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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.
51

Étude de la prévalence d’infection aux parasites du genre Echinococcus chez les canidés sauvages au Québec

Lavallée-Bourget, Ève-Marie 08 1900 (has links)
Echinococcus est un parasite zoonotique présent mondialement circulant entre les canidés et les rongeurs ou les cervidés. L’humain est un hôte accidentel et la maladie qu’il peut développer à la suite d’une infection peut entraîner de graves signes cliniques en l’absence de traitement. Dans la faune au Québec, on reconnaît E. canadensis, responsable de l’échinococcose kystique, alors qu’E. multilocularis, associé à l’échinococcose alvéolaire, n’a pas encore été détecté. Cependant, le diagnostic récent au Québec d’un cas humain d’échinococcose alvéolaire porte à croire que le parasite circule sur le territoire. Cette étude de type transversale menée dans 12 régions administratives au Québec d’octobre à mars 2020–2021 en collaboration avec des trappeurs a pour but d’estimer la prévalence du parasite chez les coyotes et les renards roux à proximité des zones habitées et de déterminer les principaux foyers d’infection. Un test RT-PCR sur contenu intestinal a été effectué sur 707 prélèvements à partir de carcasses récupérées par les trappeurs (423 coyotes et 284 renards roux). Au total, ce sont 38 échantillons qui sont revenus positifs à Echinococcus spp. (24 coyotes et 14 renards roux) et 25 à E. multilocularis (14 coyotes et 11 renards roux). Deux zones d’infection ont aussi été identifiées, soit en Montérégie et au Bas-St-Laurent, où le risque d’infection est de 5.4 à 14.4 fois plus élevé (p < 0.05). Des analyses de régression logistique n’ont pas permis de déterminer une association statistiquement significative entre le sexe, l’espèce, la localisation géographique et le statut d’infection. Les analyses effectuées ont permis de comparer les tests de diagnostic de coproscopie et RT-PCR pour Taenia spp. et l’identification des échinocoques. Cette étude a permis de démontrer la circulation du parasite sur le territoire québécois dans la majorité des régions administratives étudiées. / Echinococcus is a zoonotic parasite present worldwide circulating between canids as definitive hosts and rodents or cervids as intermediate hosts. Humans are accidental hosts and the disease they may develop because of an infection can lead to serious clinical signs if left untreated. In Quebec, the presence of E. canadensis, responsible of cystic echinococcosis is recognized in wildlife, but E. multilocularis has not yet been identified. The recent diagnosis of a human case in Quebec of alveolar echinococcosis, the disease caused by E. multilocularis, leads us to consider that the parasite may circulate on the territory. This cross-sectional study conducted in 12 administrative regions in Quebec from October 2020 to March 2021 in collaboration with trappers aims to estimate the prevalence of the parasite in coyotes (Canis Iatrans) and red foxes (Vulpes vulpes) near populated areas and to detect high-risk areas of infection. An RT-PCR test on intestinal contents was carried out on 707 samples from carcasses recovered by trappers (423 coyotes and 284 red foxes). A total of 38 samples were positive for Echinococcus spp. (24 coyotes and 14 red foxes) and 25 for E. multilocularis (14 coyotes and 11 red foxes). Two high-risk areas of infection have also been identified, in Montérégie and Bas-St-Laurent, where the risk of infection is 5.4 to 14.4 times higher (p < 0.05). Logistic regression analyzes failed to determine a statistically significant association between sex, species, geographic location and infection status. The analyzes allowed us to compare the diagnostic tests of coproscopy and RT-PCR for Taenia spp. and identification of Echinococcus. This study demonstrated the circulation of Echinococcus spp. and E. multilocularis on the Quebec territory in most of the administrative regions studied.
52

Processus écologiques déterminant les changements fauniques le long d'une chronoséquence après coupe en forêt boréale

