Le vieillissement est malheureusement souvent le fait de devoir vivre avec des problèmes qui n'affecteraient pas des personnes jeunes à cause de l'homéostasie. Lorsque quelque chose va mal, comme par exemple une chute ou une maladie aiguë, les personnes âgées peuvent avoir des conséquences bien plus terribles que des personnes jeunes. Ainsi, la prévention des chutes et la surveillance de pathologies pré-existantes comme par exemple la maladie d'Alzheimer est une des clés du "bien vieillir", car le gériatre pourra adapter sa stratégie de prévention à chaque individu. Les gérontechnologies (technologies au service de la personne âgée) peuvent aider dans le cadre des stratégies de prévention globale. Mais, qu'est-ce exactement qu'une gérontechnologie ? Quels sont les déterminants à explorer pour prévenir les chutes ? Comment évaluer de tels dispositifs ? Y a-t-il des limitations techniques auxquelles nous devrions faire attention ? Y a-t-il des résultats cliniques attendus pour ces technologies ? En passant en revue la littérature préexistante sur l'évaluation de gérontechnologies, nous avons montré quels sont les principaux résultats à attendre, ce qu'il manque dans ces évaluations, et nous avons donc proposé un modèle simple d'évaluation pluridisciplinaire. Ce dernier inclus les résultats cliniques (prévention), les limitations techniques, le médico-économique, une évaluation sociologique (acceptabilité, appropriation, habitudes d'utilisation...), et la détermination des paramètres intrinsèques des équipements. Une telle évaluation n'est rendue possible que par un environnement contrôlé, une méthodologie qui suit celle des essais cliniques et par un partenariat avec les industriels. Avec les résultats d'une étude clinique en environnement écologique sur des technologies simples d'assistance et de prévention à domicile, nous avons été capables de dimensionner un essai clinique randomisé bien plus grand en termes d'échantillon afin d'évaluer l'impact préventif d'un service de téléassistance couplé à des technologies de prévention au domicile. En effet, notre étude pilote a montré les bénéfices potentiels d'équipements gérontechnologiques pour les personnes âgées et leurs aidants en termes de santé, de chutes, et d'autonomie fonctionnelle. / Aging is unfortunately like living with a lot of conditions which aren’t affecting people because of homeostasis. When something goes wrong, such as a fall or a sudden and acute disease, elderly people would have terrible consequences, worse than for younger people. Thus, preventing falls, and monitoring pre-existing pathologies such as Alzheimer’s disease is a key to a good aging because geriatrician will adapt their prevention strategies for each individuals. Gerontechnologies (technologies for gerontological purposes) can help global prevention strategies for aging with relative ease. But, what is exactly a gerontechnology? What are the mechanics that can prevent falls? How to assess such devices? Is there any technical limitations we should pay attention for? Is there any clinical outcomes we should see? By reviewing previously made work on assessing technologies we showed what are the main outcomes on assessing technologies, what is lacking in such assessments and proposed a simple model for pluridisciplinary evaluations. This includes clinical outcomes (prevention), technical limitations, medico-economical outcomes, sociological outcomes (acceptability, appropriation, habits…) and intrinsic parameters of the devices. Such assessment is made possible with a controlled environment, clinical trial methodology and partnership with industry. With the result of a previous, real life conditions, clinical trial on simple assisting devices, we were able to design a large scale clinical trial with a complete evaluation of commercialized teleassistance service combined with home-based technologies. Indeed, our pilot study highlighted the potentials benefits of such devices on health, falls, functional autonomy and carers.

Submitted by Filipe dos Santos (fsantos@pucsp.br) on 2018-11-28T09:09:10Z No. of bitstreams: 1 Thiago Melim Braga.pdf: 984476 bytes, checksum: ac5ba406e74aef752fe5502a95cc9399 (MD5) / Made available in DSpace on 2018-11-28T09:09:10Z (GMT). No. of bitstreams: 1 Thiago Melim Braga.pdf: 984476 bytes, checksum: ac5ba406e74aef752fe5502a95cc9399 (MD5) Previous issue date: 2018-10-08 / This paper aims at verifying how democracy is guaranteed within political parties, in order to clarify whether the functional and organizational autonomy of such legal entities under private law has its application mitigated. To achieve this end, we began our investigation by studying democracy within its most varied concepts, adopting one of them to serve as the north for the development of the work. We also sought to identify a Brazilian democratic model, based on the analysis of which democratic elements are intransigible and which can be chosen by the constituent, after which we proceed with a study on constitutional democracy, its concept and how it is verified in Brazil, especially after 1985. We aim to verify the effectiveness of political parties in the Brazilian reality, using the legislative and jurisprudential evolution of the Federal Supreme Court, identifying an endemic problem, that is, the reflexive nature of the norm. Given the lack of effectiveness due to the broad organizational and functional autonomy of the political parties, we identified the pathologies of the party system, and finally, we selected three to be analyzed in more detail, and in the end, we suggested the need for system conformation. It is, therefore, a descriptive and exploratory study of a bibliographic and documentary nature. The research provided and clarified, through bibliographical data, the inner