Tesi sul tema "La Monte Young"

Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro Tecnológico, Programa de Pós-Graduação em Ciência da Computação, Florianópolis, 2016<br>Made available in DSpace on 2016-09-20T04:06:35Z (GMT). No. of bitstreams: 1 339906.pdf: 2088834 bytes, checksum: bf34a03d96c45ecf5b38e2bcf63f55be (MD5) Previous issue date: 2016<br>O Modelo de Bourgoyne e Young (BYM) é utilizado para determinar a taxa de penetração no processo de perfuração de poços de petróleo. Para tanto é necessário que esteja parametrizado por coeficientes que devem ser estimados a partir de experiências anteriores. Por se tratar de um processo físico, a operação de perfuração pode apresentar medições ruidosas e o modelo em questão naturalmente pode não representá-la corretamente. Neste trabalho os coeficientes do BYM são determinados como distribuições de probabilidade, ao invés de valores fixos, propagando essas incertezas presentes nos dados e no próprio modelo. Para isso, é descrito um método que realiza inferência Bayesiana desses coeficientes através de Monte Carlo em Cadeias de Markov. Os resultados foram satisfatórios e as distribuições de probabilidade obtidas permitem uma melhor compreensão de como diferentes coeficientes atuam no resultado das simulações. Ao fim é feita uma análise sobre as possibilidades em aberto de melhorias para o método proposto.<br><br>Abstract: The Bourgoyne and Young Model (BYM) is used to determine the rate of penetration in oil well drilling processes. To achieve this the model must be parameterized with coefficients that are estimated on the basis of prior experience. Since drilling is a physical process, measurement data may include noise and the model may naturally fail to represent it correctly. In this study the BYM coefficients are determined in the form of probability distributions, rather than fixed values, propagating the uncertainties present in the data and the model itself. This work therefore describes a method that performs a Bayesian inference conducted by a Monte Carlo Markov Chain algorithm. The results were satisfactory and the probability distributions obtained offer improved insight into the influence of different coefficients on the simulation results. At last, a discussion is carried of open possibilities for improving the proposed method.

Minimalism was a period in music throughout the postmodern twentieth century initiated by the compositions of La Monte Young (1935-- ), followed by those of Terry Riley (1935--), developed by Steve Reich (1936-- ), and evolved by Philip Glass (1937-- ). Minimalist music was influenced by the non-Western music of India, created by the constant repetition of musical patterns to generate a hypnotic state on the listener through stasis. The size of the minimalist audience has continually increased from the New York City loft-based performances of La Monte Young to the opera house performances of Philip Glass. The composer's goals for an audience, his musical adaptation, and the effect of stasis contribute to the differences in audience size. These three factors are examined through each composer's biography, early and late compositions, and concert reviews of the premieres. The techniques utilized by each composer have become more effective in the creation of stasis from the compositions of Young to Glass. The biographies of the four minimalists, their compositions, and the premieres serve as an excellent source in the examination of the connection between the composer and the audience.

This thesis explores a series of relationships between music and acoustics in order to develop a basis for discussing and critiquing aesthetics in post-Cagean experimental music. Specifically, it examines the acoustic and aesthetic theories that inform the practice of American composers La Monte Young and Alvin Lucier. One particular theme - the sine wave - emerges, both as a prominent feature in the work of these two composers, and also as a nexus point between music and acoustics. Pursuing this theme, the thesis begins by looking at issues in the science, technology, and ideology of acoustics in relation to the study of musical sound in the late nineteenth century. It then aims to situate the sine wave historically, culturally and technologically within a range of scientific and aesthetic practices in operation in the first half of the twentieth century. Finally, it explores the deployment of concepts from the field of acoustics by artists of the avant-garde, and considers what contribution these factors played in broadening the developing discourse of sound within the arts. These discussions then inform detailed investigations into the work of both Lucier and Young, examining their use of sine waves to explore and produce simple acoustic phenomena.

Thesis (Ph.D.)--University of Western Sydney, 2008.<br>A thesis presented to the University of Western Sydney, College of Arts, School of Humanities and Languages, in fulfilment of the requirements for the degree of Doctor of Philosophy. Includes bibliographies.

Made available in DSpace on 2014-06-11T19:27:26Z (GMT). No. of bitstreams: 0 Previous issue date: 2008-08-06Bitstream added on 2014-06-13T20:35:54Z : No. of bitstreams: 1 lancia_jc_me_ia.pdf: 1949570 bytes, checksum: de65c06be1d96f797a0b1521e72e719c (MD5)<br>Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)<br>O minimalismo musical de La Monte Young, Terry, Riley, Steve Reich e Philip Glass foi chamado, entre outros rótulos, de música repetitiva, modular, de pulsação, de processos e estática – e, portanto, não-teleológica – antes que o termo minimalismo prevalecesse. Uma vez que tais termos não são infundados e refletem características percebidas no minimalismo, este trabalho tenta definir as idéias por trás desses rótulos. O trabalho também discute os procedimentos mais típicos adotados por cada um dos quatro compositores mencionados, apontando as mudanças de feições na produção desses compositores entre as décadas de 1960 e 70, período normalmente utilizado como referência para estudos.<br>The musical minimalism of La Monte Young, Terry, Riley, Steve Reich and Philip Glass had been called, among other labels, repetitive, modular, pulse, process, and static – and as a result, a-teleological – music before the name minimalism finally caught on. Since those labels reflect, at least in part, some of the features commonly found in the style, this study attempts to define the concepts behind such labels. This work also discusses some of the most typical procedures adopted by the four composers aforementioned, pointing their changing style during the 1960s and 70s, period often used as a reference for studies.

Abstract Seventy-eight prepubertal children 3 to 10 years old (mean age 5,67 years, range 2.4 - 10.5 years), with symptoms suggestive of obstructive sleep apnea syndrome (OSAS) were studied. Based on overnight polysomnography (PSG) results, 32 children were classified as having OSAS, whereas 46 children were considered as primary snorers (PSs'), when an obstructive apnea-hypopnea index (AHIO) of over one was considered abnormal. Symptoms, signs and findings in these two groups were compared in a cross-sectional study. Fifty-eight of the children were retrieved for a follow-up visit, which was scheduled six months from the first visit. The children with an initial AHIO of 2 or over (n = 21) had been subjected to adenotonsillectomy swiftly after the first visit, whereas the others (n = 37) were observed without intervention. The changes in symptoms, signs and findings were analysed within and between these groups. Relative risk (RR) ratios were calculated in order to find clinical symptoms and signs predicting OSAS in snoring children. Observed apneas, restless sleep, constant snoring and tonsillar hypertrophy were significantly associated with an increased risk of OSAS. Dental arch measurements indicated that AHIO was significantly associated with the amount of overjet, suggesting that altered breathing may affect the dentofacial morphology. Nasalance measurements revealed no group differences between the OSAS children and PSs'. Adenotonsillectomy had no significant influence on the nasalence scores. Measurements of nasalance seem to contribute little to the diagnostics of OSAS in children. At the first visit the mean circulating concentrations of insulin-like growth factor-1 (IGF-1) were of the same magnitude in the OSAS children, the PSs' and the age-matched control group, but both the OSAS children and the PSs' had lower IGF-binding protein-3 (IGFBP-3) concentrations than the control subjects. At the second visit a significant increase of the peripheral concentrations of IGF-1 and IGFBP-3, along with increases in weight for height and BMI were observed in the surgically treated children, whose respiratory parameters and symptoms had improved highly significantly, as well. These results indicate that the growth of children with obstructed nighttime breathing is potentially affected through impaired growth hormone secretion. None of the primary snorers developed OSAS during the observation period, which finding suggests a favorable prognosis for primary snoring in children.

Scopo di questa tesi è proporre una traduzione di venti poesie estratte dal verse novel "Skyscraping" di Cordelia Jensen, pubblicato nel 2015. Questo romanzo narra la storia semiautobiografica dell’autrice, che nella sua prima adolescenza scoprì che il padre era affetto da AIDS. Il lavoro di traduzione è preceduto dallo studio del contesto socio-culturale e letterario relativo alle tematiche di questo romanzo, esplorate nei primi due capitoli, unitamente a un’analisi strutturale del libro, fornita nel terzo capitolo. Nello specifico, il primo capitolo descrive lo scoppio e la diffusione dell’AIDS negli Stati Uniti degli anni Ottanta, insieme all’impatto che questa epidemia ebbe sulla letteratura gay e i nuclei familiari dell’epoca. Il secondo capitolo è incentrato sul genere del verse novel, con uno sguardo speciale sulle sue origini, la sua struttura e la vicinanza con altri generi; questo capitolo fornisce inoltre una panoramica generale della letteratura Young Adult, sottolineando il recente e fortunato connubio tra questo filone e il verse novel. Il terzo capitolo presenterà una breve biografia dell’autrice e un’analisi su più livelli di Skyscraping, cercando inoltre di spiegare in che modo questi due aspetti possano essere considerati strettamente collegati nella storia narrata. Seguirà nel quarto capitolo la proposta di traduzione con testo a fronte delle poesie, selezionate in base alle tematiche affrontate e alle problematiche traduttive che sollevano. Il quinto e ultimo capitolo, infine, si incentrerà sulle necessarie riflessioni che hanno accompagnato la traduzione di un testo essenzialmente poetico, ma che reca con sé anche le difficoltà traduttive della prosa. Dopo alcune considerazioni sulla traduzione poetica e sul ruolo del traduttore, affronteremo le principali problematiche incontrate durante la traduzione, legate essenzialmente alla resa della musicalità, della forma grafica e del lessico del verse novel.

