Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2015-05-19T11:18:38Z No. of bitstreams: 1 468944 - Texto Parcial.pdf: 290383 bytes, checksum: dc3775edf2b05b287fa0c90e7451d579 (MD5) / Made available in DSpace on 2015-05-19T11:18:38Z (GMT). No. of bitstreams: 1 468944 - Texto Parcial.pdf: 290383 bytes, checksum: dc3775edf2b05b287fa0c90e7451d579 (MD5) Previous issue date: 2015-03-06 / Conselho Nacional de Pesquisa e Desenvolvimento Cient?fico e Tecnol?gico - CNPq / The way the subject gives meaning to himself and the world around him involves, in a considerable extent, his occupation practice which puts him in relation with the other. To understand the work, it is necessary to consider the subjectivity of the person who is performing it. Some professions exercise the care which requires, in most cases, an investment directed to the need and demand of the other person. Firemen consist of a class of professional caregivers that, when requested, has in the effectiveness and success of their action the maintenance of human lives that otherwise would be possibly lost. This thesis investigates the complexity inherent to the occupation of firemen. To this end, the study consists of two sections. The theoretical section, entitled "The subject in its complex plot of existing through the work experience," proposes a reflection about the work experience and its relevance to the constitution of subjectivity, highlighting the complexity of this issue. The work is legitimized as human precisely where tasks? prescriptions are insufficient, requiring subjective creativity and inventiveness, always singular, to resolve the impasses imposed by the reality. The Empiric Section entitled "From protocol to the daily challenges: the uniqueness of the subject who saves", is dedicated to understand, from the reports of professional firemen, the unique experience of working exercise related to assistance and care. The qualitative methodological assumptions were chosen. Semi-structured interviews were conducted with three military firemen who had at least five years of experience in this operational function. Data were analyzed using content analysis. To interpret the findings, the psychoanalysis was used as reference.Three final categories were identified and named as The permanent and unconditional availability to the others as an identity mark; The tensions between the protocol and the daily life; and Institutional rearguard to the subject who saves: nuances of external recognition and support to the caregiver. The study enabled an approach to a class of workers who daily faces the risk, using to this end, the training received and the procedural technique as a way to protect themselves both physically and psychically against the many intensities to which they are exposed. However, the protocol does not account for achieving all the problems of reality, being essential that the person who will perform the job presents subjective conditions to face the reality, thinking in creative and unique solutions beyond the prescription. Therefore, who saves and cares is the human, since it is the subject who does the job, through his uniqueness to overcome inventively the real in what it is not prescribed. / O modo como o sujeito significa a si mesmo e ao mundo que o cerca envolve, em consider?vel medida, sua pr?tica laboral, a qual o p?e em rela??o com um outro. Para compreender o trabalho, deve-se considerar a subjetividade de quem o realiza. Algumas profiss?es exercitam o cuidado, o qual pressup?e, na maioria vezes, um investimento direcionado ? necessidade e ? demanda do outro. Os bombeiros comp?em uma classe de profissionais cuidadores que, quando solicitada, tem na efetividade e no sucesso de sua a??o a manuten??o de vidas humanas que, de outro modo, possivelmente seriam perdidas. Esta Disserta??o investiga a complexidade inerente ? atividade profissional de bombeiros. Para tal, o estudo ? composto de duas se??es. A se??o te?rica, denominada ?O sujeito em sua complexa trama de existir pelo trabalho?, prop?e uma reflex?o acerca do trabalho e de sua relev?ncia para a constitui??o da subjetividade, destacando, assim, a complexidade desta tem?tica. O trabalho chancela-se humano precisamente onde as prescri??es de tarefas figuram insuficientes, exigindo que a criatividade e a inventividade subjetivas, sempre singulares, resolvam os impasses impostos pela realidade. A Se??o Emp?rica, intitulada ?Do protocolo aos desafios cotidianos: a singularidade do sujeito que salva?, dedica-se a compreender, a partir do relato de profissionais bombeiros, a viv?ncia singular do exerc?cio laboral de assist?ncia e cuidado. Optou-se pelos pressupostos metodol?gicos qualitativos. Foram realizadas entrevistas semiestruturadas com tr?s bombeiros militares, com experi?ncia de, pelo menos, cinco anos em fun??o operacional.Os dados obtidos foram analisados por meio da An?lise de Conte?do. Para interpreta??o dos achados, valeu-se do referencial psicanal?tico. Identificaram-se tr?s categorias finais, que foram denominadas: A permanente e incondicional disponibilidade ao outro como marca identit?ria; Os tensionamentos entre o protocolo e o cotidiano; e Retaguarda institucional ao sujeito que salva: nuances do reconhecimento externo e do amparo ao cuidador. O estudo realizado possibilitou a aproxima??o a uma classe de trabalhadores que, cotidianamente, enfrenta o risco, valendo-se, para tanto, do treinamento recebido e da t?cnica procedimental como forma de se proteger tanto f?sica quanto psiquicamente das muitas intensidades a que fica exposta. Entretanto, o protocolo n?o d? conta de alcan?ar todas as mazelas da realidade, sendo essencial que o sujeito que vai exercer o trabalho disponha de condi??es subjetivas para fazer frente ? realidade, construindo solu??es criativas e singulares, para al?m do prescrito. Imposta-se, portanto, que quem salva e quem cuida ? o humano, visto que ? o sujeito que realiza o trabalho, por meio de sua singularidade a superar inventivamente o real naquilo que n?o est? prescrito.