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

Abordagem inicial de lesões mamárias por biopsia helicóide: estudo experimental

OBJECTIVE: Evaluating the kit-Bh performance in carrying out of breast biopsies. METHODS: They were randomly selected a sample of 30 patients with breast cancer undergoing mastectomy, based on the results of a pilot study from February 2008 to April 2010. They were excluded women with had not palpable, stone-hard consistency tumors, previous surgical manipulation or that contains liquid. Using the helicoid biopsy Kit (kit Bh) and an equipment Core biopsy with cannula and needle and 14 gauge respectively, it was collected a fragment of sound equipment in the area and in tumors in each specimen, totaling 120 fragments for histological study. For data analysis, it was defined a 95% confidence level and used the SPSS-13 version, the Kappa index and the parametric Student t test. RESULTS: Mean age of patients was 51.6 years (± 11.1 years). The infiltrating ductal carcinoma showed a higher incidence, 26 cases (86.7%). The Core biopsy had a sensitivity of 93.3%, specificity of 100% and accuracy 96.7%, while the helicoid biopsy had a sensitivity of 96.7%, specificity of 100% and accuracy 98.3%. By comparing the histology of tumors and the fragments of biopsies, there was high degree of agreement in diagnoses (kappa of 0.93 with p <0.05) CONCLUSION: Both devices provided the histological diagnosis of lesions with high accuracy. Results of this study showed that the helicoid biopsy is a reliable alternative in 22 the preoperative diagnosis of breast lesions. Further studies in vivo better will define the role of Kit Bh in the diagnosis of these lesions

Satisfação do paciente com a fisioterapia :tradução, adequação cultura e validação de um instrumento de medida

The measurement of patient satisfaction can provide information about the success of the care provider in reaching the values and meeting the expectations of the patient. The purpose of this study was to translate into the Portuguese language and to culturally customize to the Brazilian population the instrument to measure patient satisfaction with physical therapy elaborated by Goldstein et al. The study sample was made up of 279 patients who were undergoing physical therapy treatment at 39 different private clinics in a middle-sized town in northeastern Brazil. For the translation of the survey instrument, the back-translation technique was employed, in association with the bilingual method. The reliability and validity of the Brazilian version of the instrument were both assessed. Reliability analysis, carried out with the computation of Cronbach alpha coefficients, showed that the measures obtained with the instrument have a high degree of internal consistency. The aspects dealing with the patient therapist relationship are the most important predictors of satisfaction, followed by those dealing with courtesy, privacy, and practical aspects such as efficiency of the facility in the patient admissions process, setting up of appointments, and waiting time in waiting room. Items dealing with aspects such as location of the facility and availability of parking facilities may underestimate the reliability of the instrument. This study translated, culturally customized, and validated an instrument to measure patient satisfaction with physical therapy originally developed in English. By so doing, this study has made this instrument available to the Brazilian society, and it has rendered it a useful parameter that can be utilized in our country in the field of physical therapy

Morfologia e avaliação do crescimento inicial de plântulas de Bactris gasipaes Kunth. (arecaceae) em diferentes substratos

Este trabalho teve por objetivos descrever a morfologia dos diásporos, as fases da germinação e determinar o substrato mais adequado para o crescimento inicial de plântulas de pupunha. Periodicamente, unidades representativas de cada fase de germinação foram retiradas para a descrição da seqüência dos eventos morfológicos. Os substratos usados para o crescimento inicial foram Plantmax HT, areia, terra (latossolo roxo) e outro com proporções iguais de terra, areia e esterco (TAE). Avaliou-se o crescimento inicial das plântulas aos 101 dias após o transplante, com base na sua altura, número de folhas, comprimento e largura das folhas. Observou-se que as sementes são albuminosas, com endosperma oleaginoso e de consistência relativamente dura. O embrião é lateral, periférico e relativamente indiferenciado, de forma cônica. A germinação inicia-se com o desenvolvimento de uma massa de células indiferenciadas na depressão micropilar. Posteriormente, esta massa de células torna-se cilíndrica, com a diferenciação dos primórdios caulinar e radicular. O primórdio caulinar é constituído por três bainhas envolvendo a primeira folha. Estas se abrem sucessivamente, permitindo a emergência da folha primária. Entre os substratos testados, de acordo com os parâmetros avaliados, os mais adequados para crescimento inicial de mudas de Bactris gasipaes Kunth foram o TAE e o Plantmax.

