Thesis (MAud (Interdisciplinary Health Sciences. Speech-Language and Hearing Therapy)--Stellenbosch University, 2008. / Individuals are increasingly undergoing bilateral cochlear implantation in an attempt to benefit from binaural hearing. The main aim of the present study was to compare the speech recognition of children fitted with bilateral cochlear implants, under binaural and monaural listening conditions, in quiet and in noise. Ten children, ranging in age from 5 years 7 months to 15 years 4 months, were tested using the Children’s Realistic Index for Speech Perception (CRISP). All the children were implanted with Nucleus multi-channel cochlear implant systems in sequential operations and used the ACE coding strategy bilaterally. The duration of cochlear implant use ranged from 4 years to 8 years 11 months for the first implant and 7 months to 3 years 5 months for the second implant. Each child was tested in eight listening conditions, which included testing in the presence and absence of competing speech. Performance with bilateral cochlear implants was not statistically better than performance with the first cochlear implant, for both quiet and noisy listening conditions. A ceiling effect may have resulted in the lack of a significant finding as the scores obtained during unilateral conditions were already close to maximum. A positive correlation between the length of use of the second cochlear implant and speech recognition performance was established. The results of the present study strongly indicated the need for testing paradigms to be devised which are more sensitive and representative of the complex auditory environments in which cochlear implant users communicate.

Expression la plus caractéristique du pouvoir de l’administration, la décision administrative est une notion familière. Pourtant, les données observables en droit positif s’avèrent hétérogènes et contingentes, compromettant la possibilité d’en circonscrire la teneur. Et derrière un consensus apparent, les présentations doctrinales de l’action adminis-trative unilatérale se caractérisent par un éclatement terminologique et conceptuel. Le choix a été fait de construire une définition, à partir d’une analyse critique du droit positif et du discours doctrinal, pour en éprouver les mérites en vue d’une meilleure compréhension de l’administration et de son droit. Signification impérative d’une manifestation de volonté uni-latérale et arrêtée d’une autorité administrative, la décision administrative constitue un utile outil d’analyse du pouvoir de l’administration, du contrôle du juge sur celui-ci et de la place à laquelle les citoyens peuvent prétendre dans son élaboration et sa mise en oeuvre. Distincte de l’incitation ou de la déclaration d’intention, la décision demeure le mode privilégié de direction de la conduite des citoyens et l’objet principal du contrôle du juge sur la légalité de l’action administrative. La portée explicative de cette définition est complétée par la compréhension qu’elle autorise des usages stratégiques que les acteurs du droit administratif peuvent en faire. En tant que signification, la décision révèle les luttes qu’ils mènent pour l’identification, au cas concret, de la portée des divers actes de l’administration ; enjeu de pouvoir, elle fait ressortir les stratégies de légitimation qui entourent son emploi par les autorités publiques. / One of the most characteristic expression of the administrative activities, the administrative decision is a familiar concept. Nevertheless, positive law on this subject turns out to be disparate and contingent. And behind a seeming consensus, the authors pre-sent the unilateral administrative actions with real terminological and conceptual disparities. The choice has been made to build a definition, from a critical analysis of positive law and doctrinal views, so as to test its merits with an eye to a better understanding of the Admin-istration and its law. Imperative meaning of a fixed and unilateral act of will of an adminis-trative body, the administrative decision is a useful tool to analyse the power of the Admin-istration, the judicial review of it and the place that citizens can aspire to in the process of its making and its implementation. Distinct from incitation or mere declaration of intent, deci-sion remains the preferred way of directing citizens behaviour and the main object of the judicial review of administrative acts. The explanatory impact of this definition is supple-mented by the understanding it enables of the strategical uses that actors of administrative law make of it. As a meaning, decision reveals the struggles they wage to identify, in a specif-ic case, the impact of the various acts of administrative bodies ; as a power issue, it brings out the strategies of legitimization that surround its use par public authorities.

