La variabilité du rythme cardiaque « Heart Rate Variability (HRV) » consiste en des fluctuations perpétuelles du rythme cardiaque autour de sa fréquence moyenne. L’analyse de l’HRV constitue un biomarqueur du fonctionnement du système nerveux autonome (SNA), par l’intermédiaire de ses effets sur le cœur. De nombreuses études ont montré qu’une diminution de l’HRV est associée à un pronostic péjoratif, notamment dans le post infarctus et dans l’insuffisance cardiaque (IC). Nous nous sommes proposés d’élargir le champ d’investigation de l’HRV à de nouveaux domaines d’application, qu'il s'agisse de pathologies cardiaque ou extra cardiaque. Nous avons ciblé des contextes pathologiques dans lesquels le SNA joue un rôle important : 1-Accidents sur la Voie Publique (AVP) et le risque de développement d’un syndrome de stress post traumatique (PTSD). 2-Effet de la douleur et de l’analgésie péridurale sur l’HRV maternelle au cours de l’accouchement. 3-Lien avec les polymorphismes génétique des récepteurs bêta adrénergiques (β;-AR) chez des patients présentant une dysfonction ventriculaire gauche et implanté d’un défibrillateur automatique implantable (DAI) en prévention secondaire. L'analyse temporelle de l'HRV sur 24 heures est un facteur prédictif de survenue d'un PTSD et aussi de sa sévérité chez les victimes d'AVP. L'indice de variabilité est le meilleur paramètre prédictif de PTSD à 6 mois, avec une aire sous la courbe de 0.92 (IC 95% : 0.785; 1.046). Le seuil de 2.19% confère une sensibilité de 85,7 £ et une spécificité e 81.8 % pour prédire la survenue d'un PTSD. les valeurs prédictives positives et négatives sont de 75 % et 90 % respectivement. L'ANI, reflétant l'influence de la ventilation sur le rythme cardiaque, permet une mesure objective de la douleur chez les parturientes. Enfin, les patients ayant subi les substitutions Arg (pour Gly) en 16 et Gln (pour Glu) en 27 pour les récepteurs β2-AR, présentent une HRV plus faible que les patients ayant la forme sauvage du gène. / The heart rate variability (HRV) has arisen as a promising simple and non invasive biomarker of autonomic nervous system (ANS) function, through its effects on the heart. Multiple studies have shown that the decrease in the HRV is associated usually with poor prognosis. We proposed to further investigate the HRV in other domains of clinical application, including cardiac or extra-cardiac pathologies. In particular, the pathological contexts in which the ANS plays an important role :1-Traffic road accident (RTA) and the risk of development of post traumatic stress disorders (PTSD) in survivors.2-Effect of pain and of epidural analgesia on maternal HRV during childbirth.3-Genetic polymorphisms of beta adrenergic receptors (β-AR) in patients with left ventricular dysfunction and implanted with an implantable cardioverter defibrillator (ICD) for secondary prevention. At first, our study is the first to show that the temporal analysis of 24-h HRV is not only a predictive factor of the occurrence of PTSD but also its severity among victims of RTA AVP. The variability index was the best predictor of PTSD with the area under the receiver-operating curve for discriminating PTSD at 6 month at 0.92 (95% CI:0.785;1.046). Acut-off at 2.19% yielded a sensitivity of 85.7% and a specificity of 81.8% for PTSD. Positive and negative predictive values were respectively 75% and 90%. At next, we showed that the ANI, which reflects the influence of ventilation on heart rate, allows an objective measure of pain in conscious subjects? At last, we found that patients with the substitutions Arg (instead of Gly) at position 16 and Gln (instead of Glu) at position 27 for β2-AR have a lower HRV value than patients with wild type receptor.

Název práce v anglickém jazyce: Liability for damage regarding occupational accidents and diseases The aim of this thesis is to analyze liability for damages regarding accupational accidents and diseases as a part of employer's liability and the evaluation of the current regulation in this area. This thesis is devided to eight chapters. First part of this thesis is a theoretical introduction to the matter of occupational accidents and diseases and the liability for damages caused by them. The target of the first part is to define the institutes of the labor law, which are crucial for the regulation of material and non-material damages in labor law. The theoretical first part consists of Chapter One, Chapter Two and Chapter Three. Chapter One is introductory and defines basic terminology used in the thesis, with the main term being liability in labour law. Chapter Two enumerates various types of liability, such as material liability, non-material liability and other types of liability. Chapter Three defines material and non-material damage in the light of new Civil Code. Chapter Four and Chapter Five are specifying the issue of damage liability, on both sides - employee's and employer's. Chapter Six provides outlines of the relevant Czech case law and is therefore subdivided into four parts. Part One...

