Contexte. Alors que le fait que les femmes manifestent moins de comportements antisociaux que les hommes est bien établi, l’étiologie des différences sexuelles liées à ces comportements demeure grandement incomprise. Objectif. Le but de cette thèse était de mieux comprendre l’étiologie des différences sexuelles liées aux comportements antisociaux de l’enfance au début de l’âge adulte. Cadre théorique. Les propositions des théories du contrôle en regard des différences sexuelles ont été examinées en comblant certaines de leurs limites utilisant une approche développementale. Les associations entre le contrôle parental, le contrôle de soi, le patriarcat familial et les comportements antisociaux des hommes et des femmes ont été analysées. Une attention particulière a été portée aux périodes développementales (ex., adolescence, âge adulte), aux types de comportements (ex., violents, contre les biens) et aux types de mesures (ex., autorapportés, dossiers criminels) afin d’assurer une analyse complète des différences sexuelles. Méthodologie. Les données proviennent de 3007 participants de l'Étude longitudinale québécoise des enfants de maternelle au Québec, prospectivement suivi de la maternelle au début de l'âge adulte. Les comportements antisociaux ont été mesurés à l'enfance (6 à 12 ans), à l'adolescence (13 à 17 ans) et au début de l’âge adulte (âgés de 18 à 26) par des questionnaires autorapportés, entrevues cliniques et dossiers criminels juvénile et adulte. Des analyses multiniveaux et modèles complexes non paramétriques (ex., régression binomiale négative avec inflation du zéro, régressions longitudinales à associations croisées) ont été utilisés pour vérifier les hypothèses des théories du contrôle social, du contrôle de soi, et du pouvoir-contrôle quant aux différences sexuelles. Principaux résultats. Les résultats ont montré que le contrôle de soi et le contrôle parental étaient associés de manière similaire aux comportements antisociaux des hommes et des femmes. Les filles avaient généralement un meilleur contrôle de soi et étaient plus contrôlées par leurs parents que les garçons, ce qui explique partiellement leur moins grande manifestation de comportements antisociaux. Ni les contrôles parentaux ni le contrôle de soi n’expliquent l’entièreté des différences sexuelles liées aux comportements antisociaux. Les résultats ont aussi révélé des influences réciproques entre le contrôle de soi, le contrôle parental et les comportements antisociaux, suggérant l’interaction de l'enfant avec son environnement dans l'émergence et la persistance des comportements antisociaux. Le patriarcat familial n’intervient généralement pas dans l’étiologie des comportements antisociaux des garçons ou des filles. Néanmoins, les résultats suggèrent que le contrôle de soi et le patriarcat familial pourraient influencer davantage la fréquence ou la diversité des comportements antisociaux rapportés dans les dossiers criminels. Conclusions. La présente thèse montre l’importance d’étudier les différences sexuelles liées aux comportements antisociaux dans toute leur complexité, c’est-à-dire en considérant la période développementale et les types de comportements et de mesures. Les résultats suggèrent que les mêmes facteurs de risque du contrôle seraient associés aux comportements antisociaux des hommes et des femmes et que ces facteurs de risque auraient un effet similaire sur eux. Ces résultats suggèrent que l’exposition différentielle des hommes et des femmes à ces facteurs de risque expliquerait les différences sexuelles liées aux comportements antisociaux. Un modèle alternatif du contrôle est proposé pour améliorer la compréhension de l’étiologie de ces différences sexuelles. / Context. The fact that girls manifest less antisocial behavior than boys is well known, although the etiology of the sex differences in antisocial behavior is still relatively misunderstood. Objective. The aim is to improve the understanding of the etiology of sex differences in antisocial behavior from childhood to early adulthood. Theoretical Framework. A theoretical framework was built based on control theories in criminology, addressing their weaknesses with developmental studies strengths. Associations between three control-related constructs (i.e., self-control, parental control, and familial patriarchy) and boys’ and girls’ antisocial behavior is assessed across developmental periods, in addition to their interplay. Method. Data are from 3007 participants of the Québec Longitudinal Study of Kindergarten Children prospectively followed from kindergarten to early-adulthood. Antisocial behavior was assessed during childhood (ages 6 to 12), adolescence (ages 13 to 17) and early adulthood (ages 18 to 26) using questionnaires, clinical interviews, and juvenile and adult official records. Multilevel analyses and non-parametric complex models (e.g., Zero-Inflated Negative Binomial Regressions, Cross-Lagged Path Modeling) were used to test the hypotheses regarding sex differences in antisocial behavior proposed by self-control theory, social control theory and power-control theory. Main Results. Results showed that self-control and parental control are risk factors of antisocial behavior for boys and girls. Girls generally had a better self-control and were more controlled by their parents than boys, which partially explained that they manifested less antisocial behavior. Neither self-control nor parental control explained the entirety of the noted sex differences in antisocial behavior. In addition, there were reciprocal influences between self-control, parental control, and antisocial behavior from childhood to adolescence, suggesting a transactional process of the child and its environment in the emergence and persistence of antisocial behavior. Familial patriarchy was overall not associated with boys’ or girls’ manifestation of antisocial behavior. Results, however, indicated that self-control and familial patriarchy could have a stronger influence in regards of the frequency and/or diversity officially recorded antisocial behavior. Conclusions. This thesis supports the relevance of considering all variations in sex differences in antisocial behavior, namely variations across developmental periods, types of behavior and measures. Results suggest that the same control risk factors are associated with boys’ and girls’ antisocial behavior and that those risk factors have a similar effect for them. Sex differences in exposition to those risk factors would generally better explain sex differences in antisocial behavior. An alternative developmental model of control is proposed to account for all sex differences.

