Made available in DSpace on 2016-03-15T19:33:59Z (GMT). No. of bitstreams: 1 Ana Cristina Sathler de Queiroz Vilar.pdf: 802114 bytes, checksum: a4813d63baf1b16f04764deddd53fb84 (MD5) Previous issue date: 2013-08-21 / This paper aims to analyze the phenomenon of the "tax war" under ICMS taxation can harm free competition, because the matched competition can easily be distorced by unilateral granting of tax incentives. Introducing the study of the subject we have government economy intervention through taxation, which is currently a powerful instrument of intervention and not only a source of funding. The taxation to do so, should conform to limits, of which the principle of Free- Enterprise and Free-Competition, guiding the exercise of the competence. Below we discuss the principle of Free-Competition and unilateral granting of tax incentives. At this point of the work shows the importance of article 146-A of the Constitution to the subject, allowing the creation of special tax criteria to prevent disturbances of competition, as well as shows what is the position adopted by the STF against the granting of incentives unilateral tax. Following, going more specifically into the phenomenon of tax war and the unilateral granting of tax incentives under ICMS and its consequences for competition. Approach the need for effective protection of free competition against the "tax war", discussing the actions of the CADE, the antitrust agency in Brazil, to minimize the anticompetitive consequences of the tax war. Finally, we present the conclusions, with criticism directed to the states that use of the autonomy constitutionally assigned them, to grant unilateral tax incentives denying legal principles for being granted. We point out the suggestion largest power of competence to CADE to act with the companies that are benefiting from the exemptions granted unilaterally harming local markets, as the CADE has no power to punish the unfair competition among states. / Este trabalho tem como objetivo analisar como o fenômeno da guerra fiscal no âmbito do ICMS pode prejudicar a Livre Concorrência, vez que a igualdade de competição pode facilmente ser falseada por meio da concessão dos incentivos fiscais unilaterais. Introduzindo o estudo do tema tratamos da intervenção do Estado sobre o domínio econômico por meio da tributação, que passou a servir de potente instrumento de intervenção deixando de figurar como mera forma de custeio. A utilização da tributação, para tanto, deve obedecer a limites, dentre os quais o princípio da Livre Iniciativa e da Livre Concorrência, delineadores do exercicio da competência tributaria. A seguir, abordamos o princípio da Livre Concorrência e a concessão dos incentivos fiscais unilaterais. Neste tópico do trabalho, demonstramos a importância do artigo 146-A da Constituição Federal para o tema, permitindo a criação de critérios especiais de tributação para prevenir distúrbios da concorrência, além de demonstrar qual é a posição adotada pelo Superior Tribunal Federal quanto à concessão dos incentivos fiscais unilaterais. Seguimos, adentrando mais especificamente na abordagem sobre o fenômeno da guerra fiscal , a concessão dos incentivos fiscais unilaterais no âmbito do ICMS e seus reflexos para a concorrência. Discutimos ainda a necessidade de efetiva defesa da concorrência frente à guerra fiscal , discutindo as ações do CADE, órgão de defesa da concorrência no Brasil, para minimizar os reflexos anticoncorrenciais da guerra fiscal . Por fim, apresentamos as conclusões, com críticas aos Estados que se utilizam da autonomia que lhes fora atribuída constitucionalmente para conceder incentivos fiscais unilateralmente, ou seja, sem observância dos preceitos legais necessários a sua concessão. Além disso, apontamos como sugestão, maior atribuição de competência ao CADE para intervir junto às empresas que se beneficiam das isenções concedidas e prejudicam os mercados locais, já que o órgão não possui competência para punir a concorrencia desleal dos Estados.

