Universiẗat, Diss., 2005--Bielefeld. / Dateiformat: zip, Dateien im PDF-Format.

Made available in DSpace on 2014-06-11T19:28:20Z (GMT). No. of bitstreams: 0 Previous issue date: 2011-01-20Bitstream added on 2014-06-13T20:57:52Z : No. of bitstreams: 1 sousa_al_me_botfm.pdf: 400232 bytes, checksum: 413adb726a7dddccb7a08b641c1afb97 (MD5) / O objetivo deste estudo foi compreender a experiência da equipe multiprofissional em uma unidade de queimados do interior paulista, visando ampliar o conhecimento sobre o tema apresentado, para subsidiar os profissionais que trabalham na referida unidade, melhorar a qualidade da assistência oferecida aos pacientes, bem como subsidiar e do ensino na área. Trata-se de um estudo descritivo, prospectivo e transversal, de abordagem qualitativa. Foram realizadas 27 entrevistas não diretivas e áudio gravadas, junto à equipe multiprofissional da unidade de tratamento de queimaduras (UTQ) do Hospital Estadual de Bauru, tendo como pergunta norteadora: Como tem sido a sua experiência trabalhando em uma unidade de queimados? A abordagem metodológica foi a de organização dos dados, baseada na Análise de Discurso do Sujeito Coletivo (DSC). Os dados obtidos geraram 21 ideias centrais no total, e destas, oito foram semelhantes para todos os entrevistados e 13 diferentes. Na análise dos discursos, pôde-se perceber a diversidade de sentimentos que afloram nos profissionais, desde a satisfação em trabalhar com esta clientela até sentimentos de pesar, incapacidade, fragilidade emocional, necessidade de suporte psicológico; bem como aspectos relacionados ao tratamento em si do queimado, como a importância do controle da dor. Compreendeu que a equipe de enfermagem é mais vulnerável à sobrecarga emocional gerada, quando comparada com as demais categorias profissionais. Outro aspecto a ser destacado é o controle da dor, principalmente na realização dos procedimentos inerentes ao tratamento. Diante disso, se destaca a importância de se oferecer aos membros da equipe multiprofissional o apoio necessário, para que o trabalho gere menos estresse e angústia e ressalta-se o uso correto do protocolo, que poderá contribuir para amenizar o sofrimento de ambos, equipe e pacientes, mas principalmente para estes últimos / The objective of this study was to understand the experience of the multidisciplinary team in a burns unit in the state of São Paulo, in order to increase the knowledge on the subject presented to support professionals working in the unit, improving the quality of care offered to patients as well as subsidize the education in the area. It is a descriptive, prospective cross-sectional, qualitative approach. 27 interviews were conducted with the non-directive taped together with the team of the multidisciplinary treatment unit burns (burn care unit), Bauru State Hospital, with the guiding question: How has been your experience working in a burn unit? The methodological approach was to organize the data based on analysis of the Collective Subject Discourse (CSD), 21 central ideas being generated in total and of these, eight were similar for all respondents and 13 different In a speech analysis it was possible to perceive the range of feelings that arose in professional satisfaction from working with these clients to feelings of grief, disability, emotional fragility, the need for psychological support, as well as aspects related to the treatment itself burned, the importance of pain control He realized that the nursing staff is more vulnerable to emotional overload generated when compared with the other professional categories. Another aspect to be highlighted is the control of pain, especially in procedures relating to treatment Therefore, we highlight the importance of providing members of the multidisciplinary team support needed to manage the job less stress and anxiety and it emphasizes the correct use of the protocol to help alleviate the suffering of both staff and patients but mainly for the latter

Chez les mammifères, deux types de tissu adipeux (TA) sont présents: le TA blanc, qui est l'organe de stockage et de libération des lipides, et le TA brun, qui est un organe spécialisé dans la production de chaleur grâce à l'expression de la protéine découplante mitochondriale UCP1.Chez l'homme, la présence d'un TA brun métaboliquement actif est inversement corrélée à l'obésité et au diabète de type 2. Ce TA brun est composé de deux types distincts de cellules thermogéniques, les adipocytes bruns classiques présents dans des dépôts spécifiques et les adipocytes "brite " (brown-in-white). Chez la souris, les adipocytes " brite " apparaissent dans le TA blanc lors d'une exposition au froid et sont protecteurs contre l'insulinorésistance induite par l'obésité. Ainsi le "brunissement " du TA blanc ouvre la voie à de nouvelles approches thérapeutiques pour lutter contre les pathologies associées à l'obésité. Toutefois, la capacité des adipocytes blancs humains à acquérir un