Cooking is mind, body, spirit work. What’s possible when we ‘drop in’ to our bodies when cooking? We begin noticing what we are energetically bringing to the food we make. This creative project practices a pedagogy that works with food to create healing space. Healing, as it is defined here, is not void of discomfort nor is it happiness all the time. Who haunts your domestic space? Who is at your back when you cook? This project finds information and sacred knowledge in the food we cook and eat; it reflects back to us deeply buried truths regarding our traumas, joys, and subjectivity. This pedagogy holds the potential for participants to bring “new meanings” to food, and thereby, be activated as cultural producers cooking up the next chapter in our peoples’ creation stories (Anzaldúa 103). This project is documented as an auto-ethnographic tale from the perspective of the practitioner, using erotic storytelling to keep fire in the pages and a methodology of refusal to “determine the length of the [academy’s] gaze” (Tuck and Ree 640).

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Il existe peu d’études qui ont exploré différentes approches pédagogiques traitant de la simulation notamment dans un contexte de formation collégiale en soins infirmiers et ce, malgré leur implantation grandissante dans ces programmes de formation. Aucun instrument de mesure au sujet de l’auto-efficacité provenant de la théorie développée par Bandura (1977 a ou b, 1986) dans ce contexte n’a été identifié. But : Explorer l’ajout de la simulation haute-fidélité (SHF) à l’examen clinique objectif structuré (ECOS) sur l’auto-efficacité, l’anxiété et la performance en situation d’apprentissage d’étudiantes de niveau collégial en soins infirmiers. Afin d’atteindre ce but, cinq objectifs ont été proposés, répartis en trois phases. Méthodes : Un comité d’experts a participé au développement du questionnaire traitant de l’auto-efficacité perçue suivi d’une validation auprès d’étudiantes en soins infirmiers et d’une analyse factorielle exploratoire (n=221). Par la suite, une étude pilote a été réalisée auprès d’étudiantes en soins infirmiers (n=20) réparties dans un groupe expérimental (ECOS suivi de SHF) et un groupe témoin (ECOS seulement). Deux questionnaires autoadministrés et une grille d’observation ont été utilisés en pré et post-test pour toutes les participantes des deux groupes, suivis d’entretiens individuels semi-dirigés auprès de volontaires (n=19). Enfin, des entretiens individuels semi-dirigés ont été réalisés auprès de candidates à l’exercice de la profession infirmière (n=14) en complément aux données recueillies lors de l’étude pilote. Résultats : Cette étude a permis de créer un nouvel instrument de mesure en langue française. Les résultats quantitatifs collectés lors de l’étude pilote permettent de constater que les deux groupes se comportent de la même façon soit par une diminution significative de l’anxiété après simulation ainsi qu’une performance moyenne de 7/10. Celle-ci étant supérieure après la réalisation d’ECOS seulement, comparativement aux ECOS suivi de la SHF. Ces résultats appuient les propos recueillis des participantes suggérant ainsi d’utiliser les deux types de simulations en complémentarité. Forces et limites : Cette étude utilise des instruments de mesure validés avec de bonnes qualités métrologiques (α > 0,80). Les limites sont principalement liées aux difficultés de recrutement. Conclusions : Cette étude contribue à une meilleure connaissance de la valeur ajoutée d’une deuxième approche pédagogique par simulation sur l’auto-efficacité, l’anxiété et la performance d’étudiantes de niveau collégial en soins infirmiers. Cette connaissance pourrait permettre de mieux préparer les futures infirmières au niveau de la pratique clinique et de favoriser la recherche dans ce domaine encore peu exploré.

