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La thèse présente est une étude canonique traitant la question de l’obligation canonique du célibat des ministres vers l’an 380 en Occident et en Orient. De fait, une comparaison entre les Traditions orientales et occidentales est effectuée. La recherche est centralisée sur l’interprétation de la péricope 1 Cor. 7, 1-9 de l’Apôtre Paul, qui fut interprétée inexactement par les papes et influença beaucoup la teneur de leurs Décrétales. Puis une analyse est faite de tous les canons orientaux du IVe siècle par les Conciles particuliers et le Concile œcuménique de Nicée comme aussi des lettres canoniques des Pères grecs. Ce matériel est une partie du droit canonique oriental. Les Conciles sont divisés en deux parties, avant et après le 380. Ensuite une approche canonique des décisions conciliaires occidentales est réalisée à travers les Conciles particuliers du IVe siècle. Ces canons présentent la première imposition de l’obligation canonique du célibat au niveau local. L’étude continue à analyser le contenu des Décrétales des trois papes : Damase, Sirice et Innocent I, qui imposent le célibat après 380, d’une manière officielle et au niveau universel en utilisant l’autorité (auctoritas) et le pouvoir (potestas) du Siège de Rome. / This thesis is a canonical study which treats the question of the canonical obligation of the celibacy of priests in 380 in West and at East. It is a comparison between the eastern and western Tradition. The Research is using as important basis the extract of 1 Cor. 7, 1-9 from Apostle Paul’s Letter. This extract was misunderstood by the popes and influenced a lot their Decrees. It has been done an analysis of all the oriental canons of 4th century of the First Ecumenical Council, of the local Councils and also of the canonical Letters of the Holy Fathers. This material is a part of the eastern canon law. The Councils are devised in two parts, before and after 380.In accordance to this there is a canonical approach to the decisions of the western councils, through the local Councils of the 4th century. Those canons present the first imposition of the canonical obligation of celibacy in a local level. The study continues by analysing the contest of the Decrees of three popes: Damasus, Siricius and Innocent I, who imposed the celibacy after 380 in an official way and in a universal level by using the authority (auctoritas) and the power (potestas) of the See of Rome.

Climate change is the first anthropogenic alteration of a global Earth system. It is globally catastrophic in terms of food production, sea level rise, fresh water availability, temperature elevation, ocean acidification, species disturbance and destruction to name just a few crisis concerns. In addition, while those changes are occurring now, they are amplifying over decadal periods and will last for centuries and possibly millennia. While there are a number of pollutants involved, carbon dioxide (CO2) which results from the combustion of any fossil fuel is the primary pollutant. It has not been considered a pollutant until recently because of its natural dissociation into oxygen and carbon compounds like wood. However, because of its molecular durability and ability to acidify water, it has become the primary pollutant as a result of the exponential increase in fossil fuel use for the production of energy by Earth’s population that has doubled over the last six decades. That increase has exceeded Earth’s ability to handle humanity’s waste CO2. Obviously, the involved changes detrimentally affect all life on Earth. Because of the evolving nature of the changes, climate change is presently denied primarily in the United States because of the costs of eliminating our carbon addiction. Because no similar global natural or anthropogenic situation has previously occurred during the lifetime of Homo sapiens, our extant ethical theories are incapable of confronting the crisis. Consequently, new ethical paradigms are necessary. This dissertation attempts to provide thoughts about the use of Aristotelian ethical theory, the aidōs feeling, Aquinian psychology and a possible new virtue of proper primility in an effort to further nurture the growth of the new climate change ethics.

