• Refine Query
  • Source
  • Publication year
  • to
  • Language
  • 1407
  • 1113
  • 783
  • 121
  • 94
  • 67
  • 33
  • 22
  • 22
  • 20
  • 20
  • 20
  • 18
  • 15
  • 13
  • Tagged with
  • 3866
  • 1440
  • 367
  • 286
  • 263
  • 240
  • 222
  • 212
  • 189
  • 179
  • 177
  • 167
  • 161
  • 142
  • 136
  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
211

Auto-Tune e humor no Youtube / -

Haroldo França Rebouças Neto 18 October 2018 (has links)
Esta dissertação intenciona investigar a construção do cômico, mediado pela tecnologia, em vídeos remix publicados na plataforma YouTube. Os trabalhos analisados propõem o riso a partir da manipulação de tempo e pitch do áudio de vídeos virais, possibilitada por softwares como Auto-Tune e Melodyne. Entendemos remix conforme autores como Lev Manovich, Eduardo Navas e Lawrence Lessig, que afirmam que vivemos em uma \"Cultura Remix\", uma época que tem como base cultural o sampling, atividade que consiste na troca inteligente entre fragmentos de diversas mídias. Analisaremos a emergência do riso nesse contexto, a partir de reapropriações de materiais preexistentes na rede. Autores como Henri Bergson e Michail Bakhtin nos fornecem o suporte conceitual para investigarmos o riso como um recurso dramático e da cultura tanto na vida cotidiana quanto nas plataformas digitais, que facilitaram, por um lado, o acesso e reciclagem de \"detritos midiáticos\", e, por outro, potencializaram as possibilidades de manipulação desses materiais / This dissertation intends to investigate the construction of the comic, mediated by technology, in video remix published on the YouTube platform. The analyzed works propose the laughter from the manipulation of time and pitch of the audio of viral videos, made possible by softwares like Auto-Tune and Melodyne. We understand remix by authors such as Lev Manovich, Eduardo Navas and Lawrence Lessig, who claim that we live in a \"Culture Remix\", an era that is based on cultural sampling, an activity that consists of the intelligent exchange between fragments of various media. We will analyze the emergence of laughter in this context, from re-appropriation of pre-existing materials in the network. Authors such as Henri Bergson and Michail Bakhtin provide us with conceptual support for investigating laughter as a dramatic and cultural resource in everyday life as well as on digital platforms that facilitated access to and recycling of \"media debris\" on the one hand, and , on the other, potentialized the possibilities of manipulation of these materials.
212

Ser surdo: o percurso (auto)biográfico das aprendizagens construídas na vida escolar e profissional / Being deaf: auto(biographical) trajectory of learnings acquired in the school and professional life

Alves, Roberto Antonio [UNESP] 08 December 2016 (has links)
Submitted by ROBERTO ANTONIO ALVES null (robert_alwes@hotmail.com) on 2017-02-10T15:47:12Z No. of bitstreams: 1 ROBERTO DISSERTAÇÃO 31-01-2017.pdf: 3754556 bytes, checksum: 14f847c3b8ea07249083a90a3bb1b78c (MD5) / Approved for entry into archive by LUIZA DE MENEZES ROMANETTO (luizamenezes@reitoria.unesp.br) on 2017-02-15T12:57:28Z (GMT) No. of bitstreams: 1 alves_ra_me_arafcl.pdf: 3754556 bytes, checksum: 14f847c3b8ea07249083a90a3bb1b78c (MD5) / Made available in DSpace on 2017-02-15T12:57:28Z (GMT). No. of bitstreams: 1 alves_ra_me_arafcl.pdf: 3754556 bytes, checksum: 14f847c3b8ea07249083a90a3bb1b78c (MD5) Previous issue date: 2016-12-08 / O presente estudo teve por objetivo resgatar minha própria história de formação pessoal, escolar e profissional do magistério, fazendo emergir as diferentes leituras das realidades vividas, em um processo em que a teoria e a prática se complementam e se fundem. Além disso, busquei apresentar reflexões no âmbito da história vivida pelo ser surdo em uma comunidade surda e o ser surdo em uma comunidade ouvinte; revelar as marcas influenciadoras do processo educativo e seu impacto no cotidiano escolar. Para alcançar estes objetivos, foi feita uma narrativa desde minha infância até a vida adulta, a perda de audição e as mudanças no rumo de minha vida. Há também relatos sobre experiências profissionais e acadêmicas. Este processo traz reflexões e questionamentos do percurso das aprendizagens construídas. Ao longo da pesquisa, percebi a importância do papel da Língua de Sinais e da língua oral, a condição de ser uma pessoa surda bilíngue e o reconhecimento da identidade surda, além de minha conscientização profissional, como arquiteto e professor. Esta pesquisa (auto)biográfica contribui diretamente para a minha formação e de outros surdos, bem como para aqueles profissionais que atuam nessa área. / The present study aims to bring past stories from my personal, scholar and professional teaching graduation experiences, bringing out the different observation from lived realities, in a process where theory and practice supplement and connect each other. This study also focuses to present reflections in a deaf’s life story within deaf and listening communities, besides revealing educative process influencing points and its impact in school routine. In order to reach those objectives, it was made a narrative since childhood up to adulthood, the hearing loss, and the changes during life. There are also reports from professional and academic experiences. This process brings reflections and questions about the built learning process. During the research, it is pointed the importance which reaches the sign and oral language role, the condition in being a bilingual deaf person and the recognition from deaf identity, professional awareness, as builder and teacher. This (auto)biographical research is to give a contribution to my degree and to other deaf people, as well to professionals which work in this area.
213

