Thèses sur le sujet « S Strike »

The growing importance of Credit agency rating in the economic indicators for a country necessitates investigating the impact of various indicators on credit agency ratings. South Africa is a country which has experienced an increase in prolonged, violent and unprotected strike action. This study aimed to determine the impact of this labour relations action on the country s credit ratings over the last 15 years and the consequent related economic factors. Credit rating agencies do not specifically identify strike actions as a key indicator nor do they indicate which indicators dictate the outcome of the ratings granted. Twelve indicators were measured using a quantitative approve of hypothesis and statistical modeling. The study used the interrelated database of The Department of Labour, The PRS Group, Stats SA and studies by Hammer, Kogan, & Lejeune as well as the published indicators of Standard & Poor s, Moodys and Fitch. This study further used the scatter plots and t - tests to determine the relationship between the indicators and strike action. These were correlated using Pearson s correlation theory in order to substantiate the findings of the scatter plot and t test. Strike action was found to have an effect on the ratings granted. Eight of the twelve indicators correlated negatively with ratings of Standard & Poors indicating that if strike action increased ratings would downgrade. Strike action plays a fundament role in the outcome of ratings granted. This is due to the effect strike action has on the driving indicators. Wages lost during strike action has a 99% correlation with the fluctuation of ratings granted. Ratings determining interest rates and the amount of foreign direct investment into South Africa. With the results as indicated, South Africa s government needs to re-evaluate the significance of strike action as a legal for of resolution and the parameters dictating it. Alternative means need to be explored that supports the growth of South Africa for it to transition from a developing country into an advanced economy.
Mini Dissertation (MBA)--University of Pretoria, 2015.
sn2016
Gordon Institute of Business Science (GIBS)
MBA
Unrestricted

Swing contracts are structured products mostly traded on energy and gas markets, tailor-made to handle simultaneously price and volume risk arising from the modern liberalized markets. This thesis deals with some specific swing contracts relevant for the gas market. In gas market, swing contracts are also known as take or pay. They are long-term supply contracts which allow flexibility of delivery: the holder of such a contract has multiple exercise rights and can decide the amount exercised as well, hedging the volume risk caused by a frequent demand fluctuation which in practice is impossible to foresee in the long period. Moreover, such type of contracts can be also seen as a strip of spread options on gas market spot price and the contractual price (called strike): in this view, they can be used to hedge the price fluctuation risk. On the other hand, even if the holder can exercise the option with a volume control, such control has however to satisfy some upper and lower limits at all times as well as a total volume, so the given flexibility need to be optimised, i.e. one must know the optimal execution of this flexibility. Today, the correct valuation of these type of contracts is important both for trading purposes as well as for portfolio optimization. In fact, after the recent liberalization, the price of such contracts is negotiated between agents and no more set by regulators. On the other hand, the embedded flexibilities may be used not only to manage demand fluctuation, but also to make profit against local market price. In this thesis we model, in a continuous time framework, a gas swing contract in the spirit of [6], with one additional state variable corresponding to a stochastic strike price. Since, in real contracts, the strike is a market index which is updated monthly, this results in a mixed discrete/continuous stochastic control problem that we reduce to the usual continuous time situation by adding another state variable, corresponding to an index rolled-over in continuous time. The price of a swing contract is then equal to the value function of one sequence of Markov control problems, each one corresponding to a period between two consecutive changing dates of the index. After that, we prove that the value function of the corresponding control problem is the unique viscosity solution of the resulting Hamilton-Jacobi-Bellman (HJB) equation, and that the value function is smooth enough to ensure the existence of an optimal strategy, that we find out. Briefly spoken, this is the content of the first two chapters of this thesis where, after having framed the valuation problem as a stochastic optimal control problem, an introductory part on viscosity solutions is then applied to the particular problem at hand. This entails in some new results in the theory of viscosity solutions for parabolic nonlinear equations stemming from these swing options. After having found the HJB equations, which become nonlinear partial differential equations, the problem is then to solve them. To do this, in the third chapter we present a finite difference (FD) method for solving the HJB equations numerically. We derive explicitly the boundary conditions for a particular model, when both gas and strike price are supposed to be in the class of the one-factor Schwartz-Smith dynamics. More in detail, we suppose that the log-prices follow Ornstein-Uhlenbeck processes driven by two correlated Brownian motions. Also, the third chapter presents the popular Least Square Monte Carlo (LSMC) algorithm, originally developed by Longstaff-Schwartz for valuing American options and here extended to the present problem. This algorithm is based on the backward solution of the discrete-time version of the control problem. It regresses the continuation value in the Bellman equation to the current available information, obtained using Monte Carlo simulations. Two critical steps using the LSMC algorithm are the choice of both type and number of the basis functions used in the regression; we approach this problem adapting to our case the radial basis function approximation introduced in [11] for storage structured products, which seems very appropriate and interesting for such applications. Several comparison examples are then numerically analysed, in particular the effect that the number of basis functions and the number of simulated paths have on the solution of LSMC as well as the efficiency of the FD method. Some conclusion on the comparison between the two algorithms ends the chapter. The last chapter is from the published paper [17] and deals with the so-called make-up clauses, which extend the swing option previously studied by allowing to the holder of the contract more flexibility among years. From a technical point of view, a swing contract with an embedded make-up clause can not be any more split into yearly contracts, but one must consider the whole contract at once, typically lasting over several years (usually from 3 to 5). To approach the complexity of such problem, another numerical method popular among practitioners is introduced for the purpose of pricing, namely lattice of trees. After having presented the algorithm and analysed its computational cost, the fourth chapter ends with many numerical examples testing for the swing option price's dependency on various crucial parameters
I contratti swing nei mercati dell'energia e del gas sono prodotti strutturati creati su misura per gli operatori al fine di gestire contemporaneamente il rischio derivante dalle variazioni del prezzo di mercato e dall'incertezza volumetrica dovuta alla continua e imprevedibile fluttuazione della domanda. La presente tesi si occupa di un particolare tipo di contratto swing, frequentemente scambiato tra grossi operatori del mercato del gas naturale. I contratti swing nei mercati del gas sono noti anche come take-or-pay e sono contratti di fornitura a lungo termine che permettono flessibilità nel ritiro del gas: l'acquirente possiede infatti la possibilità (ma non l'obbligo) di decidere sia quando sia quanto gas ritirare, essendo tuttavia obbligato a soddisfare dei vincoli di quantità minima e massima sia su ciascun periodo di ritiro (solitamente il giorno) sia complessivamente sull'anno. Da un lato, tale flessibilità volumetrica ben si adatta a soddisfare una domanda altalenante e imprevedibile. Dall'altro lato, un contratto swing può semplicisticamente essere visto come una strip di opzioni sullo spread tra il prezzo del gas di mercato e il prezzo contrattuale di ritiro: in quest'ottica, esso diventa un ottimo strumento di gestione del rischio derivante dalle fluttuazioni di prezzo nel breve periodo, permettendo di non esercitare, o di esercitare il minimo possibile, nei momenti avversi. La corretta valutazione di simili contratti è oggi di grande importanza sia per ragioni di trading, essendo il prezzo di tali opzioni contrattato direttamente tra i players del mercato e non più imposto come durante il regime regolamentato, sia per ragioni di ottimizzazione di portafoglio, poiché le flessibilità volumetriche offerte possono potenzialmente essere usate anche per generare puri profitti. Partendo da quanto esposto in [6] per i mercati energy, in questa tesi si descrive e risolve, a tempo continuo, il problema del pricing di un contratto swing tipico dei mercati gas, in cui sia il prezzo di mercato quanto il prezzo contrattuale (prezzo strike, o indice) sono aleatori. In pratica, il prezzo strike viene aggiornato mensilmente, mentre il prezzo di mercato cambia con granularità almeno giornaliera: tecnicamente questo origina un problema di controllo ottimo stocastico in cui una variabile è discreta, mentre tutte le altre sono continue. Per superare questa difficoltà, e ridurre il problema ad uno classico a solo tempo continuo, si introduce una variabile di stato ad hoc, corrispondente alla dinamica a tempo continuo dell'indice. Tale variabile continua verrà successivamente campionata ad opportuni intervalli di tempo per ottenere la reale successione discreta di strikes contrattuali. Dopodiché, si dimostra che il prezzo del contratto è dato da una serie di problemi di controllo ottimo, ciascuno dei quali viene risolto all'interno di un periodo tra due cambi consecutivi dello strike. Si dimostra quindi che le funzioni valore di tali problemi di controllo ottimo sono l'unica soluzione di viscosità delle equazioni di Hamilton-Jacobi-Bellman (HJB) associate a ciascun problema, e che tali soluzioni sono sufficientemente regolari da garantire l'esistenza del controllo ottimo. Sommariamente, questo è il contenuto dei primi due capitoli, nei quali, dopo aver richiamato la nozione e i principali risultati noti sulle soluzioni di viscosità per i problemi di controllo ottimo, la teoria classica viene estesa ed applicata al problema in oggetto, portando ad alcuni nuovi risultati per le soluzioni di viscosità di equazioni paraboliche non lineari. Il terzo capitolo è dedicato ai metodi numerici. Dopo aver ricavato l'equazione HJB il problema si sposta alla soluzione della stessa. A tal fine, si introduce uno schema di soluzione numerica basato sulle differenze finite. Tale algoritmo necessita di condizioni al contorno sui domini di soluzione, che vengono ricavate analiticamente nell'ipotesi in cui la dinamica dei prezzi di gas e indice segua un caso particolare del modello di Schwartz-Smith ad un fattore, cioè quando si suppone che il logaritmo dei prezzi sia un processo di Ornstein-Uhlenbeck guidato da due moti Browniani correlati. Uno studio empirico, attraverso un caso numerico, sulla stabilità dell'algoritmo FD al variare della discretizzazione del dominio temporale e spaziale completa la parte analitica. Al fine di confrontare i risultati ottenuti con la best practice in uso nelle aziende, il popolare algoritmo noto come Least Square Monte Carlo, originariamente sviluppato da Longstaff e Schwartz per valutare opzioni di tipo americano, viene adattato al problema del pricing di contratti swing. Questo algoritmo, molto usato tra i practitioners, risolve un'approssimazione a tempo discreto del problema originale usando la ricorsione all'indietro. Ad ogni iterazione dell'algoritmo, il valore di continuazione nell'equazione di Bellman a tempo discreto viene regredito sull'informazione presente a quell'istante, ottenuta tramite delle simulazioni Monte Carlo. Due punti in questo tipo di algoritmo risultano essere particolarmente critici: la scelta del tipo e del numero di funzioni di base usate nella regressione, nonchè il numero di simulazioni Monte Carlo adottate. Per quanto riguarda la scelta del tipo di funzioni, seguendo e adattando al caso presente quanto sviluppato in [11], viene introdotto un metodo di regressione basato su funzioni radiali di base, che sembra ben adattarsi a problemi di pricing di contratti strutturati. Riguardo invece l'effetto della scelta del numero di basi e del numero di simulazioni usate nell'algoritmo LSMC, viene presentato uno studio empirico attraverso casi numerici. L'ultimo capitolo riprende quanto già pubblicato in [17] ed estende la valutazione di contratti swing in cui è presente una clausola chiamata di make-up, che in pratica permette più flessibilità nel ritiro del gas abbassando il livello minimo di ritiro di un certo anno, e forzando in uno o più anni successivi il richiamo del gas non preso. Tecnicamente, quando tale clausola è presente, non è più possibile separare il problema di valutazione sugli anni, ma è necessario considerare l'intero intervallo temporale su cui è scritta la clausola di make-up (solitamente da 3 a 5 anni). Per affrontare la complessità del pricing di un tale contratto nel capitolo si introduce un algoritmo basato su alberi, noto come lattice of trees. Dopo un'accurata descrizione di tale algoritmo, anche da un punto di vista di complessità computazionale, il quarto capitolo termina con un'applicazione reale dell'algoritmo di pricing volto ad esaminare l'impatto di vari fattori di mercato e parametri contrattuali sul prezzo di un ipotetico contratto swing

