Construção e validação de instrumento simplificado para diagnóstico de disfunção temporomandibular em pacientes adultos

As disfunções temporomandibulares (DTM) representam a maior causa de dor não dentária da região orofacial. Dada sua alta prevalência na população em geral e a existência de inúmeros instrumentos diagnósticos não padronizados, buscou-se elaborar e validar um questionário simples, de acessibilidade ampla e aplicação prática, com vistas a contribuir para o diagnóstico e o estudo epidemiológico das mesmas. A estratégia utilizada na montagem do instrumento foi estabelecida com base na avaliação criteriosa de questionários já existentes na literatura, validação de expertos na área de DTM, validação fatorial, de face (na primeira fase do estudo) e, frente ao padrão ouro (RDC/TMD), na segunda fase do estudo. Na primeira fase, participaram 160 indivíduos. A consistência interna resultou num Coeficiente Alfa de Cronbach de 0,752 para o questionário com sete itens; enquanto que para o questionário com cinco itens, este resultado foi de 0,694, não sendo o mesmo, considerado baixo por avaliar apenas cinco questões e ainda, em razão do tema central da pesquisa ser bastante subjetivo. A análise fatorial confirmatória apontou para uma variância total dos fatores extraídos do questionário com sete itens, de 58,2 % e do questionário com cinco itens de 70,04%. Portanto, o questionário com cinco questões, apresentou resultados estatísticos superiores ao de sete questões. Na validação frente ao padrão ouro (RDC/TMD), foram avaliados 99 indivíduos tendo sido testados os dois questionários, com sete e com cinco questões. Na estrutura com sete questões, ao se categorizar as mesmas por totais de pontos obtidos, em quatro condições, obteve-se o melhor resultado quando se considerou com DTM a faixa entre 10 e 21 pontos, sendo 85,1% positivos também no RDC/TMD, com acurácia de 90,1% e Kappa 0,817. Nesta condição, a sensibilidade encontrada foi de 95% (IC 95%, 91 a 99), especificidade de 87% (IC 95%, 81 a 93), VPP 85%, VPN 96%, LR+ 7,3 e LR- 17,4. Quando os dados foram avaliados para o questionário com cinco questões (QST/DTM), pode-se observar que o melhor ponto de corte foi quando se considerou como portadores de DTM, os indivíduos na faixa entre 7 e 15 pontos, com acurácia de 85,8% e Kappa 0,817. Nesta condição, a sensibilidade foi 88% (IC 95%, 81,6 a 94,4), especificidade 84% (IC 95%, 76,8 a 91,2), VPP 80%, VPN 90,5%, LR+ 5,5 e LR- 7,0. A simplicidade do presente questionário (QST/DTM) com apenas cinco questões, possibilita seu uso como elemento de triagem inicial na área da dor orofacial em disfunção temporomandibular, com boa compreensibilidade, confiabilidade, reprodutibilidade e possibilidade de aplicação em pesquisas epidemiológicas. Concluiu-se que o questionário aqui validado, permite sua aplicação de forma simples tanto por profissionais e pesquisadores da Odontologia como de outras áreas da saúde

Um olhar sociológico sobre a criança e o brincar: espaço e tempo de construção, reinvenção e aprendizagem

This research I discuss the play, also talking with the other subjects that make up the universe in which the play is inserted, such as family, school and culture. The fundamental proposition of this dissertation assumes that the absence of play in children's lives affect their physical structure, psychological, biological, cultural, social, historical and theirs development. The initial questions were: What are the spacetimes reserved in the school for play? What is the importance of play in the development of children? Does the school recognize the importance of play in its social space? How the children perceive and use the spacetimes to play at school? Are there spacetimes at school to play? This is a theoretical and empirical research of exploratory study. The research‟s field was the Municipal School Professor Ulysses Góes, located in district of Nova Descoberta, in Natal, Rio Grande do Norte and, as research techniques, I used: participant observation, photography, structured interviews with students and questionnaires with teachers. The results indicate that for most of children, the school allows the play, few disagree with this preposition.Teachers recognize the importance of play in school, but for various reasons do not provide your practice. The dissertation points the possibility of new studies and developments for the theme.