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2015-06-15T20:28:57Z No. of bitstreams: 1 470513 - Texto Completo.pdf: 7701806 bytes, checksum: 06768de1fcc024bbd22d468864df46c9 (MD5) / Made available in DSpace on 2015-06-15T20:28:57Z (GMT). No. of bitstreams: 1 470513 - Texto Completo.pdf: 7701806 bytes, checksum: 06768de1fcc024bbd22d468864df46c9 (MD5) Previous issue date: 2015-03-30 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Conselho Nacional de Pesquisa e Desenvolvimento Cient?fico e Tecnol?gico - CNPq / Burning mouth syndrome (BMS) is a complex disease characterized mainly by symptoms of burning, pain or itching in the oral mucosa without apparent clinical alterations. The literature was reviewed in the first manuscript, emphasizing BMS characteristics, etiology and therapeutics. Low-level laser therapy (LLLT) has been widely used in oral disorders because of its analgesic, anti-inflammatory and tissue repair effects. Thereby, in the second manuscript we reviewed the applicability and protocols of LLLT in the management of lichen planus, xerostomia, recurrent aphthous stomatitis, herpes labialis, oral mucositis and BMS. Controlled trials investigating the effects of LLLT on BMS are still rare. The present randomized, placebo-controlled study aimed to clinically assess the effect of LLLT in the treatment of patients with BMS, and to investigate the impact of such therapy in the quality of life of these individuals. The sample consisted of 78 BMS patients who were randomly assigned into three laser groups and one control group (n=19), which was treated with sham LLLT. Laser groups were treated with the following parameters: IR1w group, n=20 (830 nm, 100 mW, 5 J, 176 J/cm2, 50 s, weekly LLLT sessions, ten sessions); IR3w group, n=20 (830 nm, 100 mW, 5 J, 176 J/cm2, 50 s, three weekly LLLT sessions, nine sessions); red laser group, n=19 (685 nm, 35 mW, 2 J, 72 J/cm2, 58 s, three weekly LLLT sessions, nine sessions). Symptoms were assessed at initial, at the end of the treatment and eight weeks later using visual analogue scale and visual numeric scale. Quality of life related to oral health was assessed through the Oral Health Impact Profile (OHIP-14). Statistical analysis was carried out using repeated measures ANOVA followed by the Tukey test. There was a significant reduction in the symptoms in all groups at the end of the treatment, which was maintained in the follow-up. The scores of the IR1w and IR3w laser groups were significantly lower in comparision to the control group. On the other hand, there was no significant difference between Red laser group and control group. There was also a decrease in the OHIP-14 scores in the four groups. The scores of the IR3w laser group differed significantly from those of the control group, showing that LLLT had a positive impact on the quality of life related to oral health. Based on the results of this study it is possible to conclude that infrared LLLT, in the parameters used, reduces the BMS symptoms and can be an alternative therapeutic for this disorder. / A s?ndrome da ard?ncia bucal (SAB) ? uma doen?a de etiopatogenia desconhecida, caracterizada pela sensa??o de queima??o e ard?ncia na mucosa bucal, que se apresenta clinicamente normal. No primeiro artigo desta tese foi realizada uma revis?o da literatura com ?nfase nas caracter?sticas da SAB, etiologia e terap?utica. Uma vez que a terapia laser de baixa pot?ncia (LLLT) tem sido amplamente utilizada em enfermidades bucais devido aos seus efeitos analg?sicos, biomoduladores e antiinflamat?rios, no segundo artigo foram revisados a aplicabilidade e os protocolos da LLLT no manejo do l?quen plano, xerostomia, ulcera??o aftosa recorrente, herpes labial, mucosite e SAB. Ensaios cl?nicos controlados investigando o efeito da LLLT na SAB s?o ainda escassos; portanto, o presente estudo cl?nico randomizado e controlado teve como objetivos avaliar o efeito da LLLT nos sintomas da SAB, bem como, o impacto desta terapia na qualidade de vida relacionada ? sa?de bucal dos pacientes. A amostra foi constitu?da por 78 pacientes com SAB, distribu?dos em tr?s grupos laser e um grupo-controle (n=19), no qual foi empregada sham LLLT. Os seguintes protocolos de LLLT foram empregados nos grupos-laser: grupo IR1w, n=20 (830 nm, 100 mW, 5 J, 176 J/cm2, 50 s, uma sess?o semanal, total de 10 sess?es); IR3w, n=20 (830 nm, 100 mW, 5 J, 176 J/cm2, 50 s, tr?s sess?es por semana, total de nove sess?es); laser vermelho, n=19 (685 nm, 35 mW, 2 J, 72 J/cm2, 58 s, tr?s sess?es por semana, total de nove sess?es). Os sintomas foram avaliados por meio de escala visual num?rica e escala visual anal?gica no in?cio e fim do tratamento, e oito semanas ap?s. Para avalia??o da qualidade de vida relacionada ? sa?de bucal foi usado o instrumento Oral Health Impact Profile (OHIP- 14). Os dados foram analisados por meio do teste ANOVA de medidas repetidas, seguido pelo teste de Tukey. Houve redu??o significativa dos sintomas ao final do tratamento em todos os grupos, o que se manteve no acompanhamento de oito semanas. Os escores dos grupos laser IR1w e IR3w foram significativamente inferiores aos do grupo-controle. Por outro lado, n?o houve diferen?a significativa entre o grupo laser vermelho e o grupo-controle. Houve tamb?m redu??o significativa nos escores do OHIP-14 nos quatro grupos, entretanto, somente o grupo laser IR3w apresentou diferen?a significativa em rela??o ao grupo-controle, mostrando que o tratamento teve impacto positivo na qualidade de vida relacionada ? sa?de bucal. Com base nos resultados, pode-se concluir que a LLLT no comprimento de onda infravermelho e nos par?metros utilizados neste estudo, reduz os sintomas da SAB e pode ser uma alternativa terap?utica no tratamento desta doen?a.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2015-06-26T20:34:36Z No. of bitstreams: 1 471277 - Texto Parcial.pdf: 174616 bytes, checksum: c0d731cdda7e2460a96b5c9760bc7e4a (MD5) / Made available in DSpace on 2015-06-26T20:34:36Z (GMT). No. of bitstreams: 1 471277 - Texto Parcial.pdf: 174616 bytes, checksum: c0d731cdda7e2460a96b5c9760bc7e4a (MD5) Previous issue date: 2015-01-27 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / This Master?s research is composed of two empirical papers, the first one is a characterization of quality of life (QoL), physical and psychosocial factors in patients with Colorectal cancer (CRC). The second reference is to the identification of factors that can predict QoL in this population. The objectives that guided this thesis were to characterize patients with this cancer and to identify factors that predict QoL in patients with CRC . As a method carried out a longitudinal evaluation at baseline and at follow -up 51 patients elected for convenience and were assessed through self-report to QoL in addition to social demographic and clinical variables. On the other hand, if sought - diagnostic and therapeutic information in the medical records. After, there was descriptive and inferential statistics analysis establishing the necessary comparisons and correlations. The results identified a characteristic profile with relatively homogeneous distribution 51 % men with the middle age of 60.1 ( ?9,1) at baseline , as psychosocial aspects in general had higher QoL with other studies on the same population , and a significant improvement over time of all the subscales of performance and symptoms. Also shown that the physical aspects influence QoL. Concerning the predictors in this study there was no evidence links between gender and QoL, except for the initial assessment during chemotherapy indicating relationship between a man predicts to have more diarrhea. Another relevant fact is the relationship schooling, which have higher level indicates greater loss in appetite