Le Borgne, Hélène 24 April 2018 (has links)
Comprendre comment les communautés changent dans le temps et les facteurs influençant la répartition des espèces est un aspect central de l’écologie. Bien que les changements dans les communautés animales à la suite de perturbations aient été largement décrits, peu d'études ont examiné les processus qui structurent ces communautés, en particulier durant la succession écologique résultant des activités anthropiques. L’objectif de ma thèse était donc de mieux comprendre les processus biologiques influançant l’organisation des communautés de petits mammifères et de coléoptères, de même que la répartition d’une espèce clé de l’écosystème, le campagnol à dos roux (Myodes gapperi), durant la succession forestière en forêt boréale aménagée. Dans un premier temps, nous avons donc examiné comment la succession peut influencer les processus de structuration des assemblages d’espèces. Puis, dans un second temps, nous nous sommes intéressés plus spécifiquement à une espèce clé typiquement associée aux vieilles forêts pour investiguer les mécanismes qui influencent leur organisation spatiale et donc leur répartition dans les peuplements. Enfin, nous avons étudié leur utilisation de l’habitat à plus fine échelle (micro-habitat) en caractérisant leurs déplacements afin de mieux comprendre les liens qui existent entre les animaux et les attributs fins de l’habitat durant la succession. L’étude a montré que les assemblages d’espèces étaient similaires dans les peuplements 50-60 ans après coupe et dans les forêts matures. De façon générale, la structuration des communautés lors de la succession forestière semble résulter à la fois de processus stochastiques et déterministes, ces derniers étant plus étroitement liés aux interactions interspécifiques qu’aux caractéristiques de la végétation. Par la suite, nous avons utilisé les théories de sélection d’habitat et d’approvisionnement pour identifier les processus qui peuvent expliquer l'augmentation d’abondance relative des campagnols à dos roux lors de la succession forestière. Les résultats indiquent que la compétition apparente avec la souris sylvestre (Peromyscus maniculatus) limiterait la répartition des campagnols, et que des changements dans la force relative de ce processus durant la succession forestière expliqueraient les changements de répartition observés. La gestion durable des forêts doit maintenir certains attributs de l'habitat nécessaires au rétablissement des espèces de peuplements matures, mais ces attributs peuvent être difficiles à identifier car leur utilisation peut varier fortement pendant la succession. Nous avons donc identifié certains attributs importants pour le campagnol, puis tenté d’expliquer certaines variations dans leur utilisation durant la succession forestière en évaluant les déplacements à fine échelle du petit mammifère. Nos analyses démontrent, par exemple, que les campagnols sélectionnent fortement le bois mort comme route de déplacement durant la succession forestière, et aussi que cette sélection est moins forte en milieu de succession que dans les coupes récentes et dans les forêts matures. Ces variations dans les relations animaux-habitat durant la succession peuvent s’expliquer par des ajustements comportementaux aux changements dans la couverture qu’offre la canopée prenant place à mesure que la forêt vieillie. En conclusion, cette thèse améliore les connaissances des processus régissant la répartition de la faune boréale, et cela grâce à la combinaison originale de l’étude des communautés, de la dynamique des populations et du comportement animal. / Understanding how communities change over time and the process influencing species distribution are recurrent themes in ecological research. Although changes in animal communities following disturbances have been widely examined, few studies have investigated the process structuring communities, particularly during ecological succession resulting from anthropogenic disturbances. The main objective of my thesis was to better understand the biological processes influencing the organization of small mammal and beetle communities, as well as the distribution of a key species, the red-backed vole (Myodes gapperi), during forest succession in managed boreal forests. First, we examined how forest succession influences the process structuring species assemblages. Then, we focused more specifically on red-backed voles to investigate the processes influencing their spatial organization along a chronosequence of post-logging stands. Finally, we studied their use of habitat at a fine scale (micro-habitat) by assessing the interplay between their movements and habitat attributes characterizing post-harvested stands during ecological succession. The study showed that assemblages 50-60 years after clearcutting were similar to those found in old-growth forests. Generally, community assembly during forest succession seem to be driven by both stochastic and deterministic processes, the latter being linked to interspecific interactions more strongly than to vegetation attributes. Then, we combined habitat selection and optimal foraging theories to evaluate the processes that can explain the increase in red-backed vole abundance during post-logging forest succession in boreal ecosystems. Our results suggest that apparent competition with deer mice (Peromyscus maniculatus) limits the density of red-backed voles, and changes in the relative strength of this process during forest succession can explain patterns of vole distribution and abundance. Sustainable management must maintain habitat features needed for the recovery of species typical of mature forest, an objective that may be challenging because animal-habitat relationships can vary dynamically during succession. We thus identified key habitat attributes for red-backed voles, and then tried to explain some variations in the use of those attributes during forest succession by studying fine-scale movements during forest succession. We found, for example, that voles selected coarse woody debris as a travel path during forest succession, and that this selection was weaker in mid-seral forests than in recent cuts and old-growth forests. Such variations in animal-habitat relationships observed during forest succession can be explained by behavioural adjustments to changes in the availability of canopy cover occurring as stands mature. Overall, this thesis improves our knowledge of the processes driving wildlife distribution dynamics, by its combination of studies on community assembly, population dynamics and animal behaviour.
53

