Les études sur les couples traités par fécondation in vitro (FIV) ont jusqu'à présent porté essentiellement sur l'évaluation du succès en FIV. Très peu de données sont disponibles sur le devenir à long terme de couples traités par FIV. L'objectif de ce travail était d'estimer la fréquence de réalisation du projet parental à long terme, et d'étudier les facteurs associés aux interruptions précoces des traitements et aux naissances naturelles.L'enquête DAIFI-2009 a inclus 6 507 couples ayant débuté un programme de FIV en 2000-2002 dans l'un des 8 centres de FIV participant à l'étude. Les données médicales des couples et leur parcours dans le centre ont été obtenus à partir des dossiers médicaux des centres de FIV pour tous les couples. L'information sur le devenir des couples après le départ du centre a été obtenue par questionnaire postal auprès des couples en 2008-2009 (38% de participation 7 à 9 ans après l'initiation des FIV). L'étude des facteurs associés à la participation à l'enquête postale suggérait que la fréquence de réalisation du projet parental estimée sur les répondants seulement pourrait être biaisée. Les différentes méthodes mises en œuvre pour corriger la non réponse (pondération, imputation multiple) n'ont pas modifié l'estimation de la fréquence de réalisation du projet parental. Au total, 7 à 9 ans après l'initiation des FIV, 60% des couples ont réalisé leur projet parental de façon biologique, suite à un traitement ou suite à une conception naturelle. Lorsque les adoptions sont aussi prises en compte, 71% des couples ont réalisé leur projet parental. Après l'échec d'une première tentative de FIV, un couple sur 4 (26%) a interrompu les FIV dans le centre d'inclusion. Globalement, les couples avec de mauvais facteurs pronostiques ont un plus grand risque d'interrompre les FIV. Cependant, la proportion plus importante d'interruption parmi les couples avec une origine inexpliquée de l'infécondité pourrait s'expliquer par la survenue plus fréquente de naissance naturelle dans ce sous-groupe de couples. Parmi les couples n'ayant pas eu d'enfant suite aux traitements, 24% ont ensuite conçu naturellement en médiane 28 mois après l'initiation des FIV. Parmi les couples ayant eu un enfant suite aux traitements, 17% ont ensuite conçu naturellement en médiane 33 mois après la naissance de l'enfant conçu par AMP. Les facteurs associés aux naissances naturelles sont des indicateurs d'un meilleur pronostic de fertilité, particulièrement chez les couples sans enfant AMP.L'enquête DAIFI-2009 a permis d'apporter des informations sur le parcours à long terme des couples traités par FIV qui n'avait jusqu'à présent été que peu étudié, souvent sur de faibles effectifs et avec un suivi plus court. Ces résultats doivent apporter de l'espoir aux couples inféconds, puisque la majorité d'entre eux ont finalement réalisé leur projet parental, même si cela peut prendre de nombreuses années.