Intergenerational relationships can be defined as interactions between members of different generations. There are two different groups of intergenerational relationships, historical and familial. The familial relationship consists of members who are familially related, while historical generations can be viewed as a cohort, or a group of people who have experienced similar historical events, because they are the same age or have lived through the same historical period. Most research in South Africa has focused on intergenerational relationships among African families. Research into these families highlights the role of grandparents as people with wisdom, life experience and the educative relationship they have with their grandchildren. Grandchildren, on the other hand, have to take care of their grandparents and respect them as older people. Members of the different generations provide social support, despite the fact that they are not familially-related. The norms that guided the interactions between these two generations provide individuals with a sense of continuity and stability. Social theories regarding intergenerational relationships are: the solidarity model, the solidarity and conflict model, and ambivalence. Current theories from the psychological perspective are: intergenerational intelligence and self-interactional group theory (SIGT). Little research has been conducted into intergenerational relationships among white familial generations in South Africa even though the phenomenon has been widely researched internationally. In order to establish the nature of the intergenerational relationship, young adults’ lived experiences of their relationships with older people was the focus of this research. This focus has been motivated by the fact that young adults and older people can benefit from effective intergenerational relationships; young adults provide a source of physical and emotional care for older people, where the older person in turn provide a source of affirmation and shared experience for young adults. This research is further motivated by the fact that it cannot be assumed that white generations in South Africa are necessarily following international trends. The study was conducted at the North-West University, at Potchefstroom in South Africa. Psychology Honours students were purposively selected to participate because of their age group as young adults, and their knowledge of human behaviour. It was thought that their description of their relational experiences would be of particular interest. Nineteen young adults (eighteen women and one man) aged 21 to 30 formed part of the study. Ethical approval for the research was obtained from North-West University. The participants gave informed consent that their participation was voluntary, and that they had been made aware that they could withdraw from the study at any time for whatever reason without any negative consequences. They were provided with the materials of the Mmogo-method®, which consist of clay, straws and colourful beads, and were invited to make a visual representation of their relationship with a person older than 60 years. When all the participants had completed their visual presentations, the researcher asked what each had made and why they had made it. An informal group discussion was conducted after each participant had told the others what they had made. During the discussion participants shared their subjective view of their experiences of their relationship with older people. The researcher employed visual data analysis and discourse analysis to analyse the data. Different guidelines were applied to ensure the trustworthiness of the research process and the findings. The results revealed that young adults experienced four types of relationships, which are presented as typologies. The two axes which describe the four types of relationships are: intimacy (physical and emotional) or distance and empathy or judgemental. The four types of intergenerational relationships that emerged from the combination of the different axes were: effective, normative-guided, ineffective, and double-bind. These findings can be used to develop programmes and interventions to promote intergenerational relationships. They also provide an opportunity for cross-cultural and international data to be compared with the four different relationship types. / MA (Clinical Psychology), North-West University, Potchefstroom Campus, 2014

