Made available in DSpace on 2014-12-17T15:06:43Z (GMT). No. of bitstreams: 1 JoseMS.pdf: 750563 bytes, checksum: b946f187a2df60b8c92cfc19d3e768ef (MD5) Previous issue date: 2008-09-29 / In this work we present the results of a research that aims to study the chronicle gender produced in a class of native language. The texts were written by students of a high-school class, under the orientation of the teacher who conducted a didactic sequence in order to explore this gender. In our analysis we observed aspect such as the structure of the general structure of the texts, types of speech and linguistic sequences, some mechanisms of textualization and the characteristics of the gender. In order to attain that, we adopted the theoretical presuppositions of Textual Linguistics and of the Socio-discursive Interactionism, grounding the study of texts and gender in Bronckart (2003; 2006) and Koch (2002; 2004). As a background of the Chronicle Gender we used the studies of Coutinho (1987); Mois?s (2003); S? (2005); Bender; Laurito (1993); Melo (1994); C?ndido et al. (1992) among others. The corpus, made up of 15 texts, showed that the narrative is the most used linguistic sequence in the producing of the texts, the discursive world prevailing in the narrative and some instances of the world of exposing. As for the gender characteristics, the daily life was used in order to amuse the reader and make him to reflect upon the daily life. Humor, irony, social criticism and colloquial language were also observed in the texts produced by the students. Although some texts presented the characteristics of the gender, explored in the classroom, some were typically school narratives. That make us believe that a work with textual production under the approach of a text gender is viable, but it is not consolidated yet in many schools as the main object of the central teaching of the Portuguese language. This make us defend a better systematization of the teaching contents having as the main point the reading practice and text production in order to contribute for the growing of the students? discursive potentialities and, therefore, their effective participation in the language social practices / Nesta disserta??o, apresentamos os resultados de uma pesquisa cujo objetivo ? estudar o g?nero cr?nica produzido na aula de l?ngua materna. Os textos foram produzidos pelos alunos de uma turma de ensino m?dio, sob a orienta??o da professora, que conduziu uma seq??ncia did?tica para explorar esse g?nero. Na an?lise, observamos aspectos como a infra-estrutura geral dos textos tipos de discurso e de seq??ncias ling??sticas, alguns mecanismos de textualiza??o - e as caracter?sticas do g?nero. Para isso, adotamos os pressupostos te?ricos da Ling??stica de Texto e do Interacionismo sociodiscursivo, fundamentando os estudos de texto e de g?neros em Bronckart (2003; 2006) e Koch (2002; 2004). Para embasamento sobre o g?nero cr?nica, utilizamos os estudos de Coutinho (1987); Mois?s (2003); S? (2005); Bender; Laurito (1993); Melo (1994); C?ndido et al. (1992), entre outros. O corpus, constitu?do de quinze textos, revelou a narrativa como a seq??ncia ling??stica mais usada na planifica??o dos textos produzidos, o mundo discursivo predominante da narra??o, e algumas ocorr?ncias do mundo do expor. Em rela??o ?s caracter?sticas do g?nero, a tem?tica do cotidiano fez-se notar com a finalidade de divertir o leitor e lev?-lo a refletir sobre o cotidiano. Humor, ironia, cr?tica social e linguagem coloquial tamb?m foram caracter?sticas observadas nos textos dos alunos. Embora muitos textos tenham apresentado as caracter?sticas do g?nero, explorado em sala de aula, alguns apresentaram-se, ainda, como narrativas tipicamente escolares. Isso nos faz crer que o trabalho com produ??o textual, sob o enfoque de um g?nero de texto ? vi?vel, mas ainda n?o est? consolidado, em muitas escolas, como objeto de ensino central da disciplina l?ngua portuguesa, o que nos faz defender um redirecionamento e uma melhor sistematiza??o dos conte?dos de ensino, tendo como foco a pr?tica de leitura e a produ??o de textos, tendo em vista contribuir para a amplia??o das potencialidades discursivas dos alunos e, por conseguinte, de sua participa??o efetiva nas pr?ticas sociais de linguagem

Made available in DSpace on 2014-12-17T15:06:47Z (GMT). No. of bitstreams: 1 JoanaLMO_publicar_1.pdf: 683120 bytes, checksum: 9b8e63ed7ba6c69479f52230e4a4f32e (MD5) Previous issue date: 2009-11-30 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico / This study discusses chronicler Rubem Braga and his chronicles published in O Estado de S?o Paulo newspaper (supplement Caderno 2), from 1988 to 1990. The analysis of the 84 chronicles focuses on the study of poetic spaces, mainly based on Gaston Bachelard s book The Poetics of Space. Narrator s characteristics are also shown in the analyzed chronicles, as he resembles a traditional storyteller, even though participates in a genre that belongs to a modern vehicle: the newspaper. The storyteller-chronicler moves in time and space, reporting his experiences to the readers, and also travels inside of himself, discovering places which were kept in his memory / O presente trabalho trata do cronista Rubem Braga e suas cr?nicas publicadas no jornal O Estado de S?o Paulo (Suplemento Caderno 2), nos anos de 1988 a 1990. A an?lise das 84 cr?nicas publicadas nesse per?odo no jornal aborda o estudo dos espa?os po?ticos fundamentado, principalmente, no livro A po?tica do Espa?o, de Gaston Bachelard. Destacam-se ainda as caracter?sticas do narrador presente nas cr?nicas analisadas, tendo em vista que este se assemelha a um contador de hist?rias tradicional, mesmo fazendo parte de um g?nero que pertence a um ve?culo moderno: o jornal. O cronista contador desloca-se no tempo e no espa?o transmitindo para os leitores experi?ncias vividas e tamb?m viaja dentro de si, descobrindo lugares que estavam guardados na mem?ria