Dislipidemia em pacientes com dermatomiosite juvenil / Dyslipidemia in patients with juvenile dermatomyositis

Katia Tomie Kozu 04 September 2012 (has links)
OBJETIVO: Avaliar a presença de dislipidemia em pacientes com dermatomiosite juvenil (DMJ) e seus possíveis fatores de risco. MÉTODO: 25 pacientes com DMJ foram comparados a 25 controles de acordo com dados demográficos, composição corporal, perfil lipídico, glicêmico, autoanticorpos e enzimas musculares. Foram avaliados os instrumentos de atividade da DMJ: Disease Activity Score (DAS), Childhood Myositis Assessment Scale (CMAS), Manual Muscle Testing (MMT), Myositis Disease Activity Assessment Analogue Scale (MYOACT) e Myositis Intention to Treat Activity Index (MYTAX). RESULTADOS: Perfil lipídico alterado foi encontrado em nove pacientes e quatro controles (36% vs. 16%, p=0,196). Os pacientes com DMJ demonstraram níveis significativamente mais elevados de triglicérides (TG) [80 (31-340) vs. 61 (19-182) mg/dl, p=0,011] e maior freqüência de baixos níveis de lipoproteínas de alta densidade (HDL) (28% vs. 4%, p=0,04) quando comparados aos controles. A mediana dos níveis de HDL foi significativamente menor nos pacientes com DMJ com dislipidemia comparados aos DMJ com perfil lipídico normal [29 (0-49) vs. 50 (39-72) mg/dL, p=0,0005], enquanto os níveis TG [128 (31-340) vs. 69 (46- 138) mg/dL, p=0,011] foram significativamente mais elevados no primeiro grupo. Foi observada uma maior freqüência de baixos níveis de HDL (77% vs. 0%, p=0,001) e de níveis elevados de TG (44% vs. 0%, p=0,01) e de colesterol total (CT) (33 vs. 0%, p=0,03) no grupo de pacientes com DMJ com dislipidemia. O anticorpo anti-LPL foi positivo em apenas um paciente com perfil lipídico alterado. Pacientes com DMJ com dislipidemia apresentaram níveis significativamente mais elevados de velocidade de hemossedimentação (VHS) (26 vs. 14,5 mm/1a hora, p=0,006), proteína C reativa (PCR) (2,1 vs. 0,4 mg/dL, p=0,01), DAS (6 vs. 2, p=0,008), MYOACT (0,13 vs. 0,01, p=0,012) e MYTAX 0,06 vs. 0, p=0,018) e escores mais baixos de CMAS (47 vs. 52, p=0,024) e MMT (78 vs. 80, p=0,001) comparados aos pacientes com DMJ sem dislipidemia. Os níveis de TG apresentaram correlações positivas com PCR (r=0,697, p=0,001), DAS (r=0,610, p=0,001), MYOACT (r=0,661, p=0,001) e MYTAX (r=0,511, p=0,008) e correlações negativas com CMAS (r= - 0,506, p=0,009) e MMT (r= - 0,535, p=0,005). Nenhuma diferença entre estes grupos foi encontrada em relação ao IMC, composição corporal, presença de lipodistrofia, anticorpos anti-LPL e terapêutica (doses atuais e cumulativas de prednisona, metotrexato e cloroquina) (p>0,05), exceto pela frequência significativamente mais elevada do uso de ciclosporina nos pacientes com DMJ dislipidêmicos (33% vs. 0%, p=0,03). CONCLUSÃO: A dislipidemia em pacientes com DMJ se caracterizou por elevação de níveis séricos de TG e diminuição de HDL, sendo a atividade da doença e o uso da ciclosporina os principais fatores associados a esta alteração metabólica / OBJECTIVE: To evaluate the presence of dyslipidemia in JDM and its possible risk factors. METHODS: 25 JDM patients were compared to 25 healthy controls according to demographic data, body composition, fasting lipoproteins, glycemia, insulin, antibodies and muscle enzymes. The following JDM scores were assessed: Disease Activity Score (DAS), Childhood Myositis Assessment Scale (CMAS), Manual Muscle Testing (MMT), Myositis Disease Activity Assessment Analogue Scale (MYOACT) and Myositis Intention to Treat Activity Index (MYTAX). RESULTS: Abnormal lipid profile was found in nine patients (36%) and four controls (16%) (p=0.196). JDM patients demonstrated significant higher levels of triglycerides (TG) [80 (31- 340) vs. 61 (19-182) mg/dL, p=0.011] and higher frequency of abnormal levels of high density lipoproteins (HDL) (28 vs. 4%, p=0.04) when compared to controls. JDM patients with dyslipidemia demonstrated significant lower median HDL levels compared to those without this condition [29 (0-49) vs. 50 (39-72) mg/dL, p=0.0005] and also had significant higher TG levels [128 (31- 340) vs. 69 (46-138) mg/dL, p=0.011]. Higher frequency of low HDL levels (77% vs. 0%, p=0.0001), and also a higher frequency of increased levels of TG (44% vs. 0%, p=0.01), and TC (33% vs. 0%, p=0.03) were observed in JDM patients with dyslipidemia. Positive anti-LPL antibody was detected in just one JDM patient with abnormal lipid profile. JDM with dyslipidemia had higher ESR (26 vs 14.5mm/1sthour, p=0.006), CRP (2.1 vs 0.4mg/dL, p=0.006), DAS (6 vs. 2, p=0.008), MYOACT (0.13 vs. 0.01, p=0.012), MYTAX (0.06 vs. 0, p=0.018), and lower scores of CMAS (47 vs. 52, p=0.024) and MMT (78 vs. 80, p=0.001) compared to JDM without dyslipidemia. Positive correlations were detected between TG levels and CRP (r=0.697, p=0.001), DAS (r=0.610, p=0.001), MYOACT (r=0.661, p=0.001), MYTAX (r=0.511, p=0.008), and negative correlations with CMAS (r=-0.506, p=0.009) and MMT (r=-0.535, p=0.005). No differences were found between these groups regarding body mass index, body composition, lipodystrophy, anti-LPL antibodies, and treatment (current and cumulative doses of prednisone, methotrexate and hydroxichloroquine) (p>0.05), except by higher frequency of cyclosporine use in patients with dyslipidemia (33 vs. 0%, p=0.03). CONCLUSIONS: Dyslipidemia in JDM patients was characterized by increased levels of TG and low levels of HDL, and disease activity and cyclosporine use were the mainly factors associated to these metabolic abnormalities
214

