Journal articles on the topic 'Handicap trajectory'

This study compared the differences in the putter trajectory and psychophysiological variables of winners and losers in a competitive putting game that targeted professional and amateur golfers under stress. Eight professional golfers (handicap: [Formula: see text]) and eight amateur golfers (handicap: [Formula: see text]) participated. To maximize the tension of the competition, the putting game was held in a single-elimination one-on-one knockout tournament with a single 2.1[Formula: see text]m putting competition for each group. In the case of a hole-in or a failure by both golfers, the game resumed until the winner was determined. To compare the golfers during the game, the maximum speed, moving length, and amplitude of the putter head during the back-swing and the follow-through were set as the motion variables; and psychological variables (heart rate, heart rate variability (HRV), and Competitive State Anxiety Inventory-2 (CSAI-2)) were analyzed. The results showed significant differences between the putter trajectory variables (maximum velocity and amplitude of the putter head during follow-through) of the groups, but no differences in the psychophysiological variables. In comparing winners and losers within each group, however, the professional group showed a difference in only the psychophysiological variables (HRV and self-confidence of CSAI-2), whereas the amateur group showed a difference in only one putter trajectory variable (follow-through length). It was quantitatively confirmed that factors that determine the outcome of the game differed at a technical level.

Objectives: We evaluated associations between changes in dental anxiety and oral health-related quality of life (OHRQoL) in parents of the FinnBrain Birth Cohort Study. Methods: Two-year dental anxiety trajectories measured with Modified Dental Anxiety Scale from gestational weeks (gw) 14 and 34, and 3 and 24 months after birth were used. OHRQoL was measured with the Oral Health Impact Profile 14-item questionnaire at gw34 and 4 years. Changes in the OHRQoL sum and dimension scores according to dental anxiety trajectories were analyzed with the Jonckheere–Terpstra test separately for mothers (n = 998) and fathers (n = 513). Results: Overall, OHRQoL decreased in all dental anxiety trajectory groups except the High decreasing group in mothers, and in the Stable high group in fathers. The decline in the overall OHRQoL was greatest in the Stable high trajectory group for both parents. In fathers, OHRQoL increased considerably but not statistically significantly in the High decreasing trajectory group. The changes in OHRQoL dimensions Psychological discomfort and Handicap differed according to dental anxiety trajectories for both of mothers and fathers, and also for the dimension Psychological disability for mothers. Conclusions: These findings highlight the need for targeted interventions in treating high dental anxiety and in preventing the increase in dental anxiety to improve oral health outcomes such as OHRQoL.

Proprioceptive cervicogenic dizziness (PCGD) is the most prevalent subcategory of cervicogenic dizziness. There is considerable confusion regarding this clinical syndrome’s differential diagnosis, evaluation, and treatment strategy. Our objectives were to conduct a systematic search to map out characteristics of the literature and of potential subpopulations of PCGD, and to classify accordingly the knowledge contained in the literature regarding interventions, outcomes and diagnosis. A Joanna Briggs Institute methodology-informed scoping review of the French, English, Spanish, Portuguese and Italian literature from January 2000 to June 2021 was undertaken on PsycInfo, Medline (Ovid), Embase (Ovid), All EBM Reviews (Ovid), CINAHL (Ebsco), Web of Science and Scopus databases. All pertinent randomized control trials, case studies, literature reviews, meta-analyses, and observational studies were retrieved. Evidence-charting methods were executed by two independent researchers at each stage of the scoping review. The search yielded 156 articles. Based on the potential etiology of the clinical syndrome, the analysis identified four main subpopulations of PCGD: chronic cervicalgia, traumatic, degenerative cervical disease, and occupational. The three most commonly occurring differential diagnosis categories are central causes, benign paroxysmal positional vertigo and otologic pathologies. The four most cited measures of change were the dizziness handicap inventory, visual analog scale for neck pain, cervical range of motion, and posturography. Across subpopulations, exercise therapy and manual therapy are the most commonly encountered interventions in the literature. PCGD patients have heterogeneous etiologies which can impact their care trajectory. Adapted care trajectories should be used for the different subpopulations by optimizing differential diagnosis, treatment, and evaluation of outcomes.

The object of research is the shaping of a family of displacement curves used in designing the path of a tool that processes pocket surfaces. The subject of the study is the working displacement curves in the case of multiply connected areas. Working displacement curves are lines from which non-working sections have been removed. Non-working areas include self-intersecting loops of displacement curves and sections formed when intersecting displacement curves of opposing fronts. The paper presents methods for analyzing and cutting off non-working sections for cases of self-intersection and intersection of displacement curves of opposing fronts. The spatial geometric model of the formation of displacement curves is based on the cyclographic method of displaying space. As a tool for detecting non-working areas for the case of opposing fronts, a method of a testing beam is proposed. In the case of self-intersections of the displacement curves, non-working sections are cut off by the parameter of these lines at the points of self-intersection. The novelty of the study lies in the fact that the obtained mathematical model of the formation of displacement curves for multiply connected regions with contours of complex handicap curves makes it possible to obtain parametric equations of working lines at the output of the computational algorithm in a more reliable and simple way. This greatly simplifies the solution to the problem of automated design of the trajectory of the cutting tool. A comparative assessment of the proposed method of shaping a family of displacement curves with cutting off non-working sections and known methods using the distance function is performed.

Background Hearing aid (HA) use is known to improve health outcomes for people with hearing loss. Despite that, HA use is suboptimal, and communication issues and hearing-related activity limitations and participation restrictions often remain. Web-based self-management communication programs may support people with hearing loss to effectively self-manage the impact of hearing loss in their daily lives. Objective The goal of the research is to examine the short- and long-term effects of a web-based self-management SUpport PRogram (SUPR) on communication strategy use (primary outcome) and a range of secondary outcomes for HA users aged 50 years and older. Methods Clients of 36 HA dispensing practices were randomized to SUPR (SUPR recipients; n=180 HA users) and 34 to care as usual (controls; n=163 HA users). SUPR recipients received a practical support booklet and online materials delivered via email over the course of their 6-month HA rehabilitation trajectory. They were encouraged to appoint a communication partner and were offered optional email contact with the HA dispensing practice. The online materials included 3 instruction videos on HA handling, 5 videos on communication strategies, and 3 testimonial videos. Care as usual included a HA fitting rehabilitation trajectory only. Measurements were carried out at baseline, immediately postintervention, 6 months postintervention, and 12 months postintervention. The primary outcome measure was self-reported use of communication strategies (3 subscales of the Communication Profile for the Hearing Impaired [CPHI]). Secondary outcome measures included self-reported personal adjustment to hearing loss (CPHI); use, satisfaction and benefit of HAs and SUPR (use questionnaire; International Outcome Inventory for Hearing Aids [IOI-HA], Alternative Interventions [IOI-AI]); recommendation of HA dispensing services; self-efficacy for HA handling (Measure of Audiologic Rehabilitation Self-Efficacy for Hearing Aids [MARS-HA]); readiness to act on hearing loss (University of Rhode Island Change Assessment adapted for hearing loss [URICA-HL]); and hearing disability (Amsterdam Inventory for Auditory Disability and Handicap [AIADH]). Results Linear mixed model analyses (intention to treat) showed no significant differences between the SUPR and control group in the course of communication strategy use (CPHI). Immediately postintervention, SUPR recipients showed significantly higher self-efficacy for advanced HA handling than the controls, which was sustained at 12 months (MARS-HA; mean difference immediately postintervention: 5.3, 95% CI 0.3 to 10.4; P=.04). Also, SUPR recipients showed significantly greater HA satisfaction than controls immediately postintervention (IOI-HA; 0.3, 95% CI 0.09 to 0.5; P=.006), which was sustained at 12 months, and significantly greater HA use than the controls immediately postintervention (IOI-HA; 0.3, 95% CI 0.02 to 0.5; P=.03), which was not sustained at 12 months. Conclusions This study provides ground to recommend adding SUPR to standard HA dispensing care, as long-term, modest improvements in HA outcomes were observed. Further research is needed to evaluate what adjustments to SUPR are needed to establish long-term effectiveness on outcomes in the psychosocial domain. Trial Registration ISRCTN77340339; http://www.isrctn.com/ISRCTN77340339 International Registered Report Identifier (IRRID) RR2-10.1136/bmjopen-2016-015012

Comme n’importe quel acteur social, les personnes âgées mettent en oeuvre diverses sortes de tactiques (on ne préjuge pas que leurs pratiques sont le fruit d’une élaboration consciente ou l’adaptation de routines) pour affronter les difficultés de la vie quotidienne. La diversité et la dispersion de ces pratiques s’expliquent en partie par la nature des problèmes auxquels elles sont confrontées aux différents moments de leur trajectoire. Trois sortes de problèmes importants structurent ces itinéraires : le changement provoqué par la fin de l’activité professionnelle ou familiale; la restriction des activités imposée par les déficiences ou handicaps; la dépendance physique ou morale. Autour des stratégies d’affrontement de ces problèmes, on peut élaborer un modèle simplifié des processus de vieillissement, à trois épisodes.

