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Resumo: Este projeto visa à análise cinemática de um arranjo experimental capaz de reproduzir o fluxo sanguíneo em artérias. O mecanismo procura realizar esse escoamento através de um sistema came-seguidor juntamente com um sistema hidráulico, utilizando êmbolo e duas válvulas controladoras de fluxo. O mecanismo came-seguidor será utilizado devido a sua versatilidade em garantir que o escoamento sanguíneo ocorra durante um ciclo cardíaco. A came será radial com seguidores de roletes. O seguidor de roletes será ligado ao cilindro hidráulico que controla o fluxo sanguíneo. Um tubo de látex foi acoplado ao sistema hidráulico representando a aorta abdominal, foi confeccionado com as dimensões reais desta artéria e o látex foi escolhido, pois possui um coeficiente de elasticidade muito próximo da artéria. Um manômetro foi acoplado ao sistema para medir a pressão no interior do tubo de látex. Na sequência um tubo de complacência simular as perdas de carga do sistema circulatório. O deslocamento radial do tubo de látex e variação de pressão do manômetro foram monitorados através de filmagem. Posteriormente, os resultados experimentais foram comparados e validados com os resultados numéricos obtidos com o programa ANSYS e com a literatura / Abstract: This project aims to kinematic analysis of an experimental apparatus able to reproduce the blood flow in arteries. The mechanism cam-follower and the hydraulic system using piston and two controlling valves of flow were used to realize the fluid flow. The camfollower mechanism was used to ensure that the fluid flow occurs during the cardiac cycle. The cam is radial with roller followers. The follower roller is connected to the hydraulic cylinder which controls the fluid flow. A latex tube was attached to the hydraulic system representing the abdominal aorta. The latex tube has the same real dimensions of this artery and it was chosen due the modulus of elasticity very close to the artery. A manometer was used to measure the outlet pressure of latex tube. After latex tube there is a complacency tube to control the pressure drop of circulatory system. The radial displacement of the latex tube and pressure variation of the manometer were monitored through filming. The experimental results were compared and validated with numerical results obtained with ANSYS software and with literature / Orientador: Aparecido Carlos Gonçalves / Coorientador: Amarildo Tabone Paschoalini / Banca: João Antonio Pereira / Banca: Cleudmar Amaral de Araújo / Mestre

Este trabalho se caracteriza por ser uma proposta de intervenção pedagógica construtivista, que utiliza as ideias de Jean Piaget sobre a construção do conhecimento, como diretrizes para alcançar a aprendizagem. Espera-se permitir a aprendizagem de um conteúdo específico da Ciência, que é o Sistema Circulatório (SC) e, ao mesmo tempo, a compreensão do processo de construção do conhecimento científico. Para atingir esses objetivos de aprendizagem foi construída uma sequência didática (SD). Essa SD conta com estratégias para permitir que os estudantes aprendam um conteúdo específico (SC), e participem de atividades que envolvem a História da Ciência (HC). A SD procura fatos pontuais que mostram a construção dos conceitos científicos sobre o SC, e que acima de tudo, destacam o caráter descontínuo da evolução da Ciência, entremeados por erros e acertos, ambos essenciais para prosseguir. A SD foi aplicada em um curso piloto, e os materiais produzidos pelos estudantes durante as intervenções propostas foram analisados de acordo com a \"análise discursiva textual\", no intuito de avaliar a aprendizagem em desenvolvimento e a propriedade das intervenções dentro da SD. Esta modalidade de análise foi tomada para adequar-se à natureza dos dados que se apresentavam, caracterizando uma pesquisa qualitativa. A primeira intervenção da SD foi a sondagem das concepções prévias dos estudantes, por meio de discussões em sala de aula. A segunda foi um momento de atividade prática, em que os estudantes puderam manipular nosso objeto de estudo (o elemento coração no SC). Eles receberam vários corações de galinha, e deviam analisá-los; fazer anotações e desenhos do que eles estavam observando. Depois de expressarem suas ideias, e explorarem algo concreto do SC, os estudantes receberam textos que traziam ideias distintas sobre o funcionamento deste sistema, formuladas por diferentes \"pensadores\" ao longo da HC. Muitas dessas ideias eram semelhantes às dos estudantes e outras bem distintas. Em seguida uma linha do tempo lhes foi apresentada, onde apareciam todos os pensadores dos textos anteriores, localizados na sua época. A última intervenção foi uma aula expositiva-dialogada e prática, mostrando como compreendemos o SC hoje. Depois de expor como a Ciência defende o funcionamento do SC atualmente, o coração de boi foi utilizado para mostrar estruturas importantes do coração. Foi possível perceber que existe uma forte relação entre as ideias dos estudantes e as encontradas na literatura histórica a respeito desse conteúdo. A SD permitiu em vários momentos que os estudantes fossem atores de seus próprios conhecimentos, manipulassem estruturas concretas, e tivessem acesso a ideias distintas a respeito do funcionamento do SC - muitas delas, para o contexto atual, consideradas erradas. Com isso eles se relacionaram melhor com a ideia do erro, presente tanto no contexto da HC, como no ambiente de sala de aula, o que favoreceu o processo de ensino e aprendizagem em uma perspectiva construtivista. / This work is characterized by a constructivist pedagogical intervention proposal that makes use of Jean Piaget\'s ideas of knowledge construction as ways to reach learning. It is expected that learning about a specific Science content, such as the circulatory system may be enabled simultaneously with an understanding of the scientific knowledge construction process. A didactic sequence (DS) was elaborated in order to fulfill these two learning objectives. This DS contains strategies to lead students to learn a specific content (SC) and participate in activities that involve the History of Science (HC). The DS calls the attention to points that show the building up of scientific knowledge about SC stressing the discontinuous character of science evolution with sequences of misses and hits that are both essential for progress. SD was applied to a pilot course and materials produced by students during the proposed interventions have been analysed according to the \"textual discursive analysis\", aiming to an evaluation of ongoing learning and the adequacy of interventions within the SD. This kind of analysis was used to be adequate to the nature of data, characterizing a qualitative investigation. The first DS intervention was the investigation about student\'s previous conceptions by means of classroom discussions. The second intervention involved a practice activity when students could handle our study object (the heart element at SC). They received several hicken hearts that they should analyse writing notes and drawing sketches of what was being observed. After expressing their ideas and some concrete exploration about SC, students received texts containing different ideas about his scheme that had been written by several intellectuals along HS. Many of these ideas were similar to those of students but others were quite different. Then a timeline was presented to them where all the previous texts intellectuals appeared in their epoch. The last intervention was an expositive class with dialogues and practice showing how SC is presently understood. A cow heart was then used to show the important heart structures. Is has been possible to onclude that there is a strong relation between students ideas and those that may be found in historical literature about this subject. DS often enabled students to be the actors of their own knowledge, handling concrete structures and having access to different ideas about the heart functioning- some of them to be considered as wrong in the present context. This situation led them to improvement in the idea of errors that are present in HS context but also in the classroom and this favored the teaching and learning process from a constructivist perspective.