Made available in DSpace on 2014-12-17T15:16:20Z (GMT). No. of bitstreams: 1 CibeleTDR_DISSERT.pdf: 1600601 bytes, checksum: 17a20c970bdc4a9e7d51aa44c7922b20 (MD5) Previous issue date: 2014-02-04 / Chronic venous disease (CVD) is evident among the chronic diseases and affects the elderly population and primarily is responsible for leg ulcers in this population. The use of dressings in the care of a venous ulcer is a fundamental part of the treatment for healing, however, evidence to assist in choosing the best dressing is scarce. The main objective of this study was to evaluate the effectiveness of treatment with hydrogel in the healing of venous ulcers using search methods, synthesis of information and statistical research through a systematic review and meta-analysis. Randomized controlled trials were selected in the following databases: CENTRAL; DARE; NHS EED; MEDLINE; EMBASE; CINAHL. Beyond these databases three websites were consulted to identify ongoing studies: ClinicalTrials.gov, OMS ICTRP e ISRCTN. The primary outcomes were analyzed: complete wound healing, incidence of wound infection and the secondary were: changes in ulcer size, time to ulcer healing, recurrence of ulcer, quality of life of participants, pain and costs of treatment. Four studies are currently included in the review with a total of 250 participants. The use of hydrogel appears to be superior to conventional dressing, gauze soaked in saline, for the healing of venous leg ulcers; 16/30 patients showed complete healing of ulcers (RR 5,33, 95%CI [1,73,16,42]). The alginate gel was shown to be more effective when compared to the hydrogel dressing in reduction of the wound area; 61,2% (? 26,2%) with alginate e 19,4% (? 24,3%) with hydrogel at the end of four weeks of treatment. Manuka honey has shown to be similar to the hydrogel dressings in percentage of area reduction. This review demonstrated that there is no evidence available about the effectiveness of the hydrogel compared to other types of dressings on the healing of venous leg ulcers of the lower limbs, thus demonstrating the need of future studies to assist health professionals in choosing the correct dressing. / A doen?a venosa cr?nica (DVC) evidencia-se entre as doen?as cr?nicas por acometer a popula??o idosa e ser a principal respons?vel pelas ?lceras de membros inferiores nesta popula??o. O uso de adesivos no cuidado de uma ?lcera venosa ? parte fundamental no tratamento para a cicatriza??o, no entanto, as evid?ncias para auxiliar na escolha do melhor adesivo s?o escassas. O objetivo principal do estudo foi avaliar a efic?cia do tratamento com o hidrogel na cicatriza??o de ?lceras venosas mediante m?todos de busca, s?ntese de informa??o e an?lise estat?stica atrav?s de uma revis?o sistem?tica com meta-an?lise. Foram selecionados estudos controlados randomizados nas seguintes bases de dados: CENTRAL; DARE; NHS EED; MEDLINE; EMBASE; CINAHL. Al?m dessas bases foram consultados tr?s websites para identificar estudos em andamento: ClinicalTrials.gov, OMS ICTRP e ISRCTN. Os desfechos prim?rios analisados foram: cicatriza??o completa das ?lceras e incid?ncia de infec??o das ?lceras e os secund?rios foram: altera??es no tamanho da ?lcera, tempo de cicatriza??o das ?lceras, recorr?ncia das ?lceras, qualidade de vida dos participantes, dor e custos do tratamento. Quatro estudos est?o atualmente inclu?dos na revis?o com um total de 250 pacientes. O uso do hidrogel parece ser superior ao curativo convencional, gaze embebida em salina, para a cicatriza??o de ?lceras venosas de membros inferiores; 16/30 pacientes apresentaram cicatriza??o completa das ?lceras (RR 5,33, 95%CI [1,73,16,42]). O gel de alginato demonstrou ser mais efetivo quando comparado ao hidrogel quanto ? redu??o da ?rea da ?lcera; 61,2% (? 26,2%) com o alginato e 19,4% (? 24,3%) com o hidrogel ao final das quatro semanas de tratamento. O mel de Manuka demonstrou ser similar ao hidrogel em rela??o ? porcentagem de redu??o da ?rea. Esta revis?o mostrou que n?o existem evid?ncias dispon?veis a respeito da efic?cia do hidrogel em rela??o aos outros tipos de curativo na cicatriza??o de ?lceras venosas de membros inferiores, demonstrando assim a necessidade de futuras pesquisas para auxiliar os profissionais da sa?de na escolha do adesivo correto