Estudo estrutural e termodinâmico de sistemas auto-organizados: Micelas em solução / Strutural and thermodynamic studies of self-assembled systems: micelles in solution

Oseliero Filho, Pedro Leonidas 25 September 2013 (has links)
Neste trabalho realizou-se o estudo estrutural e termodinâmico de sistemas micelares em solução formados por surfactantes de diferentes classes, tais como SDS (aniônico), TTAB (catiônico), DM (não-iônico) e SB310 (zwiteriônico). A abordagem experimental proposta neste trabalho consiste do estudo simultâneo de aspectos estruturais e termodinâmicos. Para o estudo estrutural utilizou-se as técnicas de raios X à baixo ângulo (SAXS) e Condutimetria, e pelo ajuste dos dados experimentais pode-se determinar parâmetros como a anisotropia de forma, número de agregação, grau de ionização, bem como a concentração micelar crítica das micelas em solução. O comportamento da função de distribuição de pares de distância permitiu concluir que todas as micelas formam estruturas do tipo core-shell, porém diferem em tamanho dependendo da composição da micela. O buffer usado é possivelmente o responsável por causar a diminuição da concentração micelar crítica e aumento do grau de ionização (para surfactantes iônicos) quando comparados os valores obtidos neste trabalho com aqueles da literatura, que em geral usa água como solvente. Para o estudo termodinâmico utilizou-se a técnica de calorimetria de titulação isotérmica (ITC) e pelo ajuste dos dados experimentais pode-se determinar os valores de entalpia micelar e concentração micelar crítica. A combinação dos resultados obtidos das técnicas de ITC e Condutimetria permitiu calcular o valor energia livre de Gibbs e a entropia de micelização. A partir da determinação dos parâmetros descritos acima, pode-se caracterizar a estrutura e aspectos termodinâmicos de micelas em solução. A metodologia apresentada neste manuscrito consegue fornecer parâmetros independentes e ao mesmo tempo complementares, o que acaba permitindo um estudo correlacionado e confiável. / In this work was carried out the study of the structural and thermodynamic of micelar systems in solution formed by different classes of surfactants such as SDS (anionic) TTAB (cationic), DM (non-ionic) and SB310 (zwitterionic). The experimental approach proposed in this manuscript consists of the simultaneous study of structural and thermodynamic aspects. For structural studies it was utilized the techniques of Small Angle X ray Scattering (SAXS) and Conductometry, and by fitting the experimental data it was possible to evaluate parameters such as the anisotropy, aggregation number, degree of ionization, and the critical micelle concentration of the micelles in solution. From the analysis of the behavior of the pair distance distribution function we concluded that the micelles form \"core-shell\" structures, but differ in size depending on the composition of the micelle. The buffer used is possibly responsible for causing the decrease of critical micelle concentration and the increase of the degree of ionization (for ionic surfactants) when values obtained in this study are compared to those ones in the literature, which usually uses water as a solvent. For the thermodynamic study we have used the technique of Isothermal Titration Calorimetry (ITC) and by fitting the experimental data we could determine the enthalpy values and critical micelle concentration. The combination of the results of ITC and Conductometry techniques allowed us to evaluate the value of Gibbs free energy and entropy of micellization. From the determination of the parameters described above we could characterize the structure and thermodynamic aspects of the micelles in solution. The methodology presented in this work can provide independent and complementary parameters, which ends up allowing a correlated and reliable study.
215

Dislipidemia em pacientes com dermatomiosite juvenil / Dyslipidemia in patients with juvenile dermatomyositis