Submitted by Filipe dos Santos (fsantos@pucsp.br) on 2018-02-16T19:31:06Z No. of bitstreams: 1 Andrea Cristina Zanetti.pdf: 2439766 bytes, checksum: 481dd19f7c3daf7c408724a6245a0a23 (MD5) / Made available in DSpace on 2018-02-16T19:31:06Z (GMT). No. of bitstreams: 1 Andrea Cristina Zanetti.pdf: 2439766 bytes, checksum: 481dd19f7c3daf7c408724a6245a0a23 (MD5) Previous issue date: 2018-02-05 / Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq / The purposes of this work is understanding the role of termination without cause in long-term contracts and contracts for an indefinite term, as well as their current limits, which are established in particular by the principle of good faith. To such end, in order to direct and deepen the topic, our approach focuses specifically on private healthcare contracts, a contract subject to term that exemplifies the complexity of current contractual relations and demonstrates the process of fragmentation of private law in different microsystems, which also impacts on unilateral notice as a form of termination of the contractual relationship and a kind of unilateral termination for convenience. Generally, in the perspective of unilateral termination without cause, the operability of good faith allows its control to occur in two distinct moments: upon controlling the contractual content (providing guidelines for or restricting unilateral termination) and upon controlling actual exercise of the right (by means of the observance of certain obligations, respect to codes of conduct and repression of the undue, disproportionate and illegitimate use of this form of extinction of the contract). These controls and their consequences are what may result in the invalidity of the contractual provision, the right to indemnification and even in maintaining or extending the effectiveness of the contract. This demonstrates the current dimension attributed to good faith in the control of unilateral termination, which is gradually intensified depending on the contractual microsystem involved and whether it is a business or existential (essential) contract. In view of this new perspective, the issue of unilateral termination in contracts governed by the microlegal framework of Law 9,656/1998 (Health Plans Act) is presented from the perspective of the speciality and essentiality of its contractual object, which influence the operability of good faith and requires acknowledgment of the microsystem in which it is inserted, and which also needs to relate to the other subsystems that form Private Law, in a coherent and systematic interpretation in the search for possible solutions to the issue, mainly due to the fact that the aforementioned law does not clearly deal with this form of termination regarding the different parties involved in private healthcare contracts / Este trabalho tem por finalidade compreender o papel da denúncia desmotivada nos contratos por tempo indeterminado e de longa duração, bem como seus atuais limites, dados especialmente pela boa-fé objetiva. Para tanto, aborda especificamente os contratos privados de assistência à saúde, por se tratar de um contrato de duração que exemplifica a complexidade das relações contratuais atuais e que demonstra o processo de fragmentação do direito privado em diferentes microssistemas, o que também impacta na denúncia como forma de cessação da relação contratual e espécie de resilição unilateral. De maneira geral, a operabilidade da boa-fé, na perspectiva da denúncia desmotivada, permite que seu controle ocorra em dois momentos distintos: controle do conteúdo contratual (com o direcionamento ou restrição da cláusula de denúncia); e controle de exercício (que ocorre mediante a observância de determinadas obrigações, respeito a deveres de conduta e combate ao uso desvirtuado, desproporcional e ilegítimo dessa forma de extinção do contrato). São esses controles e suas consequências que podem resultar na invalidade da disposição contratual, no direito à indenização e até mesmo na manutenção ou extensão da eficácia do contrato, demonstrando as dimensões atuais que a boa-fé alcança no controle da denúncia e que se intensificam gradualmente, conforme o microssistema contratual e segundo se trate de um contrato empresarial ou existencial (essencial). Diante dessa nova perspectiva, a questão da denúncia nos contratos regidos pelo micro-ordenamento da Lei no 9.656/1998 (Lei dos Planos de Saúde) é apresentada por meio da especialidade e essencialidade de seu objeto contratual, o que influencia na operabilidade da boa-fé e demanda o reconhecimento do microssistema em que está inserido, o qual também necessita se relacionar com outros subsistemas que compõem o Direito Privado, em uma interpretação coerente e sistemática na busca de possíveis soluções para a temática, sobretudo pelo fato de a referida lei não tratar com clareza dessa forma extintiva para as diferentes partes que compõem os contratos privados de assistência à saúde