Plano de Desenvolvimento da Escola (PDE): o processo de implantação de uma nova proposta de descentralização em duas escolas da rede municipal de ensino de Natal de 1999 a 2002

The 1988 Constitution was the legal marc to define changes in Brazilian State with major importance to the layout of public politician. In that moment of redefinitions e openness to new ways the redemocratization, participation and decentralization of public school had as their starter the elementary school. This work focus on the manage of FUNDESCOLA, particularly one of its politics called PDE (Educational Development Plan) wich purpose is guarantee a better quality in teaching and spread out democracy throughout its methodology. It was chosen two public schools: Professor Ulisses de Góis and Antonio Campos. The theoretical and methodological orientation is based on the theory of participative democracy developed by authors such as Putnam and Pateman. They says that a cultural background precedes individual participation in society. The collected data (educational legislation, surveys with all sectors of schools and technicians of Natal educational secretary, and relevant documents of de institutions) showed that PDE. Implementation had opposite runnings in the schools studied. In one, as a consequence of bad preparations of its teachers to absorve its methodology, PDE failed. In another way, PDE achieved its goals, especially helping the structure of action plans of the school and the administrative organization making possible several pedagogic activities planned. The work concludes that the main factor the failure or success of PDE relies on the organizational (both political and pedagogical) structure of each school. This discovery implies three important guidelines when comes to formulation of public politicians: a) Constitution of school; b) the local actors who manages the actions; c) the colletive interest in taking part of decisions

Brincar, atividade humana e ferramenta pedagógica no contexto escolar da região metropolitana de natal

This thesis talks about the use of guided educational tools in play and playful in public schools in the Metropolitan Region of Natal (MRN), contributing to the teaching and students learning of basic education in the contents of portuguese and mathematics. We assume that the play is an activity / human need and therefore implies the proper development of children in physical, psychological, biological, cultural, social and historical aspects. We consider the mediation exercised by the teacher in the classroom, and the affection existing between teacher and student, sine qua non terms, so that the truth and fact of the process of teaching and learning occur. Thus, theoretically collaborated Paulo Freire, with his dialogical vision; Lev S. Vygotsky says that we learn and why we develop; Lev S. Vygotsky that states that we learn and for that we develop ourselves; Pierre Bourdieu and the concept of habitus, as something embedded and therefore procedural, and the cultural capital that needs to be fed and (re)meaning at school; Luiz Pereira, Bernard Lahire, Gilles Brougère and others brought their theoretical contributions. The empirical field of research was composed by the Municipal School Professor Ulysses de Góis, located in the neighborhood of Nova Descoberta in Natal, and the Municipal School José Horacio de Góis, located in the community of Guanduba, in São Gonçalo do Amarante, municipalities of the Metropolitan Region of Natal (MRN). We used as methodology the collaborative-action-research as a possible of effective participation of the research subjects, imputing them a voice and performance in the process, and not considering them just observers. The results indicate the effectiveness of the pedagogical tools in play and playful to the learning of students, but that alone is not able to solve all the problems of the school, other referrals need to be secured, as the planning of the actions to be developed in the school and in the classroom, systematized pedagogical orienttion for faculty, family participation/involvement in the school life of students, among other actions that need to be weighted so that education fulfills its role and promote the emancipation of the subject, because in the freireana liberating perspective, "the reading of the world preced the lecture of the word"

A sistematização do conteúdo jogo nas aulas de educação física do ensino fundamental e médio

