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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
111

Nutraceutika 5. Látky využitelné jako adjuvans při léčbě Alzheimerovy choroby. / Nutraceuticals 5. Compouds usable as an adjuvant in the treatment of Alzheimer's disease.

Nejedlý, Josef January 2014 (has links)
Nejedly, J.: Nutraceuticals 5. Compounds usable as an adjuvant in the treatment of Alzheimer's disease. Diploma thesis, Charles University in Prague, Faculty of Pharmacy in Hradec Kralove, Department of Pharmaceutical Botany and Ecology, Hradec Kralove 2014, 102 p. This literature review, dealing with the pathophysiology of Alzheimer's disease and possible use of nutraceutical products as an adjuvant in the therapy of the disease, has been done by analysis of foreign and domestic literature. In the chapter Alzheimer's disease, various pathological processes, leading to the development of the disease and also risk factors, clinical picture and a brief indications of currently used treatment, were introduced. The main part of thesis called Nutraceuticals has introduced a comprehensive overview and categorization of compounds (plant extracts) which can be used in influencing of Alzheimer's disease by the mechanism of action. In the chapter Nutraceuticals in Czech Republic, various product and suplements were listed, which are available on the market in Czech Republic and could be used as an adjuvant in the therapy of Alzheimer's disease. Finally, it was shown the evaluation (pros, cons, potential interaction) of substances and supplements, which have been state in the thesis, with a proposal for their...
112

Eclairer les conditions de maintien d'exploitations de polyculture-élevage durables en zone défavorisée simple européenne. Une étude de cas dans les Coteaux de Gascogne / Understanding the adaptive capacities of sustainable mixed crop-livestock systems in European unfavoured areas. A case-study in the Coteaux de Gascogne

Ryschawy, Julie 07 November 2012 (has links)
Les exploitations de polyculture-élevage sont de plus en plus reconnues au plan international comme limitant les problèmes environnementaux tout en permettant une agriculture productive et économiquement viable. Les incitations à la spécialisation de la PAC et la diminution de la main d'oeuvre agricole les ont néanmoins marginalisées en Europe. Cette thèse vise à éclairer les conditions de maintien d'exploitations de polyculture-élevage durables. Un travail en partenariat avec des agriculteurs, maires et conseillers agricoles a été conduit sur un cas d'étude en zone défavorisée simple française, les Coteaux de Gascogne. Nos travaux ont montré que, malgré une forte variabilité entre exploitations, la polyculture-élevage locale était un bon compromis par rapport à la spécialisation pour une durabilité environnementale et économique. Une analyse des trajectoires passées des exploitations nous a permis d'éclairer quatre types de « chemins pour durer » en polyculture-élevage. Parmi ceux-ci, deux sont apparus pertinents pour le maintien de la polyculture-élevage en contexte incertain : « maximiser l'autonomie » et « diversifier les ateliers ». Sur la base de ces deux types de trajectoires, nous avons co-construit avec les partenaires deux scénarios techniques prospectifs. Pour le type « maximiser l'autonomie », implanter des intercultures fourragères basées sur des légumineuses permettrait de favoriser l'autonomie alimentaire du troupeau en maintenant la fertilité des sols. Pour le type « diversifier les ateliers », finir des génisses permettrait de les valoriser en circuit court. Ces scénarios ont été adaptés puis simulés sur des exploitations locales. Ce type de démarche a permis i) d'impliquer fortement les acteurs locaux via des réunions collectives et ii) une approche prospective originale fondée sur une étude rétrospective intégrant le temps long. / Mixed crop-livestock farms are again attracting worldwide interest, as they are considered to be a good way to limit environmental problems while allowing a productive and economically viable agriculture. The incentives of the Common Agricultural Policy and decreasing workforce availability nevertheless marginalized these farms in Europe. This thesis aims at understanding the conditions for a survival of sustainable mixed crop-livestock farms. A partnership process with farmers, mayors and technical advisers has been led in a French less favoured area, the Coteaux de Gascogne. Our work has shown that even if a wide variability existed between farms, local mixed crop-livestock farming was a good trade-off compared to farm specialization concerning an environmental and economic sustainability. An analysis of farm past trajectories allowed us to enlighten four “paths to last” in mixed crop-livestock farming. Two of these ones appeared to be suitable paths to maintain mixed crop-livestock farms in a uncertain context: “maximizing autonomy” and “diversification of production units”. On the basis of these two types of trajectories, we have co-constructed with local actors two technical prospective scenarios. In line with the type “maximizing autonomy”, forage legume intercropping could enable to autonomously feed the bovine herd while maintaining soil fertility. In line with the type “diversification of production units”, fattening heifers would allow a commercialization through short circuit. These scenarios have been adapted and then simulated on local farms. This type of approach allowed to i) strongly involve local actors through collective meetings and ii) an original future study based on a retrospective study integrating long time changes.
113

