Submitted by GIOVANNA HASS BUENO null (giovannahass@uol.com.br) on 2017-02-17T18:51:48Z No. of bitstreams: 1 DEFESA GIOVANNA HASS BUENO (pós defesa).pdf: 2166823 bytes, checksum: 0b75b021e61c018ad5c824251b548ecd (MD5) / Approved for entry into archive by Juliano Benedito Ferreira (julianoferreira@reitoria.unesp.br) on 2017-02-21T14:53:52Z (GMT) No. of bitstreams: 1 bueno_gh_me_bot.pdf: 2166823 bytes, checksum: 0b75b021e61c018ad5c824251b548ecd (MD5) / Made available in DSpace on 2017-02-21T14:53:52Z (GMT). No. of bitstreams: 1 bueno_gh_me_bot.pdf: 2166823 bytes, checksum: 0b75b021e61c018ad5c824251b548ecd (MD5) Previous issue date: 2017-02-14 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Introdução: A Oxigenoterapia Domiciliar Prolongada (ODP) é um tratamento utilizado para pacientes com DPOC grave. O tratamento apresenta inúmeras vantagens, como o aumento da capacidade funcional, melhoras nos sintomas, mas os usuários também reconhecem que há desvantagens no uso deste. Identificam-se alguns problemas, como barreiras físicas e psicossociais e desafios emocionais. Muitas vezes os usuários necessitam de auxílios para desenvolver atividades cotidianas, precisando de cuidados de parentes e amigos, exercendo o cuidado informal. É fundamental que a equipe tenha conhecimento das mudanças na vida do paciente e de seus cuidadores, dos enfrentamentos dos desafios com a terapia, de forma a otimizar o cuidado, fazendo as adaptações necessárias a eles e com a equipe, proporcionando qualidade de vida para ambos. Também é essencial reconhecer as vantagens que a terapia causa tanto para o usuário tanto para o cuidador, fortalecendo o uso da ODP e incentivando os cuidadores nas tarefas prestadas ao paciente. Objetivo: Conhecer a visão dos pacientes com diagnóstico de DPOC sobre o uso da ODP e de seus cuidadores sobre o cuidado com um paciente em uso da ODP. Método: Trata-se de estudo de caráter qualitativo. Foram entrevistados 14 pacientes com seus respectivos cuidadores, atendidos no Ambulatório de Oxigenoterapia do Hospital das Clínicas de Botucatu, da Faculdade de Medicina de Botucatu com diagnóstico de DPOC durante o segundo semestre de 2015. Foi utilizada para os pacientes uma entrevista semi-estruturada, com as seguintes questões norteadoras: “O que significa para você usar o Oxigênio?”, “O que mudou em sua vida depois que você começou a usar a ODP?”, “O que mudou na vida das pessoas que convivem com você em sua casa depois de começar a usar ODP?” e “ você tem atividade de lazer?” . Para os cuidadores, foi utilizada também uma entrevista semi-estruturada, com as seguintes questões norteadoras: “O que significa para você cuidar de uma pessoa que depende do uso da ODP?”, “O que mudou em sua vida depois que você começou a cuidar desse usuário?”, “O que mudou na vida das pessoas que convivem com você depois que começou a cuidar?” e “você tem atividade de lazer?”. Foi aplicada também a escala Caregiver Burden scale (CB scale), para medir o impacto subjetivo das doenças crônicas na vida dos cuidadores. As entrevistas foram avaliadas pela “Análise do Conteúdo de Bardin” e a CS scale foi analisada através do cálculo da média aritmética dos escores atribuídos aos 22 itens. Resultados: Os pacientes tinham idade média de 73 + 10,4anos, sendo 6 do sexo feminino, 1 analfabeto e 13 com escolaridade inferior ao ensino médio. Todos ex tabagistas, fumava em média 25 + 15,9 cigarros ao dia. O tempo médio de uso de O2 foi 3,5 ±2,0 anos, a média diária de horas de uso foi 18,8 ± 4,6. Das falas surgiram quatro categorias: Fortalezas da terapia: melhora nos sintomas, da qualidade de vida e do aspecto emocional. Desafios da terapia: isolamento social, dificuldade no envolvimento emocional, piora no autocuidado, funcionalidade do concentrador O2 e acessórios e aspectos econômicos. Alterações emocionais, sociais, da vida cotidiana e econômicas na vida do usuário: processo de adaptação com dificuldades de aceitação, mudança na autoestima e da personalidade e mudança das atividades de lazer. Alterações na relação familiar do usuário: isolamento social do cuidador, envolvimento emocional dos familiares e comprometimento do cuidador. Os cuidadores tinham idade média de 63 +11 anos, sendo 11 do sexo feminino e todos alfabetizados. O tempo médio de cuidado diário prestado foi de 19 + 8,2 horas, e a média em anos dedicados ao cuidado foi 2,7 + 2, apenas 1 cuidador tinha o trabalho remunerado, e 2 tiveram seu estado de saúde piorado depois que passaram a ser cuidador. A categoria mais sobrecarregada da CB scale foi o ambiente, seguido da decepção, tensão geral, envolvimento emocional, e por último isolamento. Das falas surgiram quatro categorias: Fortalezas do cuidador: melhora do estado geral e da capacidade funcional do usuário, facilidades no manuseio do equipamento e importância do aspecto emocional do cuidador. Desafios do cuidador: envolvimento emocional, capacidade funcional do cuidador, mudança na vida cotidiana, funcionalidade do concentrador O2 e acessórios, aspecto econômico, aspectos da personalidade do usuário. Alterações emocionais, sociais, da vida cotidiana e econômicas na vida do cuidador: isolamento social, envolvimento emocional, autonomia, aspectos da personalidade