Intergenerational relationships can be defined as interactions between members of different generations. There are two different groups of intergenerational relationships, historical and familial. The familial relationship consists of members who are familially related, while historical generations can be viewed as a cohort, or a group of people who have experienced similar historical events, because they are the same age or have lived through the same historical period. Most research in South Africa has focused on intergenerational relationships among African families. Research into these families highlights the role of grandparents as people with wisdom, life experience and the educative relationship they have with their grandchildren. Grandchildren, on the other hand, have to take care of their grandparents and respect them as older people. Members of the different generations provide social support, despite the fact that they are not familially-related. The norms that guided the interactions between these two generations provide individuals with a sense of continuity and stability. Social theories regarding intergenerational relationships are: the solidarity model, the solidarity and conflict model, and ambivalence. Current theories from the psychological perspective are: intergenerational intelligence and self-interactional group theory (SIGT). Little research has been conducted into intergenerational relationships among white familial generations in South Africa even though the phenomenon has been widely researched internationally. In order to establish the nature of the intergenerational relationship, young adults’ lived experiences of their relationships with older people was the focus of this research. This focus has been motivated by the fact that young adults and older people can benefit from effective intergenerational relationships; young adults provide a source of physical and emotional care for older people, where the older person in turn provide a source of affirmation and shared experience for young adults. This research is further motivated by the fact that it cannot be assumed that white generations in South Africa are necessarily following international trends. The study was conducted at the North-West University, at Potchefstroom in South Africa. Psychology Honours students were purposively selected to participate because of their age group as young adults, and their knowledge of human behaviour. It was thought that their description of their relational experiences would be of particular interest. Nineteen young adults (eighteen women and one man) aged 21 to 30 formed part of the study. Ethical approval for the research was obtained from North-West University. The participants gave informed consent that their participation was voluntary, and that they had been made aware that they could withdraw from the study at any time for whatever reason without any negative consequences. They were provided with the materials of the Mmogo-method®, which consist of clay, straws and colourful beads, and were invited to make a visual representation of their relationship with a person older than 60 years. When all the participants had completed their visual presentations, the researcher asked what each had made and why they had made it. An informal group discussion was conducted after each participant had told the others what they had made. During the discussion participants shared their subjective view of their experiences of their relationship with older people. The researcher employed visual data analysis and discourse analysis to analyse the data. Different guidelines were applied to ensure the trustworthiness of the research process and the findings. The results revealed that young adults experienced four types of relationships, which are presented as typologies. The two axes which describe the four types of relationships are: intimacy (physical and emotional) or distance and empathy or judgemental. The four types of intergenerational relationships that emerged from the combination of the different axes were: effective, normative-guided, ineffective, and double-bind. These findings can be used to develop programmes and interventions to promote intergenerational relationships. They also provide an opportunity for cross-cultural and international data to be compared with the four different relationship types. / MA (Clinical Psychology), North-West University, Potchefstroom Campus, 2014

