La vision fournit des informations essentielles sur la surface de marche, ainsi que sur la taille, la forme et la position d’obstacles potentiels dans notre environnement. Dans le cas d’un prédateur, la vision fournit également des informations sur la vitesse d’une proie potentielle. Les mécanismes neuronaux impliqués dans l’exécution des modifications de la marche sous guidage visuel sont relativement bien connus, mais ceux impliqués dans la planification de ces modifications de la marche sont peu étudiés. Le cortex pariétal postérieur (CPP) semble être un candidat approprié si l’on considère les propriétés du CPP lors des mouvements d’atteinte vers une cible. Le but des présents travaux est de déterminer la contribution du CPP au contrôle de la locomotion sous guidage visuel. La première étude présentée dans cette thèse a pour hypothèse que le CPP du chat est impliqué dans la planification du placement précis du pied lors des modifications volontaires de la marche. Nous avons entraîné les animaux à enjamber des obstacles en mouvement attachés à la ceinture d’un tapis roulant. Afin d’augmenter la nécessité d’intégrer les informations visuelles et proprioceptives, nous avons dissocié la vitesse des obstacles de celle du tapis roulant. Nous avons observé que plus la vision devient critique pour la tâche, plus les déficits sont importants. Notre analyse démontre que ceux-ci résultent d’un placement inapproprié du pied dans le cycle de marche précédant l’enjambement de l’obstacle. Ceci suggère que le CPP est impliqué dans la planification du placement précis du pied pendant la locomotion sous guidage visuel. La vision directe est disponible lors de la modification de l’activité des membres antérieurs, mais n’est plus disponible lorsque l’obstacle passe sous le corps. Par conséquent, la modification de l’activité des membres postérieurs doit être basée sur l’information gardée en mémoire et coordonnée avec celle des membres antérieurs. Notre deuxième étude a pour but de caractériser les mécanismes neuronaux responsables de cette coordination. Nous avons proposé que le CPP soit impliqué dans la coordination des membres antérieurs et postérieurs lors de l’enjambement d’obstacles. Pour tester cette hypothèse, nous avons enregistré l’activité de neurones de l’aire 5 pendant la même tâche. Nous avons découvert deux populations: une qui décharge lors du passage de l’obstacle entre les membres antérieurs et postérieurs et une autre qui décharge lors du passage de l’obstacle par les membres postérieurs. Dans la tâche de dissociation visuelle, la décharge est modifiée en fonction du temps de passage de l’obstacle sous le corps et reflète la modification du couplage entre les membres lors du changement dans la stratégie d’enjambement. De plus, ces mêmes neurones maintiennent une décharge soutenue lorsqu’un obstacle fixe se trouve entre les membres antérieurs et postérieurs ou les deux membres postérieurs (limite testée : 1-2min). Ces neurones pourraient être responsables de l’emmagasinage à plus long terme des caractéristiques d’un obstacle pour le guidage des mouvements des membres postérieurs. Nos résultats suggèrent que le CPP est impliqué dans l’intégration des informations visuelles et proprioceptives pour la planification du placement précis du pied devant un obstacle. Le patron de décharge de nos populations neuronales suggère qu’il encode également l’information temporelle et spatiale concernant la vitesse et la position de l’obstacle afin de coordonner l’activité des quatre membres pendant la tâche. Finalement, nous proposons qu’une des fonctions du CPP soit d’estimer la position des membres par rapport à l’obstacle en mouvement. / During locomotion, vision provides crucial information about the type of terrain one walks on, as well as the size, shape and location of possible obstacles in the path. In the case of a predator, vision also provides information about the speed of a potential prey. The neuronal mechanisms involved in the execution of visually guided gait modifications are now well studied, but those related to their planning remain poorly understood. One likely candidate involved in movement planning is the posterior parietal cortex (PPC). Based on a consideration of the properties of the PPC in visually-guided reaching, the present study was designed to determine the contribution of the PPC to the control of visually-guided locomotion. In the first study presented in this thesis, we hypothesize that the cat PPC is involved in the planning of precise foot placement during voluntary gait modifications. We trained animals to step over moving obstacles attached on a treadmill belt before and after a lesion to area 5. To increase the need for visual and proprioceptive integration, we dissociated the speed of the obstacles from that of the treadmill. We noticed that deficits were largest when the importance of vision was the greatest. Our analysis showed that the deficits were due to inappropriate paw placement prior to the step over the obstacle and thus suggests that the PPC is involved in the planning of precise paw placement during visually-guided locomotion. Direct visual information is available to guide forelimb gait modifications, but is lost when the obstacle passes under the body. Therefore, hindlimb gait modifications must rely on remembered information and must be coordinated with those of the forelimbs. Our second study is designed to determine the neuronal mechanisms responsible for this coordination. We propose that the PPC is responsible for coordinating the activity of the forelimbs and the hindlimbs during obstacle negotiation. To test this hypothesis, we recorded the activity of