De prime abord, le droit des concentrations illustre le rôle moderne joué par l’État dans l’économie : il ne s’agit plus de construire les marchés, mais de contrôler ponctuellement un ou plusieurs opérateur(s) en particulier. L’État libéral soumet ainsi à autorisation préalable les rapprochements d’entreprises, afin de vérifier que ceux-ci ne portent pas atteinte à la concurrence. Pourtant, dans le silence de la loi, tout se passe comme si l’administration se servait de la concentration comme d’un vecteur d’une réorganisation des marchés. Le procédé est d’autant plus subtil qu’il implique étroitement les entreprises elles-mêmes : tout repose sur les « engagements » que celles-ci proposent à l’administration dans le but de prévenir les effets anticoncurrentiels de leur projet. Car ces engagements connaissent une mutation juridique décisive : une fois émis, ils deviennent une mesure de police économique, incorporée dans l’autorisation administrative. Le procédé, développé à l’époque de l’économie administrée, dénote la constance du droit français par-delà la variation des objectifs économiques. Or, ces engagements contraignent les parties à la concentration, d’une part dans leurs actes avec d’autres opérateurs sur le marché et, d’autre part, dans leurs rapports à l’administration : ils orientent l’action de la concentration vis-à-vis des tiers tout en prolongeant le contrôle administratif. Incorporant les engagements dans son acte, l’administration modifie puis surveille les relations entre les parties et les tiers à l’opération. Aussi, son intervention se déplace, ratione temporis, de la concentration en projet à la concentration réalisée, et, ratione personae, des parties à l’opération aux tiers. Elle se déplace en somme de la concentration vers le marché. S’il ne s’agit donc plus, comme par le passé, de construire directement le marché, l’administration utilise désormais à cette fin les entreprises soumises à son autorisation. / At first sight, the mergers’s control illustrates the modern role played by the State in the economy: the aim is not to organize the markets anymore, but to control from time to time one or several particular operators. The liberal State submit the companies’s merging processes to prior authorization, so as to make sure they do not negatively affect the competition. Nevertheless, in the silence of the law, everything goes as if the administration was using mergers as drivers of the markets’s reorganization. This process is evenmore subtil because it implies closely the companies themselves: everything depends on the commitments the companies offer to the administration, in order to prevent the non competitive effects of their project. These commitments are indeed undergoing a major legal change: once issued, they become a measure of economic restriction, embedded in the administration’s authorization. This process, that has been developed from the time of planned economy, suggests a certain permanency of the French law, despite the economic goals’s variation. Yet, these commitments constrain the parties about to merge: on the one hand regarding their actions towards other operators on the market, and on the other hand, regarding their relation with the administration : at the same time they direct the merger according to the stakeholders, and extend the administrative control. In short, when embedding the commitments in its act, the administration first changes the relations between the parties and the stakeholders, then follows up the relations’s execution. Thus, its intervention swifts ratione temporis, -from the merger in progress to the merger achieved, ratione personae, from the parties to the stakeholders’ operations, and ratione materia, from the merger to the market. Time has gone when the administration used to build the market directly ; now it uses to this end the companies that have to require her authorization.

Title: Experiance with joga for tennis coaches Objectives of work: The aim of my thesis is to analyze the possitive effects of yoga on the mental and physical health of tennis players. The data is gained by quality data collection methods. The secondary objective is, on the basis of information obtained from short interviews with coaches, to create a theoretical model of categorization. Method: In this thesis we used the method of interview and narrative interview. The data collected from the interviews, was used to create a theoretical model of categorization. A method of narrative interview with elements of the interview was used as a key method of collecting data from selected subjects. Results: Following numerous interviews with various subjets including coaches and trainers, I have come to the conclution, that yoga has a positive effect on the mental and physical health of tennis players. The main effects of yoga include: increased confidence and concentration on the court, accelerated healing, reduced pain in the spine (notibly in lumbar region), therefore increasing the flexibility of joints and improving the performance of players. In terms of categorization on the effects of yoga, both in mental and physical health of tennis players, I classified the effects into two major categories: the...

This diploma thesis provides comparison of the termination of employment relationship in the Czech Republic and in the UK. Within both legal systems this thesis focus on termination of employment relationship based on legal actions of the participants of the employment relationship as well as based on legal situations independent on the will of the participants of the employment relationship. This thesis also analyses sources of employment law in the UK and it provides an overview of the complex judiciary system in the British employment law matters.

