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Cartazes circulantes: Atores, instituições e ambientes de manifestações midiatizadasNeves, Manoella Maria Pinto Moreira das 06 April 2017 (has links)
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Previous issue date: 2017-04-06 / PRODEP - Programa de Desenvolvimento de Pessoal / PROPEP - Pró reitoria de Pós Graduação e Pesquisa / UFAL - Universidade Federal de Alagoas / O cartaz, na sociedade em vias de midiatização, desprende-se ainda mais do suporte físico da cartolina e se mostra elemento de ingresso e performance nas manifestações contemporâneas ocorridas no Brasil e no mundo. Nesta tese, o cartaz estudado é o usado e apropriado em manifestações recentes, mais pontualmente nas de junho de 2013, no Brasil. Nas ambiências por onde passa, o cartaz é adaptado e registrado conforme as técnicas, regras e intenções de cada espaço: rua/praça - redes sociais digitais/espaço virtual - mídia tradicional/plateia. Sendo suporte físico, sendo imagem, sendo postado ou seu conteúdo sendo transformado em hashtag, as ambiências são marcadas na passagem do cartaz. E, para além de ser um suporte físico, o cartaz contém mensagem constituída em interação e circulação. Agenciando a circulação, os sentidos circulam e o cartaz se apresenta signo circulante. A tese é, nesse sentido, um esforço de registro de compreensão sobre circulação discursiva e ambiências midiatizadas desta circulação. O trabalho é referenciado teoricamente a partir de autores que tratam o tema midiatização e suas lógicas, circulação, fluxos e ambiências, em particular, alguns dos professores que dão sustentação à Linha de Pesquisa 4 do Programa do qual esta pesquisa está inscrita, são eles: Ferreira (2006, 2007, 2012, 2013, 2016), Braga (2013, 2012, 2011, 2010, 2007, 2006), Fausto Neto (2015, 2010, 2008) e Rosa (2014, 2012). Diante da necessidade de colocar em evidência o cartaz, utiliza-se, especialmente, Moles (2004). A questão Semiótica que perpassa a pesquisa baseia-se em Peirce (2013,2005) e Bakhtin (1997,1992), a partir do que suas concepções se aproximam, a saber, o valor do signo para além do objeto que representa e que, ao mesmo instante, o contém – esta aproximação foi possível através de Santaella (1994) e Santaella e Nörth (2004). Véron (2013, 2005,1997) é o autor que permite a relação entre semiótica e circulação. E por Mata (1992) são delineados os espaços de ambiência da circulação do cartaz. Assim, a pretensão teórica e metodológica desta tese é registrar uma experiência social de produção de circuitos de circulação e marcação de ambiências midiatizadas, a partir do uso e apropriação do cartaz nas Manifestações de Junho de 2013, no Brasil. / The poster, in the society in the process of mediatization, detaches itself even more from the physical support of the cardboard and shows itself as an element of entry and performance in the contemporary manifestations occurring in Brazil and in the world. In this thesis, the poster studied is the one used and appropriate in recent manifestations, most punctually in June 2013, in Brazil. In the ambiences where it passes, the poster is adapted and registered according to the techniques, rules and intentions of each space: street / square - digital social networks / virtual space - traditional media / audience. Being physical support, being image, being posted or its content being transformed into hashtag, the ambiences are marked in the passage of the poster. And, in addition to being a physical medium, the poster contains a message consisting of interaction and circulation. Managing the circulation, the senses circulate and the poster appears as a circulating sign. The thesis is, in this sense, an effort to register understanding about discursive circulation and mediated ambiences of this circulation. The work is theoretically referenced from authors who deal with the topic of mediatization and its logics, circulation, flows and ambiences, in particular, some of the professors who give support to Research Line 4 of the Program of which this research is inscribed are: Ferreira (2006, 2007, 2012, 2013, 2016), Braga (2013, 2012, 2011, 2010, 2007, 2006), Fausto Neto (2015, 2010, 2008) e Rosa (2014, 2012).. Faced with the need to highlight the poster, Moles (2004) was specially the reference. The question Semiotics that runs through the research is based on Peirce (2007,2005) and Bakhtin (1997,1992), from which their conceptions approach, namely, the value of the sign beyond the object it represents and that at the same time contains it - this approximation was possible through Santaella (1994) and Santaella and Nörth (2004). Véron (2013, 2005, 1997) is the author who allows the relation between semiotics and circulation. And by Mata (1992) are outlined the spaces of ambience of the circulation of the poster. Thus, the theoretical and methodological pretension of this thesis is to register a social experience of production of circuits of circulation and marking of mediatized ambiences, from the use and appropriation of the poster in the Manifestations of June of 2013, in Brazil.