Benefícios Precoces da Cirurgia do Bypass Gástrico em Y de Roux: Implicações do GLP-1 e Adiponectina na Melhora do Perfil Metabólico de Pacientes com Diabetes Mellitus tipo 2 / Early benefits from Roux-en-Y gastric bypass surgery: implications of GLP-1 and adiponectin in the improvement of metabolic profile in the patients with type 2 diabetes mellitus

Umeda, Luciana Mela [UNIFESP] 29 June 2011 (has links) (PDF)
Made available in DSpace on 2015-07-22T20:49:39Z (GMT). No. of bitstreams: 0 Previous issue date: 2011-06-29 / TEDE / BV UNIFESP: Teses e dissertações
54

Déterminants de la répartition des oiseaux et des micromammifères en forêt boréale naturelle et aménagée

Lemaître, Jérôme 16 April 2018 (has links)
La compréhension des déterminants de la répartition des organismes est un thème central en écologie. Mon objectif était de mieux comprendre l'influence de quatre facteurs sur la répartition des oiseaux et des micromammifères des forêts boréales naturelles et aménagées : la sélection d'habitat, le parasitisme, la compétition et la prédation. Alors que la relation entre la diversité et l'hétérogénéité de l'habitat était établie, la contribution relative de la structure et de la composition de l'habitat était incertaine. Mon étude a montré que la structure et la composition de l'habitat expliquaient la même variance dans 96 assemblages d'oiseaux occupant les vieilles forêts boréales, bien que certaines espèces répondent uniquement à la structure ou à la composition de l'habitat. Ces résultats étaient similaires à cinq échelles spatiales, soit pour des rayons de paysage allant de 100 à 1000 m autour des stations. Les stratégies de conservation devraient mettre autant d'emphase à préserver la structure et la composition de l'habitat. Ensuite, j'ai démontré que le parasitisme par l'oestre (Cuterebra spp) pourrait contribuer à la dynamique de 36 populations du campagnol à dos roux (Myodes gapperi), le micromammifère le plus abondant en forêt boréale naturelle. La probabilité de survie de 341 campagnols diminuait avec l'infection dans des conditions de stress élevé. Le principal facteur responsable du risque individuel d'infection était l'abondance de campagnols plutôt que les traits d'histoire naturelle ou les variables d'habitat. La croissance estivale des populations était négativement reliée à la prévalence du parasite. Enfin, j'ai déterminé quels facteurs, parmi la prédation et la compétition, influençaient davantage la répartition du campagnol à dos roux en fonction d'un gradient d'intensité de l'exploitation forestière. Pour ce faire, j'ai utilisé une expérience sur l'effort d'approvisionnement dans 29 stations. La compétition interspécifique avec les souris sylvestre (Peromyscus maniculaîus) semblait être le principal facteur responsable du déclin des populations de campagnols à dos roux induit par l'exploitation forestière. En conclusion, cette thèse améliore la connaissance des facteurs régissant la répartition de la faune boréale, grâce à la combinaison originale de l'étude des assemblages d'espèces, de la dynamique des populations et du comportement animal. Mes résultats devraient fournir des renseignements utiles à l'aménagement durable de nos forêts.
55