seconds findings at baseline. The presence of pain at follow -up can be correlated with the fact living alone. When considering the treatment protocols, FOLFIRI and Bevacizumab shown to be related to worse QoL. Also, if the trend showed a pain as a predictor of poor QoL. The relationship between self QoL l reporting among individuals who died and the survivors had minimum ratio indicating that they are independent. Regarding the presence of the mutated K-RAS gene the unique relationship was related with appetite loss. Finally, the symptoms of anxiety and depression were important predictors global QoL subscales and at follow-up. The main conclusion of the study findings is the need for multidisciplinary care that addresses the specific demands on this diagnosis. / Esta disserta??o est? constitu?da de dois estudos emp?ricos, o primeiro trata-se de uma caracteriza??o de qualidade de vida (QV), fatores f?sicos e psicossociais em pacientes com C?ncer de col?n e reto (CCR). J? o segundo trata-se da identifica??o de fatores que podem predizer QV nesta popula??o. Os objetivos que nortearam esta disserta??o foram de caracterizar os portadores desta neoplasia e identificar fatores que est?o associados ? QV em pacientes com CCR. Como m?todo realizou-se uma avalia??o longitudinal na linha de base e no follow-up com 51 pacientes eleitos por conveni?ncia, sendo avaliados atrav?s de autorrelato para QV al?m de vari?veis s?cio demogr?ficas e cl?nicas. Por outro lado, buscaram-se informa??es diagn?sticas e terap?uticas nos prontu?rios m?dicos. Ap?s, realizouse an?lises estat?sticas descritivas e inferenciais estabelecendo as devidas compara??es e correla??es. Os resultados identificaram um perfil caracter?stico com distribui??o relativamente homog?nea 51% s?o homens com idade m?dia de 60,1 (?9,1) na linha de base, como aspectos psicossociais em geral apresentaram QV superior a outros estudos com a mesma popula??o, al?m de uma melhora significativa com o passar do tempo de todas as subescalas de desempenho e sintomas. Tamb?m evidenciado que os aspectos f?sicos influenciam na QV. Concernente aos fatores preditores, neste estudo, n?o se evidenciou rela??es entre sexo e QV, a exce??o da avalia??o inicial durante a quimioterapia que indica rela??o entre ser homem e ter mais diarreia. Outro dado relevante ? em rela??o ? escolaridade, onde ter n?vel superior indica maior preju?zo no apetite segundo achados na linha de base. A presen?a de dor no follow-up pode ser correlacionada com o fato de morar sozinho. Quando considerados os protocolos de tratamento, Folfiri + Bevacizumbe demonstraram estar relacionados ? pior QV. Al?m disso, se evidenciou uma tend?ncia da dor como preditora de pobre QV. A rela??o entre auto relato de QV entre os indiv?duos que foram a ?bito e os sobreviventes apresentaram rela??o m?nima indicando que s?o independentes. No que diz respeito da presen?a do gene K-RAS a ?nica rela??o foi este estar relacionado ? perda de apetite. Por fim, os sintomas de ansiedade e depressivos demonstraram ser importantes fatores associados ? QV global e subescalas no follow-up. Como principal conclus?o dos achados deste estudo est? ? necessidade de cuidado multiprofissional que contemple demandas especificas a este diagn?stico.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2015-07-10T11:53:31Z No. of bitstreams: 1 471993 - Texto Completo.pdf: 2126269 bytes, checksum: f86f75c4cb3e97d7b63c12ed82e07361 (MD5) / Made available in DSpace on 2015-07-10T11:53:31Z (GMT). No. of bitstreams: 1 471993 - Texto Completo.pdf: 2126269 bytes, checksum: f86f75c4cb3e97d7b63c12ed82e07361 (MD5) Previous issue date: 2015-04-28 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Head and neck cancer represents a group of diseases affecting the face and upper aerodigestive tract. Early diagnosis of these neoplasms and their etiologic factors is crucial for patient?s survival and treatment. In the last decades, cause-and-effect relationship between some viruses and malignancies has been widely accepted. Recently, the role of Human papillomavirus (HPV) and Epstein-Barr virus (EBV) has been shown in the pathogenesis of oropharyngeal carcinoma, undifferentiated nasopharyngeal carcinoma and lymphomas. Nevertheless, the role of such viral agents in oral squamous cell carcinoma (OSCC) is still controversial. This study aimed to investigate HPV, EBV, p53 and Ki-67 in OSCC and oral lymphoma, considering clinical and histological features. The sample was composed of archived material (medical records and paraffin blocks of biopsied specimens) from patients with OSCC, oral lymphoma, and oral traumatic fibrous hyperplasia. The biopsied specimens and medical records were allocated into five groups: (1) 16 samples from patients with OSCC grade I (well-differentiated); (2) 16 samples from patients with OSCC grade II (moderately-differentiated); (3) 19 samples from patients with OSCC grade III (poorly-differentiated); (4) 14 samples from patients with oral non-Hodgkin lymphoma; and (5) 19 samples from patients with oral traumatic fibrous hyperplasia. Biopsied specimens were analyzed for HPV, EBV, p53 and Ki-67 expression by immunohistochemistry, and clinical data concerning age and gender of the patients, size and duration of the lesion as well as habits and comorbidities were collected. Marker expression was evaluated according to clinical features and histological grade of the tumors. There was no association of HPV and EBV with the tumors analyzed. Ki-67 expression was significantly lower in the fibrous hyperplasia group with no other significant differences. p53 expression was significantly lower in the lymphoma and fibrous hyperplasia groups than the OSCC groups, with no other significant differences. OSCC grade II and III were associated with male gender and tobacco smoking, while grade III was also associated with alcohol consumption. There was no association of the tumors with either chimarr?o or comorbidities. Duration of the lesion was inversely correlated to lesion size, which in turn was inversely correlated to HPV. EBV and HPV were positively correlated to each other, as was Ki-67 to lesion size and p53, which was correlated to HPV. / Os tumores malignos da regi?o de cabe?a e pesco?o constituem um grupo de doen?as que afeta a face e o trato aerodigestivo superior. O diagn?stico precoce dessas neoplasias e de seus fatores etiol?gicos ? de extrema import?ncia para a sobrevida e para o tratamento do paciente. Nas ?ltimas d?cadas, a rela??o de causa e efeito entre certos v?rus e tumores malignos tem sido amplamente aceita. Recentemente, foi relatado o papel do Human papillomavirus (HPV) e do Epstein-Barr virus (EBV) na patogenia do carcinoma espinocelular de orofaringe, no carcinoma indiferenciado de nasofaringe e em linfomas, sendo ainda controverso o papel desses agentes virais no carcinoma de c?lulas escamosas oral (CCEO). O presente estudo teve por