Estudo clínico, histopatológico e imunoistoquímico de neoplasias mamárias em cadelas

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Formação de Docentes em Serviço: o processo formativo da experiência de estágio supervisionada

Este estudio que busca para identificar como la formación de un grupo de profesores experimentados ocurrió, el tener como objetivo para saber el modelo formativo de curso de Pedagogía conveniado con el pasillo de cuidad municipal de Teresina páctico acentuar el educativo en la forma de período supervisado de entrenamiento, para saberlos que habían sido construidos y reconstruidos por medios de learnings continuos de estas noticias para saber que son decurrente del proceso formativo. Para lograr la investigación adentro los dirigimos en la pregunta siguiente: ¿a donde estará eficaz la medida el proceso formativo en la pregunta provoque los cambios cualitativos en el práctico de los profesores, objeto de estudio? Tomando para la base este preguntar, defendimos la tesis de eso que el proceso formativo debe promover cambios cualitativos en práctico el pedagógico y en desarrollo profesional de el colectivo de experimentado profesores. En nosotros todavía los apoyamos, en las cuestiones siguientes de los norteadoras del estudio: 1- ¿Cono el proyecto formativo del departamento de métodos y las técnicas de la técnicas de la educación del UFPI era considerado, en vista del perfil de profesores con el promedio de diez años de experiencia? 2- ¿Cono el proyecto citado contribuye a la cuenta de la elasticidad del necesidades profesionales de los profesores en quienes dice práctico respecto el educativo el período del entrenamiento supervisó elevado a través en servicio? 3- ¿Que obstáculos las dificultades pedagógicas emergen del proceso formativo? Uno esta sobre una investigación que si los rellenos en os parámetros del investigación cualitativa de la matriz del etnográfica, soporte en el método de autobiogáfico, sin, sin embargo, asumís el cono solamente referencia: valorizou desde el punto de vista teórico conceptual y del perspectiva en el paradigma centrado en lo pensamiento de lo profesor. Varios autores fueran consultados para la composición de lo referencial teórico, opción esta que expresa las orientaciones de la línea de la pesquisa Formación y profesionalización docente del Programa de Pós Graduación de la UFRN. Dentre los autores podemos citar: Brzezinski; Freire; García; Gatti; Gauthier; Imbernón; Nóvoa; Nuñez; Perrenoud; Steves; Stenhouse; Schön; Ramalho; Tardif e Zeichner, entre otros. Tomando cono base es a perspectiva, consideramos que la práctica profesional debe ser iluminada por un teoria. Cuando lo profesor se apoya en una referencia su lado profesional gana una consistencia cualitativa e la aprendizaje de los alumnos consiguen niveis deseaveis. Asi, nos apoyamos nos aportes teóricos metodológicos encima citados, para iluminar nuestra relexión sobre nuestro objeto de estudio. La investigación que desarrollada teniendo cono ciudadanos 8 formadoras e 8 profesores pupilas de practico la educativa periodo supervisado del entrenamiento del curso del conveniado Pedagogía. Cono campo de la colección de información, habían estado implicados 7 escuelas de la ciudad, sitio de trabajo de los profesores y la agencia de formadora el UFPI. Los datos recogidos que analizamos habían sido recogidos por medio de cuestionarios, entrevistas biograficas, documentos personales (proyecto de la intervención práctica y diaria del el educativo), comentarios y proyecto del político pedagógico de la agencia formadora. Los resultados confirman que el modele formativo desarrollado práctico adentro el educativo el período supervisado del entrenamiento contribuyo de la manera significativa para avance del profissionalidade de los profesores. Los descubrimientos sugieren, la emergencia de un nuevo perfil de docente, siendo observado la parte de las características ligadas al sexo, edad, tiempo de ejercicio de la docencia, de la formación y de los saberes profesionales adquiridos y construidos en longo del proceso formativo. Lo proceso formativo posibilitó las docente la capacidad de transformación y rompimiento con antiguas practicas tradicionales por uso de nuevas estrategias de acción pedagógica

Dificuldade de berço? Professores de matemática no ensino médio: práticas, formação continuada e juventude