do cuidador, alteração na vida cotidiana, sexualidade, autoestima, atividades de lazer. Alterações na relação familiar do cuidador: aspecto da personalidade, estrutura familiar. Conclusão: Diante desse estudo, são nítidas as mudanças no cotidiano e do comportamento dos usuários e de seus cuidadores. Frente a isso, é fundamental que a equipe esteja preparada para fornecer educação adequada a eles, para otimizar a utilização e o cuidado, diminuindo medo e barreiras com o tratamento. / Introduction: Long-term Oxygen Therapy (LTOT) is a treatment used for patients with severe COPD. The treatment has numerous advantages, such as increased functional capacity and improvements in symptons, but users also recognize that there are disadvantages in using it. Some problems like physical and psychosocial barriers and emotional challenges can be identified. Users often need help to develop everyday activities, needing care from relatives and friends, practicing informal care. It is essential that the team is aware of all the changes in the life of the patients and their caregivers and the challenges of the therapy itself, in order to optimize care, making necessary adjustments to them and the team, providing quality of life for both. It is also essential to recognize the benefits that the therapy brings to both, the user and the caregiver, by strengthening the use of LTOT and encouraging caregivers in the tasks provided to the patient. Objective: Identify the vision of patients with COPD about the use of LTOT as well as the vision of the caregivers about the care of a patient using LTOT. Methodology: This is a qualitative study. During the second semester of 2015, fourteen patients attended at the Oxygen Therapy Outpatient of Botucatu Clinic Hospital, of Botucatu Medicine College, and their respective caregivers were interviewed. A semi-structured interview was used for the patients, with the following guiding questions: “What does it mean for you to use oxygen?”, “What has changed in your life after you started using LTOT”, “What has changed in the lives of people who live with you in your home after you start using LTOT” and “Do you have any leisure activity?”. For the caregivers, a semi-structured interview was also used, with the following guiding questions: “What does it mean for you to take care of a person who depends on LTOT”, “What has changed in your life after you started taking care of this user?”, “What has changed in the lives of the people who live with you after you sarted taking care?” and “Do you have any leisure activity?”. The Caregiver Burden Scale (CB scale) was also applied to measure the subjective impact of chronic diseases on caregivers’ lives. The interviews were evaluated by the “Bardin Content Analysis” and the CB scale was anallyzed by calculating the arithmetic mean of the scores attributed to the 22 items. Results: Patients had a mean age of 73 + 10.4 years, of whom 6 were female, 1 was illiterate and 13 were under secondary school. All ex-smokers smoked, on average, 25 + 15.9 cigarettes a day. The mean time of O2 use was 3.5 ±2 years and the mean of daily hours use was 18.8 ± 4.6. Four categories emerged from the speeches: Strengths of therapy: Improvement in symptoms, quality of life and emotional aspects. Therapy challenges: Social isolation, difficulty in emotional involvement, worsening in self-care, functionality of the O2 concentrator and economic aspects. Emotional, social, daily and economic changes in the user’s life: Adaptation process with acceptance difficulties, changes in self-esteem, personality and leisure activities. User’s family relationship changes: Social isolation of the caregiver, emotional involvement of the family and commitment of the caregiver. The caregivers had a mean age of 63 + 11 years, of which 11 were female and all were literate. The daily care time mean was 19 + 8.2 hours and the mean of the years dedicated to care was 2.7 ± 2, only 1 caregiver had paid work and 2 had their health status worsened after becoming a caregiver. The most overloaded category of CB scale was the environment, followed by disappointment, general tension, emotional involvement and, ultimately, isolation. Four categories emerged from the speeches: Strengths of the caregiver: Improvement of the user’s general state and functional capacity, facility in the handling of the equipment and importance of the caregiver’s emotional aspect. Caregiver’s challenges: emotional involvement, functional capacity of the caregiver, change in daily life, functionality of the O2 concentrator and accessories, economic aspects and user’s personality aspects. Emotional, social, daily and economic changes in the caregiver’s life: Social isolation, emotional involvement, autonomy, caregiver’s personality aspects, change in daily life, sexuality, self-esteem and leisure activities. Caregiver’s family relationship changes: personality aspects and family structure. Conclusion: In face of this study, daily life changes and user’s and caregiver’s behavior changes are very clear. Therefore, the team needs to be prepared to provide adequate education to them in order to optimize use and care, reducing fear and barriers to use the treatment.