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Avaliação da saúde bucal e detecção do vírus HSV-1 e EBV na saliva de pacientes pediátricos antes e depois do transplante renal / Assessment of oral health and detection of HSV-1 and EBV in saliva of pediatric patients before and after renal transplantationErika Mont'Alverne Pereira Silva 18 November 2010 (has links)
O transplante renal é uma modalidade de tratamento para substituir os órgãos em falência. As manifestações orais mais freqüentes nos pacientes portadores de insuficiência renal crônica (IRC) e transplantados renais (TR) são as alterações do esmalte, as estomatites, gengivites, diminuição do fluxo salivar, hiperplasias gengivais e as infecções por vírus, bactérias e fungos. A prevalência de infecções ativas causadas pelos herpesvírus aumentam quando há imunossupressão dos indivíduos. Em transplantados renais, apesar de ser realizada a profilaxia antiviral, a infecção clínica pelos vírus desta família tem levado a muitas complicações póstransplante aumentando a mortalidade e a morbidade destes pacientes. O objetivo deste estudo foi avaliar comparativamente as condições bucais e a presença dos vírus HSV-1 e EBV na saliva de pacientes pediátricos com IRC, TR e em pacientes normorreativos, através da técnica de PCR. Aplicou-se questionário a todos os pais ou responsáveis para obtenção dos dados demográficos, histórias médica e odontológica. Realizou-se avaliação da saúde bucal e coleta de saliva de 100 pacientes pediátricos de 0 à 16 anos, divididos em 3 grupos. O grupo 1 foi composto por 25 crianças insuficientes renais crônicos, o grupo 2 por 25 crianças transplantadas renais na Santa Casa de Misericórdia de São Paulo, e o grupo 3 por 50 crianças normorreativas na Clínica Odontológica da FOUSP. Independentemente do grupo, a maioria das crianças exibia pobre higiene oral, gengivite e moderada incidência de cárie. Entre as manifestações bucais avaliadas as que apresentaram diferença entre os grupos foram: No grupo 1 palidez da mucosa bucal (8/25, 32%), alteração de esmalte (5/25, 20%), manchas brancas (4/25, 16%), e sensação de boca seca (3/25, 12%). No grupo 2 foram: candidíase (1/25, 4%), queilite angular (1/25, 4%), e dentes conóides (1/25, 4%). A hiperplasia gengival medicamentosa esteve presente em 4 dos 25 (16%) dos pacientes desse grupo estudado, sendo em todos os casos grau 1 . No grupo 3 observou-se alteração de esmalte (6/50, 12%), manchas brancas (8/50, 16%) e fratura dental (1/50, 2%). Quanto a presença dos vírus observou-se que o HSV-1 foi encontrado na freqüência de: 4% no G1, 28% no G2 e 22% no G3 sendo essa diferença estatisticamente significante (p=0,039). O EBV foi encontrado em 24% dos pacientes do G1, 60% do G2 e em 44% dos pacientes do G3, sendo a diferença entre G1 e G3 estatisticamente significante (p=0,010). Frente as manifestações bucais e a presença do HSV-1 e do EBV encontradas nesta população evidencia-se a o importante papel do cirurgião dentista na equipe transplantadora, participando de novos métodos de diagnóstico, adequação bucal dos pacientes na fase pré transplante, como também nas intervenções curativas nas fases pré, trans e pós transplante. / Renal transplantation may be a treatment choice for patients with a failing kidney. Patients who present chronic renal failure and have undergone renal transplantation may show enamel abnormalities, periodontal disease, decrease of the salivary flow and gingival enlargement as common oral manifestations. Bacterial, fungal and viral infections can also develop, being the later a major cause of post-transplantation morbidity and mortality despite the antiviral prophylaxis. Thus, the purpose of this study was to observe the occurrence of oral manifestations and also to detect the presence of herpes virus 1 (HSV-1) and Epstein-Barr virus (EBV) in the saliva of pediatric renal transplant patients (RT), pediatric patients with chronic renal failure (CRF) and immunocompetent patients, comparing the results among the three experimental groups. All the analyses were performed through the polymerase chain reaction (PCR). A questionnaire was applied to the respective parents or legal responsible in order to obtain the demographic data, medical and dental histories. Oral manifestation records and saliva samples were obtained from 100 pediatric patients with an age that ranged from 0 to 16 years old. The experimental groups consisted of: Group 1 (G1): 25 children with chronic renal failure, group 2 (G2): 25 children after renal