Since the enactment of LDBEN 9.9394/96, Physical Education began to be understood as a curricular component in school. Thus, we see the need for systematization of content. We observed that the physical education classes at the public schools in Natal/RN from the game content, teachers did not use the existing proposals for systematization. And it was on this reality that the study occurred, aiming to present and discuss a proposal to systematization the game content in physical education classes in elementary and secondary education. Accordingly, we departed of following question: What possibilities of systematization of the game content in school physical education classes?. The methodology used was the action research, which allowed us to structure the intervention plan for the game content, directed to a reflective didactic process. The dialogue with action research provided an opportunity to understand of the proposal of systematization, the knowledge of game content, the planning and process of teaching and learning in physical education lessons developed. We use the proposed systematization the book Educação Física Escolar e Organização Curricular , to direct and organize the lesson plans. As research technique, we use the participant observation, filming, photographic records and field diary, guiding us in the debates and discussions about the field of research. The applications of the lesson plans were carried out in three schools, all located in Natal / RN: Escola Municipal Professora Ivonete Maciel, Escola Municipal Professor Ulisses de Góis e Professor Escola Estadual Josino Macedo. The members of this study were students PIBID-EF-UFRN, teachers, supervisors and school. They made the bridge between research and action, theoretical foundation and pedagogical practice, university and school. The results were advanced for beyond the propositions submitted by the above-mentioned book. For the Elementary School 1, the proposed systematization broadened experiences and learning of knowledge of the game and of playful and body manifestations. Provided an opportunity to know and learn about game of make account, rules, popular games, cooperative games, among others. For Elementary Schools 2 and Middle education, systematized lessons allowed the practical, the incorporation of knowledge of the game and its features: such as rules, origin, meaning of the name, different denominations, among others. The students experienced and learned, popular games, pre-sport games, cooperative games, with recycled material, among others. The treatment from three dimensions of contents: procedural, conceptual and attitudinal, occurred parallel to approach the game content, and in conjunction with our interventions, not being done separately during practice, but an ongoing process during class. This new perspective of work the game, in a systematized way, with applying, description and discussion the activities, allowed elaborate a summary framework of thematizations for game content, by year of teaching

Sistema de gestão ambiental na produção de água mineral

It s more and more evident the subject of the shortage of water, worsened by the accelerated urbanization, growth of the population, increase of the demand and of the costs of its treatment, factors that are also tied up to the increase of the consumption of mineral waters, whose chemical composition or physical-chemistries characteristics do with that are considered beneficial to the health. The growth accelerated all over the world in its consumption aims the concern with the waters quality, the health and the incentive to the consumption of natural products. However, in spite of quite valuable, that resource is explored, most of the time, without optimization of production or actions that avoid wastefulness. This research is justified for the need of minimizing the negative environmental impacts caused by the mineral water s production, mainly in what it say about the generation of effluents and wastes in the productive process, through the study, development and application of cleaner production tools for the environmental management, pertinent for that section. The applicability of Environmental Management System was determined by means of the characterization of the environmental aspects of productive process in a company of the section, in the state of Rio Grande do Norte and of the discussion of the panoramas that demonstrate the tendency for a sustainable development. Actions as a reforestation, optimization of energy and water uses, recycle of solid residues and water reuse were applied during the research, resulting in the considerable reduction of wastes of raw materials and inputs and consequent environmental and economic won. A specific methodology was proposed with concepts of Environmental Management, integrating with Quality Management. As foundations for the elaboration of the methodology, it was realized a similarity analysis among the systems and, mainly, an analysis of the experiences observed in the case study, including specificities, needs and difficulties of the company. With these results, the implantation of a EMS as a company strategy has environmental, economic and social benefits, and this research can be applied and adequate to others companies and sectors

Adição de geomanta e tecido não tecido de polipropileno em cimentos geopoliméricos de pega rápida

Geopolymers are cementing materials that depict a number of advantages compared to Portland cement. Contrary to the latter, geopolymers are synthesized at room temperature, thus significantly reducing the emission of CO2 to the atmosphere. Moreover, the composition and synthesis reactions can be tailored to adjust the setting time of the material as well as its compressive mechanical strength. It is then possible to produce geopolymeric cements with short setting times and high compressive strength, although relatively brittle. The objective of the present study was to produce and characterize composite materials by reinforcing fastsetting geopolymeric matrixes with polypropylene geosynthetics (geomats and geotextiles) in an attempt to improve the toughness and tensile strength of the cementing material. Geosynthetics have been increasingly used to reinforce engineering structures, providing higher strength and better toughness. In particular, polypropylene nonwoven and geomats depict other attractive properties such as low density, durability, impact absorption and resistance to abrasion. Fast-setting geopolymers were then synthesized and reinforced with polypropylene nonwoven and geomats. The mechanical strength of the materials, reinforced or not, was characterized. The results showed that relatively short setting times and adequate flowing behavior were achieved by adjusting the composition of the geopolymer. In addition, it is possible to improve the fracture resistance of geopolymeric cements by adding polypropylene geosynthetics. The best results were achieved by reinforcing geopolymer with polypropylene TNT