Thesis (PhD)--Stellenbosch University, 2004. / ENGLISH ABSTRACT: Progressive familial heart block I (PFHBI) is an inherited autosomal dominant cardiac conduction disorder which segregates in a large South African (SA) pedigree, two smaller SA families and a Lebanese family. It specifically affects conduction in the ventricles and is of unknown cause. Clinically, PFHBI is detected on electrocardiogram (ECG) by evidence of bundle-branch disease, i.e., as right bundle branch block, left anterior or posterior hemiblock, or complete heart block with broad QRS complexes. The PFHBI-causative gene was mapped to a lOcM region on chromosome 19ql3.3 using linkage analysis, and the locus was subsequently reduced to 7cM by genetic fine mapping. The present study involved a multi-strategy approach to search for the PFHBI gene. The objectives were the further reduction of the PFHBI locus by genetic fine mapping using published and novel markers, searching for short gene transcripts from publicly available databases and the generation of an integrated map of the locus to which genes were mapped. Prioritised genes were screened for PFHBI-causing mutations and, in addition, the PFHBI locus was searched for the presence of a G protein-encoding gene (PI 15- RhoGEF), a connexin (Cx) gene and any genes containing a CTG repeat expansion motif, since these genes are plausible PFHBI candidate genes. Genotyping and fine genetic mapping using known and novel polymorphic dinucleotide (CA)n and novel tetranucleotide (A3G)n repeat markers across the PFHBI locus were performed. Publicly available databases, such as LLNL (Livermore, USA), and GENEMAP (NCBI) were searched for ESTs which, in turn, were extended using clustering programmes, such as UNIGENE (NCBI) and STACK (SANBI), and the resulting consensus sequences were subsequently BLAST-searched against the protein databases. Using the available data, an integrated physical and genetic map of the PFHBI locus was generated and, as the HGP progressed, a number of novel genes were placed thereon. Subsequently, genes were prioritised on the basis of position, function and expression profile. Genetic fine mapping reduced the PFHBI locus from 7cM to 4cM. The EST approach yielded 38 ESTs, of which 24 ESTs matched proteins, such as activating transcription factor 5 (ATF5), actin-binding protein (KPTN) and zinc finger protein 473 (ZFP473) (May 2003). All the map data generated experimentally and computationally were placed on the PFHBI map. The PI 15-RhoGEF was excluded as a PFHBI candidate gene and although homologous sequences to connexin 37 (Cx37) was located on both chromosome 19 radiation hybrid clones (RHG12 and ORIM-7), it was not identified on the DNA clones spanning the PFHBI locus. No evidence of an expansion of a CTG repeat motif sequence in PFHBI-affected individuals was found. Five highly prioritised candidate genes, namely, 5CZ2-associated X protein (BAX), potassium voltage-gated channel Shaker-related subfamily member 7 (KCNA7’), potassium inwardly-rectifying channel, subfamily J, member 14 (KIR2.4), lin-7 homolog B {LIN-7B) and glycogen synthase 1 (GSYI) were selected for mutation screening. No disease associated mutations were identified in the exonic and flanking intronic regions of these genes. In summary, this study reduced the PFHBI locus substantially and generated a detailed map of the region. A number of attractive candidate genes were excluded from causing PFHBI; however, several plausible candidate genes are still present at this gene-rich locus and remain to be screened. Identifying the PFHBI-causative gene and associated mutation will provide a platform for further studies to understand the pathophysiology, not only of PFHBI, but also of other more commonly occurring conduction disturbances. / AFRIKAANSE OPSOMMING: Progressiewe familiele hartblok I (PFHBI) is ‘n autosomaal dominant oorerflike kardiale geleidingstoomis wat in ‘n groot Suid-Afrikaanse (SA) familie, twee kleiner SA families en ‘n Lebanese familie segregeer. Dit affekteer hoofsaaklik die geleiding in die ventrikels en die oorsaak daarvan is onbekend. Klinies word PFHBI op elektrokardiogram (EKG) geidentifiseer as a bondeltak-siekte, naamlik, as regter bondeltakblok, linker anterior of posterior hemiblok, of volledige hartblok met wye QRS komplekse. Die PFHBI-veroorsakende geen is voorheen deur koppelingsanalise tot ‘n lOcM gebied op chromosoom 19ql3.3 gekarteer, en daaropvolgens is die lokus verklein tot 7cM deur genetiese fyn kartering. Die huidige studie behels ‘n veelvuldige-strategie benadering in die soektog na die PFHBI geen. Die doel van die studie was die verdere verkleining van die PFHBI lokus deur gebruik te maak van beide gepubliseerde en nuwe genetiese merkers, die identifisering van kort geentranskripte (ESTs) uit publieke databanke en die generasie van ‘n geintegreerde kaart van die lokus. Geprioritiseerde gene is