Η κατανόηση των φαινομένων που λαμβάνουν χώρα κατά την αλληλεπίδραση κυττάρου βιοϋλικού και η συσχέτιση μηχανικών παραμέτρων του κυττάρου με πολύπλοκες διεργασίες στο εξωκυττάριο (ECM) περιβάλλον οδηγεί το μέλλον στο σχεδιασμό των βιοϋλικών. Σκοπός της διατριβής ήταν η διερεύνηση της προσκόλλησης και των μεταβολών των μηχανικών ιδιοτήτων οστεοβλαστών στους αρχικούς χρόνους προσκόλλησης σε υπόστρωμα του βιοπολυμερούς χιτοζάνης. Η προετοιμασία υποστρωμάτων χιτοζάνης έγινε με ομοιοπολική πρόσδεση του βιοπολυμερούς σε επιφάνεια γυαλιού (επιφάνεια ελέγχου). Με φασματοσκοπία φωτοηλεκτρονίων από ακτίνες Χ επιβεβαιώθηκε η μεταβολή της επιφανειακής χημικής σύστασης. Η μέση επιφανειακή τραχύτητα, με χρήση Μικροσκοπίας Ατομικής Δύναμης, βρέθηκε 4 φορές μεγαλύτερη στη χιτοζάνη σε σύγκριση με το γυαλί, ενώ η μέση γωνία διαβροχής ήταν περίπου 3 φορές μεγαλύτερη στη χιτοζάνη. Ο αριθμός και η μέση επιφάνεια εξάπλωσης των προσκολλημένων κυττάρων, προσδιορίστηκαν από φωτογραφίες ηλεκτρονιακού μικροσκοπίου σάρωσης και χρήση λογισμικού ανάλυσης εικόνας. Μέχρι τα 30 λεπτά, ο αριθμός ήταν μεγαλύτερος στη χιτοζάνη, ενώ μετά τα 45 λεπτά, στο γυαλί. Σε όλους τους χρόνους, η μέση επιφάνεια εξάπλωσης ήταν μεγαλύτερη στη χιτοζάνη. Για την ποσοτικοποίηση της προσκόλλησης, χρησιμοποιήθηκε η τεχνική της μικροπιπέττας σε πειράματα αποκόλλησης μεμονωμένων οστεοβλαστών. Υπολογίστηκε η “ώθηση αποκόλλησης”, I, ως το ολοκλήρωμα της εφαρμοζόμενης δύναμης στο χρόνο (I=SFdt) για την πλήρη αποκόλληση ενός κυττάρου και βρέθηκε στατιστικά μεγαλύτερη στη χιτοζάνη σε όλους τους χρόνους. Με την τεχνική Ποσοτικής Αλυσιδωτής Αντίδρασης Πολυμεράσης, η έκφραση των γονιδίων ιντεγκρινών αν, α4, β1 και β3 βρέθηκε σημαντικά αυξημένη στη χιτοζάνη από τα 30 στα 120 λεπτά. Με συνεστιακό μικροσκόπιο σάρωσης, παρατηρήθηκε αυξημένη έκφραση της κινάσης εστιακής προσκόλλησης στη χιτοζάνη στα 30 και στα 120 λεπτά. Τέλος, χρησιμοποιήθηκε η τεχνική της μικροπιπέττας σε πειράματα εφελκυσμού και ερπυσμού των οστεοβλαστών και υπολογίστηκαν οι μεταβολές του μέτρου Young, Ε, και του φαινόμενου ιξώδους, η. Οι μέσες τιμές βρέθηκαν αυξημένες στην πορεία της προσκόλλησης στις δύο επιφάνειες, παρουσιάζοντας υψηλότερες τιμές στη χιτοζάνη. Η παρούσα διατριβή είναι μια ολοκληρωμένη φαινομενολογική προσέγγιση της μηχανικής συμπεριφοράς της οστεοβλάστης κατά την προσκόλληση. Η προσκόλληση στη χιτοζάνη συνοδεύεται από μεταβολές στη μηχανική συμπεριφορά και συνδέεται με κρίσιμες βιοχημικές διεργασίες. / The understanding of the phenomena that take place during cell-biomaterial interaction and the correlation of cell mechanical parameters with complicated processes at the extracellular environment (ECM) is driving the future of biomaterial design. The aim of the present study was the investigation of attachment and of alterations of mechanical properties of osteoblasts during the initial phase of attachment on chitosan biopolymer substrate. The preparation of the chitosan substrates was done with covalent immobilization of the biopolymer on glass surface (control substrate). X-Ray photolelectron spectroscopy confirmed the alteration of the surface chemical composition. Mean surface roughness, as measured by Atomic Force Microscopy, was increased 4-fold compared to glass, while the mean contact angle was found 3 times higher on chitosan substrate. The mean number and spreading area of the attached cells, were determined by Scanning Electron Microscopy images and the use of image processing program. Up to 30 minutes, the number of attached cells was higher on chitosan, while after 45 minutes, it was on glass. At all time points, the mean spreading area was greater on chitosan. To quantify attachment, the micropipette aspiration technique was used at experiments of detachment of individual osteoblasts. The ‘’detachment impulse’’, I, was calculated, as the integral of the applied force at time required (I=SFdt) for complete detachment of one cell, and it was found statistically higher on chitosan at all attachment times. With the quantified Polymerase Chain Reaction, the αν, α4, β1 and β3 gene integrin expression was found significantly increased from 30 to 120 minutes of attachment on chitosan. Using confocal scanning microscopy, higher expression of focal adhesion kinase was observed on chitosan at 30 and 120 minutes of attachment. Additionally, the micropipette aspiration technique was used at stretching and creep experiments so as to calculate the alterations of cell’s Young modulus, E, and apparent viscosity, η. Mean values were increased at the course of spreading for both surfaces, demonstrating greater values on chitosan. The present study is a complete phenomenological approach of the mechanical behavior of osteoblasts during attachment. Attachment on chitosan is accompanied by alterations of the mechanical behavior and is associated with critical biochemical processes.