A epidemia da aids afeta a vida de crianças e jovens, independentemente da presença do HIV/Aids, através do adoecimento, perda dos pais, estigma, discriminação, entre outros. Este estudo teve como objetivo compreender o significado de ser órfão para jovens que perderam um ou ambos os pais em decorrência da aids e compreender os processos de estigmatização decorrentes dessa morte. Foram analisadas 19 entrevistas em profundidade realizadas com jovens órfãos, com idade entre 15 e 22 anos, residentes na cidade de São Paulo, entre os anos de 2005 e 2007. O sentido atribuído à morte e todo o ritual que a cerca é concebido como socialmente construído e a morte em decorrência da aids permeada pelo estigma que acompanha a aids desde o início da epidemia. Foram encontrados cinco significados associados à orfandade: dificuldade de falar sobre a orfandade ligada à aids; sentir falta do cuidado materno; o desafio de ser independente; não se sentir órfão e sentir tristeza em decorrência da morte. Os processos de estigmatização foram divididos em estigma sentido e efetivado e aconteceram na escola, na casa de amigos, na rua e com a namorada. Todos os relatos e cenas de estigma foram de estigma por associação, pois decorriam da causa da morte do(s) pai(s). Percebe-se que a orfandade em decorrência da aids impacta a vida dos jovens. Eles convivem com as adversidades com apoio da família, na maioria das vezes, materna. Não se conhece muito sobre os órfãos, principalmente se eles não viverem com HIV/Aids, pois os serviços de saúde perdem o contato a partir do momento que a pessoa da família que vive com aids morre. É importante que os programas de aids incorporarem as visões e as perspectivas destes jovens em seus projetos para garantir-lhes seus direitos.<br>The aids epidemic affects the life of children and youngs, not only because of the presence of HIV/Aids, but also because of the sickness, death of parents, stigma, discrimination, and others. This research had the main intention of understanding the meaning of being an orphan to young people that have lost one or both parents in result of aids and the stigma that is included in this process. Nineteen interviews were studied and the public included youngs between 15 and 22 years old, living in São Paulo, between 2005 and 2007. In this report, the meaning attributed to death and all the ritual involving it was concepted as social constructed and the death regarding aids was studied with the stigma that around aids since the beginning of the epidemic. It was pointed 5 issues related to orphanhood: difficulties related with speaking about parents death by AIDS; missing of mothers care; the challenges of being independent; do not feel as an orphan and feeling sadness because of death. The process of stigma was divided as felt stigma and enacted stigma and happened at school, at friends house, at the streets and with a date. All the stores and scenes of stigmas were courtesy stigma, because were related with parents death. With this report it is possible to realize that beeing an orphans in result of aids affects direct youngs living. They get used to live with adversity, family support, mainly by mothers family. Not too much is known about orphans, even less if they do not live with HIV/AIDS, because health services do not keep contact after the person in the family with AIDS dies. It is very important that aids programs includes the expectations and the way of seeing life of those people in their programs, so they can guarantee respect and theirs rights.

Mestrado em Economia Internacional e Estudos Europeus<br>A União Europeia tem sugerido várias abordagens e soluções para a diminuição de assimetrias regionais e para o desenvolvimento das zonas rurais dos seus Estados Membros. O objetivo principal deste Trabalho Final de Mestrado é estudar uma dessas medidas, o Programa Jovens Agricultores, numa zona rural e periférica de Portugal, Trás-os-Montes. Esta região necessita de iniciativas como a do Programa Jovens Agricultores para reverter os fenómenos de envelhecimento e despovoamento e para tornar o estilo de vida rural atrativo para as gerações mais novas, incentivando-as a fixarem-se a longo prazo. Mas serão, de facto, estes jovens agricultores um vetor de inovação e modernização para Trás-os-Montes? Terão uma consciencialização ambiental e sustentável sólida? O uso digital será já uma realidade? Estarão os principais dirigentes associativos a encorajar um desenvolvimento sustentável na região? Conhecerá esta nova geração o modelo de economia circular? E tencionará adotar as suas práticas? A tentativa de resposta a estas questões é feita através dos resultados de um inquérito por questionário distribuído a uma amostra representativa de jovens agricultores e através de entrevistas aos seus principais dirigentes associativos<br>The European Union has come forward with many suggestions and approaches to decrease regional asymmetries and develop rural areas around member states. The main purpose of this dissertation is to study one of these measures, the Young Farmers Program, in a rural and peripheric region of Portugal, Trás-os-Montes. Since the ageing and depopulation phenomenon is one of this region?s biggest threats, initiatives like the Young Farmers Program might represent a gradual reversion and it might contribute to the attractiveness of the rural lifestyle for the younger generations, which is perhaps the region?s most crucial necessity. But do these farmers truly bring innovation and modernization to Trás-os-Montes? Do they have a significant environmental and sustainability awareness? Is the digital usage already a reality? Are the associative leaders encouraging the sustainable development of the region? Is this new generation aware of the meaning and potentialities of the circular economy? Does it intend to adopt its innovative and modern practices? A tentative answer to these questions is searched by means of a detailed survey by questionnaire to a representative sample of young farmers in the region and by directly interviewing their main associative leaders.<br>info:eu-repo/semantics/publishedVersion

Background: Injury accounts for 10% of worldwide mortality for all ages and causes profound functional deficits up to five years following injury, particularly in the young person population. These outcomes have devastating effects on social and emotional development as well as occupational prospects. There is insufficient understanding of the characteristics and experiences of injury in young people and the role of the family in their recovery from injury. Aim: To explore, for young people aged 16 -24 years, the characteristics and experience of major traumatic physical injury and the role of family in the initial six months. Methods: An explanatory sequential mixed methods design with a primary qualitative drive was used. In Phase 1, two epidemiological studies determined the incidence, characteristics and outcomes of major traumatic injury incurred by people in the Australian Capital Territory (ACT) and surrounding districts. These data provided sampling priorities for the subsequent primary qualitative phase. Phase 2 comprised two semi-structured in-depth interviews (in hospital and at 6 months following injury) with 12 injured young people and their family member/s. In Phase 3, findings were integrated. Findings: The largest demographic group affected by major injury was people aged 16-24 years. Road trauma was the most prevalent injury mechanism (58.4%), followed by recreation (15.4%) and violence (15.3%). Young people feel vulnerable and that they had lost control over their physicality, environment and life-course. Self-management strategies included using information technology as a form of distraction and family and friends to create a sense of normality. A young people's understanding of their recovery differed from how healthcare systems are structured to provide care. Driven by a need to protect the young person, family members sought to control potential emotional impacts of injury by creating a buffer between the young person and other people. Conclusion: For the first time, the initial six month injury trajectory and recovery process of injured young people has been conceptualised to inform the development of anticipatory guidance frameworks for clinicians and inform the provision of, and planning for, clinical services for injured young people.

Cette thèse analyse les tensions entre les dynamiques de segmentation et de normalisation des modalités de gestion sociale de l’anormalité, tant dans les institutions, les dispositifs que dans les pratiques dans le monde professionnel de l'insertion des jeunes travailleurs handicapés. Il s’agit de mettre en lumière les difficultés et les tensions que rencontrent ces professionnels, dans leur diversité,, et l'impact significatif des politiques d'inclusion. La recherche vise à comprendre, du point de vue des professionnels, les effets de la diversité des institutions sociales, des dispositifs, des pratiques, en les mettant en contextes spatial, temporel et symbolique (Abbott, 2016).La méthodologie repose sur 40 entretiens semi-directifs avec 37 professionnels de l'insertion et 3 jeunes travailleurs handicapés. Ces entretiens ont permis d'analyser les pratiques et les représentations de l'accompagnement, ainsi que de comprendre les interactions entre les professionnels issus de diverses institutions travaillant, ou pas, ensemble.Les résultats mettent en évidence les difficultés de la transition entre milieux protégés et milieux ordinaires imposée par le modèle inclusif. Ces obstacles sont liées à la diversité des établissements et institutions, des représentations du handicap et des pratiques d’accompagnement des professionnels.La construction et le maintien des réseaux occupent une place centrale dans les préoccupations des acteurs au sein de ce monde professionnel spécifique. Les questions de transition professionnelle, de collaboration entre institutions et de valorisation des compétences sont au cœur des attentions des professionnels. Leurs postures sont en tension entre adaptation technique et bricolage institutionnel, nécessitant un travail d'accompagnement complexe mêlant sensibilisation, médiation et négociation<br>This thesis analyzes tensions between the dynamics of segmentation and normalization of social management modalities of abnormality, both in institutions, devices, and practices in the professional world of integrating young workers with disabilities. The aim is to highlight the difficulties and tensions in the social and professional integration work of young workers with disabilities and the significant impact of inclusion policies. The research seeks to understand, from the professionals' perspective, their challenges by exploring the diversity of social institutions, devices, practices, and placing them in spatial, temporal, and symbolic contexts (Abbott, 2016).The methodology is based on 40 semi-structured interviews with 37 integration professionals and 3 young workers with disabilities. These interviews allowed for the analysis of support practices and representations, as well as understanding the interactions between professionals from various institutions working together or not.The results highlight administrative difficulties in the transition between protected and ordinary environments related to the variety of establishments and institutions.The representations of disability and support practices of professionals, the construction, and maintenance of professional networks play a central role in the practices of professionals in this specific professional world. Questions of professional transition, collaboration between institutions, and skills enhancement are at the heart of professionals' concerns. Professional practices are in tension between technical adaptation and institutional tinkering, requiring complex support work involving awareness, mediation, and negotiation