objetivo investigar, por meio de exame imunoistoqu?mico, os v?rus HPV e EBV, bem como os marcadores Ki-67 e p53 em carcinomas e linfomas orais considerando fatores cl?nicos e histol?gicos. Esp?cimes de bi?psia arquivados em blocos de parafina e prontu?rios de pacientes portadores de les?es orais de CCEO, linfoma e hiperplasia fibroepitelial foram distribu?dos em cinco grupos: (1) 16 amostras de CCEO grau I (bem diferenciado); (2) 16 amostras de CCEO grau II (moderadamente diferenciado); (3) 19 amostras de CCEO grau III (pobremente diferenciado); (4) 14 amostras de linfoma n?o-Hodgkin e (5) 19 amostras de hiperplasia fibroepitelial. Os esp?cimes de bi?psia foram submetidos a processamento imunoistoqu?mico para HPV, EBV, p53 e Ki-67. Dados cl?nicos referentes a idade e sexo dos pacientes, tamanho e dura??o da les?o, comorbidades e h?bitos foram coletados dos prontu?rios. A express?o dos marcadores foi analisada de acordo com os aspectos cl?nicos e grau histol?gico dos tumores. N?o houve associa??o entre HPV e EBV com os tumores analisados. A express?o do Ki-67 foi significativamente menor no grupo hiperplasia fibroepitelial, n?o havendo outras diferen?as significativas entre os demais grupos. Os linfomas e as hiperplasias fibroepiteliais exibiram express?o de p53 significativamente menor que os carcinomas, sem outras signific?ncias. CCEO grau II e III foram associados ao sexo masculino e ao tabagismo, enquanto o CCEO grau III foi tamb?m associado ao consumo de ?lcool. N?o houve associa??o dos tumores avaliados com chimarr?o ou comorbidades. Houve correla??o negativa entre dura??o e tamanho da les?o, bem como entre tamanho da les?o e HPV. EBV e HPV exibiram correla??o positiva, assim como o Ki-67 foi correlacionado ao tamanho da les?o e ? p53, que por sua vez exibiu correla??o positiva com o HPV.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2015-09-29T12:24:40Z No. of bitstreams: 1 475306 Texto Parcial.pdf: 838322 bytes, checksum: eff1e4be8410f0b48231927c597012f3 (MD5) / Made available in DSpace on 2015-09-29T12:24:40Z (GMT). No. of bitstreams: 1 475306 Texto Parcial.pdf: 838322 bytes, checksum: eff1e4be8410f0b48231927c597012f3 (MD5) Previous issue date: 2015-08-25 / This dissertation deals the use of Motivational Interviewing with undergraduate students in the senior year from different healthcare courses. Initially, it is presented a general contextualization of the current research from both a theoretical and a practical point of view. Therefore, three different studies were performed. The first paper aimed to, through an unsystematic review of literature, know the MI trainings offered to health professionals. The second used a crosssectional design in a sample of 120 undergraduate students in the senior year from Medicine, Physiotherapy, Dentistry, Psychology, Nursing, and Nutrition School in order to evaluate the knowledge level of the Motivational Interviewing basic skills. The Confidence and Importance level of using these basic skills in participants' daily practice was also verified. The third using a pre and post-test quasi-experimental design, sought to examine the effectiveness of the eight hour Motivational Interviewing basic skills training with 60 undergraduate students in the senior year from different healthcare courses. Taken together, our results have important implications for the dissemination of the relevant to offer Motivational Interviewing training for undergraduate students from different healthcare courses. / Esta tese aborda o uso da Entrevista Motivacional com estudantes do ?ltimo ano de gradua??o de diferentes cursos da ?rea da sa?de. Inicialmente apresenta uma contextualiza??o geral, contemplando o contexto da pesquisa do ponto de vista te?rico e do ponto de vista pr?tico. Para tanto, foram realizados tr?s estudos distintos. O primeiro artigo buscou, atrav?s de uma revis?o assistem?tica de literatura, conhecer os treinamentos em Entrevista Motivacional oferecidos para profissionais da ?rea da sa?de. O segundo, utilizou um delineamento transversal em uma amostra de 120 estudantes dos cursos de Medicina, Fisioterapia, Odontologia, Psicologia, Enfermagem e Nutri??o com o objetivo de avaliar o n?vel de conhecimento das habilidades fundamentais da Entrevista Motivacional. Al?m disso, foi verificado o grau de confian?a e da import?ncia em utilizar essas habilidades na pr?tica di?ria dos participantes da amostra. O terceiro, atrav?s de um delineamento pr? e p?s-teste quase-experimental, procurou examinar a efetividade de um treinamento de oito horas das habilidades b?sicas da Entrevista Motivacional com 60 estudantes do ?ltimo ano de diferentes cursos na ?rea da sa?de. Nossos resultados, tomados em conjunto, t?m implica??es importantes para a divulga??o da relev?ncia de oferecer forma??o em Entrevista Motivacional para para estudantes de gradua??o de diferentes cursos de sa?de.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2015-10-15T11:49:23Z No. of bitstreams: 1 475701 - Texto Completo.pdf: 1116299 bytes, checksum: 15319adc3058d6109c562e568c6d8a3d (MD5) / Made available in DSpace on 2015-10-15T11:49:23Z (GMT). No. of bitstreams: 1 475701 - Texto Completo.pdf: 1116299 bytes, checksum: 15319adc3058d6109c562e568c6d8a3d (MD5) Previous issue date: 2015-06-30 / Technically all steps are crucial to obtain excellence in required endodontic treatment. To minimize accidents during the preparation chemical and mechanical changes in the methods and instrumentation in nickel titanium endodontic instruments has been suggested. New instruments are often launched on the market without proper knowledge of their properties and limitations, therefore, the purpose of this thesis was to evaluate the defects in surfaces of instruments reciprocantes Unicone and Prodesign, comparing them to the instruments of continuous rotation Prodesign S and Wizard Navigator. Each system was used three times in simulated root canals and the surfaces of instruments were analyzed by scanning electron microscopy. After statistical analysis of the results, it was concluded that the instruments reciprocantes Prodesign and Unicone presented a progressive increase of surface defects, suggesting that single use for increased security during the treatment. The instruments of continuous rotation Wizard Navigator and Prodesign S presented smaller defects after the third use in relation to flute deformation, but with a trend to enhance material loss. In addition, a review of the literature was performed to cover the findings of recent years on reciprocal and continuous systems. / Tecnicamente todas as etapas s?o cruciais para obter-se excel?ncia no tratamento endod?ntico. Visando a minimizar acidentes durante a realiza??o do preparo qu?mico-mec?nico, modifica??es nos m?todos de instrumenta??o e nos instrumentos endod?nticos de n?quel tit?nio t?m sido sugeridas. Novos instrumentos s?o muitas vezes lan?ados no mercado sem