Type 2 diabetes is a global health problem. Evidence indicates that type 2 diabetes can lead to serious complications, such as a cardiac event, which usually require critical nursing care. Patients with type 2 diabetes and with a history of cardiac disease are at greater risk of a further cardiac event requiring readmission to hospital. Evidence indicates that improved diabetes management assists patients with type 2 diabetes to manage their condition efficiently, reduces risks of a further cardiac event, and therefore reduces hospitalisations. However, there is limited information found regarding a diabetes management program specifically for patients who have already had cardiac complications. Difficulties in developing patients' skills in managing and modifying their daily lives also present a challenge to coronary care staff. Therefore, there is a real need to develop a special diabetes management program for patients with diabetes who have experienced a critical cardiac event, which will be commenced in the Coronary Care Unit (CCU). The aim of this research is to gain a greater understanding of the characteristics, secondly to obtain in-depth understanding of needs and experiences of patients with type 2 diabetes hospitalised for a critical cardiac event. A further aim is to develop and pilot test a diabetes management program, specific to the patients with diabetes in the context of the CCU. The design of this research employed three studies: Study I was an exploratory study, which obtained patients' demographic and disease characteristics from the hospital records of all patients with diabetes admitted to the CCU of one public hospital between 1 January 2000 to 31 December 2003. Study II used a qualitative interpretative approach and aimed to gain an in-depth understanding of the perspectives of patients with type 2 diabetes who have experienced a critical cardiac event in managing their everyday lives with both diabetes and cardiac conditions. Study III included two parts. The first utilised the information from the first two studies and the literature (self-efficacy theory) to develop a diabetes self-management program specifically for patients with diabetes who have had a critical cardiac event. The second part pilot tested the newly-developed diabetes self-management program for patients with diabetes admitted to CCU following a critical cardiac event. The pilot study used a randomised controlled trial research design to evaluate the efficacy of the program. Study I collected data from one hospital's records retrospectively from 2000 to 2003. The results of Study I showed there were 233 (14.7%) patients admitted to CCU that had diabetes out of the total 1589 CCU admissions during the study period. More than 22% of CCU patients with diabetes were readmitted to hospital within 28 days, compared to 6% of CCU patients without diabetes. Patients with diabetes who had a longer CCU stay were more likely to be readmitted. These results indicate that a significant proportion of a CCU population had type 2 diabetes and is more likely to be readmitted to hospital. Study II used an interpretive approach comprising open-ended interviews to collect data from patients with type 2 diabetes experiencing a cardiac event who had a CCU admission in 2000-2003. The findings revealed that patients with diabetes who had a critical cardiac event experienced considerable feelings of hopelessness and fatigue. Patients also had concerns in the areas of self-confidence and confidence in health professionals. Patients indicated that greater self-confidence and confidence in health professionals would help their ability to manage their daily lives. Therefore, it is very important that intervention programs for these at-risk patients need to improve patients' confidence levels, and reduce their feelings of hopelessness and fatigue. The information gathered from Study I and Study II provided important insight into the development of an effective diabetes self-management specifically designed for patients with type 2 diabetes following a critical cardiac event, which is presented in Study III in this thesis. Study III also provided a preliminary evaluation of the newly developed program. The evaluation used a randomised controlled trial research design for the new program and the current educational program provided in the CCU. The results of the program indicate the feasibility of commencing the new diabetes self-management program in the CCU, and to be continued in wards or at home. The results also showed significant improvements in patients' knowledge in the experimental group, but not in other outcome variables (self-efficacy, vitality and mental health levels). However, as a small sample size was used in this pilot study, a larger study is needed to ensure adequate testing of the intervention. Future research is also recommended to incorporate the new diabetes self-management program into the current cardiac education program. Staff's further professional development in providing such a program also needs to be examined. Improvements in quality of care, and patients' quality of life are expected in the future.

Diss. (sammanfattning) Stockholm : Karol. inst., 2003. / Härtill 5 uppsatser.

