https://tede.unioeste.br/handle/tede/523 2026-09-15T12:59:10Z https://tede.unioeste.br/handle/tede/8618 Title: Efeitos de uma Intervenção Profilática-Terapêutica com Exercício Resistido e Suplementação de Cúrcuma com Óleo de Peixe no Músculo Extensor Longo dos Dedos em Ratos Wistar Submetidos a um Modelo de Artrite Reumatoide Autor: Dressler, Vanessa Freitas Primeiro orientador: Bertolini, Gladson Ricardo Flor Abstract: Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease that affects the joints and can cause damage to muscle tissues. It is a disabling condition treated primarily with medication; however, the continuous, long-term use of these drugs can lead to unwanted side effects. Consequently, there is growing interest in low-cost, accessible integrative interventions, such as resistance exercise (RE) and supplementation with turmeric solubilized in fish oil. Therefore, this study aimed to evaluate the morphofunctional and immunological effects of prophylactic and therapeutic interventions involving resistance exercise and turmeric/fish oil supplementation—administered either alone or in combination—on the *extensor digitorum longus* muscle of Wistar rats subjected to an RA model. Sixty-eight male Wistar rats (15 weeks old) were used and divided into six groups: Control Group (GC, n=8), RA Group (GA, n=12), Exercise and Supplementation Group (GES, n=12), RA and Exercise Group (GAE, n=12), RA and Supplementation Group (GAS, n=12), and RA, Exercise, and Supplementation Group (GAES, n=12). A ladder-climbing resistance exercise protocol was employed, consisting of five days of unloaded training for adaptation followed by 16 training sessions on alternate days—eight interventions prior to RA induction and eight afterward. Load progression was set at 25%, 35%, and 50% of body weight, while the number of sets and repetitions remained fixed (three sets of eight repetitions with a two-minute rest interval). Supplementation was administered orally for 31 consecutive days using an adjustable volume pipette; the daily dose was 500 mg/kg of *Curcuma longa* L. dry extract diluted in 500 µL of fish oil to enhance bioavailability. Arthritis (RA) was induced using the Complete Freund's Adjuvant (CFA) model. A baseline assessment was performed on day 1, followed by six functional assessments throughout the study (days 8, 15, 22, 25, 28, and 31) to measure joint edema, grip strength, and nociception. Animals were euthanized on day 32. The extensor digitorum longus (EDL) muscle was harvested and divided into two portions: the proximal portion was processed for morphological analysis of muscle fibers and tissue. Arthritic groups exhibited significant increases in joint edema and higher levels of nociception compared to control groups (p < 0.01). The GES group maintained higher grip strength, whereas arthritic groups showed a reduction in this parameter. These results indicate functional impairment associated with RA that was not fully reversed by the tested interventions. Regarding body weight, the GES group showed a higher mean, with no significant differences in naso-anal length. The GA group exhibited greater EDL muscle weight, while the GES group showed greater muscle length. This finding suggests that inflammatory processes or edema may influence the increase in muscle weight in arthritic animals. Histometric analyses revealed no significant differences in fiber area and diameter, or in the number of capillaries and muscle fibers. However, the GA group showed a higher number of peripheral nuclei and—along with the GAS and GAES groups—a larger nuclear cross-sectional area. The IHP was higher in the GA group, whereas the GAE group displayed characteristics closer to those of the control group. Furthermore, an increase in fibroblasts and disorganization of the extracellular matrix were observed in the GA group, indicating greater structural muscle damage. It was concluded that moderate ladder-based resistance exercise, applied both preventively and therapeutically, was effective in improving the muscle microstructure of the EDL—particularly in the GAE group—but did not yield significant effects on muscle strength or nociception. Thus, the results suggest that the benefits of the interventions were predominantly structural, without a direct correlation to functional improvement during the analyzed period, indicating a need to adjust protocols or intervention durations in future studies. Publisher: Universidade Estadual do Oeste do Paraná Tipo do documento: Dissertação 2026-05-22T00:00:00Z https://tede.unioeste.br/handle/tede/8600 Title: A saúde mental de professores de uma escola estadual do Paraná: contribuições da aplicação de técnicas da terapia cognitivo comportamental Autor: Pereira, Elso Alves Primeiro orientador: Machineski, Gicelle Galvan Abstract: Educators face significant challenges that can impact their mental health, including depression, anxiety, stress and emotional difficulties resulting from pressure in the school environment. Health and illness are multifaceted concepts that involve not only physical aspects, but emotional, social and psychological ones. In the educational context, illness can manifest itself in different ways, directly affecting the quality