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Fatores Associados ao parto cesariana no hospital universitário Cassiano Antonio Morais (HUCAM)Rodrigues, Patrícia Leite 13 July 2016 (has links)
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Previous issue date: 2016-07-13 / O índice de cesarianas apresenta valores elevados em todo mundo, configurando o
que se chama de epidemia de cesarianas. A OMS recomenda uma taxa de 10 a
15% dos partos realizados por meio cirúrgico, taxa considerada segura para a
morbimortalidade materna e neonatal, a partir do qual há aumento das complicações
sem levar à melhoria da qualidade da assistência obstétrica. O Brasil apresenta-se
como um dos campeões mundiais de cesariana e a maioria dos nascimentos
ocorridos no país é por parto operatório, atingindo uma taxa de 56%. O presente
trabalho propôs-se a avaliar os fatores associados à cesariana no Hospital
Universitário Cassiano Antonio Morais (HUCAM) além de estudar o índice de partos
cirúrgicos. A pesquisa utilizou o banco de dados SIP- CLAP do projeto Mãe
Adolescente do Hucam, envolvendo os partos ocorridos entre abril de 2012 até
dezembro de 2013, totalizando 2009 pacientes. As variáveis analisadas foram
divididas entre fatores maternos (idade materna, escolaridade, gestação anterior,
cesariana prévia e IMC), fatores obstétricos (qualidade do pré-natal, idade
gestacional, diabetes e pré-eclâmpsia) e fatores neonatais (apresentação fetal,
apgar, peso e IPR). Inicialmente, foi realizado análise descritiva dos dados e
ajustados para modelos lineares gerais para os 3 grupos de fatores. O índice de
partos cesarianas foi de 58,8% dos partos e os fatores associados ao parto
operatório foram: cesariana prévia, idade materna acima de 20 anos, diabetes e pré-
eclâmpsia, apresentação pélvica, idade gestacional maior que 41 semanas e peso
do recém-nascido. Encontramos associação negativa com partos não cesarianas e
tamanho fetal, comportando-se como fatores de proteção. Ao final desde trabalho
sugerimos planos de ação visando melhorias no atendimento aos usuários, em
consoante com as políticas públicas para a redução do número de cesarianas:
manter serviço estatístico e intensificar preenchimento do SIP- CLAP, promover
educação médica continuada e mudanças organizacionais em materiais e equipe de
saúde, descentralização do ensino no hospital universitário e monitorização das
ações realizadas e o impacto nos resultados encontrados / The cesarean birth rate has high values worldwide, setting the so-called epidemic of
caesarean sections. The WHO recommends a rate of 10- 15% of deliveries
performed by surgical means, considered safe for maternal and neonatal mortality,
from which can exist increase in complications that doesn’t lead to improved quality
of obstetric care. However, it is not the reality in most countries worldwide, including
Brazil, which is one of the world champions where the majority of births occurring in
this country is caesarean, reaching a rate of 56%. Among some determining factors
for this reality, we can cite the clinical conditions, population, socioeconomic and
cultural characteristics. This research proposes to assess the factors associate with
cesarean section at the Hospital Universitário Cassiano Antonio Morais (HUCAM) in
addition to studying the surgical birth rate, in order to elucidate critical issues in
health care in this institution. The survey used the SIP database-CLAP from Projeto
Mãe Adolescente at HUCAM involving the birth that occurred between April/2012 and
December/2013, totalizing 2009 patients. The variables analysed were divided
between maternal factors (maternal age, educations, previous pregnancy, c-section
and BMI), obstretic factors (quality of pre-natal, gestacional age, diabetes and pre
eclampsia) and neonatal factors (fetal presentation, APGAR, weight and IPR).