At any given time, 3-9% of the general population experiences a voice problem. The incidence of voice disorders in children can vary anywhere between 6 and 23%, yet, only 2-4% of the population are seen by speech-language pathologists for further assessment and treatment. Voice disorders have negative effects on the social, emotional, and physical functioning of the child. Unfortunately, there is little known about the appropriate management of children with voice disorders. Depending on the nature of the voice disorder, different approaches, including behavioral voice therapy, vocal hygiene management, or medical intervention, are available. However, a concern with behavioral voice therapy is the ability of the child to transfer skills learned in clinic to an outside setting - limiting generalization and adaptation of the new behavioral approach. Biofeedback has been successfully used in adults with voice disorders to help generalize new vocal behaviors. Such data is lacking in the treatment of voice problems in the pediatric population. The current case study aimed to understand the use of biofeedback in an eight-year-old male who was diagnosed with a unilateral vocal fold lesion, who exhibited difficulty maintaining and generalizing his new vocal behaviors. It was hypothesized that the child would benefit from biofeedback and would maintain new vocal behaviors including the use of a safe and efficient voice pattern outside the clinic setting. Longitudinal data on vocal parameters including the pitch, loudness, and vocal fold vibration were obtained over a period of five weeks using an ambulation phonation monitor (APM). The APM uses an accelerometer attached to the sternal notch and measures pitch, loudness, and vocal fold vibration, which helps determine an individual’s daily voice use pattern and thereby determines the appropriate biofeedback setting. The five week period included (a) a week of pretesting, (b) two weeks of biofeedback, (c) a week of post-testing immediately following the week of biofeedback, and (d) a generalization testing two months post-study. During the five-week period, vocal parameters were monitored for an average of 7- 10 hours for 2-3 days each week. On weeks two and three, the child was provided with biofeedback on loudness levels based on his data from the pretesting week. Results indicated change in vocal parameters including loudness and vocal fold vibration patterns during the weeks of biofeedback. However, such generalization was not observed neither during immediate post feedback monitoring nor two months following the study protocol. Such data provide immediate effects from biofeedback on vocal behavior, however, motor learning principles, dose, and frequency of biofeedback will be discussed to further understand the long-term effects of biofeedback in children with voice problems.

Bone conduction transmission and head‐shadow effects were determined with transcranial completely‐in‐the‐canal (TCCIC) CROS hearing aids. Five subjects with documented profound unilateral hearing loss and experience with traditional CROS/BICROS fittings (TCROS) were tested with a CIC hearing aid placed in their poorer ear. Peak SPL was measured at the tympanic membrane and ranged from 105–115 dB SPL at 2000 Hz. Pure‐tone crossover thresholds and functional gain tested at frequencies from 250–8000 Hz varied considerably more than the SPL measures. The pure‐tone results indicated that sensitivity in the better ear was moderately associated with functional gain across frequency. Speech recognition was then tested in the sound field in two conditions: direct (noise in the poorer ear, speech in the better ear) and indirect (noise in the better ear, speech in the poorer ear) at S/Ns of −6, 0, +6, +12, and quiet. The TCCIC fittings were more effective than TCROS aids across S/Ns, particularly in the direct condition. In the indirect condition, the two fittings performed similarly. When data were pooled across conditions, the TCCIC aids provided better word recognition than the TCROS aids, particularly for those subjects with greater sensitivity in the better ear.