Resumo: A beta talassemia é um dos mais freqüentes distúrbios genéticos no mundo. Estima-se que 1,5% a 3% da população mundial seja portadora do traço talassêmico. Esses portadores geralmente são oligo ou assintomáticos e têm uma expectativa de vida semelhante à dos não portadores. Entretanto, níveis elevados de ferritina sérica têm sido observados em alguns estudos comparativos entre beta talassemia heterozigota e não portadores e, alguns indivíduos, que nunca foram transfundidos, apresentam sinais clínicos e laboratoriais de sobrecarga de ferro. A fisiopatologia dessa complicação continua em discussão. Vários pesquisadores têm sugerido um efeito modulador da mutação do gene da beta globina e mutações em genes codificadores de proteínas relacionadas ao metabolismo do ferro. Mutações no gene HFE são as mais freqüentemente associadas à hemocromatose hereditária. O objetivo do presente trabalho foi avaliar a freqüência das mutações C282Y e H63D no gene HFE em portadores de beta talassemia heterozigota e analisar sua influência no metabolismo do ferro. Foram estudados 162 portadores de beta talassemia heterozigota, residentes na cidade de São Carlos ou região, caucasóides e, acompanhados no serviço de Hematologia. O diagnóstico de traço talassêmico foi confirmado em todos por meio do eritrograma e da quantificação da Hb A2 e Hb fetal por HPLC. O metabolismo do ferro foi avaliado pelas dosagens de ferro sérico, capacidade total de ligação do ferro, ferritina e saturação da transferrina e, a análise molecular das mutações no gene HFE, pela técnica de PCR-RLFP. Foram realizadas análises de correlação linear de Pearson por idade e gênero entre hemoglobina... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Beta thalassemia is one of the most frequent genetic disorder in the world. It is estimated that 1.5% to 3% of the world population is a thalassemia carrier. These individuals are generally slightly symptomatic or asymptomatic and they have a life expectancy similar to those who are non-carriers. However, high levels of serum ferritin have been observed in some comparative studies between heterozygous for beta thalassemia and non-carriers, and some individuals that were never transfused, present clinic and laboratories signs of iron overload. The physiopathology of this disease continues in discussion. Several researchers have suggested a modulator effect from the mutation of the beta globin gene and mutations in genes related with the iron metabolism. Mutations of the gene HFE are the most frequently associated to the hereditary hemochromatosis. The aim of this study was evaluate the frequency of C282Y and H63D mutations in the HFE gene in beta thalassemia carriers, and analyze its influence in the iron metabolism. 162 beta thalassemia carriers, Caucasoid, residing in the city of Sao Carlos or region and accompanied in the Hematology service were studied. The diagnostic of thalassemia trait was confirmed in every one through a complete erythrogram and quantification of Hb A2 and Hb fetal by HPLC. The iron metabolism was evaluated by serum iron, total iron-binding capacity, serum ferritin and percent saturation of transferring. The molecular analysis of the mutations in the HFE gene was made by PCR-RLFP. There were made analysis of linear Pearson' correlation, by age and gender, among hemoglobin, Hb A2, VCM and among reticulocytes count and the values of saturation of transferrin and serum ferritin. / Orientador: Claudia Regina Bonini Domingos / Coorientador: Antonio José Manzato / Banca: Celso Carlos de Campos Guerra / Banca: Paula Rahal Liberatore / Mestre

Este trabalho analisa, a partir dos pontos de vista conceitual e sociocultural, o fenômeno de sobrecarga de informação. Este termo designa uma situação em que os indivíduos, tendo em vista uma tarefa, não se sentem capazes de lidar com certa quantidade de informação, a qual, assim definida por critérios pessoais, profissionais e societais, lhes parece necessária para seus objetivos. Assim sendo, se assimila a outros, como multitudo librorum, explosão da informação, fadiga da informação e infobesidade. Para abordar esse objeto, o método usado é o da pesquisa exploratória, isto é, estruturam-se e aprofundam-se os debates presentes na literatura. O material de base do estudo são referências sobre a história da produção da informação e do conhecimento e uma seleção de artigos com os termos \"information overload\" e \"sobrecarga de informação\" encontrados em bases de dados na área da Ciência da Informação. Com tal apanhado, elencamos na pesquisa ocorrências da sobrecarga -- ou de casos análogos -- desde a Antiguidade à Idade Contemporânea, de modo a