Στην παρούσα διατριβή μελετήθηκε η ετερογενοποίηση της αντίδρασης φωτοξείδωσης του 2 μεθυλ 2 βουτενίου προς αλλυλικά υδροπεροξείδια με τη χρήση φωτοκαταλυτών που περιέχουν φουλερένιο C60 στηριγμένο σε οξειδικούς φορείς. Το φουλερένιο C60 είναι γνωστό για τη δράση του ως φωτοευαισθητοποιητής της παραγωγής οξυγόνου απλής κατάστασης (singlet oxygen) κατά την ακτινοβόληση με ορατή ακτινοβολία, το οποίο πραγματοποιεί την οξείδωση αλκενίων μέσω της αντίδρασης Schenck-Ene. Ήταν επιθυμητό να παρασκευαστούν καταλύτες στους οποίους το C60 να διαθέτει σταθερή ομοιοπολική σύνδεση με την επιφάνεια των φορέων. Αυτό πραγματοποιήθηκε μέσω της σύνθεσης ενός μονοϋποκατεστημένου μεθανοφουλερενικού παραγώγου, το οποίο συνδέθηκε με την επιφάνεια των φορέων (Grafting). Επιπλέον, τα υλικά σχεδιάστηκαν έτσι, ώστε να παρέχουν τη δυνατότητα της πλήρους και ελεγχόμενης αποκοπής κάτω από κατάλληλες συνθήκες, γεγονός που επιτρέπει τον έλεγχο της ακεραιότητας του C60 μετά από χρήση του σε αντίδραση ή μετά από θερμική ή χημική κατεργασία. Παράλληλα παρασκευάστηκαν καταλύτες με κλασικές μεθόδους σύνθεσης ετερογενών καταλυτών. Ως φορείς χρησιμοποιήθηκαν η SiO2 και η Al2O3. Τα υλικά που παρασκευάστηκαν, μελετήθηκαν ως προς τη φωτοκαταλυτική τους δράση ως προς την αντίδραση φωτοξείδωσης του 2 μεθυλ 2 βουτενίου και έγινε σύγκριση τους με βάση τον τρόπο παρασκευής και το φορέα στήριξης. Ακόμη, έγινε σύγκριση της ετερογενούς διεργασίας με την ανάλογη ομογενή. Τα υλικά εμφάνισαν στο σύνολο τους φωτοκαταλυτική δράση στην παραπάνω αντίδραση. Σε κάθε περίπτωση οι στηριγμένοι σε SiO2 καταλύτες εμφάνισαν υψηλότερη δραστικότητα από τους αντίστοιχους που παρασκευάστηκαν σε φορέα Al2O3. Ακόμη, τα υλικά που παρασκευάστηκαν με τη μέθοδο Grafting σε φορέα SiO2 παρουσίασαν την υψηλότερη δραστικότητα ανάμεσα σε όλους καταλύτες που εξετάστηκαν. Η δραστικότητά τους ήταν μάλιστα υψηλότερη και από την αντίστοιχη που παρατηρήθηκε κατά τη χρήση ισομοριακής ποσότητας C60 σε ομογενή αντίδραση αλλά μικρότερη από αυτή των γνωστών φωτοκαταλυτών Rose Bengal και TPP (5,10,15,20-τετραφαινυλο-21Η,23Η-πορφυρίνης). Τέλος, μελετήθηκε η θερμική σταθερότητα των υλικών κάτω από οξειδωτικές συνθήκες. Διαπιστώθηκε ότι η σύνδεση του C60 στην επιφάνεια των φορέων με τη μέθοδο Grafting εμφανίζει γενικά παρόμοια θερμική σταθερότητα σε σχέση με τους καταλύτες που παρασκευάστηκαν με τη μέθοδο του Υγρού Εμποτισμού. / The scope of this dissertation was the heterogenization of the photooxidation reaction of 2-methyl-2-butene towards allylic hydroperoxides with the use of fullerene C60 containing catalysts supported on oxide carriers. The reaction was known to be efficient under homogeneous conditions. The photooxidation of alkenes is conducted by singlet oxygen (1Δg) which is produced by photosensitizers. C60 is known for its photosensitizing ability to produce singlet oxygen under visible irradiation. It was a requirement that C60 would be connected through stable and covalent bonding to the catalysts surface. This became possible through the preparation of a monosubstituted methanofullerene which was subsequently attached through covalent bonding to the surface of the carriers (Grafting). Additionally, a key requirement in the materials design was to provide us with the ability of controlled -under the appropriate conditions- and quantitative detachment of the part which bears C60, and its recovery in solution. This is important because it allows us to examine possible changes in the C60 molecule after the material’s use in catalytic processes or after its thermal or chemical treatment. Employing well-known methods of heterogeneous catalysts synthesis catalysts with the corresponding % molar concentration in C60 were also prepared. The photocatalytic behavior of the prepared materials was investigated in the photooxidation reaction of 2-methyl-2-butene. The effect of carrier and preparation method was also investigated. A comparison was also made with the homogeneous case. The prepared materials were all efficient catalysts in the photooxidation reaction of 2-methyl-2-butene. In all cases, the supported on SiO2 catalysts showed higher reactivity than the corresponding ones supported on Al2O3. Moreover, the catalysts prepared with the Grafting method on SiO2 showed the highest reactivity among all the catalysts examined. The reactivity was higher than in the homogeneous case using equimolar solutions of C60 but lower to the reactivity recorded in the case of the well established photosensitizers Rose Bengal and Tetraphenylporphine (TPP). Finally, the thermal stability of the prepared materials under oxidative conditions was studied._It was realized that materials prepared through Grafting show generally similar thermal behavior with the catalysts prepared with the Incipient Wetness method.

