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A knowledge of the fundamental optical properties of breast tissues is necessary in order to optimize transillumination imaging techniques for the diagnosis of breast disease. The optical absorption and scattering coefficients have been measured in normal and diseased breast tissues, over the range of wavelengths from 500 to 1100 nm. The tissues were obtained from surgical specimens, and consisted of normal glandular and adipose tissues, fibrocystic disease, fibroadenoma, and ductal carcinoma. Total attenuation coefficients were measured for thin slices of tissue obtained on a microtome. The diffuse reflectance and transmittance were measured for 1.0 mm thick samples of these tissues, using standard integrating sphere techniques. Monte Carlo simulations were performed to derive the scattering and absorption coefficients, as well as the mean cosine of the scattering angle. The results indicate that scatter exceeds absorption by at least two orders of magnitude. The absorption coefficients are strongly affected by the presence of blood, particularly at wavelengths below 600nm. The scattering coefficients lie in the range 30 mm to 90 mm-1 at 500 nm, and fall smoothly with increasing wavelength to between 10 mm and 50 mm at 1100 nm. The scatter coefficient for adipose tissue differs, in that it is invariant with wavelength over this spectral range. The scattered light, for all tissues examined, is highly forward peaked, with the mean cosine of the scattering angle in the range 0.945 to 0.985. This value remains constant with wavelength to within +/-0.01 for any given tissue. The absorption coefficients and scattering properties of each tissue type fall within distinct ranges at each wavelength. Fibrocystic disease and adipose tissue appear to be the most clearly distinguishable groups. The optical properties of carcinoma do not differ significantly from those of normal glandular tissues, although both groups differ from other tissue types. The implications of these results for imaging are yet to be determined. / Thesis / Master of Science (MS)

Blood vessel mimics (BVMs) are tissue engineered blood vessels that are intended as an intermediate testing environment for intravascular devices, such as stents. Specifically, Cal Poly’s Tissue Engineering Lab hypothesizes that BVMs can be used to test endothelial cell and smooth muscle cell responses to existing and new vascular stents. Characterization techniques are required for BVMs to be accepted as a valid testing model, prior to being employed as an in vitro model to determine the effects of medical treatments. Quantitative real-time polymerase chain reaction (qPCR) is one available option for evaluating gene expression of tissues. qPCR can be performed on DNA synthesized from RNA isolated from cells, and in this application, will provide quantitative information on what proteins where being transcribed within the cells at the time of RNA isolation. qPCR can be used to determine the proteins expressed in BVMs at baseline in order to then characterize changes in protein expression induced by stent deployment within the BVM. The aim of this thesis was to optimize existing qPCR protocols, and implement the optimized protocols to characterize gene expression of stented and unstented blood vessel mimics (BVMs) and cells from a donor with Diabetes grown in Cal Poly’s Tissue Engineering Laboratory. To accomplish this goal, existing qPCR protocols were evaluated and modified to ensure reproducible, valid results were produced. Standard operating procedures were created for RNA isolation, cDNA synthesis, qPCR and qPCR data analysis. Optimized qPCR methods were then applied to BVMs from umbilical and coronary cell sources to compare the models and to study the BVM responses to stent deployment. Additional primers were also identified for potential usage as reference genes and as diabetic markers for diseased BVMs.

No description available.