transplantation conducted at Santa Casa de Misericórdia of São Paulo city and group 3 (G3): 50 immunocompetent children clinically examined at the School of Dentistry, University of São Paulo. All of the analyzed children presented poor hygienic conditions, periodontal diseases and decreased rates of dental caries. G1 presented the following oral manifestations: paleness of oral mucosa (8/25, 32%), enamel abnormalities (5/25, 20%) and xerostomia (3/25, 12%). G2: oral candidiasis (1/25, 4%), angular cheilitis (1/25, 4%) and conic teeth (1/25, 4%). Four patients also presented gingival enlargement at degree one (16%). G3 presented enamel abnormalities (6/50, 12%) and dental fracture (1/50, 2%). HSV-1 was detected in G1 (4%), G2 (28%) and G3 (22%) and presenting statistically significant differences among the groups (p=0,039). EBV was detected in 24% of G1, 60% of G2 and 44% of G3, being this difference statistically significant (p=0,010). Oral manifestations as well as the presence of HSV-1 and EBV in CRF e RT patients highlight the importance of a dentist in the renal transplant team, providing optimal dental care of patients before and after the renal transplant.
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A phenomenological study of contemplative experiences : implications for interior designShah, Rinkle January 2009 (has links)
This research reports on a project concerned with the relationship between the person and the environment in the context of achieving a contemplative or existential state – a state which can be experienced either consciously or subconsciously. The need for such a study originated with the desire to contribute to the design of multicultural spaces which could be used for a range of activities within the public and the personal arena, activities including contemplation, meditation and prayer. The concept of ‘sacred’ is explored in the literature review and in primary interviews with the participants of this study. Given that the word ‘sacred’ is highly value-laden and potentially alienating for some people, it was decided to use the more accessible term ‘contemplative’. The outcomes of the study inform the practice of interior design and architecture which tends currently to neglect the potential for all spaces to be existentially meaningful. Informed by phenomenological methodology, data were collected from a diverse group of people, using photo-elicitation and interviews. The technique of photo-elicitation proved to be highly effective in helping people reveal their everyday lived experience of contemplative spaces. Reflective analysis (Van Manen 2000) was used to explore the data collected. The initial stage of analysis produced three categories of data: varying conceptions of contemplation, aspects of the person involved in the contemplation, and aspects of environment involved in contemplation. From this, it was found that achieving a state of contemplation involves both the person and the environment in a dialectic process of unfolding. The unfolding has various physical, psycho-social, and existential dimensions or qualities which operate sequentially and simultaneously. Two concepts emerged as being central to unfolding: ‘Cleansing’ and ‘Nothingness’. Unfolding is found to comprise the Core; Distinction; Manifestation; Cleansing; Creation; and Sharing. This has a parallel with Mircea Eliade’s (1959) definition of sacred as something that manifests itself as different from the profane. The power of design, re-contextualization through utility and purpose, and the existential engagements between the person and environment are used as a basis for establishing the potential contribution of the study to interior design. In this way, the study makes a contribution to our understanding of how space and its elements inspire, support and sustain person environment interaction – particularly at the existential level – as well as to our understanding of the multi-dimensional and holistic nature of this interaction. In addition, it points to the need for a phenomenological re-conceptualisation of the design/client relationship. In summary, the contributions of this research are: the exploration of contemplative experience as sacred experience; an understanding of the design of space as creating engagement between person and environment; a rationale for the introduction of a phenomenological approach to the relationship between designer and clients; and raising awareness of the spiritual in a holistic approach to design.