Dissertation thesis summary: Influence of nannies on the overall development of the ward This dissertation thesis deals with the topic of child minding by an alternative caregiver, the so-called nanny. Its target is to broadly examine and describe the issue, with emphasis on defined aspects. The presented theoretical-research work covers existing institutions and services for child care in both Czech Republic and abroad. It primarily strives, however, to capture the essence of motherhood from psychological, philosophical and genetic points of view. This effort takes into consideration the question of separation, and consequently traumatization in childhood. A significant part of the paper concentrates on the area of education of the child care providing persons. The research chapters focus on the influence of the nanny not only on the child, but also on the family atmosphere and the educational stances of the parents. It further deals with the position of the nanny within the family, and with bounds of the child-nanny relationship. The output of the work is then a practical handbook, a manual with specifically defined content of an educational program (for nanny-position aspirants and for already practicing professionals). The material was drawn up with help of experts, with the aim to point out weak spots...

Si les fragilités individuelles et les conditions de travail sont accusées de conduire à l'épuisement professionnel, cela n'explique pas pourquoi un individu décide de s'enfermer dans une situation intenable pouvant le mener au suicide plutôt que de mettre fin au lien l'unissant à son organisation. Ce lien se nomme l'implication organisationnelle (Mathieu et Zajac, 1990). Ainsi, dans un contexte où les organisations cherchent à renforcer le lien qui les unit à chacun de leurs salariés, nous nous interrogeons sur le rôle joué par l'implication organisationnelle dans l'explication de l'épuisement professionnel. L'implication organisationnelle est un concept multidimensionnel (Meyer et Allen, 1991) négativement lié à l'épuisement professionnel, notamment dans sa dimension affective. Les études relatives aux autres dimensions sont beaucoup plus rares. Par ailleurs, Meyer et Maltin (2010) soulignent la contradiction des recherches s'intéressant au lien indirect entre l'implication organisationnelle et l'épuisement professionnel. Dans cette recherche nous nous intéresserons à toutes les dimensions de manière simultanée à l'aide d'une approche par profil permettant de capter les interactions entre les dimensions (Meyer et al., 2012). Le lien direct et indirect qui unit implication organisationnelle et épuisement professionnel sera étudié à la lumière de la conservation des ressources. Pour cela, nous mobilisons une méthodologie mixte combinant principalement une étude qualitative et deux études quantitatives. Les données analysées dans cette recherche défendent la thèse selon laquelle l'implication organisationnelle est une ressource à double tranchant qui permet de protéger les individus de l'épuisement professionnel mais qui peut devenir néfaste sous certaines conditions. / If individual weaknesses and working conditions are accused to lead to burnout, this does not explain why an individual decides to stay in an unbearable situation that could lead him to suicide rather than cut the link binding him to his organization. This link is called organizational commitment (Mathieu & Zajac, 1990). Thus, in a context where organizations seek to strengthen the bond between each of their employees, we question the role of organizational commitment in explaining burnout. Organizational commitment is a multidimensional concept (Meyer & Allen, 1991) negatively related to burnout, especially in its affective dimension (Meyer & Maltin, 2010). Studies related to the other dimensions are rare. Besides, Meyer and Maltin (2010) highlight the contradiction of the researches related to the indirect link between organizational commitment and burnout. In this research, we focus on all dimensions simultaneously, using an approach-based profile to capture the interactions between dimensions (Meyer et al., 2012). The direct and indirect relations that link organizational commitment to burnout are enlightened by the conservation of resources theory (Hobfoll, 1988, 2001). To do this, we mobilize a mixed methodology combining a qualitative study and two quantitative studies. The data analyzed in this study defend the thesis that organizational commitment is a double-edged resource that protects individuals from burnout but that can be harmful under certain conditions.