L’évaluation de la Distance de Marche Maximale (DMM) des artériopathes claudicants représente un enjeu primordial puisqu'une DMM inférieure à 300 mètres est en faveur d'une prise charge chirurgicale. En routine clinique, la DMM est évaluée par questionnaires, méthode d'évaluation très subjective, ou par tests de marche sur tapis roulant qui sont protocole-dépendants et reproduisent mal la douleur habituelle. Aussi, l'objet de cette thèse est de tester la validité de méthodologies innovantes utilisant le GPS et la mesure transcutanée de la pression en dioxygène (TcPO2) lors d’un test de marche sur tapis roulant à l’égard de l’évaluation de la gêne fonctionnelle à la marche de patients artériopathes claudicants. La première étude montre que les scores au questionnaire EACHQ et la DMM déclarée par les patients sont plus corrélés à la DMM mesurée avec un GPS (reflet du patron de marche spontané) qu'aux scores du questionnaire WIQ, au test de marche de 6 minutes et au test sur tapis roulant. La seconde étude montre l'intérêt de la TcPO2 d'effort dans la détection des ischémies à l’exercice chez des patients présentant des Index de Pression Systolique de Cheville normaux. Les troisième et quatrième études montrent la fiabilité du GPS ainsi que son applicabilité dans l'évolution des paramètres de marche avant et après une revascularisation. Enfin, la cinquième étude suggère que le couplage GPS-accéléromètre permet l’estimation indirecte de la dépense énergétique chez le patient artériopathe. En conclusion, l'actimétrie (e.g., GPS, accéléromètre) et laTcPO2 d’effort constituent des méthodes valides et fidèles pour évaluer la marche de patients artériopathes claudicants. / Peripheral Arterial Diseased (PAD) is a major concern regarding their clinical care since a revascularization intervention is indicated below the cut-off point of 300 m. In clinical routine, MWD is usually assessed with clinical questionnaires, a highly subjective method, and with walking treadmill tests that are design-dependent and that hardly reproduce the usual pain of the patients during the walk. Therefore, the aim of this doctoral work is to test the validity of innovative methodologies based on GPS and Transcutaneous Pressure in Oxygen (TcPO2) during a treadmill test with respect to the assessment of the functional limitation in PAD patients. The first study shows that scores of the Estimation of Ambulatory Capacity by History-Questionnaire and MWD that is declared by the patients are more related to the GPS-measured MWD (that reflects the spontaneous walking pattern) than to the scores of the Walking Impairment Questionnaire, the 6-min walking test, and the walking treadmill test. The second study evidences the relevance of the use of TcPO2 during a walking treadmill test in detecting ischemia during exercise among patients with normal Ankle to brachial Index. The third and fourth studies show the reliability of the GPS as well as its applicability to the evolvement of the walking parameters following revascularization. Finally, the fifth study suggests that the GPS-accelerometer coupling is able to estimate the energy expenditure of PAD patients. To conclude, actimetry (e.g., GPS, accelerometer) and exercise TcPO2 are valid and reliable methods to evaluate the walk of PAD patients.

Submitted by Silvana Teresinha Dornelles Studzinski (sstudzinski) on 2016-05-18T15:12:54Z No. of bitstreams: 1 Daniela Negraes Pinheiro Andrade_.pdf: 3094213 bytes, checksum: 9a9e3f421a0d29eb223c0be2ccb4462d (MD5) / Made available in DSpace on 2016-05-18T15:12:54Z (GMT). No. of bitstreams: 1 Daniela Negraes Pinheiro Andrade_.pdf: 3094213 bytes, checksum: 9a9e3f421a0d29eb223c0be2ccb4462d (MD5) Previous issue date: 2016-02-26 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / FAPERGS - Fundação de Amparo à Pesquisa do Estado do Rio Grande do Sul / Esta tese resultou da investigação sobre o programa educacional para boas práticas de saúde que um hospital da rede privada localizado no sul do Brasil, nomeado na tese como Maxcárdio, realiza com portadores/as de Síndrome Coronariana Aguda e Insuficiência Cardíaca Congestiva. Adotou-se o aparato teórico – metodológico da Análise da Conversa (SACKS, 1992; SACKS; SCHEGLOFF; JEFFERSON, 1974) para analisar 25 interações ocorridas entre pacientes e profissionais médicos/as e não médicos/as – enfermeiros/as, nutricionistas, fisioterapeutas e psicólogos/as – integrantes da equipe multidisciplinar responsável pelas orientações aos/às pacientes. As interações foram gravadas em áudio e em vídeo e transcritas segundo Jefferson (1974). Os objetivos da tese foram: (a) verificar como os/as profissionais de saúde responsáveis pela efetuação do programa educacional recomendam ou prescrevem boas práticas de saúde no turno a turno de modo a discutir quais maneiras de falar mostram-se mais (potencialmente) particularizadas ou generalizadas em relação às necessidades demonstradas (ou não) pelos/as pacientes na