Entrer en institution, c’est prendre pied dans une véritable « machine à écrire » qui scrute les comportements, définit les déviances et ne cesse de produire de l’étrangeté. À partir du dossier confectionné dans une institution pour personnes handicapées pour un jeune homme d’origine populaire que nous appelons Sébastien, nous interrogeons la façon dont sa trajectoire individuelle est façonnée par des prises d’écriture qui l’objectivent et en font, lui et sa famille, des sujets de papier. Trois moments principaux, objets d’intenses pratiques d’écriture, sont approfondis : l’entrée, le maintien et la sortie de l’institution. Durant la première étape, le jeune homme et sa mère sont décrits comme des êtres étranges, uniquement perçus sous l’angle des défaillances et des incapacités ; durant la seconde, la demande maternelle du retour de l’enfant à son domicile est jugée impossible par les professionnels, qui se basent sur les capacités supposées limitées de la mère ; enfin, la sortie donne lieu à une transformation scripturale rapide de Sébastien, afin de le présenter comme le « bon » pensionnaire, répondant aux critères des institutions susceptibles de l’accueillir après sa majorité.

This paper deals with the design and the experiments of the upper part of the ROBIAN biped robot. The motivation of the ROBIAN project is related to the study of the human being locomotion system. The major application of ROBIAN prototype is the development of a real testing bed of active/passive prosthesis devices enhancing research on the human being locomotion mechanism handicaps. The analysis of the wrench six components exerted by the upper part of a virtual manikin on the locomotion apparatus leads to the identification of two coupling relations. Based on the dynamic equivalence concept between mechanisms, the ROBIAN torso mechanism is identified. This concept leads to a four degrees of freedom mechanism able to reproduce the dynamic effects of the upper limbs during the walking gait. The mechanism parameters are optimized with respect to several design criteria and constraints. Then the prototype is built and mounted on the ROBIAN locomotion apparatus through a six components force sensor. Experimental results presented in this paper validate the proposed approach. The experimental coupling coefficients are identified. The influence of the masses motion on the ZMP trajectory are also given, showing the effectiveness of the torso mechanism contribution during a walking gait.

Le vieillissement de la population représente un défi incontournable pour le Québec, en particulierpour les milieux ruraux, plus affectés par ce phénomène. L’objectif de cet article consiste à examiner la trajectoire évolutive du vieillissement au sein des localités rurales du Québec au cours de la période 1986-2016. Les résultats sont exposés à partir d’une analyse typologique à trois niveaux réunissant des localités qui présentent certaines affinités eu égard à l’évolution et à l’intensité du vieillissement. L’analyse est effectuée suivant une approche géographique et socioéconomique. Parmi les 62 localités rurales les plus enclines au vieillissement, la plupart présentent des signes de fragilité sur les plans démographique, géographique et économique, ce qui témoigne du caractère structurel des différents malaises auxquels elles font face. La combinaison de ces difficultés contribue à handicaper leur développement, en plus d’avoir des impacts négatifs sur leurs perspectives d’avenir, d’où la nécessité de mettre en place une politique d’aménagement du territoire et de développement régional qui va bien au-delà d’une stratégie tournée uniquement vers le vieillissement démographique.