Aspectos genéticos do metabolismo lipídico e risco para colelitíase na obesidade mórbida após cirurgia bariátrica

Pinheiro Júnior, Sidney 27 March 2012 (has links)
Made available in DSpace on 2016-01-26T12:51:43Z (GMT). No. of bitstreams: 1 sidneypinheirojunior_tese.pdf: 1185692 bytes, checksum: 2cae9b38515819abe487b6260ac74acc (MD5) Previous issue date: 2012-03-27 / Background Outstanding, among the factors associated to cholelithiasis after bariatric surgery, are those related to metabolism and synthesis of lipoproteins, such as apolipoprotein E (ApoE) and protein from cholesterol ester transfer protein (CETP). Methods - 220 patients have been part of the study, 114 (G1) with cholelithiasis postoperatively and 106 (G2) without cholelithiasis in over 8 months period, including the analysis of apoE-Hha I and CETP-TaqIB polymorphisms per PCR / RFLP and biochemical profile [total cholesterol (TC), lipoprotein cholesterol fraction of low (LDL), high (HDLc) and very low density (VLDLc), triglycerides (TG) and glucose levels. It was accepted level of significance for P <0.05. Results - Preoperatively, it was observed that in G1 54% of the patients with the APOE*4 allele had serum altered levels of LDL. Postoperatively, there was a decrease (P <0.001) of LDL with TG in G2 (85.3 ± 32.1 mg / dL, P <0.0001) and glucose (G1 = 83.2 ± 10.7 mg / dL; G2 = 84.7 ± 11.5 mg / dL, P <0.0001 for both), TC and LDL and HDL cholesterol increased only in G2 (P <0.0001). The B1 allele was related to decreased (P <0.01) of TC, LDLc and TG postoperatively in both groups, in addition to lowering glucose levels and increase HDL cholesterol only in G2 (P <0.0001). The genotype APOE*_/4 in G2 was associated with decreased levels of TC, LDL, TG and glucose levels and increased levels of HDL cholesterol (P<0.01) postoperatively. Conclusions - This study does not confirm the association of apoE-Hha-I and CETP-TaqIB with gallstones in the late postoperative period after bariatric surgery. However, B1 allele seems to enhance the action of bariatric surgery in the control of dyslipidemia effectively reducing levels of TC, LDL and TG, with additional benefit to those without gallstones by decreasing blood glucose levels and also increase HDL cholesterol. The relationship of APOE*4 with increased LDLc preoperatively only in G1 suggests its association with cholelithiasis in the late postoperative bariatric surgery, which should be evaluated in prospective studies. / Introdução- Destacam-se entre os fatores associados à colelitíase após cirurgia bariátrica, aqueles relacionados a metabolismo e síntese de lipoproteínas plasmáticas, como apolipoproteína E (apo E) e proteína de transferência do éster de colesterol (CETP). Objetivos-Avaliar a associação das variantes genéticas apoE-Hha I e CETP-TaqIB na