This diploma thesis deals with the employer's liability for damages caused by work-related accidents or occupational diseases of his employees. The reason for choosing this topic was partly because of the author's experience with the assessment of work-related accidents in legal proceedings, partly due to the high- frequency of work-related accidents and also the fact, the results of work-related accidents and occupational diseases not rarely cause a long-term adverse repercussion in real life of an employee. The main point of this thesis is to analyse elements of stated employer's liability for damages. Using the case law, detailed analysis of the concept of work- related accidents is performed in the same chapter. There are analysed specific situations with conclusions if the injury can be evaluated as an work-related accident or not. Besides work-related accidents, occupational diseases and other elements of liability, this chapter deals with the possibility of an employer to be absolved from any liability as well. Case law concerning the absolution from liability is also included in this chapter. The essential part of this thesis is also the enumeration of employer's obligations connected to the fact his employee has suffered a work-related accident or an occupational disease. The most...

Title: The effect of regular training in Locomat system changing the stereotype of gait of patients after the cerebrovascular accident Objectives: The purpose of this thesis is to evaluate whether it is appropriate to use the Locomat system in therapy of gait of patients after the cerebrovascular accident, what is the effect of regular training of these patients in the Locomat system on their stereotype of gait and whether the training in the Locomat system of patients after the cerebrovascular accident is more effective in comparison with other physiotherapeutic practices. Methods: The thesis was processed in the Kladruby Rehabilitation Centre on 14 probands, who were divided after the entrance examination in order to form two equivalent homogenous groups. The first group of seven members was experimental, the second one was control. At the beginning of the study the rate of gait disorder was specified at each proband using standardized method of Wisconsin Gait Scale, they also underwent 10 - Meter Walk Test and 6 - Minute Walk Test. Afterwards all the probands absolved a three-week lasting standard regime of rehabilitation. The probands of research groups absolved except the rehabilitation regime during this time period regularly 5x times a week fifteen 30-minute lasting therapy units in the...

LL.M. / Please refer to full text to view abstract

This diploma thesis and its research deals with the preparedness of the population, pedagogues and representatives of municipal council, to participate in tasks of population protection during the leak of dangerous chemical substances. The work develops research from my Bachelor thesis from 2017, where was my task to verify preparedness of the integrated rescue system to deal with the leak of dangerous chemical substances. The aim of this diploma thesis was to find out, if is the selected area able to adequately respond to hazards arising from the leak of hazardous chemical substances. In order to assess preparedness, slightly different questionnaires were used, those questionnaires were answered by the residents of České Budějovice, teachers working at secondary schools in České Budějovice and representatives of the city and representatives of the South Bohemian Region. The results of the questionnaire survey are presented using descriptive statistics, interesting results are shown using graphs. A high degree of unpreparedness of respondents was found. According to the results of the questionnaire survey, some respondents may also behave dangerously in the events of leakage of hazardous chemicals. The contribution of this work should be increasing and improving awareness in this area. To this purpose, was created an information leaflet containing lot of important information, which was distributed to the population. The benefit which this work has already brought, is to alert representatives from city and region councils, as well as teaching staff, to improve their knowledge of hazardous substances. According to the feedback of several representatives, analyzes focusing the transport of dangerous substances can be expected in the near future. This work can be used as well as a source of information and can be used to compare it with other researches.

A dissertation submitted to the Faculty of Arts, University of the Witwatersrand, in partial fulfilment of the requirements of the degree of Master of Arts / The study reviews the literature concerning mild head injury and post concussion symptoms. It then investigates the applicability of international findings to South African patients. Three groups of subjects are compared: mildly injured, noninjured, and instructed malingerers. The study establishes base rates of postconcussive symptoms in the noninjured subjects, scores on tests of cognitive ability among the noninjured subjects, expectations regarding postconcussive sequelae among the noninjured subjects, the perceptions of injured subjects of their preand postmorbid status, and relationships between subjectively experienced symptoms and cognitive deficits am.ong injured subjects. Injured subgroups are examined to investigate pre-, peri-, and post-injury factors associated with development of postconcussive complaints. No differences in cognitive performance were found between the injured and noninjured groups. Time since injury did not affect cognitive performance, apart from on a copy task. It was found that injured subjects reported lower pre-injury levels of incidence of symptoms than those reported by noninjured subjects. No differences were found between post-injury reporting of postconcussive complaints and those symptoms reported by noninjured controls. Some postconcussive symptoms were nevertheless found to correlate with certain measures of cognitive performance. Instructed malingerers responded differently noninjured injured and not injured subjects, reporting fewer pre-injury complaints and mere post-injury complaints. They also performed more poorly on several cognitive measures. Test scores that effectively identified malingerers were then re-examined, and cut-off rates suggested for differentiating malingerers from genuinely injured subjects. / Andrew Chakane 2018