Initially, was made a descriptive analysis of the data and adjustment for general
linear models for the 3 groups of factors. The index of cesarean births was 58,8%
and the factors associated with the surgical delivery were: cesarean section,
maternal age over 20 years, diabetes and pre eclampsia, breech presentation, over
than 41 weeks gestational age and weight of the newborn. We found a negative
association with non caesarean sections and fetal size births, behaving as protective
factors. At the end of this research, was made suggestions for action plans aiming
improvements to this health service, in accordance with public policies to reduce the
number of caesareans, like as: to maintan statistical service and to intensify fill the
SIP CLAP, to promote continuing medical education and organizational changes in
materials and health staff, the decentralization of education at the university hospital
and the monitoring of the actions taken and the impact on the results found
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Determinantes da transparência das universidades federais brasileirasPessoa, Iury da Silva 31 October 2013 (has links)
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Previous issue date: 2013-10-31 / Este estudo se propôs medir o grau de transparência de informações nos portais
eletrônicos das universidades federais brasileiras e identificar determinantes para tal
transparência. Procedeu-se à elaboração de um Índice de Divulgação das
Universidades Federais (IndexDUF) com base nos índices de Dixon, Coy e Tower
(1993), Rosário et. al. (2011) e Católico (2011), o qual mediu a transparência dos
portais de todas as 59 universidades federais. Verificou-se um nível médio de
divulgação de 66,32% entre as universidades federais. As informações relacionadas
à extensão são as mais divulgadas (85,88%); já informações relacionadas à
qualidade acadêmica ou administrativa são as menos divulgadas entre as
universidades federais, com um nível de divulgação de 41,69%. Verificou-se também
que universidades do Sul e Sudeste tendem a ser mais transparentes que
universidades das demais regiões, uma vez que elas representam sete das dez
universidades brasileiras que mais divulgam. Já as universidades do Norte e
Nordeste representam oito das dez universidades que menos divulgam; contudo, tais
percepções não foram significativas estatisticamente. Também foram testadas 15
hipóteses para verificar quais determinantes (variáveis) são relevantes para explicar
a transparência nas universidades federais. Para tanto, foram utilizadas 31 proxies
para os determinantes de transparência, os quais foram testados utilizando-se
regressão linear múltipla, em que foram estimados oito modelos utilizando a eleição
intencional dos determinantes e outros cinco modelos utilizando o procedimento
Backward. Os modelos testados mostram que os determinantes Tamanho do corpo
docente (Xtadoc), Tamanho do corpo técnico-administrativo (Xtaserv), Qualidade da
graduação (Quagr), Qualidade da pós-graduação (QUAPG) e Qualificação dos
docentes (QuaDoc2) são determinantes da transparência / This study measures the degree of transparency of information in the electronic
portals of Brazilian federal universities and identifies determinants for such
transparency. It prepared an Index Disclosure of Federal Universities (IndexDUF)
based on indices Dixon, Coy and Tower (1993), Rosario et. al. (2011) and Catholic
(2011), which is applied to the portals of all 59 Brazilian federal universities. There
was an average level of disclosure of 66.32 % between the federal universities.
Information relating to the extension are the most widespread (85.88 %) has
information related to quality academic or administrative are less widely between
federal universities, with a level of disclosure of 41.69 %. It was also found that
universities in South and Southeast tend to be more transparent than universities in
other regions, since they represent seven of the ten Brazilian universities to disclose
more. Already universities North and Northeast represent eight of the ten universities
that less disclose, however, such perceptions were not statistically significant. Were
also tested 15 hypotheses to see which determinants (variables) are relevant to
explain the transparency in the federal universities. Thus, we used 31 proxies for the
determinants of transparency, which were tested using multiple linear regression, in
which eight models were estimated using the election intentional determinants and
five other models using the Backward procedure. The model 04, considered the most
relevant and what best fits the design of the research shows that the determinants
Size faculty (Xtadoc), size of the technical- administrative (Xtaserv), Quality
Graduation (Quagr), Quality post graduate (QUAPG) and Qualification of teachers
(QuaDoc2) are determinants of transparency
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Comportamento do sup(32)P, sup(35)S, sup(36)Cl e sup(42)K em oxido de magnesio. Aplicacao a separacao do par ssup(35)S-sup(32)P formados na irradiacao do cloreto de potassioSANTOS, CASUE N.T. dos 09 October 2014 (has links)
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Política 35 del Acuerdo Nacional – #PeruDigitalIriarte, Erick 24 October 2017 (has links)
Semana del Acceso Abierto 2017 - Perú. Evento organizado por la Universidad Pontificia Universidad Católica del Perú 8PUCP) y Universidad Peruana de Ciencias aplicadas (UPC), en el marco de la Semana Internacional del Acceso Abierto. En esta oportunidad, la actividad se llevó a cabo el 24 de Octubre de 2017 en el Auditorio de Humanidades PUCP. Lima, Perú. / Resumen