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An analysis and evaluation of the anoiting with the spirit in charismatic movements : a reformed assessmentSong, Jin Young January 2013 (has links)
This research has attempted to discover the ethos and characteristics of the anointing with the Spirit of the Charismatic movements with the reformed assessment. It has been studied how the exegetical interpretation and Scriptural theology of the anointing with the Spirit relate to the systematic reformed theology.
This study has indicated the key notion of this research, “the anointing with the Spirit” in Ancient Near Eastern Literature and in Scripture. The biblical foundation of the Reformed tradition on the notion of this research has been investigated and Christian reflection on the anointing with the Spirit has historically been investigated. The church’s dogmata of the anointing with the Spirit examined throughout the history of the church as well as whether the anointing with the Spirit in the Charismatic movement was implicated in the Reformed tradition. Whether the Reformed tradition disallowed all supernatural phenomena has also been examined, and what their concept is of the anointing with the Spirit.
The debates between charismatic and reformed perspectives on the theological characteristics of the anointing with the Spirit have been compared. Essential to the argument is the nature and characteristics of the Charismatic movement in relation to the anointing with the Spirit, in which the unique experiences of the Spirit and their response to the world is demonstrated.
The explored issues are systematically recapitulated and evaluated to be resolved. Four systematic spheres are examined with different hermeneutical approaches: the biblical and theological pneumatology; soteriology, in which the anointing with the Spirit is to be applied; promulgated eschatology that entails the characteristics of the missio Spiritus and the extent of the establishment of God’s kingdom in connection with the anointing with the Spirit, and finally mandated ecclesiology that requires responsibilities and commitments of those who are endowed with the charismata of the Spirit in the sphere of all contemporary areas.
The anointing with the Spirit is related to soteriological aspect, authentic repentance is preconditioned to be gifted the charismata of the Spirit (Acts 2:38-40). Unlikely the pneumatological concept of the Charismatic movements, it is not only a means to achieve the God’s redemptive task, but also a resolution to prepare a residence for the God the Spirit in the hearts of the believers. Consequently sanctification should be the centred-ethos in the manifestation and application of the charismata of the Spirit in the Charismatic movements. The Charismatic believe that the anointing with the Spirit is the presence of God. However, the sanctifying characteristics, which come through God’s presence, are scarcely demonstrated in the life of the Charismatic believers.
In the eschatological perspective, this research unveils the anointing with Spirit, poured upon the body of the Anointed One, is for eschatological completion, confirming the godly guarantee of his physical presence of the Anointed One by indwelling of his Spirit in and among their eschatological sanctuary. Simultaneously the anointing with the Spirit is perceived as a reality to encounter the upcoming dreadful judgment day of the Lord which will occur to the world. Justification and sanctification are essential requirements to face those days. Then the anointing with the Spirit in the Charismatic movement is by no means operated only for the present prosperity gospel. Eschatological imminence should be the foundational theology for both the Reformed and the Charismatic traditions.
In assessment and evaluation of the Charismatic movements, this research analyses the cohorts of the Charismatic have ostensibly collapsed into a predicament over the intuitive characteristics due to the deficiency of its confirmation with the authority of Scripture in the process of charismatic manifestations of the Spirit. Some Charismatics blunder into a deception since they incline to shape their ethos on emotional and sensational experience, rather than to formulate these experiences in response to the authentic truth of Scripture.