The geometry, deformation mechanism and kinematics of the Sü
rgü
Fault Zone is investigated by using remotely sensed data including Landsat TM and ASTER imagery combined with SRTM, and stereo-aerial photographs. They are used to extract information related to regional lineaments and tectono-morphological characteristics of the SFZ. Various image processing and enhancement techniques including contrast enhancement, PCA, DS and color composites are applied on the imagery and three different approaches including manual, semi automatic and automatic lineament extraction methods are followed. Then the lineaments obtained from ASTER and Landsat imagery using manual and automatic methods are overlaid to produce a final lineaments map. The results have indicated that, the total number and length of the lineaments obtained from automatic is more than other methods while the percentages of overlapping lineaments for the manual method is more than the automatic method which indicate that the lineaments from automatic method does not discriminate man made features which result more lineaments and less overlapping ratio with respect to final map. It is revealed from the detail analysis that, the SFZ displays characteristic deformation patterns of strike-slip faults, such as pressure ridges, linear fault controlled valleys, deflected stream courses, rotated blocks and juxtaposition of stratigraphical horizons in macroscopic scale. In addition to these, kinematic analyses carried out using fault slip data indicated that the Sü
rgü
Fault Zone is dextral strike-slip fault zone with a reverse component of slip and cumulative displacement along the fault is more than 2 km.

Nel 2011 è stato celebrato il 150° anniversario dell’Unità d’Italia. Il paese si è raccolto attorno al Presidente della Repubblica, Giorgio Napolitano, che si è prodigato, col massimo impegno, affinché questo evento fosse un momento di unificazione e non di divisione, un’occasione di riflessione, consolidamento e condivisione dell’identità della nazione, non enfatizzati dalla retorica celebrativa. Mondo politico e culturale si sono avvicendati nell’analisi delle dinamiche che hanno reso istituzioni, organizzazioni e genti protagonisti del percorso di unificazione del paese: dalla formazione ed elaborazione delle idee alla costruzione e concretizzazione dell’azione risorgimentale. A queste celebrazioni ha partecipato anche il Gruppo Ferrovie dello Stato Italiane coniando per l’occasione lo slogan: Da sempre uniamo il paese, comparso in bella mostra sui locomotori dei treni Frecciarossa assieme al logo ufficiale delle celebrazioni: le tre bandiere tricolori. «Abbiamo contribuito a realizzare l’Unità d’Italia»”- si leggeva nella Newsletter di Linea Diretta del marzo 2011, periodico del Gruppo - « Era il 17 marzo del 1861 quando, a conclusione di una delle fasi più gloriose del nostro Risorgimento, fu proclamata la nascita del Regno d’Italia. Mancava ancora il Triveneto e Roma, futura capitale, ma tutti gli Italiani sapevano che oramai si era innescato un processo che avrebbe portato anche il nostro Paese, ultimo fra le grandi nazioni europee, ad essere finalmente libero e unito dal punto di vista geografico e politico. Al giovane governo apparve subito chiaro che era necessario avviare un processo di reale unificazione sociale ed economica del paese e per raggiungere questo obiettivo fu lanciato anche un imponente piano di ammodernamento infrastrutturale, che riguardò innanzitutto la realizzazione di nuove strade ferrate».

Stroke is an important public health problem and the third leading cause of death after coronary heart diesase and all cancers in all over the world. Free radicals and oxidative stress play important role in the pathogenesis of several diseases including atherosclerosis, stroke, cancer, neurodegenerative diseases such as Alzheimer'
s dementia. The activity of paraoxonase (PON1) aganist phenylacetate is known as arylesterase (ARE). Paraoxonase is an esterase associated with high-density lipoprotein (HDL) and contributes to the protective role of this lipoprotein on low-density lipoprotein (LDL) oxidation. Oxidized LDL is known to play a central role in early events in the progression of atherosclerosis which is a risk factor for stroke. Glutathione S-transferases (GSTs) catalyze the conjugation of nonpolar compounds to reduced glutathione (GSH) and detoxify toxic metabolites produced within the cell by oxidative stress to protect cells from oxidant injury. v The maximum ARE enzyme activity was detected at 10 mM Tris-HCl buffer, pH 8.0 and at 45 °
C. ARE enzyme was saturated with its substrate phenylacetate around 20 mM concentration. The apparent Km and Vmax values of human blood serum ARE for phenylacetate were found as 1.66 mM and 3300 nmol/min/mg, respectively. The maximum GST enzyme activity was detected at 2 mM potassium phosphate buffer, pH 5.5 and at 65 °
C. GST enzyme was saturated with its substrate, CDNB around 4.5 mM concentration and with its cofactor, GSH around 8 mM concentration. The apparent Km and Vmax values of human blood serum GST for CDNB substrate were found as 2.8 mM and 0.43 nmol/min/mg and for GSH were found as 4.11 mM and 0.23 nmol/min/mg, respectively. In addition, effects of three different heavy metal ions, Cd+2, Hg+2 and Ni+2, on human blood serum ARE and GST activity were studied and half maximal inhibitory concentrations (IC50) were determined. The main objective of this study was to investigate the human blood serum ARE and GST activities in patient and control groups using the optimized conditions. For this purpose, blood samples were collected from 172 ischemic stroke patients and 105 controls. Then serum obtained from blood samples were used to determine ARE and GST activities. The mean of ARE activity in patient group (n=172, 109.9 ±
32.5 U/mL ) was insignificantly lower than the mean of ARE activity in control group (n=105, 113.5 ±
33.1 U/mL, P=0.284). GST activity of the patients (10.8 ±
4.4 U/L) was insignificantly higher than that of controls (10.5 ±
4.2 U/L, P=0.483 ). In addition, statistical analysis showed hypertension, diabetes and HDL as significant risk factors of stroke.

The topic of this master thesis is design of the mechanical two-point press with eccentric shaft and direct drive. The thesis contains design and control calculations according to given parameters and also contains drawings of main parts for the press.

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PURPOSE: Stroke is a high-incidence cerebrovascular disease with elevated morbidity that results in impairments such as functional disabilities. This study aimed to investigate the functional evolution of individuals in the first six months post-stroke. METHOD: Longitudinal study with 42 stroke patients. The functional independence measure (FIM) and The National Institutes of Health Stroke Scale (NIHSS) were used by multidisciplinary staff 3 times in each participant; the first application was at admission to rehabilitation and the others three and six months later. RESULTS: Sample predominantly female (57%), married (52%), mean age 65.26 ?10.72 years, elementary schooling level (43%), ischemic stroke (91%), and right cerebral hemisphere (74%). Motor FIM scores and NIHSS scale showed improvement in the 3 evaluations, with significant p-value (<0.001). There was a strong relation between motor FIM evolution and NIHSS evolution (r = - 0.69 p-value< 0.001). CONCLUSIONS: It was observed that functional evolution at 6 months post-stroke was significant and the smaller the evolution of clinical impairment in these patients, the larger the evolution of their functional independence. The study is important because it allows a more appropriate therapeutic planning according with functional evolution in stroke rehabilitation
O Acidente Vascular Cerebral - AVC ? uma doen?a cerebrovascular que corresponde a um dos principais motivos de incapacidade e mortalidade a n?vel mundial, tendo como conseq??ncia comprometimentos cognitivos e funcionais. OBJETIVO: Este estudo objetivou investigar a evolu??o da cogni??o e da independ?ncia funcional de pacientes p?s-AVC agudo em processo de reabilita??o. M?TODO: Por meio de uma abordagem multidisciplinar envolvendo distintas ?reas da sa?de (Fisioterapia, Neurologia, Psicologia, Terapia Ocupacional e Fonoaudiologia), esta pesquisa proporcionou a elucida??o do objeto de estudo relacionado aos dom?nios cognitivos e funcionais de pacientes p?s-AVC. O Estudo desenvolvido foi do tipo observacional e longitudinal com 42 indiv?duos p?s-AVC agudo. O Mini Exame do Estado Mental (MEEM), a Medida de Independ?ncia Funcional (MIF) e a Escala de Severidade Cl?nica (NIHSS) foram utilizados para avaliar a cogni??o, a fun??o e a severidade cl?nica do AVC respectivamente. Para an?lise estat?stica dos dados utilizou-se o programa SPSS vers?o 15.0 com emprego do Teste de Friedman e do teste de Wilcoxon com corre??o de Bonferroni. RESULTADOS: Amostra predominantemente feminina (57%), casada (52%) com n?vel de escolaridade fundamental (43%) e m?dia de idade 65,26 ?10,72 anos. Houve maior preval?ncia do AVC tipo Isqu?mico (91%), sendo o Hemisf?rio cerebral direito o mais acometido (74%). A an?lise evolutiva da MIF evidenciou evolu??o significativa para a pontua??o total (p= 0,001) e para todos os dom?nios espec?ficos (p<0,05). J? a an?lise do MEEM xiv evidenciou evolu??o significativa apenas para indiv?duos escolarizados com pvalor para pontua??o total p=0,008 e para os dom?nios espec?ficos Orienta??o Espacial (p=0,010) e Linguagem (p =0,010). A evolu??o da cogni??o e da fun??o apresentou rela??o negativa e significativa com a evolu??o da severidade cl?nica dos pacientes (r= - 0,47; p=0,01 / r = - 0,64; p= 0,001). CONCLUS?O: Os achados encontrados apontam para uma evolu??o cognitiva e funcional favor?vel de pacientes p?s-AVC num per?odo de seis meses de acompanhamento. Al?m disso, existiu rela??o entre a severidade cl?nica e o n?vel de cogni??o e independ?ncia funcional destes pacientes, evidenciando assim, a necessidade de maior aten??o aos aspectos cognitivo e funcional durante o processo de reabilita??o

Diploma thesis deals with design of crankshaft for two stroke opposed piston diesel engine. In the theoretical research part a history, comparison with competitive engines in nowadays light aircrafts and the advantages of opposed piston engines are mentioned. In the practical part the balancing is chosen and CAD model of crankshaft is designed. Geometry of this model is than checked for fatigue damage fallout. In the final part was chosen the propeller and appropriate reduction gearbox.

The master´s thesis deals with the design of two-stroke uniflow scavenged motorcycle engine according to patent František Pudil (PV 7018-80) 216305. The engine has been designed for using in off-road sport motorcycles. The objective of this thesis is to design the engine of this conception and to reveal benefits and defects of this concept by using this method. In this thesis the emphasis is put on design of the construction groups which are directly related to unconventional concept of engine. On the other hand, the parts which can be designed conventionally were solved marginally or were not solved at all. In the first part of the thesis there are thoroughly dicsussed expected benefits and disadvantages of this concept. Computational part focuses on valvetrain and porting of engine. Last part deals with design of engine parts.