Le lait n’est pas tout à fait un aliment comme les autres puisqu’il est aussi produit par l’Homme. Cet aliment est indispensable à l’alimentation de l’enfant, car sa richesse nutritionnelle combinée à sa forme liquide en font une ration « tout en un » du jeune pendant ses premières semaines de vie. L’homme a très tôt domestiqué d’autres mammifères pour produire cet aliment nécessaire pour le jeune et l’a aussi intégré dans l’alimentation de l’adulte sous forme native ou après transformation. De fait, le lait est un des rares produits animaux avec l’oeuf qui est produit régulièrement et qu’il est possible d’obtenir sans tuer l’animal. Sa production fait pleinement partie de la fonction de reproduction et son prélèvement doit être géré pour ne pas handicaper le développement du jeune animal qui est également un élément d’avenir dans l’élevage. Les vaches laitières ont longtemps bénéficié de noms très personnalisés, voire de prénoms, jusqu’à ce que la traçabilité ne vienne proposer des identifiants plus proches du matricule de la sécurité sociale que des petits noms affectueux utilisés jusqu’alors. La traite est un moment particulier où l’éleveur se substitue au jeune pour prélever le lait plusieurs fois par jour. Tout ceci fait traditionnellement de l’élevage laitier un élevage qui associe étroitement l’homme et l’animal. Au commencement de la domestication et pendant longtemps, le principal défaut du lait a résidé dans sa faible aptitude à la conservation, nécessitant une consommation plutôt locale, le temps entre production et consommation devant rester le plus court possible. De fait, le développement de sa consommation dans les villes est récent et ne s’est pas fait sans quelques soucis (Fanica 2008). Bien entendu, les évolutions de l’industrie laitière et des transports ont permis de franchir ce double cap de la conservation et des distances, faisant en quelques décennies d’un produit local du peuple d’un terroir, riche d’identité, d’histoire et de culture (Faye et al 2010), un produit générique du commerce mondial qui s’échange entre continents suivant les règles de l’organisation mondiale du commerce et dont la demande augmente régulièrement. Ce passage du local au mondial ne s’effectue pas sans des changements radicaux des modes de production et de l’organisation des filières, avec des conséquences parfois importantes sur les territoires. La production de lait en France, pays traditionnel d’élevage bovin laitier, illustre parfaitement cette évolution et se trouve aujourd’hui à une période charnière. Riche d’une grande diversité de terroirs et de produits, la production française présente un profil original dont on ne sait pas aujourd’hui si c’est une force ou une faiblesse dans cette évolution. Depuis 1984, le système des quotas laitiers liés à la terre et non commercialisables en France a ralenti, comparativement aux pays voisins, l’évolution vers une spécialisation et une intensification des systèmes de production laitiers, mais il disparaîtra en 2015. Le contexte économique des prix des matières premières et du prix du lait devient beaucoup plus instable que par le passé. Le métier d’éleveur laitier, avec sa complexité, sa charge de travail importante, ses astreintes et la diminution de sa rémunération, devient moins attractif. La nécessaire prise en compte de l’impact de l’élevage sur l’environnement et plus globalement de la durabilité, constitue un nouveau défi qui est souvent vécu comme une contrainte supplémentaire. Cependant, les connaissances scientifiques et technologiques ont beaucoup progressé et offrent de nouveaux outils à l’élevage laitier pour construire une trajectoire originale dans cette évolution. Ce numéro spécial d’INRA Productions Animales se propose donc en quelques articles de faire un état des lieux des connaissances concernant la production laitière, ainsi que des nouveaux défis et des nouveaux outils qui s’offrent à la filière pour construire son avenir. Ce panorama n’est volontairement pas exhaustif et traitera prioritairement des vaches laitières avec cependant, lorsqu’il est apparu nécessaire, quelques exemples tirés de travaux réalisés chez les caprins. De même, il ne s’agit pas ici d’aborder la transformation du lait et les évolutions des nombreux produits transformés. Mais nous avons cherché à présenter un point sur un certain nombre de sujets en mettant en avant les avancées récentes et les défis scientifiques, techniques, économiques et organisationnels qui concernent la production laitière, en quatre grandes parties. La première plantera tout d’abord le décor du secteur laitier français. La deuxième présentera les nouvelles avancées des travaux sur la femelle laitière, la lactation et le lait. La troisième analysera les différents leviers que constituent la sélection génétique, la gestion de la santé, l’alimentation et la traite, pour mieux maîtriser la production de lait en élevage. Enfin, la dernière partie abordera des questions plus spécifiques concernant les systèmes d’élevage et leur futur. Le premier article de V. Chatellier et al fournit une analyse à la fois du bilan et des perspectives du secteur laitier français. Après une analyse du marché des produits laitiers au travers de la demande et de l’offre et des grandes stratégies des acteurs de la filière, cet article présente les spécificités françaises des exploitations laitières liées en particulier à la diversité des systèmes de production et des territoires. Cette double diversité se traduit également dans les écarts de productivité et des résultats économiques des exploitations dont la main-d’oeuvre reste majoritairement familiale, avec la question de son renouvellement qui se pose différemment selon les territoires. Enfin, à l’aune des changements importants de contexte qui se préparent avec la fin des quotas et les nouvelles relations qui se mettent en place entre producteurs et transformateurs, les auteurs étudient les différents scénarios qui en découlent et qui conduiront à l’écriture du futur du secteur laitier français dans les territoires et le marché mondial. La série d’articles sur l’animal et le lait débute par une approche systémique de l’animal laitier. La vache laitière est d’abord perçue au travers de sa fonction de production, et les modèles de prévision de la lactation se sont longtemps focalisés sur cette seule fonction. La notion d’animaux plus robustes et d’élevages plus durables (cf. Dossier « Robustesse... », Sauvant et Perez 2010) amène à revisiter cet angle d’approche pour l’élargir à ensemble des fonctions physiologiques en prenant mieux en compte les interactions entre les génotypes animaux et leurs environnements. La modélisation aborde cette complexité de deux façons contrastées, l’une plutôt ascendante en partant des mécanismes élémentaires et en les agrégeant, l’autre plutôt descendante, en partant de grandes propriétés émergeantes des principales fonctions et de leurs interactions, voire de leur compétition dans l’accès aux ressources nutritionnelles. La revue de Friggens et al aborde ainsi la question de la dynamique de partition des nutriments entre fonction physiologiques chez les vaches laitières en fonction du génotype en présentant plusieurs approches de modélisation. Cette revue s’attache à montrer l’intérêt de partir des propriétés émergeantes pour arriver à modéliser les réponses complexes (production, reproduction, composition du lait, état corporel…) d’une vache soumise à différentes conduites d’élevage au cours de sa carrière. Les outils de demain qui permettront d’optimiser la conduited’élevage face aux aléas économiques et climatiques dépendront de l’avancée de ces modèles et des connaissances scientifiques qui les sous-tendent. La fonction de lactation est la conséquence de nombreux mécanismes à l’échelle de l’animal, tout particulièrement au niveau de la glande mammaire. Le développement et le fonctionnement de cet organe caractérisé par sa cyclicité ont fait l’objet de nombreux travaux à l’Inra et dans de nombreuses équipes de recherches internationales. Il ne s’agissait pas ici de relater l’ensemble de ces travaux mais de consacrer un article aux dernières connaissances acquises sur les mécanismes de biosynthèse et de sécrétion des constituants du lait. L’article de Leroux et al présente les travaux sur la régulation de l’expression génique dans la glande mammaire avec un intérêt particulier pour les données acquises avec les nouveaux outils d’études globales de génomique expressionnelle. Ceux-ci apportent de nouvelles connaissances sur les effets des facteurs génétiques sur la biosynthèse et la sécrétion du lait, sur leur régulation nutritionnelle et sur l’interaction de ces facteurs. Ce dernier point constitue un champ d’investigation supplémentaire pour décrypter les secrets du fonctionnement mammaire avec notamment l’intervention de nouveaux acteurs que sont les petits ARN non codants (ou microARN) qui vient encore accroître la complexité du fonctionnement mammaire dans son rôle prépondérant lors de la lactation. Après avoir fait cet état des lieux des connaissances sur la biosynthèse et la sécrétion des constituants du lait au niveau de la glande mammaire, l’article de Léonil et al présente la complexité des fractions protéique et lipidique du lait et de leur assemblage en structures supramoléculaires. Ces structures finales sont sous la dépendance de la nature et de la variabilité des constituants, ellesmêmes dues aux polymorphismes des gènes responsables de leur synthèse. Ainsi, les auteurs font un état des lieux des connaissances sur la structure et le polymorphisme des gènes spécifiant les protéines coagulables du lait que sont les caséines pour arriver à l’organisation de ces dernières en micelles. Le rôle nutritionnel de ces protéines majeures du lait et leur fonction biologique sont revisitées à la lumière des connaissances croissantes sur les peptides bioactifs qu’elles contiennent. La fraction lipidique n’est pas en reste avec la présentation de sa complexité et de son organisation sous forme de globule gras ainsi que de son impact nutritionnel sur le consommateur. Enfin, la découverte récente, dans le lait, de petites particules (ou exosomes) véhiculant des protéines et des ARN ouvre de nouvelle voies d’investigation de l’impact du lait sur la santé du consommateur. La série d’articles consacrée aux leviers d’action dont disposent les éleveurs pour moduler la production laitière ainsi que la composition du lait débute par l’article de Brochard et al, qui retrace l’impact de la sélection génétique pour arriver aux apports de la sélection génomique des races bovines laitières. Un bref historique de la sélection génétique présente les progrès réalisés sur les caractères de production laitière mais aussi sur des caractères de robustesse (fertilité, mammites…) et permet ainsi de dresser le décor génétique des élevages français. L’avènement des outils de génomique grâce au séquençage du génome bovin a conduit à renouveler les perspectives de sélection des bovins laitiers (cf. Numéro spécial, «amélioration génétique" Mulsant et al 2011). La présentation brève de ces outils permet de mieux appréhender les retombées attendues. Les opportunités offertes par la sélection génomique sur les caractères laitiers sensu stricto se complètent et