But: L’attention semble avoir un impact sur le fonctionnement des muscles périnéaux.Matériels : L’activité électromyographique (EMG) du sphincter anal externe (SAE) a été receuillie au cours d’effort de contractions périnéales volontaires et reflexe (provoquées par la toux) réalisées en réponse à un stimulus au marteau reflexe chez des femmes volontaires saines avec et sans épreuve de charge cognitive (ECC). Le temps de réaction (RT1) correspondant à la latence entre le stimulus et le début d’activité EMG du SAE lors d’une contraction périnéale volontaire, le RT3, correspondant au temps de latence entre le début d’activité EMG du SAE et le début d’activité EMG des muscles intercostaux externes (ICE) lors d’un effort de toux, ont été mesurés. Après randomisation (1/2) 13 femmes ont bénéficié d’une rééducation en double tache (cognitivo-musculaire) et 26 femmes constituaient le groupe témoin. Ces mêmes paramètres ont été enregistrés avant et apres rééducation dans les deux groupes.Resultats: Une ECC provoque un allongement du RT1 par un facteur 3,98 (p<0,001). Une ECC entrainne une diminution de 29% de la contraction périnéale réflexe: RT3 était respectivement de -80.00 ms sans ECC contre -56,7 ms en cas d’ECC (r=0,7, p=0,0045). Dans le groupe « rééducation » le RT1 en présence d’une ECC passait de 461,1 à 290,7 ms (r=0,6, p=0,006) contre 370 à 343 ms dans le groupe témoin (r=0,9, p=NS). Le RT3 dans le groupe « rééducation » en absence d’une ECC passait de -68,5 à -127,8 ms (r=1,9, p=0,03) et en présence d’une ECC de -42,6 ms à -59,3 ms (r=1,4, p=0,04). Conclusion: Une rééducation specifique corrige les effets provoqués par une ECC sur la contraction périnéale. / Aims: Attention may be involved in pelvic floor muscles (PFM) Methods: The electromyographic (EMG) activity of the external anal sphincter (EAS) was recorded on healthy female volunteers, during voluntary and involuntary (induced by cough) PFM contraction, elicited by local stimulation, combined (or not) with a mental Distraction Task (DT). Reaction time (RT1), ie. the latency between stimulus and the onset of EAS EMG activity, RT3, ie. the latency between the onset of EAS EMG activity and the onset of External intercostal muscle (EIC) (cough) were measured. Following randomisation (2/1) 13 volunteers underwent dual task cognitive (an attentional test and PFM exercises) rehabilitation program and 26 were the control group (no specific instruction). RT1 and RT3 were recorded before and after the program in both group.Results: The mental distraction task led to a 3.98 times greater reaction time between stimulus and EAS EMG activation (RT1), (p<0.001). DT led to a 29% shorter anticipation of the involontary PFM contraction: RT3 were respectively -80.00 ms without a DT versus -56.67 ms with a DT (r=0.7, p=0.004). In the rehabilitation group RT1 in DT conditions decreased from 461.1 ms to 290.7 ms (r=0.6, p=0.006)vs 370 to 343 ms in the control group (r=0.9, p=NS). In the study group RT3 without a DT increased from −68.5 ms to −127.8 ms (r=1.89, p = 0.03) and from 42,6 ms to -59,3 ms with a DT (r= 1.4, p=0.04).Conclusions: A specific dual task rehabilitation can prevent the effect of DT on PFM contraction characteristics.

This Master’s Thesis seeks to explain the internal conflicts faced by Guyon, the titular hero of Book II of Edmund Spenser’s Faerie Queene. Starting with Thomas Aquinas’ designations of the sensitive versus the intellectual appetite, I show that Guyon struggles to maintain the dominance of his intellectual appetite as he puts his vaunted temperance to a series of tests. The hero manages to appease his sensitive appetite through the vice of curiositas, yet the power of his sensitive appetite demands dramatic and violent acts of repression to quash it in Mammon’s Cave and in the Bower of Bliss. Guyon’s intellectual appetite to maintain temperance in Gloriana’s kingdom, aided by the guidance of the Palmer, leads Guyon to succeed in his quest yet reveals the incompatibility between temperance and the desirous and glory-seeking life of a knight errant.

