L'objectif du registre des cancers de Guyane est de collecter l ensemble des tumeurs invasives et/ou in situ survenues depuis le 1er janvier 2003 chez des patients vivant en Guyane, quels que soient la localisation de la tumeur, le lieu de diagnostic et de traitement. Cette thèse a pour but de décrire la population atteinte d un cancer afin d améliorer les connaissances sur cette maladie et ainsi de permettre aux actions de santé publique d être plus efficaces.De 2003 à 2009, le taux d incidence des cancers standardisé sur l âge était, dans les deux sexes, 30% inférieur en Guyane par rapport à la France métropolitaine et n était pas différent de celui d Amérique du Sud.Nous avons comparé l incidence, la mortalité et la survie relative des patientes atteintes d un cancer invasif du sein (CIS) et des patientes atteintes d un cancer invasif du col de l utérus (CIC) entre la Guyane et la métropole.Le ratio incidence/mortalité indiquait que les cancers du sein étaient de plus mauvais pronostic en Guyane par rapport à la métropole.La survie relative des femmes atteintes d un CIS était inférieure en Guyane par rapport à la France métropolitaine.En Guyane, le taux standardisé d incidence du cancer du col de l utérus était 4 fois plus élevé qu en métropole. Les femmes vivant dans l intérieur de la Guyane semblaient être diagnostiquées à un stade plus tardif et plus souvent sur symptômes que les femmes du littoral. L accès aux soins des migrants est un challenge et une source d inégalité de santé. La détection précoce des cancers à travers des programmes de prévention est cruciale pour améliorer la survie par cancer et notamment chez les patients étrangers. / The objective of the cancer registry of French Guiana is to compile all patients living in French Guiana with malignant invasive pathology and/or in situ lesions starting January 1st 2003 in persons living in French Guiana, whatever the tumoral location and the place of diagnosis and care. This study aimed to describe the population with invasive cancer to improve the knowledge about this disease in order to target public health interventions more effectively.The age standardised incidence rate was 30% times lower than in France in both sexes and the same than in South America.We compared incidence and relative survival of patients with invasive breast cancer (IBC) and patients with invasive cervical cancer (ICC) between women from French Guiana and metropolitan France.The ratio between incidence and mortality showed that the prognosis of IBC in French Guiana was worse than in metropolitan France.The relative survival rate among women with IBC in French Guiana was lower than among women in metropolitan France.In French Guiana, the age-standardized incidence rate of cervical cancer was four times higher than in France. Women living in remote areas seemed to be diagnosed later and more often following symptoms.Access to care for migrants is challenging and sustains health inequalities. Early detection through prevention programs is crucial for increasing cancer survival notably for foreign-born patients. Further studies with more patients and other variables could improve the knowledge about these diseases