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O desvio g?strico em Y de Roux ? a t?cnica cir?rgica mais utilizada no tratamento da obesidade m?rbida. Esta opera??o reduz o volume do est?mago e o comprimento do intestino delgado, gerando altera??es estruturais e metab?licas que podem influenciar no resultado de exames cintilogr?ficos de pacientes operados. Com o objetivo de avaliar a biodistribui??o p?s-operat?ria do pertecnetato de s?dio (Na99mTc) em ?rg?os de ratos Wistar submetidos ? t?cnica do bypass (desvio) g?strico em Y de Roux (BGYR), foram utilizados 12 ratos distribu?dos aleatoriamente em grupo tratado (n=6), submetido ? cirurgia do BGYR e o grupo controle (C; n=6). No 15? dia de p?s-operat?rio foi administrado 0,1 mL via plexo orbital de Na99mTc aos animais dos dois grupos, com atividade radioativa m?dia de 0,66MBq. Ap?s 30 minutos, os ratos foram mortos e retirados fragmentos de tire?ide, cora??o, pulm?o, f?gado, est?mago, rim e f?mur. As amostras foram lavadas com solu??o salina 0,9%, pesadas e submetidas ao Contador Gama 1470, WizardTM Perkin-Elmer-Finl?ndia para determina??o do percentual de atividade radioativa total por grama (%ATI/g) de cada ?rg?o. Empregou-se o teste t de Student para an?lise estat?stica, considerando-se significantes as diferen?as das m?dias quando p<0,05. Redu??o significante na m?dia de %ATI/g foi observada no f?gado, est?mago e f?mur dos animais submetidos ? cirurgia de BGYR comparada ao grupo controle (p<0,05). Nos demais ?rg?os n?o houve diferen?a estatisticamente significativa entre os grupos. Em conclus?o, a cirurgia BGYR em ratos modificou a biodistribui??o do Na99mTc em alguns ?rg?os, podendo ter implica??es cl?nicas na interpreta??o de exames cintilogr?ficos. Este estudo xi teve um car?ter multidisciplinar com a participa??o de pesquisadores das ?reas de Cirurgia Experimental, Farm?cia, Radiobiologia, Medicina Nuclear e Estat?stica

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Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico
ABSTRACT Introduction: The cerebrovascular accident (CVA) is an important cause of neurological impairment. Few data about the factors associated with morbidity of cerebrovascular accident are found in Brazil. Objectives: Evaluate sociodemographic characteristics, sleep habits, cognitive and functional status of patients with cerebrovascular accident. Methods: The patients evaluated through questionnaire Step 1 to survey the sociodemographic characteristics and Modified Rankin Scale for functional assessment. The neurological degree was evaluated by the National Institutes of Health Stroke Scale (NIHSS), the sleep Habits questionnaire for sleep and cognitive status by the Mini-Examination of the Mental State (MEMS). The data were analyzed using the chi-square test to determine differences in proportions of variables and linear regression analysis. Results: 305 patients were evaluated and the larger number of subjects was between 50 and 69 years (40%), most patients had no formal education (40.3%) and had ischemic type of cerebrovascular accident (72.5%). In the analysis of the functionality it was found that most patients had moderate impairment (55.1%). The results of the sleep habits showed that 63,6% of patients had one more person in the bedroom,12,3% complained about too much noise in the 11 room and 35% of too much light. From these patients 5,8% were smokers, 7,8% and 70,1% drank coffee drinkers, 28,6% had difficulty in initiate to sleep and woke up 37,6% in the middle of the night. Were showed complaints about nightmares (11%), feeling of suffocation (37,7%) and 35% felt very sleepy during the day. In addition, 95% were unemployed, 80,5% did not perform physical activities and 95,4% did not perform mental activities. The cognitive screening conducted a determined association of cognitive status with age and education level and neurological status. Conclusion: The study showed a high frequency of cases of cerebrovascular accident with functional dependence in a moderate degree, identified that many patients do not follow hygienic measures of sleep and found that the assessment of cognitive deficits must take into consideration the age, educational level and degree of neurological patients. We suggest the need for programs of assistance to victims of cerebrovascular accident patients, with a multidimensional approach including the rehabilitation team, the role of sleep medicine and Neuropsychology, so that patients have access to a more appropriate functional rehabilitation, develop a lifestyle that ensures a good sleep quality and are evaluated and rehabilitated with regard to cognitive impairment
Introdu??o: O Acidente Vascular Cerebral (AVC) ? uma importante causa de comprometimento neurol?gico. Poucos dados ? respeito dos fatores associados ? morbidade do AVC s?o encontrados no Brasil. Objetivos: Avaliar as caracter?sticas sociodemogr?ficas, h?bitos de sono, estado cognitivo e funcional de pacientes com AVC. M?todos: Os pacientes foram avaliados atrav?s do question?rio Step 1 para levantamento das caracter?sticas sociodemogr?ficas e Escala Modificada de Rankin para avalia??o funcional. O grau neurol?gico foi avaliado pela National Institute of Health Stroke Scale (NIHSS), o sono pelo Question?rio de H?bitos de sono e o estado cognitivo pelo Mini-Exame do Estado Mental (MEEM). Os dados foram analisados atrav?s do teste Qui-quadrado para verificar diferen?as nas propor??es das vari?veis estudadas e an?lise de regress?o linear. Resultados: Foram avaliados 305 pacientes e o maior n?mero de indiv?duos estava entre 50 e 69 anos (40%), grande parte dos pacientes n?o possu?a estudo formal (40,3%) e tinham AVC do tipo isqu?mico (72,5%). Na an?lise da funcionalidade constatou-se que a maioria dos pacientes tinha incapacidade moderada (55,1%). Os resultados dos h?bitos de sono apontaram que 63,6% dos pacientes apresentavam mais uma pessoa no quarto de dormir, 12,3% se queixavam de muito barulho no quarto e 35% de muita ilumina??o. Dos pacientes avaliados 5,8% fumavam, 7,8% bebiam e 70,1% tomavam caf?, 28,6% apresentavam dificuldade de iniciar o sono e 37,6% acordavam no meio da noite. Foram apresentadas queixas de pesadelos (11%), sensa??o de sufoco (37,7%) e 35% sentiam muito sono durante o dia. Al?m disso, 95% n?o trabalhavam, 80,5% n?o realizavam atividades f?sicas e 95,4% n?o realizavam atividades mentais. O rastreamento cognitivo realizado determinou uma associa??o do estado cognitivo com a idade e escolaridade e o grau neurol?gico. Conclus?o: O estudo conseguiu evidenciar uma frequ?ncia elevada de casos de AVC com depend?ncia funcional de grau moderado, identificou que muitos pacientes n?o seguem medidas de higiene do sono e verificou que a avalia??o de 10 d?ficits cognitivos deve levar em considera??o a idade, escolaridade e o grau neurol?gico dos pacientes. Sugerimos a necessidade de programas de aten??o aos pacientes v?timas do AVC, com uma abordagem multidimensional incluindo a equipe de reabilita??o, a atua??o da Medicina do sono e da Neuropsicologia, a fim de que os pacientes tenham acesso a uma reabilita?ao funcional mais adequada, desenvolvam um estilo de vida que garanta uma boa qualidade de sono e sejam bem avaliados e reabilitados quanto aos comprometimentos cognitivos

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Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior
Mirror therapy (MT) is being used as a rehabilitation tool in various diseases, including stroke. Although some studies have shown its effectiveness, little is known about neural mechanisms that underlie the rehabilitation process. Therefore, this study aimed at assessing cortical neuromodulation after a single MT intervention in ischemic stroke survivors, by means of by functional Magnetic Resonance Imaging (fMRI) and Transcranial Magnetic Stimulation (TMS). Fifteen patients participated in a single thirty minutes MT session. fMRI data was analyzed bilaterally in the following Regions of Interest (ROI): Supplementary Motor Area (SMA), Premotor cortex (PMC), Primary Motor cortex (M1), Primary Sensory cortex (S1) and Cerebellum. In each ROI, changes in the percentage of occupation and beta values were computed. Group fMRI data showed a significant decreased in the percentage of occupation in PMC and cerebellum, contralateral to the affected hand (p <0.05). Significant increase in beta values was observed in the following contralateral motor areas: SMA, Cerebellum, PMC and M1 (p<0,005). Moreover, a significant decrease was observed in the following ipsilateral motor areas: PMC and M1 (p <0,001). In S1 a bilateral significant decrease (p<0.0005) was observed.TMS consisted of the analysis of Motor Evoked Potential (MEP) of M1 hotspot. A significant increase in the amplitude of the MEP was observed after therapy in the group (p<0,0001) and individually in 4 patients (p <0.05). Altogether, our results imply that single MT intervention is already capable of promoting changes in neurobiological markers toward patterns observed in healthy subjects. Furthermore, the contralateral hemisphere motor areas changes are opposite to the ones in the ipsilateral side, suggesting an increase system homeostasis.
A Terapia Espelho (TE) vem sendo usada como ferramenta de reabilita??o para v?rias doen?as, incluindo o Acidente Vascular Cerebral (AVC). Embora alguns estudos tenham mostrado sua efic?cia cl?nica, pouco se sabe sobre os mecanismos neurais que levam ? melhora observada. Desse modo, este estudo teve como objetivo avaliar a neuromodula??o cortical promovida pela interven??o ?nica da TE em pacientes acometidos por AVC, por meio da Resson?ncia Magn?tica funcional (fMRI, do ingl?s Functional Magnetic Resonance Imaging) e da Estimula??o Magn?tica Transcraniana (TMS, do ingl?s Transcranial Magnetic Stimulation). Quinze pacientes participaram de sess?o ?nica de trinta minutos de TE. Os dados de fMRI foram analisados nas seguintes regi?es de interesse (ROI), bilateralmente: ?rea Motora Suplementar (AMS), c?rtex pr?-motor (PM), c?rtex motor prim?rio (M1), c?rtex sensorial prim?rio (S1) e Cerebelo. Em cada ROI, as mudan?as na porcentagem de ocupa??o e os valores de beta foram avaliados. Os resultados revelaram redu??o significativa no percentual de ocupa??o no PM e cerebelo contralateral ? m?o afetada (p <0,05). Al?m disso, foi observado aumento significativo nos valores de beta nas seguintes ?reas motoras contralaterais: AMS, Cerebelo, PM e M1 (p <0,005) e diminui??o significativa nas seguintes ?reas motoras ipsilaterais: PM e M1 (p < 0,001). Nas ?reas sensoriais foi observada redu??o em S1 bilateralmente (p <0,0005). Pela TMS foi analisado o Potencial Evocado Motor (PEM) sobre o hot spot de M1. Aumento significativo na amplitude do PEM foi observado ap?s a terapia no grupo (p<0,0001), e individualmente em 4 pacientes (p <0,05). Assim, nossos resultados indicam que interven??o ?nica da TE muda marcadores neurobiol?gicos em dire??o ao padr?o observado em indiv?duos saud?veis. Al?m disso, as altera??es nas ?reas motoras do hemisf?rio contralateral s?o opostas as do lado ipsilateral, sugerindo um aumento na homeostase do sistema.