En dépit de moyens importants consacrés à la lutte, certains feux de forêt, en Europe méditerranéenne, en Australie ou en Amérique du Nord, parcourent de grandes surfaces et développent des comportements violents qui piègent les pompiers. L’étude de rapports internes aux services d’incendie révèle ici les conditions météorologiques et topographiques dans lesquelles se produisent ces feux dangereux. En France, alors que le vent violent est le principal contributeur des feux les plus grands et les plus dangereux, les températures élevées mènent à un autre type d’incendies violents qui se propagent rapidement. En Australie, les pompiers sont souvent piégés par une bascule brutale de la direction du vent mais aussi par des vents forts en terrain accidenté. Au-delà des disparités intercontinentales, la recherche des comportements dynamiques de feu impliqués dans plus de 100 accidents de pompiers à travers le monde amène à distinguer trois types d’incendie. Lors des feux topographiques, en zone de montagne, les accidents sont généralement causés par l’attachement de la flamme sur des pentes supérieures à 20°. Lors des feux guidés par le vent, les zones les plus propices aux accidents sont les pentes déventées où des effets de vortex peuvent se produire. Enfin, lors des feux convectifs, les plus violents, les accidents peuvent se produire loin de toute configuration dangereuse. Pour tenir compte de ces résultats et améliorer leur sécurité, les pompiers doivent adapter leur formation et de développer des compétences d’analyste du feu. Ces experts intègreront les retours d’expérience des incendies passés pour proposer les stratégies de lutte les plus efficaces et sécurisées. / Despite the large expenditure that is dedicated to forest fire suppression in Euro-Mediterranean countries, Australia and North-America, firefighters still face large and severe fire events which eventually entrap them. Investigation of Fire Services’ internal reports addresses here the weather and terrain leading to these dangerous fires. In France, strong wind is the main driver of the largest fires and of the fires that entrap firefighters. However, high temperature is also a key contributor as it influences violent fires with high rates of surface spread. In Australia, a lot of firefighters’ entrapments are due to shifts in wind direction, but others are associated to strong winds in rugged terrain. Whatever the regional specificities, more than 100 firefighters’ entrapments across the world were investigated to find the contribution of dynamic fire behaviors in these entrapments. The results return three different types of fires. During topography-influenced fires, in mountainous area, almost all the entrapments happen on slopes steeper than 20°, prone to flame attachment. During wind-driven fires, leeward slopes prone to vorticity-driven lateral fire spread are the most prominent configurations associated with entrapments. Finally, during convective fires, which are the most violent, entrapments can happen far away from any dangerous configuration. Firefighters should adjust their training courses and promote fire behavior analysts (FBAN) capabilities to benefit from the results of this work and improve their safety. FBAN may consider feedbacks from previous fires to suggest the most efficient and secure firefighting strategies and locations.

O reator IEA-R1 do Instituto de Pesquisas Energéticas e Nucleares (IPENCNEN/ SP) é um reator de pesquisa tipo piscina aberta, projetado e construído pela empresa norte-americana \"Babcock & Wilcox\", tendo, como refrigerante e moderador, água leve deionizada e berílio e grafite como refletores. Até cerca de 1988, os sistemas de segurança do reator recebiam alimentação de uma única fonte de energia. Nos anos de 1989 e 1990, uma reforma de modernização do sistema elétrico para aumentar a potência do reator e, também, para atender às normas técnicas da Comissão Nacional de Energia Nuclear (CNEN) e da Associação Brasileira de Normas Técnicas (ABNT) foi realizada. Este trabalho tem o objetivo de mostrar a relação entre o sistema de energia elétrica e a segurança do reator IEA-R1. Além disso, ele demonstra que, caso ocorra alguma interrupção de energia elétrica durante a operação do reator, esta ocorrência não irá começar um evento de acidente. / The IEA-R1 reactor of the Nuclear and Energy Research Institute (IPENCNEN/SP) is a research reactor open pool type, designed and built by the U.S. firm \"Babcock & Wilcox\", having, as coolant and moderator, deionized light water and beryllium and graphite, as reflectors. Until about 1988, the reactor safety systems received power from only one source of energy. In the years 1989 and 1990, a reform of the electrical system upgrading to increase the reactor power and, also, to meet the technical standards of the National Commission of Nuclear Energy (CNEN) and of Brazilian Association of Technical Standards (ABNT) was carried out. This work has the objective of showing the relationship between the electric power system and the IEA-R1 reactor security. Also, it demonstrates that, should some electrical power interruption occur during the reactor operation, this occurrence would not start an accident event.