The present paper is focused on pedagogical practices and continued lecturing formation of High School Mathematic teachers. Knowing the essential importance of the teacher at the educational process since he/she is the mediator on knowledge gathering by the scholars and continued formation meaning on that process, we hereby propose to investigate and compare what Math teachers think about their professional role, the kind of continued formation they receive and their development on teacher s knowledge and doing; to gather and compare what do Math teachers know about young people at public and private schools and their demands and as which find out if they link with the way as their students are taught. To develop our comparative research, we chose a qualitative focus and an investigation of ethnographic type. We took as the subject four Math teachers that work with high school 1st and 2nd grades in public and private schools, morning and afternoon shifts and license titles. The research results reveal differences in structural matter between the spaces, but the comparisons between teacher doings and knowledge reveal that the differences refer to the sort of formation and how often do the teachers search for it. Nevertheless, the reports pointed to continued lecturing formation offering and consistence problems and these reflect on their work and on its basis. The knowledge about youth and adolescence, such as theoric and methodological knowledge that lead their practices, are revealers of teachers difficulties in developing their activities according to the target public and nowadays educational demands

Descompassos nas políticas educacionais: a reorganização da educação rural em Jardim de Piranhas/RN

The present work has as aim to analyze the reorganization process of the rural education in Jardim de Piranhas-RN, on the context of the education policies, in particular of the period of 1999-2006, having as reference the transformations in the political, cultural and socio-economic setting in the national, regional and local level, above all from the decade of 1990. The studies carried out in diverse sources made possible to understand from the context in which they had developed the education policies, in particular, that one directed for the rural way, as well as the mediation of this with the education reorganization in the local scope. Besides these research procedures, we carry out interviews - semi-structuralized - with managers and teachers, and we analyze documents from the produced ones in national level to those local ones. From the viewpoint theoretician-methodological, we focus the national discussion that comes developing under a new ideological political configuration and, being entitled by the Field Education, understood as a policy directed to education specifities in this sector and consolidated in the Operational Guidelines for the Basic Education in the Field Schools (CNE/MEC/2002). As particularity of this object in Jardim de Piranhas-RN, we emphasize events occurred that had marked the rural education reorganization in that city, especially from the creation of the Rural Education named Center Teacher Maria Edite Batista. Studies make possible to realize that until the Center creation, the schools functioned in rather precarious infrastructure and physical conditions, that is, without electric energy and water supplying, as well as the lack of school snack and the management structure. There was not a project or specific pedagogical accompaniment for the sector. Moreover, the teachers worked predominantly with several grade classes and still they fulfilled the manager functions, caretakers, and cook- in some cases as school secretary. However, exactly with the creation of the Rural Education Center, the education municipal system did not become capable to overcome problems as of the evasion and school failure, as well as decreasing the work overload of teachers, neither to give greater consistency to the pedagogical project of the field schools in that city

Qualidade de vida medida pelo "WHOQOL-bref": estudo comparativo de pacientes em hemodiálise e pós-transplante renal

Exploratory descriptive study, prospective with quantitative approach, performed in the nefrology outpatient service from the Onofre Lopes University Hospital (HUOL), Natal/RN, aiming to identify aspects that concern Quality of Life (QOL) on transplanted and hemodialysis patients, as measured by WHOQOL-bref and describe the aspects that differentiate QL between the two groups as measured by the same instrument. The population was of 62 renal patients in hemodialysis and 58 transplantd, with data collected from february to march 2006. The instrument used was WHOQOL-bref, translated to and validated for Portuguese by the multicentric group of the World Health Organization (WHO) in Brazil. The results show predominance of the masculine gender both in the post-transplant group (55,17%), as well as in the hemodialysis group (51,61%); the age strip of 28 to 43 prevailed, among which were 53,45% transplanted and 48,99% hemodialysis patients; 79,93% of the hemodialysis patients and 62,07% of the transplanted were provenient from ouside the capital of the state; from the hemodialysis population, 59,68% were married, while among the transplanted 48,28% were single; 58,06% of the hemodialisys patients had 1 to 3 children, while the majority of the transplanted, 44,83%, had no children; regarding scholarity level on both groups, there was a predominance of incomplete fundamental school, representing 62,9% of the hemodialysis patients and 46,6% of the transplanted; regarding work status, 98,39% of those in hemodialysis informed not to be working, and the same applied to the transplanted, with 75,86%; regarding treatment time, most patients of both populations were in the 1- to 4-year interval, of which were 62,9% of the hemodialisys patients and 53,45% of the transplanted. The analysis of WHOQOL-bref reliability through Crobach s Alpha coefficient had a value of 0,8816, demonstrating good internal consistency for the instrument. Regarding description of QOL tests, the average scores of the post-transplant were (Q-1) 18,14 e (Q-2) 18,69, and 12,3 (Q-1) and 11,29 (Q-2) for the group in hemodialisys. Regarding the aspects that differentiate QOL on the two groups observed through average scores from the Domains: Physical, 15,91 for the post-transplant group and 12,71 for the hemodialisys group; Psychological, 16,75 for the post-transplant group and 14,84 for the hemodialisys group; Social Relations, 17,79 on the post-transplant group and 16,58 on the hemodialisys group; Environment, 14,16 on the post-transplant group and 12,38 on the hemodialisys group. On every evaluated item, the post-transplant group achieved higher scores when compared to the hemodialisys group. The diference in QOL for both populations was significant on all items evaluated with a p<0,005