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2018-01-24T12:36:44Z No. of bitstreams: 1 MarinaAntongiovanniDaFonseca_TESE.pdf: 4205215 bytes, checksum: df6f57417e4ce36d171d894870361a2d (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2018-01-29T11:36:33Z (GMT) No. of bitstreams: 1 MarinaAntongiovanniDaFonseca_TESE.pdf: 4205215 bytes, checksum: df6f57417e4ce36d171d894870361a2d (MD5) / Made available in DSpace on 2018-01-29T11:36:33Z (GMT). No. of bitstreams: 1 MarinaAntongiovanniDaFonseca_TESE.pdf: 4205215 bytes, checksum: df6f57417e4ce36d171d894870361a2d (MD5) Previous issue date: 2017-06-22 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES) / Informa??o confi?vel em larga ? essencial para tomadores de decis?o que lidam com conserva??o da biodiversidade, restaura??o de ecossistemas, manejos de recursos e pol?ticas ambientais. O bioma Caatinga, um ecossistema semi?rido espalhado por 826.000 km2 do territ?rio brasileiro, apesar de estar altamente fragmentado, ainda mant?m metade da sua cobertura vegetal original. Os remanescentes, no entanto, t?m sido perturbando h? s?culos por uma multiplicidade de amea?as antropog?nicas, incluindo sobrepastejo, extra??o madeireira, fogo e ca?a, entre outro. Apesar disto, a ?rea sobre prote??o est? abaixo do proposto por acordos internacionais e projetos de restaura??o t?m sido escassos. Baseado em m?ltiplas an?lises espacialmente explicitas, os quatro cap?tulos desta Tese tiveram como principais objetivos: (1) analisar quantitativamente a estrutura de fragmenta??o da Caatinga, (2) estimar o n?vel de perturba??o antr?pica cr?nica potencial dos fragmentos da Caatinga, (3) identificar as ?reas priorit?rias de restaura??o da Caatinga, baseado em conectividade da paisagem e na riqueza de esp?cies de plantas amea?adas e (4) comparar a perda de habitat e a taxa de desmatamento das ?reas Priorit?rias de Conserva??o da Caatinga, definidas pelo Minist?rio do Meio Ambiente (MMA), com as ?reas Priorit?rias dos outros biomas brasileiros. An?lises de Sistemas de Informa??o Geogr?fica, executadas sobre informa??es oficiais dispon?veis, evidenciam boas e m?s not?cias para o bioma. Apesar da fragmenta??o j? sofrida pelo bioma, o n?vel de conectividade funcional permanece relativamente alta entre fragmentos e metade da vegeta??o remanescente est? preservada em fragmentos grandes (? 50.000 ha), indicando a exist?ncia de preciosas oportunidades de conserva??o pr?-ativas. Em contraste, o n?vel de fragmenta??o ? intenso e 90% da vegeta??o remanescente ocorre em dist?ncias menores que 2,5 km da borda florestal, permitindo um f?cil acesso ao j? escasso habitat interior. Um ?ndice de Perturba??o Antr?pica Cr?nica (IPC), que sintetiza o efeito de perturba??o potencial de 14 vari?veis prim?rias, indicam que todos os fragmentos de Caatinga est?o sob algum n?vel de perturba??o. No entanto, uma importante heterogeneidade regional foi detectada, com fragmentos mais perturbados ocorrendo nas por??es norte, leste e central do bioma. Apesar do IPC m?dio dos fragmentos n?o estar correlacionado com a sua ?rea, o IPC declina n?o linearmente com a dist?ncia de borda mostrando ?reas relativamente est?veis ap?s 5 km. Simula??es de paisagens, testando a import?ncia de cada bacia hidrogr?fica para a conectividade da paisagem, permitiram a identifica??o de importantes ?reas para restaura??o. Cruzando este crit?rio com o n?mero de esp?cies de plantas amea?adas, foi poss?vel identificar um subconjunto de paisagens chaves para restaura??o que compreendem apenas 8% da ?rea desmatada do bioma. Estimando a taxa de desmatamento de todas as ?reas Priorit?rias para Conserva??o dos biomas terrestres brasileiros, foi poss?vel demonstrar que a Caatinga e o Cerrado exibiram as maiores taxas de perda de habitat, demonstrando novamente a vulnerabilidade do bioma. Espera-se que as informa??es aqui disponibilizadas possam ajudar tomadores de decis?o, nacionais e estaduais, a avan?ar pol?ticas para a conserva??o, restaura??o e manejo da biodiversidade. / Reliable landscape information at large spatial scale is essential for decision makers dealing with biodiversity conservation, ecosystem restoration, resource management, and environmental policy. The Caatiga biome, a semiarid ecosystem that spreads over 826,000 km2 of the Brazilian territory, despite being highly fragmented, still holds half of its original vegetation cover. The remnants, however, have been disturbed for centuries by a multitude of different anthropogenic threats, including overgrazing, logging, fire, hunting, among others. Despite that, the area under protection is below international agreements and restoration endeavors have been scarce. Based on a multitude of spatially explicit analyses, the four chapters of this Thesis had as main objectives: (1) to analyse quantitatively the fragmentation structure of the Caatinga biome, (2) to estimate the level of potencial cronic anthropogenic disturbance of the Caatinga fragments, (3) to identify the priority areas for restoration in the Caatinga biome, based on landscape connectivity and number of endangered plant species, and (4) to compare habitat loss and deforestation rates of Conservation Priority Areas of the Caatinga, defined by the Ministery of Environment (MMA), with those in other Brazilian biomes. Geographic Information System analyses, performed on officially available information, show both good and bad news for the biome. Despite the fragmentation already experienced by the biome, the level of functional connectivity remains relatively high among fragments and half the remaining vegetation is preserved in large fragments (? 