As demandas e pressões da situação de trabalho agregadas ás características pessoais podem contribuir para o adoecimento físico e mental de trabalhadores levando ao esgotamento profissional e esse pode estar associado à ocorrência de acidentes do trabalho. Objetivo: verificar a associação entre indicadores da síndrome de burnout, presenteísmo e a ocorrência de acidentes do trabalho com exposição ao material biológico entre profissionais de enfermagem. Método: estudo transversal descritivo realizado com enfermeiros, auxiliares e técnicos de enfermagem, de um hospital de ensino do Estado de São Paulo, acometidos por acidentes do trabalho com material biológico no período 2015- 2017 e que foram cadastrados na Rede de Prevenção de Acidentes do Trabalho com Exposição ao Material Biológico (REPATUSP). A amostra foi composta por 100 trabalhadores de enfermagem. As variáveis estudadas foram: síndrome de burnout, acidentes do trabalho, características sóciodemográficas e o presenteísmo. Os instrumentos utilizados para coleta de dados foram: protocolo de registros de acidentes da REPAT- USP; questionário de dados sociodemográficos e ocupacionais; Malash Burnout Inventory; escala de presenteismo? de Stanford (SPS-6). Os dados foram coletados de abril a outubro de 2017. Foram analisados por estatística descritiva, testes de associação qui-quadrado de Pearson e os testes não paramétricos Mann-Whitney e Kruskal-Wallis. O nível de significância adotado foi ?=0,05. O projeto foi aprovado pelo Comitê de Ética em Pesquisa da Escola de Enfermagem de Ribeirão Preto da Universidade de São Paulo (protocolo CAAE: 67510017.5.0000.5393). Resultados: Com base na análise das respostas dos 71 questionários, observou-se entre os profissionais que sofreram acidente do trabalho com material biológico, que a prevalência de burnout foi de 52,11% (37). Foram analisadas associações da síndrome de burnout e o presenteísmo em que se observou que 45,5% dos profissionais apresentaram burnout e presenteísmo. Conclusão: Este estudo evidenciou uma alta prevalência da SB nos profissionais de enfermagem, revelando assim a necessidade de intervenções em relação às condições de trabalho dos enfermeiros. Foram encontradas associações significativas entre a dimensão despersonalização da síndrome de burnout e o presenteísmo. Destaca-se a importância de se avaliar a prevalência da síndrome entre os diferentes profissionais, pois o seu desenvolvimento pode acarretar resultados negativos para os profissionais, pacientes e instituições. Os esforços aqui empreendidos pretende encorajar as instituições a promoverem iniciativas para mudanças / The demands and pressures from work aggregated to personal characteristics can contribute for workers physical and mental illness leading to professional exhaustion and can be associated with the occurrence of occupational accidents. Objective: to verify the association between indicators of burnout syndrome, presenteeism and occurency of occupational accidents with exposure to biological agents between nursing professionals. Method: This is a cross-sectional study carried out with nurses, auxiliaries and technicians of a Hospital Teaching from Sao Paulo state who were affected for accidents at work with biological material between 2015-2017 and were records at the Work Accidents Prevention Network with exposure to biological agents. The sample consisted of 100 nursing workers. The variables studied were the Burnout Syndrome, occupational accidents, socio-demographic characteristics and the presenteeism. The tools used for data collection were: protocolo de registros de acidentes da REPAT- USP; questionário de dados sociodemográficos e ocupacionais; Malash Burnout Inventory; escala de presenteismo? de Stanford (SPS-6). The data were colected from april to june 2017. Data were analyzed using descriptive statistic Pearson\'s chi-square association tests and non-parametric Mann-Whitney and Kruskal-Wallis tests. The level of significance was ? = 0.05. The project was approved by the Research Ethics Committee of the University of São Paulo at Ribeirão Preto College of Nursing (protocolo CAAE: 67510017.5.0000.5393). Results: Based on the analysis of the results of the 71 questionnaires, the prevalence of burnout was 52.11% (37) among the professionals who suffered from work accident with biological material. Associations of the burnout syndrome and presenteism were analyzed in which 45.5% of the professionals presented burnout and presenteeism. Conclusion: This study evidenced a high prevalence of Burnout Syndrome in nursing professionals, thus revealing the need for interventions in relation to nurses\' working conditions. Significant associations were found between the depersonalization dimension of burnout syndrome and presenteeism. It is important to evaluate the prevalence of the syndrome among the different professionals, as their development can lead to negative results for professionals, patients and institutions. The efforts made here are intended to encourage institutions to promote initiatives for change