area 5 neurones in the same task and found two cell populations: one that discharged in relation to the passage of the obstacle between the fore and hindlimbs, and the other between the two hindlimbs. In the visual dissociation task, the discharge was modified to account for the increased time taken by the obstacle to pass under the body and the change in interlimb coupling when cats modified their stepping strategy during the step over the obstacle. We also found that these same cells maintained their discharge when the cat straddled an obstacle either between the fore and hindlimbs or between the two hindlimbs. The discharge was sustained up to the limit tested (~ 1-2min). These neurones could be responsible for the retention of obstacles characteristics to guide future hindlimb movements. Our results provide support for the hypothesis that the PPC is involved in the integration of visual and proprioceptive information for the planning of precise paw placement in front of obstacles. The discharge of our neuronal populations suggests it also encodes temporal and spatial information regarding obstacle’s location and speed to coordinate all four limbs during the task. Finally, we propose that one function of the PPC is to estimate the position of the limbs with respect to the advancing obstacle.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal.

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L’attention est sollicitée quotidiennement et peut être définie comme l’action de se concentrer sur quelque chose. Dès le plus jeune âge nous développons cette fonction cognitive, indispensable pour nos interactions avec le monde.Dans ce travail, la compréhension du fonctionnement des processus attentionnels est abordée à travers deux questions : comment les processus attentionnels se développent chez l’enfant sain et comment sont-ils atteints chez les enfants traités pour une tumeur du cervelet ? Plus précisément, cette thèse a pour objectif l’étude de la dissociation entre des processus automatiques et contrôlés de l’attention sélective visuelle dans le développement cognitif normal d’une part, et d’autre part dans leur atteinte chez des enfants ayant été traités pour une tumeur du cervelet. En intégrant une approche comportementale et une approche en imagerie fonctionnelle afin de répondre de façon complémentaire à cet objectif, ce travail interdisciplinaire se situe au carrefour de la psychologie, de la neuropsychologie et des neurosciences cognitives.Ce manuscrit comporte deux parties. Dans l’introduction théorique, une revue de la littérature se décomposant en trois chapitres est proposée ; elle porte précisément sur le fonctionnement de l’attention, son développement et ses déficits chez des enfants traités pour une tumeur du cervelet. Dans la partie expérimentale, deux chapitres sont présentées. Le premier chapitre concerne une étude sur la maturation de l’attention chez des enfants de 7 ans à l’âge adulte à travers une approche comportementale et en imagerie fonctionnelle. Le second chapitre étudie à l’aide de cette double approche les déficits attentionnels chez les enfants ayant été traités pour une tumeur du cervelet. Les résultats de nos expériences ont montré qu’entre les processus attentionnels automatiques et contrôlés, il existait une dissociation d’une part dans leur développement à un niveau comportemental et fonctionnel, et d’autre part dans la compensation des réseaux cérébraux sous-tendant une préservation comportementale chez des enfants traités pour une tumeur du cervelet. Ces données suggèrent un fonctionnement distinct de ces processus de par leur développement normal et leur dysfonctionnement en pathologie. / Attention can be defined as the act of focusing on something. We develop this cognitive function necessary to adjust our interactions with the world since birth.The general goal of this research is to understand the functioning of attentional processes through two questions: how attentional processes are developed in healthy children and how they are altered in children treated for a cerebellar tumor. This thesis specifically aims to study the dissociation between automatic and controlled processes of visual selective attention, firstly in normal cognitive development and secondly in their impairment in children treated for a cerebellar tumor. By incorporating in parallel a behavioral approach and an approach in functional imaging, this interdisciplinary work is at the crossroads of cognitive psychology, cognitive neuropsychology and cognitive neurosciences.This manuscript has two parts. The theory part is composed of three chapters: the functioning, the normal development and the deficits of attention in children treated for a cerebellar tumor. The experimental part includes two chapters. The first one concerns the attentional development in participants from seven years old to an adult age, with a behavioral approach using two experimental paradigms and an approach in functional imaging. The second chapter, with the help of this double approach, presents an alteration of attention in children treated for a posterior fossa tumor. The results showed on one side that automatic and controlled attentional processes were dissociated in their development at a behavioral and a functional level. And on the other side, the results revealed that although the automatic and controlled attentional processes are behaviorally preserved in children treated for a cerebellar tumor, they were subtended by a different modification of the functional network. Taken together these data suggest a distinct functioning of these processes in their normal development and their impairment in disease.