interação e, a partir dessa discussão, apontar tendências de (não) adesão aos autocuidados recomendados ou prescritos por parte dos/as pacientes; (b) apresentar um percurso empírico representativo do programa educacional concernente à maneira como os/as participantes negociam, no turno a turno, direitos e obrigações de saber (domínio epistêmico) e de dizer (domínio deôntico) (HERITAGE, 2012; STEVANOVIC, 2011) o que (não) pode e/ou (não) dever ser feito em termos de boas práticas de saúde e, assim, discutir as implicações interacionais e práticas relacionadas às negociações entre os/as participantes em torno de direitos e obrigações de recomendar ou prescrever boas práticas de saúde; (c) discutir os modos de organização de prestação de serviço de orientação para boas práticas de saúde à luz do princípio da integralidade (BRASIL, 1998; MATTOS, 2005a). No que toca às maneiras de falar dos/as profissionais verificou-se que a particularização tende a ocorrer quando os/as profissionais instauram cursos de ação de modo a: (a) (tentar) remover empecilhos ao aceite do/a paciente à recomendação em favor de alguma boa prática de saúde; (b) desviar da ação de prover informações contidas nos manuais de boas práticas de saúde dos programas e demonstrar conhecimento sobre aspectos peculiares ao estado de saúde do/a enfermo/a; (c) justificar a indicação para a adoção de certa medida de cuidado de saúde. No que se refere à maneira como profissionais e pacientes negociam domínios epistêmicos e deônticos, observou-se que: (a) os/as profissionais não médicos/as colocam-se na posição de alguém com direitos e obrigações de saber e de dizer como pacientes devem controlar seu quadro de saúde; (b) os/as pacientes não ratificam os direitos e obrigações desses/as especialistas não médicos/as de saberem e poderem dizer-lhes como proceder no pós-alta; (c) os/as profissionais médicos/as abordam boas práticas de saúde em turnos de fala em formato de lista, o que conflita com a expectativa dos/as pacientes de discutir tais tópicos de maneira pormenorizada. Por fim, apurou-se que o modo de organização de prestação de serviço de orientação a pacientes que participam do programa Maxcárdio aproxima-se de ações assistenciais integrais (AYRES, 2004) à medida que os/as profissionais produzem falas capazes de estabelecer uma sequência de demonstração de necessidade de orientação a partir de solicitações de informações sobre se e como o/a paciente cuida de sua saúde. A contribuição teórica desta tese traduz-se na proposta de inclusão do aspecto modo de organização sequencial de tópico na descrição do princípio de fala ajustada (SACKS, 1992; SACKS; SCHEGLOFF; JEFFERSON, 1974). O modo como as sequências de tópicos são organizadas na interação mostra-se relevante para o grau de particularização que as falas dos/as interlocutores podem alcançar na conversa. Em termos aplicados, visto que ofertar recomendações ou prescrições ajustadas às necessidades dos/as pacientes interlocutores/as locais implicar saber se e como os/as doentes controlam seu estado de saúde, sugere-se que se parta da ação de solicitar informações acerca das experiências de sucesso e das dificuldades que os/as pacientes encontram para cuidar da saúde para, então, ter material interacional para orientá-los/as de forma particularizada. / This dissertation resulted from the investigation of educational programs into good health practices that a private hospital located in the South of Brazil accomplishes with Acute Coronary Syndrome and Congestive Heart Failure patients. Conversation Analysis theoretical and methodological approach (SACKS, 1992; SACKS, SCHEGLOFF, JEFFERSON, 1974) has been adopted to analyze 25 interactions occurred between patients and medical doctors or other health providers – nurses, nutritionists, physiotherapists and psychologists – members of the multidisciplinary team responsible for the patients’ orientation. Interactions were audio and video recorded and transcribed according to Jefferson (1984). The present dissertation aimed to: (a) verify how the health professional responsible for accomplishing the educational program recommend or prescribe good health practices in the turn by turn of the interaction so as to discuss which ways of talking appear to be more (potentially) particularized or generalized in relation to patients` (not) displayed needs in the interaction and, from such discussion, to point out tendencies of (non) adherence to good practices recommended or prescribed by patients; (b) present an empirical trajectory representative of the educational program concerning the ways participants negotiate, in the interaction turn-by-turn, rights and obligation of knowing (epistemic domain) and saying (deontic domain) (HERITAGE, 2012; STEVANOVIC, 2011) what can (not) and/or must (not) be done in terms of good health practices so as to discuss the interaction and practical implication related to the negotiation around rights and obligations of