Submitted by Maike Costa (maiksebas@gmail.com) on 2016-01-06T14:43:38Z No. of bitstreams: 1 arquivototal.pdf: 1250752 bytes, checksum: f895e82ebec46f142680436b04edadd0 (MD5) / Made available in DSpace on 2016-01-06T14:43:38Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 1250752 bytes, checksum: f895e82ebec46f142680436b04edadd0 (MD5) Previous issue date: 2015-04-30 / The syntactic-semantic-discursive agglutination is a process concerning to the junction of the complement in the verb designed by Traditional Grammar (GT) as intransitive, having no material occupation as the object. However, in some situations, these verbs can be used like complement materialized in the syntax plan, with the syntactic-semantic-discursive detachment. This phenomenon is caused by enunciative reasons. Therefore, we had as main objective to analyze the syntactic-semantic-discursive agglutination and detachment of the verbs defined by the Traditional Grammar in an enunciation perspective, using, for this, printed reports. In order to answer this need, we developed the following specific objectives: to characterize the syntactic-semantic-discursive agglutination/ detachment as an enunciative phenomenon; analyze the meaning of a linguistic element (the verb) through two biases: theme (contextual meaning) and linguistic significance (in dictionaries sense) by combining with the active comprehension; understand how the syntactic-semantic-discursive agglutination and detachment are used in targeted verbs in a printed report, observing the thematic content, compositional elements and the style; discuss the factors that provide the syntactic-semantic-discursive agglutination the syntactic-semantic-discursive detachment in selected verbs for analysis. For this purpose, we used the theoretical construct defended by Bakhtin / Voloshinov (1981, 1926), Bakhtin (2003), as well as researchers of the linguistic thought from the Bakhtin Circle. Our corpus comprised twenty-two printed reports of Veja magazine, published in the period from 1968 to 2013 and selected in <http://veja.abril.com.br/acervodigital>. At first, we discuss the thematic content, compositional elements and the style of chosen reports. Subsequently, we analyze the syntactic-semantic-discursive agglutination in the verbs die, live, sunrise, fall, mature, aging, fight, react, dream, cry, smile, sleep, grow and laugh. And subsequently, we described some of the syntactic-semantic-discursive detachment in some of these verbs. Thus, we can say that, in this work, a syntactic phenomenon (the intransitive verbs) was observed by the Theory of Enunciation, according to Bakhtin / Voloshinov (1981). / A aglutinação sintático-semântico-discursiva é um processo que diz respeito à junção do complemento no verbo concebido pela Gramática Tradicional (GT) como intransitivo, não tendo a ocupação material do lugar de objeto. No entanto, em algumas situações, estes verbos podem ser usados com o complemento materializado no plano da sintaxe, havendo a desaglutinação sintático-semântico-discursiva. Este fenômeno é provocado por motivações de ordem enunciativa. Para tanto, tivemos como objetivo geral analisar a (des)aglutinação sintático-semântico-discursiva em uma perspectiva enunciativa nos verbos definidos pela GT como intransitivos, utilizando, para isso, reportagens impressas. No propósito de atender a esta necessidade, desenvolvemos os seguintes objetivos específicos: caracterizar a aglutinação e a desaglutinação sintático-semântico-discursiva como um fenômeno enunciativo; analisar o sentido de um elemento linguístico (verbo) através de dois vieses: tema (sentido contextual) e significação linguística (sentido dicionarizado), associando à compreensão ativa; compreender como a aglutinação e a desaglutinação sintático-semântico-discursiva são usadas nos verbos escolhidos em uma reportagem impressa, observando o conteúdo temático, os elementos composicionais e o estilo; discutir os fatores que proporcionam a (des)aglutinação sintático-semântico-discursiva nos verbos selecionados para a análise. Para tal propósito, recorremos ao construto teórico defendido por Bakhtin/Volochinov (1981, 1926), Bakhtin (2003), além de pesquisadores do pensamento linguístico do Círculo de Bakhtin. Nosso corpus foi composto por vinte e duas reportagens impressas da Revista Veja, publicadas no período de 1968 a 2013 e pesquisadas no site <http://veja.abril.com.br/acervodigital>. A princípio, discutimos o conteúdo temático, os elementos composicionais e o estilo das reportagens escollhidas. Posteriormente, analisamos a aglutinação sintático-semântico-discursiva nos verbos morrer, viver, nascer, cair, amadurecer, envelhecer, lutar, reagir, sonhar, chorar, sorrir, dormir, gritar, crescer e rir. E, posteriormente, discorremos sobre a desaglutinação sintático-semântico-discursiva em alguns destes verbos. Com isso, podemos dizer que, em nossa tese, um fenômeno sintático (os verbos intransitivos) foi observado à luz da Teoria da Enunciação, conforme pontuaram Bakhtin/Volochinov (1981).