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Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior
This paper aims to verify the Burnout?s possibilities of incidence, finding the creating dimensions and comparing with the socio-demographics characteristics of the researched professionals. This quantitative-descriptive search has a population of 197 workers of 23 nourishing companies in Rio Grande do Norte. This population is predominantly male, younger than 28 years old, single, relatively instructed (57,07% with complete high school) and having just started their current job since 79% of the interviewees are in the company less than six years. The AUDITORIA DO SISTEMA HUMANO (ASH) model, utilized for investigation and developed for the Spaniards Quijano and Navarro in 1999, has several dimensions about human resources management and the organizational effectiveness, but only makes part of the research in 19 questions Burnout referring. It was used factorial analyses with extraction method, varimax rotation and Kaiser normalization with the intuition to define the creating dimensions of the syndrome, they were evaluated with Cronbach Alpha coefficient after extraction. The dimensions found through the factorial analyses were: emotional exhaustion, physical exhaustion and vitality. The accumulated explanation value reached 65,30% of total variation. The data socio-demographics don t justify the syndrome appearance, because the T test and ANOVA showed irrelevant values. It has been also observed that the founded dimensions were different of the Maslach sociopsychological perspective (emotional exhaustion, depersonalization and low professional realization) allowing comparison with others researches and the possibility to develop new ones with workers from different assistance areas. These new researches are important, since the syndrome refers to chronic labor stress consequences and any professional is favorable to Burnout, harmful to the company as to the collaborators
Este estudo objetiva verificar a possibilidade de incid?ncia da s?ndrome de burnout, encontrando as dimens?es formadoras e comparando com as caracter?sticas s?ciodemogr?ficas dos profissionais pesquisados. A pesquisa de cunho quantitativodescritiva tem como popula??o 197 funcion?rios de 23 empresas do setor aliment?cio do Estado do Rio Grande do Norte e ? predominantemente masculina, com idade inferior a 28 anos, solteira, relativamente culta (57,07% possuem ensino m?dio completo) e com pouco tempo no emprego, j? que 79% dos entrevistados est?o na empresa a menos de seis anos. O modelo da Auditoria do Sistema Humano (ASH), instrumento de investiga??o utilizado que foi desenvolvido pelos espanh?is Quijano e Navarro em 1999, possui v?rias dimens?es sobre a gest?o da qualidade dos Recursos Humanos e a efetividade organizacional, mas s? fizeram parte da pesquisa as 19 quest?es referentes ao burnout. Com intuito de definir as dimens?es formadoras da s?ndrome, foi utilizada a an?lise fatorial com m?todo de extra??o, rota??o varimax e normaliza??o Kaiser, sendo avaliadas, ap?s a extra??o, com o coeficiente Alpha de Cronbach. As dimens?es encontradas atrav?s da an?lise fatorial foram: exaust?o emocional, esgotamento e vitalidade, tendo o valor da explica??o acumulada atingido 65,30% da varia??o total. Os dados s?ciodemogr?ficos n?o justificaram o aparecimento da s?ndrome, pois o Teste T e a ANOVA apresentaram valores irrelevantes. Observou-se tamb?m que as dimens?es encontradas no trabalho foram diferentes da perspectiva social-psicol?gica de Maslach (exaust?o emocional, despersonaliza??o e baixa realiza??o profissional) permitindo assim a compara??o com outros estudos e a possibilidade de desenvolvimento de novas pesquisas com funcion?rios de ?reas diferentes da assistencial. Essas novas pesquisas s?o importantes, uma vez que a s?ndrome refere-se ? conseq??ncia do estresse laboral cr?nico e qualquer profissional est? prop?cio ao burnout, prejudicial tanto para empresa quanto para os colaboradores

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Introduction: The aim of this study was to evaluate the correlation between improvement in dyslipidemia and changes in body fat percentage. Material and Method: We conducted an observational, retrospective cohort study of patients subjected to gastric bypass. We selected patients who underwent bioimpedance analysis before surgery and at 3, 6 and 12 months postoperatively. Patients underwent laboratory tests and anthropometric measurements at the same time. Results: We studied 228 patients with a mean age of 37.4 ? 11.7 years. Most patients were female (76.3%). Initially, 143 patients (66.2%) showed criteria for dyslipidemia, and 6 months after surgery, this number fell to 83 patients (50.6%) and continued falling over time to only 45 patients (28.5%) 12 months after surgery. In relating different variables with the decrease in percent body fat at 12 months, a significant association was seen with weight loss (r=0.258; p=0.009), BMI (r=0.272; p=0.005) and waist circumference (r=0.357, p <0.001). However, the only biochemical parameter showing a significant association was HDL-C level (r=-0.267; p=0.009). Patients with the greatest decrease in body fat percentage were those with the largest decrease in weight, BMI and waist circumference and highest increase in HDL-C level. Conclusion: This study demonstrated the association of decrease in percent body fat with increase in HDL-C, regardless of sex and age. The same association was also observed when using the parameters BMI, weight loss and waist circumference.
Introdu??o: O objetivo deste estudo ? avaliar a correla??o entre a melhora da dislipidemia e as altera??es do percentual de gordura corporal. Material e M?todo: Realizamos uma coorte observacional e retrospectiva, pacientes submetidos ao Bypass g?strico. Foram selecionados pacientes que realizaram bioimped?ncia antes da cirurgia e nos meses 3, 6 e 12 de p?s-operat?rio. Os pacientes realizaram exames laboratoriais e medidas antropom?tricas no mesmo momento. Resultados: Foram avaliados 228 pacientes com m?dia de idade de 37,4?11,7 anos. A predomin?ncia foi do sexo feminino (76,3%). Inicialmente 143 pacientes (66,2%) apresentavam crit?rios para dislipidemia e ap?s 6 m?s de cirurgia este n?mero caiu para 83 pacientes (50,6%) e continuou reduzindo at? um ano p?s-cir?rgico chegando a apenas 45 pacientes (28,5%) ap?s 12 meses de cirurgia. Na avalia??o da associa??o das vari?veis com a redu??o do percentual de gordura corporal aos 12 meses, as que se associaram significativamente foram a redu??o do peso (r=0,258; p=0,009), IMC (r=0,272; p=0,005) e circunfer?ncia abdominal (r=0,357; p<0,001). No entanto, com os par?metros bioqu?micos a associa??o foi significativa apenas com os n?veis de HDL (r=-0,267; p=0,009). Pacientes com maior redu??o do percentual de gordura corporal foram os que mais reduziram o peso, IMC e circunfer?ncia abdominal e tamb?m foram os que mais aumentaram os n?veis de HDL. Conclus?o: Este trabalho evidenciou a associa??o da redu??o do percentual de gordura corporal com o aumento do HDL, independente do sexo e da idade. A mesma associa??o tamb?m foi observada quando utilizados os par?metros IMC, redu??o de peso e medida da circunfer?ncia abdominal.

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A Obesidade ? uma doen?a cr?nica de etiologia multifatorial que se caracteriza por excesso de gordura corp?rea, cujo grau varia de acordo com o ?ndice de Massa Corporal (IMC=m2 /kg). A obesidade grave ? caracterizada por IMC>40, frequentemente associada a altera??es cl?nicas end?crino-metab?licas ou mec?nicas e transtornos psicol?gicos; o quadro de Compuls?o Alimentar Peri?dica (CAP) tem alta incid?ncia nesta popula??o. A cirurgia Bari?trica vem sendo o tratamento de escolha para a obesidade grave, por apresentar r?pido emagrecimento e melhora nas condi??es cl?nicas. T?m-se verificado aumento de peso ap?s dois anos de cirurgia em 20% a 30% dos casos. O objetivo geral desta pesquisa ? avaliar caracter?sticas psicol?gicas e comportamentais entre obesos graves submetidos ? Cirurgia Bari?trica do tipo Bypass G?strico h? pelo menos 24 meses. Foram investigados aspectos espec?ficos como, (1) caracter?sticas do funcionamento personalidade e presen?a de transtornos cl?nicos e de personalidade; (2) a incid?ncia de CAP e sua rela??o com perda de peso; (3) a diferen?a entre os grupos em rela??o aos acompanhamentos p?s-cir?rgicos; atividade f?sica, acompanhamento psicol?gico e nutricional. M?todo: 40 adultos (homens e mulheres), com idades entre 23 a 60 anos, submetidos ? cirurgia bari?trica h? pelo menos 24 meses, na cidade de Natal-RN, foram divididos em dois grupos com n= 20, Grupo de Ganho, com perda < 50% do peso excedente inicial, e o Grupo de Perda, com perda >50%. O protocolo de pesquisa foi composto por question?rio biossociodemogr?fico, o m?todo de Rorschach ? Sistema Compreensivo (SC); Invent?rio de Personalidade de Millon (MCMI-III); e Escala de Compuls?o Alimentar Peri?dica (ECAP). Atrav?s do m?todo de Rorschach foram evidenciadas diferen?as significativas entre os dois grupos, relacionadas aos tipos vivenciais (EB), maior presen?a de EB Extratensivo no Grupo Ganho e Intratensivo no Grupo de Perda; e ao descontrole na express?o dos afetos, com eleva??o de respostas de Cor Pura no Grupo Ganho. Em rela??o ? popula??o normativa do SC, a amostra como um todo apresentou maior tend?ncia a experienciar sofrimento ps?quico, auto percep??o denegrida, autocr?tica excessiva, distor??es perceptivas, vulnerabilidade a desenvolver transtornos afetivos e eleva??o da pontua??o na Constela??o de Suic?dio. O MCMI-III indicou maior incid?ncia de transtornos cl?nicos e de personalidade no Grupo Ganho: Transtorno Depressivo e Esquizot?pico, Ansiedade, Distimia, Depress?o Maior; Transtorno do Pensamento, Bipolar- Man?aco e Transtornos de Estresse P?s-Traum?tico. Os resultados da ECAP indicaram diferen?a significativa, com eleva??o de CAP no Grupo de Ganho como tamb?m, entre a gravidade de CAP e presen?a de transtornos cl?nicos e de personalidade. Em rela??o aos acompanhamentos foi encontrada diferen?a significativa no quesito atividade f?sica com mediana elevada no Grupo de Perda. Os grupos ainda se diferenciaram em rela??o ao peso inicial e tempo p?scir?rgico, indicando que quanto maior o peso inicial e tempo percorrido maior o aumento de peso p?s-cir?rgico. Os resultados ainda revelam que os participantes com mais de 3 anos de tempo cirurgia, apresentam eleva??o na presen?a de Transtornos Cl?nicos de Transtorno Depressivo Maior; Transtorno Somatoforme; Distimia. Tais resultados corroboram conclus?es de estudos sobre a rela??o entre CAP p?s-cir?rgico e novo ganho de peso, como tamb?m acerca de maior incid?ncia de transtornos cl?nicos na popula??o obesa grave. Conclui-se que o processo cir?rgico ? apenas uma faceta do tratamento da obesidade grave, e que o acompanhamento p?s-cir?rgico deve receber maior aten??o e ocorrer em longo prazo para a manuten??o n?o s? dos resultados cir?rgicos, como da melhoria da qualidade de vida dos pacientes.
Obesity is a chronic disease that has multi-factorial aetiology, characterized by high degree of body fat; the degree of obesity will vary according to the Body Mass Index (BMI=m2 /kg). The severe degree of obesity is characterized by BMI>40 and it is regularly associated to endocrine-metabolic or mechanic clinical alterations, and to psychological disorders. Binge Eating (BE) results were overly high for this population. The Bariatric Surgery has been the treatment chosen by those diagnosed with severe obesity as this intervention provides prompt outcomes for loss of weight and clinical improvement conditions. However, recent research has acquiesced that after two years between 20% and 30% of people subject to this intervention gained weight. The main objective of this research is to assess the psychological and behavioral characteristics of those diagnosed with severe obesity that have been subject to Gastric Bypass Surgery in the past 24 months. Specific aspects were investigated: (1) characteristics of different personalities and diagnose of clinic and personality disorders; (2) BE and its relation with loss of weight; (2) the difference between the groups regarding post-surgery care, e.g. physical activity, psychological and dietician input. Method: 40 adults (women and men) aged 23 and 60 year-old who went through a bariatric surgery in the past 24 months, in the city of Natal-RN (Brazil); they were assembled in two groups n=20, Gain group displaying loss of < 50% of their initial surplus of weight, and the Loss group displaying loss of >50%. The research protocol is made of a socio-demographic questionnaire and 3 psychometric instruments: Rorschach ? Comprehensive System; Millon Personality Inventory (MCMI-III); and the Binge Eating Scale (Escala de Compuls?o Alimentar Peri?dica (ECAP). Through Rorschach significant differences between these groups were verified according to the kind of personality (EB) - more EB Extratensivo in Gain group and Intratensivo in Loss group ? and the lack of control to express affect, increasing the answer for Color Pure at Group I. Concerning the people standardization, the sample as a whole tends to show psychic pain, denigrated selfperception, high levels of self-criticism, distorted perceptions, vulnerability to develop mood disorders and high scores regarding Suicide. MCMI-III results showed more clinic and personality disorders in Group I: Depressive Disorder and Schizotypal, Anxiety, Dysthymia, Major Depressive Disorder; Thought Disorder, Bipolar- Manic and Posttraumatic Stress Disorder. In relation to ECAP, the results indicated significant differences, showing increased BE results in Gain group. There were found significant differences between BE severity and the presence of clinic and personality disorders. Concerning the post-surgery care, the observed differences are statistically significant regarding physical activities with median-increased differences in Loss group. There is a difference between the initial weight and the time post-surgery, indicating that the higher the initial weight and the time after the surgery the higher the re-gain of weight post-surgery. Finally, the results show that the participants with more than 3 years of surgery will have Clinic and Major Depressive Disorders; Somatoform Disorder; Dysthymia. These results confirm prior studies related to BE post-surgery and re-gain of weight as well as the proneness of clinic disorders in severe obesity people. That means the results reinforce that the surgery process is a facet of the severe obesity treatment. The post-surgery process needs to be the main focus of attention and have a long-term input to sustain the care of the surgery results and the quality of life of the patients.