THE IMPACT OF DIVERSITY RELATED CORPORATE SOCIAL RESPONSIBILITY ENGAGEMENT AND PERSON-ORGANIZATION FIT ON ORGANIZATIONAL ATTRACTIVENESS AND JOB CHOICE

Mendizabal Martell, Raquel 01 May 2019 (has links)
In recent years, many organizations, such as Starbucks and Pepsi Co., have received negative public attention for company actions that are perceived as challenges to social justice issues, particularly with regard to diversity. The increased public criticism of companies involved in controversial diversity related issues is likely due to societal expectations that companies increase their Corporate Social Responsibility (CSR) and Corporate Social performance (CSP) efforts and serve as leaders of social change (Cone Communications, 2017). The current two-part experimental investigation includes two experimental Studies exploring the impact of diversity related CSP, specifically regarding immigration and race which are particularly relevant to current organizations as they are controversial, polarizing, and closely tied to politics, on prospective employees’ perceptions of an organization as a potential employer. These two Studies also contribute to the literature by looking at the impact of person-organization fit (P-O fit) on the relationship between CSP and organizational attractiveness and likelihood to accept a job offer (Study 1); and the impact of diversity-related CSP on prospective employees of color’s attractiveness to an organization and likelihood to pursue a job (Study 2).
114

Using Pupillometry to Observe Covert Mental Activity during Prospective Memory Tasks

Edward A Christopher (6619100) 14 May 2019 (has links)
Remembering to complete some future intention (i.e., prospective remembering) is a frequent requirement of everyday activities. Prospective memory failures (e.g., forgetting to take one’s medication) can have devastating consequences. Cognitive psychologists have sought to understand how individuals can successfully fulfill their prospective memory intentions. Unfortunately, it has been difficult to find evidence for specific cognitive mechanisms that could feasibly account for prospective memory behaviors. In part, this is because many theories of prospective memory stipulate that prospective remembering is accomplished through discrete/covert mental processes. In the current set of experiments, eye-tracking technology was used to test these various mechanistic explanations. Using an eye-tracking computer to measure pupillary responses to prospective memory task characteristics allowed for the observation of changes in discrete mental activity during the course of a prospective memory task scenario. Across two experiments, I observed elevated pupil dilation when participants were given additional prospective memory demands. Furthermore, when participants correctly recognized the presentation of a prospective memory target, it appeared that their pupil dilation increased dramatically, and elevated dilation persisted for several trials. This pattern of pupil dilation is consistent with an account of prospective remembering that suggests individuals sometimes engage in actively monitoring for an opportunity to<br>11<br>complete their prospective memory intention, and that at other times, individuals will reduce or discontinue monitoring activity until some cue brings the prospective memory intention back into mind. Consistent with such an account, individual differences in working memory were positively associated with pupil size only when the prospective memory task afforded monitoring. This was in line with recent research implicating the working memory system in facilitating active monitoring during certain prospective memory contexts. Finally, the current set of experiments demonstrated the utility of pupillometric methods for measuring active monitoring in a prospective memory scenario.
115

Estudo prospectivo das causas de morte de Falconiformes e Strigiformes de vida livre no município de São Paulo / Prospective study of the causes of death of free-living Falconiformes and Strigiformes at São Paulo City