o devido conhecimento de suas propriedades e limita??es, portanto o objetivo desta tese foi avaliar os defeitos de superf?cies dos instrumentos reciprocantes Unicone e Prodesign, comparando-os aos instrumentos de rota??o cont?nua Prodesign S e Wizard Navigator. Cada sistema foi utilizado tr?s vezes, em canais simulados, e as superf?cies dos instrumentos foram analisadas atrav?s da microscopia eletr?nica de varredura. Ap?s an?lise estat?stica dos resultados, concluiu-se que os instrumentos reciprocantes Prodesign e Unicone apresentaram aumento progressivo de defeitos de superf?cie, o que sugere utiliza??o ?nica para maior seguran?a durante o tratamento. Os instrumentos de rota??o cont?nua Wizard Navigator e Prodesign S apresentaram menores defeitos ap?s o terceiro uso em rela??o a deforma??o das espiras, por?m estes instrumentos apresentam uma tend?ncia maior a perda de material da superf?cie. Adicionalmente uma revis?o de literatura foi realizada com intuito de abranger os achados dos ?ltimos anos sobre sistemas rec?procos e cont?nuos.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2015-10-27T10:50:40Z No. of bitstreams: 1 475906 - Texto Completo.pdf: 2818432 bytes, checksum: ef1bbe62cc37365a42f48dd4ca4182ea (MD5) / Made available in DSpace on 2015-10-27T10:50:40Z (GMT). No. of bitstreams: 1 475906 - Texto Completo.pdf: 2818432 bytes, checksum: ef1bbe62cc37365a42f48dd4ca4182ea (MD5) Previous issue date: 2015-07-17 / Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is an important side-effect of bisphosphonates. The condition has high morbidity and its treatment is difficult, where many therapies have been tried including antibiotics, surgical interventions, and also some alternative therapies such as low-level laser therapy, platelet-rich plasma and hyperbaric oxygen therapy (HBOT). Nevertheless, there is no consensus about the effectiveness of HBOT in BRONJ. The aim of the present study was to investigate the effect of HBOT on tooth extraction site in rats treated with bisphosphonate. Thirty-five Wistar rats were treated with zoledronic acid, subjected to tooth extractions and allocated into groups according to HBOT regimen: (1) 7 days of HBOT; (2) 14 days of HBOT; (3) without HBOT (7-day control); (4) without HBOT (14-day control). The site of tooth extractions was analyzed by histomorphometry and immunohistochemistry. Bone exposure volume did not significantly differ between pre- and post-HBOT or between test groups and controls.At 7 days, the HBOT group showed amounts of epithelium and root fragment that were significantly less than the control. At 14 days, non-vital bone was significantly less in the HBOT group than in the control. HBOT groups compared to each other showed higher amounts of non-vital bone and less root fragment at 7 days. The HBOT group showed at 7 days lower expression of VEGF, RANKL, BMP-2 and OPG compared to the control, whereas at 14 days, there was no significant difference. Comparing HBOT groups at 7 and 14 days to each other, VEGF and OPG showed significantly higher expression at 14 days, whereas RANKL and BMP-2 did not show any significance.Conclusion: HBOT can reduce the amounts of non-vital bone microscopically detected in tooth extraction sites of rats subjected to bisphosphonate therapy. The effect seems to occur in a dose-dependent mode. Further studies are required to clarify the mechanisms accounting for this effect. / A osteonecrose maxilar associada aos bisfosfonatos (bisphosphonate-related osteonecrosis of the jaw, BRONJ) ? um importante efeito adverso desses f?rmacos. A condi??o exibe elevada morbidade e dif?cil tratamento, sendo que v?rias modalidades terap?uticas t?m sido empregadas, entre as quais se destacam antibioticoterapia, interven??es cir?rgicas e terapias alternativas como a terapia a laser de baixa intensidade, plasma rico em plaquetas e oxigenoterapia hiperb?rica (hyperbaric oxygen therapy, HBOT). Entretanto, n?o existe consenso sobre a efetividade da HBOT no tratamento da BRONJ. O presente estudo teve por objetivo investigar o efeito da HBOT em s?tio de exodontias em ratos sob tratamento com bisfosfonatos. Trinta e cinco ratos Wistar foram tratados com ?cido zoledr?nico, submetidos a exodontias e distribu?dos em grupos de acordo com o regime de HBOT recebido: (1) 7 dias de HBOT; (2) 14 dias de HBOT; (3) sem HBOT (controle de 7 dias); (4) sem HBOT (controle de 14 dias). O s?tio das exodontias foi analisado por meio de histomorfometria e imunoistoqu?mica. O volume de exposi??o ?ssea n?o diferiu significativamente entre os per?odos pr?- e p?s-HBOT, nem entre grupo-teste e controle.Aos 7 dias, o grupo HBOT exibiu propor??o de epit?lio e resto radicular significativamente menor que o controle. Aos 14 dias, a propor??o de osso n?o-vital foi significativamente menor no grupo HBOT que no controle. Quando os grupos-teste foram comparados entre si, foi observada maior propor??o de osso n?o-vital e menor propor??o de resto radicular aos 7 dias. O grupo HBOT exibiu, aos 7 dias, express?o de VEGF, RANKL, BMP-2 e OPG significativamente menor que o controle, enquanto aos 14 dias essa diferen?a n?o foi significativa. Quando os grupos-teste foram comparados entre si, VEGF e OPG exibiram express?o significativamente maior aos 14 dias, enquanto RANKL e BMP-2 n?o exibiram diferen?a significativa.Conclus?o: A HBOT est? associada a menor propor??o de osso n?o-vital detectado microscopicamente em s?tios de exodontias de ratos submetidos a terapia com bisfosfonato. O efeito parece ser dose-dependente e novos estudos s?o necess?rios para esclarecer os mecanismos respons?veis por esse efeito.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2016-04-04T14:21:27Z No. of bitstreams: 1 TES_JANAINA_CASTRO_NUNEZ_CARVALHO_PARCIAL.pdf: 5015625 bytes, checksum: 4c73c3dfc7f7628f236a0ad0ce99c33a (MD5) / Made available in DSpace on 2016-04-04T14:21:27Z (GMT). No. of bitstreams: 1 TES_JANAINA_CASTRO_NUNEZ_CARVALHO_PARCIAL.pdf: 5015625 bytes, checksum: 4c73c3dfc7f7628f236a0ad0ce99c33a (MD5) Previous issue date: 2016-03-04 / Conselho Nacional de Pesquisa e Desenvolvimento Cient?fico e Tecnol?gico - CNPq / The occurrence of maltreatment in childhood is a phenomenon with high prevalence around the world and is associated to a series of neurobiological, emotional and cognitive impairments in victims. A body of evidence already exists regarding its consequences for adolescent and adult samples, suggesting deleterious medium and long-term impacts; however, impairments in childhood have not been sufficiently studied. Thus, the aim of this study is to assess the impact of maltreatment on cognition during childhood, as well as the presence of associated clinical symptoms. This thesis is composed of three papers: one theoretical and two empirical. The theoretical article entitled "Cognitive, neurobiological and psychopathological alterations associated with child maltreatment: a review of