Kozu, Katia Tomie 04 September 2012 (has links)
OBJETIVO: Avaliar a presença de dislipidemia em pacientes com dermatomiosite juvenil (DMJ) e seus possíveis fatores de risco. MÉTODO: 25 pacientes com DMJ foram comparados a 25 controles de acordo com dados demográficos, composição corporal, perfil lipídico, glicêmico, autoanticorpos e enzimas musculares. Foram avaliados os instrumentos de atividade da DMJ: Disease Activity Score (DAS), Childhood Myositis Assessment Scale (CMAS), Manual Muscle Testing (MMT), Myositis Disease Activity Assessment Analogue Scale (MYOACT) e Myositis Intention to Treat Activity Index (MYTAX). RESULTADOS: Perfil lipídico alterado foi encontrado em nove pacientes e quatro controles (36% vs. 16%, p=0,196). Os pacientes com DMJ demonstraram níveis significativamente mais elevados de triglicérides (TG) [80 (31-340) vs. 61 (19-182) mg/dl, p=0,011] e maior freqüência de baixos níveis de lipoproteínas de alta densidade (HDL) (28% vs. 4%, p=0,04) quando comparados aos controles. A mediana dos níveis de HDL foi significativamente menor nos pacientes com DMJ com dislipidemia comparados aos DMJ com perfil lipídico normal [29 (0-49) vs. 50 (39-72) mg/dL, p=0,0005], enquanto os níveis TG [128 (31-340) vs. 69 (46- 138) mg/dL, p=0,011] foram significativamente mais elevados no primeiro grupo. Foi observada uma maior freqüência de baixos níveis de HDL (77% vs. 0%, p=0,001) e de níveis elevados de TG (44% vs. 0%, p=0,01) e de colesterol total (CT) (33 vs. 0%, p=0,03) no grupo de pacientes com DMJ com dislipidemia. O anticorpo anti-LPL foi positivo em apenas um paciente com perfil lipídico alterado. Pacientes com DMJ com dislipidemia apresentaram níveis significativamente mais elevados de velocidade de hemossedimentação (VHS) (26 vs. 14,5 mm/1a hora, p=0,006), proteína C reativa (PCR) (2,1 vs. 0,4 mg/dL, p=0,01), DAS (6 vs. 2, p=0,008), MYOACT (0,13 vs. 0,01, p=0,012) e MYTAX 0,06 vs. 0, p=0,018) e escores mais baixos de CMAS (47 vs. 52, p=0,024) e MMT (78 vs. 80, p=0,001) comparados aos pacientes com DMJ sem dislipidemia. Os níveis de TG apresentaram correlações positivas com PCR (r=0,697, p=0,001), DAS (r=0,610, p=0,001), MYOACT (r=0,661, p=0,001) e MYTAX (r=0,511, p=0,008) e correlações negativas com CMAS (r= - 0,506, p=0,009) e MMT (r= - 0,535, p=0,005). Nenhuma diferença entre estes grupos foi encontrada em relação ao IMC, composição corporal, presença de lipodistrofia, anticorpos anti-LPL e terapêutica (doses atuais e cumulativas de prednisona, metotrexato e cloroquina) (p>0,05), exceto pela frequência significativamente mais elevada do uso de ciclosporina nos pacientes com DMJ dislipidêmicos (33% vs. 0%, p=0,03). CONCLUSÃO: A dislipidemia em pacientes com DMJ se caracterizou por elevação de níveis séricos de TG e diminuição de HDL, sendo a atividade da doença e o uso da ciclosporina os principais fatores associados a esta alteração metabólica / OBJECTIVE: To evaluate the presence of dyslipidemia in JDM and its possible risk factors. METHODS: 25 JDM patients were compared to 25 healthy controls according to demographic data, body composition, fasting lipoproteins, glycemia, insulin, antibodies and muscle enzymes. The following JDM scores were assessed: Disease Activity Score (DAS), Childhood Myositis Assessment Scale (CMAS), Manual Muscle Testing (MMT), Myositis Disease Activity Assessment Analogue Scale (MYOACT) and Myositis Intention to Treat Activity Index (MYTAX). RESULTS: Abnormal lipid profile was found in nine patients (36%) and four controls (16%) (p=0.196). JDM patients demonstrated significant higher levels of triglycerides (TG) [80 (31- 340) vs. 61 (19-182) mg/dL, p=0.011] and higher frequency of abnormal levels of high density lipoproteins (HDL) (28 vs. 4%, p=0.04) when compared to controls. JDM patients with dyslipidemia demonstrated significant lower median HDL levels compared to those without this condition [29 (0-49) vs. 50 (39-72) mg/dL, p=0.0005] and also had significant higher TG levels [128 (31- 340) vs. 69 (46-138) mg/dL, p=0.011]. Higher frequency of low HDL levels (77% vs. 0%, p=0.0001), and also a higher frequency of increased levels of TG (44% vs. 0%, p=0.01), and TC (33% vs. 0%, p=0.03) were observed in JDM patients with dyslipidemia. Positive anti-LPL antibody was detected in just one JDM patient with abnormal lipid profile. JDM with dyslipidemia had higher ESR (26 vs 14.5mm/1sthour, p=0.006), CRP (2.1 vs 0.4mg/dL, p=0.006), DAS (6 vs. 2, p=0.008), MYOACT (0.13 vs. 0.01, p=0.012), MYTAX (0.06 vs. 0, p=0.018), and lower scores of CMAS (47 vs. 52, p=0.024) and MMT (78 vs. 80, p=0.001) compared to JDM without dyslipidemia. Positive correlations were detected between TG levels and CRP (r=0.697, p=0.001), DAS (r=0.610, p=0.001), MYOACT (r=0.661, p=0.001), MYTAX (r=0.511, p=0.008), and negative correlations with CMAS (r=-0.506, p=0.009) and MMT (r=-0.535, p=0.005). No differences were found between these groups regarding body mass index, body composition, lipodystrophy, anti-LPL antibodies, and treatment (current and cumulative doses of prednisone, methotrexate and hydroxichloroquine) (p>0.05), except by higher frequency of cyclosporine use in patients with dyslipidemia (33 vs. 0%, p=0.03). CONCLUSIONS: Dyslipidemia in JDM patients was characterized by increased levels of TG and low levels of HDL, and disease activity and cyclosporine use were the mainly factors associated to these metabolic abnormalities
216