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Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq
The present paper studies how two newspapers reported the strikes of 1978, 1979 and 1980, the two newspapers we chose for this were ABCD Jornaland Folha de S. Paulo, the choice of these strikes is due to its repercussion in the media and its unfolding by its leaders in the creations of a political party and a workers, Folha de S. Pauloand ABCD Jornalnewspapers were our sources of research. The Folhathat defended the military civilian regime at its birth will be an opponent of the created legislations and seeks to break with the imposed regime, but always maintaining a legalistic stance, the ABCD Jornalwill have a distinct path some of its idealizers started their fight against the dictatorship imposed on the Brazil with clandestine actions and formation of guerrilla groups, after their arrests this group began a rapprochement of the trade union movement, denouncing the ills suffered by the works through the newspaper that constructed the ABCD Jornal, this will have like the leaf a legalistic stance, each interpreting to the strike movement from his point of view
O presente trabalho tem por intuito o estudo de como dois jornais noticiaram as greves de 1978, 1979 e 1980. Os dois jornais escolhidos como fonte de pesquisa foram o ABCD Jornale Folha de S. Paulo.A escolha destas greves como foco do estudo se deu devido a sua repercussão na mídia e seus desdobramentos por parte de seus lideres na criação de um partido político e uma Central dos Trabalhadores. O jornal A Folha,que defendeuo regime civil militar em seu nascimento, será um opositor das legislações criadas e busca romper com o regime imposto, porém, sempre mantendo uma postura legalista. O ABCD Jornalterá um caminho distinto, pois alguns de seus idealizadores iniciaram sua luta contra a ditadura imposta no Brasil com ações clandestinas e com a formação de grupo guerrilheiro. Após suas prisões este grupo iniciou uma reaproximação do movimento sindical, denunciando as mazelas sofridas pelos trabalhadores através do jornal que construíram o ABCD Jornal. O ABCD Jornal teve, assim como a Folha, uma postura legalista, cada um interpretando a lei sob seu ponto e vista

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Introduction: Obesity is one of the most important nutritional diseases in the modern world, especially in its abdominal form, where adipose tissue implies a higher cardiovascular risk and is responsible for inflammatory phenomena. Abdominal obesity predisposes to calcification of the coronary arteries and endothelial dysfunction, as well as the occurrence of other comorbidities such as hypertension diabetes and Obstructive Sleep Apnea Hypopnea Syndrome (OSAHS). OSAHS leads to decreased quality of life (QOL) and functional capacity, together with an increased risk of cardiovascular disease, predisposing to higher rates of morbidity and mortality. Objectives: To evaluate the impact of weight loss in the first six months after bariatric surgery on endothelial function in patients with and without obstructive sleep apnea syndrome (OSAHS). Methodology: the sample consisted of 56 patients homogeneously divided into groups without OSAHS (control group) and with OSAHS (OSAHS). All patients were evaluated in the Roux-en-Y Gastric Bypass (RYGB) preoperative period and six months after surgery. OSAHS diagnosis in the preoperative period was performed using instruments validated for apnea tracking and confirmed by polysomnography. The evaluations included anthropometric measurements, electrical bioimpedance, clinical symptoms of OSAHS and endothelial function, through the flow-mediated dilatation (FMD) of the brachial artery. Results: weight loss induced by surgery improved the anthropometric, bioimpedance and endothelial function results in both groups. Patients presented a significant clinical improvement in the symptoms of OSAHS throughout the study. However, patients with OSAHS had an improvement in the endothelial function 2.5% lower (p <0.001) than the control group. Conclusion: this study shows that the presence of OSAHS before bariatric surgery interferes in the clinical picture, interfering in the improvement of endothelial function.
Introdu??o: a obesidade ? uma das doen?as nutricionais mais importantes do mundo moderno, principalmente, em sua forma abdominal, onde o tecido adiposo implica em maior risco cardiovascular e ? respons?vel por fen?menos inflamat?rios. A obesidade abdominal predisp?e ? calcifica??o das art?rias coron?rias e ? disfun??o endotelial, bem como ao aparecimento de outras comorbidades como a hipertens?o, a diabetes e a S?ndrome da Apneia Hipopneia Obstrutiva do Sono (SAHOS). A SAHOS leva ? diminui??o da qualidade de vida (QV) e da capacidade funcional, juntamente com um risco aumentado de doen?a cardiovascular, predispondo a maiores ?ndices de morbidade e mortalidade. Objetivos: avaliar o impacto da perda de peso ocorrida nos primeiros seis meses ap?s a realiza??o da cirurgia bari?trica sobre a fun??o endotelial em pacientes, com e sem s?ndrome da apneia hipopneia obstrutiva do sono (SAHOS). Metodologia: a amostra foi composta por 56 pacientes homogeneamente divididos em grupos sem SAHOS (grupo controle) e com SAHOS (SAHOSG). Todos os pacientes foram avaliados no pr?-operat?rio do Bypass G?strico em Y de Roux (RYGB) e seis meses ap?s a cirurgia. O diagn?stico de SAHOS no pr?-operat?rio foi realizado atrav?s dos instrumentos validados para rastreamento de apneia e confirmados por polissonografia. As avalia??es compreenderam medidas antropom?tricas, bioimped?ncia el?trica, sintomas cl?nicos de SAHOS e fun??o endotelial, pela dilata??o mediada pelo fluxo (FMD) da art?ria braquial. Resultados: o emagrecimento induzido pela cirurgia melhorou os resultados antropom?tricos, da bioimped?ncia e da fun??o endotelial em ambos os grupos. Os pacientes apresentaram uma sens?vel melhora cl?nica nos sintomas da SAHOS ao longo do estudo. Entretanto, os pacientes com SAHOS, apresentaram uma melhora na fun??o endotelial 2,5% menor (p< 0.001) que o grupo controle. Conclus?o: Este estudo demostrou que a presen?a de SAHOS, previamente ? cirurgia bari?trica, interfere no quadro cl?nico e na melhora da fun??o endotelial.