Thesis (Ph.D. in Nursing) -- University of Colorado Denver, 2008. / Typescript. Includes bibliographical references (leaves 100-107). Free to UCD Anschutz Medical Campus. Online version available via ProQuest Digital Dissertations;

Bakgrund: Postoperativt illamående och kräkningar (PONV) är en vanlig komplikation i samband med anestesi och drabbar cirka 30% av alla patienter. Kvinnor som genomgår gynekologiska laparoskopiska operationer är en särskilt utsatt grupp. Många individer som drabbas upplever ett onödigt lidande. Anestesisjuksköterskan har ett centralt ansvar i att arbeta preventivt och på så sätt lindra samt förebygga komplikationer. Genom att studera och jämföra olika enheter kan problemet med PONV uppmärksammas och eventuellt reduceras. Syfte: Syftet med studien är att undersöka skillnader i förekomst av postoperativt illamående och kräkningar hos kvinnor som genomgår laparoskopiska gynekologiska steriliseringar på två olika operationsenheter i södra Sverige. Metod: Kvantitativ retrospektiv jämförande studie med journalgranskning av 95 patienter som genomgått gynekologisk laparoskopisk sterilisering på ett länssjukhus i södra Sverige. Förekomsten av PONV och skillnader samt korrelation mellan enheterna har jämförts avseende profylaktiska interventioner i förhållande till riskfaktorer. Resultat: Utfallet av PONV blev 13% kontra 8% på respektive enhet. Ingen statistisk signifikant skillnad påvisades mellan enheterna. Korrelationen mellan antal riskfaktorer och antal profylaktiska interventioner visade på en svag icke signifikant korrelation på bägge enheter. Slutsats: Endast en liten del av de kvinnor som genomgår laparoskopiska steriliseringar drabbas av PONV. Bättre dokumentation skulle underlätta kartläggningen av olika faktorer som bidrar till PONV. Individernas riskfaktorer beaktas inte och patientperspektivet är inte i fokus. Gemensamma rutiner skulle kunna leda till bättre förutsättningar för god vård och minskat lidande hos fler individer. Förslag på framtida forskning är en prospektiv studie där utfallet av PONV studeras över längre tid. / Background: Postoperative nausea and vomiting (PONV) is a common complication associated with anesthesia and affects an average 30% of all patients. Women who go through gynecological laparoscopic surgery are a particularly vulnerable group. Many individuals experience an unnecessary suffering due to PONV. The nurse anesthetist has a central responsibility in working preventively, thus alleviating and reducing complications. By studying and comparing different units, the problem can be noted and possibly reduced. Aim: The aim of this study is to examine differences in postoperative nausea and vomiting in women undergoing gynecological laparoscopic sterilization at two different operating units in southern Sweden. Method: Quantitative retrospective comparative study with journal review of 95 patients undergoing gynecological laparoscopic sterilization at a county hospital in southern Sweden. The outcome of PONV with differences and correlation between the units has been compared with regard to prophylactic interventions in relation to risk factors. Results: The outcome of PONV was 13% versus 8% on the respective unit. No statistically significant difference was detected between the units. The correlation between the number of risk factors and the number of prophylactic interventions showed a weak, non-significant correlation on both units. Conclusion: Only a small proportion of women undergoing laparoscopic sterilization suffer from PONV. Better documentation would favor the mapping of various factors contributing to PONV. Risk factors are not considered for each individual and therefore the patient perspective is not in focus. Common routines could lead to better conditions for good care in more individuals, thereby reducing suffering. A proposal for future research is a prospective study where the outcome of PONV is studied over a longer period of time.

Subject: The knowledge of the sport performance structure with individual identification of the sport training model is a prerequisite for the effective management of sport training. Achieving the sports top limit performance in sport is possible by adapting the training plan to the athlete's individuality by his physiological and psychological prerequisites. To achieve the highest sports performance, sports training analysis is an indispensable tool for international competitiveness. This case study deals with the description of sports training models identified by the composition and dynamics of the training load predictors. A retrospective longitudinal study provides with insights into the possibilities of influencing sports training, which made national, Czech, records on the course of 800 m men and 3,000 m of women's steeplechase. Probandé (n=2) at the age of 21 (runner 1) and 28 resp. 29 years old (runner 2) reached limiting sports performances. The track record dates originates from 1995 to 2012. Runners were participants or medalists from top world or European athletic competitions. Objectiv: The aim of the thesis is to identify retrospectively through the found predictors, by whom were reached limit sports performance and sporting performance in the middle distances run. Methods: The...