Einleitung: Fehlbildungen der Nieren und ableitenden Harnwege gehören zu den häufigsten angeborenen Anomalien. Ihr Anteil an den pränatal diagnostizierten Fehlbildungen wird mit bis zu 50% angegeben. Die Behandlung urogenitaler Fehlbildungen hat sich nicht zuletzt unter dem Einfluss der Pränatalen Diagnostik erheblich gewandelt. Nach einer Phase der Übertherapie nach Einführung der pränatalen Diagnostik ergab sich nach modernen diagnostischen Kriterien und im Ergebnis von Langzeitstudien des natürlichen Ganges der Fehlbildungen eine wesentlich differenziertere Indikationsstellung für das aktive therapeutische Vorgehen Fragestellung: In der retro- und prospektiv angelegten Studie sollte untersucht werden, inwieweit die pränatale Diagnostik das postnatale Vorgehen beeinflusst. So sollte untersucht werden, aus welchen pränatalen Befunden welche pränatalen Verdachtsdiagnosen gestellt wurden und wie sich diese zu den definitiven postnatalen Diagnosen verhalten. Des weiteren sollte der Aussagewert einzelner pränataler Befunde herausgearbeitet werden. Besondere Beachtung sollte dabei die Frage finden, inwieweit aus den pränatalen Befunden eine Aussage über die postnatale Therapiebedürftigkeit und schließlich auch für die Prognose der Nierenfunktion möglich ist. Patienten und Methoden: Ausgangspunkt waren 21.616 in der Abteilung für pränatale Diagnostik und Therapie in der Zeit von 1984 bis 1996 untersuchte Schwangerschaften. Unter diesen fanden sich 1.574 Feten mit angeborenen Anomalien mit fraglich kinderchirurgischer Relevanz. 1077 Fälle konnten ausgewertet werden. Mit 990 Fällen dominierten die Fehlbildungen des Urogenitalsystems, von denen 693 in die komplette Analyse mit einbezogen werden konnten. Ergebnisse: Bei 7,28% aller untersuchten Feten fanden sich Organfehlbildungen außerhalb des Zentralnervensystems. Unter diesen dominierten Harntraktfehlbildungen mit 63%. Als häufigste Diagnose wurde pränatal eine "Hydronephrose" angegeben. Dieser Begriff umschreibt jedoch in dem hier verwandten Sinne eine Harntransportstörung jeglicher Ursache. Echte Diagnosen obstruktiver Uropathien wurden lediglich zu 30% in den einzelnen Gruppen gestellt. Die pränatalen Verdachtsdiagnosen bestätigen sich zu zwischen 80 und 90% wenn: - eine isolierte Hydronephrose mit einem Nierenbeckendurchmesser von über 10 mm als Ureterabgangsstenose befundet wurde - die typische Konfiguration einer Multizystischen Nierendysplasie gefunden wurde - aus der Kombination von Oligohydramnion, Megazystis und bilateraler Harntransportstörung des männlichen Feten auf Urethralklappen geschlossen wurde. Lediglich bei der unilateralen multizystischen Nierendysplasie und der subpelvinen Obstruktion wird im pränatalen Befund bezüglich der definitiven Diagnose eine akzeptable Sensitivität und Spezifität erreicht. Alle anderen Diagnosen werden zu 70% postnatal gestellt. Der Einfluss der pränatalen Diagnostik auf das postnatale Management bezieht sich in erster Linie auf die Aufdeckung vorerst symptomloser Fehlbildungen. Eine pränatale Aussage über die zu erwartende Nierenfunktion ist bei einseitigen Fehlbildungen derzeit nicht möglich. Zusammenfassung: Obstruktive Uropathien sind häufige, zumeist benigne Fehlbildungen. Sie sind der pränatalen Diagnostik gut zugänglich. Konkrete Diagnosen mit Aussagen zur postnatalen therapeutischen Relevanz können jedoch nur gestellt werden, wenn sonografisch pathognomonische Konstellationen dies ermöglichen. In allen anderen Fällen muss die pränatal beschriebene Auffälligkeit Anlass zu postnataler sorgfältiger Diagnostik sein, um im präsymptomatischen Intervall die Entscheidung zu konservativer oder operativer Therapie stellen zu können. / Introduction: Among congenital dysplasias the anomalies of kidney and urogenital tract are among the most frequent encountered. Their rate in prenatally made diagnoses is about 50 %. Modern prenatal diagnostic facilities have changed the therapeutic access to these anomalies in the last decade. After a phase of overtreatment in the beginning, nowadays new insights