permettent également de proposer une sélection sur de nouveaux caractères. En effet, la prise en compte progressive d’autres caractères oriente la sélection vers une complexité accrue notamment grâce à l’établissement de nouvelles mesures phénotypiques. L’évolution vers une meilleure robustesse, une efficacité alimentaire optimisée mais aussi une empreinte environnementale réduite, sera d’autant plus envisageable que la sélection pourra s’appuyer sur des capacités de phénotypage de plus en plus fin et à grande échelle. Un autre facteur prépondérant dans l’élevage laitier concerne la gestion de la santé animale qui affecte, notamment, la durabilité des élevages sous l’angle socio-économique. Cette gestion complexe doit prendre en compte de nombreux paramètres tel que le nombre des traitements nécessaires, le temps passé, les pertes économiques directes à court et long terme, etc. Les infections ne touchent pas toutes directement la glande mammaire, mais en affectant l’animal, elles impactent la lactation, l’efficacité de production du troupeau et donc l’élevage. L’article de Seegers et al passe en revue sept maladies majeures classées en trois groupes affectant les bovins laitiers. Il présente les connaissances récentes acquises sur ces maladies et les perspectives qu’elles ouvrent pour mieux les maîtriser. Ces maladies ont bien souvent un impact économique fort sur les élevages et/ou sont transmissibles à l’Homme constituant ainsi des questionnements de recherche forts et pour lesquels les moyens d’actions sont aussi multiples que variés. De plus, les attentes sociétales visent à diminuer, autant que faire se peut, les intrants médicamenteux. L’alimentation est un levier de maîtrise de la production et de la composition du lait qui présente l’avantage d’avoir des effets rapides et réversibles. Bien que ce levier puisse également moduler la composition protéique du lait, l’impact prépondérant de l’alimentation sur la composition en acides gras du lait, dans le but de fournir aux consommateurs une qualité nutritionnelle du lait la plus favorable possible, a été mis en exergue par de nombreuses études. La détermination de la composition en acides gras des laits est de plus en plus précise, notamment du fait des nouvelles techniques qui permettent une meilleure caractérisation de ces profils. Outre l’impact de l’alimentation, les effets des apports nutritionnels chez le ruminant sur les teneurs en composés vitaminiques du lait sont également à prendre en compte dans la perspective de l’utilisation du lait comme source complémentaire naturelle de vitamines chez les sujets présentant une efficacité d’absorption réduite (tel que les jeunes ou à l’inverse les personnes âgées). L’article de Ferlay et al recense les principaux facteurs alimentaires (nature de la ration de base, supplémentation oléagineuse, différents types de suppléments lipidiques et leurs interactions) influençant la composition en acides gras et en vitamines du lait de vache. Enfin, la traite constitue un outil supplémentaire de pilotage des troupeaux en termes de production laitière mais aussi de qualité sanitaire, technologique et nutritionnelle du lait. De plus, une meilleure connaissance des effets des différentes pratiques de traite est cruciale dans le contexte actuel de gestion du travail dans les exploitations laitières (cf. Numéro spécial, « Travail en élevage », Hostiou et al 2012). Les moyens mis en oeuvre se situent à différents niveaux allant de la fréquence de traite aux systèmes de stockage des laits en passant par les réglages possibles ou les types de machines à traire. L’article de Guinard-Flament et al fait le point des connaissances actuelles sur les effets et les conséquences de modifications de la conduite des animaux à la traite. Il présente les effets de la fréquence de traite sur le niveau de production laitière et sur la composition du lait. Le contexte de la traite, avec les effets mécaniques de la machine à traire et celui du système de stockage, est également présenté dans ses multiples facettes pour souligner leur rôle prépondérant sur la qualité microbienne des laits. La conduite des vaches à la traite est également un moyen de gestion de la carrière d’une vache laitière à travers le pilotage de certaines phases du cycle de production (effets sur la reproduction et sur la durée de la lactation et leurs conséquences sur la santé de l’animal...). La dimension des systèmes d’élevage est dominée ces dernières années par la question environnementale, notamment depuis la parution du rapport de la FAO « Livestock’s long shadow » (Steinfeld et al 2006). L’élevage laitier, très consommateur de ressources de qualité, est concerné au premier rang par ce défi environnemental. Mais ces enjeux, peu perceptibles à l’échelle de l’élevage pourtant à l’origine de ces risques, sont difficiles à intégrer dans les objectifs des systèmes de production. L’article de Dollé et al sur les impacts environnementaux des systèmes bovins laitiers français apporte de nombreux éléments quantifiés sur les émissions des éléments à risque pour l’environnement par les élevages laitiers. Ces risques concernent bien entendu la qualité de l’eau, notamment via les excrétions d’azote et de phosphore, ce qui est connu depuis longtemps avec leurs impacts sur l’eutrophisation des cours d’eau et des côtes. Les risques liés à la qualité de l’air ont été pris en compte beaucoup plus récemment et concernent principalement les émissions d’ammoniac pouvant affecter la santé humaine et des gaz à effet de serre responsables du réchauffement climatique (cf. Dossier, « Gaz à effet de serre en élevage bovin : le méthane », Doreau et al 2011). Ensuite, l’article aborde la question de la biodiversité, auxiliaire de l’agriculture et des paysages, où l’élevage joue un rôle central au sein des territoires agricoles. L’article aborde pour finir la question de la quantification de ces impacts afin d’améliorer objectivement les performances environnementales des élevages et montre que performances environnementales et économiques en élevage laitier ne sont pas antinomiques. En guise de conclusion de ce numéro, J.L. Peyraud et K. Duhem se sont prêtés à un exercice d’analyse prospective des élevages laitiers et du lait de demain en reprenant certains des constats de l’article introductif, notamment sur la diversité des systèmes et des territoires, la restructuration rapide de la filière et la reconstruction du métier d’éleveur. La filière devra demain affronter la tension entre l’amélioration de la compétitivité et celle de la durabilité de l’élevage en tirant profit des innovations. La meilleure prise en compte des qualités nutritionnelles des produits et de l’évolution des demandes tout en améliorant l’intégration de l’élevage au sein des territoires constitue un double défi pour résoudre cette tension. L’analyse des auteurs prône cependant un maintien de la diversité et la complémentarité des systèmes dans une diversité de territoires pour mieux répondre aux enjeux de la société et des éleveurs. Ce numéro spécial montre combien la filière laitière est aujourd’hui plus que jamais à la croisée des chemins avec des défis économiques et sociétaux difficiles à relever dans un climat de plus en plus incertain. Entre diversité d'une part, et spécialisation et standardisation d'autre part, le chemin de la filière française reste complexe à définir. Les nombreuses évolutions des connaissances scientifiques permettent de disposer à court ou moyen terme de nouveaux outils pour relever ces défis. La sélection génomique pour disposer des animaux les plus adaptés à leur système, les modèles de prévision pour anticiper les aléas et leurs conséquences, les outils d’évaluation environnementale pour maîtriser les risques, les outils de monitoring et d’information des troupeaux d’élevage pour améliorer les conditions de travail et l’efficience des troupeaux, les possibilités de piloter la qualité des produits par les conduites d’élevage et en particulier l’alimentation, une meilleure connaissance des mécanismes de régulation de la lactation, la découverte de la richesse des constituants du lait et de leurs propriétés nutritionnelles et fonctionnelles sont autant d’atouts pour la filière pour affronter ces défis. A travers les articles de ce numéro, nous avons voulu illustrer quelques un de ces défis et des perspectives offertes par la recherche. L’enjeu sera de les mobiliser à bon escient dans le cadre de stratégies cohérentes. Cela nécessitera la collaboration de tous les acteurs de la recherche, de la formation, du développement et de la filière. A leur niveau, les articles de ce numéro, par les nombreuses signatures communes entre chercheurs, enseignants-chercheurs et ingénieurs de recherche-développement, témoignent de la vitalité des unités mixtes de recherche et des unités mixtes thématiques impliquées dans l’élevage laitier. De même, bon nombre de travaux relatés dans les articles de ce numéro sont le fruit de programmes de recherche co-financés et menés en collaboration étroite entre la recherche, les instituts technique et la filière. Nous y voyons un fort signe positif pour l'avenir de l'élevage laitier en France Cet avant-propos ne saurait s’achever sans remercier René Baumont et le comité de rédaction d’Inra Productions Animales pour l’initiative judicieuse de ce numéro spécial, mais aussi pour nous avoir aidés à mener à bien ce projet comprenant de nombreux auteurs, qui ont bien voulu se prêter à l’exercice difficile de la rédaction d’un article de synthèse qui conjugue la rigueur de l’information scientifique avec l’exigence de la rendre accessible à un large public. Ce numéro doit beaucoup aussi aux relectures constructives de nombreux collègues que nous remercions ici anonymement. Enfin, cet ouvrage doit aussi sa qualité à un travail remarquable d’édition technique assuré par Pascale Béraudque nous associons à ces remerciements. Nous avons eu la primeur de ces articles et nous espérons que vous partagerez l’intérêt que nous avons eu à leur lecture à la fois instructive, enrichissante et propice à nourrir notre réflexion pour le futur de la recherche-développement dans le domaine de l’élevage bovin laitier.Philippe FAVERDIN, Christine LEROUX RéférencesDoreau M., Baumont R., Perez J.M., (Eds) 2011. Dossier, Gaz à effet de serre en élevage bovin : le méthane. INRA Prod. Anim., 24, 411-474. Fanica P.O., 2008. Le lait, la vache et le citadin. Du XVIIe au XXe siècle. Editions Quae, Paris, France,520p. Faye B., Bonnet P., Corniaux C., Duteurtre G., 2010. Peuples du lait. Editions Quae, Paris France, 160p. Hostiou N., Dedieu B., Baumont R., (Eds) 2012. Numéro spécial, Travail en élevage. INRA Prod. Anim., 25, 83-220. Mulsant P., Bodin L., Coudurier B., Deretz S., Le Roy P., Quillet E., Perez J.M., (Eds) 2011. Numéro spécial, Amélioration génétique. INRA Prod. Anim., 24, 283-404. Sauvant D., Perez J.M., (Eds) 2010. Dossier, Robustesse, rusticité, flexibilité, plasticité, résilience… les nouveaux critères de qualité des animaux et des systèmes d'élevage. INRA Prod. Anim., 23, 1-102. Steinfeld H., Gerber P., Wassenaar T., Castel V., Rosales M., de Haan C., 2006. Livestock's long shadow: environmental issues and options. Food and Agriculture Organization of the United Nations,414p.