Optimization of the number of nursing staff at selected workplaces of the České Budějovice Hospital As the title shows determination of the optimum number of non-physician health care staff members at surgical departments of České Budějovice Hospital is the main question this thesis deals with. The topic is up-to-date mainly for the lack of funds in health care and for the permanent pressure from the general public on the need of health care quality improvement. The works of Karla and Otakar Pochylý, who published their first book dealing with these issues in 1999, were the basic inputs for the research part of the thesis. We set the following hypotheses before commencement of the research: 1 ? The numbers of nursing staff at standard health care units are in line with K. Pochylá?s methodology. This hypothesis was partly confirmed. The average numbers of nursing staff workloads are in line with K. Pochylá?s methodology at two surgical departments only. 2 ? Qualification representation of nursing staff at the individual health care units complies with the recommended methodology of K. Pochylá. This hypothesis was not confirmed. Representation of the nursing staff qualifications is based on the individual needs of the particular departments. 3 ? The number of nursing staff members at the intensive care unit corresponds with the recommended methodology of K. Pochylá. This hypothesis was not confirmed. The number of nurses is lower by 2.23 in average at the intensive care unit. The content of the work has more informative character and should actually serve as an insight into the existing situation at the particular departments. It might also serve as a guide helping top managers with efficient utilization of human resources in health care facilities. This is why the results will be provided to the surgical department management of the České Budějovice Hospital.

Cette étude, syntaxique et textuelle, se penche sur le problème de la définition de l’apposition. Les grammaires de l’allemand et les études linguistiques consacrées à l’apposition font apparaître de grandes divergences quant à l’extension de la notion qui reste encore empreinte du poids de la tradition grammaticale. Les critères relevés dans les différentes définitions (accord casuel, accolage, identité référentielle, non restrictivité, suppressibilité, parenté avec une structure propositionnelle ou relation prédicative) sont soumis à un examen critique qui motive une redéfinition en intension et en extension de l’objet d’étude : la construction détachée à support nominal est une prédication supplémentaire averbale dans laquelle l’apport GN2 peut morphosyntaxiquement toujours se positionner directement à droite du support GN1. Cette définition permet de distinguer la construction détachée de phénomènes considérés comme appositifs (le GN en als et wie, la dislocation, la construction absolue).La mise à distance de GN2 par rapport à GN1 s’explique par la répartition et la hiérarchisation de l’information dans l’énoncé et au-delà, dans le texte. La construction détachée apporte les éléments pertinents pour la compréhension du texte. Cette fonction explicative instaure et entretient l’ethos coopératif du locuteur-scripteur dont celui-ci peut jouer à des fins argumentatives.Le corpus d’étude (volume 2) est composé de textes de presse et de textes littéraires contemporains. / This syntactic and textual study examines the various ways apposition can be defined. German grammars and linguistic studies devoted to apposition vary widely in the range of that notion, which is still very much under the influence of grammatical tradition. The various criteria which appear in definitions (case agreement, adjacency, referential identity, non-restrictiveness, deletability, similarity to a grammatical clause, subject-predicate relation) are critically examined, which leads to a redefinition of the object of our study, both intensionally and extentionally: noun-based detached constructions can be seen as additional averbal predications in which the appositive NP2 can always be morphosyntactically positioned immediately to the right of the NP1 base. Our definition makes it possible to distinguish detached constructions from phenomena which are usually considered as appositive (als- or wie-introduced NPs, dislocations, absolute constructions).NP2 displacement away from NP1 results from the distribution and prioritization of information within utterances, and further at the textual level. Detached constructions provide relevant elements for textual comprehension. This explanatory function creates and maintains a high level of mutual comprehension between the speaker/writer and the reader, which the speaker can use for argumentative purposes.The corpus of our study (vol. 2) is made up of newspaper and magazine articles and contemporary literary texts.