Joppert, Adriana Marques 09 April 2007 (has links)
O presente trabalho teve como objetivo identificar e caracterizar as causas de morte de aves de rapina de vida livre da região do município de São Paulo e áreas vizinhas. O estudo incluiu 114 aves de rapina, sendo 40 da ordem Falconiformes e 74 da ordem Strigiformes, atendidas pela Divisão de Fauna do município de São Paulo, São Paulo, Brasil, durante o período de outubro de 2002 a maio de 2006. As causas de morte identificadas foram: eutanásia (41,2%); causas não-infecciosas (32,5%); causas infecciosas (19,3%); causas parasitárias (3,5%) e causas indeterminadas (3,5%). As lesões traumáticas osteoarticulares foram o motivo mais freqüente de eutanásia (51,1%), seguindo-se das lesões em tecidos moles (17,0%), lesões isquêmicas das extremidades das asas (17,0%), tricomoníase (10,6%) e causas variadas (4,3%). Os traumas se destacaram como uma importante causa de morte natural ou induzida (eutanásia). Dentre as causas de morte infecciosas, as infecções por protozoários (tricomoníase) (54,5%) foram as mais freqüentes, seguindo-se das infecções bacterianas (40,9%). O presente trabalho permitiu identificar os principais processos que causam a morte de aves de rapina, Falconiformes e Strigiformes na região de São Paulo, fornecendo importantes subsídios para o atendimento clínico e tratamento das condições mais comumente encontradas nessa população. / The goal of this work was to identify and characterize the causes of death of free-living birds of prey from São Paulo city and its surroundings. In the present work 114 raptors were studied, 40 of them belonging to the Falconiformes order and 74 to the Strigiformes order, all admitted at the São Paulo City Fauna Division, Brazil, during the period of October 2002 to May 2006. The causes of death were determined as: euthanasia (41,2%), non-infectious causes (32,5%), infectious causes (19,3%), parasitic diseases (3,5%) and indeterminate (3,5%). Bones and joints lesions were the most frequent cause that lead to euthanasia (51,1%), followed by soft tissue lesions (17%), wing tips ischemic lesions (17%), Trichomoniasis (10,6%) and various causes (4,3%). Trauma outstands as an important cause of natural or induced death, while in the field of infectious diseases trichomoniasis (54,5%) was the most frequent, followed by bacterial infections (40,9%). The present study allowed us to identify the principal processes that cause the death of raptorial birds at São Paulo City. These findings also provided important information for clinical attendance and medical treatment for the most common conditions in this population.
116

Estudo da gestação no período de 40 a 42 semanas: avaliação da vitalidade fetal e resultados neonatais / Study about pregnancy between 40 to 42 weeks: evaluation of the fetal well being and neonatal outcome