In this regards, this research indicates the Charismatics is to revise their dogmata according to Scripture. If spirituality is correlated to the knowledge of God through his Spirit, then the experience of genuine spirituality must be joined to what is meant by the truth of the Spirit. Nevertheless in search for the charismatic anointing with the Spirit, this study does not disregard the essential function of both inspirational intuition and rational conception to form their theology and beliefs on Scriptural foundation. The Reformed contends that they should eliminate the insecure and instinctive category of procedures and solemnly rely on the adequacy and exclusivity of Scriptural authority. The Charismatics believe that such knowledge is not seriously dissimilar to the imperfect nature of contemporary causes. However, both perspectives require some consideration. The instruction of the essence either repeats Scripture either Scriptural or is invalid.
Finally this investigation illustrates some contributions of the Charismatic movement that entails the revitalized crucial function of the charismata with manifestations of the Spirit for individual edification, energetic communal worship, and influential evangelism and particularly the contextualization in communication with other society and community in evangelism in the areas of the missio Spiritus, eschatology, and experience. / Thesis (PhD)--University of Pretoria, 2013. / gm2014 / Dogmatics and Christian Ethics / unrestricted
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The Dragons in your DreamsWalther, Jacquelyn 09 May 2012 (has links)
What if every craving that you ever felt stayed with you forever? Suppose facades couldn’t exist, and what should only be the deepest, densest core of a desire was formed into a mass, a body. Its will matching yours in its physical presence. I make creatures that are embodiments of emotions. In this study I mainly focus on desires and inhibitions surrounding romance. I explore anatomical structures and how material make-up can directly reflect emotional character. In this exploration, the materiality of clay allows for a thorough manipulation of the composition of the creatures. In this I am also able to manipulate the material properties of clay to reflect states of existential discomfort, pushing the limits of material structure and stability. The final presentation of these creatures are as specimens of inhibitions, drawing in the viewer with empathy and repulsion as a fantastic other.
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Analyse foucaldienne du dispositif policier à l'ère des manifestations altermondialistes et assembléistesLafleur, Sylvain 08 1900 (has links)
Cette thèse poursuit la réflexion de Foucault sur les « sociétés de sécurité » en abordant le thème de l’inflexion des (in)conduites des « sujets interstitiels » : les individus qui s’inscrivent en marge du pouvoir politique et qui par leurs revendications et leurs présences suscitent des inquiétudes, provoquent des dérangements. Plus précisément, elle interroge l’histoire de la police et les stratégies de gestion des manifestations pour dégager les facteurs menant, dans la foulée des grandes mobilisations altermondialistes, à l’adoption de l’incapacitation stratégique. Sur le plan méthodologique et théorique, elle convoque les réflexions de Foucault sur la police, la loi et la communication pour élaborer un cadre à partir duquel les travaux des sociologues des manifestations et des historiens de la police, portant sur l’évolution du contrôle des foules, seront interrogés dans l’objectif de dégager les tendances « lourdes » et la rationalité policière (et étatique) marquant le maintien de l’ordre contemporain. De même, elle examine des lois encadrant les manifestations pour mettre en lumière que celles-ci sont le fruit de tactiques permettant d’accroître la puissance d’action de leurs « convocateurs ». En parallèle à cette réflexion sur les caractéristiques de la ratio sécuritaire actuelle et sur les tactiques de contrôle, cette thèse identifie les principaux objets utilisés pour circonscrire les pratiques manifestantes afin d’en dégager leurs « fonctions », mais aussi, de relever les indices permettant de schématiser les relations constitutives du dispositif policier. Ainsi, en plus de réaliser une « analytique du présent », cette thèse explicite un diagramme de pouvoir. / This thesis pursues Foucault's reflections on the "security society" through an investigation into the theme of the modulation of the conduct of "interstitials subjects": individuals on the margins of powers whose presence and demands provoke concern and threaten the social order. More precisely, the thesis investigates the history of police and its strategies of crowd control as they lead to the adoption of a strategy of "preventive incapacitation," the aftermath of anti-globalization protests. On a theoretical and methodological level, the thesis draws on Foucault's theories of the police, law, and communication, in dialogue with the work of sociologists of social movements and historians of police, with the aim of better understanding the "hard" tendencies and (State) rationality characteristizing today's policing. The thesis will also examine the laws concerning protests, in order to shed light on how their implementation augments the power of those with the authority to enact them. Furthering these analyses of the ratio of security and the tactics of control, the thesis identifies the principal objects and objectives employed to circumscribe the actions of protesters. This is done in order to reconceptualize the different functions now fulfilled by policing and to schematize the constitutive relations of the contemporary police apparatus. The overall aim of the thesis is to produce an "analytic of the present" of policing, and more generally to elaborate a "diagram" of power.
