Thèse de doctorat : Sciences et techniques des activités physiques et sportives : Rennes 2 : 2007. / Bibliogr. f. 233-258.

Reproduction de : Thèse d' exercice : Médecine spécialisée : Nancy 1 : 2002. / Thèse : 2002NAN11137. Titre provenant de l'écran-titre.

Reproduction de : Thèse d'exercice : Médecine : Nancy 1 : 2003. / Titre provenant de l'écran-titre.

The cardiovascular effects of whole body heat stress during exercise are well established. However the independent contribution of elevated skin temperature (Tsk) or core temperature (Tc) on these responses remains unclear. The purpose of this study was to determine how increases in Tsk and Tc alone and in combination, impact cardiovascular responses during moderate intensity exercise. To accomplish this goal, eight healthy, recreationally active males were immersed to the neck in a cold (14 - 17°C) or hot (40 - 42.5°C) water bath for 20 to 25 min to alter Tc immediately prior to exercise with either cool Tsk (i.e. fans) or warm Tsk (i.e. heaters). Conditions during exercise were cool skin and cool core (CC), warm skin and cool core (WC), cool skin and warm core (CW), and warm skin and warm core (WW), and were conducted in a randomized crossover design. When data was combined (n=16), warm core conditions (CW and WW) were associated with significantly higher average heart rate (HR) and lower stroke volume (SV) during exercise compared to cool core conditions (CC and WC); 168.1 ± 3.2 vs. 152.2 ± 4.0 beats/min and 139.2 ± 7.3 vs. 147.7 ± 9.4 mL/beat, respectively. The approximate 9 mL/beat decline in SV and 16 beat/min increase in HR in warm core conditions tended to increase cardiac output (Q), 23.2 ± 0.6 vs. 22.2 ± 0.7 L/min, P=0.078. Similarly, warm Tsk conditions (WC and WW) were associated with significantly higher average HR and lower SV during exercise compared to cool Tsk conditions (CC and CW); 165.2 ± 3.3 vs. 155.1 ± 3.4 beats/min and 140.8 ± 7.8 vs. 146.0 ± 8.7 mL/beat, respectively. Additionally, there was also a trend for Q to be elevated with warm skin (23.0 ± 0.6 vs. 22.4 ± 0.6, P=0.075). Although combined data indicated that warm Tsk conditions significantly lowered average SV by ~6 mL/beat, there was no reduction in SV during exercise by warm Tsk, when Tes was cool (i.e. <37.0°C), as evidenced by identical values for SV in CC and WC, 147.7 ± 9.8 vs. 147.7 ± 9.0 mL/beat, respectively. In contrast, SV was significantly lower in WW compared with CW, 133.9 ± 7.0 vs. 144.4 ± 7.8 mL/beat, respectively. Therefore, the major reduction in SV by warm Tsk occurred during WW, when Tes was elevated (i.e. >38.0°C). Analyzing data independently for precooling and preheating conditions revealed that warm Tsk was associated with greater HR drift from 5 to 20 min of exercise, compared to cool Tsk, when esophageal temperature (Tes) was both cool or warm (23.9 ± 2.2 vs. 17.5 ± 2.3 and 12.3 ± 1.3 vs. 4.6 ± 1.7 beats/min, respectively). These observations demonstrate that both Tes and Tsk can directly influence cardiovascular responses during exercise, as indicated by elevations in HR during exercise with warm Tsk, with both warm and cool Tes. However SV is not compromised by warm Tsk if Tes is below 37.5°C. Furthermore, when both Tes and Tsk are elevated simultaneously, cardiovascular strain (i.e. increased HR and reduced SV) is much greater than when either is elevated alone. This is demonstrated by the finding that average HR was 175.8 ± 3.2 beats/min in WW, compared to 149.8 ± 4.0, 154.7 ± 4.1, and 160.3 ± 3.5 beats/min, in CC, WC, and CW, respectively, and the fact that SV was lowest during exercise in WW. In conclusion, individuals exercising in the heat should take measures to keep skin cool, especially when Tes is 39°C or greater to attenuate the cardiovascular strain that occurs with warm Tsk, when Tes is elevated. / text

Sammanfattning Studien undersöker hur revisionsansträngningen hos företag på Nasdaq OMX Nordic Stockholms listor, Mid cap och Small cap, påverkas under hög – respektive lågkonjunktur genom att undersöka faktorerna: Komplexiteten hos företag Risken hos företag  Revisorns erfarenhet   Studien undersöker revisionsansträngningen genom revisionsarvodet under 2007-2009. Multipla linjära regressioner har används för att nå resultatet. Resultatet av studien visade att för samtliga tre undersökningsår var komplexitet signifikant, revisorerna ansåg att utländska dotterföretag var en faktor som påverkade revisionsansträngningen hos företag på Small – och Mid Cap oavsett om Sverige befann sig i en hög- eller lågkonjunktur. Risken hos företag påverkar revisionsansträngningen i hög – respektive lågkonjunktur. Kundfodringar i relation till totala tillgångar ökade revisionsansträngningen samtliga undersökningsår och ett negativt resultat medförde en ökad revisionsansträngning i hög – och lågkonjunktur. Revisorns erfarenhet påverkade inte revisionsarvodet i varken hög – eller lågkonjunktur. Av de undersökta variablerna visade resultatet att revisorn granskar samma faktorer oberoende av hög- och lågkonjunktur och att ansträngningen har ökat mellan åren och det kan beror på konjunkturen men också av andra faktorer. Eftersom studien är kvantitativ kan vi inte yttra oss om varför revisorer agerar på ett visst sätt, och vi ser därför att ytterligare forskning behövs för att undersöka revisorernas beteende samt ytterligare studier kring hur svenska dotterföretag påverkar revisionsansträngningen, då resultatet går emot vad tidigare forskning visat.   Studien har bidragit med att ge en indikation på att revisionsansträngningen är av högre kvalitet när Sverige befinner sig i hög – som lågkonjunktur.