Les enfants atteints de paralysie cérébrale unilatérale spastique ont un membre supérieur dont les mouvements sont dégradés. Un des symptômes en cause est la co-activation spastique, une activation excessive de certains muscles qui s’opposent au mouvement. En clinique, il n’existe pas d’outil pour distinguer quels muscles ont une activation pathologique. Les signaux électromyographiques, mesurés de façon non invasive, peuvent discriminer des activations musculaires pathologiques. Cependant, ils sont rarement mesurés au membre supérieur des enfants atteints de paralysie cérébrale, en raison d’obstacles méthodologiques et statistiques. Cette thèse aborde ces obstacles. Les signaux électromyographiques de muscles du membre supérieur ont été mesurés chez 63 enfants avec et sans paralysie cérébrale unilatérale spastique, dans le cadre de 5 études de recherche. Les 2 premières études ont consisté à détecter et caractériser les anomalies de commande musculaire chez les enfants avec une paralysie cérébrale, afin de cibler les paramètres électromyographiques pertinents. La 3ème étude a validé la mesure électromyographique au membre supérieur, en évaluant sa variabilité. Les 4ème et 5ème études ont appliqué la méthodologie développée à des problématiques cliniques : distinguer, pour chaque enfant, les muscles responsables des limitations de mouvements actifs ; évaluer les modifications d’activation musculaire à la suite de thérapies. Le développement méthodologique lié à ces études a permis d’évaluer la fiabilité de l’analyse électromyographique du membre supérieur, et a montré son fort potentiel pour le « diagnostic fonctionnel » des enfants atteints de paralysie cérébrale. / Children with unilateral spastic cerebral palsy have restricted movement of one upper limb.One of the symptoms responsible for this limitation is spastic co-activation, which is an excessive activation from specific muscles opposing the movement. In clinical routine, no tool can detect which muscles have a pathological activation.Electromyographic signals, measured non-invasively, can discriminate pathological muscle activations.However, they are rarely measured at the upper limb of children with cerebral palsy, due to methodological and statistical difficulties. This thesis addresses these difficulties. Electromyographic signals of upper limb muscles were measured in 63 children with and without unilateral spastic cerebral palsy, as part of 5 research studies.The first two studies consisted in detecting and characterizing abnormal muscle activations in children with cerebral palsy, in order to target relevant electromyographic parameters. The third study validated the measure of upper limb electromyography, and evaluated its variability.Fourth and fifth studies applied the developed methodology to clinical problems: the distinction, for each child, of the muscles responsible for active movement restrictions; the evaluation of muscle activation modifications following a therapy.Methodological development associated with these studies assessed the reliability of upper limb electromyography, and showed its strong potential for the “functional diagnosis” of children with cerebral palsy.

In der vorliegenden Arbeit wurden einseitig mit Human-Cochlea-Implantat versorgte Meerschweinchen verwendet, die auf dem anderen Ohr normalhörend waren und mit einer einseitig vertäubten, aber nicht elektrostimulierten Kontrollgruppe verglichen wurden. Untersucht wurde der Einfluss von drei unterschiedlichen Stimulationsraten und drei Stimulationsintensitäten während einer einseitigen Elektrostimulation. Dabei wurde zunächst der Einfluss der Elektrostimulation auf die Hörschwellen mittels Hirnstammaudiometrie (ABR) untersucht. Anschließend wurden die Zelldichten in der aufsteigenden Hörbahn (dorsaler Nucleus Cochlearis, Colliculus Inferior, medialer Kniehöcker und auditorischer Cortex) im Hirnschnitt unter Verwendung einer Hämalaun-Eosin Färbung bestimmt. Ein Zusammenhang zwischen der verwendeten Stimulationsrate und den in der zentralen Hörbahn gefundenen Zelldichten wurde ebenso wenig gezeigt wie ein Zusammenhang mit den mittels ABR ermittelten Hörschwellen der normalhörenden Seite. Dagegen wurde jedoch ein Zusammenhang zwischen den in der Elektrostimulation verwendeten Stimulationsintensitäten und den ermittelten Zelldichten festgestellt. Die niedrigste verwendete Stimulationsintensität führte zu einer bilateralen Konservierung der Zelldichten in der gesamten untersuchten Hörbahn, wogegen eine Elektrostimulation mit der höchsten Stimulationsintensität zum Teil einen bilateralen Zellverlust im dorsalen Nucleus Cochlearis, medialen Kniehöcker und im auditorischen Cortex zur Folge hatte. Dieser Zellverlust führte in dem Untersuchungszeitraum nicht zu einer signifikanten Veränderung der Hörschwelle. / In this study, human cochlear implants (CI) were implanted unilaterally in the cochlea of guinea pigs that were normal hearing on the contralateral side. Electro-stimulation was used on the cochlea with the implanted CI. They were compared to an unilaterally implanted but not electro-stimulated control group. This study investigates the effect of three different stimulation-rates and three different stimulation-intensities in unilateral electro-stimulation. The effect of the electro-stimulation on the hearing thresholds was determined using auditory brainstem recordings (ABR). Afterwards, cell densities in the ascending auditory pathway (dorsal cochlear nucleus, inferior colliculus, medial geniculate body and auditory cortex) were measured in brain slices stained with hematoxylin and eosin. No evidence was found of a connection between the different stimulation rates of electro-stimulation in the cochlea with a CI and cell densities seen in the central auditory pathway. Furthermore, there were no links found between hearing thresholds determined by ABR and the different parameters that were used for the electro-stimulation. However a significant effect of the different stimulation intensities on the cell densities identified in the auditory pathway was demonstrated. The lowest intensity used in the electro stimulation led to a bilateral preservation of cell densities in the entire auditory pathway whereas electro-stimulation with the highest intensity induced a significant cell loss in the auditory pathway (dorsal cochlear nucleus, the medial geniculate body and the auditory cortex). Interestingly, this cell loss was not accompanied by significant changes in the auditory threshold.