substanciar uma exposição das características do conceito e esclarecer as relações entre ele e as várias expressões (como as citadas acima) que o manifestam. Com esse estudo, torna-se claro que precisam ser repensadas as perspectivas que entendem os danos advindos do excesso de informação como produtos únicos da contemporaneidade -- é preciso compreender esses acontecimentos nas interrelações de fatores em cada momento e recuperar aprendizados possivelmente esquecidos. Portanto, destacamos o vínculo entre as situações de sobrecarga e o desenvolvimento de novos recursos de tratamento informacional, principalmente no que se refere à Ciência da Informação. / This work analyses, conceptually and socioculturally, the phenomenon of information overload. The term designates a situation in which individuals, having a task in mind, don\'t feel capable of dealing with a certain amount of information that is deemed necessary to their assignment, based on personal, professional and social criteria. Therefore, \"information overload\" is comparable to others notions as multitudo librorum, information explosion, information fatigue and infobesity. To understand this subject, the exploratory research method is used, that is, we structure and deepen previous debates concerning the theme. Our basic material are references in the history of the production of information and knowledge and a selection of articles with the incidence of the terms \"information overload\" and \"sobrecarga de informação\", found in Information Science databases. By these means, we compile instances of overload -- or analogous cases -- since Antiquity to the Contemporary Age, so as to be able to expose the concept\'s characteristics and clarify the relations between it and the various expressions (as the ones cited above) around it. Considering what we found, it becomes clear that it is necessary to rethink perspectives which believe that the damages caused by the information excess are an exclusive product of our days -- it is necessary to understand these circumstances from the point of view of the interrelations of factors in each moment and retrieve possibly forgotten learnings. Hence, we underline the conection between the situations of overload and the development of new informational tools, principally regarding Information Science.

Introdução: A hemocromatose hereditária (HH) é uma doença autossômica recessiva caracterizada principalmente pelo aumento da absorção intestinal de ferro e seu acúmulo em órgãos. O diagnóstico da HH baseia-se nas avaliações de exames laboratoriais de ferro, imagem por ressonância magnética (RMN) e/ou testes genéticos. Diferentes genótipos são identificados como resultados de testes genéticos em pacientes com suspeita de sobrecarga de ferro primário. Além disso, questionários como o SF-36 (short form health survey), têm sido cada vez mais utilizados para avaliar o impacto das doenças na qualidade de vida (QV) do paciente. No presente estudo, nossos objetivos foram: avaliar se os domínios de QV avaliados pelo questionário SF-36 são diferentes de acordo com os grupos genotípicos em pacientes com suspeita de HH e desenvolver materiais informativos e educativos sobre HH para pacientes, familiares e profissionais de saúde. Métodos: Foram utilizados os questionários SF-36, PHQ-9 (patient health questionnaire-9) e dados gerais e específicos para avaliar domínios de qualidade de vida e depressão e características gerais da doença. Pacientes com sobrecarga de ferro primária foram incluídos (n=79) e dois grupos genotípicos foram formados: grupo 1: genótipo homozigoto para a mutação HFE p.Cys282Tyr e grupo 2: outros genótipos. Resultados: O grupo 1 apresentou maiores médias de saturação de transferrina (86±19%) e ferritina sérica (1669±1209 ng/mL) comparado ao grupo 2 (71±12%, 1252±750 ng/mL, respectivamente; P=0,001). Quatro domínios foram significativamente diferentes entre os grupos 1 e 2: capacidade funcional (P=0,03), dor (P=0,03), vitalidade (P=0,02) e aspectos sociais (P=0,01). O grupo 1 apresentou valores mais baixos para estes domínios. O grupo brasileiro de hemocromatose hereditária (GBHH) foi criado, o site foi desenvolvido e foram recebidos vários cadastros. O material informativo/educativo foi desenvolvido e distribuído aos pacientes, familiares e profissionais de saúde envolvidos neste estudo. Conclusões: O principal achado deste estudo foi que os pacientes com genótipo homozigoto para p.Cys282Tyr apresentaram um pior cenário de QV avaliado pelo SF-36, em comparação aos pacientes com sobrecarga de ferro sem o mesmo genótipo. O conhecimento desta relação entre genótipos e QV pode ser útil no manejo geral de