Le pronostic des victimes d’arrêts cardiaques traumatiques (ACT) est considéré comme très péjoratif et la « futilité » d’une réanimation est souvent évoquée chez ces patients. Les recommandations internationales concernant leur prise en charge font l’objet d’un réel débat. L’objectif de cette thèse est de fournir des données épidémiologiques à grande échelle de ces patients, de leur prise en charge et de leur survie afin d’orienter les recommandations.Matériel et Méthode : Etude nationale multicentrique basée sur les données du Registre national français des arrêts cardiaques (RéAC). Tous les ACT survenus entre le 01/07/2011 et le 01/01/2016 dont les données étaient disponibles dans la base RéAC étaient inclus. La première étape consistait en la description de la population. La seconde partie consistait en la comparaison de la population d’ACT à une population d’AC médicaux (ACM) avant et après appariement sur score de propension.Résultats : Sur la période choisie, 3303 patients ont été inclus. Trois quarts des victimes d’ACT étaient des hommes et l’âge médian était de 45 ans. L’ACT survenait hors domicile dans 75,9% des cas. Un témoin était présent lors de l’AC dans 54,3% des cas mais ils n’initiaient une réanimation cardiopulmonaire (RCP) que chez 31,8% des victimes. A l’arrivée du SMUR, 86,9% des patients étaient en asystolie, 5,9% présentaient un rythme sans pouls, 1,4% un rythme choquable et 5,8% une activité efficace. Une RCP spécialisée avait été initiée chez 71,3% des patients, au décours ou à l’issue de laquelle 16,5% avaient eu une reprise d’activité cardiaque spontanée. A l’admission, 14,5% étaient en vie. A J+30, 1,5% (n=51) avaient survécu dont 67,4% avec un bon pronostic neurologique. Parallèlement, 48 patients (1,4%) avaient fait l’objet d’un prélèvement d’organes: à cœur arrêté (n=8) ou sur patient en état de mort encéphalique (n=40).Sur la même période, 42628 ACM ont été inclus. Cette population était statistiquement plus âgée, plus féminine et l’ACM survenait davantage à domicile. Les patients étaient plus pris en charge par les témoins, les pompiers et le SMUR. A l’admission comme à J+30, les victimes d’ACM survivaient plus (OR des ACT respectivement 0,629[0,570;0,695]; p<10-3 et 0,253[0,191;0,335]; p<10-3). Après appariement, 2449 paires ont été obtenues. Ainsi, sur populations appariées, les victimes d’ACT survivaient statistiquement moins que les victimes d’ACM. Leurs chances de survie étaient 2,4 fois moindres à l’admission (OR : 0,416[0,359;0,482]; p<10-3) et 6 fois moindres à J+30 (OR : 0,168[0,117;0,241]; p<10-3).Discussion : Les caractéristiques des victimes d’ACT incluses sont comparables à une partie du corpus bibliographique, notamment européen. On constate des faiblesses dans la chaîne de survie qui ont été évoquées par ailleurs. Les taux de survie sont faibles, parfois même en comparaison de la littérature. Cependant, on retrouve des survivants, quels que soient le rythme et les caractéristiques lésionnelles, fait contestant, en particulier, la bibliographie américaine ainsi que les recommandations en découlant. Toutefois, dans un contexte quasi-expérimental, les chances de survie des ACT étaient significativement inférieures aux ACM, contredisant certaines des rares études antérieures. Ainsi, les recommandations européennes qui soulevaient ces lacunes peuvent bénéficier de ce nouvel apport. Les ACT ont des taux de survie significativement inférieurs aux ACM toutes choses égales par ailleurs. Néanmoins, ils suggèrent qu'il n'est pas « futile » de proposer une RCP préhospitalière pour ces patients. Les résultats nous permettent de nous positionner davantage dans le sens proposé par les recommandations européennes qu’en celui proposé par les Etats-Unis. Toutefois, ces nouvelles données pourraient permettre de les affiner. Enfin, Il est important de garder à l’esprit que le don d’organe n’est pas anecdotique dans cette jeune population. / Traumatic cardiac arrests (TCA) prognosis is known to be dismal and resuscitation attempts “futility” is often discussed. Hence, resuscitation international guidelines regarding their care are frequently debated. This PhD work objective is to provide large scale epidemiological data on these patients, on their care and survival in order to bring matter for orientating the forthcoming guidelines.Material and Methods: National multicentre study based on the French national cardiac arrest registry (RéAC) data. All TCA which occurred between the 01/07/2011 and 01/01/2016 for which RéAC data were available were included. The first step consisted in a description of the TCA population. The second one consisted in a comparison of TCA to medical CA (MCA) before and after propensity score matching.Results: On the selected time span, 3303 TCA victims were included. Three quarter of them were males and the median age was 45. TCA occurred out of home in 75,9% cases. Bystander(s)’ presence was recorded in 54,3% cases. Yet, only 31,8% provided a basic life support. At mobile medical teams’ arrival, 86,9% of patients were in asystole, 5,9% had a pulseless electrical activity, 1,4% had a shockable rhythm and 5,8% had an effective activity. An advanced life support was attempted in 71,3% of patients and 15,6% sustained a return of spontaneous activity. At hospital admission, 14,5% were alive. At Day 30, 1,5% (n=51) survived among which 67,4% had a good neurological outcome. Besides, 48 patients (1,4%) gave their organs, in non-beating heart framework (n=8) or in encephalic death organ retrieval framework (n=40).On the same period, 42628 MCA were included. This population was significantly older, more feminine and most of them occurred at home. Patients were more often cared by bystanders, firemen and medical teams. At hospital admission and at 30 days, their survival chances were higher than in TCA population (TCA OR respectively 0,629[0,570;0,695]; p<10-3 and 0,253[0,191;0,335]; p<10-3). After adjustment, TCA survival odds were even lower than in MCA: 2,4 times lower at admission (OR: 0,416[0,359;0,482]; p<10-3) and 6 times lower at day 30 (OR: 0,168[0,117;0,241]; p<10-3). Included TCA characteristics are coherent with a part of the bibliographical corpus, mostly European. We observe weaknesses in the TCA chain of survival which were also described elsewhere. Survival rate are indeed low, sometimes even regarding some other studies. However, we record survivors regardless of initial recorded rhythm of lesional characteristics. This fact particularly questions American literature and guidelines. However, in a quasi-experimental context, TCA odds of survival were significantly lower than MCA, contradicting the scarce literature dealing with this issue. Therefore, European guidelines that raised these shortcomings can henceforth benefit from this new contributionConclusion: TCA have significantly lower survival rates than MCA all things being equal. Still, prehospital life support initiation does not seem futile in these patients. These results enable us to position ourselves more in favour of European guidelines than in American ones. Yet, this new information could help to refine them. Finally, we can also keep in mind that organ donation is not anecdotical in this young population.