Diseases of the circulatory system have long been the most frequent cause of death in the developed world. The aim of this study is to describe and analyze the evolution of mortality from selected diseases of the circulatory system in the Czech Republic, Italy and Sweden from the 1980th to the present with the emphasis on the regional aspects. Its main part consists of analysis of regional differentiation, including international comparisons. Mortality from ischemic heart disease, cerebral vascular disease and atherosclerosis decreased during the reporting period, while mortality from hypertensive diseases increased. Despite the gradual convergence, mortality rates remain distinctly different in selected countries.

Ventricular assist devices are used in patients with heart failure refractory to standard management. Though left ventricular assist devices are more often used, patients with severe right ventricular dysfunction may also be treated with mechanical support. This case presents a patient with mixed cardiogenic and septic shock requiring placement of a percutaneous right ventricular assist device. A 38-year-old obese male with a medical history of alcoholism presented to the hospital with a complaint of dyspnea. He was found to have volume overload and was given intravenous diuretics. However, he had progressive renal insufficiency, hypotension requiring vasopressor support, and worsening respiratory status requiring mechanical ventilation. An echocardiogram showed a severely enlarged right ventricle, reduced RV function, normal RV wall thickness, moderate to severe tricuspid regurgitation, a severely dilated right atrium, ventricular septal flattening, and mild pulmonary hypertension. Left ventricular ejection fraction was 65-70%, LV diastolic function was normal, and there were no other significant valvular abnormalities. Troponin levels, ECG, and CT pulmonary angiography were unrevealing. Right heart catheterization showed a right atrial pressure of 29 mmHg (2 – 6 mmHg), right ventricular pressures of 50/24 mmHg (15-25/0-8 mmHg), pulmonary artery pressures of 56/35/43 mmHg (15-25/8-15/10-20 mmHg), a pulmonary capillary wedge pressure of 22 mmHg (6-12 mmHg), and a Prognostic Impact of Pulmonary Artery Pulsatility Index (PAPi) score of 0.3 to 0.6 (>1). Cardiac chamber oxygen saturations did not demonstrate intracardiac shunting. A right-sided mechanical circulatory support device was placed. The hospital course was complicated by sepsis due to pneumonia and presumed central line-associated bloodstream infection requiring antibiotic therapy, anemia secondary to device-related hemolysis requiring blood transfusions, renal failure requiring renal replacement therapy, and candidemia requiring antifungal therapy. Due to concern for device-associated infection, his central lines were replaced. The mechanical circulatory support device was able to be removed after ten days. Subsequent cardiac imaging did not reveal any other structural abnormalities, and a definitive cause for the right heart failure was not determined. Etiologies of right-sided heart failure include left-sided heart failure, pulmonary hypertension, chronic pulmonary disease, myocardial infarction, pulmonary embolism, myocarditis, valvular dysfunction, and congenital anomalies. Mechanical circulatory support may be used to support cardiac function, to allow the ventricular function to improve. Potential complications of mechanical circulatory support include infection, hemolysis, bleeding, device migration, and malfunction. RVAD therapy should be considered for patients with isolated right ventricular failure refractory to less invasive therapy.