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O instituto da ouvidoria como instrumento para a melhoria da gestão pública universitária: estudo de caso da ouvidoria geral da Universidade Federal do Espírito SantoAlves, Juliana Cruz 24 July 2014 (has links)
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Previous issue date: 2015 / No âmbito da Democracia Participativa, cujos elementos foram inseridos na democracia brasileira pela Constituição Federal de 1988 (CF/88), ao legitimar a
participação do usuário na administração pública direta e indireta, prevendo
mecanismos de controle social, destacamos as ouvidorias públicas, e dentre elas as ouvidorias universitárias, como instrumentos de interlocução e intermediação entre os cidadãos e as instituições públicas. Embora existam
importantes estudos acerca das ouvidorias públicas, sobretudo nas áreas da saúde e judiciária, ainda há escassez no campo da gestão pública quanto a estudos específicos sobre as ouvidorias universitárias, restando uma lacuna que necessita ser preenchida. Nesse sentido, a presente pesquisa teve o propósito de investigar a atuação da Ouvidoria Geral da Universidade Federal do Espírito Santo (UFES), buscando responder à seguinte questão: Qual a importância da Ouvidoria Geral da UFES na gestão pública dessa instituição? E, com isso, trazer à tona aspectos relevantes e peculiares das ouvidorias universitárias, que certamente alcançam, a exemplo da Ouvidoria Geral da UFES, ouvidorias de outras instituições públicas de ensino superior, dando
maior visibilidade a um instituto por vezes desconhecido ou tratado sem a
atenção devida. Para tanto, foi realizada uma pesquisa qualitativa a partir do
procedimento técnico do estudo de caso, com utilização de análise documental,
observação espontânea e aplicação de entrevistas. Assim, além de abordar
aspectos estruturais e conjunturais que envolvem a Ouvidoria, esse estudo traz
a percepção de cidadãos que utilizaram os serviços do órgão, propiciando a ampliação da discussão sobre o tema na Academia e, porventura, a indução de mudanças organizacionais. / In the context of Participatory Democracy, whose elements were inserted in the
Brazilian Democracy by the 1988 Federal Constitution, by legitimating user
participation in direct and indirect public administration providing mechanisms
for social control, we emphasize the public ombudsman, and among them the
university ombudsman, as mechanisms for dialogue and mediation between citizens and public institutions. Although there are important studies about public ombudsman, particularly in the health and judicial areas, there is still a lack of studies in public administration field when refering to specific studies on
university ombudsman, leaving a gap that needs to be filled. Accordingly, the
present research aimed to investigate the performance of the UFES's General Ombudsman, seeking to answer the question: How important is the UFES's General Ombudsman in UFES's public administration? And, along with that, bring up relevant and peculiar aspects of the university ombudsmen, which certainly reach, such as the UFES's General Ombudsman, other higher
education public institutions's ombudsmen, giving greater visibility to an institute
sometimes unknown or treated without due attention. Therefore, a qualitative
research from the technical procedure of the case study was conducted, using
documentary analysis, spontaneous observation and the application of
interviews. Thus, in addition to addressing structural and cyclical aspects
involving the Ombudsman, this work brings the perception of citizens who used
the services of the agency, providing a magnification onto the discussion on the
subject at the Academy, and perhaps inducing organizational changes.
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The Task of Responsible Reading: Developing an Approach for Dealing with Issues of Normative Practice in Acts 2:42-47 and Acts 4:32-35Trautwein , Sherri Lynn January 2005 (has links)
The interpretive question of normativity is a challenge that confronts the reader of the biblical text, particularly as it relates to the book of Acts. The task of reading the biblical text in a way that allows it to speak its message and that enables it to make the transition from the first-century into the twenty-first century is often anything but straightforward and as such requires a responsible approach to reading on the part of the interpreter. Based upon the challenges directly associated with reading the book of Acts, with special attention paid to the contribution of sociological criticism, four principles for reading that are characterized by cultural analysis, narrative structure, theological impact and personal faith have been developed in order to assist the reader in considering essential elements related to the quest for normativity. By holding these principles in balance, the reader will be given the opportunity to construct a meaningful foundation for interpretation that may be followed by application of five guidelines for normativity identified as a subset of the proposed principles. Analyses of Acts 2:42-47 and Acts 4:32-35 demonstrate the application of the principles for responsible reading and the guidelines for normativity by considering normative versus non-normative practices of the early church in the context of the community of goods. Evaluation of the strengths and weaknesses of the principles for responsible reading identify the positive contribution of this thesis as well as areas that require further study and development. / Thesis / Master of Theological Studies (MTS)
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Observed Flow Characteristics of Rotating Stall Inception and its Prevention Using Discrete Tip Injection in the NASA Stage 35 Axial Compressor with New Analysis MethodsJohnson, Benjamin P. 05 September 2008 (has links)
No description available.