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Deixar as informações que estão fora do quadrado ) Folha de aprovação - Fonte: Arial / Tamanho da fonte: 12 - nesta folha NÃO tem SÃO PAULO 2018 - DEDICATÓRIA Fonte: Arial / Tamanho da fonte: 12 ( A PALAVRA DEDICATÓRIA DEVE SER MAIUSCULO/NEGRITO E CENTRALIZADO ) - Opcional - AGRADECIMENTOS - Fonte: Arial / Tamanho da fonte: 12 (A PALAVRA AGRADECIMENTO DEVE SER MAIUSCULO/NEGRITO E CENTRALIZADO ) - RESUMO (A PALAVRA RESUMO DEVE SER MAIUSCULO/NEGRITO E CENTRALIZADO): espaçamento simples (150 a 500 palavras), com palavras-chave (obrigatório). - ABSTRACT ( A PALAVRA ABSTRACT DEVE SER MAIUSCULO/NEGRITO E CENTRALIZADO ) em língua estrangeira . A numeração só pode aparecer a partir da Introdução (antes não pode ) Após os ajustes excluir o pdf já postado e submete-lo novamente para analise e aprovação. Qualquer duvida estamos a disposição, Att. 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No pedido da ficha catalográfica que foi solicitado a biblioteca, o título que o senhor enviou foi: Master’s thesis: retrospective voting in Brazil: a case study of São Paulo’s smart-card policy, porém no trabalho o título está diferente, houve alteração do título do seu trabalho? 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No. of bitstreams: 1 Defesa_vfinal_biblioteca.pdf: 941554 bytes, checksum: ff6a3af8c2471aca559bef0bdb338573 (MD5) Previous issue date: 2018-02-28 / Retrospective voting is a major concern of scholars worried about democratic accountability. The work attempts to measure the retrospective voting of an important urban policy in Brazil’s largest metropolis, São Paulo - SP. The Bilhete Único policy was the first smart-card for public transportation in Brazil. Commuters with the smart-card were able to save up to three bus fares in a journey, a substantial amount of money for most of São Paulo’s citizens. Using a mixed method approach, I try to test the hypothesis that the policy improvement on welfare positively impacted the electorate performance of the incumbent mayor. My findings suggest that not all bus users rewarded the incumbent mayor for delivering the policy. In particular, students and students’ families seem to be the ones who actually felt the policy effects and cast a retrospective vote. This could be due to delivery network difficulties and to the timing of the policy. Additionally, I employ a normative discussion to establish benchmarks of better public goods. Retrospective voting does not necessarily reward the best policies, therefore the need to discuss benchmarks. / O voto retrospectivo é um grande tema de acadêmicos preocupados com a responsabilidade democrática. O trabalho tenta medir a votação retrospectiva de uma importante política urbana na maior metrópole do Brasil, São Paulo - SP. A política do Bilhete Único foi o primeiro cartão inteligente para transporte público no Brasil. Os passageiros com o cartão inteligente conseguiram economizar até três passagens de ônibus em uma viagem, uma quantia substancial de dinheiro para a maioria dos cidadãos de São Paulo. Usando uma abordagem de método misto, tento testar a hipótese de que a melhoria da política sobre o bem-estar impactou positivamente o desempenho do eleitorado da prefeita em exercício. Minhas descobertas sugerem que nem todos os usuários de ônibus recompensaram a prefeita por ter entregue a política. Em particular, alunos e as famílias dos alunos parecem ter sido os que realmente sentiram os efeitos da política e votaram retrospectivamente. Isso pode ser devido às dificuldades na rede de entrega e ao momento da política. Além disso, emprego uma discussão normativa para estabelecer benchmarks de melhores bens públicos. A votação retrospectiva não necessariamente recompensa as melhores políticas, por isso, a necessidade de discutir benchmarks.