recommending or prescribing good health practices; (c) discuss the ways of organizing provision of orientation to good health practices in the light of principle of integrality (BRASIL, 1998; MATTOS, 2005a). Regarding more or less particularized ways of talking concerning patients’ orientation needs, it has been verified that the professional members’ talk appear to be more particularized in situations in which they implement courses of action in such a way as to: (a) (try to) remove obstacles so that patients may accept professional members’ recommendations in favor of good health practices; (b) deviate from the action of providing information included in the manuals of good health practices of the programs and display knowledge regarding patients’ peculiar health conditions; (c) justify the indication of certain good health practice. In relation of the ways professional members and patients negotiate epistemic and deontic domains, it has been observed that: (a) non-medical members assume the position of someone who has rights and obligations of knowing and saying how patients must control their health conditions; (b) patients do not ratify these professionals’ rights and obligations of knowing and saying how they should proceed in the post-discharge; (c) medical doctors talk about good heath practices by list-formatting their turns at talk, which conflicts with patients’ expectations of discussing these topics in a minutely detailed way. In the third one, a comparing analysis between two interactions has been done. Finally, it has been verified that the way of organizing service of orientation to patients approximate integral assistance actions (AYRES, 2004) insofar as professional members produce talk capable of establish a demonstration sequence of orientation need from information solicitation concerning if and how the patient takes care of their health. The theoretical contribution of this dissertation may be translated into the proposal of including the aspect topic sequential organization mode in the description of the principle of recipiency-designed (SACKS, 1992; SACKS; SCHEGLOFF; JEFFERSON, 1974). The way topical sequences are organized in the interaction displays relevance to the degree of particularization interlocutors’ talk may reach. In terms of applicability, as providing recipient-designed recommendations or prescriptions to situated interlocutors’ needs implicates knowing if and how patients control their health conditions, we suggest that professional members depart from the action of soliciting information regarding patients’ successful and failed experiences and their difficulties in heath-caring so that interactional material may be generated and patients’ orientation may be done in a particularized way.

This study acknowledges that historical antipathies towards gay men have marginalised their theatrical representation in the past. However, over the last century a change has occurred in the social location of gay men in Canada (from being marginalised to being included). Given these changes, questions arise as to whether staged representations of gay men are still marginalised today. Given antipathies towards homosexuality and homophobia may contribute to the how theatres determine the riskiness of productions, my investigation sought a correlation between financial risk in theatrical production and the marginalisation of gay representations on stage. Furthermore, given that gay sex itself, and its representation on stage, have been theorised as loci of antipathies to gayness, I investigate the relationship between the visibility and overtness of gay sex in a given play and the production of that play’s proximity to the mainstream. The study located four plays from across the spectrum of production conditions (from high to low financial risk) in BC. Analysis of these four plays shows general trends, not only in the plays’ constructions but also in the material conditions of their productions that indicate that gay representations become more overt, visible and sexually explicit when less financial risk was at stake. Various factors are identified – including the development of the script, the producing theatre, venue, and promotion of the production – that shape gay representation. The analysis reveals that historical theatrical practices, that have had the effect of marginalizing the representations of gays in the past, are still in place. These practices appear more prevalent the higher the financial risk of the production. / The author would like to sincerely thank Ann Wilson, Ric Knowles, Matthew Hayday, Alan Shepard, Sky Gilbert, Daniel MacIvor, Michael Lewis MacLennan, Conrad Alexandrowicz, Chris Grignard, Edward Roy, Brad Fraser, Cole J. Alvis, Jonathan Seinan, David Oiye, Clinton Walker, Sean Cummings, Darrin Hagin, and Chris Galatchian. / SSHRC, The Heather McCallum Scholarship, Lambda Prize for achievement in lesbian, gay, bisexual and trans-gendered studies.