La proteína de adhesión vascular 1 (VAP-1) es una proteína pro-inflamatoria que facilita el reclutamiento leucocitario a través de su actividad amino oxidasa sensible a semicarbazida (SSAO, E.C 1.4.3.21). La SSAO plasmática incrementa en pacientes con infarto cerebral o “stroke” isquémico y hemorrágico, y su actividad predice la aparición de hemorragias después del tratamiento con tPA. Además, la SSAO/VAP-1 se encuentra incrementada en plasma y tejido cerebral de pacientes con enfermedad de Alzheimer (EA). Así pues, creemos que la SSAO/VAP-1 puede contribuir al daño vascular en stroke y EA. Sin embargo, los mecanismos moleculares y su posible contribución al nexo stroke-EA se desconocen. En este trabajo hemos establecido un modelo de isquemia sencillo usando células endoteliales periféricas que expresan la SSAO/VAP-1 humana (HUVEC hSSAO/VAP-1) en condiciones de deprivación de oxígeno y glucosa (OGD). Mediante este modelo encontramos que la expresión de SSAO/VAP-1 incrementa la susceptibilidad de las células endoteliales a la OGD, y la oxidación de sus sustratos aumenta el daño vascular. Las caspasas 3 y 8 se activan durante esta muerte celular. Además, la OGD constituye un estímulo para la liberación de SSAO/VAP-1 soluble. También, una OGD corta induce la unión de leucocitos al endotelio dependiente de SSAO/VAP-1, parcialmente mediada por su actividad enzimática. Para evaluar mejor los efectos beneficiosos de nuevos compuestos inhibidores de la actividad SSAO/VAP-1 en isquemia cerebral generamos una línea celular endotelial cerebral humana que expresa la SSAO/VAP-1 (hCMEC/D3 hSSAO/VAP-1), como modelo de barrera hematoencefálica (BHE), y establecimos también las condiciones óptimas de OGD. Mediante el uso de las células HUVEC y hCMEC/D3 que expresan SSAO/VAP-1 probamos que el DPH-4, un nuevo compuesto multidiana diseñado para la EA, es capaz de proteger ambas células y disminuir la adhesión leucocitaria dependiente de SSAO en OGD con reoxigenación (OGD-Reox). El DPH-4 también fue efectivo contra el daño inducido por OGD-Reox en presencia de beta amiloide, como modelo de patología de EA. Para determinar los mecanismos moleculares subyacentes a los efectos beneficiosos de la simvastatina en el stroke, utilizamos las células hCMEC/D3 que expresan SSAO/VAP-1 en OGD, así como dos modelos animales de oclusión de la arteria cerebral media (MCAO). Los resultados revelaron que la simvastatina impide la liberación de SSAO/VAP-1 soluble al plasma o medio de cultivo, la cual induce la expresión de E-selectina y VCAM-1, y amplifica la inflamación y el daño subsiguiente en el cerebro infartado. Finalmente, se estudió del posible papel de la SSAO/VAP-1 en el nexo existente entre el stroke y la EA con las células hCMEC/D3. Resultados preliminares mostraron que en las células que expresan SSAO/VAP-1, la OGD-Reox induce la expresión de BACE1 y la disminución de LRP-1, y que su sustrato es capaz de incrementar los niveles de APP. Además, el metabolismo de la metilamina por la SSAO/VAP-1 induce una muerte celular adicional cuando se co-trata con Aβ1-40D, en OGD-Reox. De estos resultados concluimos que la expresión de SSAO/VAP-1 en endotelio puede incrementar el daño asociado a la OGD, y que la OGD induce la liberación de SSAO/VAP-1 soluble. También, que la oxidación de su sustrato media parte del daño vascular y que la adhesión leucocitaria dependiente de la SSAO/VAP-1 agrava la progresión de la patología aumentando la inflamación en isquemia. La inhibición de SSAO/VAP-1 por el DPH-4 puede aportar un beneficio terapéutico para el retraso y/o prevención del stroke, así como para su progresión a EA. La modulación de los niveles de SSAO/VAP-1 media parte de los efectos beneficiosos de la simvastatina en isquemia cerebral. Además, la presencia de SSAO/VAP-1 en el endotelio cerebral puede facilitar la generación de β-amiloide, incrementando el riesgo y el empeoramiento neurológico de la EA.
Vascular adhesion protein 1 (VAP-1) is a pro-inflammatory protein that mediates leukocyte recruitment through its semicarbazide-sensitive amine oxidase (SSAO, E.C 1.4.3.21) activity. Plasmatic SSAO increases in ischemic and in hemorrhagic stroke patients, and its activity predicts the appearance of parenchymal hemorrhages after tPA treatment in ischemic stroke patients. Moreover, SSAO/VAP-1 is also increased in AD patients’ plasma and brain tissue. Hence, we believe that SSAO/VAP-1 could contribute to the vascular damage in both stroke and AD. However, the molecular mechanisms of SSAO/VAP-1 in stroke and its possible contribution to the nexus of ischemic stroke and AD have not been studied in detail. In this work, an easy ischemic model was set up by using peripheral endothelial cells expressing the human SSAO/VAP-1 protein (HUVEC hSSAO/VAP-1) under oxygen-glucose deprivation (OGD) conditions. Based on this model, it was found that SSAO/VAP-1 expression increases the susceptibility of endothelial cells to OGD, and that its substrates oxidation through its enzymatic activity increases the vascular cell damage. Caspase-3 and caspase-8 are activated during the death process. In addition, OGD constitutes a stimulus for the soluble SSAO/VAP-1 release, partly mediated by metalloproteinase-2-dependent shedding. Also, short-time OGD induces SSAO/VAP-1-dependent leukocyte binding on endothelial cells, which is partly dependent on its enzymatic activity. In order to better evaluate the beneficial effects of new pharmaceutical compounds by SSAO/VAP-1 activity inhibition under cerebral ischemia conditions, a human brain endothelial cell line expressing the human SSAO/VAP-1 (hCMEC/D3 hSSAO/VAP-1) was further generated as a model of the brain blood barrier (BBB). OGD conditions were established with these cells as well. By using hSSAO/VAP-1 HUVEC and hCMEC/D3 cells, a novel multitarget-directed ligand (MTDL) DPH-4, designed for AD therapy, was proved able to protect both endothelial cells, as well as to decrease the SSAO-dependent leukocyte adhesion under OGD with reoxygenation. DPH-4 was also effective against the damage induced by OGD and reoxygenation in the presence of beta amyloid as a model of AD pathology. With regard to determine the molecular mechanisms underlying the beneficial effect of simvastatin on ischemic stroke, hCMEC/D3 hSSAO/VAP-1 cells subjected to OGD conditions and two middle cerebral arterial occlusion (MCAO) rat models were used. Results revealed that simvastatin could suppress the release of soluble SSAO/VAP-1 into the plasma or cell culture media, which induces the expression of the adhesion molecules E-selectin and VCAM-1, and amplifies the inflammation and the consequent damage in the infarcted brain. At last, hCMEC/D3 hSSAO/VAP-1 cells were used so as to study the possible role of SSAO/VAP-1 in the nexus between ischemic stroke and AD. Preliminary results showed that in SSAO/VAP-1-expressing cells, OGD with reoxygenation induces the expression of BACE1 and decreases the expression of LRP-1, and that the substrate of SSAO/VAP-1 can further up-regulate the levels of APP under OGD with reoxygenation. Furthermore, the metabolism of methylamine by SSAO/VAP-1 activity induces additional cell death when co-treated with Aβ1-40D under OGD with reoxygenation. In summary, these results conclude that the expression of SSAO/VAP-1 in endothelial cells can increase the OGD-associated cell damage. OGD induces soluble SSAO/VAP-1 release. The oxidation of its substrate mediates part of the tissue damage. SSAO/VAP-1 activity-dependent leukocyte binding further exacerbates the disease progression by augmenting inflammation in cerebral ischemia. The inhibition of SSAO/VAP-1 activity by DPH-4 can provide a therapeutic benefit to the delay and/or prevention of ischemic stroke as well as its progression to AD. The modulation of the SSAO/VAP-1 levels mediates part of the beneficial effect of simvastatin on cerebral ischemia. In addition of ischemic condition, the presence of SSAO/VAP-1 in brain endothelium may facilitate the generation of β-amyloid, hence increasing the risk and neurological worsening of AD.

En av de grundläggande rättigheterna som tillerkänns den enskilde är egendomsskyddet. Denna rättighet är stadgad i regeringsformen. Ingrepp i den enskildes egendomsskydd medges om det syftar till att tillgodose ett angeläget allmänt intresse samt om inskränkningen klarar det test på proportionalitet som skapats genom praxis. Kravet på förvärvstillstånd i jordförvärvslagen är en typ av ingrepp i den enskildes egendomsskydd. Att den enskilde inte fritt kan förfoga över sin egendom genom att sälja den till vem han vill utgör ett sådant ingrepp. För att ingreppet ska anses vara proportionerligt krävs det att enskild ersätts genom att staten löser in fastigheten till det pris som avtalats. Inlösen vägras om priset skulle betydligt överstiga egendomens värde. Det är länsstyrelsen som har bevisbörda på att priset betydligt överstiger egendomens marknadsvärde med hänsyn till dess avkastning och marknadsvärdet på andra nyttigheter, till exempel eventuell jakträtt. Staten, genom länsstyrelsen, kräver att köpare sedan tidigare äger mark inom området för att kunna erhålla förvärvstillstånd. Detta är av länsstyrelsen själv uppställt krav som inte tydligt framgår vid en genomläsning av tillståndslagstiftning. I denna uppsats presenteras vilka konsekvenser en sådan marknadsbegränsning får på frågan om värdering av fastighet vid inlösen. Frågan ställs huruvida länsstyrelsen agerar i enlighet med lagen när, vid vägrat förvärvstillstånd fastigheten ej löses in till det pris där även eventuell jakträtt åsätts det marknadsmässiga värde som bedöms på en marknad som ej är begränsad. Frågan besvaras i uppsatsens avslutande kommentarer.
One of the fundamental rights conferred on the individual is the property protection. This fundamental right is enacted in the Swedish Constitution (Regeringsformen). Interference with a person’s right to his own property is allowed if it aims to meet a public interest and if it passes the test of proportionality created through practice. The requirement for an authorization to acquire property according the Swedish Land Acquisition Act (Jordförvärvslagen) is a type of interference with a person`s right to his own property. When the individual cannot freely dispose over his property by selling it to whoever he wants, is an example on such interference. In order to such a procedure be considered proportionate it requires that the Government (through the County Administrative Board) remunerates the individual at the price the parties (seller and buyer) agreed on. The Government`s obligation to remunerate falls if the price would significantly exceed the property`s value. It is the County Administrative Board that has the burden of proof that the price significantly exceeds the property`s market value with respect to its return and the market value of other utilities, such as hunting rights. The County Administrative Board requires that buyers already own property in the area in order to obtain such approvals. This is by the Board itself set up requirement that is not apparent when studying the state of law. This paper presents the implications of such a market restriction on the question on the valuation of the property at redemption. The question is whether the County Administrative Board acts in accordance with the state of law when, after not allowing the acquisition, the property is not redeemed at the price where even possible hunting rights are assigned the market value as assessed in a market that is not limited. The question is answered in the final comments of this paper.

碩士
國立臺灣大學
物理治療學研究所
107
Background: Gait disorder is a common motor symptom for people with Parkinson’s disease (PD). Clinicians often use verbal instructions to improve walking ability in people with PD. One of the most commonly used verbal instructions in the clinics is “lift your foot up high/ take big steps.” However, patients often complain that this exaggerated gait pattern is not easy to maintain for a long period of time and they may get fatigue pretty easily. Therefore, seeking another effective verbal instruction to improve walking ability is necessary for people with PD. Biomechanical studies revealed that presence of heel-strike at the initial contact phase could facilitate the generation of longer step length and faster walking speed. Thus, emphasizing “heel-strike at initial contact” may be an alternative effective verbal instruction to restore walking ability in people with PD. This study, we were interested in determining the benefits of 1-month gait training emphasizing heel-strike walking on gait and other behavioral outcomes. Besides, changes in corticomotor excitability associated with the verbal instruction and gait training would be documented. Purpose: To determine the effects of gait training emphasizing heel-strike walking on motor behavioral outcomes and corticomotor excitability in people with PD. Methods: This study was a single-blinded, randomized controlled trial. Thirty people with idiopathic PD were recruited and randomly allocated to the heel-strike (HS) group (n=15) and the big steps (BIG) group (n=15). All participants received 1 hour of treadmill training program for 12 sessions. The verbal instructions of “strike your foot with heel” and “lift your foot high” were given to the participants in the HS group and the BIG group, respectively. All assessments were completed at pre-test, post-test and 1-month follow-up, and the participants were assessed during “ON” medication status. The primary outcomes were gait performances, including the foot-strike (FS) angle, step length, gait velocity and cadence. The secondary outcomes were the motor subscale of Unified Parkinson''s Disease Rating Scale (UPDRS-III), gait-related items of UPDRS-III (UPDRS-III-gait), the Timed Up and Go test (TUG), the Activities-Specific Balance Confidence Scale (ABC scale) and the Parkinson’s Disease Quetionnaire-39 (PDQ-39). In addition, change of corticomotor excitability of tibialis anterior (TA) was assessed with transcranial magnetic stimulation (TMS). Statistical analysis: Independent t-test and chi-square test were used to analyze the demographic characteristics and outcome measures at baseline. Two-way mixed model ANOVA was used to assess the intervention effects for each outcome measures. If group by time interactions or main effects were found, LSD post hoc analysis was further performed. A significant level was set at =0.05. Results: Regardless of the verbal instruction emphasizing on heel-strike or taking BIG steps, participants showed significant increases in step length, gait velocity and FS angle after intervention, and the improvement maintained for at least 1 month after intervention. The participants in both groups also showed equivalent amount of improvement on UPDRS-III, TUG and PDQ-39. However, the score of UPDRS-III-gait, ABC scale, and corticomotor excitability did not change significantly after the training sessions in both groups. Based on the feedback from our participants, we further conducted a subgroup analysis to determine whether different verbal instruction might have different effects on patients who had greater gait disturbances, that is those with freezing of gait (FOG). Subgroup analysis interestingly showed that participants with FOG who received “strike your foot with heel” showed a trend of increased step length and decreased UPDRS-III after intervention, while those who received “lift your foot high” did not improve after intervention. On the other hand, patients without FOG showed similar amount of improvement in step length and UPDRS-III regardless of the instructions they received. Conclusion: This study provided a preliminary evidence showing that treadmill training with verbal instruction emphasizing heel-strike walking was as effective as taking BIG steps in reducing gait disturbances for people with PD. Additionally subgroup analysis suggested that clinicians may provide verbal instruction of “heel-strike walking” instead of “BIG steps” to improve walking ability in patients with FOG.