Objetivos: Determinar las medidas de autocuidado que tienen los pacientes que asisten a la ESN-PCT del Centro de Salud Conde de la Vega Baja. Material y método: El presente estudio es de enfoque cuantitativo, tipo descriptivo, de corte transversal, nivel aplicativo. Población: La población de estudio estuvo conformada por 30 pacientes con diagnóstico de tuberculosis que reciben el tratamiento de Esquema I y 10 pacientes en tratamiento Multidrogoresistente (MDR) que asisten al Centro de Salud Conde de la Vega Baja. Técnica e instrumento: La técnica fue la entrevista, y el instrumento un cuestionario. Resultados: Los resultados fueron que 25 pacientes (62.5%) realiza medidas de autocuidado adecuadas y 15 pacientes (37.5%) tiene medidas de autocuidado inadecuadas. Respecto a la alimentación, 14 pacientes (35%) consume 5 comidas durante el día; 9 pacientes (22.5%) ingiere una alimentación balanceada; 7 pacientes (17.5%) toma 5-7 vasos de agua diario; 33 pacientes (82.5%) come las principales comidas en el hogar. En relación al descanso y sueño, 28 pacientes (70 %) duerme de 6 a 8 horas diarias; en cuanto a medidas higiénicas, 28 pacientes (70%) se baña diario; 18 pacientes (45%) tiene habitación privada; 34 pacientes (85%) tiene ventilación e iluminación en el hogar; 26 pacientes (65%) refiere tener ventanas en el dormitorio; 10 pacientes (25%) tiene el habito de lavado de manos; 19 pacientes (47.5%) usa papel desechable cubriéndose la boca y nariz. En cuanto a la práctica de hábitos nocivos 15 pacientes (37.5%) toma alcohol; 9 pacientes (22.5%) consume cigarrillos; y 3 pacientes (7.5%) consume drogas; 11 pacientes (27.5%) asiste a reuniones sociales, fiestas; Respecto a control y tratamiento de la enfermedad, 34 pacientes (85%) asiste al tratamiento; 24 pacientes (60%) refiere que acude a la consulta con el médico; Respecto a ejercicio y recreación, 29 pacientes (72.5%) ve televisión; 13 pacientes (32.5%) practica ejercicios; 11 pacientes (27.5%) sale con su familia; 9 pacientes (22.5%) acudeal internet. Respecto a cuidado emocional, social y espiritual; 32 pacientes (80%) cuenta con una red social, 3 pacientes (7.5%) siente rechazo de las personas; 13 pacientes (32.5%) asiste a la iglesia, 17 pacientes (42.5%) busca la armonía con Dios y su ser. Conclusiones: La mayoría de los pacientes con tuberculosis realiza medidas de autocuidado adecuadas respecto a descanso y sueño, control y tratamiento de la enfermedad, hábitos nocivos, cuidado emocional, social, sin embargo un porcentaje significativo tiene medidas de autocuidado inadecuadas respecto a alimentación, medidas higiénicas, ejercicio y recreación, cuidado espiritual. -- PALABRAS CLAVES: MEDIDAS DE AUTOCUIDADO, PACIENTES CON TUBERCULOSIS EN LA ESN-PCT / -- Objectives: To determine the measures of self-care that patients have attending ESN-PCT Health Center Count of Vega Baja. Materials and Methods: This study is a quantitative approach, descriptive, cross-sectional, application level. Population: The study population consisted of 30 patients diagnosed with tuberculosis who are treated Scheme I and 10 patients treated Multidrogoresistente (MDR) attending the Health Centre Count of Vega Baja. . Technical and instrument: The technique was the interview, and a questionnaire instrument. Results: The results were that 25 patients (62.5%) perform appropriate self-care measures and 15 patients (37.5%) have inadequate self-care measures.With regard to food, 14 patients (35%) consume 5 meals throughout the day, 9 patients (22.5%) eat a balanced diet, 7 patients (17.5%) takes 5-7 glasses of water daily, 33 patients (82.5%) eating the main meal at home.In relation to rest and sleep, 28 patients (70%) sleep of 6-8 hours per day, in terms of hygiene, 28 patients (70%) bathes daily, 18 patients (45%) have private room, 34 patients (85%) have ventilation and lighting in the home, 26 patients (65%) reports having windows in the bedroom and 10 (25%) have the habit of washing hands, 19 patients (47.5%) use disposable paper covering his mouth and nose. As for the practice of harmful habits 15 patients (37.5%) drink alcohol, 9 patients (22.5%) consumed cigarettes, and 3 patients (7.5%) using drugs, 11 patients (27.5%) attending social gatherings, parties, respect to control and treatment of disease, 34 patients (85%) attending treatment, 24 patients (60%) states that goes to the consultation with the doctor; As for exercise and recreation, 29 patients (72.5%) watch television and 13 patients (32.5%) practice exercises, 11 patients (27.5%) out with his family, 9 patients (22.5%) goes to the internet. Regarding emotional care, social and spiritual, 32 patients (80%) have a social network, 3 patients (7.5%) people feel rejection and 13 patients (32.5%) attend church, 17 patients (42.5%) seeks harmony with God and being.Conclusions: Most patients with tuberculosis takes appropriate self-care measures regarding rest and sleep, control and treatment of disease, bad habits, emotional care, social, however a significant percentage have inadequate selfcare measures regarding food, measures hygiene, exercise and recreation, spiritual care. -- KEYWORDS: MEASURES OF SELF, TUBERCULOSIS IN PATIENTS WITH ESN-PCT