systematic reviews" aims to review the association between maltreatment and neurobiological, cognitive and lifetime comorbid psychiatric alterations. Important neurobiological alterations were found to be associated with maltreatment, as changes in levels of cortisol, dopamine, norepinephrine and serotonin. Structural impairments were found in regions such as the frontal cortex and hippocampus in adult victims of childhood maltreatment. The most consistent finding was the association between childhood maltreatment and presence of psychiatric conditions in adulthood. Regarding the impact of maltreatment on cognition, there are few studies to date and they report contrasting results. A need for further studies with child samples was evidenced through the literature review, in order to assess the immediate or short-term impact of maltreatment in cognition, as well as the presence of clinical symptoms. Thus, the first empirical article entitled "Cognitive Performance and Clinical Symptoms in Maltreatment Victims: Intellectual Impairment Evidence in a Child Sample in Brazil" aims to assess global cognitive profile and the prevalence of intellectual impairment of a sample of child victims of maltreatment between 6 and 12 years of age. A further objective is to assess the presence of internalizing and externalizing symptoms and their relation to the cognitive profile of the sample. Group differences were found across all assessed functions, with the presence of important intellectual impairment in the maltreatment group. More clinical symptoms, especially externalizing symptoms, were found in the maltreatment group. Few associations were found between clinical symptoms and cognitive profile. The second empirical article, "Executive Function and clinical symptoms in children exposed to maltreatment", sought to assess in a more specific manner the executive functioning of a group of child victims of maltreatment aged 8 to 12 years. Furthermore, clinical symptoms were more broadly investigated in the sample, through the assessment of depression, anxiety and post-traumatic stress symptoms. Evidence of an important executive impairment was found in the maltreatment group. Inhibitory control remained impaired even when controlling for intelligence. More clinical symptoms were found in the maltreatment group, with no association between most of the cognitive and clinical measures. Lastly, final considerations about the work are drawn. In view of the findings of a high prevalence of intellectual impairments in the maltreatment group and the dissociation between cognitive impairments and clinical profile, the discussion revolves around preventive and cognitive stimulation interventions for victims. / A ocorr?ncia de maus-tratos na inf?ncia ? um fen?meno com alta preval?ncia ao redor do mundo e est? associado a uma s?rie de preju?zos neurobiol?gicos, emocionais e cognitivos nas v?timas. Ainda que j? exista um corpo de evid?ncias sobre as suas sequelas em amostras de adolescentes e adultos, sugerindo um impacto delet?rio a m?dio e longo prazo, os preju?zos na inf?ncia ainda n?o foram suficientemente estudados. Dessa forma, o objetivo geral deste trabalho foi avaliar o impacto dos maus-tratos na cogni??o durante a inf?ncia, bem como a presen?a de sintomatologia cl?nica associada. A presente tese ? composta de 3 artigos, sendo um artigo te?rico e dois artigos emp?ricos. O primeiro artigo te?rico denominado ?Cognitive, neurobiological and psychopathological alterations associated with child maltreatment: a review of systematic reviews? teve como objetivo revisar a associa??o entre maus-tratos e altera??es neurobiol?gicas, cognitivas e comorbidades psiqui?tricas ao longo da vida. Foram encontradas importantes altera??es neurobiol?gicas associadas aos maus-tratos com modifica??es nos n?veis de cortisol, dopamina, noradrenalina e serotonina. Em n?vel estrutural foram encontradas diminui??es em regi?es como c?rtex frontal e hipocampo em adultos v?timas de maus-tratos na inf?ncia. O achado mais consistente foi a associa??o entre maus-tratos na inf?ncia e presen?a de quadros psiqui?tricos na vida adulta. Em rela??o ao impacto dos maus-tratos na cogni??o, existem poucos estudos at? o momento e estes encontraram resultados contrastantes. A partir da revis?o da literatura evidenciou-se a necessidade de mais estudos com amostras de crian?as, para avaliar o impacto imediato, ou de curto prazo, dos maus-tratos na cogni??o, bem como a presen?a de sintomatologia cl?nica. Dessa forma, o primeiro artigo emp?rico denominado ?Desempenho Cognitivo e Sintomas Cl?nicos em V?timas de Maus-tratos: Evid?ncias de Preju?zo Intelectual em uma Amostra de Crian?as no Brasil? teve como objetivo avaliar o perfil cognitivo global, bem como a preval?ncia de preju?zo intelectual de uma amostra de crian?as v?timas de maus-tratos de 6 a 12 anos. Teve como objetivo ainda avaliar a presen?a de sintomas internalizantes e externalizantes na amostra e sua rela??o com o perfil cognitivo. Foram encontradas diferen?as entre os grupos em todas as fun??es avaliadas, com a presen?a de importante preju?zo intelectual no grupo maus-tratos. Foi encontrada, ainda, maior sintomatologia cl?nica, sobretudo de sintomas externalizantes, no grupo maus-tratos. Foram encontradas poucas associa??es entre a sintomatologia cl?nica e o perfil cognitivo encontrado. O segundo artigo emp?rico, ?Fun??es Executivas e sintomatologia cl?nica em crian?as expostas a maus-tratos?, buscou avaliar de uma forma mais espec?fica as fun??es executivas de um grupo de crian?as de 8 a 12 anos v?timas de maus-tratos bem como investigar de forma mais ampla a sintomatologia cl?nica na amostra, avaliando sintomas de depress?o, ansiedade e sintomatologia de estresse p?s-traum?tico. Foram encontradas evid?ncias de importante preju?zo executivo no grupo maus-tratos. O controle inibit?rio manteve-se prejudicado, mesmo quando a intelig?ncia foi controlada. Houve maior presen?a de sintomatologia cl?nica no grupo maus-tratos, sem associa??o entre a maior parte das medidas cognitivas e cl?nicas. Por ?ltimo, foram tra?adas considera??es finais sobre o trabalho. Tendo em vista os achados de alta preval?ncia de preju?zos intelectuais no grupo maus-tratos e dissocia??o entre os preju?zos cognitivos e o perfil cl?nico, foram discutidas, a partir da literatura, interven??es preventivas e de estimula??o cognitiva para as v?timas.