This submitted paper aims to give a communicative image of the conflicts of the Czech Estates Uprising in the south of Bohemia. The focal point of the research has been three clashes of Protestant and Catholic armies. The first was the Battle of Lomnice, which took place on November 11, 1618, between the allied estates troops of Jindřich Matyáš Thurn and Jiří Fridrich Hohenlohe and the catholic military assembly of Karel Bonaventura Buquoy. After the battle that was victorious for the generals of the estates, the military actions moved to the area around České Budějovice, which was besieged by the army of the estates, as the catholic troops withdrew here. Ending the siege of the South Bohemian metropolis caused the third conflict, which has become part of this work. The battle at Záblatí took place on June 10, 1619, by the troops of Petr Arnošt of Mansfeld, the general of the rebellious Czech estates, and the military corps of imperial mercenaries commanded by Karel Bonaventura Buquoy. The aim of the author was to capture the fullest range of information framework, which was completed by reports of these military clashes of the Czech Estates Uprising. As part of research activities, attention was paid first to the works which explored the battle of Záblatí from political and military point of view. This view became a basic framework in which the research was conducted. However, the work should not only to recapitulate the conclusions already drawn, but the aim was to look at the examined issue with a new look. Such a view was based in the research of either new or to-nowoverlooked sources, such as the period news that historical science began to discover in recent years. A relatively large part of the historical community took the argument in saying that under the tide of propaganda and perspice it is not possible to find the truth about individual events of the Czech Estates Uprising. It would certainly be possible to claim that credible authentic information was scarce in the leaflets of the Czech Estates Uprising. These who contracted the prints, however, attempted to influence the readers of contemporary journalism and help them orientate in their intellectual worlds that were in this way uncovering to us. Another possibility for viewing the conflicts of the Czech Estates Uprising was offered through the view of the ordinary villages and towns inhabitants that were coming into contacts or were just observers of the South Bohemian battlefield. Although the preservation of the sources of the early 17th century from the environment of towns and villages was far from abundant, we managed to find some authentic testimonies that evaluated the battles of the Czech Estates Uprising from the very distinctive angles of view. The author interpreted sources of song lyrics reporting to the rural environment and sources of interurban correspondence, through which he tried to uncover at least part of the mental world of ordinary residents of South Bohemia affected by war in the first third of the 17th century and their view on the South Bohemian battlegrounds. Similarly, he also proceeded in the interpretation of the noble correspondence, whether it were warriors or the aristocrats affected by war misfortunes.

L’information des patients est devenue un enjeu de santé publique et une composante essentielle de la relation médecin patient. De nombreux auteurs s’accordent à dire que l’information écrite est un complément indispensable à l’obligation d’information orale car elle améliore la qualité des soins et l’adhérence du patient à sa prise en charge. Malgré l’existence de nombreuses Fiches d’Information Patient (FIP), le médecin a du mal à se les approprier. Elles sont souvent non validées, peu lisibles, difficiles à stocker, sans références, sources ni dates de rédaction. La première étape de notre travail a consisté à proposer une méthode pour élaborer des fiches d’information du patient (FIP) et à partir d’elle, 125 FIP concernant des motifs de consultation les plus fréquents en soins primaires. Une étude observationnelle réalisée dans 26 cabinets de médecine générale auprès de 350 patients, a montré d’une part que les patients sont demandeurs de FIP et qu’elles sont appréciées des patients. Et d’autre part, que la compréhension des maladies aiguës est plus limitée que celles des maladies chroniques ou situations de prescription chez les patients à faible niveau scolaire. Une étude interventionnelle randomisée en clusters réalisée dans 24 cabinets de médecine générale auprès de 400 patients, nous a permis de montrer que les FIP permettaient aux patients d’améliorer leur niveau de connaissances sur les pathologies et de modifier positivement leur comportements de santé, y compris pour les patients à faible niveau scolaire. Néanmoins, il n’était pas possible de comparer ces résultats à ceux de la littérature, les protocoles de recherche étant trop hétérogènes (critères de jugement spécifiques d’une situation clinique donnée).Pour surmonter cette difficulté, nous basant sur une « revue des revues » de la littérature, nous avons proposé un modèle théorique décrivant les modalités d’action des FIP au cours de la consultation, à partir duquel nous avons élaboré trois scores génériques utilisables pour tout type de