Emilio Carballido: Invocando dos obras para una regeneración humana

Quackenbush, Claudia Linares 01 March 2017 (has links)
Emilio Carballido (1925-2008) es uno de los dramaturgos más destacados de México y de más prestigio del teatro occidental. Ha escrito una gran cantidad de obras teatrales, novelas, cuentos, obras infantiles y pedagógicas—dirigidas para docentes—, guiones teatrales y ha tanto formado como patrocinado una multitud de jóvenes dramaturgos en el país. Dos de sus primeras piezas, La zona intermedia: auto sacramental y La triple porfía, que datan de 1948, no han sido estudiadas con interés o en detalle por los críticos literarios, pese al prestigio con el que fueron recibidas en el momento de su presentación. L. Howard Quackenbush, uno de los pocos estudiosos sobre estos dos autos sacramentales, ha sostenido que son dos obras en una; la primera es el auto largo y la segunda es su loa, una es la continuación de la otra. Lo que se desarrolla en esta tesis es un análisis profundo de estos dos autos y su aplicación al género del auto, así como su aportación innovadora al mismo; se exponen la deshumanización de los personajes, así como la solución carballidesca para que los mismos recobren su humanismo o, al menos, trascienden a un nivel más allá de su desesperación existencialista. Se plantean las falacias socio-religiosas, así como las nuevas visiones—soluciones que aporta el autor y el impacto que transmite a su receptor, a través de la mirada cosmogónica del Nahual. Para fines del estudio de la tesis, emplearé fuentes como crítica literaria de L. Howard Quackenbush, Las razones del caos y Devotas irreverencias, diferentes estudios sobre existencialismo y Filosofía náhuatl, igualmente, me basaré de los estudios psicológicos de Sigmund Freud, Civilization and Its Discontents; por último, para estudios del Nahual, emplearé recopilaciones de relato oral que una profesora de la (UAT) México hizo, al igual que de algunos estudios históricos y literarios, básicamente. Se describen las aportaciones literarias, especialmente su aporte al teatro mexicano (y mundial) contemporáneo y culturales que proporcionan estas obras carballidescas para resaltar el porqué la crítica teatral debería darles más importancia, como muestra de la creatividad perenne de Carballido.
217

L'empowerment des patients atteints de maladie chronique : des processus multiples : auto-détermination, auto-efficacité, securite et coherence identitaire

Aujoulat, Isabelle 12 March 2007 (has links)
Un nombre croissant de professionnels qui pratiquent l'éducation thérapeutique du patient s'interrogent sur leurs pratiques et considèrent qu'une éducation qui vise seulement une meilleure compliance ou adhésion au traitement par la transmission d'informations en rapport avec la maladie et le traitement est inefficace et fortement réductrice de la personne malade. Ces professionnels considèrent que dans le cadre de la relation de soins, les patients doivent avoir une place pour exprimer leurs préférences et leurs réticences, ce qu'ils espèrent pour eux et ce qui est difficile pour eux dans leur vie de tous les jours, afin de participer au choix des modalités de leur traitement, qui acquiert alors un statut de traitement « proposé » et «négocié », plutôt que «prescrit» par le médecin. Une telle relation de soins, qui s'appuie sur un patient-sujet, s'inspire d'une philosophie humaniste qui affirme le droit à l'auto-détermination de chaque individu et qui reconnaît à chaque personne la capacité et le désir d'être l'acteur de sa vie. Dans une telle perspective, la finalité de l'éducation est de permettre aux patients d'exercer un meilleur contrôle sur leur vie, et pas seulement sur leur maladie et leur traitement. Il est courant d'utiliser le terme de « empowerment » pour désigner ce processus par lequel une personne malade, au départ d'une situation ou d'un sentiment d'impuissance (powerlessness), augmente sa capacité à identifier et satisfaire ses besoins, résoudre ses problèmes et mobiliser ses ressources, de manière à avoir le sentiment de contrôler sa propre vie. Afin de mieux comprendre dans quelle mesure les soignants peuvent effectivement contribuer à l'empowerment des patients atteints de maladie chronique, la signification de l'empowerment du patient a été explorée par une double approche : 1. exploration de la signification de l'empowerment en tant qu'expérience vécue par des patients atteints de maladie chronique : 40 entretiens qualitatifs semi-dirigés ; 12 maladies représentées ; méthodes d'analyse inspirées de la phénoménologie et de la théorisation ancrée (grounded theory). 2. exploration de la signification de l'empowerment en tant que concept utilisé à des fins de recherche ou de pratique : revue de littérature portant sur 55 articles scientifiques parus entre 1995 et 2006 ; analyse qualitative de contenu. Alors que les résultats de la revue de littérature présentent les finalités de l'empowerment comme étant essentiellement la capacité de participation dans la relation de soins et un sentiment de maîtrise quant à l'adoption et au maintien de comportements d'auto-soins, l'analyse des entretiens montre que les situations ou sentiments d'impuissance à partir desquels un processus d'empowerment est susceptible d'émerger dépassent largement ces questions. En effet, les personnes malades expriment souvent être ou avoir été confrontées à des sentiments d'insécurité et de rupture d'identité, qui ont été (ou non) à l'origine d'un processus de transformation personnelle, au cours duquel un effort de dissociation identitaire visant à développer ou maintenir un sentiment de maîtrise était accompagné d'un travail de réconciliation identitaire, marqué par la capacité de "lâcher prise" et une recherche de sens, visant à acquérir un plus grand sentiment de cohérence.
218