Recently, women’s presence on top boards of directors has significantly increased, challenging the long standing of male-led corporate elites. In light of the still-developing literature, this article provides a century-long examination of women’s entry into the Spanish corporate elite, offering several original contributions. In addition to its pioneering input into the country’s historiography, the work uses a holistic model to introduce a comparative European approach. Moreover, it empirically examines the significant yet previously unexplored impact of elite training institutions on the advancement of female directors as well as their arrival through a national holding company and their presence in leading publicly traded companies. Findings showed four distinct stages in their trajectory: discriminatory exclusion, during the first third of the twentieth century; exceptional inclusion, with early positions in their family-owned firms; gradual incorporation, with increased political representation and expanded academic access in the latter decades of the last century; and promotion, supported by twenty-first-century political strategies, while still revealing the handicap of women’s delayed entry into the corporate network.

Abstract Background In this study we investigated the health-related rehabilitation trajectories of young Norwegian adults between 2004–2019. The study period is interesting because it overlaps with an extensive welfare system reform that occurred in Norway between 2006–2011. In parallel with the reform there was a substantial increase in health-related welfare dependency among young people due to mental health conditions. To better understand this group, we addressed three questions: 1) what were the most typical health-related rehabilitation trajectories for young Norwegians aged 23–27 between 2004–2019, 2) did the trajectories and composition of health-related benefit recipients change overtime and 3) in parallel with the welfare reform, do we see improved labour market outcomes in our study population? Methods Using high-quality Norwegian registry data, we established four cohorts of Norwegian health-related rehabilitation benefit recipients aged 23–27 in either 2004 (cohort 1), 2008 (cohort 2), 2011 (cohort 3) or 2014 (cohort 4). The follow-up period for each cohort was six years. We used sequence and cluster analyses to identify typical health-related rehabilitation trajectories. In addition, descriptive statistics and multinomial logistic regression were used to scrutinise the relationship between trajectory types, sociodemographic characteristics and cohort membership. Results The majority follow trajectories consisting of welfare dependency, unemployment and unstable, low-income work. Both the trajectories and composition of the study population changed across cohorts. Over the observation period there was a 1) three-fold increase in the proportion following a trajectory ending in permanent disability benefits, 2) nine-fold increase in the proportion following trajectories characterised by long periods of health-related rehabilitation, 3) five-fold decrease in the share following unemployment occupational handicap trajectories 4) 6.9% increase in the proportion of early school leavers and 5) 8.9% decrease in the share with disabled parents. Conclusion Our study population is a vulnerable group with suboptimal mental health, functioning and employment outcomes. In conjunction with the welfare reform, we witnessed a significant drop in use of work-related benefits, accompanied by a substantial increase in uptake of health-related rehabilitation- and disability benefits. Thus, it appears that rather than improving employment outcomes, welfare policy changes have created a new problem by steering a greater proportion into disability benefits.

This article aims to present a point of reflection, the trajectory of knowledge and concepts, apparently as different as medicine and culture. The multidimensional analysis of singing and the validation of the version of the Singing Voice Handicap Index (SVHI), translated and adapted culturally to the Portuguese language of Portugal, reminds us, in its assumptions, the Agustin Escolano Benito´s interpretative model of culture. The questionnaire used in the evaluation of disadvantage in singers with vocal problems (SVHI), in which data of different natures are present for analysis, presupposes, rather than the physiological body, the cultural body in which scientific culture is manifested and interacted, political culture And empirical culture. It is this body, as heritage to be preserved, that is read as narrative with the details of its uniqueness. The article presents the interpretive model of culture and advances to the concept of voice, to focus on the study of multidimensional analysis of voice, adding the model to the list of translated versions (now for Portuguese). Finally, it is demonstrated that the Portuguese version of the SVHI is a reliable and valid instrument in the evaluation of the vocal disadvantage in the Portuguese singers and can be added to the list of translated versions of this instrument originally created for the vocal evaluation of the Englishspeaking singers of America., and that the model of analysis of Escolano Benito is valid for other cultural universes that not only the school culture. Key words: Cultural body, Culture, Intangible Culture, Voice, Hermeneutic/interpretive model of Agustin Escolano Benito, Invalidity assessment; Vocal disorders,

AbstractLittle is known about the trajectory of tinnitus over time. This study addressed (1) how often tinnitus remitted in patients with chronic tinnitus; (2) how subjective reported tinnitus characteristics, such as loudness, laterality, and type and measures of burden, such as tinnitus distress, depression, and quality of life, changes over time; (3) how often tinnitus-specific treatments were undertaken and the prevalence of comorbidities, (4) if the number of treatments and comorbidities were associated to changes in tinnitus distress over time. Data from 388 patients with chronic tinnitus who visited a tertiary tinnitus clinic between 2012 and 2017 were interrogated via a mail survey in 2018. Tinnitus characteristics were measured with the Tinnitus Sample Case History Questionnaire and numeric rating scales; tinnitus distress with Tinnitus Handicap Inventory (THI) and the Tinnitus Questionnaire (TQ), depression with the Major Depression Inventory and Quality of life with the World Health Organisation Quality of Life BREF at both time points and the clinical global impression scale. Comorbidities experienced and undertaken treatments were assessed with an in-house survey. Three participants (0.8% of the sample) reported tinnitus remission between both assessments. A decrease in the THI and TQ, and numeric ratings for tinnitus severity, annoyance, unpleasantness, and discomfort was observed, but no differences in tinnitus characteristics, depression, quality of life or overall health status. 64% presented at least one comorbidity, and 88% sought at least on tinnitus-specific treatment. Common comorbidities were psychological and sleeping problems, and the most common interventions were going to the dentist, taking medications, and wearing hearing aids. Our results suggest that full remission of tinnitus is a rare condition, that tinnitus distress on average decreases over time, and that tinnitus characteristics, quality of life, and depression tend to remain unaltered. The high number of interventions and comorbidities displayed minimal association to the changes in tinnitus distress, highlighting the substantial and durable burden of tinnitus sufferers.

Abstract Background Idiopathic sudden sensorineural hearing loss (ISSNHL) is a rapid-onset sensorineural hearing impairment with unclear etiology and unsatisfying treatment effects. Vestibular dysfunction has been considered as a poor indicator in the clinical manifestations and prognosis of ISSNHL, which occurred in approximately 28–57% cases. Glucocorticoids, administered through oral or intratympanic way, are currently regularly and standardly applied for ISSNHL to improve the hearing outcome. However, the vestibular prognosis of ISSNHL after routine treatments remains seldom explored. This study aims to compare the effectiveness of oral and intratympanic glucocorticoids in ISSNHL with vestibular dysfunction in terms of the pattern and trajectory of possible process of vestibular function recovery. Methods/design A randomized, outcome-assessor- and analyst-blinded, controlled, clinical trial (RCT) will be carried out. Seventy-two patients with ISSNHL complaining of vestibular dysfunction appearing as vertigo or imbalance will be recruited and randomized into either oral or intratympanic glucocorticoid therapy group with a 1:1 allocation ratio. The primary outcomes will be vestibular function outcomes assessed by sensory organization test, caloric test, video head impulse test, cervical vestibular evoked myogenic potential, and ocular vestibular evoked myogenic potential; the secondary outcomes include self-reported vestibular dysfunction symptoms; dizziness-related handicap, visual analogue scale for vertigo and tinnitus; and pure tone audiometry. Assessments of primary outcomes will be performed at baseline and at 4 and 8 weeks post-randomization, while assessments of secondary outcomes will be performed at baseline and 1, 2, 4, and 8 weeks post-randomization. Discussion Previous intervention studies of ISSNHL included only hearing outcomes, with little attention paid on the prognosis of vestibular dysfunction. This trial will be the first RCT study focusing on the progress and prognosis of vestibular dysfunction in ISSNHL. The efficacy of two commonly used therapies of glucocorticoids will be compared in both auditory and vestibular function fields, rather than in the hearing outcome alone. Trial registration ClinicalTrials.gov NCT03974867. Registered on 23 July 2019