geanaliseer vir die PFHBI-veroorsakende mutasie en, daarby, is die PFHBI lokus deursoek vir die teenwoordigheid van ‘n G proteien-enkodeeringsgeen (PIJ5-RhoGEF), ‘n konneksien (Kx) geen en enige gene wat ‘n uitgebreide CTG-herhalingsmotief bevat, aangesien hierdie gene as sterk PFHBI kandidaatgene geag is. Genotipering en fynkartering deur die gebruik van bekende asook nuwe polimorfiese dinukleotied- [(CA)n] en nuwe tertranukleotied- [(A3G)n] herhalingsmerkers wat die PFHBI lokus oorbrug, is uitgevoer. Publieke databanke, soos LLNL (Livermore, USA), en GENEMAP (NCBI) is ondersoek vir ESTs wat vervolgens verleng is deur gebruik te maak van groeperende programme soos UNIGENE (NCBI) en STACK (SANBI) en die gevolglike konsensus volgordes is daama met behulp van BLAST geanaliseer teen die protei'endatabanke. Die bekomde data is vervolgens gebruik om ‘n geintegreerde fisiese en genetiese kaart van die PFHBI lokus te produseer en, soos die mens genoomprojek gevorder het, is nuwe gene daarop geplaas. Daarna is gene geprioritiseer vir mutasie analise gebaseer op posisie, funksie en uitdrukkingsprofiele. Genetiese fynkartering het die PFHBI lokus van 7cM tot 4cM verklein. Die EST benadering het 38 ESTs gei'dentifiseer, waarvan 24 ESTs proteien gelyke gehad het, bv aktiverende transkripsie faktor 5 (ATF5), aktien-verbindingsprotei'en (KPTN) en sink-vingerproteien 473 (ZFP473) (Mei 2003). A1 die karterings data wat eksperimenteel en rekenaar-gewys gegenereer is, is op die PFHBI kaart geposisioneer. Die P115-RhoGEF is uitgeskakel as ‘n PFHBI kandidaatgeen en alhoewel ’n volgorde met homologie aan konneksien37 (Kx37) gevind is op albei chromosoom 19 radiasiehibried klone (RGH12 and ORIM-7), is dit nie gei'dentifiseer in die DNS klone wat die PFHBI lokus oorbrug nie. Geen bewyse van uitbreiding van CTG herhalingsmotiewe is gevind in PFHBIaangetasde persone nie. Vyf hoogs-geprioritiseerde kandidaat gene, naamlik, BCL2-geassosieerde X proteien (BAX), kalium spanningsbeheerde kanaal, subfamilie J, lid 14 (KIR2.4), lin-7 homoloog B (LIN-7b) en glikogeen sintase 1 (GYS1), is geselekteer vir mutasie-analise. Geen siekteveroorsakende mutasie is egter gei'dentifiseer in die eksoniese of die naasliggende introniese gebiede van hierdie gene nie. Ter opsomming, hierdie studie het die PFHBI lokus verklein en het ‘n omvattende kaart van die gebied gegenereer. Verskillende kandidaat gene is uitgesluit as die oorsaak van PFHBI, alhoewel daar nog heelwat goeie kandidaat gene in hierdie geen-ryke lokus is wat geanaliseer behoort te word. Die identifiseering van die PFHBI-veroorsakende mutasie sal ‘n platform bied vir verdere studies om die patofisiologie van nie alleen PFHBI nie, maar ook meer algemene geleidingstoomisse, te verstaan.

This study explored the relationship between characteristics of children's families and their social adjustment and how extra-familial connections affect this relationship. According to human ecological theory, children who are in jeopardy through higher-risk family systems and other social forces were expected to be protected from sociocultural risks by social connections in such settings as school, church, kin groups, and neighborhood.

Thèse numérisée par la Division de la gestion de documents et des archives de l'Université de Montréal.

This diploma thesis explores the area of sexuality of older people, summarizes previously published theoretical knowledge in this area and is complemented by empirical research. It deals with aging and outlines the changes that may occur in humans during this process, especially in terms of development and transformation of sexuality. This thesis also pursues the perception of senior sexuality by his surroundings and the general public. This thesis also partially covers the issue of institutional care for the elderly. Objective: Mapping of senior population's behaviors and attitudes towards sex and their comparison across genders. Methods: Research conducted by a quantitative survey. Processing and interpretation of data regarding to the relevant age groups, which are based on a survey of sexual behavior carried out in 2013 and guaranteed by Prof. PhDr. Petr Weiss, Ph.D. a Doc. MUDr. Jaroslav Zvěřina, CSc. from the Institute of Sexology, 1st Faculty of Medicine at Charles University, Results: More than a half of the senior population in the Czech Republic does not feel the need to sexually realize themselves. For women this phenomenon is represented more strongly than for men. If older people are living in a stable relationship, they are more likely to keep active sexual life. The average frequency...