Lopes, Marco Antonio Borges 18 April 1996 (has links)
Neste trabalho foi proposto o estudo prospectivo de gestações após a 40a semana, objetivando: a) verificar os índices de morbidade e mortalidade perinatais; b) identificar os testes de avaliação da vitalidade fetal mais adequados para a vigilância destas gestações; c) comparar os resultados dos testes de avaliação da vitalidade fetal com os resultados perinatais na 1a e 2a semana, após a 40a semana de gestação, para testar o protocolo do Serviço. Para a realização do estudo, selecionaram-se 52, gestantes divididas em 2 grupos: GI (1a semana) com 32 gestantes e GIl (2a semana) com 20 gestantes. Acompanhou-se a vitalidade fetal com a Cardiotocografia de Repouso e Intraparto, Teste da Estimulação Sônica, Avaliação do Volume do Líquido Amniótico através da Técnica dos Quatro Quadrantes, Perfil Biofisico Fetal e Dopplerfluxometria Uterina e Umbilical, realizados 2 vezes na semana. Os resultados neonatais e os índices de morbidade foram: Índices de Apgar no 10 e 50 minutos (alterados < 7), pH da artéria umbilical (alterado < 7,20), peso dos recém-nascidos, tempo de internação dos recém-nascidos, oligoidrâmnia, líquido amniótico meconial, alterações na cardiotocografia com presença de desacelerações e índices de cesárea. O estudo permitiu como resultados e conclusões: a) a incidência de oligoidrâmnio foi de 44,23%, líquido meconial de 28,85%, cardiotocografia alterada, 50,00% e partos cesáreos, 57,70%, não havendo óbito fetal ou neonatal. Não houve alterações significativas nos índices de Apgar, pH da artéria umbilical e tempo de internação dos recém-nascidos. b) A cardiotocografia e, principalmente, a avaliação do volume do líquido amniótico, pelo índice de líquido amniótico, foram os métodos mais adequados na detecção de alterações verificadas neste grupo de gestantes. Do parâmetro ultra-sonográfico do Perfil Biofisico Fetal, apenas o Volume do Líquido Amniótico demonstrou ser importante. A Dopplerfluxometria (uterina e umbilical) não revelou nenhuma utilidade na vigilância destas gestações. c) A distribuição dos casos com oligoidramnia, líquido meconial, cardiotocografia alterada, índices de cesárea e pH da artéria umbilical < 7,20, semelhante na 41a semana (GI) e 42a semana (GIl), valida o protocolo do Serviço. d) Adicionalmente, este estudo permite ainda as seguintes observações: 1) importância da oligoidrâmnia e líquido meconial na determinação dos elevados índices de cesáreas; 2) incidência elevada (50,00) de nulíparas nesta casuística. / This study proposed pros.pectively the evaluation of the gestations after 40 weeks with these objectives: a) Analysis of the perinatal outcome. b) Identification of the proper test for fetal well-being assessment for this gestation. c) Comparation of these tests results with perinatal outcome at the first and second weeks after 40 weeks, therefore, testing the protocol of this Service. It recruited 52 patients divided in two groups: GI (1st week) with 32 patients and Gil (2nd week) with 20 patients. The fetal surveillance was assessed by antepartum and intrapartum cardiotocography, acoustic stimulation test, amniotic fluid volume assessment by the ultrasonographic four quadrant technique (amniotic fluid index), fetal biophysical profile and umbilical and uterine doppler velocimetry, ali tests were performed twice weekly. The neonatal outcome results and morbidity parameters were: Apgar index in 1st and s\" minutes (alterated < 7), umbilical artery pH (alterated < 7,20), the new born weight, oligohydramnios, meconium stained, deceleration (DIP 11 or umbilical deceleration) and cesarean section rates. The study permitted these results and conclusions: a) The oligohydramnios, meconium stained, cardiotocography alterations and cesarean section incidences were 44,23%, 28,85%, 50,00% and 57,70%, respectively. There was no fetal death. b) The cardiotocography and amniotic fluid assessment by the amniotic fluid index, were the best tests to detect the alterations verified. The amniotic fluid volume was the most important parameter in the fetal biophysical profile. Doppler (uterine and umbilical) revealed no utility. c) The equal distribution of the oligohydramnios, meconium stained, altereted cardiotocography, cesarean section and umbilical artery pH < 7,20 cases in the group studied reassure the Service protocol. d) In addition this study also permitted observation of: 1) The importance of the meconium stained in the cesarean section rate. 2) The nuliparus elevated incidence (50,00%) in this group.
117

A prospecção do futuro como suporte à busca de informações para a decisão empresarial: um estudo exploratório / The use of future studies to support information searching for decision making: exploratory research.

