Autonomie

In deze scriptie maak je kennis met ideeën over autonomie. Het begint met een historische vogelvlucht van belangrijke filosofen die elementen van zelfsturing beschrijven. Daarna wordt er gedetailleerd ingegaan op drie actuele auteurs over autonomie: Harry Frankfurt, Diana Meyers en Peter Bieri. Harry Frankfurt legt nadruk op het vermogen afstand tot jezelf in te nemen en je te te verbinden aan sommige verlangens en andere te verwerpen. Diana Meyers ziet autonomie vooral als een set vaardigheden die er voor moeten zorgen dat je een authentiek zelf creëert. Peter Bieri roept ons op onze wil te onderzoeken en te begrijpen in het licht van onze innerlijke structuur en oordelen over onszelf. Door deze visies te integreren schets ik een beeld van autonomie dat gebruikt kan worden om zelfsturing bij mensen te bevorderen, zonder dat dit leidt tot egoïstische, op eigen belang gerichte individuen. Mensen kunnen autonomer worden door bepaalde kennis, zelfkennis, vaardigheden, houdingen en methoden te verkrijgen en te oefenen. Als slot leest u een beschrijving van een toepassing van deze visie op autonomie in een persoonlijke situatie

Big deep voice : indexation de données massives de parole grâce à des réseaux de neurones profonds

National audienceLes systèmes de synthèse de parole sont des outils permettant de générer un signal de parole correspondant à un texte. Les solutions actuelles fournissent un signal de qualité, mais la parole générée est peu expressive, notamment en raison de leur jeu de données limité. Pour résoudre ce probleme, il est donc nécessaire d'augmenter la quantité de données pour y intégrer de la variabilité. Cela soulève néanmoins plusieurs problématiques : comment décrire et comparer les données ? et comment rechercher des données lorsque leurs descripteurs sont de grande taille et que le nombre de données est conséquent ? Le but de ce stage est de mettre en place une mesure de similarité entre phonèmes, puis éventuellement un algorithme de recherche de plus proches voisins, qui pourront être intégrés au système de synthèse de parole de l'équipe Expression. Pour répondre à la problématique de description et comparaison des données, nous utiliserons la propriété de plongement des réseaux de neurones. Pour répondre à la problématique de recherche de données, nous proposons d'utiliser une méthode de recherche de plus proches voisins en grande dimension. Le but de ce stage est d'étudier la faisabilité de la solution choisie, notamment en proposant des méthodes d'évaluation de la qualité d'un plongement

Chronic pain in children and adolescents: observational studies

In adults, chronic pain is by most people involved considered to be a serious disorder. Although chronic pain in adults is in general not life-threatening, a considerable amount of literature elucidates the large number of sufferers, the high cost to the person in question and to the society as a whole, and the often crushing effects it has on personal and family life.' Both in children and adolescents however, there is only little objective information available about the prevalence and prognosis of different types of pain, and the related consequences. Pain in children and adolescents probably does not create the same economic burden of illness as does pain in adults.' However, a better understanding of pain in children and adolescents is warranted to gain more insight in the etiology of pain, to relieve the associated burden for children and their families, and for the adequate allocation of health care resources. Does a subset of the children and adolescents with chronic pain become adults with debilitating chronic pains that are often resistant to effective treatment? If so, it might be possible to reduce the proportion of adults with chronic pain if these syndromes were identified and managed in childhood. The International Association for the study of Pain (!ASP) agreed on a common definition of pain: Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage. Note: Pain is always subjective. Each individual learns the application of the word through experiences related to injury in early life-' The !ASP definition highlights the fact that learning about pain and how to respond to painful situations occurs during childhood. Like for adults, pain is an unpleasant sensory and emotional experience for children. Their pain perceptions are subjective. Like their other perceptions, it is impossible to know exactly what a child's pain experience is like, even though there are methods available to measure different aspects of pain. Children describe their pains according to the unpleasantness or aversive dimension, the sensory attributes, the intensity, quality (such as aching, sharp), location, and duration. They understand the concept of pain and the multidimensional nature of pain; even very young children describe the emotional and suffering aspects of pain as well as the physical aspects.4 Obviously, their concepts of pain differ according to their age, sex, cognitive level, and pain experience. From this perspective, studies on pain in children have to include not only measures on the sensory aspects of pain, but also measures of disability and handicap

Difficulties in recruitment for a randomized controlled trial involving hysterosalpingography

BACKGROUND: The usefulness of hysterosalpingography (HSG) as routine investigation in the fertility work-up prior to laparoscopy and dye had been assessed in a randomized controlled trial. Recruiting subjects to the study was more difficult than anticipated. The objective of this study was to explore possible reasons for non-participation in the trial. METHODS: All newly referred subfertile women admitted to the Reproductive Medicine Clinic of Leiden University Medical Centre between 1 April 1997 and 31 December 1999, were eligible for the study. The reasons for non-participation were evaluated by scrutinizing the medical records. RESULTS: Out of 759 women, a total of 127 (17%) agreed to participate in the trial. The most important reason for non-participation was because of exclusion criteria (73%). Other reasons were inattentive clinicians (3%) and patient-associated reasons (24%). Patient refusal and indecisiveness to enroll in the study were the most common patient-associated reasons. The most frequently stated reason for trial refusal was reluctance to undergo laparoscopy and dye mainly due to issues related to anesthesia and scheduling of procedure. CONCLUSION: Almost three-quarters of recruitment difficulties in this study were due to unavoidable reasons. To overcome the remaining avoidable reasons for non-participation, attention should be paid to appropriate instruction of the study protocol to the participating doctors and to provide adequate information, in layman's terms, to the patients. Reminding patients by notes or telephone calls for attending the clinic are helpful. It may be contingent upon tracing the reasons of clinicians and patients for non-participation to improve enrollment during a trial