L’obésité est un véritable problème de santé publique. De nombreuses études ont été menées à l’échelle de l’individu mais le phénomène ne cesse de s’amplifier surtout chez les enfants et les adolescents. Nous proposons donc un angle de vue différent à savoir l’étude du fonctionnement familial en vue d’apporter un nouveau sens au symptôme en le resituant au cœur des relations intersubjectives. Pour cela, nous avons opté pour une perspective psychanalytique à travers l’utilisation d’outils projectifs spécifiquement groupaux à savoir l’épreuve de génographie projective (ou dessin libre de l’arbre généalogique) et l’épreuve de spatiographie projective (ou dessin de la maison de rêve). Ces outils, par un processus de projection, investiguent les dimensions diachronique et synchronique permettant une approche complète de l’image inconsciente du corps familial. Nous avons donc effectué une étude longitudinale sur 43 familles dont un adolescent est atteint d’obésité. Les résultats mettent en évidence une grande fragilité du groupe familial notamment en ce qui concerne son enveloppe. Sur le plan des liens intersubjectifs, nous avons repéré une indifférenciation psychique conduisant à des liens de type isomorphique. Enfin, nous avons repéré que la séparation entre l’adolescent et sa famille s’est effectuée sur un mode traumatique venant réactiver des traumas anciens. Ainsi, les familles mettent en place d’importantes résistances vis-à-vis du changement de l’un des leurs, contraignant l’adolescent à reprendre sa place en reprenant le poids perdu dans le but de préserver l’homéostasie familiale / Obesity has become a real health problem. So far, research has only considered obesity in an individual point of view, but this scourge is still getting increasing, especially among children and teenagers. For this reason, we have decided to bring a new point of view and focus upon the family and the way its members behave with one another, thus placing obesity at the heart of inter-subjective relationships. Hence we chose a psychoanalytical perspective and used groupal projective tools, the projective genography test (a free drawing of a family tree) and the family projective spatiography test (a drawing of the dream house). These projective tests examine the diachronic and synchronic dimensions and materialize a unconscious picture of the family body. We therefore carried out a longitudinal study with a representative sample of 43 families whose teenager suffered from obesity. The results show how weak and vulnerable the envelope of the family group can be. Concerning intersubjective bonds, we spotted a psychic undifferenciation leading to isomorphic relationships. Finally, we noticed that the teenage having been separated from his family proved to be traumatic, and that it reactivated former traumas. Thus families build strong strategies of resistance to counteract the fact that one member is changing, forcing the teenager to regain his previous position within the family, by regaining weight, in order to maintain family homeostasis

A hipercolesterolemia familiar (HF) é uma doença caracterizada por elevadas concentrações do colesterol das lipoproteínas de baixa densidade (LDL) e doença coronariana (DAC) prematura. Os remanescentes de quilomícrons são removidos principalmente pelo seu receptor específico (RLP), mas também pelo receptor da LDL. Este último encontra-se defeituoso na maior parte dos casos de HF e poderia levar a menor remoção plasmática dos quilomícrons. Há controvérsias se existem distúrbios do metabolismo dos quilomícrons em portadores de HF. Mais ainda não se sabe se estes defeitos poderiam contribuir para o desenvolvimento de DAC na HF. O objetivo deste estudo foi avaliar se portadores de HF apresentam defeitos na remoção plasmática de quilomícrons artificiais e seus remanescentes em relação a indivíduos normolipidêmicos. Foi avaliado também em estudo transversal se existe associação da cinética dos quilomícrons com a presença de DAC subclínica medida pela calcificação da artéria coronária (CAC). Foram estudados 36 pacientes portadores de HF e 50 controles normolipidêmicos pareados para idade e sexo. A remoção plasmática dos quilomícrons foi medida pelo decaimento radioisotópico da emulsão de quilomícrons artificiais injetada após jejum. A CAC foi determinada por tomografia computadorizada cardíaca nos portadores de HF. As taxas fracionais de remoção (TFR) dos quilomícrons e de seus remanescentes representadas pelo decaimento do 14C-éster de colesterol (TFR 14C-CE em min-1) foram menores nos portadores de HF em comparação aos normolipidêmicos: mediana (intervalos) 0,0013 (1,5.10-9;0,082) vs. 0,012 (1,51.10-9;0,017) p= 0,001. Não houve diferença em relação à remoção dos triglicérides da emulsão representada pelo decaimento da 3H-triglicérides (TFR 3H-TG em min-1) entre os grupos: 0,027 (0,0004;0,23) e 0,03 (0,0004;0,4) respectivamente nos grupo HF e controle (p= 0,26). Não foram encontradas diferenças significativas nas TFR tanto do 14C-CE 0,0007 (1,47. 10-9; 0,082) e 0,0013 (1,6. 