La commune de Plozévet est située à l’extrémité sud-ouest de la Bretagne, au bord de la baie d’Audierne. Son parler breton conserve des formes archaïques révélant une ancienne continuité méridionale qui allait des bords de la baie d’Audierne au Vannetais, continuité perceptible dans certains aspects de la phonologie, de la morphologie et du lexique. Il garde également des traits communs aux trois presqu’îles occidentales (Léon, Crozon, Cap Sizun et Cap Caval), caractéristiques aussi de la périphérie du domaine bretonnant.Mais des innovations, venues d’abord du centre de ce domaine (région de Carhaix), puis du Léon, toutes diffusées par Quimper, ont brisé ces anciennes continuités. Ce parler présente bien sûr des traits communs à tout le sud-ouest de la Cornouaille, mais aussi des spécificités : ainsi, la réalisation [-ŋ] des groupes historiques « -r n » et « -l n », l’ouverture du second élément de la diphtongue /ew/ en /ea/, réalisée [eaɔ] en finale absolue, la prédilection pour les syllabes composées de voyelle brève suivie de consonne forte, y compris dans les monosyllabes, et aussi la neutralisation de l’opposition entre les morphèmes des deuxièmes personnes du singulier et du pluriel. L’étude du lexique breton du cadastre napoléonien (1828) révèle que, si certains lexèmes sont tombés en désuétude, le parler a peu évolué au cours des XIXe et XXe siècles. Au XIXe siècle, les maires de Plozévet ont réclamé des maîtres d’école, d’abord pour enseigner le français aux enfants, qui ne savaient que le breton. Celui-ci est resté la langue la plus parlée jusque dans les années 1960, mais a ensuite très vite décliné / The commune of Plozévet is situated at the south-western tip of Brittany, on the shore of the « baie d’ Audierne ».The spoken Breton of Plozévet has kept archaic features suggesting a former continuity stretching from the shores of the « baie d’ Audierne » to the Vannetais area, perceptible in some aspects of its phonology, morphology and lexis. It has also kept some characteristics common to the three western peninsulas (Léon, Crozon, Cap Sizun and Cap Caval), also peculiar to the periphery of Celticspeaking Brittany.But some innovations coming from the central zone (Carhaix region), and then from Léon, filtered through Quimper and brought these former continuities to an end.The spoken Breton of Plozévet obviously shares many features with the rest of southwestern Cornouaille, but also has some distinctive characteristics: thus, the groups «-r n » and « –l n » pronounced [ŋ], the opening of the second element of the diphthong /ew/ into /ea/, pronounced [eaɔ] in absolute final position, a predilection for syllables composed of a short vowel followed by a fortis consonant, in monosyllables too, and also the neutralization of the opposition between themorphemes of the second persons singular and plural.The study of the Breton vocabulary contained in the so-called Napoleonic cadastre (1828) reveals that, although some of the lexemes have become obsolete, the language evolved but little during the 19th and 20th centuries.In the 19th century, the mayors of Plozévet asked for schoolmasters, above all to teach French to the children, who only knew Breton. Breton was spoken more than French until the 1960’s, but then declined rapidly.

Recently, e-government in the Czech Republic has started to develop rapidly, mainly due to the implementation of new projects. Citizens of the Czech Republic have begun to use electronic communication with public administration more often. This diploma thesis deals with the projects implementation e-goverment in routine. These projects significantly alter public administration functioning. The thesis analyses citizen readiness to use electronic communications and other e-government applications with regard to households access to personal computer and internet.

The work deals with the phenomenon of information asymmetry on the insurance markets. The aim of this work is to identify the information asymmetry as such and its specifics on the insurance markets, to describe and evaluate the possible procedures for its reduction and finally to estimate the future developments in this field. We use the study of the scientific literature, analysis of related legislation and insurance conditions of relevant insurance products and last but not least the author's own experience of work in the field of banking. There are described the procedures to reduce the information asymmetry such as the insurance legislation, possible modifications in the insurance conditions, information registers and expert systems.