Cette thèse a pour vocation de dresser un catalogue exhaustif des hermès à portrait provenant des provinces occidentales de l’empire romain afin d’appréhender toute la richesse sémantique de ce support figuré original. Disposés depuis l’époque archaïque aux carrefours et aux portes des villes grecques, les piliers hermaïques deviennent, sous l’impulsion des Romains, le support de véritables portraits et non plus uniquement celui d’effigies divines. Deux catégories iconographiques émergent, les portraits rétrospectifs restituant les traits de personnages historiques fameux tels Homère ou Ménandre, et ceux de particuliers, parfois dédiés à leur Genius et élevés dans l’atrium de leur demeure. Au-delà de la nécessaire analyse stylistique et iconographique du corpus, cette étude a pour ambition de donner une lecture historico-culturelle du phénomène et de rendre compte de la mise en œuvre concrète de ces hermès, depuis l’atelier jusqu’aux lieux où ils sont exposés. Leur remise en contexte doit permettre de dresser un tableau des acteurs de cette pratique de dédicace, des personnages représentés, des motifs présidant au choix de ces images abrégées et de la place qu’elles occupent dans l’espace privé des villas romaines, dans le cadre du culte domestique comme dans celui de l’otium. / This study aspires to acheive a catalog of portrait herms in the Roman West in order to apprehend the semantic meaning of this original figurative support. Erected since achairc times by the crossroads and doors of greek cities, herms become, under roman influence, pedestals for portraits and not only representations of divinity. Those portraits can be divided into two iconographical categories : retrospective ones reproducing features of historical figures such as Homer and Menander, and those of private citizens, sometimes dedicated to their Genius and raised in the atrium of their house. More than a simple stylistical and iconographical analysis of this corpus, this study tries to give an historical and cultural reading of thoses sculptures, from the workshop to their exhibition contexts. This approach must allow the depiction of all the actors involved in thoses dedications, the clarification of thematic choices as of the reasons for choosing these abbreviated images, the definition of their place in the private space of the Roman villas in the context of domestic cults or that of the otium.

A partir da teoria do escopo formulada por Katharina Reiß e Hans Vermeer em Grundlegung einer allgemeinen Translationstheorie (1984) e de uma expansão do modelo de análise textual de relevância tradutória apresentado por Christiane Nord em Textanalyse und Übersetzen (1988), a presente tese de doutorado apresenta um novo modelo teórico para a execução da TRADUÇÃO RETROSPECTIVA, definida como a tradução a posteriori de um TP (texto precursor) ainda inédito na cultura-alvo que mantenha uma relação de influência e/ou precedência cronológica com um TS (texto sucessor) já traduzido anteriormente para a cultura-alvo, de maneira que a tradução de TP cause a impressão de ser anterior e/ou de ter influenciado a tradução de TS. A tradução retrospectiva tem por objetivo simular, na culturaalvo, a relação existente entre o original de TP e o original de TS na cultura-fonte através de uma inversão das relações de influência literária segundo os moldes propostos por Jorge Luis Borges no ensaio “Kafka y sus precursores”. Uma vez exposto o modelo teórico, o trabalho apresenta um estudo de caso sobre o volume O grande deus Pã, totalmente concebido em função de uma tradução retrospectiva do TP The Great God Pan, de Arthur Machen, feita com uma visada sobre o TS “The Dunwich Horror”, de Howard Phillips Lovecraft, traduzido anteriormente por mim. / By building on the Skopos theory proposed by Katharina Reiß and Hans Vermeer in Grundlegung einer allgemeinen Translationstheorie (1984) and on an expansion of the model for text analysis in translation presented by Christiane Nord in Textanalyse und Übersetzen (1988), this doctoral dissertation introduces a new theoretical model for RETROSPECTIVE TRANSLATION, defined as an a posteriori translation of a PT (precursor text) still unpublished in the target culture which in turn maintains a relationship of influence and/or chronological precedence with an ST (successor text) previously translated in the target culture, so that the translation of PT may seem to have anticipated and/or influenced the translation of ST. The objective of a retrospective translation is to simulate, in the target culture, the existing relation between the original of PT and the original of ST in the source culture by promoting an inversion of traditional literary influence relations inspired by Jorge Luis Borges's essay “Kafka and his precursors”. Once the theoretical model is laid out, there follows a case study of the volume O grande deus Pã, entirely conceived around a retrospective translation of the PT The Great God Pan, by Arthur Machen, done with a backward glance toward the ST “The Dunwich Horror”, by Howard Phillips Lovecraft, previously translated by me.