Orientadores: Newton Kara-Jose, Rodrigo Pessoa Cavalcanti Lira / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-09T11:04:58Z (GMT). No. of bitstreams: 1 Soares_PauloHenriqueLimeira_D.pdf: 4979795 bytes, checksum: a3e56d06c84ca0781142bae68e8cc1ef (MD5) Previous issue date: 2007 / Resumo: Os objetivos deste estudo foram caracterizar a demanda e a capacidade resolutiva de um serviço oftalmológico terciário para pacientes com doenças vitreorretinianas em uma população urbana definida no sudeste brasileiro. Os dados foram coletados dos pacientes consecutivos atendidos pela primeira vez no Departamento de Oftalmologia, Universidade Estadual de Campinas, São Paulo, Brasil, de 1º. de junho de 2003 a 31 de julho de 2004. A capacidade resolutiva e a incidência da demanda foram calculadas para cirurgia de retina e fotocoagulação. Os dados foram analisados com os programas EpiInfo¿ 2000 (Centers for Disease Control and Prevention, Atlanta, Georgia, USA) e Statistical Package for the Social Sciences® (version 11.0). A estimativa populacional da área de abrangência é de 3.389.294 de pessoas. Dos 7500 pacientes referidos para o Departamento no período do estudo, 641 foram incluídos no estudo. Os diagnósticos considerados para análise foram descolamento de retina (26,0%), retinopatia diabética (21,0%) e hemorragia vítrea (7,7%) com medianas das idades de 52, 59 e 57,5, respectivamente. A capacidade resolutiva para descolamento de retina, hemorragia vítrea e retinopatia diabética foram, respectivamente, 38,1%, 33,0% e 93,5%. O principal motivo para a não realização de cirurgia de retina ou fotocoagulação foi horário não disponível (87,1%). A incidência da demanda global para descolamento de retina foi 9,2:100.000. Descolamentos em fácicos não traumáticos apresentaram a mais alta incidência da demanda com 7,1:100.000. 26,5% dos pacientes apresentaram descolamentos de retina inoperáveis. A incidência da demanda idade-específica aumenta com a idade. Descolamentos de retina não traumáticos em fácicos foram o tipo mais comum. A incidência de descolamentos traumáticos foi maior no gênero masculino. O estudo revelou que condições que ameaçam a visão como descolamento de retina e retinopatia diabética não são totalmente cobertos pelo Serviço nesta área. Alternativas para solução do problema são consideradas. O estudo fornece informações para planejamento de serviços oftalmológicos de alta complexidade na população estudada / Abstract: The aims of the study were to evaluate either the characteristics of the demand and the performance of the tertiary care delivered to patients with vitreoretinal diseases in a defined urban population in the Southeast of Brazil. Data were collected from consecutive first time patients between June 1 2003 and July 31 2004 in the Department of Ophthalmology, State University of Campinas, São Paulo, Brazil. Problem-solving capacity rates as well as demand incidence were calculated for vitreoretinal surgery and photocoagulation. Data were entered into the Statistical Package for the Social Sciences (version 11.0). There were a total population of 3 389 294 in the cities of Campinas catchment area. Of the 7500 patients referred to the Department, 641 were deemed to analysis. Diagnoses analyzed were retinal detachment (26.0%), diabetic retinopathy (21.0%), and vitreous hemorrhage (7.7%). Median ages were 52, 59, 57.5, respectively. The problem-solving capacity rates showed that 38.1%, 33.0%, and 93.5% of those eligible for ophthalmic intervention (retinal detachment, vitreous hemorrhage and diabetic retinopathy) have obtained the treatment. The main reason for not performing the treatment was lack of available intervention time (87.1%). The overall demand incidence of retinal detachment was 9.2:100 000. Nontraumatic phakic detachments had the highest demand incidence of 7.1:100 000. 26,5% of all patients seeking treatment presented inoperable cases of retinal detachments. The age specific demand incidence increases with age. Nontraumatic phakic detachments were the most common type of detachment. The incidence of the traumatic types of detachment was higher in males than that in females. Sight threatening conditions are not thoroughly covered by the health system in this area. Some alternatives to reduce the problem are considered. It provides valuable information on planning high complexity eye services in the population likely to be served. / Doutorado / Oftalmologia / Doutor em Ciências Médicas