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

Les lymphocytes T (LT) sont des cellules essentielles du système immunitaire. Elles expriment à leur surface un récepteur, le TCR, qui a la capacité de reconnaître des peptides issus de la dégradation de protéines provenant d'agent infectieux associés aux molécules du complexe majeur d'histocompatibilité. Cette reconnaissance conduit à l'activation de signaux intracellulaires dans les LT propagés grâce à la coordination fine de molécules de signalisations cytosoliques ou membranaires qui agissent de concert pour entraîner des réponses cellulaires adaptées au type d'agent infectieux et permettre le développement d'une réponse immunitaire efficace. Au cours de ce travail de thèse, j'ai étudié deux protéines impliquées dans ces processus, CD5 et Themis1. Les protéines CD5 sont des co-récepteurs des LT capables d'inhiber la signalisation transmise par les TCR. Ils contribuent à réguler le répertoire des TCR en modulant finement les processus de sélection dans le thymus. Le rôle de ces co-récepteurs dans les LT périphériques et les mécanismes moléculaires par lesquels ils opèrent restent mal compris. Pour essayer d'élucider ces mécanismes, j'ai analysé l'interactome de CD5 dans les LT par spectrométrie de masse. J'ai montré que l'engagement des TCR entraîne le recrutement par CD5 d'un complexe moléculaire formé des protéines c-Cbl, Sts-2, SHIP, CIN85, CrkL et Pi3K. L'analyse de l'interactome de CD5 dans les LT c-cbl-/- suggère que c-CBL agit comme une protéine adaptatrice au sein de ce complexe qui relie CD5 aux autres protéines de signalisation. J'ai montré qu'une tyrosine, localisée en position 429 sur la région intracytoplasmique de CD5, était nécessaire à la formation de ce signalosome. L'analyse de la signalisation des TCR dans les LT provenant de souris contenant une mutation invalidante de la tyrosine 429 montre que ce complexe moléculaire régule négativement la phosphorylation de protéines telles que ZAP-70, SLP-76 et ERK et diminue la capacité des lymphocytes T à proliférer en réponse à l'engagement des TCR. CD5 réprime parallèlement l'activité des protéines Foxo1 en facilitant l'activation d'Akt et diminue ainsi la différentiation des LT naïfs en LT régulateurs (Treg) dans les organes lymphoïdes périphériques. Nos résultats suggèrent que CD5 pourrait faciliter le développement de réponses immunitaires efficaces en bloquant la différentiation de Treg dirigés contre des antigènes étrangers. La protéine Themis1 a été découverte récemment et joue un rôle essentiel dans le développement des LT en inhibant l'activité catalytique des tyrosines phosphatases SHP-1 et SHP-2. Les fonctions moléculaires et cellulaires régulées par Themis1 dans les LT périphériques sont inconnues. Au cours de ma thèse, j'ai étudié un nouveau modèle murin sélectivement déficient pour Themis1 dans les LT périphériques après leur développement dans le thymus. Des analyses in vitro montrent que Themis1 augmente les seuils de signalisation des TCR nécessaire pour activer les LT et réprime sélectivement la production d'IFNƴ dans des cellules polarisées Th1. In vivo, l'expression de Themis1 augmente la susceptibilité au développement d'Encephalomyélite Autoimmune Expérimental (EAE), un modèle murin de sclérose en plaques. Des résultats préliminaires obtenus dans ce modèle suggèrent de façon inattendue que Themis1 favorise la différentiation des LT encephalitogènes producteurs d'IFNƴet de GM-CSF. Themis1 pourrait agir in vivo en réprimant l'activité des co-récepteurs inhibiteurs tels que PD-1 et CTLA-4 qui recrutent des phosphatases à domaines SH2. / T-cells play a key role in immune responses. Each T-cell expresses a unique TCR (T-cell receptor) which specifically recognises a microbial-derived antigen presented by MHC molecules (major histocompatibility complex) on the surfaces of host cells. This interaction leads to the activation of T-cells via highly regulated intracellular signalling pathways using numerous membrane-bound and cytoplasmic proteins. These complex signals are responsible for the development of a customised immune response specifically directed against