Background: the pre-participation screening program of athletes has the goal of the early identification of previously unsuspected cardiovascular diseases with a prompt disqualification of the athletes from competitive physical activity. The most frequent disqualifying condition consists of rhythm and conduction abnormalities (nearly 40%). Aim of the study and methods: the study of non-invasive cardiac examinations of young athletes discovered to have ventricular arrhythmias during the preparticipation screening program. A total of 145 young (<35 years) competitive athletes (M/F=106/39=2.7, mean age 17.3±5.3 years) were evaluated in the outpatient clinic of the department of Cardiology of Padua University from years 2007 to 2010. All subjects were referred to our laboratory due to ventricular arrhythmias detected during preparticipations screening, through 12 lead-ECG or during exercise stress test or ECG-Holter monitoring. The study protocol included family and personal history, 12-lead basal ECG, echocardiography-Doppler, ECG-Holter monitoring, exercise stress test, signal-averaged ECG, cardiac magnetic resonance (CMR). Moreover in selected cases invasive examination and genetic study were performed. When available, follow-up was also reported. Results: In 15% of athletes ECG was pathologic. Negative T-waves beyond V2 were present in 2.1% and were associated with the presence of cardiac disease. Late potentials were present in 6.8%. Frequent echocardiographic findings were right and left ventricular enlargement, mitral valve prolapse and mild atrioventricular valve regurgitation. Congenital diseases were detected in 2.7%. Moreover a possible form of cardiomyopathy was identified in 2.1%. Premature ventricular beats (PVBs) were more frequently monomorphic (88%) and isolated (57%). Rapid ventricular tachycardia was rare (2.7%). During exercise stress test PVBs disappeared in 55.7%, were present only during recovery in 11.5%, persisted in 8.6% and in were exercise-induced in 13.7%. Most frequent PVBs morphology was LBBB with inferior axis deviation. The presence of segmental abnormalities on CMR, present in almost half of the athletes in which it was performed, is not always easy to interpretate and follow-up is needed. Overall 30% of athletes were judged to have potentially dangerous arrhythmias and in 10% of athletes antiarrhythmic therapy was initiated. A total of 44% athletes were put on detraining or disqualified. Conclusion: pre-participation screening program identifies athletes with ventricular arrhythmias, of which 30% are judged to be potentially dangerous. ECG and submaximal exercise stress test are important tools that allow identification of arrhythmias in competitive sports, thus submaximal exercise stress test should always accompany ECG in the first level of evaluation of an athlete. Cardiologic screening with non-invasive techniques is fundamental for the study of young athletes with no previously known organic heart disease, suspected channelopathy or potentially dangerous idiopathic arrhythmias, as exercise may be harmful either as progression of disease or as arrhythmic death. Follow-up study demonstrated that the identification of arrhythmias in athletes, pharmacologic therapy or sport squalification, can prevent adverse outcomes. Collaboration of sports medicine and cardiology permits the identification of athletes with ventricular arrhythmias and the prevention of sudden death. Risk stratification of athletes with ventricular arrhythmias remains difficult even after a thorough investigation of the heart with all the techniques available.<br>Introduzione: Il programma dello screening di preparticipazione per gli atleti ha il ruolo dell’identificazione precoce di malattie cardiovascolari non prima sospettate e la squalificazione dell’atleta dall’attività competitive. La più frequente condizione di squalifica sono le anomalie di ritmo e conduzione (circa 40%.) Scopo e metodi lo studio con esami non invasivi cardiaci, i giovani atleti che sono scoperti di avere aritmie ventricolari durante il programma dello screening di preparticipazione. Un totale di 145 giovani atleti (>35 anni) sono studiati (età media 17.3±5.3 anni, M/F=106/39=2.7), valutati nell’ambulatorio “genetica clinica e molecolare delle cardiomiopatie” del Dipartimento della Cardiologia del Università di Padova dagli anni 2007-2010. Tutti i soggetti sono stati rivolti al nostro ambulatorio per aritmie ventricolari rilevate durante lo screening preparticipazione per la presenza di BEV all’ECG, durante la prova da sforzo o all’ECG-Holter delle 24 ore. Il protocollo di studio comprendeva: storia familiare e personale, ECG a 12 derivazioni, ecocardiogramma-Doppler, ECG-Holter, prova da sforzo, ricerca dei potenziali tardivi (SAECG), risonanza magnetica (RMC). In casi selezionati esami invasivi e studio genetico è stato eseguito. Quando disponibile è stato eseguito anche il follow-up. Risultati Nel 15% degli atleti l’ECG era patologico. Onde T negative dopo V2 erano presenti in 2.1% ed erano associate con cardiopatia organica. I potenziali tardivi erano presenti solo nel 6.8%. Frequenti alterazioni ecocardiografiche erano la dilatazione del ventricolo destro e sinistro, il prolasso valvolare mitralico e lieve insufficienza delle valvole atrioventricolari. Cardiopatie congenite sono identificate nel 2.7%. Inoltre forme sospette di cardiomiopatia sono identificate nel 2.1%. I battiti ectopici ventricolari (BEV) erano più frequentemente monomorfi (88%), isolati (57%). Tachicardia ventricolare veloce era rara (2.7%). Durante la prova da sforzo i BEV scomparivano nel 55.7%, erano presenti solo nel recupero nel 11.5%, persistevano nel 8.6% ed erano indotti dall’esercizio nel 13.7%. La più frequente morfologia era tipo BBsn con asse inferiore. La presenza di anomalie segmentarie nella RMC, presenti in circa la metà degli atleti sottoposti all’esame, non è sempre facile d’interpretare e serve follow-up. Il 30% degli atleti sono stati giudicati di avere potenzialmente pericolose aritmie e nel 10% terapia antiaritmica è stata instaurata. Un totale di 44% atleti sono messi in defaticamento o sono stati squalificati. Conclusione: Lo screening preparticipazione identifica atleti con aritmie ventricolari, dei quali il 30% sono giudicate potenzialmente pericolose. L’ECG e la prova da sforzo sotto massimale sono dei test fondamentali per l’identificazione di aritmie per gli sport competitivi e la prova da sforzo sottomassimale dovrebbe sempre accompagnare l’ECG come valutazione di primo livello negli atleti. Lo screening cardiologico con esami non invasivi è fondamentale per lo studio di atleti giovani con cardiopatia organica misconosciuta, il sospetto di cannalopatia o aritmie idiopatiche potenzialmente pericolose, dove l’esercizio può essere dannoso o come progressione di malattia o come morte aritmica. Lo studio di follow-up ha dimostrato che l’identificazione delle aritmie negli atleti, la terapia farmacologica o la squalificazione può prevenire la morte improvvisa. La collaborazione della medicina dello sport e della cardiologia permette l’identificazione di atleti con aritmie ventricolari e la prevenzione della morte improvvisa. La stratificazione del rischio rimane difficile anche dopo uno studio cardiaco approfondito con tutte le tecniche a disposizione.

Philosophiae Doctor - PhD (School of Public Health)<br>Poor water, sanitation and hygiene (WASH) services and practices in communities are known to be responsible for most of the infections occurring among infants and young children in developing countries. A combined effect of disease, poor diet, care practices and other factors among infants/children are known to lead to undernutrition reported in most developing countries. Apart from the reduced growth and productivity potential that malnutrition exhibits on the affected population, it is also an underlying cause to 50% of child mortality in poor communities. In light of this, the primary objective of the study was to evaluate the effect of poor WASH practices on growth and infectious disease incidence in infants and young children aged 6-23 months in the rural district of Monze in Zambia.