colelitíase e sua influência no perfil bioquímico,além de perfil antropométrico e co-morbidades em pacientes com obesidade mórbida após cirurgia bariátrica. Métodos- Foram estudados 220 pacientes: 114 (G1) com colelitíase no pós-operatório e 106 (G2) sem colelitíase, em período >8 meses, incluindo a análise dos polimorfismos apoE-HhaI e CETP-TaqIB por PCR/RFLP e perfil bioquímico [colesterol total (CT), fração de colesterol de lipoproteína de baixa (LDLc), alta (HDLc) e muito baixa densidade (VLDLc), triglicérides (TG) e glicemia], além do índice de massa corporal (IMC), cintura abdominal (CA), hipertensão e diabete melito. Admitiu-se nível de significância para P<0,05. Resultados- Houve semelhança entre os grupos para os genótipos de apoE-HhaI e CETP-TaqIB. O genótipo APOE*3/3 prevaleceu em ambos os grupos (G1: 65% e G2:73%; P=0,204), enquanto genótipos APOE*_/4 destacaram-se em G1 (23% versus 16%; P=0,269). Para CETP o alelo B1 prevaleceu em G1 (0,59) e G2 (0,62; P=0,558). O perfil bioquímico, com valores recomendados já no pré-operatório em ambos os grupos, exceto para TG (141,4±75,4; 159,3±90,9mg/dL, respectivamente, P=0,123) e glicemia (113,0±53,2; 105,8±34,3mg/dL, respectivamente; P=0,262), mostrou decréscimo (P<0,001) no pós-operatório para todas as variáveis, incluindo TG (respectivamente, 89,0±34,6mg/dL; 85,3±32,1mg/dL; P<0,0001 para ambos) e glicemia (respectivamente, 83,2±10,7mg/dL; 84,7±11,5mg/dL; P<0,0001 para ambos). Níveis de HDLc mostraram acréscimo no pós-operatório apenas em G2 (52,5±14,7 versus 43,0±11,9; P<0,0001). Em G1, 54% dos pacientes portadores do alelo APOE*4 tinham níveis séricos alterados de LDLc no pré-operatório. O genótipo APOE*3/3, em G1, associou-se com decréscimo nos níveis de CT, LDLc, TG e glicemia e aumento nos níveis de HDLc (P<0,01). O mesmo ocorreu para genótipos APOE*_/4, em G2. O alelo B1 relacionou-se com decréscimo (P<0,01) de CT, LDLc e TG no pós-operatório em ambos os grupos, além de redução de glicemia e aumento de HDLc apenas em G2 (P<0,0001).Ambos os grupos mostraram redução nos valores de IMC e CA, além de hipertensão e diabete melito. Conclusões: Variantes de apoE-HhaI e CETP-TaqIB não diferenciam os grupos com e sem colelitíase no pós-operatório tardio de cirurgia bariátrica. Presença de APOE*4 relacionada com aumento de LDLc no pré-operatório, sugere sua influência no desenvolvimento de colelitíase no pós- operatório tardio, a ser confirmado em estudos prospectivos. CETP-Taq IB, representado pelo alelo B1 parece potencializar a ação da cirurgia bariátrica no controle do perfil bioquímico, particularmente em G2 com aumento de HDLc e decréscimo da glicemia. Além disso, independente da presença de colelitiase, a cirurgia bariátrica controla também doenças crônicas como diabete melito e hipertensão arterial.
56