Le Bassin de Valence, situé à l’est de l’Ibérie et séparé du Bassin Algérien par le Promontoire Baléares, résulte d’une évolution polyphasée dans l’espace et dans le temps. Son histoire cénozoïque, celle d’un bassin d’arrière-arc Oligo-Miocène, est à présent reconnue. Toutefois cette extension se surimpose à plusieurs phases de rift observées à terre du Permien au Crétacé inférieur. Cette histoire plus ancienne demeure méconnue en mer malgré son importance dans l’héritage structural du bassin. Au sud du Bassin de Valence, le Bassin de Columbrets en témoigne en révélant d’épaisses séquences mésozoïques jusqu’alors incluses dans un « socle acoustique » indifférencié. Ce domaine permet donc le déchiffrage du mécanisme des évènements tectoniques qui se sont succédé du Mésozoïque à l’Est de l’Ibérie d’une part, au Cénozoïque en Méditerranée occidentale d’autre part.Basé sur une stratégie d’étude terre-mer, ce travail vise une meilleure compréhension (1) des processus tectoniques tertiaires modelant le sud du Bassin de Valence et la Méditerranée occidentale (2) de la réponse sédimentaire à des processus d’extension et d’hyper-extension au Mésozoïque (3) de l’importance de l’halocinèse lors la mise en place des structures sédimentaires et tectoniques.L’étude structurale d’Ibiza, l’île la plus méridionale du Promontoire Baléare, reconsidère le calendrier tectonique de la région ainsi que son intégration dans l’histoire géodynamique de la Méditerranée occidentale. Le rift Oligo-Miocène décrit dans le Bassin de Valence et initié par le Système de Rifts Cénozoïques Européens a été observé sur Ibiza. Cet évènement est suivi au Miocène Moyen d’une déformation compressive localisée par les failles normales précédemment formées. La comparaison avec le calendrier tectonique des Kabylies en Algérie montre que cette déformation compressive, qui épargne le Bassin Algérien, résulte de la convergence Europe-Afrique. Des cartes rétro-tectoniques intègrent ces évènements dans le contexte géodynamique de la Méditerranée occidentale depuis l’Oligocène.L’étude des séries Mésozoïques effectuées à terre et en mer (grâce à l’interprétation de données sismiques et de forages) révèle plusieurs phases de rifting du Permien au Crétacé inférieur. Un épisode majeur Jurassique supérieur à Crétacé inférieur est à l’origine de l’épaisse séquence sédimentaire du Bassin de Columbrets. Documentée à terre, cette phase ayant conduit à l’ouverture de la partie sud de l’Atlantique Nord est à l’origine de bassins ibériques ou péri-ibériques tels Maestrat, Caméros ou Parentis.Un amincissement majeur de la croûte est visible sous l’épaisse séquence mésozoïque, la réduisant à 5km. Le mécanisme d’extension voire d’hyper-extension proposé invoque une faille de détachement à pendage NW qui s’enracine dans la croûte inférieure litée. Une représentation des structures en 3D a été réalisée afin de comprendre l’évolution du Bassin de Columbrets.L’architecture sédimentaire du Bassin de Columbrets est également contrôlée par le mouvement des séries salifères depuis leur dépôt au Trias supérieur jusqu’à l’actuel. La partie septentrionale du bassin se caractérise par une halocinèse surtout lié aux déformations extensives de la région. En revanche au sud du front chevauchant des Bétiques, le sel est aussi remobilisé en compression. La géométrie et la répartition des structures salifères décrites à terre et en mer dépendent fortement de l’épaisseur initiale de la couche de sel dans le bassin; cette observation apporte des éléments de réponse sur la paléogéographie des séries du Keuper au sud du Bassin de Valence.Au final cette étude aborde d’une part des thèmes liés au mécanisme de formation des bassins intracontinentaux et plus particulièrement la relation entre hyper-extension, signature sédimentaire et halocinèse. D’autre, elle permet une meilleure intégration du sud du Promontoire Baléare et du Bassin de Valence dans la géodynamique Ouest- Méditerranéenne. / The Valencia Basin, located east of Iberia and separated from the Algerian Basin by the Balearic promontory, underwent a poly-phased tectonic evolution in space and time. The Cenozoic evolution of the basin has been widely discussed, the most classical interpretation being an Oligo-Miocene aborted back-arc basin. However, this extensional tectonic regime postdated several rifting events from the Permian to the Lower Cretaceous. This older evolution remains poorly understood offshore, despite its influence on the tectonic inheritance of the basin. The Columbrets Basin, in the southernmost part of the Valencia Basin, exhibits a thick Mesozoic sequence that was considered to belong to an undifferentiated “acoustic basement”. Hence, the Columbrets Basin is a key study area to unravel the successive Mesozoic to Cenozoic tectonic events in Eastern Iberia and Western Mediterranean.Our study integrates onshore and offshore data to better constrain (1) the Cenozoic tectonic processes that led to the current morphology of the southern Valencia Basin and the Western Mediterranean (2) the sedimentary records Mesozoic extensional to hyper-extensional processes and (3) the importance of the halokinesis in the sedimentary and tectonic architectures.Ibiza Island, located on the southernmost part of the Balearic Promontory, questions the standard tectonic agenda of the area and its integration in the Western Mediterranean geodynamic frame. The Oligo-Miocene rifting phase described in the Valencia basin is initiated by the European Cenozoic Rift System (ECRIS) and has been observed in Ibiza. This event is followed by a Middle Miocene contractional phase reactivating the inherited normal faults. The comparison with the tectonic history of the Kabylies in Algeria shows that this stage that does not affect the Algeria basin, results from the convergence between Europe and Africa. A set of retro-tectonic maps integrates these events in the geodynamic context of West