Lucinda Childs est une figure majeure de la danse au XXe siècle. Au début des années 1960, elle participe à la fondation du Judson Dance Theater, un collectif de danseurs, danseuses, chorégraphes, artistes et compositeurs qui renouvellent à New York les formes et les pratiques de la danse. Avec sa compagnie crée en 1973, elle devient l’une des cheffes de file de la danse minimale et de la danse postmoderne américaines, tout en collaborant à partir des années 1980 avec les plus importantes compagnies de ballet en Europe et aux États-Unis. Dans le processus de création, répétition et représentation que Childs met en œuvre seule, avec sa compagnie, ou des compagnies de répertoire, l’écriture et la lecture jouent un rôle déterminant pour concevoir et incorporer ses danses. Grâce à une enquête anthropologique au cœur des studios de danse, Lou Forster montre que le geste technique consistant à danser page à la main se construit à l’intersection de deux histoires parallèles. Au cours des années 1950, John Cage et Merce Cunningham inventent un ensemble de pratiques de lecture et d’écriture afin de s’opposer, détourner et reconfigurer des approches académiques dans lesquelles l’écrit constitue un support pour assoir des partages disciplinaires et des hiérarchies. Cette approche néo-avant-gardiste joue un rôle primordial au Judson ; et parmi les membres de ce groupe, Childs est l’une des chorégraphes qui se montrent la plus attentive à ces pratiques lettrées car elles rejoignent un aspect méconnu de sa formation de danseuse. En effet, elle étudie la danse moderne de 1955 à 1962 au sein de l’important réseau de la diaspora allemande de New York. Elle suit en particulier la formation dispensée dans l’école de la chorégraphe Hanya Holm (1893-1992) où est enseignée une forme américanisée de danse d’expression (Ausdruckstanz). Childs y découvre la cinétographie Laban ou Labanotation, le système d’analyse et d’écriture du mouvement développé par le chorégraphe austro-hongrois Rudolf Laban (1879-1958), dans lequel les danseurs et danseuses répètent page à la main. C’est vers cet événement de lecture atypique pour le monde de la danse que Childs se tourne quinze ans plus tard pour travailler avec sa compagnie. L’histoire de l’art et l’histoire de la danse ont dissocié ces deux versants des modernités chorégraphiques lorsqu’à partir de 1933 une partie de la danse d’expression se compromet avec le régime nazi. Aux États-Unis se construit alors le mythe d’une originalité de la danse moderne américaine, qui s’accentue encore dans le cadre de la guerre froide. La position privilégiée que Childs occupe dans cette histoire connectée la conduit à faire des pratiques graphiques une matrice du postmodernisme. À partir de 1973, elle aborde l’ensemble des techniques canoniques de la danse occidentale, passant au fil des années de la danse d’expression aux activités piétonnières, au ballet néoclassique puis baroque. Se positionnant comme une appropriationiste, elle développe une perspective historique et critique sur ces techniques d’emprunt. Dans ses pièces, elle tend ainsi à rassembler des genres et des histoires de la danse qui ont été séparées et disjointes, élaborant une véritable poétique de la relation<br>Lucinda Childs is a major figure in twentieth-century dance. In the early 1960s, she was one of the founding members of the Judson Dance Theater, a group of dancers, choreographers, artists and composers in New York City who reinvigorated dance forms and practices. With the establishment of her company in 1973, she emerged as one of the leading figures of American minimal dance and postmodern dance, while collaborating from the 1980s onward with major ballet companies in Europe and the United States. Whether with her own company, with repertory dance companies, or at Judson, literacy plays a crucial role in the conceiving, embodying, and performing of her dances. Through an anthropological investigation within dance studios, Lou Forster demonstrates that the technical gesture of dancing, page in hand, is constructed at the intersection of two parallel histories. In the 1950s, John Cage and Merce Cunningham devised a range of reading and writing practices in order to oppose, divert and reconfigure academic methods in which literacy serves as a foundation to establish disciplinary divisions and hierarchies. This neo-avant-garde approach played a crucial role at Judson. Among the members of this group, Childs was one of the choreographers who paid the most attention to these literacy practices, as they tied in with a lesser-known aspect of her dance training. From 1955 to 1962, she studied modern dance within the extensive network of the German diaspora in New York. Specifically, she attended the school run by the choreographer Hanya Holm (1893-1992), where an Americanised form of dance of expression (Ausdruckstanz) was taught. There Childs discovered Kinetography Laban or Labanotation, the system of analysing and writing movement developed by the Austro-Hungarian choreographer Rudolf Laban (1879-1958), in which dancers rehearse with page in hand. Fifteen years later she turned toward this literacy event, unusual for the dance world, to work with her company. Art history and dance history dissociated these two aspects of choreographic modernity when, from 1933, part of the dance of expression became involved with the Nazi regime. In the United States, the myth of the originality of American Modern dance began to take shape, further emphasized during the Cold War. Childs' unique position in this connected history meant that graphic practices became a matrix for postmodernism. Since 1973, she embraced all canonical techniques of Western dance, moving over the years from dance of expression to pedestrian activities, to Neoclassical and then to the Baroque. Positioning herself as an appropriationist, she developed a historical and critical perspective on these borrowed techniques. In her pieces, she seeks to bring together practices, genres and histories of dance that have been separated and disjointed, crafting a genuine poetics of relation

L’historiographie a souvent négligé la place occupée par les migrants francophones au sein de la jeune république américaine, se bornant à suivre l’itinéraire des exilés politiques les plus célèbres, bannis par la Révolution Française ou la Restauration, ou celui des utopistes rêvant d’instaurer une société nouvelle au Nouveau Monde. Au cœur de la Jeune Amérique confrontée à l’épineux problème de l’esclavage, à l’agonie des empires coloniaux et à la naissance de l’esprit d’entreprise et du capitalisme, ils furent nombreux à tenter la fortune outre atlantique entre 1783 et 1815, établissant dans le corridor créole de puissants liens commerciaux, culturels et religieux entre côte Est, Nouvelle-Orléans, Antilles et espace atlantique. Tel est l’objet de la présente réflexion qui emprunte la voie ouverte par l’histoire atlantique, et propose, en tirant parti de la correspondance et des ressources archivistiques, une écriture novatrice de l’histoire des migrations commerciales francophones entre Pittsburgh et Louisville à l’époque des révolutions atlantiques<br>Historiography often neglects the part of Francophone migrants in the young American republic, merely following the route of the most famous political exiles banished by the French Revolution and the Restoration, or the Utopians dreaming to establish a new society in the New World. In the Early Republic faced with the thorny problem of slavery, the agony of colonial empires and the birth of entrepreneurship and capitalism, many migrants tried fortune beyond the Atlantic Ocean, between 1783 and 1815, establishing in the “Creole corridor” powerful commercial, cultural and religious ties between east coast, New Orleans, West Indies and Atlantic space. This is the purpose of this discussion that borrows the path opened by the Atlantic history, and proposes, through the study of correspondence and archival resources, an innovative history of francophone business migrations from Pittsburgh to Louisville in the age of the Atlantic Revolutions

This thesis explores a series of relationships between music and acoustics in order to develop a basis for discussing and critiquing aesthetics in post-Cagean experimental music. Specifically, it examines the acoustic and aesthetic theories that inform the practice of American composers La Monte Young and Alvin Lucier. One particular theme - the sine wave - emerges, both as a prominent feature in the work of these two composers, and also as a nexus point between music and acoustics. Pursuing this theme, the thesis begins by looking at issues in the science, technology, and ideology of acoustics in relation to the study of musical sound in the late nineteenth century. It then aims to situate the sine wave historically, culturally and technologically within a range of scientific and aesthetic practices in operation in the first half of the twentieth century. Finally, it explores the deployment of concepts from the field of acoustics by artists of the avant-garde, and considers what contribution these factors played in broadening the developing discourse of sound within the arts. These discussions then inform detailed investigations into the work of both Lucier and Young, examining their use of sine waves to explore and produce simple acoustic phenomena.<br>Doctor of Philosophy (PhD)

Afin de mieux comprendre l'évolution des étoiles jeunes, nous avons utilisé un code Monte Carlo simulant leur environnement afin d'étudier une nouvelle distribution chez les étoiles Herbig Ae/Be et pour reproduire des cartes d'intensité et de polarisation linéaire obtenues au télescope Canada-France-Hawaii (TCFH) en novembre 2003. Le code datant de la fin des années 80, nous avons dû non seulement le corriger, mais aussi ajouter quelques éléments afin de tenir compte des dernières avancées dans le domaine de la polarisation provenant du milieu circumstellaire. Les étoiles à l'étude étant jeunes (moins de quelques millions d'années), leur voisinage est toujours constitué de grains de poussière mélangés avec du gaz. Selon leur âge, nous retrouvons cette poussière sous différentes structures soit, par exemple, par un disque entouré d'une enveloppe (objets jeunes de classe I) ou par un simple disque (objets de classe II et III). Selon la structure que prend la poussière, les cartes de polarisation et d'intensité qui en résultent vont changer. Nous allons discuter de cette variation des cartes de polarisation selon la distribution de poussière. Suite aux modifications apportées au code, il a fallu s'assurer que celui-ci fonctionne bien. Pour ce faire, nous avons mis au point quelques critères qui nous assurent, s'ils sont satisfaits, que le code Monte Carlo produit de bons résultats. Après avoir validé le code, il est maintenant possible de l'utiliser aux fins d'avancer le domaine de la polarisation. En effet, Dullemond et al.(2001) proposent une nouvelle distribution de grain autour des étoiles Herbig Ae/Be afin de mieux expliquer leur distribution d'énergie spectrale. Par contre, qu'en est-il des cartes de polarisation résultantes? C'est sur cette question que nous nous sommes arrêtés. Par la suite, nous avons essayé de reproduire du mieux possible, tenant compte des limitations du code, les cartes de polarisation obtenues au TCFH. Nous avons étudié en détail les données de R Mon (résultats qui seront présentés sous forme d'article pour fin de publication) et de V376 Cas. De plus, notre étude de V376 Cas nous a permis d'amener des conclusions sur les processus causant les vecteurs parallèles aux disques des étoiles jeunes.<br>To further understand the evolution of young stellar objects, we used a Monte Carlo code simulating their environment in order to study a new density distribution for the Herbig Ae/Be stars and to reproduce intensity and linear polarization maps obtained at the Canada-France-Hawaii telescope (CFHT) in November 2003. As the code was first created in the 80's, we had to correct some bugs and add new elements in order to take into account the latest advances in studies of polarization produced by circumstellar matter. Since the stars studied are young (less than a few million years), their neighborhood still contains dust mixed with gas which will be distributed according to their age. Younger stars will have a disk structure inside a bigger envelope (class I) while older stars will exhibit only a disk (class II and III). As we can expect, different structures create different intensity and polarization maps. We will discuss the variations induced in the polarization and intensity maps when changing the dust distribution. Following the modifications to the code, we ran some tests to check its functionality. We developed some criteria that once they are satisfied, we can safely assume the Monte Carlo code is operational and that it will produce good results. The code can now be used to increase our knowledge of circumstellar matter around young stellar objects. Indeed, Dullemond et al.(2001) proposed a new dust distribution around Herbig Ae/Be stars which explains better their spectral energy distribution (SED). However, there are still no studies to find out if the polarization maps resulting of this new distribution was also compatible with the observations. This problem was treated with our Monte Carlo code. We then tried to reproduce, as well as possible and taking into account the limits of the code, the polarization and intensity maps obtained at the TCFH. Our study was focused on R Mon, which is presented as an article to be submitted, and V376 Cas. Also, our study of V376 Cas helped us to shed some light on the causes for aligned polarization vectors seen on our maps.