Estudo do comportamento no estado fresco e endurecido do concreto com incorporação de resíduo de corte de botão

This works aims at investigating the effects of adding waste from RCBP-polyester button manufacturing to Portland cement concrete, particularly regarding its consistency and mechanic strength. The RCBP used came from a button factory located in Parnamirim, RN, Brazil. The waste was added to the concrete on different ratios: 5 %, 10 %, 15 % and 20 % of the total cement mass. A sample of concrete without the RCBP was used as reference, 1:1,33:2,45:0,50. For the mechanic strength test four samples were tested with different ages (3, 7 and 28 days old) and mixtures. Furthermore, a Slump Test was also conducted in order to verify the concrete s consistency. A tendency to a reduction in the compression resistance was noticed for all samples. For the samples with 5 % and 10 %, there was also an increase in the traction resistance during inflexion, regarding the reference concrete. In the microstructural analysis, the RBCP was observed to show an irregular and porous surface, thus explaining the consistency decrease

Análise de Argamassas Com Substituição Parcial do Cimento Portland Por Cinza Residual de Lenha de Algaroba

With the increase in cement consumption, it has quickly become one of the inputs most consumed by mankind over the last century. This has caused an increase in CO2 emissions, as cement production releases large quantities of this gas into the atmosphere. Adding this fact to the growing consciousness of environmental preservation, it has led to a search for alternatives to cement to complement its derivatives, in the form of waste materials like the ashes. This research aimed to analyze the properties of mortars in fresh and hardened state with partial replacement of Portland cement by residual algaroba wood ash (CRLA) potteries produced by the state of Rio Grande do Norte. The CRLA was collected and sieved, where part of it was ground and characterized in comparison with that just sifted, being characterized according to its chemical composition, grain size, fineness, density, bulk density and index of pozzolanic activity. It was found that the wood ash does not act as pozzolan, and grinding it has not changed its characteristics compared to those just sifted, not justifying its use. Two traces were adopted for this research: 1:3 (cement: fine sand) and 1:2:8 (cement: hydrated lime: medium sand); both in volume, using as materials the CRLA just sifted, CP II F-32 Portland cement, CH-I hydrated lime, river sand and water from the local utility. For each trace were adopted six percentages of partial replacement of cement for wood ash: 0% (control) 5%, 7%, 10%, 12% and 15%. In the fresh state, the mortars were tested towards their consistency index and mass density. In the hardened state, they were tested towards their tensile strength in bending, compressive strength and tensile adhesion strength, and its mass density in the hardened state. The mortar was also analyzed by scanning electron microscopy and X-ray diffraction. Furthermore, it was classified according to NBR 13281 (2005). The results showed that up to a content of 5% substitution and for both traces, the residual algaroba wood ash can replace Portland cement without compromising the mortars microstructure and its fresh and hardened state

Análise do Comportamento Mecânico de Concretos Produzidos com Incorporação de Cinza do Bagaço da Cana-de-Açúcar de Variedades SP911049, RB92579 E SP816949

Concrete is the second most consumed product in the world and the incorporation of the Sugar Bagasse Ash (SBA) into this material can provide solutions for the utilization of by-products from other industries, thus reducing the environmental impact. The general aim of this dissertation focuses on analyzing the mechanical behavior of concrete with addition of SBA from three different species of sugar cane, through tests of consistency, compressive strength, porosity, absorption, voids and Scanning Electron Microscopy (SEM). Were prepared 13 specimens for each specific pattern and level of incorporation of SBA (10%, 20% and 30%) of the three varieties collected, totaling 130 samples of concrete. The trait was employed 1:2:3 (cement: sand: aggregates) in relation to the cement mass with a water / cement ratio of 0.532 and 1% additive Tec 400 Mult also based on the weight of cement. According to the results obtained in this study, it was concluded that the variety of cane sugar, used in the production of the CBC, influenced the mechanical behavior of the resulting concrete. All concrete with addition of SBA, reported a reduction of at least 10% in the properties related to permeability and an increase in the compressive strength of at least 16% compared to standard concrete at 28 days