métabolisme brun/brite reste méconnue. Notre étude cherche donc à identifier les changements moléculaires et métaboliques associés à la conversion d'adipocytes blancs humains différenciés en adipocytes " brite ", après un traitement par des agonistes des récepteurs nucléaires PPARgamma ou PPARalpha. Dans un premier temps, nous avons montré in vitro que les cellules hMADS(adipocytes humains dérivés des cellules souches mésenchymateuses), différenciées en adipocytes blancs sont convertis en adipocytes " brites " par les agonistes PPARgamma et PPARalpha. Ces adipocytes brites ont une activité mitochondriale élevée et expriment la protéine découplante UCP1. Dans un deuxième temps, nous avons mis en évidence que le brunissement s'accompagne d'un profond changement métabolique. La mise en place d'un cycle futile lipolyse/ré-estérification couplé à une augmentation de l'oxydation des acides gras permet de fournir les substrats nécessaires à la thermogenèse mitochondriale. A l'inverse, le transport et l'oxydation du glucose sont diminués notamment suite à l'inhibition de la pyruvate déshydrogénase par la protéine PDK4. A la place le glucose va être dirigé vers la voie de la glycéronéogenèse pour fournir le glycérol-3-phosphate nécessaire à la synthèse des triglycérides. Ainsi, l'ensemble du métabolisme des adipocytes " brite " est réorganisé vers l'utilisation des acides gras comme source principale d'énergie. Enfin, nous avons validé l'implication de PPARalpha dans les mécanismes de brunissement in vivo grâce à l'utilisation de souris dont le gène codant pour PPARalpha a été invalidé. L'induction du brunissement par un agoniste betea3-adrénergique nous a permis de confirmer que PPARalpha est nécessaire à l'expression optimale des gènes thermogéniques et au brunissement du tissu adipeux blanc. L'ensemble de ces données permet d'affirmer que chez l'homme, les adipocytes blancs sont capables de se convertir en adipocytes " brite ". Cette conversion s'accompagne de changements métaboliques qui favorisent l'utilisation intracellulaire des acides gras, ce qui pourrait diminuer leur niveau plasmatique limitant ainsi leur stockage ectopique dans les tissus insulinosensibles. / Two types of adipose tissue are present in mammals, white and brown adipose tissue. White adipose tissue (WAT) is specialized in storage and release of lipids, and brown adipose tissue (BAT) is specialized in energy dissipation as heat through the mitochondrial uncoupling protein 1 (UCP1).In humans,thermogenically-competent brown adipose tissue is negatively associated with body mass index and diabetes. BAT is composed of two distinct types of thermogenic cells, classical brown adipocytes located in specific depots and brite adipocytes (brown-in white). In mice, these cells appear in WAT upon cold exposure and are protective against obesity-induced insulin resistance. Therefore, fighting obesity through "browning" of white adipose tissue emerges as a promising strategy. However, the ability of human white adipocytes to acquire a brown/brite phenotype is not yet understood. Here, we aimed at identifying the molecular and metabolic changes associated with the white-to-brown conversion of human mesenchymal adipose-derived stem (hMADS) cells following treatment by agonists of the nuclear receptor PPARgamma or PPARalpha. First, we demonstrated in vitro that PPARgamma or PPARalpha agonists similarly induce white-to-brown conversion of hMADS cells into brite adipocytes that possess high mitochondrial content and express UCP1. Second, we showed that browning is associated with profound metabolic changes. The lipolytic machinery and fatty acid re-esterification was stimulated by the two treatments, resulting in a futile cycle. These adaptations combined with an increase of fatty acid betaoxidation provide substrates to sustain the high level of mitochondrial thermogenesis. In contrast, glucose uptake and oxidation are decreased through inactivation of the pyruvate dehydrogenase by PDK4. Consequently, glucose-carbons are redirected towards glyceroneogenesis to provide the glycerol-3-phosphate backbone necessary for triglyceride esterification. Thus, brite adipocyte metabolism is modified to promote fatty acid utilization as the main energy source. In order to confirm the involvement of PPARalpha in inducing browning in vivo, we treated mice with inactivation of the PPARalpha gene with a beta3-adrenergic agonist. In subcutaneous WAT, expression of BAT- and brite-specific markers was lower in PPARalpha knock out than in wild type mice, confirming that PPARa is required for WAT browning. Altogether, this study shows that PPARgamma and PPARalpha activation in human white adipocytes promotes browning associated with an increase in fatty acid utilization without enhancement of glucose metabolism. These metabolic changes favor intra-adipose fatty acid utilization and thus could diminish plasma fatty flux for ectopic storage into insulin-sensitive tissues.