For over 20 years occupational therapists have been using functional capacity evaluations to provide information about individuals’ ability to work after a musculoskeletal injury. An important component of these evaluations is the determination of the clients’ level of effort during the assessment. Only when a client puts forth high effort are the results considered an accurate measure of their work ability. This qualitative study explored therapists’ perception of the process of determining effort. Consistent with the literature, the results show that effort is a complex construct that is not easily defined, understood, or consistently assessed in practice. The participants in this study spoke about their own struggles defining, explaining, and assessing effort within the medico-legal context of an insurance system. The study results suggest support is needed for clinicians to navigate multiple client contexts, and the term ‘effort’ needs to be conceptualized in line with current knowledge about disability.

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Syftet med studien var att undersöka vilka stressreducerade ledarskapsbeteenden som chefer använder sig av gentemot sina medarbetare. Studien har en deduktiv ansats där två etablerade balansteorier; Karasek och Theorells (1990) krav och kontrollmodell samt Siegrits (1996) ansträngning och belöningsmodell, användes för att studera empirin. Ett målinriktat urval gjordes (n = 10) och av dessa var fem stycken kvinnor och fem stycken män. Semi-strukturerade intervjuer genomfördes med chefer på samma eller liknande position i en organisation. Det empiriska materialet analyserades genom en tematisk modell. Resultatet visade att cheferna använder sig av olika dimensioner av balansteorierna. Samtliga chefer använde sig av socialt stöd i olika former och majoriteten av cheferna gav medarbetarna kontroll över sin arbetssituation för att reducera stress. Ett fåtal av cheferna försökte få medarbetarna att uppleva yrkesstatus som belöning och slutligen lyfte cheferna fram vikten av att skapa en balans mellan arbetslivet och privatlivet för att främja medarbetarnas hälsa.

Purpose: Hearing loss is a prevalent condition among older adults. Structural changes at the auditory periphery, changes in central audition and cognitive function are all known to influence speech understanding in older adults. Biological aging also alters speech and voice characteristics from the age of 50 years. These changes are likely to reduce the clarity of speech signals received by older adults with age-related hearing loss. Recent findings suggest that older adults with hearing loss subjectively find listening to the speech of other older adults more effortful than listening to the speech of younger adults. However, the observations of listener effort were subjective and follow up using an objective measure was recommended. Therefore, the purpose of this study was to determine the influence of speaker age (young versus older) on speech understanding and listener effort in older adults with hearing loss. In addition, the relationships between these parameters, and age and working memory was investigated. It is hypothesised that older adults with hearing loss will recognise less speech, and expend more effort, while listening to speech of an older adult relative to a younger adult. Method: A dual task paradigm was used to measure speech understanding and listening effort in 18 older adult listeners with hearing loss. The primary task involved recognition of target words in sentences containing either high or low contextual cues. The secondary task required listeners to memorise the target words for later recall following a set length of sentences. Listeners performed speech understanding (primary task) under six experimental conditions: For each speaker (i.e., older adult and younger adult) there were 3 listening backgrounds: quiet, and noise at 0 dB SNR and +5 dB SNR. Results: Speech understanding in older adults with hearing loss was significantly improved when the speaker was an older adult, especially in noise. The ability to recall words from memory was also significantly better when the speaker was an older adult. Age was strongly correlated with speech understanding with contributions from hearing loss. Age and working memory had moderate correlations with word recall. Conclusion: The findings provide further evidence that peripheral hearing loss is not the only contributor to speech understanding and word recall ability in older adults. The naturally occurring speech signal also has the potential to influence speech understanding and listening effort in older adults.

One of the most interesting aspects of human beings is their ability to choose a course of action and strive to achieve it. When participating in therapeutic interventions involving physical activities, people may allocate different amounts of effort, persistence and commitment to succeed in them. The reason for this difference lies in their motivation. The present thesis focuses on the energising of behaviour, that is, the differential effort and motivation that people put into therapeutic activities. Placebo responses are generally explained by the mechanisms of response expectancy, conditioning and motivational concordance. Findings presented in this thesis partially supported motivational concordance, testing for the first time that therapeutic outcome after engagement in intrinsically motivated tasks requiring physical activity was explained both by response expectancy and motivational concordance . The effects of response expectancy, perceptions of effort and intrinsic motivation on therapeutic benefit and mood change were investigated in both laboratory (Studies 1-4) and real-life therapeutic contexts (Study 5). Study 1 showed that effort mediated the effects of expectancy on perceived benefit, and effort predicted both positive and negative affect following the performance of a breathing exercise. Study 2 showed that differences in outcome between guided imagery and meditation were very small, but that non-specific factors play the major role in outcome. Study 3 showed that perceiving a task as difficult enhances effort perceptions, intrinsic motivation and therapeutic outcome. Motivated behaviour predicted therapeutic outcome but not expectancy. Study 4 showed that the provision of success feedback enhances outcome expectancies, motivated behaviour and mood change. Expectancies, motivation and effort predicted positive affect, whereas only effort predicted negative affect. Finally, results from Study 5 suggest that placebo responses may differ in real-life therapeutic interventions according to the strength motivational factors are elicited within the intervention. Both expectancy and motivated behaviour predicted change in positive affect, whereas motivated behaviour predicted change in negative affect and empowerment. Therapeutic outcome and its underlying mechanisms are likely to reflect a mixture of response expectancies and intervening motivational factors.