in the natural course of these dysplasias and the results of long-term follow-up studies resulted in a more differentiated apporach. Questions and methods: In this retro- and prospective study we looked for the the influence of prenatal diagnostics on the postnatal course and management. The question was to examine the relationship between the prenatal ultrasound results, the suggested prenatal diagnosis and then the defintive postnatal disease. Of interest was the prognostic impact of typical prenatal sonographic imaging on the postnatal course of the baby. Because of its frequency we focused on anomalies of the kidney and urogenital tract. Patients: Between 1984 and 1996 21.616 pregnancies were examined by ultrasound in our Department of Prenatal Medicine. Among these, 1.574 anomalies of surgical relevance were described. 1.077 cases were available for follow-up including 990 cases of urogenital anomalies. Among these, the records of 693 cases were complete and these patients form the collective of this study. Results: When the CNS was excluded we found organic anomalies in 7,28 % of these cases. Among them 63% were attributed to the urogenital system. The most common prenatal diagnosis was "hydronephrosis". But this term was used only in a descriptive manner because proof of a real obstructive uropathy postnatally was made only in 30% of these cases. Concerning all anomalies of the urogenital tract, the prenatal diagnosis proved correct in the overwhelming majority of cases ( 90%) if these sonographic signs have been described: - diameter fo the renal pelvis of more than 10 mm in isolated hydronephrosis predicted ureteropelvic junction obstruction - typical formation of a multicystic dysplastic kidney - combination of oligohydramnion, megacystis and bilateral kidney anomalies in a male fetus predicted posterior urethral valve disease Sensitivity and specifity in regard to the definitive diagnosis were acceptable in multicystic dysplasia of the kidney and ureteropelvic junction obstruction. In all other cases, the correct diagnosis was made postnatally in 70 %. Therefore, the main value of prenatal sonography was to reveal otherwise symptomless dysplasias. Until now, a prenatal prediction of kidney function in the unilateral case is not possible. Conclusion: Obstructive uropathies are common an in most cases benign anomalies. They are easily detected by prenatal ultrasound. Therapeutical consequences, however, only arise in selected cases if typical sonographic signs can be seen. In the majority of cases, therefore, the main purpose of prenatal diagnostic ultrasound points out the necessity for postnatal diagnostic workup in order to detect and treat severe diseases before symptoms occur.

Title: Posterior chain muscle endurance and arm paddling peak power in amateur female surfers Objectives: Thesis is dedicated to female surfing, particularly paddling, as this is an undiscovered area of research. Very few studies have been carried out, which would focus on muscle activity in surfing. None of the studies focused on posterior chain or muscle activity of female surfers while paddling. Not only that the level of competitive surfing is increasing rapidly, as it will be part of Olympic Games in Tokyo in 2020, but the recreational surfers are also becoming more literate about surf science and willing to improve their surfing performance by dry land surf specific trainings. Surfing industry represents a worldwide business, where big companies offer sponsorship, which is reasonable motivation for young athletes (M. Mendez-Villanueva & Bishop, 2005). As the number of recreational and competitive female surfers is raising as well, the level of competitive female surfing is increasing (Booth, 2001) and professional female surfers are becoming equal in regards to getting the same amount of prize money in competitions, more research should be dedicated to female surfing. The aim of this thesis was to study association between posterior chain endurance and other variables such as frequency of...