Mediterranean.The Mesozoic units were studied onshore and offshore (using drilling and seismic data); it reveals several rifting phases from the Permian to the Lower Cretaceous. A major Upper Jurassic to Lower Cretaceous event was responsible for the deposition of the thick sequence present in the Columbrets Basin. This tectonic event led to the opening of the southern part of the north Atlantic but is also at the origin of several Iberian or peri-iberian basins such as Maestrat, Cameros, or Parentis basins.A major crustal thinning has been observed underneath the thick Mesozoic sequence, reducing the crustal thickness to 5 km. The proposed extensional and even hyper-extensional mechanism used a NW dipping detachment fault rooting deeply into the layered lower crust. A 3D geometrical model of the structures illustrates the evolution of the Columbrets Basin.The sedimentary architecture of this basin is also controlled by salt movements from their deposition during the Late Triassic to current times. The northern part of the Basin is characterized by salt movements mainly linked to the extensional deformations of the area. South of the Betics Front, the salt is remobilized by compressional deformations. The geometry and the location of the salt structures described onshore and offshore depend on the initial thickness of the salt in the basin; this observation gives evidence for the paleogeography of the Keuper sequences in the south of Valencia Basin.Finally, this study documents the mechanisms leading to the formation of intracontinental basins and especially the relationships between hyperextension, sedimentary filling and halokinesis. On the other hand, our study allows a better integration of the southern part of the Balearic Promontory and Valencia Basin in the geodynamic frame of the West Mediterranean.

Le Golfe de Californie (GOC) est un exemple de rift très oblique, au stade d'accrétion depuis 3,6 Ma au sud. La déformation continentale débute au Miocène dans un contexte arrière-arc, en relation avec la subduction de la plaque Pacifique sous la Plaque Nord-Américaine. L'objectif de cette thèse est de déterminer I'histoire de la déformation à I'origine de la rupture continentale ainsi que les phénomènes post-rupture. Cette étude utilise des données tectoniques, sismologiques et géomorphologiques sur la marge Ouest du GOC en Basse Californie du Sud. Elles sont calées temporellement par des datations d'isotopes radiogéniques et cosmogéniques. Une histoire polyphasée de la déformation, essentiellement post-magmatique, est proposée en termes d'évolution des directions des failles et de déformations relativement à la cinématique des plaques. Je démontre dans cette zone que la déformation qui conduit à l'amincissement et à l'étirement lithosphérique est d'abord fortement oblique et devient transtensive et moins oblique relativement à la cinématique à partir de 7-8 Ma. La marge étudiée est intégrée de manière cohérente à I'ensemble des domaines déformés associés à la formation du GOC. On montre notamment que les marges du GOC sont diachrones et qu'elles se forment par migration vers I'Ouest de la déformation vers la zone de subduction, qui devient inactive vers 12 Ma. La dynamique post-breakup du GOC est interprétée en termes de mobilisation par fluage de la croûte inférieure en relation avec un évènement thermique lié à la rupture du slab. En conclusion, l'évolution du GOC ne peut s'expliquer par les modèles simples de rifting oblique et de formation de marges passives. / The Gulf of California (GOC) is an example of highly-oblique rift. Oceanic accretion started 3.6 Ma ago at its southern end. The earliest continental extension started during the Miocene, in a back-arc setting, in connection with the subduction of the Pacific plate (PAC) beneath North America (NAM). ln this study, I reconstitute the strain evolution along the proximal Baja California margin. For this, I used original tectonic and seismological data which I collected in Baja California Sur (BCS). Those data were time-constrained with absolute dating (radiogenic and cosmogenic isotopes). I outline that the main stretching and thinning of the Late Miocene-Pliocene Baja California margin was highly oblique regarding NAM-PAC kinematic vector, turning less oblique. By integrating the studied margin in the evolution of the GOC, it is proposed that the final break-up mechanism occurred within a broad semi-ductile right-lateral central shear-zone. lt is shown that the two GOC passive margins didn't form at the same time, crustal strain migrating westward during the Miocene in response to a probable retreat of the dying slab. The active post-breakup deformation in the proximal BCS is best interpreted in connection with an outward flow of the lower crust in a trend compatible with the margin shaping inherited from the major GOC-normal to GOC-oblique Miocene crustal deformation. This ductile flow would be enhanced by the heat input from the slab rupture. To conclude, the GOC evolution as an oblique rift system adjusts with no existing analogical or numerical model of strain field evolution of oblique rifting, a probable consequence to the complex dynamics in back-arc settings.