Yoshida, Nelson Daishiro 13 October 2011 (has links)
Nesta pesquisa foi estudada a prática de prospecção do futuro (estudos do futuro) como suporte à busca de informações para a decisão empresarial. Dentre os objetivos da pesquisa se encontram a busca de associações entre os métodos de prospecção e as diferentes categorias de informação, a avaliação da importância atribuída à atividade de prospecção, a identificação da frequência de uso e dos horizontes de tempo para os quais os métodos são utilizados, bem como a obtenção do grau de satisfação percebida com os resultados obtidos. A pesquisa é realizada por metodologia mista, quantitativa e qualitativa. Foram feitos levantamento de dados quantitativos e estudos de casos, e os resultados foram analisados de forma complementar. Na amostra de respondentes foi identificado que há associação entre a categoria da informação que está sendo prospectada e os métodos de estudos do futuro. Determinados métodos são mais utilizados para algumas categorias de informação, a exemplo do método de Cenários para buscar informações sobre Política e Sociedade. Por outro lado, determinadas combinações apresentaram menor uso, como o método Roadmap Tecnológico para buscar informação sobre Tecnologia. É atribuída elevada importância para a prospecção do futuro. Tal avaliação depende do tipo de decisão ser estratégico ou tático, e este último fator também influencia a frequência em que a atividade é praticada. O horizonte de tempo da prospecção também está associado aos métodos, sendo que Cenários apresenta maior uso para horizontes de mais de cinco anos. Há métodos que apresentam maior satisfação dos respondentes da amostra, sendo eles: Cenários, Previsões e Projeções de Executivos e Pesquisas de Mercado. Os métodos mais praticados são os que apresentam a possibilidade de interatividade pessoal, como Cenários e Previsões e Projeções de Executivos. Por outro lado, os métodos mais objetivos, como os que utilizam modelos matemáticos e os que possuem metodologia mais estruturada, não figuraram entre os mais praticados. Nos casos estudados foi identificado que os métodos mais praticados são baseados em opinião e julgamento e utilizam a interatividade pessoal como principal forma de condução. Houve também preocupação manifestada sobre a necessidade de estruturação da atividade nas empresas e sobre a prática da mesma seguindo recomendações metodológicas. / The use of future studies methodologies to provide information for decision making has been studied in this research. The objectives of the research are to analyze the association of methods to different information categories, to evaluate the importance of future studies, to identify the frequency of use of future studies and the time horizon in which the methods are used in searching information, and to gather users perceived satisfaction with the results. The research is implemented through a mixed-methods methodology, quantitative and qualitative. Quantitative survey and case studies have been made and combined results have been analyzed in a complementary approach. Results from the sample indicate that there is an association of methods with information categories. Some methods are more used to deal with some information categories, e.g. Scenario method with Political and Social information. On the other hand, some method-information category combinations are less used, e.g. Technology Roadmap method with Technology. Evaluation of the importance of future studies is high and depends on the decision type to be strategic or tactical. These types of decision influence the frequency of use of future studies methodologies. Time horizon is associated to methods, as in Scenario method to time horizons greater than five years ahead. There are methods with higher satisfaction ratings: Scenario, jury of Executive Opinion and Market Survey. The most used methods are the ones with high personal interaction possibility, e.g. Scenario and jury of Executive Opinion. On the other hand, objective methods, as those that make use of mathematical techniques or more structured methodologies are not among the most used. In the case studies results, methods based on judgment and opinion with high personal interaction are the most used. There were concerns about the need for more structure to deal with future studies in the company and also about its practice in accordance with methodological recommendations.
118

Correlação colpo-cito-histológica da infecção pelo papilomavírus humano em adolescentes com atividade sexual / Colposcopic, cytologic and histologic findings correlation with human papillomavirus infection in sexually active adolescents