This diploma thesis deals with registration of hardware in the banking environment which is typical of its limitations. The goal of the thesis is to design a system for automated hardware management that complies with all aspects of this environment. The first step to achieve the goal is a selection of development methodology and its adaptation to the nature if the project. The chosen methodology helps to understand and to define the system requirements in terms of future users. According to the requirements there is performed analysis of the market. The result of this analysis confirms the need for designing of a custom solution. For its development is mainly used scripting language PowerShell 2.0, supplemented by SQLite database system. Fully functional system which should decrease the time overhead and improve the quality of the services provided to our internal customers, is the main contribution of the thesis. Finally, after deployment of the system to the operation, is assessed suitability of the chosen methodology and evaluated success of the whole thesis.

This thesis is focused on the issue of registers of public administration with a focus on identification of persons. The analysis is compared to the current state of the system registers with the future government of the state, after the introduction of information system of basic registers of 1 July 2012. The theoretical part deals with the history of public registers, important milestones, development and a description of the system and relevant legislation of the Czech Republic. In the practical part of the analysis is done comparison of both conditions in selected life situations. In this part is included description of the functioning of the internal processes of the newly introduced information system of basic registers, his logic, infrastructure and interconnectedness of the elements.

Siguiendo la tendencia de otros países de la región, el feminici­dio —el asesinato de mujeres por razones de género— ha sido incorporado en la legislación peruana como un tipo penal. Dicha inclusión es resultado del interés del Estado y las organizaciones de la sociedad civil en producir políticas dirigidas a reducir la violen­cia de género, y ha marchado en correlato a un discurso sobre «el aumento del feminicidio» y a la aparición sistemática de noticias mediáticas e informes oficiales que advierten sobre su crecimiento exponencial. Este artículo muestra la situación del feminicidio en el Perú a través de una perspectiva comparada. El objetivo es dar cuenta de la incidencia del feminicidio en términos sociométricos y mostrar que no se trata de un fenómeno en crecimiento exponencial en términos epidemiológicos. Esto en función de reconocer dos problemas: por un lado, la manera de construir indicadores para cifras de registro criminal y sus formas de medición; por otro, para dar cuenta de la importancia de este fenómeno en una estructura de violencia más compleja y extendida. / Like other countries in the region, femicide—the gender-based murdering of women—has been incorporated into Peruvian law as a criminal offense. This inclusion is the result of the government and civil society organizations interest in producing policies aimed at reducing gender-based violence, and it has emerged as a result of a debate regarding «the increase in femicide» and the systematic appearance of media stories and official reports warning of an exponential growth. This article focuses upon the problem of femicide in Peru through a comparative approach. The aim is to account for the incidence of femicide in sociometric terms and demonstrate that this is not a phenomenon of exponential growth in epidemiological terms. This is achieved through the recognition of two issues: on the one hand, the way indicators are produced for criminal record figures and the ways these are measured; and on the other hand, through recognition of the importance of the significance of this phenomenon within a more complex and broader structure of violence.

Introduction: The anterior cruciate ligament (ACL) is a supporting ligament in the knee. ACL injuries are associated with concomitant meniscal tears and cartilage lesions. Aim: Our aim was to study the incidence of meniscal tears and cartilage lesions in patients with ACL injury and how it varies with time from injury to surgery Methods: This was a cohort study using the Swedish Knee Ligament Registry. We reviewed 479 patients who had ACL reconstruction in Region Örebro County between 2005-01-01 and 2019-03-19. Results: The incidence of meniscal tears was 33 %, cartilage lesions 18 %, both meniscal tears and cartilage lesions 29 %. The incidence of meniscal tears distributed over time from injury to surgery was 8 % for 0-3 months., 38 % for 4-12 months, 53 % for &gt; 12 months. The incidence of cartilage lesions was 8 % for 0-3 months, 45 % for 4-12 months, 47 % for &gt; 12 months. The incidence of both meniscal tears and cartilage lesions was 4 % for 0-3 months, 34 % for 4-12 months, 62 % for &gt; 12 months Conclusions: Patients treated with ACL reconstruction had an increased rate of concomitant damage to menisci and articular cartilage with increased time from injury to surgery, suggesting a benefit of early reconstructive interventions following an ACL injury. Male patients displayed a higher incidence in cartilage lesions than did female. Young age was associated with a higher incidence of meniscal tears, whereas an increasing of age was associated with an increased incidence of cartilage lesions.

This diploma theses concerns the matter of blockchain technology and its practical use, especially for nonfinancial services. Theoretical part describes the blockchain technology from the technological and juridical point of view and examples of its practical use are also mentioned. In the practical part two laboratory exercises were designed for further familiarization of the blockchain technology, in which students try some real applications on their own.