Les caractères musicaux au sein d'une démarche artistique dramatique : exploration des indices acoustiques jouant un rôle dans l'évocation des états affectifs en musique

Cette thèse de doctorat en composition comprend deux projets de nature différente et complémentaire : (1) un projet de recherche théorique sur la communication des caractères musicaux; (2) un projet artistique s'articulant autour de la composition de trois pièces : L'homme à deux têtes - opéra de chambre, Un instant dans l'esprit de Lovecraft - pour clarinette solo, orchestre à cordes et percussions, et Balade ornithologique - pour orchestre à vents. La conception de la musique comme un moyen de communication est à l'origine de cette recherche théorique qui est motivée par un désir de compréhension des stratégies d'expressions des émotions en musique, à partir du point de vue du compositeur. Cette thèse aborde les modèles de communication, le concept de personnage virtuel et la théorie de la contagion des humeurs. Par la suite, nous détaillerons les indices acoustiques menant à la perception des caractères musicaux. Toutes ces notions sont illustrées et explorées par la composition de miniature ayant un caractère bien ciblé. Finalement, nous proposons un système d'analyse musical des caractères et des émotions qui est appliqué à l'analyse de sections des pièces composées au cours de ce projet de doctorat. Ce dernier chapitre met en lumière les stratégies utilisées pour créer un discours dramatique tout en exposant l'évocation de différents caractères musicaux.

Are stress and mixed urinary incontinence associated with impaired executive control in community-dwelling older women?

Objectives: To assess whether stress or mixed urinary incontinence (UI) is associated with deficits in executive functioning among community-dwelling women. Design: An observational study comparing the performance, using multivariate analyses of variance (MANOVAs) and Bonferroni post hoc test, of continent women and women with stress or mixed UI during executive control tasks. Setting: The research center of the Institut universitaire de gériatrie de Montréal. Participants: One hundred and fifty-five community-dwelling women aged 60 and older participated in the study. Measurements: Based on the Urogenital Distress Inventory (UDI), participants were split into three groups: 35 continent women, 43 women with stress UI, and 78 women with mixed UI. Participants completed a battery of neuropsychological tests and a computerized dual-task test. Results: Women with mixed UI showed poorer performances than continent and stress UI women in executive control functions. Deficits were specific to tests involving switching and sharing/dividing attention between two tasks. Conclusion: Results of this study suggest that mixed UI can be associated with executive control deficits in community-dwelling older women. Future intervention studies in the treatment of UI should take the higher risk of an executive control deficit in women with UI under consideration.

Virtual reality rehabilitation as a treatment approach for older women with mixed urinary incontinence : a feasibility study

Background Motivated patients are more likely to adhere to treatment resulting in better outcomes. Virtual reality rehabilitation (VRR) is a treatment approach that includes video gaming to enhance motivation and functional training. Aims The study objectives were (1) to evaluate the feasibility of using a combination of pelvic floor muscles (PFM) exercises and VRR (PFM/VRR) to treat mixed urinary incontinence (MUI) in older women, (2) to evaluate the effectiveness of the PFM/VRR program on MUI symptoms, quality of life (QoL), and (3) gather quantitative information regarding patient satisfaction with this new combined training program. Methods Women 65 years and older with at least 2 weekly episodes of MUI were recruited. Participants were evaluated two times before and one time after a 12-week PFM/VRR training program. Feasibility was defined as the participants' rate of participation in and completion of both the PFM/VRR training program and the home exercise. Effectiveness was evaluated through a bladder diary, pad test, symptom and QoL questionnaire, and participant's satisfaction through a questionnaire. Results Twenty-four women (70.5 ± 3.6 years) participated. The participants complied with the study demands in terms of attendance at the weekly treatment sessions (91%), adherence to home exercise (92%) and completion of the three evaluations (96%). Post-intervention, the frequency and quantity of urine leakage decreased and patientreported symptoms and QoL improved significantly. Most participants were very satisfied with treatment (91%). Conclusion A combined PFM/VRR program is an acceptable, efficient, and satisfying functional treatment for older women with MUI and should be explore through further RCTs.