50,000 ha), indicating the existence of precious pro-active conservation opportunities. In contrast, the fragmentation level is intense and 90% of the remaining vegetation occurs at distances lower than 2.5 km from the forest edge, allowing an easy access to the already scarce Caatinga core area. An Index of Chronic Anthropogenic Disturbance (IPC), which synthesizes the potential perturbation effect of 14 primary variables, indicates that all Caatinga fragments are under some degree of perturbation. However, important regional heterogeneity was detected with more disturbed fragments occurring in the Northern, Eastern, and Central regional of the biome. Although the mean IPC of the fragments is not correlated to its area, IPC drops non-linearly with edge distance, showing relatively stable core areas after 5 km. Landscape simulations, testing the importance of each watershed for landscape connectivity, allowed the identification of relevant areas for restoration. By crossing this criterion with the number of endangered plant species in each watershed, we were able to identify a subset of key watersheds for restoration that hold only 8% of the deforested area of the biome. By estimating the deforestation rate of all Priority Areas for Conservation of the Brazilian terrestrial biomes, it was possible to demonstrate that the Caatinga and the Cerrado biomes exhibited the higher rates of habitat loss, further demonstrating the vulnerability of the biome. Hopefully, the information here provided can help national and state decision makers to advance biodiversity policies for biodiversity conservation, restoration, and management.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-04-03T22:49:32Z No. of bitstreams: 1 DanielGermanoMaciel_DISSERT.pdf: 1593169 bytes, checksum: 5afe86923f3e38d947bd98013d678865 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-04-11T21:40:36Z (GMT) No. of bitstreams: 1 DanielGermanoMaciel_DISSERT.pdf: 1593169 bytes, checksum: 5afe86923f3e38d947bd98013d678865 (MD5) / Made available in DSpace on 2017-04-11T21:40:36Z (GMT). No. of bitstreams: 1 DanielGermanoMaciel_DISSERT.pdf: 1593169 bytes, checksum: 5afe86923f3e38d947bd98013d678865 (MD5) Previous issue date: 2017-03-02 / A fibromialgia ? uma doen?a que apresenta dor musculoesquel?tica cr?nica e difusa associada a fadiga, dist?rbio do sono, problemas cognitivos e baixos n?veis de condicionamento f?sico. Trabalhos recentes mostram bons resultados tanto com a pr?tica de exerc?cios funcionais quanto com a utiliza??o da terapia laser de baixa intensidade (TLBI) para reduzir os sintomas dessa popula??o. Por?m, n?o foram encontradas evid?ncias que associem as duas formas de terapia no tratamento da fibromialgia. Objetivo: Investigar os efeitos de um programa de exerc?cios funcionais associado ? TLBI na dor, desempenho funcional e qualidade de vida de indiv?duos com fibromialgia. M?todos: Trata-se de um ensaio cl?nico randomizado e duplo-cego composto por 22 mulheres divididas em dois grupos de forma aleat?ria em blocos: grupo placebo (n=11) que foi submetido a um programa de exerc?cios funcionais associado a TLBI placebo; e o grupo laser (n=11) que foi submetido ao mesmo programa de exerc?cios associado a TLBI ativa. O programa de exerc?cio teve dura??o de dois meses e frequ?ncia de tr?s vezes semanais. A TLBI (808nm; 100mW; 4J e 142,85 J/cm2 por ponto) foi aplicada imediatamente ap?s cada sess?o de exerc?cio em diferentes pontos dos m?sculos quadr?ceps (8), isquiotibiais (6) e tr?ceps sural (3), bilateralmente. Todos os indiv?duos foram submetidos a avalia??es pr? e p?s interven??o quanto a: dor (locais, intensidade e limiar), desempenho funcional (equil?brio, testes funcionais), desempenho muscular (flexibilidade e vari?veis isocin?ticas), depress?o e qualidade de vida. A an?lise estat?stica foi realizada por meio do SPSS 20.0 adotando um intervalo de confian?a de 95%. Resultados: Pode-se observar que houve uma redu??o da dor e melhora do desempenho funcional e muscular, da depress?o e qualidade de vida em ambos os grupos (p<0,05), por?m, sem diferen?as significativas entre eles (p>0,05). Conclus?o: O programa de exerc?cio funcional foi eficaz na melhora da dor, desempenho funcional e qualidade de vida de indiv?duos com fibromialgia. No entanto, a TLBI n?o promoveu um incremento nos efeitos positivos proporcionados pelo exerc?cio. / Background: Fibromyalgia is a disease that presents chronic and diffuse musculoskeletal pain associated with fatigue, sleep disturbance, cognitive problems and low levels of physical conditioning. Recent studies have shown good results both with the practice of functional exercises or with the use of low-level laser therapy (LLLT) to reduce the symptoms of this population. However, no evidence was found associating both forms of therapy in the treatment of fibromyalgia. Objective: To investigate the effects of a LLLT associated with an exercise program on pain, functional capacity and quality of life of individuals with fibromyalgia. Methods: It was performed a randomized, double-blind clinical trial with 22 women randomly divided into two blocked groups: placebo group (n = 11) who went through a functional exercise program associated with placebo LLLT and the laser group (n = 11), who underwent the same functional exercise program associated with active TLBI. The exercise program occurred in two months and three times a week. The LLLT (808nm; 100mW; 4J e 142,85 J/cm2 per point) was applied right after each exercise program session in different points of quadriceps (8), hamstrings (6) and sural tr?ceps (3), bilaterally. Both groups were submitted to an evaluation of pain (sites, intensity and threshold), functional capacity (balance, functional tests), muscle performance (flexibility and isokinetic variables), depression and quality of life, before and after the intervention. Statistical analysis was performed using SPSS 20.0 adopting a 95% confidence interval. Results: It was observed that there was a reduction of pain and depression levels and an improvement of functional capacity, muscular performance and quality of life in both groups (p<0.05), but with no significant differences among them (p>0.05). Conclusion: The functional exercise program was effective on pain relief, better functional capacity and quality of life of individuals with fibromyalgia. However, LLLT did not promote an increase on the positive effects caused by the exercise.