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2018<br>Introdução: O exercício físico é recomendado universalmente, contudo, alguns indivíduos, devido à sua genética e fisiologia, estão em risco de morte súbita durante a prática de exercício, sendo a principal causa cardíaca. Apesar de não ser comum entre os jovens atletas, quando ocorre, é um evento com elevado impacto emocional em toda a comunidade. Objetivos: Desenvolver uma revisão bibliográfica sobre as principais causas de morte súbita cardíaca e apresentar um algoritmo de avaliação baseado nas recomendações e guidelines atuais. Métodos: Revisão bibliográfica baseada em documentos publicados entre 2006-2018 nas bases de dados: PubMed, European Society of Cardiology, American Heart Association e American College of Cardiology, sobre as principais causas de morte súbita cardíaca em atletas, complementado com a pesquisa de algoritmos recomendados, tanto a nível Europeu como Americano. Resultados: O risco de morte súbita cardíaca em jovens varia entre 0.5 e 3.7 por 100.000 pessoas/ano e o exercício atua como fator precipitante. As causas mais comuns são miocardiopatias (miocardiopatia hipertrófica e a displasia arritmogénica do ventrículo direito) e anomalias coronárias. Estas condições são difíceis de identificar e a sua primeira manifestação é frequentemente a morte súbita. Assim sendo, a identificação de fatores de risco, como sintomas relacionados com arritmia, uso de determinados fármacos e história familiar de doenças cardíacas é de extrema importância porque podem alertar para uma alteração cardíaca potencialmente fatal. Conclusões: As principais causas de morte súbita cardíaca já foram identificadas, mas o problema consiste na dificuldade do diagnóstico: a maioria das doenças são indolentes, a primeira manifestação é frequentemente a morte súbita e não há consenso sobre qual a melhor maneira de selecionar os atletas que poderão praticar exercício e aqueles em que deve ser evitado. O algoritmo apresentado é uma síntese das guidelines atuais, direcionado a auxiliar a decisão do médico relativamente à prática de exercício.<br>Introduction: Physical exercise is recommended to everyone, however, some individuals, due to their genetics and physiology, are at risk of suffering from sudden death (SD) while practicing sports and the most frequent cause is sudden cardiac death (SCD). Although SCD is not common among young athletes, when it happens is an event with huge emotional impact in the community. Objectives: To develop a bibliographic review of the main causes of SCD and to present an evaluation algorithm based on current recommendations and guidelines. Methods: Bibliographic review of documents published between 2006-2018 in PubMed, European Society of Cardiology, American Heart Association and American College of Cardiology focusing the main causes of SCD in the athlete complemented with the research of algorithms recommended, at European and American level. Results: The risk of SCD in young individuals ranges from 0.5 to 3.7 events per 100.000 person/year and exercise acts as a precipitation factor. The most common causes are cardiomyopathies (hypertrophic cardiomyopathy (HCM) and arrhythmogenic right ventricular dysplasia (ARVD)) and coronary artery anomalies. It is difficult to identify these conditions, since they may not be clinically apparent and may first present with SD. Therefore, identification of risk factors, such as symptoms related to arrhythmia, medications used to improve physical performance and family history of cardiac conditions is of highly importance, as they can alert to a potentially fatal cardiac condition. Conclusions: The main causes have already been identified, but the problem remains the difficulty of the diagnosis: most diseases are indolent, the first manifestation is often SD and there is no consensus on how to select athletes that can take part in sports and those who should be recommended to avoid practicing. The algorithm presented is a synthesis of current recommendations and guidelines aimed to help the physician to better decide regarding exercise practice.

碩士<br>靜宜大學<br>英國語文學系研究所<br>92<br>The aim of this study was to observe longitudinally the development of refusal strategies in five young Taiwanese children, aged four months to four years old. In order to enrich the study, thirty-six questionnaires were administered to the parents or adult caregivers of children ranging from (0; 2) to (0; 7). The present study focused on subjects’ non-verbal and verbal refusal strategies. For non-verbal strategies, all documentation, from the five subjects and the questionnaires, was divided into two categories: gestural refusal strategies and vocal sounds. Moreover, this study also looked at the verbal refusal strategies of these five subjects, from (0; 4) to (4; 8), as well. All verbal documentation was categorized into twelve types of verbal refusal strategies based on the refusal strategies of Beebe et al. (1990) and Wang (2001). All of the subjects’ data were audiotaped and videotaped by the author. The results indicated that the most frequently used non-verbal refusal strategies were “shake head” and “wave hands”. The babies expressed their unwillingness by whole body physical movements, whereas the children at the age of 1 ½ to 4 only used certain parts of their bodies to refuse. For example, they shook their head, or stamped their feet, etc. The results also showed that as children grew older, they used fewer gestural refusal strategies to convey their unwillingness. Regarding vocal sounds, the results showed that the subjects preferred to make various sounds, or noises such as: ‘a….’ and ‘um….’ to refuse. The observation of the subjects also revealed that the younger the subjects were, the more frequently they used the vocal sounds. As they grew older, they used the vocal sounds less frequently. The results also indicated that “Direct refusal”, “Insistence” and “Reason” were the most commonly used verbal refusal strategies. When the children were refusing, they did not concern themselves with others’ feelings, but rather conveyed their unwillingness directly. As the children grew older, they used more refusal strategies in one utterance and there were more words in one of these refusals than in those of the younger children. Furthermore, the study also found that although the subjects were able to use more words to express their feelings, it did not mean that they would be more considerate of people’s feelings. In conclusion, first of all, the older children used fewer non-verbal refusal strategies than the younger children. “Shake head” and “wave hands” were the most frequent responses that the subjects used. Secondly, the subjects would like to make the vocal sounds: “a….” and “um….” The younger child was able to make these vocal sounds more often. Thirdly, there were twelve different verbal refusal strategies that the subjects used: (1) Direct refusal (2) Insistence (3) Reason (4) Alternative (5) Dissuade interlocutor (6) Postponement (7) Acceptance as a refusal (8) Unrelated answer (9) No answer (10) Call for help (11) Name of the person (12) Other. “Direct refusal” was the most frequent verbal refusal strategy that the subjects used. Fourth, the older children were able to use more words to express their unwillingness.

Yes<br>Purpose: This study analyzes the effects of a 3-month vigorous physical activity (VPA) intervention on eating behavior and body composition in overweight and obese children and adolescents. Methods: Forty-seven participants (7-16 years) took part in the study: 28 were assigned to the intervention group (IG) (10 boys and 18 girls) and 19 in a control group (CG) (8 boys and 11 girls). Body composition (dual-energy X-ray absorptiometry), anthropometrics (body mass, height, and body mass index [BMI]), and eating behavior traits (Three Factor Eating Questionnaire-R21C) were determined before and after the VPA intervention. Results: A decrease in the percentage of body fat and BMI (−2.8% and −1.8%, respectively), and an increase in lean mass variables were found in the IG (all p ≤ 0.05). In relation to the eating behavior traits, IG subjects showed a 14% reduction in the Emotional Eating score (p = 0.04), while Cognitive Restraint score did not change after the VPA intervention. The baseline factors of the questionnaire predicted changes in body mass and fat mass variables only in the CG. Conclusion: A 3-month VPA intervention influenced eating behaviors of overweight or obese young, especially the Emotional Eating factor, in the presence of favorable body composition changes.<br>Shanghai University of Sport