Die Belastungsinkontinenz des Mannes ist eine häufige Komplikation der radikalen Prostatovesikulektomie. Abgewandelte Operationstechniken und Rekonstruktions-verfahren führen zu verbesserten postoperativen Kontinenzraten und weisen auf die Bedeutung einzelner Komponenten am urethralen Verschlussmechanismus hin. Im Vergleich zum weiblichen ist der männliche Harnkontinenzmechanismus nur ansatzweise verstanden. In der vorliegenden Arbeit werden die am urethralen Verschluss beteiligten Komponenten und ihre Verbindungen zu angrenzenden Strukturen makroskopisch und mikroskopisch analysiert und auf ihre funktionelle Bedeutung untersucht. Zehn konservierte Leichname wurden für Untersuchungen des männlichen Urogenitaltraktes genutzt, aus drei Becken wurden Organpakete für die Erstellung von mikroskopischen Schnittpräparaten entnommen. Die histologischen Untersuchungen konnten zeigen, dass die Form des Musculus sphincter urethrae externus im Transversalschnitt von der Schnitthöhe abhängig ist. Seine Fasern strahlen in die Faszie des Musculus levator ani ein. Auch die Fasern des Corpus perineale inserieren in die Faszie dieses Muskels. Anhand dieser Ergebnisse wird die zentrale Rolle des Musculus levator ani im männlichen Harnkontinenzapparat deutlich. Der eigentliche Verschlussdruck wird demnach durch den Musculus levator ani aufgebaut und durch das Corpus perineale von dorsal auf die Urethra übertragen. Die Aufgabe des Musculus sphincter urethrae externus wird nicht als primär aktiv, sondern als dynamisches Widerlager für die membranöse Urethra beschrieben. Außerdem geht die Arbeit auf die noch wenig erforschte Mediatorfunktion der glatten Muskulatur im männlichen Urogenitaltrakt ein. Diese Ergebnisse präzisieren die Vorstellung des Kontinenzmechanismus des Mannes als Zusammenspiel von unterschiedlichen Komponenten und geben Anlass, aktuelle Standardtechniken der Beckenchirurgie zu überdenken und den Fokus auf schonende bzw. rekonstruktive Operationsverfahren zu richten.

Made available in DSpace on 2014-06-12T23:14:52Z (GMT). No. of bitstreams: 2 arquivo6590_1.pdf: 4689974 bytes, checksum: 60df8508cb5a4c82b137ee4b188152c5 (MD5) license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) Previous issue date: 2011 / A incontinência urinária e fecal representa importante situação de saúde que afeta diretamente a qualidade de vida dos adolescentes que as possui. As principais motivações para a escolha do tema desta pesquisa foram: o limitado número de profissionais Estomaterapeutas interessados em atuar na área de incontinência; a escassez de estudos acerca do tema; a reduzida oferta de serviços em saúde especializados, interdisciplinares e voltados ao atendimento de pacientes portadores de incontinências; a precariedade comumente encontrada nesses serviços e que, de um modo geral, não possuem estrutura física adequada, recursos humanos e fomentos suficientes para alicerçar a assistência à saúde desse público. A partir disso sucedeu-se a delimitação do problema e a realização desta pesquisa que está estruturada em duas partes. A primeira consta do artigo Qualidade de vida de adolescentes incontinentes: revisão integrativa da literatura , realizada a partir das bases de dados LILACS, MEDLINE e Cochrane, no período de janeiro de 2001 a março de 2011. Foram utilizados para busca os descritores qualidade de vida, adolescente, criança, estomia e enema, e as palavras MACE (Malone antegrade continence enema), Malone, bexiga e incontinência, cuja seleção da amostra foi composta por oito artigos. Os resultados demonstraram que as pesquisas com adolescentes incontinentes ainda são incipientes e heterogêneas, sendo pouco comuns os estudos que abranjam exclusivamente este público. A segunda parte corresponde ao artigo original Qualidade de vida de adolescentes submetidos à ampliação vesical e à cirurgia de Malone que objetivou descrever a qualidade de vida de adolescentes incontinentes submetidos a estas cirurgias. O estudo descritivo com abordagem quantitativa foi realizado no ambulatório de cirurgia