Eficiência reprodutiva e produtiva em rebanhos leiteiros comerciais monitorados por sistema informatizado

O estudo foi conduzido com os objetivos de analisar o desempenho produtivo e algumas medidas de eficiência reprodutiva de 1877 vacas provenientes de quatro grupos genéticos Holandês ¾ Zebu e estimar os parâmetros genéticos pertinentes. Os animais pertenciam a três rebanhos comerciais que foram monitorados pelo Sistema Computacional de Informação DAISY (The Dairy Information System), durante período de 1989 a 1998. Para consistência dos dados, formação dos arquivos e análises preliminares foram usados os procedimentos disponíveis no SAS (Statistical Analysis System), enquanto os componentes de (co)variância foram estimados pelo método de máxima verossimilhança restrita livre de derivada (MTDFREML), sob um modelo animal. Os efeitos de grupo genético e ano do parto foram significativos sobre a idade da vaca ao primeiro parto (IPC), intervalo parto - primeiro serviço (PP1S), duração da lactação(DL), produção total de leite (PT) e produção de leite por dia de intervalo de parto (PLIEP). As estimativas de herdabilidade (h²) para as características reprodutivas ficaram próximas de zero, evidenciando grande dependência do manejo oferecido aos rebanhos, enquanto o valor de 0,28 para a h² da PT mostrou variância genética aditiva média. A correlação genética entre PT e DL de 0,81 pode ser considerada de alta magnitude.

Estudo da viabilidade da utilização de cinza de lodo de esgoto como adição em argamassa de cimento Portland

The use of sewage sludge as a raw material falls within the waste recycling key in the current process model environmental sustainability .Waste recycling has been consolidated as a sustainable environmentally sound technical solution, and. Despite showing very variable composition and characteristics, sewage sludge, can be considered as a residue with a high recycling potential in the building sector. In this paper the feasibility of using sewage sludge ash was studied in addition to Portland cement mortar in 1:3 mass considered the standard dash. This gray additions were studied in proportions of 5%, 10 %, 15 %, 20 %, 25% and 30% by mass of cement. The methodology was focused on the characterization of materials by physical, chemical , mechanical , environmental and morphological followed by the production of mortar tests ,and finalized by the characterization tests of mortar in the fresh state, through the consistency index, content of entrained air, bulk density and water retention, and in the hardened state by bulk density, water absorption by capillarity capillarity coefficient, compressive strength, tensile strength in bending ,tensile bond strength and microstructural analysis for percentages of 0 to 20%. After comparing with the standard mortar mortars with addition of ash, it is concluded that the ash of sewage sludge did not impair the integrity and properties of mortars with addition, including increasing resistance to compression and tension, being 20% more indicated percentage. Thus, it becomes feasible the addition of sewage sludge ash in Portland cement mortar for the trait studied

Desempenho de argamassas produzidas com agregados reciclados oriundos do resíduo de construção e demolição da Grande Natal-RN

The construction industry is responsible for generating a lot of waste because of their activities. Consequently, it is noticeable the occurrence of environmental problems in terms of its disposal in inappropriate places. Faced with this problem, some studies have been conducted with the aim of developing technologies and alternatives for recycling construction and demolition waste (CDW), motivated by the scarcity of natural resources and reduction of environmental problems generated. The research aims to characterize the recycled aggregates derived from construction and demolition waste (CDW) produced in the Greater Natal-RN and analyze the performance of mortar coating produced with recycled aggregates. The study includes the chemical , physical and microstructural characterization of recycled aggregates , as well as conducting microscopic analysis and laboratory tests in the fresh state (consistency index , water retention , bulk density and content of entrained air ) and in the hardened state ( compressive strength , tensile strength in bending , water absorption by immersion and capillary , mass density and void ratio ) for mortars produced from different levels of substitution of aggregates ( 0, 20 %, 40 %, 60 %, 80 % and 100 %). The results were satisfactory, providing mortars produced with recycled aggregates, smaller mass density and dynamic modulus values as well as an increase in the rates of absorption and porosity. The tensile strength in bending and compression for TP1 (1:2:8) trait were lower for mortars produced with recycled aggregates and the best result was 20% for replacement. For the TP2 (1:8) mapping, there was an increase in resistance to traction and compression and the best result was for 100% replacement of natural aggregates by recycled. The experiments led to the conclusion that the technical and economic point of view that the mortars produced with recycled aggregates can be used in construction, only if there is an effective control in production processes of recycled aggregate and at the dosage of mortars