Chez les patients présentant un syndrome métabolique, le développement des comorbidités cardiaques et rénales associées au diabète de type 2 sont liées à des altérations au niveau vasculaire. Afin d’évaluer l’effet protecteur rénal et cardiaque de nouvelles molécules, le modèle de rat Zucker fatty/Spontaneously hypertensive heart failure F1 hybrid (ZSF1) semblait approprié. Cependant, son développement lent et les impacts rénaux et cardiaques modestes en limitaient son utilisation. Notre but fut d’exacerber ces altérations par deux méthodes. Nous avons d’abord effectué une néphrectomie unilatérale chez le rat ZSF1 et évalué l’évolution des fonctions cardiaque et rénale en fonction de l’âge. Seule une exacerbation de la dysfonction rénale a été mise en évidence. Néanmoins nous avons pu démontrer l’effet protecteur rénal de l’inhibiteur de l’enzyme de conversion de l’angiotensine lisinopril ainsi que d’un composé antioxydant, le bardoxolone. Notre seconde stratégie a consisté à infuser de l’angiotensine II (AngII) à des rats ZSF1. L’hypertension déjà existante dans ce modèle a été fortement accrue, et le niveau d’aldostérone circulante a été significativement augmenté. Dans ce contexte, les fonctions cardiaque et rénale ont été dégradées de manière importante. Enfin nous avons montré que dans ce modèle, un inhibiteur de l’aldostérone synthase induisait une meilleure protection rénale que l’antagoniste des récepteurs à l’aldostérone éplérénone. Nous avons donc mis en évidence que le rat ZSF1-AngII est un modèle de dysfonction cardio-rénale permettant d’évaluer l’effet protecteur de composés sur les fonctions rénale et cardiaque, dans un contexte de syndrome métabolique / In the context of metabolic syndrome, development of Type 2 Diabetes is associated with (and influenced by) cardiac and renal comorbidities linked to micro- and macro-vasculature alterations. To assess the efficacy of new compounds on targeted organs in the context of metabolic syndrome, the Zucker fatty/Spontaneously hypertensive heart failure F1 hybrid (ZSF1) rat model could be suitable assuming cardiorenal alterations would develop in a short timeframe. Actually, the ZSF1 rat model recapitulates features of human metabolic syndrome, but develops relatively late (1year-time) and moderate cardiac and renal dysfunctions. The aim of our work was to exacerbate cardiorenal impairments in terms of onset and extent. Two options were explored. On one hand, unilateral nephrectomy was performed in ZSF1 rats, and cardiac and renal functions were longitudinally assessed. This surgical insult only significantly deteriorated renal function, which was prevented by standard of care, lisinopril and new renal protective agent, bardoxolone. On the other hand, subcutaneous infusion of angiotensin II (AngII) was used in the aim to induce hemodynamic and hormonal stress and thus to enhance cardiorenal impairments. AngII-infused ZSF1 rats displayed significant hypertension and increased levels of circulating aldosterone. Moreover, renal and cardiac functions dropped, concomitantly. We showed in this model that an aldosterone synthase inhibitor induced overall better renal protection than the mineralocorticoid receptor antagonist eplerenone. Our data showed that ZSF1-AngII rat is a suitable model to evaluate the cardio and renoprotective effects of drugs in the context of metabolic syndrome

No description available.