e urologia pediátrica do Hospital Infantil Maria Lucinda, e investigou os adolescentes de 10 a 18 anos com incontinência urinária e/ou fecal, submetidos à ampliação vesical e à cirurgia de Malone, concomitantemente ou não, totalizando 35 participantes. Os dados foram coletados através de entrevista presencial após consentimento do adolescente e de seu responsável, e foram utilizados dois instrumentos: o questionário estruturado sociodemográfico e o questionário genérico autoadministrado de qualidade de vida, o Pediatrics Quality of Life InventotyTM Version 4.0 (PedsQLTM). O banco de dados foi criado no programa EPI-INFO 6.04, bem como as análises estatísticas que foram expressas pelas médias dos escores das dimensões física e psicossocial e escore total. Os resultados mostraram que a qualidade de vida relacionada à saúde dos adolescentes incontinentes, de um modo geral foi positiva e demonstrou que a ampliação vesical e a cirurgia de Malone contribuem para minimizar os efeitos negativos da incontinência urinária e fecal sobre as dimensões física e psicossocial

No description available.

Cholinergic input to, and cholinergic mechanisms within the lower lumbar (L6) and upper sacral (S1) spinal cord of rat may influence neuronal excitability and afferent transmission (Thor et al, 2000) and may provide the environment necessary for appropriate central nervous system control of bladder and bowel function. It is unclear, however, if cholinergic terminals and receptors are present in the L6 & S1 spinal segments of rat and when this may develop. Cholinergic mechanisms have been shown to alter sensory afferent transmission, enhance motoneuron excitability, induce plateau potentials via non-linear membrane properties in motoneurons and reveal oscillations in locomotor-related interneurons. The enhanced activity of sphincter motoneurons was attributed to non-linear properties during the continence phase of distention-evoked voiding in the decerebrate cat (Paroschy & Shefchyk, 2000). Candidate neurotransmitters inducing non-linear properties in cat sphincter motoneurons are 5-HT (Paroschy & Shefchyk, 2000) and acetylcholine via motoneuron axon collaterals (Sasaki, 1994) and other spinal sources. We have established using the antibody to the vesicular acetylcholine transporter (VAChT) that cholinergic terminals are present on ventrolateral Onuf (VLO), dorsomedial Onuf (DMO) motoneurons and parasympathetic preganglionic motoneurons (PGN) in the L6 and S1 rat spinal cord segments. Muscarinic receptor (M2), nicotinic-α4 and α7 receptor subunit immunoreactivity was also present on Onuf motoneurons and in regions dorsal to the PGN. One source of the cholinergic puncta on Onuf motoneurons may be from motoneuron axon collaterals which we observed on a postnatal day 15 VLO motoneuron. Cholinergic terminals were observed on vasoactive intestinal polypeptide-immunoreactive (VIP) afferents, interneurons in the intermediolateral (IML) region and perhaps on other afferents in the lateral and medial collateral pathway of L6 and S1 spinal segments. In the ventral horn, the cholinergic puncta and receptors appear to have a mature distribution around two weeks postnatal and the cholinergic terminals appeared to have a mature distribution in the IML region by three weeks postnatal. Using whole cell patch clamp recording techniques and thick slices of the L6 and S1 rat spinal cord, we observed excitatory responses of ventral horn neurons and motoneurons to carbachol (10-50 μM), a non-specific cholinergic agonist. Ventral horn neurons (postnatal day 8- 16) exhibited prolonged firing and prolonged depolarizations (plateau potentials) beyond the duration of the applied excitatory input from cholinergic (n=6/33) and other (n= 4/37) neurotransmitter systems. In a selection of the neurons with plateau potentials, the L-type calcium current played a role in the plateau production (n=5/5) and low frequency oscillations (n=2/2) as revealed by nifedipine. Postnatally, the voiding reflex changes from a perineal-evoked reflex, to the adult bladder-bladder reflex. Cholinergic input may be responsible in part for the bursting activity of the external urethral sphincter and the activation of the bladder, which is required for complete voiding reflexes in the adult rat. Plateau potentials and enhanced excitability due to cholinergic mechanisms could render inessential a constant excitatory drive that is required in the perineal-evoked voiding reflex in the neonatal rat and may underlie changes in the voiding reflexes that occur during postnatal development. / February 2006