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-08-10T11:59:48Z No. of bitstreams: 1 LeonidasDeOliveiraNeto_TESE.pdf: 1668906 bytes, checksum: 3fa7c80c1f7980340ddded1cd5fc5726 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-08-11T15:48:54Z (GMT) No. of bitstreams: 1 LeonidasDeOliveiraNeto_TESE.pdf: 1668906 bytes, checksum: 3fa7c80c1f7980340ddded1cd5fc5726 (MD5) / Made available in DSpace on 2017-08-11T15:48:54Z (GMT). No. of bitstreams: 1 LeonidasDeOliveiraNeto_TESE.pdf: 1668906 bytes, checksum: 3fa7c80c1f7980340ddded1cd5fc5726 (MD5) Previous issue date: 2017-06-05 / Introdu??o: O diagn?stico da sarcopenia ? restrito aqueles com boa capacidade f?sica e cognitiva, n?o sendo adaptado ?s condi??es dos idosos institucionalizados. Al?m disso, apesar da perda de massa muscular ser determinante para seu diagn?stico, redu??o associada de massa gorda tem sido observada na sarcopenia. Ademais, embora o estado inflamat?rio seja considerado um gatilho da perda de massa muscular, a redu??o no tecido adiposo tem sido associado ? redu??o do estado inflamat?rio, concorrendo no constructo te?rico da associa??o entre inflamm-aging e sarcopenia. Objetivo: Discutir o diagn?stico para sarcopenia em idosos institucionalizados e verificar a associa??o entre inflamm-aging e sarcopenia, assim como analisar seus fatores associados. Metodologia: Tr?s estudos foram conduzidos em idosos de ambos os sexos, residentes em institui??es de longa perman?ncia na cidade do Natal/RN. No estudo 1 (n=219) foi realizado uma adapta??o do Consenso Europeu para Diagn?stico da Sarcopenia (2010) agregando idosos com baixa capacidade f?sica e cognitiva. No estudo 2 (n=219) foi verificado quais os fatores est?o associados ? sarcopenia. No estudo 3 (n=187) foi realizado an?lise de conglomerados de idosos segundo seu estado inflamat?rio e verificado os fatores associados ? esta condi??o. Resultados: Inclus?o de idosos com baixa condi??o f?sica e cognitiva (estudo 1) acresceu em 32,2% a preval?ncia de sarcopenia. No estudo 2, os fatores associados ? sarcopenia foram altura do joelho, eutrofia e excesso de peso (segundo IMC) e capacidade de deambular. No estudo 3 foi poss?vel verificar que aumento de 1 unidade ?g/dL no LDL, HDL e triglicer?deos apresentaram aumento de 1,5%, 4,1% e 0,9% a chance de inflamm-aging e idosos longevos (?80 anos) possu?ram 84,9% mais de chance de inflamm-aging. Conclus?o: Inclus?o de idosos com baixa capacidade f?sica e cognitiva para c?lculo de sarcopenia ? valida e representa de modo mais adequado os idosos institucionalizados, apresentando o aspectos antropom?tricos e f?sicos como seus principais fatores associados. Ademais, os indicadores bioqu?micos e antropom?tricos demonstraram rela??o da sarcopenia com desnutri??o. Al?m disso, n?o foi observado associa??o do inflamm-aging com sarcopenia, corroborando o constructo de que na sarcopenia n?o ocorre perda seletiva da massa muscular. / Introduction: The diagnosis of sarcopenia is restricted to those with good physical and cognitive capacity, not being adapted to the conditions of the institutionalized elderly. In addition, dispite the loss of muscle mass is determinant for its diagnosis, associated reduction of fat mass has been observed in sarcopenia. Although the inflammatory state is considered a trigger to loss of muscle mass, reduction in adipose tissue has been associated with the reduction of the inflammatory state, competing in the theoretical construct of the association between inflammation and sarcopenia. Objective: To discuss the diagnosis of sarcopenia in institutionalized elderly patients and to verify the association between inflammation and sarcopenia, as well as to analyze their associated factors. Methodology: Three studies were conducted in elderly people of both sexes, living in nursing homes in the city of Natal / RN. In study 1 (n = 219) an adaptation of the European Consensus for Diagnosis of Sarcopenia (2010) was carried out, adding elderly people with low physical and cognitive capacity. In study 2 (n = 219) it was verified which factors are associated with sarcopenia. In study 3 (n = 187), the analysis of elderly conglomerates according to their inflammatory state was performed and the factors associated with this condition were verified. Results: Inclusion of elderly people with low physical and cognitive status (study 1) increased the prevalence of sarcopenia by 32.2%. In study 2, the factors associated with sarcopenia were knee height, eutrophy and excess weight (according to BMI) and the ability to ambulate. In study 3 it was possible to verify that increase of 1 unit ?g / dL in LDL, HDL and triglycerides presented a 1.5%, 4.1% and 0.9% increase in the chance of inflamm-aging and elderly individuals (?80 years ) had an 84.9% greater chance of inflammation. Conclusion: Inclusion of elderly with low physical and cognitive capacity to calculate sarcopenia is valid and represents more appropriately the institutionalized elderly, presenting the anthropometric and physical aspects as their main associated factors. In addition, the biochemical and anthropometric indicators demonstrated a relationship of sarcopenia with malnutrition. In addition, no association of inflammation with sarcopenia was observed, corroborating the construct that in sarcopenia there is no selective muscle mass loss.