the invading pathogen. This thesis examines the role of two proteins involved in TCR signalling, CD5 and Themis1. CD5 proteins are TCR-associated co-receptors which exhibit inhibitory activity on TCR signalling. They modulate the variability of the TCR repertoire by finely regulating positive and negative selection in the thymus. However, their role in peripheral T-cells and the underlying molecular mechanisms by which they act is poorly understood. To answer this question, the CD5 interactome in peripheral T-cells was determined by mass spectrometry. Analysis of the interactome shows that, upon TCR engagement, CD5 recruits several proteins in a molecular complex referred to hereafter as "CD5 signalosome", namely: c-Cbl, Sts-2, SHIP, CIN85, CrkL and Pi3K. The same interactome analysis in c-Cbl deficient T-cells proves that c-Cbl acts as an adaptor necessary for the interaction between CD5 and the other proteins of the CD5 signalosome. These data have also demonstrated the necessity of a specific tyrosine for signalosome recruitment, located in position 429 within the intracytoplasmic domain of CD5. Analysis of TCR signalling in T-cells harbouring an invalidating Tyr429 mutation reveals that the CD5 signalosome downregulates phosphorylation of key proteins such as ZAP-70, ERK1/2 and SLP-76 and decreases T-cell auto-amplification upon stimulation. In parallel, CD5 also inhibits activity of Foxo1 protein by facilitating Akt recruitment, thereby reducing regulatory T-cell (Treg) generation in secondary lymphoid organs. Altogether, our data suggest that the CD5 co-receptor could promote a specifically adapted immune response against exogenous antigens by limitation of Treg differentiation. In 2009, our team identified a previously unknown signalling protein called Themis1 (THymocyte-Express Molecule Important for Selection) that is essential for T-cell development. The role of Themis1 has been extensively studied in thymocytes and recent data show that Themis enhances TCR signalling by selective inhibition of SHP-1 and SPH-2 phosphatases in these cells. However, its role in peripheral T-cells remains elusive. To study the post-thymic role of Themis1, we generated a new mouse model selectively deficient for Themis1 in peripheral T-cells but not in thymocytes. My in vitro analyses show that Themis1 enhances the TCR signalling threshold necessary to activate T-cells and selectively represses IFNƴ production in Th1 polarised T-cells. In vivo, Themis1 expression increases susceptibility to experimental autoimmune encephalomyelitis (EAE, multiple Sclerosis mouse model). Surprisingly, preliminary results obtained in the same mouse model also suggest that Themis1 enhances differentiation of encephalitogenic T-cells producing IFNƴ and GM-CSF. We therefore hypothesise that Themis1 could act in vivo by repressing the activity of co-inhibitory receptors such as PD-1 or CTLA-4 by recruiting SH2 domain-containing phosphatases.

Orientadora: Maria Eunice Quilici Gonzalez / Banca: Mariana Cláudia Broens / Banca: Ivo Assad Ibri / Resumo: O objetivo deste trabalho é analisar o problema da identidade pessoal em uma perspectiva filosófico-interdisciplinar. O problema da identidade pessoal consiste na dificuldade de se estabelecer critérios que possibilitem (ou não) a identificação de características constantes de um indivíduo, como sendo o mesmo, apesar das inúmeras mudanças a que é suscetível ao longo da vida. Analisaremos o problema da identidade pessoal empregando recursos da filosofia da mente, da Teoria dos Sistemas Complexos (TSC) e da filosofia da informação, os quais sustentam o eixo interdisciplinar de nossa pesquisa. Na perspectiva da TSC, ênfase é dada ao modo pelo qual as partes de um sistema interagem entre si em diferentes escalas. Os conceitos de auto-organização, emergência e de complexidade, centrais à TSC, servirão como recursos de investigação do problema da identidade pessoal. Analisaremos, como um estudo de caso, possíveis implicações de modificações corporais concebidas pelos defensores do projeto transhumanista de aprimoramento humano radical. Com a análise dos pressupostos filosóficos subjacentes ao projeto transhumanista, pretendemos ilustrar aspectos da pesquisa filosófico-interdisciplinar na investigação do problema da identidade pessoal. / Abstract: The aim of this work is to investigate the problem of personal identity from a philosophicalinterdisciplinary perspective. The problem of personal identity concerns the difficulty of establishing criteria that allows (or not) the identification of constant characteristics of an individual that remains the same despite the many changes that occur throughout