Cholinergic input to, and cholinergic mechanisms within the lower lumbar (L6) and upper sacral (S1) spinal cord of rat may influence neuronal excitability and afferent transmission (Thor et al, 2000) and may provide the environment necessary for appropriate central nervous system control of bladder and bowel function. It is unclear, however, if cholinergic terminals and receptors are present in the L6 & S1 spinal segments of rat and when this may develop. Cholinergic mechanisms have been shown to alter sensory afferent transmission, enhance motoneuron excitability, induce plateau potentials via non-linear membrane properties in motoneurons and reveal oscillations in locomotor-related interneurons. The enhanced activity of sphincter motoneurons was attributed to non-linear properties during the continence phase of distention-evoked voiding in the decerebrate cat (Paroschy & Shefchyk, 2000). Candidate neurotransmitters inducing non-linear properties in cat sphincter motoneurons are 5-HT (Paroschy & Shefchyk, 2000) and acetylcholine via motoneuron axon collaterals (Sasaki, 1994) and other spinal sources. We have established using the antibody to the vesicular acetylcholine transporter (VAChT) that cholinergic terminals are present on ventrolateral Onuf (VLO), dorsomedial Onuf (DMO) motoneurons and parasympathetic preganglionic motoneurons (PGN) in the L6 and S1 rat spinal cord segments. Muscarinic receptor (M2), nicotinic-α4 and α7 receptor subunit immunoreactivity was also present on Onuf motoneurons and in regions dorsal to the PGN. One source of the cholinergic puncta on Onuf motoneurons may be from motoneuron axon collaterals which we observed on a postnatal day 15 VLO motoneuron. Cholinergic terminals were observed on vasoactive intestinal polypeptide-immunoreactive (VIP) afferents, interneurons in the intermediolateral (IML) region and perhaps on other afferents in the lateral and medial collateral pathway of L6 and S1 spinal segments. In the ventral horn, the cholinergic puncta and receptors appear to have a mature distribution around two weeks postnatal and the cholinergic terminals appeared to have a mature distribution in the IML region by three weeks postnatal. Using whole cell patch clamp recording techniques and thick slices of the L6 and S1 rat spinal cord, we observed excitatory responses of ventral horn neurons and motoneurons to carbachol (10-50 μM), a non-specific cholinergic agonist. Ventral horn neurons (postnatal day 8- 16) exhibited prolonged firing and prolonged depolarizations (plateau potentials) beyond the duration of the applied excitatory input from cholinergic (n=6/33) and other (n= 4/37) neurotransmitter systems. In a selection of the neurons with plateau potentials, the L-type calcium current played a role in the plateau production (n=5/5) and low frequency oscillations (n=2/2) as revealed by nifedipine. Postnatally, the voiding reflex changes from a perineal-evoked reflex, to the adult bladder-bladder reflex. Cholinergic input may be responsible in part for the bursting activity of the external urethral sphincter and the activation of the bladder, which is required for complete voiding reflexes in the adult rat. Plateau potentials and enhanced excitability due to cholinergic mechanisms could render inessential a constant excitatory drive that is required in the perineal-evoked voiding reflex in the neonatal rat and may underlie changes in the voiding reflexes that occur during postnatal development.