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Interleukin 35 inhibits ischemia-induced angiogenesis essentially through the key receptor subunit Interleukin 12 receptor beta 2Fu, Hangfei January 2019 (has links)
Peripheral arterial disease (PAD) is a worldwide disease caused by atherosclerosis. It is a circulatory condition where narrowed blood vessels reduce blood flow to the peripheral such as legs. Although current gold standard treatment for advanced PAD patients is still based on surgical revascularization, there is no effective therapy for many patients that are not suitable for surgery. In addition, better recovery from surgical revascularization largely relies on angiogenesis in the adjacent ischemic tissue. Thus, novel pro-angiogenic therapies to improve post-ischemic neovascularization are urgently desired. However, current poor understanding of the roles of anti-inflammatory cytokines in angiogenesis prevents the development of these new therapies. We and others have reported that IL-35 is a newly identified inducible immunosuppressive heterodimeric cytokine in the IL-12 family. IL-35 is composed of p35 (IL-12A) and EBI3, and its receptors are comprised of homodimers or heterodimer of IL-12Rb2 and gp130 (IL-6ST). We have shown that IL-35 inhibits endothelial cell (EC) activation induced by lipopolysaccharide (LPS) or atherogenic lysophosphatidylcholine (LPC). At least partially through these new EC-dependent mechanisms, IL-35 inhibits inflammation in autoimmune diseases, infectious diseases, atherosclerosis, and tumors. Recent studies have indicated the role of IL-35 in angiogenesis in rheumatoid arthritis and different tumors. However, whether and how IL-35 regulates post-ischemic angiogenesis in peripheral artery disease are unrevealed. In our study, we used hindlimb ischemia (HLI) and Matrigel plug assay as in vivo angiogenesis models and wound healing assay as in vitro angiogenesis model to study the role and underlying mechanisms of IL-35-mediated angiogenesis. We made the following findings: 1) muscle in human and mouse has high angiogenic potential in physiological conditions; 2) angiogenic cytokines and chemokines including anti-inflammatory cytokines are predominantly regulated by inflammatory transcription factors; 3) IL-35 signaling is induced in ischemic muscle; 4) IL-12Rb2, but not IL-6ST, is the key receptor component of IL-35 signaling in ischemic muscle and hypoxic human microvascular endothelial cells (HMVECs); 5) hyperlipidemia (atherogenic factor) impairs angiogenesis in vivo and in vitro, which partially acts through the induction of IL-35; 6) IL-12Rb2 deficiency improves HLI-induced angiogenesis in both WT or apolipoprotein E (ApoE) -/- mice (an atherosclerosis model); 7) IL-35 injection inhibits HLI-induced angiogenesis in WT mice but not that in the IL-12Rb2 deficient mice; 8) IL-35 injection enlarges the avascular area in gastrocnemius muscle after HLI; 9) IL-35 obstructs fibroblast growth factor-2 (FGF2)-induced angiogenesis in Matrigel plug assay in vivo; 10) CD45-CD31+ ECs from the IL-35-injected ischemic muscle at day 14 of HLI have an abnormal extracellular matrix organization, activated integrin pathways (cell-matrix adhesions), disrupted vascular endothelial (VE)-cadherin-plakoglobin complex (cell-cell adhesions), and increased infiltration and migration of bone marrow-derived leukocytes; 11) IL-35 inhibits HMVEC migration in wound healing assay in vitro presumably through upregulation of anti-angiogenic proteins including pigment epithelium-derived factor (PEDF), serpin family B member 5 (SERPINB5, Maspin), and thrombospondin (THBS)-1. These results suggest that anti-inflammatory cytokine IL-35, signaling through the key receptor subunit IL-12Rb2, inhibits HLI-induced angiogenesis and delays tissue repair by dysregulating cell-cell and cell-matrix adhesions, which leads to the impaired vascular adhesion junction and maturation of blood vessels. / Biomedical Sciences