Made available in DSpace on 2014-12-17T15:38:41Z (GMT). No. of bitstreams: 1 RemersonRM.pdf: 448865 bytes, checksum: 14cbfed29d38210302974844ec6adb11 (MD5) Previous issue date: 2008-07-11 / Introduction: This work intents to characterize behavioral indicators of tack to the hemodialysis treatment in a sample of carrying patients of chronic kidney failure (CKF) in the great Natal/RN. The therapeutical adherence represents the agreement degree between the patient behavior and the health team lapsings. The CKF is the gradual and irreversible loss of the renal function, being the hemodialysis treatment an important alternative to assist or to substitute the kidneys. Method: The sample consisted in 80 chronic kidney patients in hemodialysis treatment in two located clinical centers in the region of the great Natal, RN. It was used as instruments (a) a protocol of clinical data collection, (b) the Millon Index of Personality Styles (MIPS) and (c) a script of halfstructuralized interview. Results: The results show a balance between the genders (51% of female and 48.8% of the male sex), average age and equal average time of dialysis respectively to the 43,4 years (?13,25 years) and 22,04 years (?4,24 years). The marital status of half of the sample is married, predominating basic education (43.6%) and a familiar income until a minimum wage (43.8%). It had been defined six physicianlaboratorial indicators to evaluate the therapeutical adherence, further the use of the evaluation of the health team and the patient themselves. Thus, there was an average adherence around 55.97% of the sample ?18.37%). However only between selfassessment of the patients about the adherence and the assessment made by blood pressure post-dialysis indicated a significant association (p=0,029, qui-square test). On the other hand, there was a significant association (p <0.05, chi-square test) among the criteria for treatment adherence and issues investigated in the interview - the perception on the quality of the health services provided to patients, the difficulties following the prescribed diet, the characterization of the days between dialysis sessions and the perception of patients about the dialysis sessions. It was also noted a significant association (p <0.05, Levene test) between adherence to therapy and scales that constitute the MIPS. The health team characterized the patients more adherent behavior as an attitude of acceptance of the treatment, looking actively for their implementation, for more information and knowledge, and establishing a positive communication with the team and with other patients. Similar results were confirmed by the MIPS evaluation. According to that assessment the more compliant patients adopt a more optimistic attitude, trying to act or adapt themselves to their environment, processing cognitively both concrete and objective information, such as more speculative and symbolic information. In addition they establish a gregarious, cooperative, submissive and flexibly pattern of interpersonal relationships to social demands. These characteristics managed to explain 55.7% of the adherence variation according the health team and 23.3% of the variation according the CaxP laboratory indicator. Conclusions: The MIPS shown to be able to identify the most and least adherent to therapy patients. The use of different adherence indicators is important for an evaluation covering the different facets of this process. The adhesion levels are observed within registered by the relevant literature. There is need for further studies with a larger sample to deepen the data findings in this work / Introdu??o: Este trabalho busca caracterizar indicadores comportamentais de ader?ncia ao tratamento hemodial?tico por meio do Invent?rio Millon de Estilos de Personalidade em uma amostra de pacientes portadores de insufici?ncia renal cr?nica (IRC) na grande Natal/RN. A ader?ncia terap?utica representa o grau de concord?ncia entre o comportamento do paciente e as prescri??es da equipe de sa?de. A IRC ? a perda progressiva e irrevers?vel da fun??o renal, sendo o tratamento hemodial?tico uma importante alternativa para auxiliar ou substituir os rins. M?todo: A amostra consistiu de 80 pacientes renais cr?nicos em tratamento hemodial?tico em dois centros cl?nicos localizados na regi?o da grande Natal, RN. Utilizaram-se como instrumentos (a) um protocolo de coleta de dados cl?nicos, (b) o invent?rio Millon de estilos de personalidade (MIPS) e (c) um roteiro de entrevista semi-estruturada. Resultados: Os resultados mostram que houve equil?brio entre os sexos (51% do sexo feminino e 48,8% do sexo masculino), idade m?dia e tempo m?dio de di?lise respectivamente iguais ? 43,4 anos (?13,25 anos) e 22,04 anos (?4,24 anos). O estado civil de metade da amostra ? casado, predominando o ensino fundamental (43,6%) e uma renda familiar at? um sal?rio m?nimo (43,8%). Definiram-se seis indicadores cl?nico-laboratoriais para avaliar a ader?ncia terap?utica, mais o uso da avalia??o da equipe de sa?de e do pr?prio paciente. Desse modo, observou-se uma ader?ncia m?dia em torno de 55,97% da amostra (?18,37%). Contudo apenas entre a auto-avalia??o do paciente acerca da ader?ncia e a avalia??o feita atrav?s da press?o arterial p?s-di?lise indicou-se uma associa??o significativa (p=0,029, teste qui-quadrado). Por outro lado, houve uma associa??o significativa (p<0,05, teste qui-quadrado) entre os crit?rios de ader?ncia ao tratamento e aspectos investigados na entrevista a percep??o da qualidade dos servi?os de sa?de prestados aos pacientes, as dificuldades no