O objetivo é caracterizar a voz e vibração glótica de pregas vocais com paralisia unilateral. Método: trata-se de um estudo retrospectivo que utilizou o banco de dados do grupo de pesquisa em engenharia médica da Universidade Federal de São Carlos. Foram utilizados dados de 35 pacientes adultos (11 homens e 24 mulheres) e cinco instrumentos de análise multidimensional. O primeiro deles foi o protocolo de auto-avaliação (Índice de Desvantagem Vocal - IDV). Foram extraídos os escores de domínio: físico, orgânico, emocional e total. Foram utilizados sinais de voz para realizar as análises: perceptivo-auditiva (escala analógica visual - EVA e parâmetros: grau global - G, rugosidade - R, soprosidade - S, tensão - T e Instabilidade na emissão vocal - I); acústica tradicional (parâmetros de perturbação - Jitter e Shimmer), experimental (parâmetro Coaptação Glótica - CG) e a análise não linear (NL) da dinâmica vocal (parâmetros qualitativos: número de loops, graus de convergência e regularidade; e quantitativos: desvio padrão do eixo e da dispersão - DPE, DPD). A quinta análise utilizou quimografias geradas de videolaringoscopias em alta velocidade para extração de parâmetros quantitativos (Razão de Abertura - RA, de Fechamento - RF e Assimetria). Análise estatística: descritiva e correlação de Spearman. Resultados: A análise perceptiva caracterizou intensidade moderada do desvio vocal. A rugosidade foi o tipo de voz predominante em amostras masculinas (55,84%) e a soprosidade em amostras femininas (63,59%). Os domínios de IDV apresentaram baixo impacto da disfonia na qualidade de vida dos pacientes. Houve correlação do domínio físico com S em amostras masculinas e com todos os parâmetros perceptivos em amostras femininas. Ambas as amostras apresentaram parâmetros de perturbação aumentados (Jitter: 0,90% homens e 1,20% mulheres; Shimmer: 3,30% homens e 2,76% mulheres), e de CG diminuídos (0,28 homens e 0,25 mulheres). Amostras femininas apresentaram correlação de Jitter e Shimmer com os parâmetros perceptivos. Amostras masculinas apresentaram correlação de Jitter com R e de Shimmer com R e T. A CG correlacionou com a S e l em amostras masculinas. Na análise NL da dinâmica vocal de ambas as amostras apresentaram reduzidos: número de loops, grau de convergência e de regularidade, enquanto que os valores de DPE e DPD apresentaram-se aumentados. Houve correlação de parâmetros perceptuais com os da análise NL em ambas as amostras. Os resultados de parâmetros quimográficos são: RA 1,55 para homens e 1,50 para mulheres; RF 0,37 para homens e 0,18 para mulheres; e Assimetria: 23,68º para homens e 9, 85º para mulheres. Todos os parâmetros perceptuais femininos correlacionaram com os quimográficos, exceto a I. A I de amostras masculinas correlacionou com RF. Conclusão: a caracterização vocal de pacientes com paralisia unilateral de pregas vocais foi possível usando a avaliação multidimensional da voz. / The goal is to characterize the voice and glottal vibration of patients with unilateral vocal fold paralysis. Method: this is a retrospective study that used database samples of Universidade de São Carlos\'s research group in medical engineering. Data from 35 adults patients (11 men and 24 women) and five were used. They were used five tools for multidimensional analysis. The first one was the self-assessment protocol (Voice Handicap Index - VHI). Physical, organic, emotional and total scores were extracted. Voice signals were used in analyzes: perceptual (visual analogue scale - VAS and parameters: overall degrees - G, roughness - R, Breathiness - B, tension - T and instability in phonation - I); traditional acoustic (perturbation parameters - Jitter and Shimmer), experimental (glottal cloure parameter - GC) and nonlinear (NL) dynamic vocal analysis (Qualitative: number of loops, regularity and convergence degree. Quantitative: standard deviation of dispersion - SDD and standard deviation of the axis - SDA). The fifth analysis it was performed through extraction of kymographic parameters generated of the High speed videolaryngoscopys (Opening reason - Or; Closed reason - Cr and Asymmetry). Statistical analysis: descriptive and Spearman correlation. Results: perceptual analysis characterized moderate intensity of vocal deviation. Roughness was the predominant kind of voice in males samples (55,84%) and Breathiness in females samples (63,59%). VHI\'s scores showed low impact of dysphonia in the patients\' quality of life. There was correlation between score physical and B in the male samples and between score physical and all perceptual parameters in the female samples. Both samples showed increased of perturbation parameters (Jitter: 0.90% men and 1.20% women and Shimmer: 3.30% men and 2.76% women) and GC decreased (0.28 men and women 0.25). Female samples showed correlation of Jitter and Shimmer with all perceptual parameters. Male samples showed correlation of Jitter with the R and Shimmer with R and T. GC correlation with B and I only male samples. Qualitative NL dynamic vocal analysis showed number of loops, regularity and convergence degree reduced, whereas quantitative analysis of SDD and SDA increased. There were correlations between perceptual parameters and of nonlinear dynamic vocal analysis for both the samples. Results of Kymographic parameters are Or: 1.55 for men and 1.50 for women; Cr: 0.37 for men and 0.18 for women; and Asymmetry: 23.68º for men and 9.85º for women. All perceptual parameters correlate with Or and Cr at female samples, except I. Male samples showed correlation between I and Cr. Conclusion: the vocal characterization of patients with unilateral vocal fold paralysis was possible using the multidimensional voice assessment.