Cet article vise à analyser la relation entre la danse afro-brésilienne et le handicap à partir de la proposition artistico-éducative « Danse des Reines : danse afro et handicap », un atelier organisé en 2019 à l’École de danse de l’Université fédérale de Bahia. L’événement a permis de repenser les processus artistico-éducatifs qui contribuent à de nouvelles perspectives dans le domaine de la danse. Il a supprimé les logiques d’exclusion et d’oppression des personnes handicapées grâce à et par le biais de la construction de danses qui nient la suprématie de la verticalité et de la virtuosité présentes dans d’autres danses, de conception eurocentrique. Ces danses ont aussi renversé historiquement les oppressions de la communauté noire, qui tend à intérioriser et à adapter à ses propres conceptions artistiques des modes d’organisation différents de ceux de la culture africaine, retravaillés ici. Nous attirons donc l’attention sur l’exclusion des personnes noires handicapées dans la construction des danses brésiliennes afro-centrées. Nous avons choisi Mercedes Baptista et Josy Brasil, des femmes noires à la représentativité indéniable, qui ont vécu la violence du racisme dans leur corps et celle du capacitisme dans leur trajectoire artistique. Les résultats de la recherche reconnaissent les incohérences historiques des enseignants et artistes ayant pris comme ligne directrice le modèle des danses configurées par le patriarcat blanc, hétéro, cis et bipède, qui ignore la richesse et la beauté de la diversité.

Les études portant sur les activités de pleine nature des personnes en situation de handicap sont fortement centrées sur l’accessibilité, sous un angle souvent aménagiste, parfois culturel. Elles sont ici appréhendées en tant qu’innovation tant matérielle que sociale, au prisme de la sociologie de l’acteur-réseau. L’article se focalise sur le fauteuil tout-terrain mono-roue, également appelé joëlette, qui permet d’accéder aux sentiers non aménagés. Par ses caractéristiques sociotechniques, la joëlette se révèle, en tant que dispositif hybride, à la fois produit et producteur d’interdépendances. En référence au courant de l’analyse sociotechnique des innovations, l’approche décrit la trajectoire de l’objet, de son invention artisanale pour permettre à une famille de pratiquer la randonnée avec un adolescent atteint de myopathie, à son entrée dans un processus d’innovation par l’impulsion d’une dynamique sociale de propagation de la demande, de diffusion industrielle et d’extension des usages qui a pu se concrétiser au sein d’un réseau élargi. Inscrite dans un temps long (1987-2016), l’approche permet de saisir le laborieux processus de traduction qui va transformer l’objet en même temps que vont se recomposer ses usages, à partir d’enjeux tant sociaux que techniques pour généraliser, de manière contrastée, l’approche inclusive dont il est promoteur.