consultation : un score de Communication Médecin Malade (CMM), un score de satisfaction et un score d’adhérence globale. Une fois les propriétés psychométriques de ces scores validés, nous avons étudié leurs déterminants. En situation aiguë, le seul déterminant de la CMM était la qualité de l’information reçu (quoi et que faire multipliant la probabilité d’une bonne communication par 11.9), les caractéristiques du patient n’influençant pas la CMM. L’adhérence globale est déterminée par le type de pathologie (paramètre inflexible) et par la qualité de la CMM. Enfin, la satisfaction, bien que tout autant liée à l’infrastructure, à l’équipe paramédicale et à l’équipe médicale, est également améliorée par une CMM de bonne qualité. En situation aiguë, la CMM est donc primordiale et impacte sur les indicateurs santé usuels que sont la satisfaction et l’adhérence des patients.Enfin, nous avons évalué avec ces nouveaux outils l’impact de 6 FIP sur la CMM, l’adhérence globale du patient et la satisfaction dans deux services d’urgences auprès de 324 patients. Cette étude interventionnelle avant-après nous a permis de montrer que les FIP améliorent: la CMM, la satisfaction vis-à-vis des professionnels de santé, le comportement des patients (qui respectent mieux les modalités de prises des médicaments et reconsultent moins dans les services d’urgences pour une même pathologie) et le comportement des médecins (qui prescrivent moins médicaments et davantage d’examens complémentaires). En situation aiguë, un outil simple pour améliorer la CMM est l’usage de FIP délivrée en complément de l’information orale.La CMM est un critère de jugement fondamental qu’il conviendra à l’avenir d’utiliser plus souvent, notamment pour évaluer les interventions thérapeutiques non pharmacologiques en plein essor, et pour lesquelles la communication est probablement un déterminant majeur de l’efficacité. / Patient information has become a public health issue and an essential component of Doctor-Patient communication (DPC). Many authors agree that written information is an indispensable complement to the obligatory oral information, since it improves the quality of care and the patient adherence. Despite the existence of numerous Patient Information Leaflets (PILs), physicians have difficulty appropriating them; they are often not validated, hard to read, difficult to store, without references, sources and dates of writing. The first step in our work was to propose a methodology for developing PILs and from there, design 125 PILs for the most common reasons for consultation in primary care. An observational study carried out in 26 general practice offices with 350 patients showed that patients appreciate PILs. On the other hand, the understanding of Acute Conditions (AC) is more limited than that of chronic diseases or prescription situations, particularly patients with a low school level. A cluster randomized interventional study performed in 24 general practice offices with 400 patients showed that PILs allowed patients to improve their knowledge about pathologies and modify their health behaviors positively, independently of their level of education. Nevertheless, the heterogeneity of the research protocols made it impossible to compare our results with those of the literature.To overcome this scientific hurdle and continue our work on the assessment of PILs, we performed a review of the literature on the subject, constructed a theoretical model describing the various effects of PILs and created three generic scales usable for evaluating the impact of PILs on any type of condition (scales of Doctor-Patient Communication, satisfaction and overall adherence). An observational study carried out in 2 Emergency Departments (ED) allowed us to validate the 3 scores, assess the psychometric properties and elucidate their determinants. In the context of AC, the only determinant of the DPC was the quality of the information received (both information "what to do" and "when to reconsult" have an adjusted Odds Ratio 11.9. Characteristics of the patient did not influence the DPC score. The overall adhesion is determined by the type of pathology (inflexible parameter) and by the quality of the DPC. Finally, although satisfaction was strongly associated with the hospital infrastructure and the attitude of the paramedical and medical staff, a high DPC score multiplied the probability of having a good satisfaction score. In a context of emergency consultations, the DPC is paramount and has an impact on the usual health indicators: satisfaction and adherence.Finally, a before-after intervention study conducted in two ED showed that PILs improve DPC, satisfaction with healthcare professionals, and adherence to medication regimens. PILs decrease the number of reconsultations for the same pathology, in particular return to the ED. They reduce the number of drug prescriptions given by the doctor in favor of complementary examinations and specialized advice. In a context of AC, a PIL given by the doctor improves DPC, the patient’s satisfaction with healthcare professionals and improves both the doctor’s and the patient’s behaviors.The DPC is a fundamental outcome that will need to be measured more frequently in the future, including in acute situations.