of life of teachers and, consequently, the school environment. This study aimed to identify whether group therapy techniques can reduce levels of stress, anxiety and depression among teachers in the state education system. This is an integrative literature review and descriptive case study field research, carried out in a state school in the city of Cascavel – PR. The integrative literature review was carried out in the Virtual Health Library databases, from July to August 2023, using complete research, in Portuguese, published between 2010 and 2023, with the following descriptors: education, mental health, teachers and Boolean ANDThe studies were organized into synoptic tables containing authors, year, title, methodology and results and classified according to the level of evidence. Being analyzed according to the literature on the subject. The following themes were identified: stress, anxiety and depression among teachers, excessive workload, depersonalization, mental fatigue, lack of recognition. The field research, descriptive of the case study type, was carried out with five readapted teachers from a state school in Western Paraná, from July to September 2022. To this end, all 20 teachers from the school were invited to participate and it was An instrument of questions was applied via Google Forms with the Mental Health Status Questionnaire, in order to identify teachers with some type of mental suffering between regular and very bad, who were invited to participate in the research. Of these, five teachers accepted. The psychological assessment instruments (BFP), Baptista Depression Scale Adult Version (EBADEP-A), and the Brief Symptom and Intervention Inventory (BSI) were then applied. From that moment on, group therapy meetings were held and, at the end, the aforementioned instruments were reapplied. The data obtained was systematized on computerized platforms and described. The study sample was five women, between 44 and 54 years old, with significant professional experience in public education, with ten group therapy meetings lasting 50 minutes. The analysis was carried out after corrections to the instruments, and their scores were displayed in comparative tables. The study findings indicate a reduction in levels of depression, anxiety and stress. These results highlight the importance of psychological support strategies in the educational environment, showing that promoting mental health among teachers is essential not only for the well-being of these professionals, but also for the quality of education offered to students. It is important to emphasize the need for more research and interventions aimed at the mental health of educators, recognizing education as a pillar for social development, but which must be accompanied by psychological support to guarantee the health of its professionals. Publisher: Universidade Estadual do Oeste do Paraná Tipo do documento: Dissertação 2024-09-03T00:00:00Z https://tede.unioeste.br/handle/tede/8566 Title: O nervo vago influencia o eixo hepcidina-ferro e a histologia do tecido esplênico em ratos Wistar obesos e não obesos induzidos à anemia hemolítica. Autor: Helene, Eveline Cristiane Batista Schmidt Primeiro orientador: Grassiolli, Sabrina Abstract: Introduction: The spleen plays a central role in immune responses and iron recycling through the reticuloendothelial system. Obesity exerts deleterious effects on splenic metabolic and immune activities, as well as on the regulation of endogenous iron, thereby favoring the development of anemia. In this context, the low-grade chronic inflammation characteristic of obesity has been associated with disruption of iron homeostasis, a process that appears to involve alterations in the secretion of hepcidin, the principal hormone regulating systemic iron flow. The parasympathetic branch of the autonomic nervous system, via Vagus Nerve (VN), exerts an anti-inflammatory effect that depends on splenic activity. However, whether this VN-spleen interface modulates iron homeostasis remains unclear. Objective: To evaluate the effects of VN absence on the splenic histology of obese and non-obese rodents induced to hemolytic anemia by phenylhydrazine. Methods: Male Wistar rats were rendered obese through hypothalamic injury induced by subcutaneous administration of monosodium glutamate (MSG; 4 g/kg) from postnatal day 2 to 10 (PND 2–10). Control rats (CTRL) received an equimolar saline solution. On PND 60, MSG (n=32) and CTRL (n=32) rats were randomly assigned into subgroups (n=16) according to the surgical procedures: subdiaphragmatic vagotomy (SV) or sham operation (SHAM). On PND 90, half of the animals in each group (n=8) were induced to hemolytic anemia by intraperitoneal administration of phenylhydrazine (PHZ; 40 mg/kg). On PND 120, animals were weighed and euthanized; whole blood was collected for plasma analysis, including iron and hepcidin quantification. Retroperitoneal white adipose tissue (rWAT) was excised and weighed. The spleen was harvested, weighed, and stored for histological analysis to assess area and morphological aspects of the White Pulp (WP), including the Lymphoid Nodule (LN) and Marginal Zone (MZ), as well as Red Pulp (RP) area. Results: MSG-treated animals developed