Populiarusis nežinomas žanras: žurnalistinė (auto) biografija / Popular unknown genre: jounalistic (auto) biography

Jeromina, Loreta 14 August 2012 (has links)
Paskutiniu metu Lietuvoje vis daugėja knygų apie šou verslo atstovus. Šių knygų žanrą gana sudėtinga apibrėžti: jis žanras artimas artimas autobiografijai, todėl tiriamojoje dalyje nagrinėjama autobiografijos istorija, svarbiausi jos bruožai ir jai artimi žanrai. Bandoma išsiaiškinti, kokiam žanrui galėtume priskirti knygas apie šou verslo atstovus, aiškinamasi, kokius autobiografijos bruožus jos atitinka, ir kokių – ne. Kitas svarbus klausimas – kas skatina pasakoti savo gyvenimo istoriją ir ar jos yra skaitomos. Darbe pateikta apklausa ir jos rezultatai, kodėl kyla noras pasakoti savo gyvenimo istoriją; apklausiamos žurnalistės apie šou verslo atstovų gyvenimo naujienų skaitomumą; aiškinamasi, kokie žurnalai skaitomiaisi, ir kokios televizijos laidos žiūrimiausios. Kadangi reklama vaidina labai svarbų vaidmenį žmogaus gyvenime, knygose apie šou verslo atstovus ieškoma reklamos užuominų, taip pat ieškoma reklamų internete, kurių reklaminis veidas – mūsų nagrinėjamų knygų personažai. Nagrinėjama, kokį poveikį produktų pardavimui gali turėti žinomo žmogaus kaip reklaminio veido panaudojimas. Visų nagrinėjamų knygų autiorius nurodytas žurnalistas, todėl svarbu išsiaiškinti, kaip žurnalistai pristato asmenį, kokį įvaizdį kuria. Tyrinėjama, kokios vertybės teigiamos šiose knygose. Pagrindinė darbo problema – populiariojo nežinomo žanro apibrėžimas, jo atsiradimo prielaidos bei pasekmės (skaitomumas, prigijimas, aiškinimas). / Recently there is a significant growing of books about show business representatives in Lithuania. It is difficult to define the book genre, it is close to an autobiography genre, that is why the history of autobiography, the most important features of the familiar genres are analyzed in the exploratory part. Attempting to figure out which genre can be assigned to the books about show business representatives, developing what the autobiography features they match and which do not. Another important question - what leads to tell the own story and whether they are read. The work presents the case study and its results, why there is a desire to tell a life story, interviews with journalists about the readability of show business life news, examines what readable magazines are and what TV shows are most viewed. As an advertising plays an important role in human life, looking for hints of advertising in the books about show business representatives, including search ads on the Internet when the advertising face - our characters. Examining the impact of sales may be known as the human face of an advertising recovery. The author of all the books is a journalist, so it is important to understand how journalists present a person, which imagine is created. Analyzing what the positive values of this book are. The main problem of the work - the popular genre definition, its origin and the consequences are unknown (readability, taken root, explanation).
219

Probabilidade do alarme falso no gráfico de controle EWMA para o monitoramento de processo autocorrelacionado / Probability of false alarm in the EWMA control graph for monitoring an autocorrelated process.