his/her life. We will address this problem by employing resources available from the areas of Philosophy of Mind, Complex Systems Theory (CST), and Philosophy of Information (this emphasizes the interdisciplinary nature of the proposed research). From the perspective of CST, emphasis is given to the ways in which different parts of a system interact with each other at various levels. The concepts of self-organization, emergence, and complexity, which are central to CST, can be of assistance in the investigation the problem of personal identity. We will analyze, as a case study, possible implications of bodily modifications conceived by proponents of the transhumanist project of radical human enhancement.Using an analysis of the philosophical criteria on which the transhumanist project is founded, we intend to illustrate ways in which aspects of philosophical and interdisciplinary research can be used to investigate the problem of personal identity / Mestre

Multiple sclerosis (MS) is an inflammatory disease that affects the central nervous system and is considered to be a T-cell mediated autoimmune disease. The “ideal” method in treating MS would be an antigen-specific therapy that does not require generalized immunosuppression. To date there are no definitive treatments for MS but there are several licensed therapies such as -interferon. Unfortunately the effect of interferon (IFN) is reduced by the development of neutralizing antibodies (NAbs) in up to 35% of MS patients within two years of starting treatment. An immunization schedule was developed in the BALB/c mice by subcutaneous administration of recombinant human IFN, and this resulted in development of high incidence of NAbs to the protein in the BALB/c model termed “NAbs model”. The mechanism of NAbs formation in this model is believed to be similar to that observed in IFN-treated MS patients with NAbs, which is as a result of an immune response to the protein. We elected to study NAbs in the context of IFN rather than MS directly to investigate the effects of antigen-specific tolerization strategies on the outcome of NAbs and indirectly on the outcome of IFN treatment in MS disease. The depletion of the immune cells triggers a reconstitution program that leads to renewal of the immune cell repertoire. Tolerance can be induced by intravenous administration of a protein. Within this window of reconstitution following depletion, it is hoped that the immune system can be manipulated to tolerate an otherwise foreign protein (human recombinant IFN). The tolerance strategy employed in this project was immune cell depletion using antibodies and mitoxantrone, followed by intravenous re-introduction of rhIFN. Tolerance was successfully induced in the NAbs model by intravenous administration of rhIFN, and further enhanced by immune cell depletion prior to intravenous administration of rhIFN. The BALB/c “NAbs model” offers a suitable model for use in investigating induction of tolerance to rhIFN following the formation of NAbs to the protein. The antigen of interest is known and the time to NAbs formation is also known. Tolerance induction can be monitored and investigated in this model.

Submitted by Gisely Teixeira (gisely.teixeira@uniceub.br) on 2018-06-16T14:26:19Z No. of bitstreams: 1 51500375.pdf: 389001 bytes, checksum: 3bb432e9df600aff3a3821d4f6f4a3bc (MD5) / Made available in DSpace on 2018-06-16T14:26:19Z (GMT). No. of bitstreams: 1 51500375.pdf: 389001 bytes, checksum: 3bb432e9df600aff3a3821d4f6f4a3bc (MD5) Previous issue date: 2018 / Um novo sistema construtivo surgiu na Dinamarca e tem ganhado o mercado mundial, trata-se do sistema de lajes tipo BubbleDeck. O sistema é composto pela adição de esferas plásticas em lajes de concreto armado, uniformemente espaçadas entre telas de aço. Por haver a necessidade de preencher os vazios entre as esferas, requer-se que o concreto tenha certo nível de fluidez e que o diâmetro de seu agregado seja controlado, sem que haja o comprometimento de sua resistência e da qualidade do sistema. Seguindo a tendência mundial, muitas obras no Brasil vêm utilizando essa tecnologia e, por se tratar de um sistema relativamente novo, precisa-se da validação de suas características. O presente trabalho tem por objetivo a análise das características do concreto utilizado na execução das lajes tipo BubbleDeck da obra do Centro Administrativo do Distrito Federal – CADF. Busca-se avaliar a trabalhabilidade do concreto, a fim de verificar a importância dos materiais utilizados para a viabilidade desse sistema. Além disso, serão avaliadas também as resistências nas primeiras idades e com 28 dias, bem como o módulo de elasticidade atingido.