pacientes com suspeita de HH. Este estudo foi capaz de contribuir para mais informações sobre a HH, aumentando a educação em saúde e a divulgação deste cenário / Background: Hereditary hemochromatosis (HH) is an autosomal recessive disease mainly characterized by increased intestinal absorption of iron and its accumulation in organs. The diagnosis of HH is based on laboratory tests of iron, magnetic resonance imaging (MRI) evaluations and / or genetic testing. Different genotypes are identified as results of genetic tests in patients with suspected of primary iron overload. In addition, questionnaires such as the SF-36 (short form health survey), have been increasingly used to assess the impact of diseases on the patient\'s quality of life (QL). In the present study, our aims were: evaluate if the domains of QL by SF-36 questionnaire are different according to genotypic groups in patients with suspected of HH and develop informative and educational materials about HH for patients, family members and health professionals. Methods: The SF-36, PHQ-9 (Patient health questionnaire-9) questionnaires, general and disease-specific data were used to evaluate the domains of quality of life and depression and general characteristics of the disease. Patients with primary iron overload were included (n=79) and two genotypic groups were formed group 1: homozygous genotype for the HFE p.Cys282Tyr mutation and group 2: other genotypes. Results: Group 1 presented higher mean values of transferrin saturation (86±19%) and serum ferritin (1669±1209 ng/mL) compared to group 2 (71±12%, 1252±750 ng/mL, respectively, P= 0.001). Four domains were significantly different between groups 1 and 2: physical functioning (P= 0.03), bodily pain (P= 0.03), vitality (P= 0.02) and social functioning (P= 0.01). Group 1 presented lower values for these domains. The \"Brazilian group of hereditary hemochromatosis\" (GBHH) was created, the website was developed and several registrations were received. The informative/educational material was developed and distributed to patients, family members and health professionals involved in this study. Conclusion: The main finding of this study was that patients with genotype homozygous for p.Cys282Tyr presented worse scenario of QL evaluated by SF-36, compared to patients with iron overload without the same genotype. The knowledge of this relationship between genotypes and QL may be useful in the general management of patients with suspected of HH. This study was able to contribute with more information about HH, increasing health education and the divulgation of this scenario

Made available in DSpace on 2016-04-28T20:38:35Z (GMT). No. of bitstreams: 1 Maria Apparecida Gomes.pdf: 4004130 bytes, checksum: 350751a8a7fd8557e6564e377a75b3a5 (MD5) Previous issue date: 2012-11-05 / The research was done in an ONG located in a city in central-western of Sao Paulo State. It's goal was to realize how the female identity was built in it's original family and how they live their woman function in their present family. The specific goals were: to think about principIes in the construction of the female identity, how women notice themselves. The interest by this text came because of mothers'complaint about their lives. They must work to survive and after that they need to do a lot of housework at home. Four mothers with children between 5 and 10 years old participated in this research. They were alphabetized and hired. They were from 22 and 42 years old. The method used was based in the qualitative research. Under the focus of social constructionism those assumptions were derived from conversational exchan,ges in which meanings are socially constructed and language is understood in its active character is considered a social practice, constituent of the reality. To achieve the objective instruments were used such as: History Life, Reflection Group, Focal Group. It is showed as results work overload, insufficient wages to keep family and answer the unexpected even:ts of life. They work in their jobs for 46 hours per week and then for doing housework they spend, on average, 20 hours per week. These data are in accordance with Brazilian demographic surveys. It was also showed by the survey the lack of dialogue with their original family about sex education. They know that they are doing the same with their children / A pesquisa foi realizada em uma ONG localizada em uma cidade no centro-oeste do Estado de São Paulo. Teve como objetivo compreender como foi construída a identidade feminina na família de origem por um grupo de mulheres e como elas vivenciam seu papel de mulher na família atual. Os objetivos específicos foram: refletir sobre os valores envolvidos na construção da identidade feminina; como as mulheres percebem a si mesmas. O interesse pelo tema surgiu a partir das queixas de cansaço e de tensão enunciados por mães que iam buscar seus filhos na ONG, ap6s o trabalho no espaço publico. Além das horas dedicadas ao trabalho remunerado iam, em seguida, para suas casas executar os afazeres domésticos. Participaram da pesquisa quatro mães com filhos entre 5 a 10 anos de idade, alfabetizadas, assalariadas. A idade delas ficou num intervalo entre 22 a 42 anos. O método utilizado baseou-se na pesquisa qualitativa. A base epistemológica foi o construcionismo social com seus pressupostos derivados das trocas conversacionais em que os significados são construídos socialmente e a linguagem e entendida em seu carácter ativo sendo considerada uma pratica social, constituinte da realidade. Para atingir o objetivo foram usados instrumentos: entrevistas individuais e grupais. Com estes instrumentos foram construídas as atividades grupais: História de Vida, Grupo Reflexivo e Grupo Focal. Apontam-se como resultados do cansaço a sobrecarga de trabalho, os salários insuficientes para manterem a família e atenderem os acontecimentos inesperados da vida. Trabalham em seus empregos durante 46 horas semanais, em media. Para os afazeres domésticos empregam 20 horas semanais, em media. Tais dados estão em conformidade com os levantamentos demográficos brasileiros. Constatou-se que seus parceiros dedicam momentos aleatórios para os afazeres domésticos. Elas aprenderam, em suas famílias de origem, as habilidades de donas de casa e o valor que se deve dar ao trabalho remunerado. Outro resultado apontado pela pesquisa consiste na falta de dialogo com sua família de origem sobre as questões de educação da sexualidade. Reconhecem que estão reproduzindo com os filhos e filhas semelhante educação

Fatigue damage of aluminium alloys is one of the key concerns in transport industries, particularly in the aerospace industry. The purpose of the project is to develop new knowledge and techniques against fatigue failure for these industries through a systematic investigation of fatigue resistance and crack growth behaviours of aluminium alloys. Fatigue and fracture mechanics have been investigated analytically, numerically and experimentally in this project. Overload transient effect on fatigue crack growth has been examined by considering various parameters including crack closure, overload ratio (OLR), load ratio (R ratio), baseline stress intensity factor range, (∆K)_BL and geometry. It was found that crack closure can be correlated qualitatively and quantitatively to all other parameters associated with overload transient behaviour. It is proposed that the effect of crack tip plasticity on the non-linearity of the compliance curve can be separated to obtain reliable crack closure measurement. In this project, different methods are used to better understand the transient retardation process so that the damage tolerance design (DTD) of the components made of aluminium alloys can be enhanced. Another important parameter for fatigue and damage tolerance design (DTD) of engineering components is the threshold stress intensity factor range for fatigue crack growth, ∆K_th. A small variation in identification of ∆K_th can lead to a big change in overall estimation of fatigue life. In this project, an analytical model has been developed for aluminium alloys by fitting an analytical curve with raw crack growth data in order to identify the ∆K_th. This model has the capacity to identify ∆K_th for different aluminium alloys at various R ratios. There is a great demand for enhanced fatigue life of aluminium alloys in the transport industry. This project has carried out a detailed investigation of electromagnetic treatment (ET) in the form of electropulsing treatment to develop an efficient technique for fatigue resistance enhancement. ET parameters including the treatment intensity, treatment time and the number of applications have been optimised. It is suggested that the duration of ET treatment can be used as the main parameter among all these to control the fatigue resistance of the aluminium alloy. The improvement in fatigue resistance has been explained by the change in microhardness and conductivity of aluminium alloy due to ET. Additionally, the fracture morphology was analysed using scanning electron microscopy (SEM). The precipitates and dislocation characteristics were also studied using transmission electron microscopy (TEM). The outcomes of this investigation will help improve structural integrity by enhancing fatigue resistance of aluminium alloys.