Rosa, Lidiane Maria Ferraz 24 July 2012 (has links)
Made available in DSpace on 2015-03-26T13:32:16Z (GMT). No. of bitstreams: 1 texto completo.pdf: 540189 bytes, checksum: 0753831535740967a377e10eb2b9b68d (MD5) Previous issue date: 2012-07-24 / This work aimed to estimate the probability of false alarm caused by the control graph of the exponentially weighted moving average (EWMA) in an autocorrelated process along rational subgroups, using different combinations of the values of the following terms: number of standard deviations (2 ≤ k ≤ 6), weight of the rational subgroup (0.01 ≤ λ ≤ 1) and first order correlation (ρ). To study these values, data of a random variable Y were simulated, under normal distribution with average μ0 = 0 and standard deviation σ0 = 1 for a statistically-controlled process of up to 50 rational subgroups , with individual observations (n = 1). To obtain the values of Y along the 50 rational subgroups, 10 different situations were performed, according to the following first order autocorrelations (ρ = 0; 0.1; 0.2; 0.3; 0.4; 0.5; 0.6; 0.7; 0.8; 0.9). A total of 1.000 simulations were carried out for each situation. A probability of false alarm (α) decreased with the respective increase of k and λ. On the other hand, this probability increassed with the increase of ρ. Thus, in case the response variable Y is monitored by the EWMA control graph under an autocorrelated process, it is necessary to increase the values of k and λ, as the autocorrelation increases in degree. This requires widening the control limits by adopting values of k above three, so that the false alarm probabilities may be found at low levels, such as values lower than 0.01. To confirm α equal or lower than 0.1, 0.05, or 0.01, according to the first order autocorrealation, different combinations of k and λ are recommended. For ρ ≤ 0.6, λ = 0.01 was recommended , combined with values of k aproximately equal to 2.5 (ρ = 0), 2.7 (ρ = 0.1), 3.0 (ρ = 0.2), 3.3 (ρ = 0.3), 3.7 (ρ = 0.4), 4.4 (ρ = 0.5) and 5.3 (ρ = 0.6).Under these situations, the effect of λ on the decrese of α was small. Thus, one could use any value up to the unit, without the need to change the magnitude of k too much. However, despite the fact that the decrease of λ leads to the increase of k in order to maintain the same false alarm probability, such decision to indicate λ = 0.01 was taken to search for a greater distancing from the Shewhart control graph, which is equal to EWMA for λ = 1. On the other hand, for 0.7 ≤ ρ ≤ 0.9, it was also necessary to increase the values of λ, together with that of k, to obtain a low false alarm probability. In such cases,the following recommendations approximate of λ, were established for k = 6: 0.5 (ρ = 0.7), 0.6 (ρ = 0.8) and 0.95 (ρ = 0.9). Such conclusions agree with those by Costa et al. (2004), who proposed widening the control limits, since autocorrealation provides an estimate of the random variability caused by the process. In this work, widening the control limits occurred due to the imposition of k values higher than three during the design of the EWMA control graph. / O presente trabalho teve por objetivo estimar a probabilidade do alarme falso provocada pelo gráfico de controle da média móvel ponderada exponencialmente (EWMA) em um processo autocorrelacionado ao longo dos subgrupos racionais, em função de diferentes combinações entre os valores dos termos: número de desvios-padrão (2 ≤ k ≤ 6), peso do subgrupo racional (0,01 ≤ λ ≤ 1) e autocorrelação de 1a ordem (ρ). Para estudá-los, foram simulados dados de uma variável aleatória Y, sob distribuição normal com média μ0 = 0 e desvio-padrão σ0 = 1 para um processo sob controle estatístico para até 50 subgrupos racionais com observações individuais (n = 1). Para a obtenção dos valores de Y ao longo dos 50 subgrupos racionais, foram realizadas dez situações diferentes de acordo com as seguintes autocorrelações de 1a ordem (ρ = 0; 0,1; 0,2; 0,3; 0,4; 0,5; 0,6; 0,7; 0,8; 0,9). Foram realizadas 1.000 simulações para cada situação. A probabilidade do alarme falso (α) diminuiu com os respectivos aumentos de k e λ. Por outro lado, essa probabilidade aumentou de acordo com o aumento de ρ. Portanto, caso a variável resposta Y seja monitorada pelo gráfico de controle EWMA em um processo autocorrelacionado, torna-se necessário aumentar os valores de k e de λ, à medida que a autocorrelação aumentar de grau. Isso implica em alargar os limites de controle, em função da adoção de valores de k acima de três, para que as probabilidades dos alarmes falsos possam se situar em níveis baixos, como, por exemplo, para valores menores do que 0,01. Para conferir α igual ou inferior a 0,1, 0,05 ou 0,01, de acordo com a autocorrelação de 1a ordem, recomendaram-se diferentes combinações de k e λ. Para ρ ≤ 0,6, recomendou-se λ = 0,01 combinado com valores de k aproximadamente iguais a 2,5 (ρ = 0), 2,7 (ρ = 0,1), 3,0 (ρ = 0,2), 3,3 (ρ = 0,3), 3,7 (ρ = 0,4), 4,4 (ρ = 0,5) e 5,3 (ρ = 0,6). Nessas situações, o efeito do λ sobre a diminuição do α foi pequena. Portanto, poderia se trabalhar com quaisquer valores até a unidade, sem haver a necessidade de mudar muito a magnitude do k. Porém, apesar da diminuição do λ implicar no aumento do k para manter a mesma probabilidade do alarme falso, tal decisão de indicar λ = 0,01 ocorreu pelo fato de buscar um maior distanciamento do gráfico de controle de Shewhart, que é igual ao EWMA para λ = 1. No entanto, para 0,7 ≤ ρ ≤ 0,9, foi necessário aumentar também o valor de λ, juntamente com o de k, para que a probabilidade do alarme falso fosse baixa. Nestes casos, foram estabelecidas as seguintes recomendações aproximadas de λ, para k = 6: 0,5 (ρ = 0,7), 0,6 (ρ = 0,8) e 0,95 (ρ = 0,9). Tais conclusões vão de encontro às de Costa et al. (2004) que propuseram o alargamento dos limites de controle, dado que a autocorrelação propicia uma estimativa da variabilidade aleatória provocada pelo processo. Neste trabalho, o alargamento do limite de controle ocorreu devido à imposição de valores de k maiores do que três durante a construção do gráfico de controle EWMA.
220

Les auto-anticorps, marqueurs immunologiques de l’hétérogénéité de la sclérodermie systémique / Auto-antibodies in systemic sclerosis, immunological markers of heterogeneity