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2016-04-13T17:20:13Z No. of bitstreams: 1 DIS_CAROLINE_LOUISE_MALLMANN_PARCIAL.pdf: 708883 bytes, checksum: ebda139ac547d01c7ff34a06be132dd6 (MD5) / Made available in DSpace on 2016-04-13T17:20:13Z (GMT). No. of bitstreams: 1 DIS_CAROLINE_LOUISE_MALLMANN_PARCIAL.pdf: 708883 bytes, checksum: ebda139ac547d01c7ff34a06be132dd6 (MD5) Previous issue date: 2016-01-21 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Cyberbullying is defined as a phenomenon involving aggressive, intentional and repetitive behaviors, carried out by electronic means, during a given period and perpetrated by an individual or group against a victim with difficulties in defending herself or himself. Coping strategies are a set of mutable cognitive and behavioristic efforts, used to deal with internal or external demands that are evaluated by the individual as excessive to his or her resources. Finally, Early Maladaptive Schemes (EMSs) are a dysfunctional cognitive and emotional pattern, related to oneself or to other individuals, developed during childhood or adolescence. Thus, the objective of this paper was to investigate the process of cyberbullying in adolescents of two cities in the State of Rio Grande do Sul (Brazil), as well the relation of this phenomenon with coping strategies and with Early Maladaptive Schemes. To do so, the investigation was divided into two empirical articles. The first article aimed at relating the social roles in cyberbullying (non-involved, victims, aggressors or victim-aggressors) and the styles of coping. A total of 273 students took part in the survey (average age=14,91; DP=1.43). The teenagers were invited to answer the Sociodemographic Data Questionnaire, the Revised Cyberbullying Inventory (RCBI), the Young Schema Questionnaire for Adolescents (SQA) and the Lazarus and Folkman Coping Strategies Inventory. The results indicated that almost 58% of the adolescents suffered or perpetrated some sort of virtual violence. Moreover, the average of the coping strategies of self-control, social support and escape-avoidance were significantly higher to the victims than to the non-involved. On the other hand, the confrontation strategy was more frequent in the reports of victim-aggressors than in the non-involved. It is discussed the high cyberbullying frequency in the sample surveyed, as well as the dominance of coping strategies focused on emotion. The second article aimed at investigating the relations between social roles in cyberbullying and the Early Maladaptive Schemes proposed by Young. The participants, as well as the procedures, were the same as in Study 1. The results showed that girls tend to be more involved in cyberbullying practices than boys. Adolescents involved in cyberbullying as victims and victim-aggressors tend to present higher averages in the majority of EMSs than the non-involved. Victims presented significantly higher scores in the Defect scheme in comparison to aggressors, victim-aggressors and non-involved, as well as presented significantly higher scores in the Distrust, insufficient Self-Control, Subjugation and Self-Sacrifice Schemes in comparison with the non-involved and in the Entanglement Scheme in comparison to victim-aggressors. On the other hand, the victim-aggressors presented higher scores in the grandiosity, insufficient self-control and search for approval schemes. It was observed a higher frequency of cyberbullying among girls, which brings interpretations on cultural and biological influences related to genre and aggressiveness. Finally, it is equally debated the issue of EMSs as possible factors that make the individual vulnerable to the cyber victimization or that allow the perpetration of aggressive acts in the virtual context. / Cyberbullying ? definido como um fen?meno que envolve comportamentos agressivos, intencionais e repetitivos, realizados atrav?s de meios eletr?nicos, ao longo de um determinado per?odo e perpetrados por um indiv?duo ou grupo contra uma v?tima que apresenta dificuldade em se defender. J? estrat?gias de coping s?o um conjunto de esfor?os cognitivos e comportamentais mut?veis, utilizados para lidar com exig?ncias internas ou externas, avaliadas pelo indiv?duo como excessivas aos seus recursos. Por fim, Esquemas Iniciais Desadaptativos (EIDs) referem-se a um padr?o cognitivo e emocional disfuncional, relacionado a si mesmo ou a outros indiv?duos, os quais s?o desenvolvidos durante a inf?ncia ou adolesc?ncia. Assim, o presente trabalho teve por objetivo investigar o processo de cyberbullying em adolescentes de duas cidades do Rio Grande do Sul (Brasil), bem como a rela??o desse fen?meno com as estrat?gias de coping e com os Esquemas Iniciais Desadaptativos. Para isso, a investiga??o foi dividida em dois artigos emp?ricos. O primeiro artigo objetivou relacionar os pap?is sociais no cyberbullying (n?o-envolvidos, v?timas, agressores ou v?timas-agressores) e os estilos de coping. Participaram do estudo 273 estudantes (idade m?dia=14,91; DP=1,43). Os adolescentes foram convidados a responder ao Question?rio de Dados Sociodemogr?ficos, ao Revised Cyberbullying Inventory (RCBI), ao Question?rio de Esquemas de Young para Adolescentes (QEA) e ao Invent?rio de Estrat?gias de Coping de Lazarus e Folkman. Os resultados indicaram que 58% dos adolescentes sofreram ou perpetraram alguma forma de agress?o virtual. Al?m disso, as m?dias das estrat?gias coping de autocontrole, suporte social e fuga-esquiva foram significativamente maiores para as v?timas do que para os n?o-envolvidos. Por sua vez, a estrat?gia de confronto foi mais frequente no relato das v?timas-agressores que dos n?o-envolvidos. Discute-se a frequ?ncia elevada do cyberbullying na amostra pesquisada, bem como a preval?ncia de estrat?gias de coping focadas na emo??o. J? o segundo artigo buscou investigar as rela??es entre os pap?is sociais no cyberbullying e os Esquemas Iniciais Desadaptativos propostos por Young. Os participantes, bem como os procedimentos, foram os mesmo do Estudo 1. Os resultados apontaram que as meninas tenderam a estar mais envolvidas em pr?ticas de cyberbullying que os meninos. Os adolescentes envolvidos em cyberbullying como v?timas e v?timas-agressores tenderam a apresentar m?dias mais elevadas na maioria dos EIDs do que os n?o-envolvidos. V?timas apresentarem escores significativamente maiores no esquema de Defeito, em compara??o a agressores, v?timas-agressores e n?o-envolvidos, assim como obtiveram pontua??es significativamente maiores nos esquemas de Desconfian?a, Autocontrole insuficiente, Subjuga??o e Auto-sacrif?cio, em compara??o aos n?o-envolvidos e no esquema de Emaranhamento em compara??o a v?timas- agressores. Por outro lado, as v?timas-agressores apresentaram escores mais elevados nos esquemas de grandiosidade, auto-controle insuficiente e busca de aprova??o em compara??o a n?o-envolvidos. Observou-se uma frequ?ncia mais elevada de cyberbullying entre as meninas, o que remete a interpreta??es sobre influ?ncias culturais e biol?gicas relacionadas a g?nero e agressividade. Por fim, ? igualmente problematizada a quest?o dos EIDs como poss?veis fatores que vulnerabilizam o indiv?duo ? cyber vitimiza??o ou propiciam a realiza??o de atos agressivos no contexto virtual.