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La lecture des textes à contrainteRaymond, Dominique 20 April 2018 (has links)
Pour éviter de laisser le hasard et l'inspiration guider leur écriture, les auteurs de textes à contrainte utilisent un principe structurant dans l'échafaudage de leur texte. L’œuvre issue de cette pratique d’écriture porte les traces, perceptibles ou non, de la règle; à partir de ce postulat de base, nous pouvons considérer qu'un rapport indirect existe entre une contrainte et ses retombées textuelles, qui appelle une sémiotique de la lecture. Une relation dynamique s'établit entre le lecteur, le texte et la contrainte. Nous examinons cette relation, en considérant que l'activité lectorale opère dans diverses conditions; que le texte est un objet sémiotique complexe ne se réduisant pas au seul réglage instancié; que la contrainte se manifeste sous plusieurs formes (indices, symboles, énoncés plus ou moins explicites), qui demandent la collaboration du lecteur pour être interprétées comme telles. Lire ou ne pas lire la contrainte, telle ne peut, donc, être la question. Car si le procédé balise de façon serrée l’écriture, nous ne pouvons en dire autant de la lecture; l’activité présente un certain degré d’autonomie vis-à-vis de l’inscription d’une contrainte. C'est du moins l'hypothèse que nous tentons d'étayer tout au long de ce travail de recherche.
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Florimont : édition critique de l'édition de 1528 (Paris, Jehan Longis), avec introduction, notes et étude comparativeKendris, Theodore 11 April 2018 (has links)
L’Histoire de Florimont, écrit en 1188 par Aimon de Varennes, a connu un succès important au Moyen Âge. Ce poème a été mis en prose au quinzième siècle sous forme manuscrite dont il existe une version longue, B.N. f. fr. 12566, et une version courte, B.N. f. fr. 1490. En 1528 paraît une édition, également en prose, due aux soins de l'imprimeur Jehan Longis. D ’autres imprimeurs ont ensuite choisi de tirer leurs propres éditions de ce texte, le modifiant légèrement selon leur goût. Bien que la version en vers ait suscité l’intérêt de nombreux chercheurs à partir de la fin du XIXe siècle, notamment Alfons Hillca, qui a publié une édition du poème en 1932, la version en prose imprimée demeure relativement inconnue, et peu de chercheurs ont consacré leurs efforts à son étude. L’objet de cette thèse est de faire connaître la version imprimée de Florimont, établie selon les normes des éditeurs modernes des textes de la Renaissance et du Moyen Âge. Nous avons également tenu compte de la recherche connue sur ce texte, recherche aussi bien philologique que critique ; nous l'avons parfois acceptée, parfois remise en question, toujours dans la perspective de mieux faire comprendre ce récit. Voilà pourquoi nous avons étudié la façon dont le remanieur de l’imprimé parvient à retenir les éléments structuraux, les rapports féodaux entre les personnages, les éléments du bestiaire médiéval et le jeu onomastique qui ont tous contribué à la beauté du poème du XIIe siècle. Notre étude « génético-comparative » permettra de voir en quoi les versions en prose diffèrent de la version originale. Cette analyse s’est avérée compliquée, car les remanieurs des versions en prose ont tous pris le poème comme point de départ. Il existe donc plusieurs genèses à suivre en parallèle. L’étude des rapports féodaux éclaire celle de l’influence du bestiaire médiéval parce que le comportement des personnages relève des deux domaines. Quant au jeu onomastique, nous avons repéré tous les renseignements possible afin de démontrer comment le remanieur de Florimont (1528) retient les éléments de cet outil créateur, déjà en place dans le poème d’Aimon de Varennes. Enfin, nous espérons que notre recherche suscitera un nouvel intérêt pour ce texte, qui mènera encore plus loin que les marges de cette thèse. / Québec Université Laval, Bibliothèque 2017
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