Bariatric Surgery for Obesity: A Systematic Review and Meta-analysis

Alobaid, Abdulhakeem M. 14 May 2013 (has links)
Obesity is the fifth leading cause of global deaths. The efficacy and safety of obesity treatment is still controversial. The objective of the thesis is to evaluate the efficacy and safety of bariatric surgery, through a systematic review of the current evidence and meta- analysis of important outcomes. Nineteen (19) randomized controlled trials (RCTs) with 1346 participants were included. Bariatric surgery resulted in greater weight loss when compared to non-surgical treatment. Weight loss was also associated with resolution and/or improvement of obesity related comorbidites such as diabetes, hypertension, hyperlipidemia, and sleep apnea. Weight loss and safety varied across the surgical procedures. Biliopancreatic diversion/duodenal switch had the greatest weight loss, followed by sleeve gastrectomy and Roux-en-Y gastric bypass, purely restrictive procedures such as vertical banded gastroplasty and adjustable gastric banding resulted in the least weight loss. Long term, high quality, and adequately powered trials are still needed to support the available evidence
57

Biodistribui??o do pertecnetato de s?dio ap?s desvio g?strico em Y de Roux (t?cnica de capella)

R?go, Am?lia Cinthia Meneses do 25 March 2010 (has links)
Made available in DSpace on 2014-12-17T14:13:31Z (GMT). No. of bitstreams: 1 Tese_AmaliaCMR.pdf: 1553698 bytes, checksum: 6cd45ea63f2dac82fefb452ca8fd0c89 (MD5) Previous issue date: 2010-03-25 / O desvio g?strico em Y de Roux ? a t?cnica cir?rgica mais utilizada no tratamento da obesidade m?rbida. Esta opera??o reduz o volume do est?mago e o comprimento do intestino delgado, gerando altera??es estruturais e metab?licas que podem influenciar no resultado de exames cintilogr?ficos de pacientes operados. Com o objetivo de avaliar a biodistribui??o p?s-operat?ria do pertecnetato de s?dio (Na99mTc) em ?rg?os de ratos Wistar submetidos ? t?cnica do bypass (desvio) g?strico em Y de Roux (BGYR), foram utilizados 12 ratos distribu?dos aleatoriamente em grupo tratado (n=6), submetido ? cirurgia do BGYR e o grupo controle (C; n=6). No 15? dia de p?s-operat?rio foi administrado 0,1 mL via plexo orbital de Na99mTc aos animais dos dois grupos, com atividade radioativa m?dia de 0,66MBq. Ap?s 30 minutos, os ratos foram mortos e retirados fragmentos de tire?ide, cora??o, pulm?o, f?gado, est?mago, rim e f?mur. As amostras foram lavadas com solu??o salina 0,9%, pesadas e submetidas ao Contador Gama 1470, WizardTM Perkin-Elmer-Finl?ndia para determina??o do percentual de atividade radioativa total por grama (%ATI/g) de cada ?rg?o. Empregou-se o teste t de Student para an?lise estat?stica, considerando-se significantes as diferen?as das m?dias quando p<0,05. Redu??o significante na m?dia de %ATI/g foi observada no f?gado, est?mago e f?mur dos animais submetidos ? cirurgia de BGYR comparada ao grupo controle (p<0,05). Nos demais ?rg?os n?o houve diferen?a estatisticamente significativa entre os grupos. Em conclus?o, a cirurgia BGYR em ratos modificou a biodistribui??o do Na99mTc em alguns ?rg?os, podendo ter implica??es cl?nicas na interpreta??o de exames cintilogr?ficos. Este estudo xi teve um car?ter multidisciplinar com a participa??o de pesquisadores das ?reas de Cirurgia Experimental, Farm?cia, Radiobiologia, Medicina Nuclear e Estat?stica
58

Bariatric Surgery for Obesity: A Systematic Review and Meta-analysis

Alobaid, Abdulhakeem M. January 2013 (has links)
Obesity is the fifth leading cause of global deaths. The efficacy and safety of obesity treatment is still controversial. The objective of the thesis is to evaluate the efficacy and safety of bariatric surgery, through a systematic review of the current evidence and meta- analysis of important outcomes. Nineteen (19) randomized controlled trials (RCTs) with 1346 participants were included. Bariatric surgery resulted in greater weight loss when compared to non-surgical treatment. Weight loss was also associated with resolution and/or improvement of obesity related comorbidites such as diabetes, hypertension, hyperlipidemia, and sleep apnea. Weight loss and safety varied across the surgical procedures. Biliopancreatic diversion/duodenal switch had the greatest weight loss, followed by sleeve gastrectomy and Roux-en-Y gastric bypass, purely restrictive procedures such as vertical banded gastroplasty and adjustable gastric banding resulted in the least weight loss. Long term, high quality, and adequately powered trials are still needed to support the available evidence
59