Tesis (Magíster de Derecho de Familia (s) y Derecho de la Infancia y de la Adolescencia / Actividad formativa equivalente a tesis (AFET)

Dans la littérature, les résultats, dans le domaine de la rééducation neurologique des patients hémiplégiques, montraient que la performance motrice du membre atteint était améliorée lorsque les deux membres homolatéraux étaient mobilisés dans des mouvements symétriques. Il a alors été suggéré que le système nerveux avait plus de facilité à adapter une commande bilatérale symétrique, qu’une commande bilatérale asymétrique.L’objet des travaux dans cette thèse est de tester la généralité de ces résultats dans le cas du processus d’initiation de la marche (IM). Le handicap est simulé par une hypomobilité de la cheville, induite avec strapping et orthèse unilatéralement ou bilatéralement. Les résultats montrent que, dès la présence d’une contrainte, la biomécanique et les activités électromyographiques, des phases de préparation posturale et d’exécution du processus d’IM, sont modifiées. De plus, la performance motrice est également perturbée. Toutefois, il apparaît des différences « locales » selon où s'applique la contrainte. Un résultat est à souligner tout particulièrement : comme pour les patients hémi-handicapés, la performance motrice (i.e. vitesse du centre des masses à la fin du premier pas) est supérieure dans la condition « contrainte bilatérale i.e. hypomobilité des deux chevilles » versus « contrainte unilatérale i.e. hypomobilité du pied d’appui ». L’ensemble des résultats est discuté dans le cadre des processus d’adaptation de la commande motrice face aux contraintes biomécaniques unilatérales et bilatérales induites sur les appuis. En d'autres termes, tout se passe comme si un rééquilibrage des capacités fonctionnelles s’opère, permettant ainsi de générer une meilleure performance motrice. Enfin, les résultats permettent d’envisager des perspectives dans le domaine de la rééducation fonctionnelle. / In the literature, the rehabilitation of hemiplegic patients showed that motor performance of the affected limb is improved when both limbs are mobilised in a symmetrical movement. It has been suggested that it was easier for the nervous system to adapt to symmetrical bilateral command. The aim of this dissertation is to test the validity of these results in gait initiation (GI). Handicap was simulated by means of blocking the ankle unilaterally or bilaterally with a strap or orthosis.Results showed that in the presence of a constraint, electromyographic activity and the kinematics of both postural preparation and step execution phase of GI declined. Furthermore, the motor performance was also perturbed.However, « Local » differences appeared according to the localisation of the constraint, reflecting the adaptation of the motor command. Nonetheless, a result needs to be particularly underlying.Like in hemi-handicapped patients, the motor performance (i.e. centre of mass velocity at the end of the first step) was higher in « bilateral constraint, hypomobility on both ankles » versus « unilateral constraint, hypomobility on stance ankle ».In the dissertation, the results are discussed in terms of the adaptation of the motor command of unilateral and bilateral induced biomechanical constraint. More specifically, we discuss how rebalancing the functional capacity of both legs should allow to increase motor performance. These results put forward new perspectives in the domain of functional rehabilitation.

En droit colombien, face à une inexécution contractuelle, règne la règle, issue du droit français, de la résolution judiciaire. Ses conditions d’exercice ont été précisées par la doctrine et la jurisprudence, non sans de nombreuses ambiguïtés qui résultent de la difficulté de comprendre et de mettre en pratique ce procédé. Face à cette vision traditionnelle, l’unilatéralisme a fait irruption dans le monde contractuel contemporain et, plus concrètement, la possibilité de mettre fin à un contrat de manière unilatérale en cas d’inexécution. Cette tendance, qui trouve ses origines dans le droit anglo-saxon avant d’avoir pénétré le droit des pays de tradition romano-germanique, prétend revitaliser cette phase critique du contrat en évitant le recours au juge, au moins dans un premier moment, permettant que le créancier remédie à l’inexécution en mettant rapidement fin au contrat afin de rechercher sur le marché des solutions efficaces. Cette règle pourrait-elle être retenue en droit colombien ? En dépit de l’apparent monopole qu’y détient la résolution judiciaire, tant le Code civil que le Code de commerce colombiens, prévoient des hypothèses qui reconnaissent cette possibilité. Par ailleurs, plus récemment, a été acceptée la possibilité de convenir de clauses résolutoires. Ainsi, nous considérons qu’il est possible d’accepter la généralisation d’une règle de rupture unilatérale pour inexécution. À cet égard, l’étude du droit comparé s’agissant de l’inexécution ouvrant la voie à une rupture du contrat, d’une part, et de la manière dont elle s’exerce une rupture en cas d’inexécution, d’autre part, est d’un grand intérêt. Une telle analyse nourrit une proposition qui non seulement fournit des éléments en vue de l’admission de la rupture unilatérale du contrat pour inexécution en droit colombien, mais aussi cherche à éclairer la lecture qui a, jusqu’à présent, prévalu en matière d’inexécution résolutoire. / Under the Colombian law, the general rule in case of breach of contract is that of termination as a consequence of a court order. Its conditions of exercise have been the object of development by the doctrine and case law, not without several issues that make difficult to understand and put into practice such category. In contrast with this traditional vision, unilateralism breaks in the contemporary contractual world and more specifically, the possibility of termination of contract in such a unilateral way in case of a breach. This trend has its roots in Common law and has been permeating the countries of Roman-Germanic law tradition; and it aims to grant vitality to that critical contractual phase, thus avoiding the intervention of the judge, at least as a first measure, allowing the creditor to remedy the consequences of the breach of contract by an early termination in order to seek effective solutions in the marketplace. Could this rule have a place in Colombian law? Despite the seemingly apparent monopoly of judicial termination of contract, both the civil code and the code of commerce acknowledge this as a possibility. Similarly, more recently the possibility of including termination clauses has been accepted. However, we hold that it is possible to accept a generalization of the rule of unilateral termination of contract in case of breach. A study of comparative law regarding the breach that results in contract termination and the analysis on the way this prerogative should be exercised are of great importance; it does not only enriches a proposal providing the parameters for the unilateral termination of a contract when a breach arises in Colombian Law, but also clarifies the understanding that until now exists in the matter of termination for non-performance.