The southern Patagonian Andes record the Late Cretaceous closure and inversion of the Late Jurassic – Early Cretaceous Rocas Verdes marginal basin, subsequent development of the Patagonian retroarc fold-thrust belt and the Neogene to present tectonic superposition of a left-lateral strike-slip plate margin defined by the Magallanes- Fagnano fault zone. In this dissertation, I present new geologic maps, cross sections and detailed macro- and microscopic structural analyses that describe the geometry and kinematic evolution of the fold-thrust belt and superposed strike-slip deformation over ~200 km along-strike between 53° and 55° S latitude. Results are discussed in the context of the regional tectonic development of the southernmost Andes and are relevant to the understanding of important tectonic processes including the development of a retroarc fold-thrust belt, the formation of a basal décollement below and toward the hinterland of a fold-thrust belt and the spatial distribution of deformation along a strike-slip plate margin. New maps and balanced cross-sections of the Patagonian fold-thrust belt show that it developed during two main phases of Late Cretaceous to Paleogene shortening that were partly controlled by the antecedent geology and mechanical stratigraphy of the Rocas Verdes basin. During the Late Cretaceous, a thin-skinned thrust belt developed above a décollement that formed first in relatively weak shale deposits of the Rocas Verdes basin and later deepened to <1 km below the basement-cover contact. Ramps that cut mechanically rigid volcanic rocks of the marginal basin link the two décollements. Basement-involved reverse faults that cut the early décollements and probably reactivate Jurassic normal faults reflect Paleogene shortening. Shortening estimates increase northwest to southeast from 26 to 37% over 100 km along-strike and are consistent with regional models of the fold-thrust belt. Structural data, kinematic analyses, and microstructural observations from the lower décollement show that it is defined by transposition of several generations of northeast-vergent noncylindrical folds, shear bands, and a quartz stretching lineation that are kinematically compatible with first-generation structures of the fold-thrust belt. Quartz microstructural data from the décollement are consistent with deformation temperatures that decrease from ~500-650° C to ~400-550° C over ~75 km in the transport direction, indicating that the décollement dipped shallowly (~6°) toward the hinterland. The décollement decoupled the underthrust continental margin from the fold- thrust belt and exemplifies the kinematic relationship between shortening that occurs coevally in a retroarc fold thrust-belt and its polydeformed metamorphic ‘basement’. Fault kinematic data and crosscutting relationships show kinematic and temporal relationships between populations of thrust, strike-slip and normal faults that occur in the study area. Thrust faults form an internally compatible population that shows subhorizontal northeast-trending shortening of the fold-thrust belt and is kinematically distinct from populations of normal and strike-slip faults. Both strike-slip and normal faults crosscut the fold-thrust belt, are localized near segments of the Magallanes- Fagnano fault zone, have mutually compatible kinematic axes and are interpreted to be coeval. Strike-slip faults form Riedel and P-shear geometries that are compatible with left-lateral slip on the Magallanes-Fagnano fault-zone. Strike-slip and normal faults occur in a releasing step-over between two overlapping left-lateral, left-stepping segments of the Magallanes fault zone and record a tectonic event defined by sinistral transtension that probably reflects changing plate dynamics associated with the opening of the Drake Passage during the Early Miocene.
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碩士
中國文化大學
藝術研究所
92
Chapter 1 Introduction With overemphasis on the appearance, I felt my utilization of stroke and lines was weak, and my work was unable to express the form of vitality. Therefore, I chose to study Bonnard （1867─1947）to learn how to free my work from the existing boundaries. Chapter 2 Background of Bonnard The tranquil art environment experienced changes, especially in the thirty-year period after 19th century. The development of art schools came one after another, and gave birth to talented artists continuously. Bonnard was one of the elites during that period. Chapter 3 The background and uniqueness of Bonnard’s stroke in oil painting Bonnard absorbed, integrated, and digested the strength of many art masters, such as Corot、Monet、Renoir、Degas,and Lautrec, to develop his own characteristics. Chapter 4 Concept foundation of painting Aside from learning from Bonnard and Delacroix, I discussed my own thoughts on use of creativity, art creation inspired from the soul, inspiration in art creation, and functionality of arts. Chapter 5 Painting by Yao Chia Liang My paintings express the beauty of life in tranquility, and the sense of happiness from the care of family and friends. The themes were derived from feelings toward the life and nature. Chapter 6 Conclusion Bonnard observed this world with amazingly keen sense, and created art pieces with creativity. It was his way to retain his initial ideas. I followed the same manner in art creation, and solved a number of blind points previously occurred in the art creation process.

Diskettes comprise Appendix N andO.
System requirements: IBM compatible, requires Word for windows 6 or higher.
Bibliography: leaves 400-428.
xix, 428 leaves ; 30 cm. + 2 diskettes (3 1/2 in.)
Thesis (Ph.D.)--University of Adelaide, Dept. of Psychology, 1997?

Diskettes comprise Appendix N andO.
System requirements: IBM compatible, requires Word for windows 6 or higher.
Bibliography: leaves 400-428.
xix, 428 leaves ; 30 cm. + 2 diskettes (3 1/2 in.)
Title page, contents and abstract only. The complete thesis in print form is available from the University Library.
Thesis (Ph.D.)--University of Adelaide, Dept. of Psychology, 1997?

Title: The usage of virtual reality in therapy of patients with neglect syndrome with consideration of a cybersickness risk. Objective: To find out if stroke patients with neglect syndrome tend to have higher risk of gaining cybersickness after using virtual reality compared to stroke patients without neglect syndrome and healthy population. Also, to find out if the severity of neglect syndrome has correlation with the severity of gained cybersickness. Afterwards to evaluate the trend of making games in virtual reality for treating neglect syndrome with consideration of a cybersickness risk. Methods: The experiment participants played game in virtual reality developed for treating neglect syndrome for ten minutes. During the game participants were seated and were playing using head movements. A HTC VIVE console was used to deliver the virtual reality game. Participants were divided into 3 groups: the group Zdraví (n = 12) without neurological impairment, the group CMP (n = 6) for stroke patients without neglect syndrome and the group Neglect (n = 10) for stroke patients with neglect syndrome (KF-NAP ≥ 1). Each proband had to fill Sickness Simulator Questionnaire which was used to detect cybersickness before and after playing the game in virtual reality. Collecting and sorting of the data was done...

Strokes are one of the most serious diseases that often lead to permanent disability and in some cases even to death. Currently, widely available treatment by intravenous thrombolysis is recommended. The objectives of this diploma thesis are to analyse complications that may arise for patients with iCMP treated by intravenous system thrombolysis, to define the role of a nurse in ICU in terms of taking care of this group of patients, and to map all the factors influencing the result of the treatment. In order to obtain the data necessary, combined research method has been applied. The quantitative part was retrospectively evaluated based on SITS Registry data. The research part comprised of patients, to whom IVT was applied between January 2014 and December 2015. The subjects of the analysis were treatment complications, gender of patients treated by IVT, risk factors present, time data, and heaviness of the deficit before the treatment and after. Furthermore, we observed where is the patient released to after IVT and how many patients are able to stay in home environments three months after the treatment. Qualitative part of the investigation was evaluated based on half-structured interviews with the nurses working in ICUs for highly specialized care for patients with stroke. We observed their...

碩士
國立中正大學
企業管理研究所
103
The pharmaceutical industry is related to human life and health. With life is more affluent and science is more developed, the drug quality management become more and more stringent for every country. In 2015, Taiwan implements PIC / S GMP in full. Taiwan pharmaceutical industry follows international standards entering a new milestone. However, the pharmaceutical companies make huge capital investment to upgrade facility, but the profit decline in original domestic market because the health insurance payments decrease, the companies must involve in new markets more actively. Therefore, Taiwan pharmaceutical companies must follow the Government policy, international trends and combine their own advantages to strength the cooperation with international relationship and find a new direction. This study is to understand after the implementation of PIC / S GMP, the competitive strategy and effectiveness of Taiwan pharmaceutical companies to enter the international market and take orders, but also as learn to other companies for entering the international market. After interviewing with the respondents, this study summarize in the following conclusions. 1. PIC / S GMP is to enhance the competitive advantage for international orders. 2. Implementing PIC / S GMP could reduce the technical trading barriers. 3. Product differentiation is conducive to compete in the international market. 4. The stronger cross-functional integration helps to get the international orders. 5. Abundant network is gotten more opportunity to get international orders. 6. Cooperation with international pharmaceutical companies helps to improve the international competitiveness of its own Although the Government has expanded international medical cooperation actively, but it limited by political, national sovereignty, the effect is not clear at present. Taiwanese companies still need to enhance their own strength, training personnel with an international perspective and increasing acuity on the international market, in order to fight for international orders successfully.

碩士
國立臺北科技大學
電腦與通訊研究所
98
One stroke patient is not only to much affect his physical and mental state but also heavily inflict the body and mind of patient’s family member. Therefore, our major subject of this study is to design an auxiliary tool for the evaluation after the stroke patient rehabilitation and then promoting a better life quality of the patient’s family. Our system employs the gait analysis algorithm to offer the quantized gait information through the vision base. Hence, our system can provide the gait state for the stroke patient himself. Moreover, the rehabilitation goal will be obvious such that it highly promote the rehabilitation volition for the stroke patients. Our system owns the two advantages of the portable and low-cost characteristics. Therefore, our design of the gait analysis system can be indeed applied to hospitals, organizations, or homes for the rehabilitation evaluation. Meanwhile, our system is consisting of the low-cost consumer products, a video camera, PC, and simple electronic components. There are 3 phases in our design of the gait symmetry evaluation. First, our system uses the video camera to track and record the track of the marked LED points for getting the gait image of the stroke patient. These marked tracks are recorded within a gait video file, and then it will be analyzed by our algorithm on PC. The second phase is called the quantization and analysis stage. The gotten gait video file can be analyzed by our gait analysis algorithm, and then we can obtain the quantization of the gait information. The third phase is called the information service stage. The therapists can offer the objective gait analysis results to the stroke patient as the next rehabilitation suggestions. Our system has been verified by the experiment and analysis gaits of 12 stroke patients and 6 healthy persons. Our experiment results indicate that our system can effective offer an auxiliary tool for the evaluation after the stroke patient rehabilitation.

碩士
國立臺北科技大學
機電整合研究所
102
PD patients often have motionless tremor, freezing of gait, gait instability problems and so on, which are prone to affect the function of daily life. When freezing of gait occurs on PD patients, how to immediately help patients to remind themselves to walk again is the research project of this thesis, and the main goal is to develop a kneepad style laser reminding device for PD patients to assist walking. In markets there has been some products designed for walking stick combined with visual reminding, but most PD patients do not need to use walking sticks as walking helper and additionally that pace distance of the visual reminding products is fixed, as a result in this research we consider the convenience, portability and adaptability and then do research to design the laser device which can combine with kneepads. We utilize visual reminding and adjustable pace distance to develop and design the device and this device can effectively give reminding immediately and give assistance when PD patients are in need. This device utilize switch of sole, single chip, and accelerator to control communication and adjudgement. When PD patients are in need, through the conveyance of switch of sole to single chip of kneepad laser device followed by shooting laser beam in front of the feet of PD patients to remind them cross over this laser beam and allow PD patients to walk forward smoothly, it can also through the stepper motor to control the light head of laser and adjust the pace distance in demand. Additionally, this research utilize accelerators combined with switches of sole to calculate pace distance and detect the FOG, and immediately convey the walking distance and frequency to computer by blue-tooth to see and adjudge that pace situation.