seguimento da dieta prescrita, a caracteriza??o dos dias entre as sess?es de di?lise e a percep??o dos pacientes acerca das sess?es de di?lise. Tamb?m se observou uma associa??o significativa (p<0,05, teste de Levene) entre a ader?ncia terap?utica e as escalas que constituem o MIPS. A equipe de sa?de caracterizou o comportamento do paciente mais aderente como uma postura de aceita??o do tratamento, buscando ativamente pela sua realiza??o, por informa??es e mais conhecimento, al?m de estabelecer uma comunica??o positiva com a equipe e com os demais pacientes. Resultados semelhantes foram confirmados pela avalia??o do MIPS. Segundo essa avalia??o os pacientes mais aderentes adotam uma atitude mais otimista, buscando agir ou adaptar-se ao seu meio, processando cognitivamente tanto informa??es concretas e objetivas, como informa??es mais especulativas e simb?licas. Al?m de estabelecer um padr?o de relacionamento interpessoal greg?rio, cooperativo, submisso e flex?vel ?s demandas sociais. Estas caracter?sticas conseguiram explicar 55,7% da varia??o da ader?ncia definida segundo a equipe de sa?de e 23,3% da varia??o da ader?ncia segundo o indicador laboratorial CaxP. Conclus?es: O MIPS demonstrou ser capaz de identificar os pacientes mais e menos aderentes. O uso de diferentes indicadores de ader?ncia ? importante para uma avalia??o que abarque as diferentes facetas desse processo. Os n?veis de ader?ncia observados est?o dentro do registrado pela literatura pertinente. H? a necessidade de outros estudos com uma amostra maior para aprofundar os dados achados nesse trabalho

Tesis para optar al grado de Mag?ster en Ling??stica menci?n Lengua Espa?ola / La tesis que a continuaci?n expongo ofrece un establecimiento cr?tico de la lectura de la Cr?nica de Jer?nimo de Vivar, ling??sticamente anotada y prologada. En ella doy cuenta de una visi?n descriptiva y anal?tica, no exhaustiva, de sus principales rasgos fon?ticos, morfol?gicos y sint?cticos. El estudio filol?gico-ling??stico se realiza sobre la base de una completa transcripci?n paleogr?fica de la obra, con el prop?sito de obtener un documento lo m?s fiel al original. Para ello, se contrastaron dos transcripciones de la misma: una de Leopoldo S?ez-Godoy (Coloquium Verlag, Berl?n, 1979) y otra realizada por el profesor Manuel Contreras Seitz. El estudio filol?gico, que se efectu? con la Cr?nica de Vivar, tuvo como modelos las ediciones cr?ticas realizadas por los profesores Ferreccio y Kordic en sus descripciones ling??sticas, dejando de lado la moderaci?n fonografem?tica y los aspectos literarios y referenciales por lo extenso que resultar?a un trabajo de este tipo. Para el estudio netamente ling??stico, realic? la revisi?n de la Historia del Espa?ol de Am?rica de Juan Antonio Frago, la Historia de la Lengua Espa?ola de Rafael Lapesa y la Gram?tica Hist?rica Espa?ola de Vicente Garc?a de Diego, con el fin de identificar los principales rasgos idiom?ticos meridionales presentes en la obra de Vivar; y, establec?, por contraste, los rasgos caracter?sticos del centro norte espa?ol (Burgos, lugar hipot?tico de nacimiento del autor) presentes en la Cr?nica, tomando como base fuentes sobre el espa?ol peninsular como las obras ya citadas de Lapesa y Garc?a de Diego.

Made available in DSpace on 2014-12-17T14:46:50Z (GMT). No. of bitstreams: 1 SueniaSMX_DISSERT.pdf: 1506804 bytes, checksum: e19da1d457fc43b9cffcb6bedf264524 (MD5) Previous issue date: 2011-12-09 / Reconstruct, from listening, the life histories of a chronic renal patient, submitted to hemodialysis, is the objective of this investigation. How methodological procedure,we worked with oral history of life, ,according Meihy, within a qualitative approach. For this, we had the approval of the Ethics Committee in Research of Hospital Universit?rio Onofre Lopes (HUOL), under protocol no 591/2011. As instrument to approach the patient, we did interviews with open questions, conducted in the patient's house. There were five meetings, in which we hear his story, experiences and ways of coping during their course of illness and treatment. The analysis was based on the collaborator's narratives, anchored in studies dealing with oral history, of human subjectivity, highlighting the resilience, as indicated Cyrulnik. Her story leads us to conclude that despite the adversities of life and suffering, there is in humans, the strength to navigate the streams and be happy. This is the lesson that leaves us the collaborator this study. / Reconstruir, a partir da escuta, a trajet?ria de vida de uma paciente renal cr?nica, submetida ao tratamento hemodial?tico, constitui o objetivo desta investiga??o. Como procedimento metodol?gico, trabalhamos com a hist?ria oral de vida, conforme Meihy, dentro de uma abordagem qualitativa. Para isto, tivemos a aprova??o do Comit? de ?tica em Pesquisa, do Hospital Universit?rio Onofre Lopes (HUOL), sob protocolo de n?. 591/2011. Como instrumento de abordagem da paciente, fizemos entrevistas com quest?es abertas, realizadas na casa da paciente. Foram cinco encontros, nos quais escutamos sua hist?ria, experi?ncias e formas de enfrentamento, durante sua trajet?ria de adoecimento e tratamento. A an?lise foi pautada nas narrativas da colaboradora, ancorada em estudos que tratam da hist?ria oral, da subjetividade humana, com destaque para a resili?ncia, conforme assinala Cyrulnik. Sua hist?ria nos leva a concluir que, apesar das adversidades da vida e do sofrimento, existe, no ser humano, a for?a de navegar nas torrentes e conseguir ser feliz. Essa ? a li??o que nos lega a colaboradora deste estudo.