Tubaki, Márcia Emy 04 May 2004 (has links)
Este estudo prospectivo foi delineado com o objetivo de avaliar os achados citológicos, colposcópicos e histológicos da infecção pelo papilomavírus humano em adolescentes e estabelecer a correlação entre o resultado da colpocitologia oncológica e os fatores de risco para a infecção pelo papilomavírus humano. O grupo foi constituído por 82 adolescentes entre 13 e 19 anos, acompanhadas no Ambulatório de Adolescentes e encaminhadas ao Setor de Patologia do Trato Genital Inferior e Colposcopia da Clínica Ginecológica do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. As pacientes foram submetidas a anamnese, coleta da colpocitologia oncológica, colposcopia e biópsia de colo uterino na presença de aspectos colposcópicos anormais. A média etária das pacientes foi de 17,7 anos, com desvio-padrão de 1,4 anos. A colpocitologia oncológica foi normal em 57% e alterada em 43%. Os achados citológicos anormais diagnosticados foram: lesão intra-epitelial escamosa de baixo grau em 38%, lesão intra-epitelial escamosa de alto grau em 4% e células escamosas atípicas de significado indeterminado em 1%. A colposcopia foi satisfatória em todos os casos. Os achados colposcópicos normais foram o epitélio pavimentoso original em 4%, epitélio cilíndrico em 18% e a zona de transformação normal em 28%. A zona de transformação anormal estava presente em 50% dos casos, sendo representada pelas alterações epiteliais em 52%, seguida das vasculares em 41% e mistas em 7%. O exame histológico do material de biópsia de colo uterino diagnosticou cervicite crônica em 33%, cervicite crônica associada à infecção pelo papilomavírus humano em 2,4%, neoplasia intra-epitelial cervical grau 1 em 11%, neoplasia intra-epitelial cervical grau 2 em 2,4% e neoplasia intra-epitelial cervical grau 3 em 1,2%. Quanto aos fatores de risco e sua associação com o resultado da colpocitologia oncológica, a análise univariada dos parâmetros idade, menarca, início da atividade sexual, intervalo entre menarca e primeira relação sexual, número de parceiros, tabagismo e método contraceptivo não apresentou diferença estatisticamente significante. A análise conjunta das variáveis independentes através do método de regressão logística identificou os parâmetros idade, menarca e método contraceptivo como fatores relevantes. O aumento em um ano na idade da adolescente diminui a probabilidade (30%) de alteração no resultado citológico. O atraso em um ano na menarca reduz a probabilidade (35%) de colpocitologia oncológica alterada. A utilização de método anticoncepcional hormonal (anticoncepcional oral ou injetável) aumenta a probabilidade de alteração citológica / This prospective study was designed to evaluate the cytologic, colposcopic and histologic findings related to human papillomavirus infections in adolescents and to correlate cytologic reports with risk factors. The study sample consisted of 82 adolescents from 13 to 19 years of age, who were examined in a hospital-based adolescent clinic and referred to Inferior Genital Tract Disease and Colposcopy Unit in the Gynecologic Department - Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Every adolescent answered a questionnaire administered by the physician and afterwards underwent cytologic and colposcopic examination followed by cervical biopsy when colposcopic abnormalities were found. Participant mean age was 17.7 years old and the standard-deviation was 1.4 years. Normal patterns of cytologic findings were present in 57% of the cases. Abnormalities were found in 43%. Abnormal cytologic findings were placed as follows: low-grade squamous intraepithelial lesion in 38%, high-grade squamous intraepithelial lesion in 4% and atypical squamous cells of undetermined significance in 1%. All colposcopic examination were satisfactory. Normal colposcopic appearance was represented by original squamous epithelium in 4%, columnar epithelium in 18% and transformation zone in 28%. Abnormal colposcopic findings corresponded to 50% of the cases, distributed in epithelial abnormalities in 52%, followed by vascular pattern in 41% and both (epithelial and vascular pattern) in 7%. Histological exam of cervical biopsy specimen revelead chronic cervicitis in 33%, chronic cervicites associated with human papillomavirus infection in 2.4%, cervical intra-epithelial neoplasia grade 1 in 11%, cervical intraepithelial neoplasia grade 2 in 2.4% and cervical intraepithelial neoplasia grade 3 in 1.2%. Univariate analysis was used to correlate the concerning risk factors such as age, menarche, sexual activity onset, interval between menarche and first sexual intercourse, number of sexual partners, smoking and contraceptive method, and cytologic results and no statistically significant correlation was found. Logistic regression modelling was used to determine variables associated with abnormal cytology and pointed up age, menarche and hormonal contraceptive method as relevant factors. Aging one year decreases the probability (30%) of abnormal cytology, as well as, delay in one year in menarche results in reduction (35%) of abnormal cervical cytology. Hormonal contraceptive methods (oral contraceptives and injection) increase the probability of cytologic abnormalities
119