Made available in DSpace on 2014-12-17T15:36:53Z (GMT). No. of bitstreams: 1 RuthnaldoRML.pdf: 3880208 bytes, checksum: 7da0684594a4d62a80785416490983fa (MD5) Previous issue date: 2008-04-30 / Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico / In rodents, the suprachiasmatic nucleus (SCN) and the intergeniculate leaflet (IGL) are the main components of the circadian system. The SCN is considerate the site of an endogenous biological clock because can to generate rhythm and to synchronize to the environmental cues (zeitgebers) and IGL has been related as one of the main areas that modulate the action of SCN. Both receive projections of ganglion cells of retina and this projection to SCN is called retinohypothalamic tract (RHT). Moreover, the IGL is connected with SCN through of geniculohypothalamic tract (GHT). In primates (include humans) was not still demonstrated the presence of a homologous structure to the IGL. It is believed that the pregeniculate nucleus (PGN) can be the answer, but nothing it was still proven. Trying to answer that question, the objective of our study is to do a comparative analysis among PGN and IGL through of techniques immunohystochemicals, neural tracers and FOS expression after dark pulses. For this, we used as experimental model a primate of the new world, the common marmoset (Callithrix jacchus). Ours results may contribute to the elucidation of this lacuna in the circadian system once that the IGL is responsible for the transmission of nonphotic information to SCN and participate in the integration between photic and nonphotic stimulus to adjust the function of the SCN. In this way to find a same structure in primates represent an important achieve in the understanding of the biological rhythms in those animals / O sistema de temporiza??o circadiana (STC) ? respons?vel pela gera??o e modula??o dos ritmos circadianos que s?o oscila??es end?genas manifestadas pelos seres vivos para a maioria das fun??es e comportamentos, com per?odo em torno de 24 horas. Estes ritmos s?o sincronizados principalmente ao ciclo claro-escuro di?rio. O STC ? constitu?do por um conjunto de estruturas neurais interligadas, incluindo na sua composi??o um marca-passo encarregado da gera??o do ritmo, vias sincronizadoras e de sa?da aos efetores comportamentais. O n?cleo supraquiasm?tico do hipot?lamo (NSQ) ? tido como principal marcapasso circadiano. A les?o desse conjunto de c?lulas deixa o animal arr?tmico para algumas fun??es circadianas. A principal via direta de sincroniza??o ? o tracto retinohipotal?mico (TRH), que leva informa??o f?tica ambiental da retina ao NSQ. Uma segunda via, tida como de sincroniza??o indireta para o NSQ, ? o tracto gen?culohipotal?mico (TGH), que se origina das c?lulas produtoras de neuropept?deo Y (NPY) do folheto intergeniculado (FIG) do complexo geniculado lateral do t?lamo de roedores. Essas c?lulas tamb?m recebem proje??o direta da retina. Em primatas essa estrutura ainda n?o foi identificada. No entanto, um conjunto de c?lulas medial ao n?cleo geniculado lateral dorsal (GLD) do t?lamo, denominado de n?cleo pr?geniculado (NPG), se apresenta como poss?vel estrutura hom?loga ao FIG dos roedores, j? que algumas c?lulas do NPG apresentam imunorreatividade ao anticorpo contra NPY em diversos primatas estudados. Sabe-se que o sistema FIG-TGH al?m de estar relacionado ? modula??o f?tica do NSQ, parece tamb?m estar fortemente envolvido na sincroniza??o n?o-f?tica desse sistema. Ainda, as c?lulas imunorreativas a NPY est?o claramente mais envolvidas na sincroniza??o n?o-f?tica, comprovado pela marca??o da atividade metab?lica envolvendo o gene c-fos (gene de express?o imediata). Considerando este aspecto funcional e a dificuldade de identificar com precis?o uma estrutura hom?loga ao FIG em primatas, realizamos a caracteriza??o neuroqu?mica, analisamos o padr?o da proje??o retiniana e a express?o da prote?na do gene c-fos ap?s pulso de escuro, para melhor definir o papel do NPG dentro do STC. Para isso, usamos como modelo experimental um primata do novo mundo, o Callitrhix jacchus, conhecido popularmente como sag?i. Nossos dados confirmaram a hip?tese inicial de que o NPG, ou parte dele, seria hom?logo ao FIG de roedores. Encontramos, em toda extens?o do NPG do sag?i, neur?nios imunorreativos a NPY e uma densa proje??o retiniana em uma regi?o localizada mais pr?xima ao GLD. Conclu?mos que esta ?rea situada mais internamente, em rela??o ao complexo geniculado lateral do t?lamo, corresponde ao FIG e a por??o mais externa ao n?cleo geniculado lateral ventral dos roedores