Made available in DSpace on 2014-12-17T14:47:04Z (GMT). No. of bitstreams: 1 MariaICDF_DISSERT.pdf: 1911495 bytes, checksum: b33fd53ec7c7e2b2d0bd96f5e0ea12e9 (MD5) Previous issue date: 2014-01-27 / Trasnversal study, with the objective of evaluating the accuracy of clinical indicators of nursing diagnosis excessive fluid volume in patients undergoing hemodialysis. The study occurred in two stages, the first consisted of the evaluation of the diagnostic indicators in study; and the second, the diagnostic inference conducted by nurse diagnosticians. The first stage occurred from december 2012 to april 2013, in a University Hospital and a Hemodialysis Clinic in Northeastern of Brazil, with a sample of 100 chronic renal failure patients on hemodialysis. The data were selected through an interview form and a physical examination, organized into spreadsheets and analyzed as to the presence or absence of the indicators of diagnosis excessive fluid volume. In the second step, the spreadsheets were sent to three nurses diagnosticians, who judged the presence or absence of diagnosis in the clientele searched. This step was conducted from july to september 2013. For analysis of the data, we used descriptive and inferential statistics. In the descriptive analysis, we used measures of central tendency and dispersion. In inferential analysis, we used the tests Chi- square, Fisher and prevalence ratios. The accuracy of the clinical indicators pertaining to the diagnosis were measured as to the specificity, sensitivity, predictive values, likelihood ratios and Diagnostic Odds Ratio. Also developed a logistic regression. The results were organized in tables and discussed with literature. This study was approved by the Ethics Committee in Research of the Federal University of Rio Grande do Norte, with Presentation Certificate for Ethics Appreciation n? 08696212.7.0000.5537. The results revealed that the diagnosis studied was present in 82% of patients. The characteristics with prevalence above 50 % that stood out were: azotemia, decreased hematocrit, electrolyte imbalance, intake exceeds output, anxiety, edema, decreased hemoglobin, oliguria and blood pressure changes. Eight defining characteristics were presented statistically significant association with the nursing diagnosis investigated: pulmonary congestion, intake exceeds output, electrolytes imbalance, jugular vein distension, edema, weight gain over short period of time, agitation and adventitious breath sounds. Among these, the 10 characteristics which showed higher prevalence ratios were: edema and weight gain over short period of time. The features with the highest sensitivity were edema, electrolytes imbalance and intake exceeds output and the standing out with greater specificity were: anasarca, weight gain over short period of time, change in respiratory pattern, adventitious breath sounds, pulmonary congestion, agitation and jugular vein distension. The indicators jugular vein distension, electrolytes imbalance, intake exceeds output, increased central venous pressure and edema, together, were identified in the logistic regression model as the most significant predictors. It is concluded that the identification of accurate clinical indicators allow a good prediction of the nursing diagnosis of excessive fluid volume in patients undergoing hemodialysis in order to assist the nurse in the inference process, which will contribute to the success of patient care. In addition, nurses will consider for diagnostic inference not only his clinical experience, but also scientific evidence of the occurrence of excessive fluid volume, contributing to the control of volemia in these patients / Estudo transversal, com o objetivo de avaliar a acur?cia dos indicadores cl?nicos do diagn?stico de enfermagem Volume de l?quidos excessivo em pacientes submetidos ? hemodi?lise. Ocorreu em duas etapas, a primeira composta pela avalia??o dos indicadores do diagn?stico em estudo; e a segunda, pela infer?ncia diagn?stica realizada por enfermeiros diagnosticadores. A primeira etapa aconteceu nos meses de dezembro de 2012 a abril de 2013, em um Hospital Universit?rio e em uma Cl?nica de Hemodi?lise do Nordeste do Brasil, com uma amostra de 100 pacientes renais cr?nicos submetidos ? hemodi?lise. Os dados foram obtidos mediante formul?rio de entrevista e exame f?sico, organizados em planilhas eletr?nicas e analisados quanto ? presen?a ou aus?ncia dos indicadores do diagn?stico Volume de l?quidos excessivo. Na segunda etapa, as planilhas foram encaminhadas a tr?s diagnosticadores, que julgaram a presen?a ou aus?ncia do diagn?stico na clientela pesquisada. Essa etapa desenvolveu-se nos meses de julho a setembro de 2013. Para a an?lise dos dados, utilizou-se a estat?stica descritiva e inferencial. Na an?lise descritiva, utilizaram-se medidas de tend?ncia central e de dispers?o. Na inferencial, utilizaram-se os testes de Qui-quadrado, Fisher e as raz?es de preval?ncia. Mensurou-se a acur?cia dos indicadores cl?nicos do diagn?stico estudado por meio da especificidade, da sensibilidade, dos valores preditivos, das raz?es de verossimilhan?a e da Odds Ratio Diagn?stica. Desenvolveu-se tamb?m uma regress?o log?stica. Os resultados foram organizados em tabelas e discutidos com literatura pertinente. O estudo foi aprovado pelo Comit? de ?tica da Universidade Federal do Rio Grande do Norte, com Certificado de Apresenta??o para Aprecia??o ?tica n? 08696212.7.0000.5537. Os resultados revelaram que o diagn?stico de enfermagem estudado esteve presente em 82% dos pacientes. Dentre as caracter?sticas com preval?ncia acima de 50% destacaram-se: azotemia, hemat?crito diminu?do, eletr?litos alterados, ingest?o maior que o d?bito, ansiedade, edema, hemoglobina diminu?da, olig?ria e mudan?a na press?o arterial. 8 Apresentaram associa??o estatisticamente significativa com o diagn?stico de enfermagem investigado oito caracter?sticas definidoras: congest?o pulmonar, ingesta maior que o d?bito, eletr?litos alterados, distens?o da jugular, edema, ganho de peso em um curto per?odo de tempo, agita??o e ru?dos advent?cios. Dentre estas, as que apresentaram maiores raz?es de preval?ncia foram edema e ganho de peso em um curto per?odo de tempo. A caracter?stica com maior sensibilidade foi o edema e sobressa?ram-se com maior especificidade ru?dos advent?cios, congest?o pulmonar e agita??o. Os indicadores distens?o da jugular, eletr?litos alterados, ingesta maior que o d?bito, press?o venosa central aumentada e edema, em conjunto, foram identificados no modelo da regress?o como as caracter?sticas preditoras mais significantes. Conclui-se que a identifica??o de indicadores cl?nicos acurados permite uma boa predi??o do diagn?stico de enfermagem Volume de l?quidos excessivo em pacientes submetidos ? hemodi?lise, de modo a auxiliar no processo de infer?ncia do enfermeiro, o que contribuir? no sucesso do cuidado prestado ao paciente. Al?m disso, os enfermeiros considerar?o para a infer?ncia diagn?stica n?o apenas sua experi?ncia cl?nica, mas tamb?m evid?ncias cient?ficas da ocorr?ncia do Volume de l?quidos excessivo, contribuindo para o controle da volemia nesses pacientes