Objetivo: Avaliar o impacto do nascimento pré-termo sobre a mortalidade neonatal numa série temporal de 2000 a 2014 no município de Porto Alegre. Métodos: Estudo de coorte retrospectivo de base populacional com a utilização dos registros oficiais de nascimento e de morte ligados de 2000 a 2014 de recém-nascidos com menos de 32 semanas de idade gestacional de Porto Alegre. Foram utilizadas como variáveis independentes idade e escolaridade maternas, número de consultas pré-natal, tipo de hospital, via de parto, idade gestacional (IG), sexo e peso do recém-nascido e ano de nascimento. O desfecho primário foi morte neonatal (morte ocorrida de 0 a 27 dias de vida). Foram excluídos recém-nascidos duplicados, com menos de 500 gramas ou com peso inconsistente, com IG menor de 22 semanas, com anomalias congênitas, gemelares e de partos extra hospitalares. Foi calculado razão de risco (hazard ratio-HR) ajustado para o risco de morte neonatal para todas as variáveis independentes através de análise de sobrevivência pela regressão de Cox para riscos proporcionais com nível de significância p<0,05. Posteriormente, foi realizado análise por quintil de peso de nascimento. Resultados: Foram analisados os registros de 3282 recém-nascidos com IG menor que 32 semanas de 2000 a 2014 dos quais, 643 foram ao óbito neonatal e 2639 sobreviveram. O risco de morte neonatal absoluto diminuiu de 25% no triênio 2000 a 2002 para 17% no período de 2012 a 2014. O mesmo risco ajustado foi significativamente menor para os recém-nascidos de menor peso (média de 673 ± 86 gramas) de parto cesáreo [HR 0,57 (IC95% 0,45-0,73)] enquanto que, para os de maior peso (média 1.834 ± 212 gramas) este risco inverteu-se e foi significativamente maior para esta via de parto [HR 8,44 (IC95% 1,86-38,22)]. Conclusão: Houve diminuição do risco absoluto de morte neonatal entre os recém-nascidos com IG menor de 32 semanas nos últimos anos em Porto Alegre e o aprimoramento do uso racional do parto cesáreo nos hospitais do município pode contribuir para uma redução ainda maior desse indicador. / Objective: Assess impact of prematurity on neonatal mortality from 2000 to 2014 in Porto Alegre through official information systems. Methods: Populational base retrospective cohort study with record linkage of birth and death database certificates. There were included records of birth and death from 2000 to 2014 of infants with less than 32 weeks of gestational age of Porto Alegre. There were used mother age and schooling, number of antenatal visits, delivery type, hospital type, gestational age, sex and birth weight and birth year of infant as independent variables. The primary outcome examined was neonatal death (death at 0-27 days of age). There were excluded infant records duplicate, with less than 500g or inconsistent birthweight, with gestational age less than 22 weeks, with congenital anomalies, twins and out-of-hospital births. Adjusted Hazard Ratio (HR) were calculated for the risk of neonatal death for all independent variables through Cox regression for survival analysis with p-value<0,05 for statistical significance. The analysis also was performed at quintiles of birthweight. Results: There were 3282 infant records of infants with less than 32 weeks of gestational age from 2000 to 2014 who progress to 643 neonatal deaths or 2639 survival. The neonatal death absolut risk decline from 25% at 2000-2002 period to 17% at 2012-2014 period. The adjusted neonatal death risk was significantly reduced for lightest preterm (mean birthweight 673g ± 86) born by C-section [HR 0.57 (CI95% 0.45-0.73)], while, for the heaviest ones (mean birthweight 1.834g ± 212) the risk was significantly increased for that delivery route [HR 8.44 (CI95% 1.86-38.22)]. Conclusion: The absolut risk of neonatal death in infants with less than 32 weeks of gestational age has been declining over the years and more rational use of C-section can contribute to further improving the neonatal survival.