Dans notre environnement, nous sommes constamment exposés à de multiples stimuli sensoriels que notre cerveau doit analyser. Afin d'interagir avec le monde qui nous entoure, nous devons intégrer ces différentes sources d'informations sensorielles. L'étude des processus d'intégration multisensorielle est essentielle pour comprendre comment le cerveau intègre les éléments séparés d'un objet défini par plusieurs composantes sensorielles pour former un percept unifié. Il est maintenant couramment admis que la présentation conjointe de plusieurs informations sensorielles de modalités différentes d'un même stimulus peut faciliter la perception. Cette facilitation multisensorielle semble être soumise à des règles particulières puisque certains facteurs l'influencent. Parmi eux, nous avons étudié, dans notre première étude, l'impact de trois facteurs que sont la saillance, la congruence sémantique et le changement de modalité sur les performances de détection de stimuli naturels chez l'homme et le singe. L'utilisation de stimuli naturels nous a permis de mettre en lumière l'influence des paramètres physiques des stimuli sur l'intégration multisensorielle. De plus, nous avons montré que les effets de ces facteurs sur des stimuli naturels diffèrent de ceux retrouvés avec des stimuli simples. Ces résultats convergent vers des effets multifactoriels sur la facilitation multisensorielle dont la force, les interdépendances et l'ordre varieraient en fonction de la tâche comportementale et de ce fait, de la charge cognitive. D'un point de vue anatomique et plus précisément au niveau cortical, les processus d'intégration multisensorielle paraissaient être jusqu'à récemment une caractéristique que seules possédaient les aires associatives situées au sommet de la hiérarchie du traitement de l'information. On sait maintenant que des aires corticales de bas niveau, pensées jusque-là comme étant unisensorielles, sont impliquées dans les processus multisensoriels, soulevant ainsi la question des aires sous-corticales. Des études anatomiques ont mis en évidence l'existence de noyaux thalamiques qui, par leurs connexions, pourraient permettre un transfert rapide et même une intégration des informations sensorielles. Cette nouvelle littérature témoigne de la grande complexité des réseaux cérébraux de la multisensorialité. Dans deux études électrophysiologiques chez le singe, nous avons examiné les propriétés multisensorielles de deux structures, le gyrus cingulaire postérieur et le pulvinar médian, qui n'avaient jamais été explorées auparavant dans un contexte multisensoriel. Nous avons montré que ces structures sont non seulement multisensorielles mais également intégratives et qu'elles pourraient appartenir à un même système fonctionnel. Ces travaux de thèse ont apporté des éléments supplémentaires quant à notre compréhension des processus d'intégration multisensorielle au niveau comportemental et des réseaux cérébraux sous-jacents et particulièrement ceux liés à l'intégration de stimuli naturels. / In our environment, we are constantly exposed to multiple sensory stimuli that our brain has to analyze. To interact with the surrounding world, we have to integrate these different sources of sensory information. The study of the processes of multisensory integration are essential in understanding how our brain integrates the individual parts of an object defined by several sensory components to arrive at a unified percept. It is now widely accepted that the concurrent presentation of several sensory information about the same stimulus in different modalities can facilitate its perception. This multisensory facilitation seems to be subjected to specific rules since some factors influence it. Amongst them, we have studied, in our first experiment, the impact of three factors, namely saliency, semantic congruency and modality switch, on the detection of natural stimuli in humans and monkeys. Using natural stimuli enabled us to highlight the influence of the physical parameters of stimuli on multisensory integration. Moreover, we showed that the effect of these factors on natural stimuli are different from those found with simple stimuli. These results point toward multifactorial effects on multisensory facilitation, of which the force, the interdependency and the order would vary as a function of the behavioral task, and, thus as a function of the cognitive load. From an anatomical point of view and more specifically at the cortical level, the integration mechanism appeared to be, until recently, a characteristic possessed only by associative areas at the top of the hierarchy of information processing. We now know that low level cortical areas, thought up to then to be only unisensory, are implicated in multisensory processes, thus raising the question about subcortical areas. Anatomical studies have shown the existence of thalamic nuclei which, through their connectivity, could allow for a rapid transfer and even an integration of sensory information. This new literature demonstrates the high complexity of the multisensory cerebral networks. In two electrophysiological studies in the monkey, we examined the multisensory properties of two structures, the posterior cingulate gyrus and the median pulvinar, which had never been explored before in a multisensory context. We not only showed that these structures are multisensory, but also integrative and that they could be part of the same functional network. This thesis has brought additional elements towards a better understanding of multisensory integration processes at the behavioral level and about the underlying brain networks, in particular those linked with the integration of natural stimuli.