No description available.

Zusammengestellt im März 2009-03-09 von Christian Leutemann.

Orientador: Janete Pessuto Simonetti / Coorientador: Silvia Cristina Mangini / Banca: Magda Cristina Q. Dell Acqua / Banca: Lídia Aparecida Rossi / Resumo: O objetivo deste estudo foi compreender a experiência da equipe multiprofissional em uma unidade de queimados do interior paulista, visando ampliar o conhecimento sobre o tema apresentado, para subsidiar os profissionais que trabalham na referida unidade, melhorar a qualidade da assistência oferecida aos pacientes, bem como subsidiar e do ensino na área. Trata-se de um estudo descritivo, prospectivo e transversal, de abordagem qualitativa. Foram realizadas 27 entrevistas não diretivas e áudio gravadas, junto à equipe multiprofissional da unidade de tratamento de queimaduras (UTQ) do Hospital Estadual de Bauru, tendo como pergunta norteadora: Como tem sido a sua experiência trabalhando em uma unidade de queimados? A abordagem metodológica foi a de organização dos dados, baseada na Análise de Discurso do Sujeito Coletivo (DSC). Os dados obtidos geraram 21 ideias centrais no total, e destas, oito foram semelhantes para todos os entrevistados e 13 diferentes. Na análise dos discursos, pôde-se perceber a diversidade de sentimentos que afloram nos profissionais, desde a satisfação em trabalhar com esta clientela até sentimentos de pesar, incapacidade, fragilidade emocional, necessidade de suporte psicológico; bem como aspectos relacionados ao tratamento em si do queimado, como a importância do controle da dor. Compreendeu que a equipe de enfermagem é mais vulnerável à sobrecarga emocional gerada, quando comparada com as demais categorias profissionais. Outro aspecto a ser destacado é o controle da dor, principalmente na realização dos procedimentos inerentes ao tratamento. Diante disso, se destaca a importância de se oferecer aos membros da equipe multiprofissional o apoio necessário, para que o trabalho gere menos estresse e angústia e ressalta-se o uso correto do protocolo, que poderá contribuir para amenizar o sofrimento de ambos, equipe e pacientes, mas principalmente para estes últimos / Abstract: The objective of this study was to understand the experience of the multidisciplinary team in a burns unit in the state of São Paulo, in order to increase the knowledge on the subject presented to support professionals working in the unit, improving the quality of care offered to patients as well as subsidize the education in the area. It is a descriptive, prospective cross-sectional, qualitative approach. 27 interviews were conducted with the non-directive taped together with the team of the multidisciplinary treatment unit burns (burn care unit), Bauru State Hospital, with the guiding question: How has been your experience working in a burn unit? The methodological approach was to organize the data based on analysis of the Collective Subject Discourse (CSD), 21 central ideas being generated in total and of these, eight were similar for all respondents and 13 different In a speech analysis it was possible to perceive the range of feelings that arose in professional satisfaction from working with these clients to feelings of grief, disability, emotional fragility, the need for psychological support, as well as aspects related to the treatment itself burned, the importance of pain control He realized that the nursing staff is more vulnerable to emotional overload generated when compared with the other professional categories. Another aspect to be highlighted is the control of pain, especially in procedures relating to treatment Therefore, we highlight the importance of providing members of the multidisciplinary team support needed to manage the job less stress and anxiety and it emphasizes the correct use of the protocol to help alleviate the suffering of both staff and patients but mainly for the latter / Mestre

