMS, surgiram 10,4 milh?es de novos casos de tuberculose no mundo. Atualmente os tratamentos comumente utilizados n?o s?o eficientes contra as formas da doen?a resistentes aos f?rmacos anti-TB mais eficazes, sendo necess?rios f?rmacos com novos mecanismos de a??o. A di-hidroneopterina aldolase de Mycobacterium tuberculosis (MtDHNA/FolB) ? uma enzima da via do folato, codificada pelo gene folB, que apresenta caracter?sticas importantes que a tornam um potencial alvo para s?ntese de novos agentes antimicrobianos. Neste estudo, por meio de mutag?nese s?tio-direcionada, an?lises bioqu?micas e experimentos de nocaute g?nico, demostramos que o gene folB ? essencial para a sobreviv?ncia de Mtb, e al?m disso provamos que essa essencialidade depende das atividades de aldolase/epimerase da prote?na MtFolB. O gene do tipo selvagem (wt) e os mutantes pontuais K99A e Y54F foram clonados e expressos, e as prote?nas recombinantes correspondentes foram purificadas e monitoradas para as atividades de aldolase, epimerase e oxigenase utilizando HPLC. Em contraste com a enzima MtFolB selvagem (wt), ambas as mutantes n?o apresentaram atividade de aldolase nem de epimerase nas condi??es testadas. A mutante Y54F manteve a atividade da oxigenase, enquanto que para a mutante K99A foi poss?vel detectar a atividade de oxigenase apenas na presen?a de HP e GA como substratos. Os experimentos de nocaute mostraram que o gene folB ? essencial para a sobreviv?ncia de Mtb sob as condi??es testadas. Entretanto, diferentemente da c?pia selvagem, quando as sequ?ncias que codificam os mutantes K99A ou Y54F foram utilizadas para complementa??o, n?o foram obtidas col?nias vi?veis, indicando que estes mutantes pontuais n?o poderiam resgatar as c?lulas ap?s o nocaute do gene folB. Esses resultados indicam que as atividades de aldolase e/ou epimerase s?o cruciais para a sobreviv?ncia de Mtb. A constru??o de cepas com fus?o folB-GFP de Mycobacterium tuberculosis (Mtb) que cont?m a sequ?ncia do tipo selvagem do gene folB ou um mutante com o C-terminal deletado (folB?C), desprovida da sequ?ncia supostamente necess?ria para a ancoragem da enzima dentro dos compartimentos de nanocargas, foram realizadas e juntamente com outros m?todos de biologia celular descritos neste trabalho tamb?m poder?o ser utilizados para um melhor entendimento das fun??es celulares apresentadas por MtDHNA/FolB e para valida??o dessa enzima como potencial alvo terap?utico.