Quantificação do colágeno na camada muscular da bexiga de pacientes com obstrução infravesical por hiperplasia prostática benigna: correlação com parâmetros urodinâmicos / -

Ribeiro, Wesley de Oliveira 05 November 2004 (has links)
Avaliou-se prospectivamente 19 pacientes com obstrução infravesical por hiperplasia prostática benigna selecionados pra prostatectomia transvesical. Obteve-se um fragmento da parede da bexiga e quantificou-se o colágeno no epimísio, perimísio e endomísio do detrusor. Amostra vesicais de oito doadores cadavéricos de órgãos serviram como controles. Observou-se padrão focal de aumento do colágeno na camada muscular da bexiga dos pacientes com obstrução. Demonstrou-se que a idade correlaciona-se positivamente com o aumento da quantidade de colágeno com a diminuição da complacência vesical, o aumento da prevalência de hiperatividade detrusora e a maior chance de retenção urinária / We prospectively evaluated 19 patients with bladder outlet obstruction by benign prostatic hyperplasia selected for transvesical prostatectomy. A sample of the bladder wall was obtained and the collagen was measured at the level of epimysium, premysium and endomysium. Bladder samples from eight cadaveric organ donors were used as controls. A focal pattern of collagen increase was observed at the bladder smooth muscle layer of obstructed patients. Age was shown to correlate with increased collagen quantity. Increased collagen quantity also correlated with decreased bladder compliance, higher prevalence of detrusor overactivity and of urinary retention
120

Bio-psycho-soziale Prädiktoren der Frühgeburtlichkeit und Differentialdiagnose zur intrauterinen fetalen Retardierung