Efeito de adições poliméricas na aderência de pastas de cimento a tubos metálicos após ciclagem térmica

Thermal recovery methods, especially steam injection, have been used to produce heavy oils. However, these methods imply that the metallic casing-cement sheath interface is submitted to thermal cycling. As a consequence, cracking may develop due to the thermal expansion mismatch of such materials, which allows the flow of oil and gas through the cement sheath, with environmental and economical consequences. It is therefore important to anticipate interfacial discontinuities that may arise upon Thermal recovery. The present study reports a simple alternative method to measure the shear strength of casing-sheath interfaces using pushthrough geometry, applied to polymer-containing hardened cement slurries. Polyurethane and recycled tire rubber were added to Portland-bases slurries to improve the fracture energy of intrinsically brittle cement. Samples consisting of metallic casing sections surrounded by hardened polymer-cement composites were prepared and mechanically tested. The effect of thermal cycles was investigated to simulate temperature conditions encountered in steam injection recovery. The results showed that the addition of polyurethane significantly improved the shear strength of the casing-sheath interface. The strength values obtained adding 10% BWOC of polyurethane to a Portland-base slurry more than doubled with respect to that of polyurethane-free slurries. Therefore, the use of polyurethane significantly contributes to reduce the damage caused by thermal cycling to cement sheath, improving the safety conditions of oil wells and the recovery of heavy oils

Fresamento com ar quente: uma proposta para minimizar a formação de trincas térmicas em ferramentas de metal duro

This work presents the results, analyses and conclusions about a study carried out with objective of minimizing the thermal cracks formation on cemented carbide inserts during face milling. The main focus of investigation was based on the observation that milling process is an interrupted machining process, which imposes cyclic thermal loads to the cutting tool, causing frequent stresses changes in its superficial and sub-superficial layers. These characteristics cause the formation of perpendicular cracks from cutting edge which aid the cutting tool wear, reducing its life. Several works on this subject emphasizing the thermal cyclic behavior imposed by the milling process as the main responsible for thermal cracks formation have been published. In these cases, the phenomenon appears as a consequence of the difference in temperature experienced by the cutting tool with each rotation of the cutter, usually defined as the difference between the temperatures in the cutting tool wedge at the end of the cutting and idle periods (T factor). Thus, a technique to minimize this cyclic behavior with objective of transforming the milling in an almost-continuous process in terms of temperature was proposed. In this case, a hot air stream was applied into the idle period, during the machining process. This procedure aimed to minimize the T factor. This technique was applied using three values of temperature from the hot air stream (100, 350 e 580 oC) with no cutting fluid (dry condition) and with cutting fluid mist (wet condition) using the hot air stream at 580oC. Besides, trials at room temperature were carried out. Afterwards the inserts were analyzed using a scanning electron microscope, where the quantity of thermal cracks generated in each condition, the wear and others damages was analyzed. In a general way, it was found that the heating of the idle period was positive for reducing the number of thermal cracks during face milling with cemented carbide inserts. Further, the cutting fluid mist application was effective in reducing the wear of the cutting tools.

Análise da viabilidade econômica de um sistema de aquecimento solar de água para uma empresa do setor hoteleiro

This paper presents an analysis of technical and financial feasibility of the use of a solar system for water heating in a fictitious hotel located in the Northeast region. Thereunto it is used techniques of solar collectors´ sizing and methods of financial mathematics, such as Net Present Value (NPV), Internal Rate of Return (IRR) and Payback. It will also be presented a sensitivity analysis to verify which are the factors that impact the viability of the solar heating. Comparative analysis will be used concerning three cities of distinct regions of Brazil: Curitiba, Belém and João Pessoa. The viability of using a solar heating system will be demonstrated to the whole Brazil, especially to the northeast region as it is the most viable for such an application of solar power because of its high levels of solar radiation. Among the cities examined for a future installation of solar heating systems for water heating in the hotel chain, João Pessoa was the one that has proved more viable.