Dissertação de mestrado em Enfermagem da Pessoa em Situação Crítica<br>Juventude é sinónimo de longevidade. A morte de jovens assume uma conotação trágica e é vista como um dos maiores desafios enfrentados pelos profissionais de saúde. Nos serviços de urgência, além de salvarem vidas, os enfermeiros cuidam de jovens e famílias em morte iminente. Nestes contextos o paradigma assistencial implica que as intervenções terapêuticas sejam urgentes e emergentes e dirigidas para a cura, através da estabilização das funções orgânicas alteradas. No entanto, muitas vezes, os jovens que recorrem ao serviço de urgência têm prognóstico de limite de vida, para o qual não existe efetivamente nenhuma hipótese de recuperação, ou todas as intervenções falham. Os enfermeiros perante esta realidade são continuamente confrontados com vivências pessoais que influenciam a sua conduta, e a sua forma de cuidar. O presente estudo pretende compreender as vivências dos enfermeiros com a situação de morte de jovens/família em contexto de urgência/emergência. Para responder ao objetivo proposto desenvolveu-se um estudo exploratório, descritivo do tipo fenomenológico, cuja recolha de dados foi efetuada no serviço de um hospital da região norte de Portugal com recurso à entrevista semiestruturada. Os participantes do estudo são enfermeiros que cumpriam os critérios definidos tendo em conta as considerações éticas e operacionais intrínsecas à investigação, bem como o princípio da saturação de dados. Os dados obtidos permitiram identificar quatro áreas temáticas, i) experiências dos enfermeiros perante a morte de um jovem; ii) dificuldades sentidas pelos enfermeiros perante a morte de um jovem; iii) estratégias utilizadas pelos enfermeiros para enfrentar a morte de jovens e iv) informação complementar. Dentro de cada área temática foram ainda identificadas categorias e subcategorias, como, equipa orientada para a cura; acontecimento contranatura; vivência marcante; tomada de decisão; comunicação de más notícias; informação e cuidado à família; identificação das necessidades efetivas da família; envolvimento emocional/gestão de sentimentos; transição da situação para o contexto pessoal; discussão de situações vivenciados e partilha de emoções e sentimentos com colegas de equipa; apoio familiar; afastamento dos cuidados/fuga/distanciamento e necessidade de apoio psicológico à equipa/debriefing. Os resultados revelaram que os cuidados aos jovens em morte iminente e família têm impacte emocional nos enfermeiros, sendo um acontecimento que os marca para sempre. Para além da gestão emocional os participantes revelaram dificuldades que se prendem com a tomada de decisão, a comunicação de más notícias, a informação e cuidado à família, a identificação das necessidades efetivas da família, a gestão das emoções e a transição da situação para o contexto pessoal. As estratégias mais utilizadas pelos participantes para minimizar o impacte das perdas foram a discussão das situações vivenciadas e a partilha de emoções e sentimentos com colegas de equipa, o apoio familiar e o afastamento dos cuidados. Conclui-se que a implementação de programas de debriefing em equipa e o apoio emocional aos profissionais, que vivenciam o evento morte de jovens, poderiam contribuir para minimizar os danos causados pelo impacte desta experiência, no sentido de melhorar a qualidade de vida dos profissionais que trabalham num serviço de urgência e consequentemente, a qualidade dos cuidados.<br>Youth is synonymous with longevity. The death of young people assumes a tragic connotation and is seen as one of the greatest challenges faced by health professionals. In emergency department, in addition to saving lives, nurses care for young people and families in imminent death. In these contexts, the care paradigm implies that therapeutic interventions are urgent and emergent and directed towards cure, through the stabilization of altered organic functions. However, many times, the young people who resort to the emergency service have a life-limiting prognosis, for which there is effectively no chance of recovery, or all interventions fail. Nurses, faced with this reality, are continuously confronted with personal experiences that influence their conduct and their way of providing care. This study aims to understand how nurses experience the situation of death of young people/family in an emergency context. To answer the proposed objective, an exploratory and descriptive phenomenological study was developed, which data were collected in the unit of a hospital in the northern region of Portugal, using semi-structured interview. The study participants were nurses who met the criteria defined, taking into account the ethical and operational considerations intrinsic to the research, as well as the principle of data saturation. The data obtained allowed us to identify four thematic areas, i) nurses’ experiences when facing the death of a young person; ii) difficulties experiences by nurses when facing the death of a young person; iii) strategies used by nurses to deal with the death of young people and iv) additional information. Within each thematic area, categories and subcategories were also identified, such as: cure-oriented team; unnatural event; remarkable experience; decision-making; communication of bad news; family information and care; identification of the family’s effective needs; emotional involvement/management of feelings; transition of the situation to the personal context; discussion of situations experienced and sharing of emotions and feelings with teammates; family support; withdrawal from care/escape/distancing and need for phycological support to the team/debriefing. The results revealed that the care provided to young people in imminent death and their families has an emotional impact on nurses, as it is an event that marks them forever. The results revealed that the care with imminent death of young people and their families impact the nurses emotionally, being an event that marks them forever. Besides the emotional management, the participants have shown difficulties regarding decision making, bad news communication, information and care towards the family, identify effective family needs, emotion management, and the situation's transition to the personal context. The main strategies used by the participants to minimize the impact of loss were discussing the experiences lived and sharing their feelings and emotions with their teammates, family support, and care withdrawal. In conclusion, the debriefing team programs' implementation and psychological support to professionals who experience situations of death of young people may contribute to minimizing the effects caused by these types of events, in order to improve the quality of life of these professionals and the quality of care.

Dissertação de Mestrado em Medicina do Desporto apresentada à Faculdade de Medicina<br>Sudden cardiac death (SCD) usually affects patients under 40 years of age, with most of its victims displaying a cardiac abnormality, either previously known or even unrecognized. However, in up to 5–10% of cases, the underlying cardiac arrest takes the form of ventricular fibrillation and the context of no obvious cardiac pathology, in what researchers now agreed upon to correspond to idiopathic ventricular fibrillation (IVF). As expected, these patients represent a highly heterogeneous group, in whom both diagnosis and management are challenging. Nowadays, it remains unclear if this condition really exhibits no cardiac abnormalities or if our exams are to blame as not being powerful enough to detect them. In fact, the goal of this review is to provide a broad insight into IVF potential underlying etiopathologies, even asking whether it represents a real individual clinical entity. In order to accomplish so, an extensive literature review, focused on the key aspects surrounding the concept of IVF, namely its definition, diagnosis, etiology, pathophysiology and follow-up, was performed. IVF incidence seems to be decreasing in the last few decades, which can be, at last, partially attributed to the stipulation of new well-defined primary arrhythmia syndromes, the improvement in high-resolution imaging modalities and the further implementation of genetic testing. On the other hand, a majority of unexplained SCAs remain insufficiently investigated, thus resulting in the diagnosis of IVF to be still probably overused. Therefore, a constant diagnosis re-evaluation during a long-term follow-up seems of utmost importance in virtually all cases. As such, there is a desperate need for international medical societies to frame management guidelines, so that standardized and systematic approaches could be implemented, in order to improve the proportion of definitive diagnosis in otherwise apparently unexplained SCAs and to ensure that opportunities for specific therapies and preventive strategies, including among family members, are not missed. After all, the rate of potentially lethal arrhythmic recurrences in IVF patients is not neglectable.<br>As vítimas de morte súbita cardíaca (MSC) têm, habitualmente, idade inferior a 40 anos, apresentando, a maioria, anomalias cardíacas, quer previamente conhecidas quer não documentadas à data do evento. No entanto, em 5-10% dos casos, a causa subjacente deve-se a um episódio de fibrilhação ventricular (FV) sem patologia cardíaca subjacente, sendo assim designada como idiopática (FVI). Estes doentes constituem um grupo heterogéneo e desafiante, tanto em termos de diagnóstico como de seguimento. Atualmente, permanece por esclarecer se esta condição é, efetivamente, idiopática, por não exibir qualquer anomalia cardíaca, ou se, ao invés, os exames complementares de diagnóstico disponíveis não têm acurácia suficiente para a deteção de uma causa subjacente. O objetivo desta revisão é averiguar as potenciais etiopatogenias da FVI, questionando, até, a existência desta entidade. Foi feita uma revisão da literatura existente, tendo como âmbito o conceito de FVI, nomeadamente quanto à sua definição, diagnóstico, etiologia, fisiopatologia e follow-up. A incidência da FVI tem vindo a decrescer ao longo das últimas décadas, o que poderá dever-se ao surgimento de novos síndromes arrítmicos primários, melhoria nas modalidades de imagem, concretamente de alta resolução, e maior acessibilidade na implementação de testes genéticos. Por outro lado, grande parte dos casos de MSC continuam sub-investigados, pelo que o diagnóstico de FVI poderá ser sobre-utilizado. Adicionalmente, esta entidade deverá ser periodicamente reavaliada, sendo da máxima importância um follow-up a longo prazo. Assim, existe uma necessidade emergente de serem estabelecidas guidelines internacionais acerca do correto diagnóstico e management desta entidade, para que a sua abordagem possa ser estandardizada e sistemática, melhorando desta forma tanto o diagnóstico como também o tratamento, a prevenção de novos eventos e o aconselhamento familiar, já que o risco de recorrência de arritmias potencialmente fatais nestes doentes não é negligenciável.