obesity, associated with hypertriglyceridemia, insulin resistance (IR), and decreased circulating iron and hepcidin concentrations, along with reduced spleen weight, decreased WP and RP areas, and increased iron deposition compared to CTRL rats. In both CTRL and MSG groups, SV reduced body weight and adiposity and increased stomach weight. In the CTRLSV group, worsened TG and IR were observed, accompanied by reduced plasma hepcidin levels and increased hemosiderin deposits in splenic tissue. In CTRLPHZ animals, spleen weight was increased, with no significant histological changes, except for a reduced number of WP per field due to PHZ. However, in MSGSV animals, TG levels decreased, IR and fasting glycemia improved, and plasma hepcidin concentration increased – an effect enhanced in the MSGSV+PHZ group. The area and number of WP per field were greater in the MSGSV group. MSGPHZ rats exhibited splenomegaly and increased hemosiderin deposition, with a reduction in LN area and an increase in RP area. Conclusion: Rats with hypothalamic obesity present alterations in the hepcidin-iron axis, with greater splenic iron accumulation. The absence of vagal signaling increases iron deposition in splenic tissue and exerts opposite effects on hepcidin concentration in healthy and obese rats. Publisher: Universidade Estadual do Oeste do Paraná Tipo do documento: Dissertação 2026-05-15T00:00:00Z https://tede.unioeste.br/handle/tede/8524 Title: Avaliação da Qualidade do Serviço de Triagem Auditiva Neonatal de uma Regional de Saúde do Paraná Autor: Taborda, Leonardo Pires Primeiro orientador: Rodrigues, Rosa Maria Abstract: Neonatal Hearing Screening Programs (NHSPs) are essential for the early detection of hearing loss (HL) and for ensuring timely diagnosis and intervention, thereby reducing adverse impacts on child development. Despite their importance, these programs face barriers that limit their effectiveness. This study aimed to evaluate the quality of the NHSP in a Health Region of Paraná, Brazil, considering the dimensions of structure, process, and outcomes according to Donabedian’s framework. The research consisted of an integrative review and an evaluative study. The review was conducted using PubMed, SciELO, and the Virtual Health Library databases, with study selection performed by two independent reviewers and synthesis of findings organized according to Donabedian’s framework. The evaluative study included documentary analysis of DATASUS data, collection of information from the Regional Health Department, and a field study conducted at the regional hearing healthcare referral service. The field study was carried out in two stages. In the first stage, a cross-sectional design was adopted, and an initial questionnaire was administered to parents and/or caregivers of children receiving care at the service in order to characterize aspects related to structure, process, and outcomes. Caregivers of children in institutional care were excluded. A total of 63 caregivers participated in this stage. The second stage employed a longitudinal qualitative design. Among the participants from the first stage, only caregivers of children who had received a “refer” result on neonatal hearing screening and were younger than six months of age at the time of the initial data collection were selected. These participants were followed for two months via WhatsApp. Follow-up questionnaires were administered after hearing related appointments, and a final questionnaire was applied to assess perceptions of the care pathway, characterizing a case study design. Two participants remained in the study until its completion. The results revealed weaknesses across all three Donabedian dimensions. Regarding structure, limited availability of screening sites, shortages of professionals, a high dependence on outsourced services, and the absence of an integrated information system were identified. In the outcomes dimension, estimated coverage rates were below recommended levels, and delays in completing neonatal hearing screening were observed. In the process dimension, inconsistencies in care referrals were identified, affecting the timing of diagnosis and intervention. Longitudinal follow-up revealed communication failures, diagnostic delays, and variations in family satisfaction throughout the care pathway. The findings were consistent with the results of the integrative review, which demonstrated that NHSPs worldwide present limitations in structure, process, and outcomes, as well as recurrent delays in audiological diagnosis. It is concluded that the evaluated NHSP demonstrates compromised quality resulting from interdependent weaknesses across structure, process, and outcomes. Structural limitations directly affect care processes, generating delays, coordination failures, and difficulties in continuity of care, resulting in indicators below recommended standards. These findings highlight the need to reorganize care pathways, strengthen regional management, improve information systems, and expand access in order to ensure timely diagnosis and intervention for children with suspected hearing loss. Publisher: Universidade Estadual do Oeste do Paraná Tipo do documento: Dissertação 2026-03-11T00:00:00Z