Submitted by Sara Ribeiro (sara.ribeiro@ucb.br) on 2018-11-09T17:57:39Z No. of bitstreams: 1 OrlandoMaurizRamosDissertacao2018.pdf: 901886 bytes, checksum: 651204f0a4fd8e26d90341f87258fac2 (MD5) / Approved for entry into archive by Sara Ribeiro (sara.ribeiro@ucb.br) on 2018-11-13T15:56:26Z (GMT) No. of bitstreams: 1 OrlandoMaurizRamosDissertacao2018.pdf: 901886 bytes, checksum: 651204f0a4fd8e26d90341f87258fac2 (MD5) / Made available in DSpace on 2018-11-13T15:56:26Z (GMT). No. of bitstreams: 1 OrlandoMaurizRamosDissertacao2018.pdf: 901886 bytes, checksum: 651204f0a4fd8e26d90341f87258fac2 (MD5) Previous issue date: 2018-09-15 / The Principle of Equality should be used in all situations involving legal relationships. With the advent of Law no. 9249/95, and consequently with the possibility of extinguishing punishment of authors of crimes against the tax order, after the effective payment of the helpless taxes, some controversies arose regarding the coercive effectiveness of Criminal Law. However, it is observed a differentiated treatment of non-taxable offenders, hence the importance of analyzing the instituting of punishment and acquittals in another perspective. Given that the Brazilian prison population is large, mainly due to practices of crimes against the patrimony, it is searched with the present work, to analyze the fact of the equal application of the benefit given to the authors of the crimes against the tax order, also to the authors of other crimes, who may repent of the criminal practice, restoring the injured object or, in its impossibility, repairing, in a certain way, the damage caused. Equal treatment is proposed between offenders, observing the possibility of extinguishing punishment, with an eye towards reducing new criminal practices, as well as reducing the prison population, generating a possibility of saving for the state, since it will not be obliged to costing the maintenance of the prisoners, a benefit for the victim, since they will be compensated for the damage caused by the practice of the crime, and a possibility of a second chance for the perpetrator, who will not be incarcerated. The analysis was based on bibliographical research, having as sources the doctrine, technical productions and jurisprudences. At first, the importance of taxes was analyzed for the maintenance of state activities, conceptualizing and extracting the purpose of the taxes, in order to understand the need to classify crimes against the tax order, and consequent application of a penalty to the offender. In a second moment, it is sought to understand the beneficent institutes of the Later Regret (Later Repentance) and the Acquittal Excuse (Excusive Absence). And then, the possibility of equal treatment and possible benefits, with the application of the abovementioned institutes, against the State, the victim and the aggressor was evaluated. / O Princípio da Igualdade deverá ser utilizado em todas as situações que envolvam relações jurídicas. Com o advento da Lei nº9.249/95, e, consequentemente, com a possibilidade da extinção de punibilidade aos autores de crimes contra a ordem tributária, após o efetivo pagamento dos tributos sonegados, surgiram algumas controvérsias no tocante à eficácia coercitiva do Direito Penal. Contudo, observa-se um tratamento diferenciado para com os autores de infrações que não tenham cunho tributário, daí a importância da análise dos institutos da extinção de punibilidade e das escusas absolutórias, numa outra ótica. Dado que a população carcerária brasileira encontra-se vultuosa, principalmente devido a práticas de crimes contra o patrimônio, busca-se com o presente trabalho, analisar o fato da aplicação equiparada do benefício dado aos autores dos crimes contra a ordem tributária, também aos autores de outros crimes, que porventura venham a se arrepender da prática delituosa, restituindo o objeto lesado, ou, na sua impossibilidade, reparando, de certa forma, o dano causado. Propõem-se um tratamento igualitário entre os infratores, observando a possibilidade da extinção da punibilidade, com olhos voltados à redução de novas práticas delituosas, bem como na diminuição da população carcerária, gerando uma possibilidade de economia para o estado, pois não será obrigado a custear a manutenção dos presos, um benefício para a vítima, vez que será ressarcida do prejuízo causado pela prática do crime, e uma possibilidade de segunda chance para o autor, que não será encarcerado. A análise se fundamentou em pesquisas bibliográficas, tendo como fontes a doutrina, produções técnicas e jurisprudências. Num primeiro momento foi analisado a importância dos tributos para a manutenção das atividades estatais, conceituando e extraindo a finalidade dos tributos, para se entender a necessidade da tipificação de crimes contra a ordem tributária, e consequente aplicação de uma pena ao infrator. Num segundo momento busca-se entender os institutos benéficos do Arrependimento Posterior e da Escusa Absolutória. E em seguida foi avaliado a possibilidade do tratamento igualitário e eventuais benefícios, com a aplicação dos institutos acima mencionados, frente o Estado, a vítima e o agressor.