A thesis submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in fulfilment of the requirements for the degree of Doctor of Philosophy. Johannesburg, 2017.<br>Over recent decades medical and surgical advances have significantly lowered the mortality rate for children born with congenital heart defects. Congenital heart disease (CHD) survivors are at high-risk of growth retardation and developmental morbidity that negatively affect their health-related quality of life (HRQOL). In addition, caring for a child with a chronic health condition such as CHD places a considerable financial and emotional burden on parents, putting them at risk of ongoing stress and psychological morbidity including anxiety and depression. The outcomes of children living with CHD and their families in South Africa (SA) are unknown. Outcomes for children with CHD in SA are likely to be further complicated by social disadvantage and Human Immunodeficiency Virus (HIV) co-infection. The aim of this observational descriptive study (Phase I and II) was to determine the pre-cardiac intervention, and three-month and six-month post-cardiac intervention development, growth, HRQOL and parenting stress outcomes of young children with CHD in central SA. Outcomes were compared over time, and variables associated with development, HRQOL and parenting stress outcomes determined. In addition, the developmental needs of young children living with CHD in central SA were to be identified. In order to meet the Phase I and II objectives, forty-eight consecutive children, 30 months and younger, and their parents were recruited into this study at the Universitas Academic Hospital in Bloemfontein. Children who had previous or emergency cardiac surgery were excluded. Development was assessed using the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III), HRQOL using the Paediatric Quality of Life Inventory (PedsQLTM) and levels of parenting stress using the Parenting Stress Index Short-Form (PSI-SF). Growth outcomes were determined by z-scores calculated for growth parameters. Medical severity of the cardiac disease was rated by a paediatric cardiologist using the Cardiologists Perception of Medical Severity Scale. Baseline data was collected for 40 children. The majority of children (n=26) underwent open-heart surgery in infancy with cardiopulmonary bypass. Most children (n=30) had moderate disease severity, with twenty percent (n=8) having cyanotic heart defects. A quarter of the children (n=10) had Down syndrome (DS). Surgical outcomes were comparable to those reported in developed countries, with a mortality rate of 15%. There was a high attrition rate during Phase II of this study, with 47.5% of children and their families missing one or more follow-up visit. Mothers fulfilled the role of primary caregiver, and carried most of the burden of care. The majority of families were from a low socioeconomic backgrounds (87.5%) and mothers had low levels of education, with only 40% having graduated high school. The majority (68%) of children had suboptimal growth prior to cardiac intervention. There was significant growth catch-up for both weight (p=0.04) and head circumference (p= 0.02) by the six-month post-cardiac intervention. Complete catchup growth had not yet taken place by the six-month post-cardiac intervention, with 40.9% of the children still presenting with malnutrition. The growth trends of children with CHD with DS were found to be similar to those of children with CHD without DS. Growth in children with cyanotic heart defects tended to be poorer both before and after cardiac intervention. There was a high prevalence of moderate developmental delay across all development domains. Motor delays (27.5%) were most prevalent prior to cardiac intervention. Motor performance improved with age and post cardiac intervention, but language and cognitive performance declined with age and increasing skill complexity. There was not a significant change in the developmental outcome of the children over the timespan of this study. The developmental outcome for children with cyanotic heart defects tended to be similar to those with acyanotic heart defects. The presence of DS was significantly (p<0.001) associated with developmental outcome across all developmental domains at all time-points of assessment. Children with CHD with DS tended to have considerably poorer developmental outcomes compared to children with CHD without DS. Disease severity (p=0.02) and maternal age (p=0.01) were significantly associated with cognitive development. Age at first cardiac surgery was found to be significantly associated with language development both before cardiac intervention (p<0.01) and at three-month post-cardiac intervention (p=0.04). Suboptimal growth prior to cardiac intervention (p=0.04) and maternal age (p<0.001) were significantly associated with motor development. Developmental performance was well below the test mean on all subscales of the BSID-III at all the time points of assessment. Although the patterns of development and the prevalence of developmental delays in the current study were similar to those reported in developed countries, children living with CHD in central SA performed below the expected developmental levels for children with CHD when assessed on the BSID-III. Hypotonia was the most significant abnormal neurological finding, with 45% of the children presenting with hypotonia prior to cardiac intervention. The hypotonia tended to resolve in the children without DS by the six-month post-cardiac intervention. Overall parents’ perceived their children’s HRQOL as being relatively good, and similar to that of their healthy same-aged peers and other children with CHD in developed countries. Parents’ perception of their children’s HRQOL improved significantly after cardiac intervention (p= 0.04). Perceived HRQOL tended to be similar for children with cyanotic and acyanotic heart defects. Parents of children with CHD with DS tended to perceive their children’s HRQOL as poorer when compared with parents of children with CHD without DS. Motor development (p=0.01) and levels of parenting stress (p=0.02) were significantly associated with parents’ perceptions of their children’s HRQOL prior to cardiac intervention. The majority of parents’ (60%) experienced clinically significant levels of stress prior to their children undergoing cardiac intervention. Parenting stress decreased significantly from pre-cardiac intervention levels at both three-month (p<0.001) and six-month (p<0.001) post-cardiac intervention as the child’s cardiac symptoms resolved or decreased, and their health status improved. Parents of children with cyanotic and acyanotic heart defects tended to experience similar levels of stress. Parents of children with CHD with DS tended to experience higher levels of ongoing stress when compared with parents of children with CHD without DS. Parenting stress prior to cardiac intervention was significantly associated with parents’ perception of their child’s HRQOL (p=0.02) and language development (p=0.04). Parenting stress at threemonth post-cardiac intervention was significantly associated with age at first cardiac surgery (p=0.03), language development (p=0.03) and level of maternal education (p=0.04). HRQOL and parenting stress outcomes were closely linked before cardiac intervention. Parents perceiving their child as having a poor ability to function in everyday situations experienced increased stress levels. Based on developmental performance on the BSID-III 59% of the children in the current study would qualify for referral to early intervention (EI) services including physiotherapy, occupational therapy and speech therapy, with many children requiring access to more than one service. A home-based parent-driven developmental activity programme would likely be best suited to meet the developmental needs of children with CHD living in central SA taking into account the geography of the area and service delivery challenges in the public healthcare sector. Phase III of the study resulted in the development of a home-based developmental activity programme to meet the identified developmental needs of children with CHD in central SA. Qualitative methods, including an expert panel of rehabilitation professionals and a focus group of parents, were used to gain consensus on the content of the developmental activity programme. In conclusion, it is encouraging that the longer-term outcomes of children with CHD in central SA were not vastly different from those of children in developed countries. The greater extent of the growth retardation and developmental delay of the children in the current study is however of concern. The findings in this study strongly support the implementation of a cardiac neurodevelopmental programme as part standard cardiac care in SA. Early developmental intervention and psychosocial support services are indicated to optimise the outcome for both children living with CHD and their families. A home-based parent-driven developmental stimulation programme provides an innovative approach to meeting the developmental needs of young children living with CHD. Keywords Congenital heart disease, neurodevelopment, growth, parenting stress, health-related quality of life, home-based developmental activity programme, Bayley Scales of Infant and Toddler Development, Third Edition, Paediatric Quality of Life Inventory, Parenting Stress Index-Short Form.<br>LG2018

Introduction: Intimate Partner Violence (IPV), also called domestic violence, is defined as any physical, psychological, or sexual violence, and emotional violence perpetrated by an intimate partner (CDC, 2016). Sexual violence or rape is defined as a sexual act committed against someone without that person’s freely-given consent (CDC, 2017). IPV is experienced among heterosexual women globally, although this phenomenon is not unique to this population. IPV also disproportionately affects young gay, bisexual, and other men who have sex with men (MSM) (Stults et al., 2016). The purpose of this study is to examine the association between IPV victimization and the increased risk of HIV and other health outcomes among YBMSM. Methods: The 6-month follow-up was conducted in Jackson, MS. A total 600 YBMSM were eligible to participant in the study. The participants were recruited from two local clinics that were focused on diagnosing and treating STI’s. Also, recruiters promoted the opportunity to enroll in the study through social media, attending bars, and nightclubs. Inclusion criteria were: 1) assigned male at birth; 2) self-identification as Black/African American; 3) 15-29 years of age; 4) attending the clinic to be tested for HIV or other STIs, 5) having engaged in anal sex with a male partner at least once in the past 6 months, and 6) the ability to speak and comprehend English. Results: The overall study sample consisted of 600 YMSM. All participants were identified as African–American. The average age of the sample was 22.6 years (SD=±3.2). Bottoms were more likely to experience rape (AOR=1.7,CI 1.1,2.6; p=.02). YBMSM who experienced IPV since enrolling in the study, as compared to those who did not experience IPV, were more likely to use marijuana, alcohol, crack, and painkillers (AOR=7.7 ,CI 5.1,11.7; p= Conclusion: These findings suggest that IPV and Rape shows a significant association with decreased condom use, decreased condom negotiation, sexual position, drug use and HIV risk among YBMSM in Jackson, MS.