10-9; 0,038) p= 0,67 como do 3H-TG 0,025 (0,0004; 0,07) e 0,0029 (0,009; 0,23), p=0,80 respectivamente nos portadores de HF apresentando (n=20) ou não CAC (n= 16). Em conclusão os portadores de HF apresentaram diminuição significativa da remoção dos quilomícrons e seus remanescentes em comparação com normolipidêmicos. Contudo, não foi encontrada associação entre esses distúrbios e a presença da DAC subclínica / Familial hypercholesterolemia (FH) is characterized by high concentrations of low density lipoproteins (LDL) cholesterol and early onset of coronary artery disease (CAD). Chylomicron remnants are removed mainly by their specific receptors (RLP) but also by the LDL receptor. The latter is defective in most cases of FH and could lead to lower plasma removal of chylomicrons and their remnants. There is controversy whether there are disorders of chylomicron metabolism in patients with FH. Moreover, it is unclear if these defects could contribute to the development of CAD in FH. The aim of this study was to evaluate whether there are defects on the removal from plasma of chylomicrons and their remnants in FH patients in comparison with normolipidemic subjects. We also evaluated in a cross sectional study the association of chylomicron kinetics with the presence of subclinical CAD represented by coronary artery calcification (CAC). We studied 36 patients with FH and 50 normolipidemic controls matched for age and sex. The plasma removal of chylomicrons was measured by isotopic decay of artificial chylomicron emulsion injected after fasting. CAC was determined by cardiac computed tomography in FH patients. The fractional catabolic rates (FCR) of chylomicrons and remnants removal represented by 14C-cholesteryl ester decay (14C-CE FCR in min-1) were lower in FH in comparison with normolipidemics: median (ranges) 0.0013 (1.47.10-9; 0.082) vs. 0.012 (1.51.10-9, 0.169) p = 0.001. There was no difference regarding the removal of emulsion triglyceride represented by 3H-triglyceride decay of ( 3H- TG FCR in min-1) between the groups: 0.026 (0.0004; 0.23) and 0.031 (0.0004; 0.4) respectively in FH and in normolipidemics (p = 0.264). There were no significant differences in both the 14C-CE FCR 0.0007 (1.47.10-9; 0.08) and 0.0013 (1.61.10-9; 0.038) p = 0.67 and in the 3H-TG FCR 0.025 (0.0004; 0.075) and 0.029 (0.0095; 0.23), p = 0.80 respectively in FH patients presenting (n = 20) or not CAC (n = 16). In conclusion patients with FH had a significant decrease on the removal from plasma of chylomicrons and their remnants compared with normolipidemics. However, no association between these disorders and the presence of CAC was found

Submitted by Filipe dos Santos (fsantos@pucsp.br) on 2017-03-24T11:45:58Z No. of bitstreams: 1 Maria Irene Ferreira Lima Neta.pdf: 6047924 bytes, checksum: 46e5ed53c0d01c2fb4b2c1eaf521b0d8 (MD5) / Made available in DSpace on 2017-03-24T11:45:58Z (GMT). No. of bitstreams: 1 Maria Irene Ferreira Lima Neta.pdf: 6047924 bytes, checksum: 46e5ed53c0d01c2fb4b2c1eaf521b0d8 (MD5) Previous issue date: 2017-03-17 / Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq / Talking about family today means encountering several historically and socially changed issues regarding this institution. These changes, which are both structural and functional, have taken place over its existence, which dates from thousands of years ago. In relation to family, there must be taken into consideration the experiences lived and the affectional bonds formed by an individual within the familial relationship. In this aspect, familial relationships may be constructive or destructive or, in some families, both constructive and destructive. These family patterns must be taken into consideration when discussing and studying families. We observe that all changes in families are influenced by social, legal and work-related events, in addition to health and illness factors. Slightly over three decades ago, society learned of a new disease which is sexually transmissible through the human immunodeficiency virus (HIV). This disease is the cause of changes, not only to the lives of persons living with HIV, but also to the lives of their relatives as they learn of the lived experiences of a seropositive family member. Since an HIV diagnosis is associated with strong prejudice and, in many cases, reveals a person’s sexual practices and/or betrayal by a spouse or partner, few people disclose their HIV seropositive status to their families. Among those who do, there are criteria for telling one family member and not telling another one. Therefore, studies show that an HIV diagnosis causes changes in family functioning and in the relationships between family members. At times, these relationships become so deteriorated that what is considered as family, family experiences and family patterns changes in a different manner for each family member. With the increase in the number of elderly seropositive persons and considering that they are the oldest representatives and the depositaries of family traditions, the objective of our study was to unveil the family structures of elderly people living with HIV. We worked with both extended and nuclear families. The study was carried out at the Outpatient Clinic for Infection-Contagious and Parasitic Diseases of the Federal University of Sao Paulo, state of Sao Paulo. Participants were 37 elderly people (24 men and 13 women) aged between 60 and 82 years, in addition to 19 family members aged between 17 and 79 years. All participants signed the Free and Informed Consent Form, and individually provided responses, which were audio-recorded, to questions about familial relationships, sexuality, the influence of HIV on familial relationships, and secrecy. Finally, family-of-origin