Cette thèse propose d’examiner des situations d’enseignement et d’apprentissage autour de la circulation du sang au cycle 3 de l’école élémentaire française de façon à en inférer des éléments susceptibles de les déterminer. Les analyses didactiques sont menées dans le cadre de la Théorie de l’Action Conjointe en Didactique (Sensevy et Mercier, 2007) qui modélise l’action humaine en situation didactique comme une série de jeux d’apprentissage. Il s’agit de comprendre quelques uns des déterminants de ces jeux : le rapport aux objets de savoir du professeur, son épistémologie pratique et son activité adressée. La recherche propose de poursuivre l’exploration des déterminants du côté des élèves en examinant leur rapport aux objets de savoir et leur rapport à l’apprendre (Charlot, 1997). Pour cela, on procède à l’analyse ascendante de pratiques conjointes dans trois classes de CM2 dans lesquelles évoluent trois professeurs de formation initiale contrastée : un ayant une formation en psychologie, un de formation littéraire et un ayant une formation de biologiste. Les résultats obtenus montrent une grande complexité dans les déterminants professoraux due à l’imbrication de blocs de déterminants qui laissent plus ou moins de place, selon les classes, à l’expression et la prise en compte des rapports aux objets de savoir des élèves. L’influence de ces derniers sur l’action conjointe par leur rapport aux objets de savoir est variable selon leur rapport à l’apprendre. Ces éléments apportant une meilleure compréhension des pratiques de classe peuvent fournir des pistes pour la formation des enseignants et des points d’appui pour l’évolution des pratiques enseignantes. / This essay try to examin teaching and learning situations around circulatory system in primary french school (level 6) with the purpose to infer factors which could give determination of them. We do didactic analysis in Joint Action Didactic Theory (Sensevy and Mercier, 2007) who modelise human action in didactic situation like a set learning games. We have to understand some of games déterminants : teacher relationship to knowledge, practic epistemology and adressed activity. The research offer to continue student determinants exploration inspecting student relationship to knowledge and student knowlegde approach (Charlot, 1997). For that, we do bottom up analysis of joint practices in three clasrooms (CM2) with three teachers of contrasted initial background : a psychology background, a litterary and a scientific bakground.Results show a very important complexity of teacher determinants on account of very closely interlinked bundle of determinants who let more or less space in the classrooms for expression and taking into consideration students relationship to knowledge. Student impact on joint action by relationship to knowledge varies among knowledge approach. Those elements can give a better understanding of classroom practices and suggested some indications for training teachers and to focus on teacher practices evolution.

Determinants of circulatory system diseases among the Czech population Abstract The determinants of circulatory system diseases are very well known, modifiable risk factors and factors widely spread among populations are in focus for the public health research. The aim of this thesis is a quantification of main cardiovascular risk factors in the Czech population using the survival analysis and HAPIEE cohort data. The epidemiologic situation, trends in the Czech population health including "the cardiovascular revolution" is discussed in the first part of the thesis. Among the Czech population high prevalence of many risk factors were found. The education had the strongest impact on cardiovascular health from sociodemographic characteristics. The negative effect of smoking, prevalence of high blood pressure, prevalence of diabetes and physical inactivity was confirmed. On the other hand the impact of obesity, binge drinking and high blood cholesterol level was not significant among the Czech population. The population approach in cardiovascular epidemiology and cardiovascular health promotion as well are discussed in the last chapter. Keywords: diseases of the circulatory system, mortality, health transition, cardiovascular health, risk factors, survival analysis, health promotion

This study aimed to investigate the relationships among high school students&rsquo / relevant prior knowledge, meaningful learning orientation, reasoning ability, self-efficacy, locus of control, attitudes toward biology and achievement in human circulatory system in learning cycle and traditional classrooms. This study was conducted with 2 teachers and 4 classes and total of 60 11th grade students in the private high schools at &Uuml / mitk&ouml / y district of Ankara in the fall semester of 2008-2009 academic years. One class of each teacher was assigned as experimental group and treated with 5E learning cycle instruction and other class was assigned as control group and treated with traditional instruction. At the beginning of the study, both teachers were trained for how to implement 5E learning cycle instruction in the classrooms. The Human Circulatory System Achievement Test was applied twice as pre-test and after treatment period as a post-test to both experimental and control groups. Learning Approach Questionnaire was used to measure students&rsquo / approach to learning and Test of Logical Thinking was used to measure reasoning abilitiy of students. Students&rsquo / levels of self-efficacy, locus of control and their attitudes toward biology also were measured. The data obtained from the administration of post-test were analyzed by using ANOVA. The statistical result indicates that learning cycle instruction improved students&rsquo / achievement in human circulatory system compared to traditional instruction. Stepwise multiple regression analysis revealed that in learning cycle classrooms, the main predictors of achievement in human circulatory system were students&rsquo / reasoning ability (45.8%) and their prior knowledge (15.9%). In traditional classrooms, students&rsquo / meaningful learning orientation (40%) and locus of control (9.8%) were the main predictors of achievement. This study indicated that different variables may be significant for 11th grade students&rsquo / human circulatory system achievement in learning cycle and traditional classes.

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