Despite numerous critics describing him as an auteur (i.e. a film-maker who ‘does’ everything and fulfils every production role [Bordwell and Thompson 37] and/or with a signature “world-view” detectable in his/her work [Caughie 10]), Rolf de Heer appears to have declined primary authorship of Dance Me to My Song (1997), his seventh in an oeuvre of twelve feature films. Indeed, the opening credits do not mention his name at all: it is only with the closing credits that the audience learns de Heer has directed the film. Rather, as the film commences, the viewer is informed by the titles that it is “A film by Heather Rose”, thus suggesting that the work is her singular creation. Direct and uncompromising, with its unflattering shots of the lead actor and writer (Heather Rose Slattery, a young woman born with cerebral palsy), the film may be read as a courageous self-portrait which finds the grace, humanity and humour trapped inside Rose’s twisted body. Alternatively, it may be read as yet another example of de Heer’s signature interest in foregrounding a world view which gives voice to marginalised characters such as the disabled or the disadvantaged. For example, the developmentally retarded eponyme of Bad Boy Bubby (1993) is eventually able to make art as a singer in a band and succeeds in creating a happy family with a wife and two kids. The ‘mute’ girl in The Quiet Room (1996) makes herself heard by her squabbling parents through her persistent activism. In Ten Canoes (2006) the Indigenous Australians cast themselves according to kinship ties, not according to the director’s choosing, and tell their story in their own uncolonised language. A cursory glance at the films of Rolf de Heer suggests he is overtly interested in conveying to the audience the often overlooked agency of his unlikely protagonists. In the ultra-competitive world of professional film-making it is rare to see primary authorship ceded by a director so generously. However, the allocation of authorship to a member of a marginalized population re-invigorates questions prompted by Andy Medhurst regarding a film’s “authorship test” (198) and its relationship to a subaltern community wherein he writes that “a biographical approach has more political justification if the project being undertaken is one concerned with the cultural history of a marginalized group” (202-3). Just as films by gay authors about gay characters may have greater credibility, as Medhurst posits, one might wonder would a film by a person with a disability about a character with the same disability be better received? Enabling authorship by an unknown, crippled woman such as Rose rather than a famous, able-bodied male such as de Heer may be cynically regarded as good (show) business in that it is politically correct. This essay therefore asks if the appellation “A film by Heather Rose” is appropriate for Dance Me to My Song. Whose agency in telling the story (or ‘doing’ the film-making), the able bodied Rolf de Heer or the disabled Heather Rose, is reflected in this cinematic production? In other words, whose voice is enabled when an audience receives this film? In attempting to answer these questions it is inevitable that Paul Darke’s concept of the “normality drama” (181) is referred to and questioned, as I argue that Dance Me to My Song makes groundbreaking departures from the conventions of the typical disability narrative. Heather Rose as Auteur Rose plays the film’s heroine, Julia, who like herself has cerebral palsy, a group of non-progressive, chronic disorders resulting from changes produced in the brain during the prenatal stages of life. Although severely affected physically, Rose suffered no intellectual impairment and had acted in Rolf de Heer’s cult hit Bad Boy Bubby five years before, a confidence-building experience that grew into an ongoing fascination with the filmmaking process. Subsequently, working with co-writer Frederick Stahl, she devised the scenario for this film, writing the lead role for herself and then proactively bringing it to de Heer’s attention. Rose wrote of de Heer’s deliberate lack of involvement in the script-writing process: “Rolf didn’t even want to read what we’d done so far, saying he didn’t want to interfere with our process” (de Heer, “Production Notes”). In 2002, aged 36, Rose died and Stahl reports in her obituary an excerpt from her diary: People see me as a person who has to be controlled. But let me tell you something, people. I am not! And I am going to make something real special of my life! I am going to go out there and grab life with both hands!!! I am going to make the most sexy and honest film about disability that has ever been made!! (Stahl, “Standing Room Only”) This proclamation of her ability and ambition in screen-writing is indicative of Rose’s desire to do. In a guest lecture Rose gave further insights into the active intent in writing Dance Me to My Song: I wanted to create a screenplay, but not just another soppy disability film, I wanted to make a hot sexy film, which showed the real world … The message I wanted to convey to an audience was “As people with disabilities, we have the same feelings and desires as others”. (Rose, “ISAAC 2000 Conference Presentation”) Rose went on to explain her strategy for winning over director de Heer: “Rolf was not sure about committing to the movie; I had to pester him really. I decided to invite him to my birthday party. It took a few drinks, but I got him to agree to be the director” (ibid) and with this revelation of her tactical approach her film-making agency is further evidenced. Rose’s proactive innovation is not just evident in her successfully approaching de Heer. Her screenplay serves as a radical exception to films featuring disabled persons, which, according to Paul Darke in 1998, typically involve the disabled protagonist struggling to triumph over the limitations imposed by their disability in their ‘admirable’ attempts to normalize. Such normality dramas are usually characterized by two generic themes: first, that the state of abnormality is nothing other than tragic because of its medical implications; and, second, that the struggle for normality, or some semblance of it in normalization – as represented in the film by the other characters – is unquestionably right owing to its axiomatic supremacy. (187) Darke argues that the so-called normality drama is “unambiguously a negation of ascribing any real social or individual value to the impaired or abnormal” (196), and that such dramas function to reinforce the able-bodied audience’s self image of normality and the notion of the disabled as the inferior Other. Able-bodied characters are typically portrayed positively in the normality drama: “A normality as represented in the decency and support of those characters who exist around, and for, the impaired central character. Thus many of the disabled characters in such narratives are bitter, frustrated and unfulfilled and either antisocial or asocial” (193). Darke then identifies The Elephant Man (David Lynch, 1980) and Born on the Fourth of July (Oliver Stone, 1989) as archetypal films of this genre. Even in films in which seemingly positive images of the disabled are featured, the protagonist is still to be regarded as the abnormal Other, because in comparison to the other characters within that narrative the impaired character is still a comparatively second-class citizen in the world of the film. My Left Foot is, as always, a prime example: Christy Brown may well be a writer, relatively wealthy and happy, but he is not seen as sexual in any way (194). However, Dance Me to My Song defies such generic restrictions: Julia’s temperament is upbeat and cheerful and her disability, rather than appearing tragic, is made to look healthy, not “second class”, in comparison with her physically attractive, able-bodied but deeply unhappy carer, Madelaine (Joey Kennedy). Within the first few minutes of the film we see Madelaine dissatisfied as she stands, inspecting her healthy, toned and naked body in the bathroom mirror, contrasted with vision of Julia’s twisted form, prostrate, pale and naked on the bed. Yet, in due course, it is the able-bodied girl who is shown to be insecure and lacking in character. Madelaine steals Julia’s money and calls her “spastic”. Foul-mouthed and short-tempered, Madelaine perversely positions Julia in her wheelchair to force her to watch as she has perfunctory sex with her latest boyfriend. Madelaine even masquerades as Julia, commandeering her voice synthesizer to give a fraudulently positive account of her on-the-job performance to the employment agency she works for. Madelaine’s “axiomatic supremacy” is thoroughly undermined and in the most striking contrast to the typical normality drama, Julia is unashamedly sexual: she is no Christy Brown. The affective juxtaposition of these two different personalities stems from the internal nature of Madelaine’s problems compared to the external nature of Julia’s problems. Madelaine has an emotional disability rather than a physical disability and several scenes in the film show her reduced to helpless tears. Then one day when Madelaine has left her to her own devices, Julia defiantly wheels herself outside and bumps into - almost literally - handsome, able-bodied Eddie (John Brumpton). Cheerfully determined, Julia wins him over and a lasting friendship is formed. Having seen the joy that sex brings to Madelaine, Julia also wants carnal fulfilment so she telephones Eddie and arranges a date. When Eddie arrives, he reads the text on her voice machine’s screen containing the title line to the film ‘Dance me to my song’ and they share a tender moment. Eddie’s gentleness as he dances Julia to her song (“Kizugu” written by Bernard Huber and John Laidler, as performed by Okapi Guitars) is simultaneously contrasted with the near-date-rapes Madelaine endures in her casual relationships. The conflict between Madeline and Julia is such that it prompts Albert Moran and Errol Vieth to categorize the film as “women’s melodrama”: Dance Me to My Song clearly belongs to the genre of the romance. However, it is also important to recognize it under the mantle of the women’s melodrama … because it has to do with a woman’s feelings and suffering, not so much because of the flow of circumstance but rather because of the wickedness and malevolence of another woman who is her enemy and rival. (198-9) Melodrama is a genre that frequently resorts to depicting disability in which a person condemned by society as disabled struggles to succeed in love: some prime examples include An Affair to Remember (Leo McCarey, 1957) involving a paraplegic woman, and The Piano (Jane Campion, 1993) in which a strong-spirited but mute woman achieves love. The more conventional Hollywood romances typically involve attractive, able-bodied characters. In Dance Me to My Song the melodramatic conflict between the two remarkably different women at first seems dominated by Madelaine, who states: “I know I’m good looking, good in bed ... better off than you, you poor thing” in a stream-of-consciousness delivery in which Julia is constructed as listener rather than converser. Julia is further reduced to the status of sub-human as Madelaine says: “I wish you could eat like a normal person instead of a bloody animal” and her erstwhile boyfriend Trevor says: “She looks like a fuckin’ insect.” Even the benevolent Eddie says: “I don’t like leaving you alone but I guess you’re used to it.” To this the defiant Julia replies; “Please don’t talk about me in front of me like I’m an animal or not there at all.” Eddie is suitably chastised and when he treats her to an over-priced ice-cream the shop assistant says “Poor little thing … She’ll enjoy this, won’t she?” Julia smiles, types the words “Fuck me!”, and promptly drops the ice-cream on the floor. Eddie laughs supportively. “I’ll just get her another one,” says the flustered shop assistant, “and then get her out of here, please!” With striking eloquence, Julia wheels herself out of the shop, her voice machine announcing “Fuck me, fuck me, fuck me, fuck me, fuck me”, as she departs exultantly. With this bold statement of independence and defiance in the face of patronising condescension, the audience sees Rose’s burgeoning strength of character and agency reflected in the onscreen character she has created. Dance Me to My Song and the films mentioned above are, however, rare exceptions in the many that dare represent disability on the screen at all, compliant as the majority are with Darke’s expectations of the normality drama. Significantly, the usual medical-model nexus in many normality films is ignored in Rose’s screenplay: no medication, hospitals or white laboratory coats are to be seen in Julia’s world. Finally, as I have described elsewhere, Julia is shown joyfully dancing in her wheelchair with Eddie while Madelaine proves her physical inferiority with a ‘dance’ of frustration around her broken-down car (see Starrs, "Dance"). In Rose’s authorial vision, audience’s expectations of yet another film of the normality drama genre are subverted as the disabled protagonist proves superior to her ‘normal’ adversary in their melodramatic rivalry for the sexual favours of an able-bodied love-interest. Rolf de Heer as Auteur De Heer does not like to dwell on the topic of auteurism: in an interview in 2007 he somewhat impatiently states: I don’t go in much for that sort of analysis that in the end is terminology. … Look, I write the damn things, and direct them, and I don’t completely produce them anymore – there are other people. If that makes me an auteur in other people’s terminologies, then fine. (Starrs, "Sounds" 20) De Heer has been described as a “remarkably non-egotistical filmmaker” (Davis “Working together”) which is possibly why he handed ownership of this film to Rose. Of the writer/actor who plied him with drink so he would agree to back her script, de Heer states: It is impossible to overstate the courage of the performance that you see on the screen. … Heather somehow found the means to respond on cue, to maintain the concentration, to move in the desired direction, all the myriad of acting fundamentals that we take for granted as normal things to do in our normal lives. (“Production NHotes”) De Heer’s willingness to shift authorship from director to writer/actor is representative of this film’s groundbreaking promotion of the potential for agency within disability. Rather than being passive and suffering, Rose is able to ‘do.’ As the lead actor she is central to the narrative. As the principle writer she is central to the film’s production. And she does both. But in conflict with this auteurial intent is the temptation to describe Dance Me to My Song as an autobiographical documentary, since it is Rose herself, with her unique and obvious physical handicap, playing the film’s heroine, Julia. In interview, however, De Heer apparently disagrees with this interpretation: Rolf de Heer is quick to point out, though, that the film is not a biography.“Not at all; only in the sense that writers use material from their own lives.Madelaine is merely the collection of the worst qualities of the worst carers Heather’s ever had.” Dance Me to My Song could be seen as a dramatised documentary, since it is Rose herself playing Julia, and her physical or surface life is so intense and she is so obviously handicapped. While he understands that response, de Heer draws a comparison with the first films that used black actors instead of white actors in blackface. “I don’t know how it felt emotionally to an audience, I wasn’t there, but I think that is the equivalent”. (Urban) An example of an actor wearing “black-face” to portray a cerebral palsy victim might well be Gus Trikonis’s 1980 film Touched By Love. In this, the disabled girl is unconvincingly played by the pretty, able-bodied actress Diane Lane. The true nature of the character’s disability is hidden and cosmeticized to Hollywood expectations. Compared to that inauthentic film, Rose’s screenwriting and performance in Dance Me to My Song is a self-penned fiction couched in unmediated reality and certainly warrants authorial recognition. Despite his unselfish credit-giving, de Heer’s direction of this remarkable film is nevertheless detectable. His auteur signature is especially evident in his technological employment of sound as I have argued elsewhere (see Starrs, "Awoval"). The first distinctly de Heer influence is the use of a binaural recording device - similar to that used in Bad Boy Bubby (1993) - to convey to the audience the laboured nature of Julia’s breathing and to subjectively align the audience with her point of view. This apparatus provides a disturbing sound bed that is part wheezing, part grunting. There is no escaping Julia’s physically unusual life, from her reliance on others for food, toilet and showering, to the half-strangled sounds emanating from her ineffectual larynx. But de Heer insists that Julia does speak, like Stephen Hawkings, via her Epson RealVoice computerized voice synthesizer, and thus Julia manages to retain her dignity. De Heer has her play this machine like a musical instrument, its neatly modulated feminine tones immediately prompting empathy. Rose Capp notes de Heer’s preoccupation with finding a voice for those minority groups within the population who struggle to be heard, stating: de Heer has been equally consistent in exploring the communicative difficulties underpinning troubled relationships. From the mute young protagonist of The Quiet Room to the aphasic heroine of Dance Me to My Song, De Heer’s films are frequently preoccupied with the profound inadequacy or outright failure of language as a means of communication (21). Certainly, the importance to Julia of her only means of communication, her voice synthesizer, is stressed by de Heer throughout the film. Everybody around her has, to varying degrees, problems in hearing correctly or understanding both what and how Julia communicates with her alien mode of conversing, and she is frequently asked to repeat herself. Even the well-meaning Eddie says: “I don’t know what the machine is trying to say”. But it is ultimately via her voice synthesizer that Julia expresses her indomitable character. When first she meets Eddie, she types: “Please put my voice machine on my chair, STUPID.” She proudly declares ownership of a condom found in the bathroom with “It’s mine!” The callous Madelaine soon realizes Julia’s strength is in her voice machine and withholds access to the device as punishment for if she takes it away then Julia is less demanding for the self-centred carer. Indeed, the film which starts off portraying the physical superiority of Madelaine soon shows us that the carer’s life, for all her able-bodied, free-love ways, is far more miserable than Julia’s. As de Heer has done in many of his other films, a voice has been given to those who might otherwise not be heard through significant decision making in direction. In Rose’s case, this is achieved most obviously via her electric voice synthesizer. I have also suggested elsewhere (see Starrs, "Dance") that de Heer has helped find a second voice for Rose via the language of dance, and in doing so has expanded the audience’s understandings of quality of life for the disabled, as per Mike Oliver’s social model of disability, rather than the more usual medical model of disability. Empowered by her act of courage with Eddie, Julia sacks her uncaring ‘carer’ and the film ends optimistically with Julia and her new man dancing on the front porch. By picturing the couple in long shot and from above, Julia’s joyous dance of triumph is depicted as ordinary, normal and not deserving of close examination. This happy ending is intercut with a shot of Madeline and her broken down car, performing her own frustrated dance and this further emphasizes that she was unable to ‘dance’ (i.e. communicate and compete) with Julia. The disabled performer such as Rose, whether deliberately appropriating a role or passively accepting it, usually struggles to placate two contrasting realities: (s)he is at once invisible in the public world of interhuman relations and simultaneously hyper-visible due to physical Otherness and subsequent instantaneous typecasting. But by the end of Dance Me to My Song, Rose and de Heer have subverted this notion of the disabled performer grappling with the dual roles of invisible victim and hyper-visible victim by depicting Julia as socially and physically adept. She ‘wins the guy’ and dances her victory as de Heer’s inspirational camera looks down at her success like an omniscient and pleased god. Film academic Vivian Sobchack writes of the phenomenology of dance choreography for the disabled and her own experience of waltzing with the maker of her prosthetic leg, Steve, with the comment: “for the moment I did displace focus on my bodily immanence to the transcendent ensemble of our movement and I really began to waltz” (65). It is easy to imagine Rose’s own, similar feeling of bodily transcendence in the closing shot of Dance Me to My Song as she shows she can ‘dance’ better than her able-bodied rival, content as she is with her self-identity. Conclusion: Validation of the Auteurial OtherRolf de Heer was a well-known film-maker by the time he directed Dance Me to My Song. His films Bad Boy Bubby (1993) and The Quiet Room (1996) had both screened at the Cannes International Film Festival. He was rapidly developing a reputation for non-mainstream representations of marginalised, subaltern populations, a cinematic trajectory that was to be further consolidated by later films privileging the voice of Indigenous Peoples in The Tracker (2002) and Ten Canoes (2006), the latter winning the Special Jury prize at Cannes. His films often feature unlikely protagonists or as Liz Ferrier writes, are “characterised by vulnerable bodies … feminised … none of whom embody hegemonic masculinity” (65): they are the opposite of Hollywood’s hyper-masculine, hard-bodied, controlling heroes. With a nascent politically correct worldview proving popular, de Heer may have considered the assigning of authorship to Rose a marketable idea, her being representative of a marginalized group, which as Andy Medhurst might argue, may be more politically justifiable, as it apparently is with films of gay authorship. However, it must be emphasized that there is no evidence that de Heer’s reticence about claiming authorship of Dance Me to My Song is motivated by pecuniary interests, nor does he seem to have been trying to distance himself from the project through embarrassment or dissatisfaction with the film or its relatively unknown writer/actor. Rather, he seems to be giving credit for authorship where credit is due, for as a result of Rose’s tenacity and agency this film is, in two ways, her creative success. Firstly, it is a rare exception to the disability film genre defined by Paul Darke as the “normality drama” because in the film’s diegesis, Julia is shown triumphing not simply over the limitations of her disability, but over her able-bodied rival in love as well: she ‘dances’ better than the ‘normal’ Madelaine. Secondly, in her gaining possession of the primary credits, and the mantle of the film’s primary author, Rose is shown triumphing over other aspiring able-bodied film-makers in the notoriously competitive film-making industry. Despite being an unpublished and unknown author, the label “A film by Heather Rose” is, I believe, a deserved coup for the woman who set out to make “the most sexy and honest film about disability ever made”. As with de Heer’s other films in which marginalised peoples are given voice, he demonstrates a desire not to subjugate the Other, but to validate and empower him/her. He both acknowledges their authorial voices and credits them as essential beings, and in enabling such subaltern populations to be heard, willingly cedes his privileged position as a successful, white, male, able-bodied film-maker. In the credits of this film he seems to be saying ‘I may be an auteur, but Heather Rose is a no less able auteur’. References Bordwell, David and Kristin Thompson. 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London and Portland: Frank Cass and Co., 2001. 57-78. Medhurst, Andy. “That Special Thrill: Brief Encounter, Homosexuality and Authorship.” Screen 32.2 (1991): 197-208. Moran, Albert, and Errol Veith. Film in Australia: An Introduction. Melbourne: Cambridge UP, 2006. Oliver, Mike. Social Work with Disabled People. Basingstoke: MacMillan, 1983. Rose Slattery, Heather. “ISAAC 2000 Conference Presentation.” Words+ n.d. 6 June 2008 ‹http://www.words-plus.com/website/stories/isaac2000.htm›. Sobchack, Vivian. “‘Choreography for One, Two, and Three Legs’ (A Phenomenological Meditation in Movements).” Topoi 24.1 (2005): 55-66. Stahl, Frederick. “Standing Room Only for a Thunderbolt in a Wheelchair,” Sydney Morning Herald 31 Oct. 2002. 6 June 2008 ‹http://www.smh.com.au/articles/2002/10/30/1035683471529.html›. Starrs, D. Bruno. “Sounds of Silence: An Interview with Rolf de Heer.” Metro 152 (2007): 18-21. ———. “An avowal of male lack: Sound in Rolf de Heer’s The Old Man Who Read Love Stories (2003).” Metro 156 (2008): 148-153. ———. “Dance Me to My Song (Rolf de Heer 1997): The Story of a Disabled Dancer.” Proceedings Scopic Bodies Dance Studies Research Seminar Series 2007. Ed. Mark Harvey. University of Auckland, 2008 (in press). Urban, Andrew L. “Dance Me to My Song, Rolf de Heer, Australia.” Film Festivals 1988. 6 June 2008. ‹http://www.filmfestivals.com/cannes98/selofus9.htm›.