and currentfamily genograms were built. Results show that the family structures of elderly people living with HIV are the constructive ones, with behaviors of care, shelter and union, whereas destructive family structures are those of isolation, prejudice and discrimination. In most cases, gender is represented by unequal gender practices, where the hegemonic roles are those of caregivers for women and providers for men. For most participants, HIV plays a secondary role in familial relationships, since other family issues prove to be of greater importance than living with the virus, and the condition does not interfere with familial relationships. For those families where HIV is a determining factor, this causes family members to live under constant alert and limits familial relationships. Secrecy is protective when it safeguards familial relationships and shields family members against prejudice. It is destructive when it causes suffering to those family members who know, and when it limits their behaviors. Our conclusion is that for both groups, i.e. families and participants without family members, family structures involve constructive patterns with care, shelter and union, where HIV plays a secondary role in familial relationships and secrecy has a protective function. In turn, also for both groups, destructive family patterns are formed with isolation, prejudice and discrimination, where HIV is a determining factor and secrecy plays a destructive role / Falar de família atualmente é se deparar com várias questões modificadas histórica e socialmente com relação a esta instituição. Tais modificações, tanto estruturais quanto funcionais, ocorreram ao longo de sua existência, há milhares de anos. Com relação à família, devem-se levar em consideração as vivências e vínculos protagonizados pelo indivíduo nesta relação. Neste aspecto, pode haver relações de construtividade, de destrutividade ou ainda famílias que possuem ambas as características. São padrões familiares que devem ser levados em consideração ao se falar de família e ao estudá-la. Notamos que todas as mudanças na família sofrem influência de acontecimentos sociais, jurídicos, profissionais, bem como de saúde e doença. Há pouco mais de três décadas, a sociedade tomou conhecimento de uma nova doença sexualmente transmissível por meio do vírus da imunodeficiência humana (HIV). Esta é causadora de alterações não apenas na vida de quem vive com HIV, mas também na de familiares que tomam conhecimento da vivência de um familiar soropositivo. Sendo uma doença que carrega grandes preconceitos e por seu diagnóstico, em muitos casos, revelar a traição de um dos membros do casal e/ou práticas sexuais, são poucas as pessoas que falam para a família sobre sua soropositividade do HIV. Dentre as que falam, há critérios para contar a um familiar e não contar a outro; desta forma, estudos mostram que este diagnóstico provoca uma mudança no funcionamento familiar, bem como na relação existente entre seus membros. E estas relações por vezes ficam tão desqualificadas que o que se assume como família, vivência e padrões familiares se modificam de forma diferenciada para cada um. Com o aumento do número de idosos soropositivos, e sendo estes os representantes mais antigos da família, depositários das tradições familiares, objetivamos desvendar as formas constitutivas de família de pessoas idosas vivendo com HIV. Trabalhamos tanto com a família extensa quanto com a família nuclear. Este trabalho foi realizado no Ambulatório de Moléstias Infectocontagiosas e Parasitárias da Universidade Federal de São Paulo/SP. Participaram 37 idosos, sendo 24 homens e 13 mulheres, com idades entre 60 e 82 anos, e 19 familiares, na faixa etária de 17 a 79 anos. Todos assinaram o Termo de Consentimento Livre e Esclarecido e, de forma individual e gravada, responderam a questões sobre relações familiares, sexualidade, HIV nas relações familiares e segredo. Por fim, foi feito o genograma da família de origem e da atual. Os resultados mostram que as formas constitutivas de família para a vida com HIV são as construtivas com comportamentos de cuidado, acolhimento e união, enquanto as formas destrutivas de família são as isoladas, preconceituosas e discriminatórias. Para a maioria, a sexualidade é representada por práticas sexuais de desigualdade em que os papéis hegemônicos são de cuidadora para a mulher e de provedor para o homem. O HIV nas relações familiares torna-se coadjuvante para a maioria, pois os demais problemas familiares mostram-se maiores que a vida com o vírus, e este não interfere nas relações familiares. Já para as famílias em que o HIV é determinante, assim se configura por viver em alerta constante e por limitar as relações familiares. O segredo se torna protetor quando preserva as relações familiares e protege do preconceito. E é destruidor quando gera sofrimento aos familiares que sabem, e quando limita seus comportamentos. Concluímos que as formas constitutivas de família para ambos os grupos, famílias e participantes sem familiares, foram os padrões de construtividade com cuidado, acolhimento e união, tendo o HIV nas relações familiares como coadjuvante e o segredo como protetivo. Enquanto os padrões familiares de destrutividade, também para ambos os grupos, se configuram com isolamento, preconceito e discriminação, tendo o HIV nas relações familiares como determinante e o segredo como destruidor