Submitted by Setor de Tratamento da Informa??o - BC/PUCRS (tede2@pucrs.br) on 2016-04-14T14:42:50Z No. of bitstreams: 1 DIS_FERNANDA_DE_ALMEIDA_RIBEIRO_PARCIAL.pdf: 499422 bytes, checksum: 6dd17a563b352aeb63ea3edda8b04509 (MD5) / Made available in DSpace on 2016-04-14T14:42:50Z (GMT). No. of bitstreams: 1 DIS_FERNANDA_DE_ALMEIDA_RIBEIRO_PARCIAL.pdf: 499422 bytes, checksum: 6dd17a563b352aeb63ea3edda8b04509 (MD5) Previous issue date: 2016-01-20 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / The overweight and obesity increase represents a threat in all countries of the world. A preliminary study with 1136 Brazilian adolescents shows that 20% were overweight and 10% obese. The conventional treatment of obesity is based on reducing calorie intake, increase energy expenditure, behavior change, and family involvement. The transtheoretical Model of Change (TTM) is a model that works behavior change, seeking an increase in motivation for change and self-efficacy. This dissertation aims to describe and explain an interdisciplinary intervention based on the transtheoretical model of change (TTM) for adolescents with overweight/obesity. The Section I had as goal describe the methodology of Randomized Clinical Trial Modification Lifestyle and Cardiovascular Risk (MERC). The method of this randomized controlled trial is single blinded, with control group and aims to recruit 120 adolescents aged 15 to 18 years with overweight or obese (BMI ? 85th percentile). The control group will receive the traditional intervention of health education and the experimental group will receive a motivational and interdisciplinary intervention. The results of this randomized controlled trial will determine if the motivational interdisciplinary intervention based on the transtheoretical model of change has an impact on lifestyle change adolescents with overweight/obesity. The Section II aimed to explore self-efficacy and motivation for behavioral change eating habits and physical exercise in the process of an interdisciplinary intervention based on TTM for overweight/obesity. It was used a quantitative and qualitative descriptive study, ith a pre and post study design test to collect quantitative data and and a multiple case study to collect qualitative data. In this study, there were five adolescents aged between 15 and 18 with overweight/obese. It was applied before and after the intervention the following instruments and evaluations: questionnaire of sociodemographic data, anthropometric profile, self-efficacy to regulate eating habits, self-efficacy for regular exercise and readiness ruler. The results, of the Student t test, show that the variables of interest did not present statistically significant differences (p?0,001 and p?0,05). Regarding the impact of the intervention from the estimate of effect size, were classified as small effects for the variable weight and self-efficacy to regulate eating habits and moderate effect for the variables motivation for physical exercise, motivation to change eating habits, waist circumference and self-efficacy to maintain an exercise routine. These initial findings indicate that this intervention has a moderate effect for most variables of interest. The qualitative results show that the intervention had an impact on all participants, some advancing on the motivation to change, but remaining in cognitive processes, and others advancing on behavioral processes. Most of the participants showed an increase in selfefficacy for both target behaviors. This study enabled initial data of the impact of an intervention based on the transtheoretical model of change for overweight /obesity. / O aumento do sobrepeso e da obesidade representa uma amea?a em todos os pa?ses do mundo. Um estudo preliminar com 1136 adolescentes brasileiros aponta que 20% apresentaram sobrepeso e 10% obesidade. O tratamento convencional da obesidade fundamenta-se na redu??o da ingest?o cal?rica, aumento do gasto energ?tico, modifica??o comportamental e envolvimento familiar. O Modelo Transte?rico de Mudan?a (MTT) ? um modelo que trabalha a modifica??o comportamental, buscando um aumento da motiva??o para mudan?a e da autoefic?cia. Esta disserta??o tem como objetivo descrever e explorar uma interven??o interdisciplinar baseada no modelo transte?rico de mudan?a (MTT) para adolescentes com sobrepeso/obesidade. A Se??o I teve como objetivo descrever a metodologia do Ensaio Cl?nico Randomizado Modifica??o do Estilo de Vida e Risco Cardiovascular (MERC). O m?todo deste ensaio cl?nico randomizado ? cego simples, com grupo controle e visa recrutar 120 adolescentes de 15 a 18 anos com sobrepeso ou obesidade (IMC ? percentil 85). O grupo controle receber? a interven??o tradicional de educa??o em sa?de e o grupo experimental receber? a interven??o interdisciplinar motivacional em grupo. Os resultados desse ensaio cl?nico randomizado ir?o determinar se a interven??o interdisciplinar motivacional baseada no modelo transte?rico de mudan?a tem impacto na modifica??o do estilo de vida dos adolescentes com sobrepeso/obesidade. A Se??o II teve como objetivo explorar a autoefic?cia e motiva??o para mudan?a dos comportamentos h?bito alimentar e pr?tica de exerc?cio f?sico no processo de uma interven??o interdisciplinar baseada no MTT para adolescentes com sobrepeso/obesidade. Utilizou-se um estudo descritivo quantitativo e qualitativo, com um desenho de estudo pr? e p?s teste para coletar os dados quantitativos, e um estudo de casos m?ltiplos para coletar os dados qualitativos. Participaram do estudo cinco adolescentes com idade entre 15 e 18 anos com sobrepeso/obesidade. Foram aplicados antes e ap?s a interven??o os seguintes instrumentos e avalia??es: question?rio de dados s?cio-demogr?ficos, perfil antropom?trico, autoefic?cia para regular h?bitos alimentares, autoefic?cia para regular exerc?cio f?sico e r?gua de prontid?o. Os resultados do Teste t de Student apontaram que as vari?veis de interesse n?o apresentaram diferen?as estat?sticas significativas (p?0,001 e p?0,05). Com rela??o ao impacto da interven??o a partir da estimativa do tamanho do efeito, foram classificados como pequenos os efeitos para as vari?veis peso e autoefic?cia para regular os h?bitos alimentares e efeito moderado para as vari?veis motiva??o para a pr?tica de exerc?cio f?sico, motiva??o para mudan?a de h?bito alimentar, circunfer?ncia abdominal e autoefic?cia para manter uma rotina de exerc?cios f?sicos. Estes achados inicias indicam que esta interven??o possui um efeito moderado para a maioria das vari?veis de interesse. Os resultados qualitativos apontam que a interven??o teve impacto sobre todos os participantes, alguns avan?ando na motiva??o para mudan?a, mas permanecendo em processos cognitivos, e alguns avan?ando em processos comportamentais. A maioria dos participantes apresentou um aumento da autoefic?cia para os dois comportamentos alvo. Este estudo possibilitou dados iniciais do impacto de uma interven??o baseada no modelo transte?rico de mudan?a para adolescentes com sobrepeso/obesidade.