Rauchfuß, Martina 15 July 2003 (has links)
Fragestellung: Die Symptome einer drohenden und die tatsächlich eingetretene Frühgeburt stehen am Ende eines pathophysiologischen Prozesses, der bislang ungenügend verstanden wird. So verwundert es nicht, wenn bisherige Präventions- und Therapiestrategien unzureichende Erfolge in der Prävention der Frühgeburtlichkeit gebracht haben. Ähnliches ist für die intrauterine Wachstumsretardierung festzustellen, die wohl das Ergebnis eines sehr früh in der Schwangerschaft beginnenden Prozesses darstellt. Es gibt eine Reihe von Studien, die die Bedeutung psychosozialer Bedingungen für den Verlauf von Schwangerschaft und Geburt belegen. Entscheidende Defizite bisheriger Untersuchungen liegen zum einen in der Vernachlässigung wichtiger psychosozialer Einflussfaktoren (insbesondere Ängste, Kindheitserfahrungen, soziale Netze und Partnerschaft) zum anderen beschränkt das retrospektive Design die Aussagekraft. Material und Methode: In der vorliegenden prospektiven Studie wurde 589 Frauen in der 16. - 22. SSW mittels eines im Projekt entwickelten Fragebogens untersucht. Von 508 Einlingsschwangeren konnten später Daten zum Schwangerschafts- und Geburtsverlauf aus den medizinischen Unterlagen entnommen werden. Zur Datenreduktion wurden Faktorenanalysen mit der Hauptkomponentenmethode und anschließender Varimax-Rotation gerechnet und die ermittelten Faktoren einer Reliabilitätsprüfung unterzogen. Als statistisches Auswertungsverfahren wurde die logistische Regression eingesetzt. Ergebnisse: Die vorliegende Untersuchung erbrachte erste interessante Hinweise auf gleichgerichtete aber auch unterschiedliche Ressourcen- und Risikokonstellationen bei verschiedenen, im Kontext der Frühgeburtlichkeit bedeutsamen Komplikationen. Schwangere, die wegen drohender Frühgeburt behandelt werden, scheinen stärker sozial belastet zu sein als diejenigen, die später tatsächlich vor der vollendeten 37. SSW gebären. Ein fehlendes weibliches Netzwerk und fehlendes emotionales Verständnis des Partners sind mit beiden Komplikationen korreliert, wobei die Paarbeziehung für die tatsächliche eintretende Frühgeburt eine besondere Bedeutung hat. Eine anamnestische Belastung durch gynäkologische Störungen war ebenfalls sowohl für die drohenden wie auch die tatsächlich eingetretene Frühgeburt prädiktiv. Ausgeprägte schwangerschaftsbezogene Ängste und eine geringe allgemeine Ängstlichkeit sind weitere signifikante Prädiktoren im Modell der Frühgeburt vor der vollendeten 37. SSW. Schwangere, deren Kinder intrauterin eine Mangelentwicklung erfahren, haben in der vorliegenden Studie eine unreflektierte Ambivalenz gegenüber Schwangerschaft und Mutterrolle. Sie betonen auf bewusster Ebene die Erwünschtheit ihrer Schwangerschaft, während unbewusste negative Emotionen auf potentielle somatische Probleme projiziert werden. Ein niedriger prägravider BMI wird sowohl durch andere Untersucher wie auch durch die eigenen Ergebnisse als Risikofaktor bestätigt. Neben den bekannten somatischen Einflüssen ist auch an einen Zusammenhang im Kontext der unbewussten Ablehnung weiblicher Körperlichkeit, wie sie z.B. von Anorexiepatientinnen bekannt ist, zu denken. Schlussfolgerungen: Paarbeziehung, weibliche Netzwerke, psychosomatische Reagibilität in Hinblick auf Erkrankungen der reproduktiven Organe und Ängste verdienen zur Prävention der Frühgeburt stärkere Aufmerksamkeit. Angebote psychosozialer Unterstützung sollten frühzeitig in der Gravidität und zielgruppenspezifisch gemacht werden und die Schwangeren in ihrem Kompetenz- und Autonomieempfinden stützen. / Research question: The symptoms of preterm labour and preterm delivery stand at the end of a pathophysiological process which is understood up to now insufficiently. So it does not amaze if previous preventive and therapeutic strategies have brought inadequate successes in the prevention of preterm delivery. Similar one is to be arrested for the intrauterine fetal growth retardation which represents presumably the result of a process beginning very early in the pregnancy. Some studies give evidence for psychosocial conditions for the process of pregnancy and birth. On the one hand fundamental deficits of previous investigations are in the disregard of important psychosocial performance-influencing factors (in particular fears, biographic factors, social network and partnership), on the other hand the retrospective design limits the informative value. Material and means: In the present prospective study 589 women between 16th and 22nd week of pregnancy were examined using a questionnaire that was designed for the study. This resulted in 508 women pregnant with a single child, whose pregnancy and delivery were examined based on their medical records. Factor analysis and main component analysis with subsequent varimax rotation resulted in factors that were subject to a proof of reliability. Statistical analysis was based on logistic regression. Results: The present investigation produced first interesting indications of rectified but also different resource and risk constellations in the context of the preterm delivery. Pregnant women with preterm labour seeming to be burdened more strongly socially than those that later in fact have a preterm delivery. A missing feminine net and missing emotional understanding of the partner are correlated with both complications. The partnership has a special importance for the preterm delivery. An anamnestic load through gynaecological troubles was predictive also both for the threatening labour ones as also the preterm delivery. Marked pregnancy related fears and a small general anxiety are further significant predictors in the model of the preterm delivery. Pregnant women with intrauterine fetal retardation have in the present study an unconscious ambivalence opposite pregnancy and motherhood. On conscious tier they stress the desire of their pregnancy while unconscious negative emotions are being projected onto potential somatic problems. Compatible with other investigations a low pre-pregnancy weight was a risk factor. Next to the known somatic influences also a connection is to be thought of in the context of the unconscious refusal of feminine body as for example is known from anorectic patients. Conclusions: Partner relationship, female networks, psychosomatic reactivity in terms of diseases/disorders of the reproductive organs, and anxieties appear to be worthwhile targets in the prevention of preterm delivery. Psychosocial support should be given oriented to different target groups from early in the pregnancy.

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