Base teórica: Disfunções do trato urinário inferior são sintomas não motores comuns na Doença de Parkinson (DP) e incluem a Síndrome da Bexiga Hiperativa Neurogênica (SBHN), caracterizada pela urgência miccional, com ou sem urgeincontinência, acompanhada de aumento da frequência urinária e noctúria. A estimulação do nervo tibial posterior (ENTP) é uma das modalidades de tratamento disponíveis para o tratamento da SBHN. Objetivo: Determinar e comparar os efeitos do tratamento com ENTP em pacientes com DP e sintomas de SBHN e a manutenção dos resultados em 1 e 3 meses após o término do tratamento. Métodos: Ensaio-clínico, duplo-cego, randomizado, controlado e comparado com placebo. A pesquisa foi realizada com mulheres com DP e sintomas de SBHN no Hospital de Clínicas de Porto Alegre. Para o tratamento com ENTP domiciliar por 12 semanas as pacientes foram divididas em dois grupos: grupo ENTP e grupo ENTP sham/placebo. A avaliação da resposta pré e pós-tratamento foi realizada através de formulário específico, questionários de avaliação da incontinência urinária e qualidade de vida (OAB-V8 e KHQ) e de um diário miccional (DM) de 24 horas. Após, o fim do tratamento foi feito seguimento dos resultados para avaliação da melhora subjetiva em 30 e 90 dias. Resultados: O grupo ENTP apresentou uma diminuição da noctúria, número de episódios de urgência micciional e urge-incontinência, número de uso de proteções para incontinência, pontuação OAB-V8 e em sete domínios do KHQ (p <0,001). Embora, o grupo controle também tenha apresentado melhora dos sintomas, o grupo ENTP apresentou uma melhora superior no final do tratamento nas medidas do DM, OAB-V8 e na maioria dos domínios do KHQ. A ETNTP foi considerada um tratamento efetivo para SBHN em 93,3%, enquanto 33,3% dos tratados com placebo também melhoraram (p = 0,002). No seguimento de 30 e 90 dias, 53,3% e 33,31%, respectivamente, do grupo ENTP relataram que mantinham- se melhores dos sintomas da SBHN. Conclusão: a ENTP foi um tratamento efetivo para as pacientes com DP e SBHN. Nossa hipótese de superioridade clínica do grupo ENTP foi confirmada e a melhora subjetiva foi considerada positiva, mesmo que parcialmente em 30 e 90 dias após fim do tratamento. / Blackround: Lower urinary tract dysfunctions are common non-motor symptoms in Parkinson's disease (PD) and include Neurogenic Overactive Bladder Syndrome (NOBS), characterized by urinary urgency, with or without urge incontinence, accompanied by increased urinary frequency and nocturia . Posterior Tibial Nerve Stimulation (PTNS) is one of the treatment modalities available for the treatment of NOBS. Objective: To determine and compare the effects of PTNS treatment in patients with PD and NOBS symptoms and to maintain long-term results (1 and 3 months). Methods: Controlled, randomized, double-blind and compared with placebo clinical trial. The research was carried out with women with PD and symptoms of NOBS at the Hospital de Clínicas de Porto Alegre. For treatment with PTNS at 12 weeks, patients were divided into two groups: PTNS group and PTNS sham/placebo group. The evaluation of the pre- and post-treatment response was through a specific form, questionnaires to evaluate incontinence and quality of life (OVA-V8 and KHQ), and a voiding diary. After the end of the treatment, the results were followed up to evaluate the subjective improvement in 30 and 90 days. Results: The PTNS group presented a decreased nighttime urinary frequency, number of urgency and urinary incontinence episodes, number of incontinence protection, OAB-V8 and 7 domains of KHQ (p<0.001). Although the control group also showed improvement of the symptoms, the ENTP group presented a superior improvement at the end of the treatment in DM, OAB-V8 and most KHQ domains. PTNS was considered an effective treatment for OAB in 93.3%, while 33.3% of those treated with placebo was considered a responder (p=0.002). After 30 and 90 days, 53.3% and 33.31%, respectively, of the ENTP group reported that they maintained better SBHN symptoms. Conclusion: PTNS was an effective treatment for patients with PD and NOBS. Our hypothesis of clinical superiority of the ENTP group was confirmed and the subjective improvement was considered positive, even if partially at 30 and 90 days after the end of the treatment.!