reality of political parties in Brazil. We conclude that there is no absolute right, not even dedicated to political parties, and that the conformation of the system is necessary. However, the possibility of limiting the full applicability of the functional and organizational autonomy of political parties over other constitutional values should be analyzed from a careful analysis / Este trabalho tem por finalidade verificar de que maneira é garantida a democracia no interior dos partidos políticos, visando esclarecer se as autonomias funcional e organizacional de tais pessoas jurídicas de direito privado têm a sua aplicação mitigada. Para atingir essa finalidade, o estudo começa pela investigação e estudo da democracia dentro de seus mais variados conceitos, adotando um deles para servir de norte para o desenvolvimento do trabalho. A pesquisa busca também identificar um modelo democrático brasileiro, partindo da análise de quais são os elementos democráticos intransigíveis e quais os que podem ser objeto de escolha por parte do constituinte. Em seguida, prossegue averiguando a democracia constitucional, seu conceito e a forma como é verificada no Brasil, especialmente após 1985. Observa-se como ocorre a efetividade aos partidos políticos na realidade brasileira, com base na evolução legislativa e jurisprudencial do Supremo Tribunal Federal, identificando um problema endêmico, qual seja, o caráter reflexivo da norma. Evidenciada a falta de efetividade, em razão da ampla autonomia organizacional e funcional dos partidos políticos, são identificadas as patologias do sistema partidário e, por fim, selecionadas três para serem analisadas mais detalhadamente. Ao final, é sugerida a necessidade de conformação do sistema. Trata-se, portanto, de um estudo descritivo e exploratório de cunho bibliográfico e documental. A investigação propiciou e esclareceu, através dos dados bibliográficos obtidos, a realidade interior dos partidos políticos no Brasil. Ao final, concluiu que não há um direito absoluto, nem mesmo dedicado aos partidos políticos e que a conformação do sistema é necessária. Todavia, a possibilidade de limitação da aplicabilidade plena da autonomia funcional e organizacional dos partidos políticos frente a outros valores constitucionais deve ser criteriosamente analisada

Made available in DSpace on 2014-12-17T14:13:46Z (GMT). No. of bitstreams: 1 PatriciaULCa_DISSERT.pdf: 2743414 bytes, checksum: fafad318359f9c84684ded266ac5c9d5 (MD5) Previous issue date: 2010-03-24 / The aim of this study was to analyze the effects of an aerobic exercise program on the internal right carotid resistive index (IRCRI) and the functional autonomy levels of elderly women. The sample was composed of 25 elderly sedentary women, aged between 60 and 75 years, allocated into two groups: an experimental group consisting of 14 women submitted to aerobic treatment and a control group (n=11). Carotid artery resistance assessment was conducted using Doppler ultrasound and functional autonomy by the following tests: 10m walk (10mW), rising from a sitting position (RSP), rising from a chair and moving about the house (RCMH), rising from the ventral decubitus position (RVDP) and putting on and removing a t-shirt (PRTS). Aerobic training consisted of walking 30 minutes a day, 3 times a week, for 3 months. To control the intensity of the walk, the index of perceived exertion was used, with standardized Borg scale values corresponding to 13-15 points, characterized as slightly tiring exercise with training heart rate (TRH) between 50% and 80% of heart rate reserve (HRR). Repeated measures ANOVA was used for statistical analysis. Compared to the control, the experimental group obtained a statistically significant decrease in right internal carotid resistance (p = 0.021) and a significant increase in the following tests: 10mW (p=0.000), RSP (p=0.035) and RCMH (p=0.016). These results suggest that engaging in aerobic exercises was effective in decreasing IRCRI and improving functional autonomy inelderly women / Este estudo teve como objetivo analisar os efeitos de um programa de exerc?cio f?sico aer?bico sobre o ?ndice de resist?ncia da art?ria car?tida interna direita (IRCID) e os n?veis de autonomia funcional de mulheres idosas. A amostra foi constitu?da por 25 idosas sedent?rias, com idade entre 60 e 75 anos, divididas em dois grupos: grupo experimental com 14 idosas submetidas ao treinamento aer?bico e grupo controle (n=11). A avalia??o da resist?ncia da art?ria car?tida foi realizada pelo m?todo de ultrasom Doppler e a autonomia funcional pelos testes: caminhar 10m (C10m), levantar da posi??o sentada (LPS), levantar-se da cadeira e locomover-se pela casa (LCLC), levantar-se da posi??o dec?bito ventral (LPDV) e vestir e tirar a camisa (VTC). O treinamento aer?bico foi realizado na forma de caminhada, 30 minutos por dia, 3 vezes por semana, durante 3 meses. Para o controle da intensidade da caminhada foi utilizado o ?ndice de esfor?o percebido, com valores padronizados pela escala de Borg onde a intensidade deveria corresponder a uma faixa entre os valores 13 a 15 pontos, correspondente a uma situa??o org?nica derivada de um exerc?cio compreendido como ligeiramente cansativo e a frequ?ncia card?aca de treino (FCT) entre 50% a 80% da frequ?ncia card?aca de reserva. Para analise estat?stica foi utilizado a ANOVA de medidas repetidas. O grupo experimental quando comparados com o grupo controle obteve uma diminui??o estatisticamente significativa na resist?ncia da art?ria car?tida interna direita (p=0,021), e um aumento significativo nos testes: C10m (p=0,000), LPS (p=0,035) e no LCLC (p=0,016). Estes resultados sugerem que a pr?tica de exerc?cios f?sicos aer?bicos foi eficaz em diminuir o IRCID e melhorar os n?veis de autonomia funcional em mulheres idosa