Le phytomanagement est une méthode de gestion de sites pollués basée sur la capacité des plantes à séquestrer les polluants. L’utilisation de symbiotes fongiques peut représenter un atout afin d’augmenter la production de biomasse. Les endophytes bruns septés (DSE) pourraient stimuler la croissance végétale et augmenter leur protection contre les éléments-traces-métalliques (ETM). Cette thèse se déroule dans le cadre du projet LORVER et vise à comprendre l’interaction « plantes-DSE-sols pollués ». A ces fins, des champignons DSE isolés de racines de peupliers issues de sols pollués par des ETM ont été caractérisés. Ils appartiennent aux genres Leptodontidium, Phialophora, Cadophora et Phialocephala. Trois de ces souches ont ensuite été inoculées à des plantes en présence d’ETM. Dans certains cas, la croissance végétale a été stimulée et une augmentation de la teneur en chlorophylles, en P et en K, ou une réduction de la teneur en Cd dans les parties aériennes ont été mises en évidence. Puis, la souche la plus efficace sur la croissance végétale, Cadophora sp. Fe06, a été utilisée dans un double inoculum avec une souche endomycorhizienne, chez du ray-grass en présence d’ETM. Cette association diminue la teneur en Cd dans les feuilles. Enfin, les mécanismes impliqués dans la tolérance aux ETM chez les DSE ont été examinés via le criblage d’une banque de mutants d’insertions aléatoires, et via l’étude du rôle de la mélanine. Ce travail met en évidence que l’utilisation de DSE, de part leur capacité à coloniser de nombreuses plantes dans différents sols et à stimuler leur croissance, pourrait représenter un atout considérable pour des opérations de phytomanagement / Phytomanagement is a handling method of contaminated sites based on the ability of plants to sequester pollutants. Fungi could favor plant growth in contaminated sites but were far less studied in the context of phytomanagement. Dark septate endophytes (DSE) were reported to improve plant tolerance against metallic trace elements (TE). The present work is part of the LORVER project and aims to understand the “plant-DSE-TE”. DSE were isolated from poplar roots growing on TE-contaminated soils and characterized. They belong to Leptodontidium, Phialophora, Cadophora and Phialocephala genera. Three strains were inoculated to birch and poplar in TE-contaminated soils. Leptodontidium sp. improved plant growth with an increase in chlorophyll, P and K concentrations, whereas Cadophora sp. decreased Cd concentration in shoots of birch. Then, Cadophora sp. Fe06, was used with an endomycorrhizal fungus, to co-inoculate ryegrass in a TE-polluted soil. The co-inoculation leads to the decrease of Cd concentration in shoots. Finally, the mechanisms involved in TE-tolerance by DSE were studied through the screening of a library of Leptondontidium sp. insertional random-mutants and an evaluation of the role of melanin against TE stress. The present work highlights the complexity of the interactions between DSE and plants under TE stress. These interactions were influenced by different parameters including plant species, DSE strains, and soil properties. Nevertheless, the ability of DSE to colonize a broad spectrum of plants in different soils and to promote plant growth, suggest that DSE could represent a substantial benefit for the fungus-assisted phytomanagement of polluted soils