L’hémochromatose HFE est une maladie du métabolisme du fer liée au gène HFE dont la principale mutation est C282Y. L’objectif général de ce travail était d’étudier l’influence de facteurs génétiques et non génétiques sur l’expression phénotypique de patients atteints d’hémochromatose HFE. Cette étude prospective incluait les patients C282Y/C282Y etC282Y/H63D inclus en protocole de saignées entre janvier 2004 et décembre 2011 au centre de santé brestois de l’EFS-Bretagne. Dans un premier temps, nous avons étudié l’influence du génotype C282Y/H63D sur la survenue d’une surcharge en fer. Nous avons confirmé que le variant H63D doit être considéré comme un facteur de susceptibilité dont l’expression est liée à la présence de co-facteurs responsables d’une hyper ferritinémie. Ensuite, nous avons étudié le rôle des grossesses et de l’alimentation sur l’expression phénotypique du génotype C282Yhomozygote. Nous avons montré qu’il existe bien une différence d’expressivité clinique liée au sexe chez les patients C282Y/C282Y. Cependant, nos données n’ont pas confirmé l’effet protecteur typiquement attribué aux grossesses pour expliquer la plus lente accumulation de fer chez les femmes. Cette étude a également mis en évidence une association modérée entre la consommation d’aliments riches en fer et le degré de surcharge en fer des patients C282Yhomozygotes traités par phlébotomies. Ce travail contribue à mieux comprendre l’hétérogénéité phénotypique observée dans l’hémochromatose HFE. La finalité est de pouvoir repérer précocement les sujets les plus à risque de développer les surcharges en fer les plus sévères et par conséquent des complications cliniques. / HFE hemochromatosis is a disorder of iron metabolism related to the HFE gene whose mainmutation is C282Y. The overall aim of this study was to investigate the influence of genetic and non genetic factors on phenotypic expression of patients with HFE hemochromatosis. This prospective study included the C282Y/C282Y and C282Y/H63D patients enrolled in a phlebotomy program between 2004 and 2011 in a blood centre of western Brittany (Brest, France). First, weassessed the weight of the C282Y/H63D genotype in the occurrence of iron overload. We confirmed that H63D is a discrete genetic susceptibility factor whose expression is most visible in association with other co-factors responsible for hyper ferritinemia. Then we investigated the effect of pregnancies and iron-rich diet on phenotypic expressivity of the C282Y/C282Y genotype. We have shown that there is a difference in clinical expression related to gender in C282Y/C282Ypatients. However our findings did not confirm that pregnancies protect against iron accumulationin women. This study established a moderate link between dietary iron intake and the degree of iron overload in HFE hemochromatosis patients who come to medical attention. This work contributes to a better understanding of the phenotypic heterogeneity observed in HFE hemochromatosis. The purpose is to identify precociously subjects the most at risk of developing iron overload and therefore clinical complications.

Neste estudo, os objetivos propostos foram: 1) verificar o efeito da sobrecarga salina 1% sobre a pressão arterial e variáveis relacionadas ao controle hídrico em camundongos machos e fêmeas; 2) comparar os efeitos da sobrecarga salina sobre o remodelamento vascular de artérias elásticas e de resistência em machos e fêmeas. Para tal, foram usados camundongos C57Bl/6 machos e fêmeas tratados por 2 ou 12 semanas com solução de NaCl 1% para beber ou água fresca (grupo controle). Os animais foram pesados semanalmente e acompanhados em gaiola metabólica ao final do estudo (coleta de água e urina). A pressão arterial (PA) e frequência cardíaca (FC) foram medidas por pletismografia de cauda. Os animais foram eutanasiados, tiveram peso e comprimento naso-anal medidos, sendo coletados coração (análise de artérias cardíacas) e aorta para análise morfométrica, avaliando-se fibras colágenas e lamelas elásticas. Também foi avaliada a relação percentual peso cardíaco/peso corporal. Urina e sangue foram coletados para quantificação de proteínas totais, creatinina, sódio e cloreto. Ao final dos tempos de sobrecarga salina, não foram observadas diferenças significantes de peso corporal, pressão arterial e frequência cardíaca, hematócrito e medida naso-anal entre os grupos. Verificamos aumento de peso relativo do coração em períodos mais curtos de sobrecarga em machos (2 semanas) e mais longos em fêmeas (12 semanas). Os valores urinários de sódio, proteína total e creatinina aumentaram com a sobrecarga salina, tanto em machos como em fêmeas. A avaliação morfométrica das artérias elásticas apontou aumento do número de lamelas em machos, enquanto a avaliação das artérias musculares apontou aumento da deposição colágena em fêmeas. / In this study, the objectives were: 1) determine the effect of 1% salt overload on blood pressure and related variables controlling water in male and female mice, 2) to compare the effects of salt overload on vascular remodeling of elastic arteries and strength in both males and females. To this end, we used C57BL / 6 males and females treated for 2 or 12 weeks with 1% NaCl solution for drinking or fresh water (control group). The animals were weighed weekly and monitored in metabolic cage at the end of the study (collecting water and urine). Blood pressure (BP) and heart rate (HR) were measured by tail plethysmography. The animals were euthanized, had weight and naso-anal length measured heart being collected (analysis of heart arteries) and aorta for morphometric analysis, evaluating elastic lamellae and collagen fibers. We also evaluated the percentage ratio heart weight / body weight. Blood and urine were collected for measurement of total protein, creatinine, sodium and chloride. At the end of the times of saline overload, no significant differences were observed in body weight, blood pressure and heart rate, and hematocrit measured naso-anal between groups. We observed increase in relative heart weight in shorter periods of overload in males (2 weeks) and longer in females (12 weeks). The values of urinary sodium, total protein and creatinine increased with saline overload in both males and females. The morphometric analysis of the elastic arteries showed an increase in the number of lamellae in males, while the evaluation of muscular arteries showed increased collagen deposition in females.