Orientação: Prof.ª Doutora Maria Cristina Vieira de Freitas.<br>O medo da Morte provavelmente é justificado pela abordagem ainda incipiente desta temática na Literatura Infanto-Juvenil e pela falta de preparação dos professores / mediadores de leitura em relação a esta vertente. Este nosso estudo tem como objetivo geral explorar a morte na Literatura Infanto-Juvenil, em vinte obras com valor literário, de autores portugueses e estrangeiros, de clássicos a contemporâneos, e sugerir o seu aproveitamento em atividades de promoção da leitura pela biblioteca escolar. São objetivos específicos: a) explorar as origens da literatura infanto-juvenil, bem como o papel dos professores bibliotecários e das bibliotecas escolares na sua promoção e divulgação; b) selecionar e analisar um conjunto de obras da literatura infantil e juvenil, presentes em catálogos e listas de referência nacionais, que abordam a temática da morte, organizando-as em fichas de leitura; c) analisar e interpretar os conteúdos relevantes nas obras selecionadas, de modo a fundamentar a sua relação com a temática da morte; d) sugerir formas concretas de aproveitamento das obras analisadas nas bibliotecas escolares pelos professores bibliotecários. Do ponto de vista metodológico trata-se de um estudo de índole qualitativa, em que se recorre às seguintes estratégias: a) pesquisa bibliográfica e pesquisa documental; b) análise dos conteúdos das obras, realizada nas seguintes etapas: seleção e leitura de obras literárias; organização de fichas de leitura; análise e interpretação de dados. Pretendemos que os resultados culminem em sugestões a desenvolver na Hora do Conto pelas bibliotecas escolares e pelos professores bibliotecários nas escolas, tendo em vista a promoção da leitura desta temática emergente e a compreensão da mesma na vida quotidiana. Como asserção principal, infere-se que o que verdadeiramente interessa é que as crianças e os jovens consigam interagir e aceitar que a vida continua após enfrentarem uma perda, ultrapassando “as fases do luto”, e atingindo através “desta viagem” a necessária aprendizagem e maturidade, desenvolvendo uma compreensão saudável acerca da realidade: a morte faz parte da “Roleta da Vida”. A produção de novo conhecimento está sempre presente na base do nosso estudo: minimizar os reflexos negativos da literatura sobre a morte, pois os textos literários contribuem para o verdadeiro desenvolvimento da identidade dos mais novos.<br>Fear of Death is probably explained by the incipient approach of this topic in Literature for Children and Youngsters and the lack of preparation of teachers / reading mediators in relation to this subject. As overall purpose, this study aims to explore death in Literature for Children and Young People in twenty books with literary value by Portuguese and foreign authors, from classics to contemporary ones, and suggest their use in activities of reading promotion by school library. Specific objectives are: a) to explore the origins of youngsters’ literature, as well as school libraries and teacher librarians’ role in its promotion and dissemination; b) select and analyze a set of works of youngsters’ literature in catalogs and in national reference lists that work up the topic of death, gathering them into book reports; c) analyze and understand the relevant contents in the selected works, in order to find its relation with the subject of death; d) suggest current ways of using the analyzed books by teacher librarians at school libraries. From the methodological point of view it is a study of qualitative nature, in which it uses the following strategies: a) bibliographical and documentary research; b) content analysis of the books carried out in the following steps: selection and reading of literary texts; organization of book reports; analysis and interpretation of data. We want the outcomes leading up to a set of suggestions to develop at Story Hour by teacher librarians at schools libraries, regarding the reading promotion and understanding of this emergent topic in everyday life. As a main assertion, it appears that what really matters is that children and young people can interact and accept that life goes on after coping with a loss, dealing with a “grief cycle”, and reaching through “this trip” the necessary learning and maturity, developing a healthy comprehension about reality: death is part of the “Gamble of Life”. The production of new knowledge is always present on the basis of our study: to minimize the negative effects of death in literature, since the literary texts contribute to the real development of the youngsters’ identity.

Tese de doutoramento em Ciências do Desporto, no ramo de Atividade Física e Saúde, apresentada à Faculdade de Ciências do Desporto e Educação Física da Universidade de Coimbra<br>Esta tese está organizada em sete capítulos. No capítulo I, procurou-se introduzir conceitos básicos e estabelecer o objetivo geral considerando matérias em torno do estudo das dimensões cardíacas e da sua relação com o crescimento, maturação biológica e treino em jovens atletas. Adicionalmente disponibiliza-se uma perspetiva geral sobre as adaptações cardiovasculares crónicas ao treino, bem como sobre a avaliação e os limites fisiológicos do ventrículo esquerdo (VE). O capítulo II contém uma descrição detalhada das amostras estudadas, bem como dos materiais e métodos utilizados. Os capítulos III e IV contêm respetivamente os estudos 1 e 2 e procuram analisar a morfologia do VE entre atletas adolescentes de elite e não atletas, realçando a associação entre a massa ventricular esquerda (MVE) e a estatura, bem como identificar a influência da modalidade desportiva sobre a remodelagem cardíaca. O capítulo V contém o estudo 3 onde se procura dentro da mesma modalidade desportiva (basquetebol), (i) avaliar a interdependência entre descritores de tamanho e composição corporal com os efeitos da idade cronológica (IC) e do estado maturacional recorrendo à modelação alométrica proporcional e (ii) comparar os principais parâmetros relativos à morfologia do VE entre jogadores de nível local e de nível internacional. No capítulo VI, o estudo 4 além de avaliar a inter-relação multivariada entre os descritores de tamanho corporal e os parâmetros do VE, examina a relação entre os últimos e os componentes do somatótipo. O último capítulo contém uma discussão e conclusão geral, onde os resultados dos diferentes estudos estão sumariados e contextualizados. A partir da análise dos principais resultados, os estudos efetuados mostram que: (i) o diâmetro das cavidades esquerdas e da raiz da aorta, a espessura das paredes do VE, a massa e o índice de massa ventricular esquerda (IMVE) dos jovens atletas são superiores às dos jovens não atletas; (ii) a variação das dimensões cardíacas não pode ser apenas atribuível à metodologia de treino utilizada; (iii) a relação entre a massa ventricular esquerda e o tamanho corporal é não linear; (iv) a estatura não foi um bom preditor único para a MVE e as análises alométricas proporcionais indicaram que, após o ajuste para o efeito da estatura, é necessário considerar a estatura matura predita como covariável simultânea; (v) A maturação somática, o endomorfismo e o mesomorfismo estão diretamente associados ao diâmetro e à espessura das paredes do ventrículo esquerdo, mas a associação com o ectomorfismo é inversa; (vi) a morfologia do ventrículo esquerdo acompanha o incremento da morfologia externa, tanto ao nível da robustez músculo-esquelética, como a nível da sobrecarga ponderal atribuível à adiposidade relativa; (vii) valores estaturo-ponderais elevados, independentemente do tamanho absoluto da estatura, tendem a associar-se inversamente com as dimensões do ventrículo esquerdo.<br>The present thesis, organized into four cross-sectional studies, aims to identify a set of variables likely to explain the effect of continued training on cardiac remodelling in young male athletes. At the same time, offers a general perspective on chronic cardiovascular adaptations to training, as well as about the physiological limits of the left ventricle (LV). The first two studies embrace an alignment of complementarity. The sample of study 1 comprised thirty highly trained male athletes (15 roller hockey players and 15 basketball players; 15.37±0.61 years) who represented Portugal in the respective European Championships and by twenty eight age matched healthy nonathletes (15.22±1.27 years). Study 2 was composed of athletes from several sports (n=164; 15.28±0.76 years) that had been engaged in formal training and competition for at least 5 years. The aforementioned studies aimed to examine the contribution of body size and sport participation to changes of LV morphology, as well as to identify the influence of the practice of different sports on cardiac remodelling. The sample of study 3 included forty five local (15.10±0.57 years) and sixty four international basketball players (15.35±0.51 years). Objectives were twofold: firstly, to independent and combined effects of age, biological maturity status, body size and body composition to explain the inter-individual variability in LV mass (LVM) using proportional allometric modelling and, secondly to evaluate the contributions of these variables to the discrimination of players by competitive level (international versus local). Finally, study 4, comprised 79 male competitive judo athletes aged 15.6±0.8 years that participated in the national tem preparation internships of the Portuguese Judo Federation. The purpose of this study was to determine the interrelationship between multivariate descriptors of body size and parameters of LVM, and to examine the relationships between echocardiographic dimensions and the Heath-Carter anthropometric somatotype. Overall, studies’ results highlighted that: (i) young elite athletes showed significant higher telediastolic and telesistolic diameters of the LV, thickness of interventricular septum in diastole, thickness of the posterior wall of the LV, diameter of left atrium, aortic root diameter, LVM and LVM index than the non-athletes, even after adjusting for stature; (ii) the variation of cardiac dimensions cannot be solely attributable to the nature of training; (iii) nonlinear relationships were apparent between body size descriptors and LVM; (iv) stature alone did not adequately normalize LVM and the proportional allometric modelling indicated that after adjusting for the effects of stature, it was also necessary to consider predicted mature stature as a simultaneous covariate; (v) somatic maturity, endomorphy and mesomorphy are positively associated with the telediastolic and telesistolic diameters of the LV, thickness of interventricular septum in diastole and thickness of the posterior wall of the LV, but the association with Ectomorphy is inverse; (vi) LV morphology follows the increase of body morphology, both at the musculoskeletal level and at the overload attributable to relative fatness; (vii) High ponderal values, regardless of the absolute stature, tend to be inversely associated with LV dimensions.<br>Fundação para a Ciência e Tecnologia