Les anomalies de croissance maxillo-faciale résultent de variations du processus normal de croissance. Après les caries, elles représentent les problèmes bucco-dentaires les plus fréquents chez les jeunes et peuvent entraîner des troubles fonctionnels (mastication, phonation, respiration), esthétiques et parfois psychologiques. Le traitement orthodontique vise à corriger les anomalies de croissance maxillo-faciale. L’objectif de cette thèse est de rechercher des facteurs de risque précoces d’anomalies de croissance maxillo-faciale et d’étudier le rôle des facteurs socio-économiques, culturels et géographiques de l’accès au traitement orthodontique en France. Les enfants de la cohorte EPIPAGE, qui avait inclus toutes les naissances survenues entre 22 et 32 semaines d’aménorrhée dans neuf régions françaises en 1997, ont été examinés à 5 ans. Nous avons étudié les relations entre les caractéristiques néonatales et la déformation du palais à 5 ans chez 1711 enfants. Le sexe masculin, le petit âge gestationnel, le petit poids pour l’âge gestationnel et peut-être l’intubation de longue durée sont identifiés comme des facteurs de risque de déformation du palais à 5 ans chez les grands prématurés ; de plus, les enfants avec des déficiences neuro-motrices semblent particulièrement à risque. La cohorte mère-enfant EDEN, a inclus des femmes enceintes en 2002-2003 et leur enfant à la naissance. Nous avons recherché les facteurs de risque précoces de l’occlusion postérieure inversée et de la béance antérieure chez 422 enfants de 3 ans. En plus d’une tétine encore utilisée à 3 ans et de la respiration buccale qui sont des facteurs connus, un nouveau facteur de risque d’occlusion postérieure inversée en denture temporaire est mis en évidence : la prématurité. Enfin, l’étude chez les 5988 enfants et les adolescents de l’enquête sur la santé et la consommation de soins en France réalisée par l’Insee en 2002-2003, enquête transversale sur échantillon représentatif de la population vivant en France, montre que 23% des 12-15 ans ont un traitement orthodontique. En plus du facteur économique, le moindre recours au traitement orthodontique est aussi lié à l’environnement social et culturel moins favorisé de l’enfant, à l’absence de couverture complémentaire et à l’habitation en zone rurale.En conclusion, pour mieux comprendre les inégalités dans le traitement orthodontique, il faudrait en évaluer les besoins en amont. Nous avons étudié des facteurs liés à la présence d’anomalies de croissance maxillo-faciale à des âges très jeunes afin de pouvoir identifier tôt des enfants à risque de ces anomalies. Il est nécessaire de vérifier leur évolution pour savoir si elles sont de réels marqueurs précoces de besoin en traitement orthodontique. / Malocclusions are due to variations of normal process of growth. Besides caries, they are the most common oral problems encountered by children and teenagers. They may lead to oral dysfunction (in chewing, speaking and breathing), esthetic and sometimes psychological issues. Orthodontic treatment aims at correcting malocclusions.The purpose of this thesis is to investigate early risk factors for malocclusions and to analyze the role of socioeconomic, cultural and geographic factors in access to orthodontic treatment in France. In the EPIPAGE cohort study, which included all live births between 22 and 32 weeks of gestation in 9 French regions in 1997, 1711 children were examined at 5 years. We explored the relations between neonatal characteristics and alteration of palatal morphology at 5 years. Male sex, low gestational age, small for gestational age and maybe intubation of long duration were identified as risk factors for alteration of palatal morphology et 5 years in very preterm children; children with neuromotor deficiencies seem particularly at risk. The mother-child EDEN cohort included pregnant women in 2002-2003 and their child at birth. We investigated early risk factors for posterior crossbite and anterior open bite in 422 3-year-old children. In addition to ongoing pacifier sucking habit at 3 years and mouth breathing, which are well-known risk factors, prematurity appears to be a new risk factor for posterior crossbite in temporary dentition. Finally, the French survey on health and care consumption, carried out in 2002-2003 in a representative sample of 5988 children and teenagers, shows that 23% of the 12-15 years old have an orthodontic treatment. Besides the economic factor, the less orthodontic treatment uptake is related to a less privileged social environment, to the absence of supplementary insurance and to living in a rural area.In conclusion, to understand inequalities in orthodontic treatment better, orthodontic treatment need should be evaluated first. We investigated factors related to malocclusions at very young ages, which could help to early identify children at risk. The assessment of how these early malocclusions would evolve is therefore needed in order to control if those malocclusions are indeed early markers for orthodontic treatment need.