Reading the prison narrative: An examination of selected Southern African Post - 2000 writings

Moyo, Robert 21 September 2018 (has links)
MA (English Literature) / Department of English / This study examines a selection of Post-2000 Southern African prison narratives. It primarily focuses on fictional narratives that were written in South Africa and Zimbabwe. Little critical attention has been given to fictional prison writing in Southern Africa considering that much critical attention has been accorded to autobiographies by political prisoners. The demise of autobiographical writing has led to the rise in the production of prison novels, hence the need to examine this evolving genre. This study is driven by the need to examine the construction and representation of subjectivity in the selected narratives. It explores how the prison is experienced, by paying attention to issues of criminality, identity, gender and power. This study begins with the examination of criminality and the representation of the function of the prison in Red Ink by Angela Makholwa (2007), followed by the exploration of gender and identity issues in A Book of Memory by Petina Gappah (2015). It further examines how the notions of power and counter-discourse are portrayed in The Violent Gestures of Life by Tshifhiwa Given Mukwevho (2014). This study employs the method of close textual analysis of the selected narratives. It is underpinned by post-colonial theory, the paradigm of the Panopticon which is foregrounded by Michel Foucault in Discipline and Punish: The Birth of Prison (1977) and Daniel Roux’s perceptions of the prison in Doing Time under Apartheid (2013). This study contends that notions of detention and imprisonment continue to play a central role in the production of selfhood in literary works. It is clear in the study that the prison is used as an institution to critique different phenomena regarding the prison experience. In this study, I clearly show that the selected narratives can be read as platforms for resistance against social ills that prevail in the post-apartheid/post-colonial society. I also argue that there is a thin line between fiction and non-fiction, apartheid/colonial and post-apartheid/post-colonial prison systems. The narratives I explore in this study reveal more continuities than discontinuities from the apartheid/colonial prisons. / NRF
60

Factors Influencing Bariatric Patients’ Level of Compliance with Supplement Recommendations and Bioavailability of Iron Supplement Formulations in Roux-en-Y Gastric Bypass Patients

Haley R Snell-Sparapany (8083127) 06 December 2019 (has links)
<p>In our first study, we explored the barriers to complying with iron supplement recommendations using focus groups. We recruited adults, ages 18-75 years, who have had bariatric surgery at least two months previously to participate in one of four 90-minute focus groups. Participants filled out a survey asking for information on demographics and supplement use, and a facilitator asked a set of pre-determined questions to each group. Responses were written, recorded, transcribed using TranscribeMe (San Francisco CA), and analyzed using NVivo (QSR International Pty Ltd, Doncaster, Victoria). The focus groups contained nineteen participants, five of which had sleeve gastrectomy (SG) and fourteen had Roux-en-Y gastric bypass (RYGB). The average age of the participants was 49.3 ± 9.4 years, and they had undergone surgery 3.9 ± 3.6 years previously. The key factors that influenced participants’ adherence to supplement guidelines were cost, tolerability, and palatability of the supplement, level of knowledge and support from healthcare providers, and convenience of the supplementation regime.</p> <p>The second study was a prospective observational study to determine the bioavailability of ASP compared to FS. Iron deficient RYGB patients ages 18-65 years, who had surgery at least 6 months previously, participated in 8-hour iron absorption tests. Participants received a low-iron breakfast with 65 mg ASP (N=7) or FS (N=3). We assessed serum iron every 30 minutes for 8 hours following the supplementation using a colorimetric assay (South Bend Medical Foundation, South Bend, IN). In participants administered FS, serum iron increased 96.0 ± 27.2 µg/dL compared to baseline, whereas with ASP, serum iron increased 5.8 ± 4.7 µg/dL compared to baseline (<i>P</i> = 0.02). These data indicate that ASP is not as bioavailable as FS in RYGB patients.</p>

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