Sobanski, Vincent 20 September 2017 (has links)
La sclérodermie systémique (ScS) est une connectivite associant atteinte vasculaire, auto-immunité et fibrose. Cette pathologie est associée à une morbi-mortalité importante, et les ressources thérapeutiques sont limitées. La physiopathologie de la ScS n’est que partiellement connue, mais il apparait que les liens entre le système immunitaire et la fibrose sont étroits. Ainsi, la ScS peut être considérée comme un modèle prototypique d’étude des liens immunité-fibrose. Il s’agit d’une maladie hétérogène, c’est-à-dire que les phénotypes cliniques présentés par les patients sont variables, rendant complexe l’établissement d’une classification des patients en groupes homogènes. Mieux comprendre cette hétérogénéité est un préalable indispensable à la constitution d’endotypes, permettant l’étude des mécanismes physiopathologiques propres à chacun d’entre eux.L’objectif de cette Thèse a été de mieux appréhender cette hétérogénéité clinique et d’étudier la place des marqueurs immunologiques, en particulier les auto-anticorps, en tant que biomarqueurs de cette hétérogénéité.Le premier travail a été une classification sans a priori des patients de la cohorte européenne EUSTAR (European Scleroderma Trials and Research Group) par une analyse en cluster sur 24 variables sélectionnées (atteintes cliniques, auto-anticorps). Deux puis 6 groupes de patients homogènes ont été obtenus, dont la survie était significativement différente. Ce travail a suggéré qu’il existait des groupes homogènes de patients au-delà de la dichotomie historique forme cutanée diffuse vs. limitée. La présence d’atteintes viscérales et le statut des auto-anticorps apparaissent comme des éléments importants dans la constitution des groupes.Le deuxième travail s’est intéressé au dosage des chaines légères libres sériques (serum free light chain : SFLC) dans la ScS. Le taux de SFLC est plus élevé chez les patients ScS que chez les contrôles et est associé à des paramètres de gravité de la maladie tels que le score de Rodnan, les scores d’activité, les pressions pulmonaires et la DLCO. Cette étude apporte des arguments supplémentaires pour évoquer la participation active des lymphocytes B à la physiopathologie de la ScS.Nous avons ensuite réalisé une estimation de la prévalence des anticorps anti-ARN polymérase de type III dans notre cohorte de patients avec ScS avant d’inclure ces données dans une revue systématique avec méta-analyse. Ce travail a montré que la prévalence de ces anticorps était hétérogène entre les centres. Les facteurs potentiels pouvant expliquer une partie de cette hétérogénéité sont des facteurs géographiques, suggérant l’implication de facteurs génétiques et/ou environnementaux.Le dernier travail a été dédié à l’hypertension artérielle pulmonaire (HTAP) des connectivites, en particulier de la ScS. A partir d’une cohorte de patients provenant du centre de référence de l’HTAP du Royaume-Uni, les anticorps anti-U1RNP ont été analysés en tant que marqueur pronostique. Ces anticorps sont associés de façon significative à une meilleure survie des patients avec connectivite et HTAP. Dans la ScS, on observe une tendance vers une meilleure survie également chez les patients porteurs de ces anticorps.Les auto-anticorps constituent donc des biomarqueurs diagnostiques et pronostiques puissants dans la ScS. Ils permettent de mieux cerner l’hétérogénéité de cette pathologie, et devraient probablement être intégrés dans les futures classifications. Leur rôle pathogénique reste encore à démontrer. Les perspectives de notre travail sont d’identifier de nouveaux auto-anticorps et d’étudier leurs effets sur le fibroblaste, cellule effectrice centrale de la fibrose. / Systemic sclerosis (SSc) is a connective tissue disease (CTD) characterized by vasculopathy, auto-immunity and fibrosis. This condition is associated with a significant morbi-mortality, and the therapeutic armamentarium is limited. The pathological mechanisms of SSc are partially known, but the links between the immune system and fibrosis appear tight. ScS can be considered as a prototypical model for the study of the links between immunity and fibrosis. There is a high heterogeneity in SSc. The clinical phenotypes of patients are highly variable, making the classification of patients into homogeneous groups complex. A better understanding of this heterogeneity could lead to the identification of endotypes, which are needed to study the pathophysiological processes of each group.This PhD Thesis aimed to better decipher this clinical heterogeneity and to assess the immunological components, in particular auto-antibodies, as biomarkers of heterogeneity.The first work was a without any a priori cluster analysis in the EUSTAR (European Scleroderma Trials and Research Group) cohort using 24 selected variables (encompassing clinical involvement and auto-antibodies). Two then 6 homogeneous clusters were obtained, with significantly different survival curves. We suggested that there could be homogeneous groups of patients beyond the classical dichotomy diffuse cutaneous form vs. limited. Organ involvement as well as antibody status were suggested to play a major role in defining homogeneous groups of patients with different prognosis.Our second work assessed the value of serum free light chain (SFLC) in SSc. The SFLC level was higher in SSc patients than in controls and was associated with severity parameters, such as Rodnan skin score, disease activity score, pulmonary pressures and DLCO. This study suggested that B cells could play an active role in the mechanisms of SSc.Then we estimated the prevalence of anti-RNA polymerase III antibodies in SSc in our cohort of patients followed by a systematic review with meta-analysis. We showed that the prevalence was highly heterogeneous between centers. Potential factors explaining partly the observed heterogeneity were geographical factors, which underscore the probable implication that genetic background and environmental factors play a role.Finally we focused on CTD-associated pulmonary arterial hypertension (PAH) in a large cohort of patients from the United Kingdom national reference center for PAH. We assessed whether anti-U1 RNP antibodies could be a prognostic factor in CTD-associated PAH with a focus on SSc- associated PAH. Anti-U1RNP antibodies were significantly associated with a decreased mortality in CTD-PAH patients. There was a trend towards a decreased mortality in SSc-PAH patients with anti-U1RNP antibodies.Auto-antibodies are strong biomarkers of diagnosis and prognosis in SSc. They allow to partly capture the clinical heterogeneity of this condition, and should be integrated in the future classifications of patients. Their pathogenic role remains to be shown. We plan to identify new auto-antibodies in SSc and to study their direct effects on the fibroblast, which is the key effector cell of fibrosis.

Page generated in 2.4227 seconds