La thermogenèse adaptative est un mécanisme de production de chaleur médié par les adipocytes bruns. En réponse au froid, ou à un stimulus adrénergique, les adipocytes blancs peuvent être convertis en adipocytes beiges lors d’un processus que l’on nomme le « beiging ». Contrairement aux adipocytes blancs, les adipocytes beiges et bruns expriment des taux élevés de la protéine de découplage 1 (UCP1) et dissipent l'énergie sous forme de chaleur grâce à l'oxydation des lipides. Il a été démontré chez les rongeurs que l’activation des adipocytes bruns et beiges entraîne une réduction significative du poids corporel et l’activation de ces adipocytes chez l’humain semble être un traitement prometteur contre l’obésité et le diabète. Nous avons précédemment identifié un rôle essentiel de la protéine d’échafaudage 14-3-3ζ dans l'adipogenèse, mais son rôle dans d'autres processus adipocytaires reste incertain. Une des premières fonctions identifiées de la 14-3-3ζ est sa capacité à réguler l'activité enzymatique de la tyrosine hydroxylase, indispensable à la production de norépinephrine pour la thermogenèse. Notre étude vise donc à déterminer si la 14-3-3ζ influence le développement et la fonction des adipocytes beiges et bruns. Nos données montrent que la délétion d’un allèle du gène de la 14-3-3ζ n’affecte pas la tolérance au froid aiguë. Comparées aux souris de type sauvage (WT), les souris transgéniques mâles surexprimant la 14-3-3ζ (TAP) ont une meilleure tolérance au froid aiguë (3 heures, 4 °C) et chronique (3 jours, 4 °C). On observe chez les TAP une augmentation du beiging due à une élévation significative de l'ARNm et de la protéine UCP1 dans le tissu adipeux blanc inguinal (iWAT). Par ailleurs, les souris TAP présentent également une réduction significative de la conductance thermique lors d’exposition au froid leur permettant de mieux conserver la chaleur. Collectivement, nos résultats soulignent le rôle novateur de la 14-3-3ζ dans le beiging et nous permettent de mieux comprendre comment la thermogenèse adaptative est régulée. / Adaptive thermogenesis is a mechanism of heat production primarily mediated by brown fat. In some instances, cold exposure or adrenergic stimuli can convert white adipocytes into brown-like or beige adipocytes during a process termed “beiging”. Both beige and brown adipocytes express higher levels of uncoupling protein 1 (UCP1) and can release energy in the form of heat following lipid oxidation. The activation of these thermogenic adipocytes increases energy expenditure to reduce body weight in rodents, and it has been postulated to be a promising therapy for the treatment of obesity and diabetes. We previously identified an essential role of the molecular scaffold, 14-3-3ζ, in adipogenesis, but its roles in other adipocyte processes is uncertain. An early identified function of 14-3-3 was its ability to regulate the enzymatic activity of tyrosine hydroxylase, which is indispensable in the production of norepinephrine for thermogenesis. Thus, our study aims to investigate whether 14-3-3ζ influences the development and function of beige and brown adipocytes. We report here that one allele deletion of the gene of 14-3-3ζ did not affect acute cold tolerance. On the other hand, transgenic overexpression of 14-3-3ζ in male mice (TAP) improves cold tolerance due to enhanced beiging with a remarkable increase in Ucp1 mRNA and protein in inguinal white adipose tissue (iWAT). Interestingly, beiging is increased in the TAP mice without any changes in sensitivity to beta-adrenergic stimuli, sympathetic innervation, or norepinephrine content being detected between WT and TAP mice. TAP mice also displayed significantly lower thermal conductance decreasing heat loss during the chronic cold challenge. Collectively, our results point to a novel role of 14-3-3ζ in beiging and increases our understanding of how adaptive thermogenesis is regulated.