The human vestibulo-ocular reflex (VOR) stabilizes gaze during head movement. The reflex is typically tested in a clinic or laboratory using passive rotations or artificial stimuli which measure the amount of damage the vestibular apparatus has suffered. However, during everyday activities the vestibular system is stimulated by active, self generated head movements. Head movements are often rapid and associated with the goal of achieving either gaze-fixation or re-fixation. Patients who complain of on-going symptoms will typically identify a particular position or movement that aggravates their symptoms in their everyday life. There is a need to identify objective parameters which correlate with the subjective complaints of patients whose symptoms persist after vestibular damage. In the first study, a gaze-refixation task, patients who complain of ongoing symptoms (poorly-compensated), during rapid head turns, after unilateral vestibular de-afferentation (uVD) were compared with those who did not have the same complaints (well-compensated) and normal subjects. Well- and poorly-compensated groups were sorted according to responses on a standardized questionnaire. All subjects were then located in a real-world, non-laboratory environment in which poorly-compensated subjects reported experiencing symptoms. Each subject’s head, eye and gaze displacement and velocity, head rotation frequency and blink or eye-lid closure were measured and analysed and compared between ipsi- and contra-lesional head rotations within and between subject groups. When subjects are able to generate their own active head rotations it has been suggested that a number of vestibular and extra-vestibular strategies might be employed to compensate for an impaired VOR. In subsequent studies, high resolution scleral search coils were used to identify the compensatory mechanisms used during active head rotations during a gaze-fixation task. A corrective saccade is typically observed during passive ipsilesional head rotations or “impulses” and might be potentiated during rapid, active or self-generated head rotations. The conditions which predict or contribute to the generation of the rapid, corrective eye movement were investigated. The results were compared with responses to passive head impulses of matched velocity and acceleration to determine if active head impulses could be used to identify a lesioned vestibular apparatus as is routinely clinically achieved with passive head impulses.

Unilateral cleft lip and palate (UCLP) is a craniofacial malformation with functional and aesthetical impact on the face and the upper airways. The aims of the current thesis were to evaluate Quality of life (QoL) in adults treated for UCLP  (I), to objectively evaluate nasal form and function and to search for possible differences in residual nasal deformity and impairment of function between patients operated according to one-stage and two-stage palate closure (II) as well as to evaluate the relationship between professional and lay rating and patient satisfaction with nasolabial appearance (III) and to identify factors associated with lower levels of QoL and less satisfaction with nasal appearance among adults treated for UCLP (IV). Analyses of data from a homogenous population of UCLP patients treated at Uppsala University Hospital form the basis of this thesis. The mean follow-up time after primary surgery was 35 years (20-47 years) and participation rate was 79% (n=86). An age and gender matched control group of 68 people without clefts were evaluated according to the same protocol. The evaluation protocol included the Short Form 36 questionnaire (SF-36), rhinomanometry, acoustic rhinometry, odor test, peak nasal inspiratory flow test and photographies of faces. For the SF-36 data, age- and gender-matched norm data of 1385 people from the Swedish population were used. Unilateral cleft lip and palate affected QoL differently depending on gender and age of the patient. Younger patients were affected more negatively than older patients in several subscales. However, except for lower values in the Mental Health subscale, QoL was similar among UCLP patients and norm data. Objectively measured nasal function was extensively affected among adults treated for UCLP. No difference in impairment of nasal function was found between one-stage and two-stage palate closure protocols on the cleft side. Judgment of nasolabial appearance differed between professionals, lay people and patients. Large infant cleft width was associated with less satisfaction with nasal appearance and male gender was associated with lower levels of mental QoL. Correlation between high nasal breathing resistance and low levels of physical QoL was found. In conclusion, this thesis provides a platform for future research for optimal evaluation of cleft treatment outcome.