This diploma thesis deals with the topic of nutritional support in patients with neurological diseases (stroke and Critical-Illness-Polyneuropathy). The aim of this thesis is to find out, how implemented unified system of nutritional support affects the well-being of patients at neuro-rehabilitation clinic Asklepios Schlossberg Klinik in Bad König. There were observed 55 patients (30 men and 25 women) for 8 weeks. The theoretical part of this thesis describes basic components of nutrition, energy expenditure and needs, selected neurological diseases, dysphagia, malnutrition. The emphasis is put on nutrition in intensive neurological care. The practical part of the thesis analyses data obtained by the observation. There are observed changes of body weight, BMI and laboratory values of total protein, albumin and glycaemia in serum. These data are divided by sex, age, type of disease and initial BMI values. The observed patients had mainly overweight and obesity, which have lost a part of their excess weight due to catabolism. At the beginning of the observation 13 patient had normal BMI value, this number of patients rose to 24 after eight weeks. At the end of the observation the reduction of BMI value was on the average 2.45 units. Based on the results, it was found that although patients due to...

碩士
國立中興大學
運動與健康管理研究所
107
Background: Hemiplegia caused by stroke may make it difficult to control the upper limb of the affected side. When the affected side can’t grasp and release object, it also may have shoulder’s movement limitation, drop-hand or spastic. It’s inconvenient for daily life. Occupational therapy usually offers the dynamic splint for position or inhibit abnormal muscle tone. Considerate that dynamic splint it’s too heavy can’t easy to do daily living activities. We provide spider orthoses to increase the possibility of using the affected side in daily life, achieve the same effect of upper limb performance. Objective: the purpose of this study was to examine the effect of upper limb movements and user’s opinion who wearing dynamic splint and spider orthoses. Method: Compare patient didn’t wear any orthoses, wearing dynamic splint and spider orthoses who did the Action Research Arm Test and Block and Box test. The test including the way of disposing items, quality and dexterity of upper limb movements. We asked the patient to answer the questionnaire to investigate the user’s opinion. Result: Both of wearing dynamic splint and spider orthoses had improvement at the Action Research Arm Test. Especially the grip part was significantly increased (P=.007). At Block and Box test, wearing spider orthoses was significantly increased at dexterity part. And there were significant differences in spider orthoses between the two assistant devices. There had 30% subject responded positive with dynamic splint and about 60% subjects responded negative. More than half of the other subject responded positive about wearing comfortable with spider orthoses but it’s no significant differences. Apart from this, most items among the questionnaire showed satisfaction with spider orthoses, especially the looks and willing to wear more than 70%. The score of spider orthoses was significantly higher than dynamic splint (P=.006). Conclusion: Like the other studies, dynamic splint can improve upper limb movements. And spider orthoses can also achieve the same effect as the dynamic splint, correct drop hand and improve upper limb movements immediate. User satisfaction shown spider orthoses was better than dynamic splint. It provides a choice for the future.

Author's name: Bc. Sára Miczová Supervisor:: Mgr. Miriama Dědková, DiS Opponent: Thesis title: Occupational therapy practise guidelines in patients with functional upper limb impairment after stroke in subacute phase To be able to provide occupational therapy intervention of high quality the occupatioal therpaists should rely on relevant standards of clinical care and clinical guidelines. (Švestková, 2018). Occupational therapists as well as other members of the interdisciplinar team provide professional care to the patients recovering from stroke. Those patients often have to deal with upper limb impairment which leads to decrese of quality of life. Relevant studies focused on this topic were searched via key words in PubMed, Web of Science and OVID Evidence Based Medicine Reviews databasis. The criterias of selection were: public access to the content, english language which were mainly focused on stroke patients rehabilitation. The suggestion of guideline was created based on methods accepted by department. The occupational therapist as well as physiotherapeutist of early rehabilitation were included in the process of creating the guideline using the GRADE programme for it. Only 48 out of 4054 studies were used, these were divided into two cathegories, one being the cathegory of assessment, the...

Title: The influence of physiotherapeutic intervention with Propriomed on postural stability of 11-13 years old tennis players Objectives: The main aim of this thesis is objectivize the influence of physiotherapeutic intervention involving exercise with Propriomed on the success of strokes and speed of the swing phase of 11-13 years old tennis players. Methods: Teoretical part is composed like a recherche in which are informations that make base fot the practical part. For the practical part was made experimental study which contains sample of 17 probands in age between 11-13 that are active tennis players for more than 5 years. Pobands was divided into intervention group and control group. Intervention group had training with Propriomed once a week. Main task of study was analysis of succes rate and speed of the swing phase of different tennis shots before and after physiotherapeutic intervention with Propriomed and comparing results of both groups. Results: In beckhand shot was observed statistically significant difference after finishing first intervention. It is possible to claim that training with Propriomed positively influence precision of the backhand shot in a short term. Proband reached the best results of succes rate of forehands after last measurement. From that we could claim that...

We evaluated the effectiveness of two virtual reality therapies (VRT) with visual biofeedback, Armeo Spring® upper limb exoskeleton (Armeo) and Homebalance® interactive system (Homebalance), in early post-stroke rehabilitation. Using a randomized controlled study design, participants within 30 days after stroke with arm paresis (Armeo study) or with balance problem (Homebalance study) were assigned either to the respective intervention group (Armeo IG n=25; mean age 66.5 years, and Homebalance IG n=25; mean age 69.6 years) performing VRT instead of conventional physiotherapy or to the control group (Armeo CG, n=25, mean age 68.1 years, and Homebalance CG, n=25, mean age 65.9 years) having conventional physiotherapy only. Montreal Cognitive Assessment (MoCA), Functional Independence Measure (FIM), Fugl Mayer Assessment-Upper Extremity Scale (FMA-UE), Modified Rivermead Mobility Index (m-RIM) and Berg Balance Scale (BBS) were performed before and after the 3-week therapy with 12 therapies. Results of participants <65 and ≥65 years old were compared. Acceptance of both VRTs was evaluated by self-rated questionnaire. In the Armeo study, paretic upper arm function improved significantly in both IG and CG groups, the improvement in FMA-UE was significantly higher in Armeo IG as compared to CG (p=0.02)...

Background: Sonolysis is an important factor in therapeutic use of ultrasound in patients with cerebrovascular diseases, it is ultrasound induced lysis of thrombus or embolus. The aim of this work was to asses safety and efficacy of therapeutic ultrasound effect (sonolysis) in acute stroke patients and in patients undergoing carotid artery intervention. First partial aim of this work was to confirm the safety and efficacy of endovascular sonolysis by using the EkoSonic Endovascular System in subjects with acute ischemic stroke. Second partial aim of this work was to test the clinical efficacy of sonolysis for reducing the risk of incidence of new brain ischaemic lesions detected on brain magnetic resonance imaging in patients undergoing elective CEA or CAS for severe internal carotid stenosis. In addition, we assessed the effects of sonolysis on cognitive function, morbidity, and mortality at 30 days post-surgery. Methods: Patients with acute ischemic stroke and occlusion of the middle cerebral artery or basilar artery were enrolled consecutively to the prospective study tested safety and efficacy of endovascular sonolysis using the EkoSonic Endovascular System (EKOS) in patients with acute stroke. The control group (44 MCA and 12 BA occlusions) was selected from historical controls. EkoSonic...

碩士
國立臺灣大學
醫學工程學研究所
105
It is well established in clinics now to use surgical treatment or recombinant tissue plasminogen activator(rt-PA) approach to treatment for ischemic stroke, but both ways have their limitation. According Taiwan Stroke Association data indicate most people in Taiwan stroke in sleep, and miss an opportunity to use rt-PA in ischemic stroke treatment. It will seriously affect patients prognosis. In literature review, some researchers found that there are some significant different between normal person and stroke patient’s Electroencephalograph (EEG), such as alpha to delta ratio and alpha peak frequency in frequency domain. Further studies found that frequency in stroke patient’s Electroencephalograph have strongly correlate with cerebral blood flow. However, in the current study we haven’t seen the complete results analysis the time domain, frequency domain features in each frequency band. Therefore, this paper discusses 20 stroke patients Electroencephalograph(EEG) signal , according to the stroke area of the brain is divided into four regions, stroke region, penumbra region and these two areas symmetrical region, and divided into four bands in time domain, frequency domain and time-frequency domain, and a total of 16 characteristic values were analyzed and compared. Analysis of the results and try to use in ischemic stroke detection algorithm. This paper found that, slow alpha to delta ratio(slow alpha ADR) and theta firing rate(theta FR) in stroke area; fast alpha peak frequency(fast alpha PKF) and delta peak frequency(delta PKF) in penumbra area compare with the symmetrical region have significant difference(p <0.05). Each band eigenvalues also have significant differences in comparison with the normal people. And theta firing rate and delta peak frequency are use in ischemic stroke detection algorithm. In the algorithm test, ten people are classify in the algorithm including normal and ischemic stroke patients, the sensitivity was 75% , specificity was 66.67%.

(v AJ) Nursing care for patients with dysphagia after stroke is nowadays a very serious problem. This disease is particularly dangerous for patients because of the risk of imminent aspiration pneumonia. In 2015, Czech Republic has developed a standard treatment plan for patients with dysphagia after stroke and following this plan a new screening method was put into practice, which would prevent aspiration pneumonia (Salt, 2015). This method is called THE GUGGING SWALLOWING SCREEN - GUSS test. After a positive GUSS test result a standardized nursing care should follow, which would involve the whole medical team (doctors, health nurses, speech therapists, physiotherapists and orderly). The aim of this work is to verify whether the GUSS test and subsequently the determined process of the standard treatment together with the nursing care meets and the needs of the nurses. Another objective is to verify whether the nurses would want to add, innovate or make necessary updates based on the already acquired experiences. Furthermore, taking into consideration the frequent collaboration of nurses with the speech therapists, this study also aims to evaluate and asses the cooperation between nurses and the speech therapists. The work also evaluates the effectiveness of the use of GUSS test in providing nursing...

The thesis evaluates the effect of four-week home therapy using stabilometric platform Nintendo Wii Balance Board and tablet with integrated software HomeBalance in patients with brain injury. Software HomeBalance has been developed for the treatment of balance disorders and cognitive function. Manipulating the platform and the tablet may also develop grip and handling abilities of hand, both will be evaluated in this work as well. The theoretical part describes new trends in rehabilitation of cognitive-motor interference, dual-task therapy and therapy using technological equipments. Methods: A total of 9 subjects underwent four weeks of therapy using a therapeutic set HomeBalance. The control group of 12 subjects received therapy without any technological equipment. Patients participated in the initial examination, home therapy and final examination. As an evaluation of the therapy Mini-BESTest, Timed Up and Go test, Montreal cognitive assessment, 9- hole peg test, and also two games from HomeBalance software and questionnaire assessing satisfaction with therapy have been used. Results: After treatment the whole group improved in only two tests evaluated: in Mini- BESTest and the time of diagnostic scene in HomeBalance software. The research group had statistically better results in both tests...

TITLE Efficacy of physiotherapeutic interventions in stroke patients with pusher and neglect syndrome. OBJECTIVES The aim of the thesis is to summarise current literature concerning two peculiar phenomena following stroke - pusher syndrome and neglect. Furthermore the work focuses on evaluation of efficacy of physiotherapeutic interventions. METHODS The thesis represents a critical review of a literature and it consists of three parts. The first one summarize issues concerning the pusher syndrome and neglect in general. In a special part you can find a detailed description of physiotherapeutic methods that are widely used in a rehabilitation treatment of these two neuronal symptoms. This work is concluded by evaluating results of effects of the therapeutic interventions that are discussed with respect to the future research. RESULTS Up till now there are no clinical trials concerning efficiacy of physiotherapeutic methods in a treatment of a pusher syndrome. The similar situation seems to be in case of a neglect syndrome as number of available clinical trials testing the efficiacy of physiotherapeutic techniques is very limited. The studies show positive results of a training of visual and spatial orientation or prism adaptation to effectively treat neglect patients. On the contrary, pharmacological...