Plasmamembranet är en komplex struktur som består av biomolekyler som lipider, proteiner och glykaner. Membranets rena komplexitet begränsar vår förmåga att förstå den spatiotemporala dynamiken hos sådana komponenter och deras kollektiva biofysiska membranparametrar. En sådan parameter som är svår att studera är asymmetri mellan lagren. Celler investerar mycket energi i den ojämna fördelningen av lipider mellan de inre och yttre lagren under olika cellulära händelser. Kunskapen om sådana parametrar kan vara av stor betydelse för förståelsen av cellers biologi och för att utveckla läkemedel och vacciner. Plasmamembranets tjocklek på 4-6 nm är en stor begränsande faktor eftersom det blir svårt att särskilja skillnaden mellan cytosoliska och exoplasmatiska signaler i plasmamembranet med fluorescent konfokalmikroskopi och superupplösande mikroskopi. I det här projektet använde jag MAP-expansionsmikroskopiprotokollet för att fysiskt öka avståndet mellan cytosoliska och exoplasmatiska lager, tillsammans med tvåfärgsmärkning av båda dessa strukturer för att förbättra deras visualisering. Biomimetiska cellmembranmodeller som Giant Plasma Membrane Vesicles (GPMVs), användes för att identifiera lämpliga märkningsstrategier. Klickkemibaserad märkningsstrategi valdes för exoplasmatisk märkning av lager och fluorescerande proteinbaserad märkning valdes för cytosolisk märkning av lager. GPMV-modellen användes för att identifiera de membranproteiner som specifikt aggregerar i de vätskestörda regionerna av membranet. MAP-expansionsprotokoll, när det utfördes på både celler och GPMV: er, visade att celler var mer tillförlitliga för expansion eftersom närvaron av cytoskeletts fysikalisk-mekaniska egenskaper som hjälper till med deras deformation. Expansionsfaktorn för MAP-protokollet beräknades till 3,3 med användning av kärnexpansion och en isotrop expansion observerades i densamma. Med denna expansionsfaktor och mer rödfärgsbaserade märkningsstrategier, antar jag att det skulle vara möjligt att visualisera asymmetrin mellan broschyrerna med hjälp av Superupplösande stimulerad emission utarmningsmikroskopi. / The plasma membrane is a complex structure comprised of biomolecules such as lipids, proteins, and glycans. The sheer complexity of the membrane limits our ability to understand the spatiotemporal dynamics of its components and their collective biophysical membrane parameters. One such parameter that is difficult to study is inter-leaflet asymmetry. Cells invest a lot of energy in the inhomogeneous distribution of lipids between the inner and outer leaflets during different cellular events. The knowledge of this parameter could be of great importance for understanding the membrane biology of cells and for designing drugs and vaccines. The 4-6nm thickness of the plasma membrane is a major limiting factor since it becomes difficult to distinguish the difference between the cytosolic and exoplasmic plasma membrane leaflet signals with fluorescence confocal and super-resolution microscopy. In this project, I employed the MAP expansion microscopy protocol to physically increase the distance between the cytosolic and the exoplasmic leaflets, coupled with two-colour labelling of both these structures to improve their visualization. Biomimetic cell membrane models like the Giant Plasma Membrane Vesicles (GPMVs), were used for identifying suitable labelling strategies. Click chemistry-based labelling strategy was chosen for exoplasmic leaflet labelling and fluorescent protein-based labelling was chosen for cytosolic leaflet labelling. The GPMV model was used to identify that the membrane proteins specifically aggregate in the liquid-disordered regions of the membrane. MAP expansion protocol, when performed on both cells and GPMVs, revealed cells to be more reliable for expansion, since the presence of cytoskeleton conferred physicomechanical properties to cells, aiding in their deformation. The expansion factor of the MAP protocol was calculated to be 3.3 using nuclear expansion and an isotropic expansion was observed in the same. With this expansion factor and more red dye-based labelling strategies, I hypothesize that it would be possible to visualize the inter-leaflet asymmetry using super-resolution Stimulated Emission Depletion microscopy.