Läpp-, käk och gomspalt (LKG) kan medföra svårigheter med tal, artikulation och röst. Enligt tidigare forskning har vuxna individer behandlade för LKG liknande förekomst av röstavvikelser som kontrollpersoner utan spalt. Syftet med denna studie var att undersöka grad av röstavvikelser hos vuxna patienter behandlade för enkelsidig LKG och kartlägga eventuella samband mellan röstavvikelser och kirurgiska metoder för gomslutning, kön och operation med eller utan svalglambå samt jämföra röstresultat med data från individer utan LKG. Sjuttio patienter behandlade för enkelsidig genomgående LKG deltog i studien, varav 45 patienter hade opererats med gomslutning i en seans och 25 patienter hade opererats i två seanser. Elva av patienterna i patientgruppen hade genomgått svalglambåoperation. I studien ingick även en åldersmatchad kontrollgrupp med 63 individer utan LKG. Röstinspelningar utvärderades med perceptuell röstbedömning med Stockholm Voice Evaluation Approach (SVEA) av två erfarna logopeder. Skattning skedde individuellt av randomiserade och blindade inspelningar. Inter- och intrabedömarreliabilitet beräknades. Grad av avvikelse i röstkvalité var ca. 5/100 i patientgrupp och kontrollgrupp vilket är lägre jämfört med tidigare studier. “Knarr” fanns lägre i patientgruppen i jämförelse med kontrollgrupp. Skattningar av övriga röstparametrar skiljde sig inte mellan patientgrupp och kontrollgrupp. Patienter opererade med gomslutning i en eller två seanser hade inga skillnader i röstparametrar. Enstaka små skillnader fanns mellan könen. Ingen skillnad fanns mellan patienter som genomgått svalglambåoperation och de som inte gjort det. / Cleft lip and palate (CLP) may cause impairments in speech, articulation and voice. Treatment of patients with CLP include different types of palatoplasty. Recent studies have found a comparable prevalence rate of dysphonia in adult patients treated for CLP and controls without cleft. The purpose of this study was to investigate the rate of dysphonic deviation in adult patients treated for unilateral CLP and determine, if any, the relationship between voice quality outcome and differences in surgical procedures, gender, palatoplasty with or without pharyngeal flap surgery and compare the voice characteristics with age related normative data. Seventy patients treated for unilateral CLP with one- or two-stage palatoplasty participated in this study, of which 45 patientshad undergone one-stage palatoplasty and 25 patients two-stage palatoplasty. Eleven ofthe patients had also undergone pharyngeal flap surgery. Data from an age matched non-cleft group consisted of 63 participants. Sound recordings of participants' voices were perceptually assessed by two speech-language pathologists. Individual ratings of randomized and blinded sound recordings were performed. Inter- and intra-raterreliability was calculated. The study showed a lower degree of dysphonia in patients treated for unilateral CLP than earlier studies. Among patients treated for unilateral CLP and the non-cleft group, a degree of approximately 5/100 voice quality deviation was found. ”Vocal fry” was found significantly lower in patients treated for CLP than the non-cleft group. Measures of voice parameters did not differ significantly between patients and non-cleft groups. Patients that had undergone palatoplasty in one or two stages showed no significant differences in voice parameters. Minor statistical significance was found in a few of the measured voice parameters as related to gender. Between patients that had undergone pharyngeal flap surgery and those that had not no differences were found.