Le domaine de notre recherche est la décision stratégique au sein des organisations. Plus précisément il s'agit de l'aide à la prise de décision stratégique et de la problématique de l'acquisition des informations utiles pour de telles décisions. D'un côté les ‘informations de terrain' issus des contacts entre personnes, des réunions professionnelles, etc. demeurent essentielles pour les dirigeants. D'un autre côté les journaux quotidiens nationaux et internationaux fournissent un volume considérable de données que l'on peut qualifier de données brutes (Raw data). Mais, outre ces sources classiques, le recueil des informations a évolué de façon considérable avec l'avènement des technologies de l'information et notamment de l'Internet pour ce qui concerne dans notre recherche. Nous avons choisi le domaine concernant l'acquisition des informations de terrain fournies par les journaux nationaux quotidiens : les journaux quotidiens colombiens pour ce qui concernera notre étude empirique. Pour acquérir cette information nous avons proposé sur la base d'une recherche du type « Action Design Research », de concevoir, de construire et d'expérimenter un artéfact permettant de détecter des signaux faibles potentiels issus des données extraites d'Internet et qui aideraient les dirigeants de l'entreprise à découvrir et comprendre leur environnement. L'artéfact a été conçu et construit en deux phases utilisant des concepts théoriques liés à la surcharge de données, à la veille stratégique notamment la VAS-IC® (Veille Anticipative Stratégique – Intelligence Collective) et sur les caractéristiques souhaitables des systèmes informatisés d'aide à la décision stratégique. Après sa construction, l'artéfact a été expérimenté sur un terrain permettant d'évaluer son effectivité. Cette expérimentation a permis d'améliorer nos connaissances sur la pertinence des données numériques dans le processus de la prise de la décision. Les décideurs impliqués ont également pu d'intégrer des nouvelles pratiques adaptées à leurs besoins d'information. / Our research area is around the strategic decision within organizations. More precisely, it is applicable as an aid for strategic decision-making and detecting useful information for such decisions. On the one hand, the ‘information from the field' from the contacts between individuals, business meetings, etc. is always essential for managers. On the other hand, national and international newspapers can provide a considerable volume of data that can be defined as the raw data. However, besides these classical sources, gathering information has changed dramatically with the advent of information technology and particularly internet that is related to our research. We chose the area for the acquisition of ‘information from the field' provided by the national daily newspapers: the Colombian newspaper which concerns to our empirical study. In order to detect weak signals of potential internet base issues which help managers to discover and understand their environment, we proposed a research based on “Action Design Research” type and then applied for designing, building and testing an artifact to gain the required information. The artifact has been designed and built in two phases that is included of using theoretical concepts about the data overload, environmental scanning particularly the “anticipatory and collective environmental scanning model” (VAS-IC®) and the desirable characteristics of strategic decision making support systems. After its construction, the artifact applied to real experimentation that has allowed us to evaluate its effectiveness. Afterwards, we improved our knowledge about the relevance of digital data in the decision making process. The results of all the involved decision makers have been able to integrate these new practices into their information needs.

Background: The Theory of Cultural Distress offers a framework for understanding the potential outcomes in patients who do not receive care that incorporates their cultural beliefs (DeWilde & Burton, 2017).This study represents initial steps in researching the theory byexploring the layering of stressors that place the patient at risk for Cultural Distress. Methods: Utilized aCross-sectional descriptive correlational analysis of intersecting identities (Structural Stressors), ethnicity-related stressors (Otherness) and ethnic-identity (Otherness) to develop understanding of the potential effects of these variables on psychological stress. Independent variables included intersecting identities, perceived ethnic discrimination, concern for stereotype confirmation, own group conformity pressure, and group membership. The dependent variable was perceived stress. Participants were also asked to define the word culture. Results: Stereotype confirmation concern, perceived ethnic discrimination, group membership, and own group conformity pressure were significantly associated with perceived stress. Intersectionality was not significantly associated with perceived stress but was significantly associated with perceived ethnic discrimination. Regression analysis revealed stereotype confirmation concern, own group conformity pressure, and group membership as significant predictors of perceived stress. Participant definitions of culture primarily fell under two themes, Collectiveness and Individualness, indicating that the way we live is highly influenced by our shared experiences, and also a product of individual choices. Discussion: Results indicated that structural stressors had no influence on psychological stress but were associated with perceptions of discrimination. The experience of otherness significantly influenced psychological stress. Additional research and tool development is needed to better understand how structural stressors may influence psychological stress.