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Současná grafika a výtvarná výchova na základní škole / Contemporary printmaking and art educationKopicová, Jiřina January 2011 (has links)
KOPICOVÁ, Jiřina. Contemporary Printmaking and Art Education. Prague, 2011. 115 p. Master Thesis. Charles University in Prague - Faculty of Educati- on. Head of the Master Thesis Mgr. Linda Arbanová, PhD. This is a theoretical study investigating the present-day free graphic arts (designs). It describes the main trends, materials and techniques used. The text contains an an- notated selection of several Czech and foreign authors, which illustrates the different mainstreams of contemporary graphic arts. The didactic part of this study contains a research on the topic entitled Relation of Ba- sic-School Students to the Graphic Arts and a suggestion of a didactic approach to Art teaching based on the results of the research. The creative part of the study shows my own works-based on the topic: Time of Natu- re-made with the combined technique of digital print and linocut.
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A declaração de vontade negocial na formação do negócio jurídicoAvillés, André Guimarães 19 February 2016 (has links)
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Previous issue date: 2016-02-19 / This work comes in response to the great importance of study about transaction
declaration of will to the transaction acts. The analysis of subjective and objective
aspects, of the will and its manifestation does not have consensus between the
doctrine and the main Roman-Germanic origin civil legislation in force. Therefore, the
work seeks to analyze the concept of transaction act, in order to dissect what is in
fact the place of declaration of will on its formation, and what are its necessary
elements to bring a declaration of will able to create, modify or extinguish rights
within the sphere of Private Law. In addition, the study seeks to address the main
forms of known declaration of will, as well as how these are viewed by contemporary
laws / A escolha do objeto deste estudo se deveu à grande importância que o estudo da
declaração de vontade negocial tem para a formação do negócio jurídico. A análise
de seus aspectos subjetivos e objetivos, da vontade e de seu modo de
exteriorização ainda não possui consenso entre a doutrina e as principais
legislações civis de origem romano-germânica vigentes. Por isso, buscou-se
adentrar no próprio conceito de negócio jurídico, a fim de se dissecar qual é de fato
o papel da declaração de vontade negocial na sua formação, bem como quais são
os elementos necessários para que se produza manifestação de vontade apta a
criar, alterar ou extinguir direitos dentro da esfera do Direito Privado. Além disso, o
trabalho buscou enfrentar as principais formas de declaração de vontade negocial
conhecidas, bem como a maneira como estas são encaradas pelas legislações
contemporâneas
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Parceria público-privada para produção de moradia popular no estado de São Paulo: o Programa da Casa Paulista / Public-Private Partnership to Build Social Housing in São Paulo State: The Casa Paulista ProgramPalladini, Gabriel Maldonado 08 May 2018 (has links)
A presente dissertação tem como objeto de estudo o programa de parceria público-privada para a construção de moradia popular no centro da cidade de São Paulo. Promovido pelo Governo do Estado de São Paulo, o projeto foi escolhido como estudo de caso para discutir a utilização do instrumento jurídico-contratual de parceria público-privada, regido pela lei federal nº 11.079 de 2004 na construção de moradia popular no Estado de São Paulo. De modo específico, pretendeu-se entender como foram feitos os estudos pelas instituições privadas no processo da Manifestação de Interesse Privado (MIP) que resultaram no edital de licitação lançado de 2012. A coleta de informação foi feita a partir de entrevista com os principais atores envolvidos no projeto, desde funcionários do Governo do Estado, consultores privados e funcionários de empresas do setor de construção civil. Como suporte às entrevistas, utilizou-se documentos disponibilizados pela Secretaria de Habitação. Previsto na legislação brasileira desde 1995, o instrumento que permite que instituições privadas ofereçam projetos de parceria entre o setor público e o privado passa a ser mais amplamente utilizado a partir de 2004, com a aprovação da lei federal das PPPs. Partindo de uma análise da própria estrutura administrativa do Governo do Estado de São Paulo, o presente estudo se propôs a entender como as parcerias público-privadas estão sendo utilizadas no setor de habitação social. / The aim of this dissertation is to study the Public-Private Partnership Program for the construction of popular housing in the city of São Paulo. Promoted by the São Paulo Government State, the project was chosen as a case study to discuss the use of the contractual instrument of public-private partnership, governed by federal law 11.079 of 2004 in the construction of popular housing in the State of São Paulo. Specifically, it intends to understand how the studies were done by the private institutions in the process of the Private Interest Manifestation (MIP) that resulted in the auction notice issued of 2012. The data collection was made from interviews with the stakeholders involved in the project, from State Government employees, private consultants and employees of construction companies. To support the interviews, documents made available by the Housing Secretariat of São Paulo State were analyzed. Under Brazilian law since 1995, the instrument that allows private institutions to offer public-private partnership to the government became more widely used in 2004, with the approval of the federal PPP law. Based on an analysis of the administrative structure of the São Paulo Government State, the present study aims to understand how public-private partnerships are used in the social housing sector.