This thesis introduces and analyses the emerging Website genre of Resource Centre Sites. RCSs are sites which combine news, rumours and background information as well as community discussion and commentary on their chosen topic, and frequently serve as a first point of entry for readers interested in learning more about the field. They also offer spaces for virtual communities of specialists or enthusiasts to emerge, who in the process and as a product of their interaction on these sites collate detailed resource collections and hyperlink directories for their fields of interest. Therefore, Resource Centre Sites significantly involve their users as content contributors and producers, turning them into what is here termed ‘produsers’ of the site. Aiming to evaluate all the content relevant to their field that is becoming available online, and to coopt or at least link to this information from the news and resources collection that is a central part of the RCS, Resource Centre Site produsers engage in an adaptation of both traditional journalistic gatekeeping methodologies and librarianly resource collection approaches to the Web environment: in the absence of gates to keep online, they have become ‘gatewatchers’, observing the publication of news and information in other sources and publicising its existence through their own sites. Their operation is studied here through a number of case studies of major existing Resource Centre Sites from various fields of interest. These sites are analysed both based on their available Web content, and using background information obtained in a series of email interviews with RCS creators. In combination, this offers insights into the operating philosophies of sites and site editors, and provides an opportunity to assess to what extent these ideas have been translated into everyday practice. Chapter 1 provides an overview of past and current theoretical views of the Web in an effort to evaluate their suitability for the current study. Older approaches positing an abstract ‘ideal’ form of hypertext are rejected in favour of a direct engagement with the World Wide Web as the now dominant mode of hypertextuality. Chapter 2 outlines the principles of gatewatching in contrast to traditional methods of evaluating news and information as they exist in journalistic media and archival institutions, and investigates the effects such gatewatching practices may have on editors and users. Chapter 3 describes the overall characteristics of Resource Centre Sites as a genre of Web publications. It notes the special role site users play in the operation of such sites (in their new role as ‘produsers’), and distinguishes the RCS genre from similar Website models such as portals and cybermediaries. Chapter 4 observes the everyday operation of such Websites in practice, using case studies of major existing Resource Centre Sites including Slashdot, MediaChannel and CountingDown, and interviews with their creators. (These interviews are included in full in the Appendix.) This analysis works with both a synchronic view to the variety of topics existing Resource Centre Sites are able to address, and a diachronic view to the evolution of proto-RCSs (such as enthusiast community or online advocacy sites) into fully-featured Resource Centre Sites. Finally, based on this analysis, Chapter 5 is then able to point out some of the implications and effects that increasing use of this media form may have on its users and the network of news and information publications on- and offline, and to indicate the potential for further developments of the site genre.

This thesis introduces and analyses the emerging Website genre of Resource Centre Sites. RCSs are sites which combine news, rumours and background information as well as community discussion and commentary on their chosen topic, and frequently serve as a first point of entry for readers interested in learning more about the field. They also offer spaces for virtual communities of specialists or enthusiasts to emerge, who in the process and as a product of their interaction on these sites collate detailed resource collections and hyperlink directories for their fields of interest. Therefore, Resource Centre Sites significantly involve their users as content contributors and producers, turning them into what is here termed ‘produsers’ of the site. Aiming to evaluate all the content relevant to their field that is becoming available online, and to coopt or at least link to this information from the news and resources collection that is a central part of the RCS, Resource Centre Site produsers engage in an adaptation of both traditional journalistic gatekeeping methodologies and librarianly resource collection approaches to the Web environment: in the absence of gates to keep online, they have become ‘gatewatchers’, observing the publication of news and information in other sources and publicising its existence through their own sites. Their operation is studied here through a number of case studies of major existing Resource Centre Sites from various fields of interest. These sites are analysed both based on their available Web content, and using background information obtained in a series of email interviews with RCS creators. In combination, this offers insights into the operating philosophies of sites and site editors, and provides an opportunity to assess to what extent these ideas have been translated into everyday practice. Chapter 1 provides an overview of past and current theoretical views of the Web in an effort to evaluate their suitability for the current study. Older approaches positing an abstract ‘ideal’ form of hypertext are rejected in favour of a direct engagement with the World Wide Web as the now dominant mode of hypertextuality. Chapter 2 outlines the principles of gatewatching in contrast to traditional methods of evaluating news and information as they exist in journalistic media and archival institutions, and investigates the effects such gatewatching practices may have on editors and users. Chapter 3 describes the overall characteristics of Resource Centre Sites as a genre of Web publications. It notes the special role site users play in the operation of such sites (in their new role as ‘produsers’), and distinguishes the RCS genre from similar Website models such as portals and cybermediaries. Chapter 4 observes the everyday operation of such Websites in practice, using case studies of major existing Resource Centre Sites including Slashdot, MediaChannel and CountingDown, and interviews with their creators. (These interviews are included in full in the Appendix.) This analysis works with both a synchronic view to the variety of topics existing Resource Centre Sites are able to address, and a diachronic view to the evolution of proto-RCSs (such as enthusiast community or online advocacy sites) into fully-featured Resource Centre Sites. Finally, based on this analysis, Chapter 5 is then able to point out some of the implications and effects that increasing use of this media form may have on its users and the network of news and information publications on- and offline, and to indicate the potential for further developments of the site genre.