Otimização do fresamento de roscas internas com a técnica de interpolação helicoidal

In machining of internal threads, dedicated tools, known as taps, are needed for each profile type, diameter, and low cutting speed values are used when compared to main machining processes. This restriction in the cutting speed is associated with the difficulty of synchronizing the tool s rotation speed and feed velocity in the process. This fact restricts the flexibility and makes machining lead times longer when manufacturing of components with threads is required. An alternative to the constraints imposed by the tap is the thread milling with helical interpolation technique. The technique is the fusion of two movements: rotation and helical interpolation. The tools may have different configurations: a single edge or multiple edges (axial, radial or both). However, thread milling with helical interpolation technique is relatively new and there are limited studies on the subject, a fact which promotes challenges to its wide application in the manufacturing shop floor. The objective of this research is determine the performance of different types of tools in the thread milling with helical interpolation technique using hardened steel workpieces. In this sense, four tool configurations were used for threading milling in AISI 4340 quenched and tempered steel (40 HRC). The results showed that climb cut promoted a greater number of machined threads, regardless of tool configuration. The upcut milling causes chippings in cutting edge, while the climb cutting promotes abrasive wear. Another important point is that increase in hole diameter by tool diameter ratio increases tool lifetime

Desenvolvimento de um secador spray para obtenção de pós finos de precursores de nióbio

This work presents a spray-dryer designed to oxalate-niobate precursors and suitable for the production of Niobium Carbide. The dryer was intended to produce powders of controlled particle size. First, the precursor is dissolved in water to produce a solution of known concentration and then it is atomized on the spray-dryer to produce the powder. This equipment consists of a 304 stainless steel chamber, 0.48 m x 1.9 m (diameter x length), with a conical shape at the lower portion, which is assembled on a vertical platform. The chamber is heated by three 4 kW electrical resistances. In this process, drying air is heated as it flows inside a serpentine surrounding the chamber, in contrary to more traditional processes in which the hot drying air is used to heat the component. The air enters the chamber at the same temperature of the chamber, thus avoiding adherence of particles on the internal surface. The low speed flow is concurrent, directed from the top to the bottom portion of the chamber. Powders are deposited on a 0.4 m diameter tray, which separates the cylindrical portion from the conical portion of the chamber. The humid air is discharged though a plug placed underneath the collecting tray. A factorial experimental planning was prepared to study the influence of five parameters (concentration, input flow, operation temperature, drying air flow and spray air flow) on the characteristics of the powders produced. Particle size distribution and shape were measured by laser granulometry and scanning electronic microscopy. Then, the powders are submitted to reaction in a CH4 / H2 atmosphere to compare the characteristics of spray-dried powders with powders synthetizided by conventional methods

Avaliação da desadaptação das selas de próteses parciais removíveis após 1 a 5 anos de uso

The non-adaptation of the removable partial prosthesis (RPP) base to fibromucosal tissue is caused by resorption of residual ridges (RRR). The onset of bone resorption, which occurs after tooth extraction and continues throughout life, is accelerated by local or systemic factors. Aim: Assess the degree of non-adaptation of removable partial prosthesis saddles and the factors that influence it. Methodology: A sectional study was conducted with 81 patients using RPP who had their prostheses installed between 2003 and 2007 (1 to 5 years of use) at the Faculty of Dentistry of the Universidade Federal do Rio Grande do Norte (UFRN). After anamnese and clinical examination, a cast was made with polyether-based material, using the base of the prosthesis to make the impression. The base of the saddle was loaded with the casting material and positioned in the mouth, applying pressure on the supports. After polymerization, the material was removed from the saddle and measurements were taken at 3 different points using a pachymeter. Results: The non-adaptation of the saddle increased significantly with years of use (p = 0.005). The tooth-tissue supported prostheses obtained higher mean non-adaptation values than those of tooth supported prostheses (p < 0.001). Flaccid mucosa showed the worst non-adaptation results, which were statistically different from resilient mucosa (p < 0.001). The greater the extension of the saddle, the greater the non-adaptation (p < 0.001). The natural tooth antagonistic arch yielded better results than did RPP and total prosthesis (p < 0.001). Saddle non-adaptation at the free end was less near the pillar tooth and greater in the more posterior region (p < 0.001). When adaptation of the supports to the niches was poor, greater saddle non-adaptation occurred than when it was good or fair (p < 0.001). Saddles located in the posterior region of the arch had greater non-adaptation than those in the anterior region (p = 0.023). Conclusion: The mean non-adaptation of the saddle to the residual ridges was 0.27 mm. It can be concluded that, even with the use of RPP, bone height reduction was slight within the 1-5-year period of use. The following are factors that influence adaptation of the RPP saddle base: years of use, age, force transmission path to the alveolar bone, location of the toothless area, antagonistic arch, type of mucosa, adaptation of supports to the niche and extension of the saddle