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Approche diagnostique et fonctionnelle dans l'artériopathie oblitérante des membres inférieurs : étude de l'apprentissage et de l'enseignement de l'index de pression systolique de repos chez des étudiants en médecine, et développement d'une méthode ambulatoire de quantification de la douleur ischémique à la marche par couplage de moniteurs portables / Diagnostic and functional approach in peripheral artery diseaseChaudru, Ségolène 25 October 2018 (has links)
L’Artériopathie Oblitérante des Membres Inférieurs (AOMI) est une pathologie chronique grave, induite par le processus physiopathologique d’athérosclérose. Diagnostiquée par la mesure de l’Index de Pression Systolique (IPS) de repos cette pathologie se traduit chez la plupart des patients par une ischémie (apports sanguins insuffisants) à l’exercice pouvant causer l’apparition de douleurs au niveau des membres inférieurs lors de la marche. Le premier axe de travail de cette thèse visait à évaluer la pertinence pédagogique des méthodes actuelles d’enseignement de l’IPS dans les facultés de médecine françaises. Les résultats des premiers travaux de recherche qui ont été menés montrent que les méthodes actuelles ne permettent pas aux étudiants de maîtriser les fondamentaux de cette mesure diagnostique. D’autres travaux ont alors été menés afin de définir la place et la forme que devrait prendre l’enseignement de l’IPS dans le cursus médical afin qu’il puisse être acquis par les futurs médecins de manière fiable et durable. Le second axe de travail de cette thèse visait à proposer une nouvelle approche méthodologique basée sur l’utilisation conjointe de deux moniteurs portables (accéléromètre et montre marqueur d’événements) permettant la quantification des douleurs ischémiques à l’exercice des patients atteints d’AOMI en condition de vie réelle. Les résultats issus de ces travaux ouvrent des perspectives nouvelles pour le chercheur ou le clinicien pour la compréhension des limitations fonctionnelles des patients atteints d’AOMI dans leur contexte de vie. / Lower-extremity Peripheral Artery Disease (PAD) is a severe non-communicable disease that is associated with atherosclerosis. Diagnosed by Ankle- Brachial Index (ABI), PAD leads, in most patients, to ischemia (mismatch between blood demand and blood supply) during exercise that may lead to the occurrence of pain in the lower extremities during walking. The first axis of the present thesis was to assess the level of knowledge on this diagnostic tool among French medical students. Our results suggest that the way of teaching or learning the ABI procedure is deficient. According to these results we conducted another study to determine the best teaching method to improve students’ ABI proficiency. The second axis of the present thesis was to proposed a new method using wearable monitors (accelerometer and Micro Motion logger watch) to objectively identify and quantify lower limb walking pain manifestation as well as stop induced by walking pain during daily life in PAD patients. Our results can provide researchers and clinicians with a more realistic and holistic view of the functional limitations of PAD patients in free-living conditions.
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