Avaliação clínica e comparativa da oclusão balanceada bilateral e desoclusão com guia canino sobre a função mastigatória de usuários de prótese total removível

The maintenance of masticatory function is especially important for patients who wear complete dentures due to the limitations of this type of prosthesis. Thus, the bilateral balanced occlusion (BBO) is used to achieve, besides other advantages, greater masticatory efficiency. However, analyzing critically the literature, it is observed that there is not enough scientific evidence that support the BBO as the most appropriate occlusal concept in complete dentures. This way, the purpose of the present study was to verify if complete dentures wearers with BBO present better masticatory efficiency and capacity than those with canine guidance (CG). A double-blind controlled crossover clinical trial was conducted. The sample was made of 24 completely edentulous patients. The subjects wore sets of complete dentures with both occlusal concepts for equal periods of 3 months. Objective data were collected through the masticatory efficiency test, performed by the colorimetric method, in which capsules of a synthetic material enclosing fuchsine- containing granules were used. Subjective data were recorded by patient´s ratings of their chewing function, which is the masticatory ability. No significant statistical difference was found for masticatory efficiency (p=0,0952) and masticatory ability (x2=0,5711/ p=0,4498) between the two occlusal concepts studied, as well as there was no correlation between these two variables (p=0,2985). Based on these results, it seems reasonable to use CG for the setup of complete dentures, since it is an easier and quicker technical procedure, until that future researches can come to complement this question

Qualidade de Vida, Saúde Geral e Ansiedade em pacientes com diferentes tipos e níveis de disfunção temporomandibular

Some studies reported in the literature that emotional factors and quality of life may be involved both in aetiology, as in the progression of Temporomandibular disorders (TMD). Proposition: The purpose of this study is to observe a possible association between different forms of anxiety, quality of life and general health of patients diagnosed as carriers of various types and levels of Temporomandibular Dysfunction. Methodology: The sample consisted of 60 patients diagnosed as carriers of TMJD origin of muscle, joint, or both, with different levels of severity (mild TMD, moderate and severe). The patients were diagnosed with TMD-RDC (Research Diagnostic Criteria) to assess the type of dysfunction (muscle or joint) and by the Protocol of Fonseca to verify the degree of dysfunction (mild, moderate or severe). To evaluate the psychosocial aspects were used three self-applied, with the purpose of obtaining information about the general health (General Health Questionnaire - GHQ), the type of anxiety (Trait Anxiety Inventory-State - STAI) and quality of life (World Health Organization Quality Of Life Short WHOQOL-brief). Results: There was a correlation between all indicators studied in several forms of TMD with varying degrees of commitment. Quality of life appeared linked to the type and the level of TMD: Muscular and Articular TMD (p = 0,037), Disk Displacement With Reduction (p = 0.01) and Mild TMD (p = 0.042). The General Health showed association with the level of TMD, with the exception of the stress factor (p = 0.78). For the analysis of the types and levels to Severe Muscular TMD had a statistically significant indicator of the quality of life (p = 0049). The anxiety only showed association with the level of TMD (p = 0,047 for anxiety-trait). Conclusion: Besides the limitations of the study, it was concluded that anxiety, quality of life and general health are important psychosocial indicators, which are linked to several forms of TMD in different levels of severity