Classe hospitalar: a articulação da saúde e educação como expressão da política de humanização do SUS

A saúde é determinada por condições sociais, econômicas, educacionais, políticas e ambientais, extrapolando, portanto, a dimensão exclusivamente biológica. O presente trabalho tenta estabelecer uma reflexão interpretativa sobre os princípios do SUS e mostrar a interface deles com a proposta da classe hospitalar, uma modalidade de educação especial que estimula a construção de conhecimentos, a capacitação e o ensino de algumas habilidades, contribuindo para o desenvolvimento infantil. Tratase de um exercício de argumentação para o entendimento do papel da classe hospitalar na realização da atenção integral à saúde no Brasil. O desenvolvimento de atividades pedagógico-educacionais em hospitais permite oferecer às crianças e adolescentes hospitalizados a continuidade do seu aprendizado.

Effects of dietary fatty acids on patterns of early mineralisation and bone formation in the axial skeleton of Sparus aurata (Linnaeus, 1758)

Máster Oficial en Cultivos Marinos. VI Máster Internacional en Acuicultura. Trabajo presentado como requisito parcial para la obtención del Título de Máster Oficial en Cultivos Marinos, otorgado por la Universidad de Las Palmas de Gran Canaria (ULPGC), el Instituto Canario de Ciencias Marinas (ICCM), y el Centro Internacional de Altos Estudios Agronómicos Mediterráneos de Zaragoza (CIHEAM)

Parity violating asymmetry in the electron deuteron quasielastic scattering, strange vector and axial vector form factors and beam normal spin asymmetries

In dieser Arbeit wurde die paritätsverletzende Asymmetrie in derrnquasielastischen Elektron-Deuteron-Streuung bei Q^2=0.23 (GeV/c)^2 mitrneinem longitudinal polarisierten Elektronstrahl bei einer Energie von 315rnMeV bestimmt. Die Messung erfolgte unter Rückwärtswinkeln. Der Detektor überdeckte einen polaren Streuwinkelbereichrnzwischen 140 und 150 deg. Das Target bestand aus flüssigemrnDeuterium in einer Targetzelle mit einer Länge von 23.4 cm. Dierngemessene paritätsverletzende Asymmetrie beträgt A_{PV}^d = (-20.11 pm 0.87_{stat} pm 1.03_{syst}), wobei der erste Fehler den statistischenrnFehlereitrag und der zweite den systematischen Fehlerbeitrag beschreibt. Ausrnder Kombination dieser Messung mit Messungen der paritätsverletzendenrnAsymmetrie in der elastischen Elektron-Proton-Streuung bei gleichem Q^2rnsowohl bei Vorwärts- als auch bei Rückwärtsmessungen können diernVektor-Strange-Formfaktoren sowie der effektive isovektorielle und isoskalarernVektorstrom des Protons, der die elektroschwachen radiativen Anapolkorrekturenrnenthält, bestimmt werden. Diese Arbeit umfasst ausserdem die Bestimmungrnder Asymmetrien bei einem transversal polarisierten Elektronstrahl sowohl beirneinem Proton- als auch einem Deuterontarget unter Rückwärtswinkeln beirnImpulsüberträgen von Q^2=0.10 (GeV/c)^2, Q^2=0.23 (GeV/c)^2rnund Q^2=0.35 (GeV/c)^2. Die im Experiment beobachteten Asymmetrien werdenrnmit theoretischen Berechnungen verglichen, welche den Imaginärteil der Zweiphoton-Austauschamplitude beinhalten.

Interaction between axial force, shear and bending moment in reinforced concrete elements

Il collasso di diverse colonne, caratterizzate da danneggiamenti simili, quali ampie fessure fortemente inclinate ad entrambe le estremità dell’elemento, lo schiacciamento del calcestruzzo e l’instabilità dei ferri longitudinali, ha portato ad interrogarsi riguardo gli effetti dell’interazione tra lo sforzo normale, il taglio ed il momento flettente. Lo studio è iniziato con una ricerca bibliografica che ha evidenziato una sostanziale carenza nella trattazione dell’argomento. Il problema è stato approcciato attraverso una ricerca di formule della scienza delle costruzioni, allo scopo di mettere in relazione lo sforzo assiale, il taglio ed il momento; la ricerca si è principalmente concentrata sulla teoria di Mohr. In un primo momento è stata considerata l’interazione tra solo due componenti di sollecitazione: sforzo assiale e taglio. L’analisi ha condotto alla costruzione di un dominio elastico di taglio e sforzo assiale che, confrontato con il dominio della Modified Compression Field Theory, trovata tramite ricerca bibliografica, ha permesso di concludere che i risultati sono assolutamente paragonabili. L’analisi si è poi orientata verso l’interazione tra sforzo assiale, taglio e momento flettente. Imponendo due criteri di rottura, il raggiungimento della resistenza a trazione ed a compressione del calcestruzzo, inserendo le componenti di sollecitazione tramite le formule di Navier e Jourawsky, sono state definite due formule che mettono in relazione le tre azioni e che, implementate nel software Matlab, hanno permesso la costruzione di un dominio tridimensionale. In questo caso non è stato possibile confrontare i risultati, non avendo la ricerca bibliografica mostrato niente di paragonabile. Lo studio si è poi concentrato sullo sviluppo di una procedura che tenta di analizzare il comportamento di una sezione sottoposta a sforzo normale, taglio e momento: è stato sviluppato un modello a fibre della sezione nel tentativo di condurre un calcolo non lineare, corrispondente ad una sequenza di analisi lineari. La procedura è stata applicata a casi reali di crollo, confermando l’avvenimento dei collassi.

Conical crowns with electroplated gold copings: retention force changes caused by wear and combined off-axial load

The aim of this study was to examine the wear behavior of conical crowns of gold alloy and zirconium dioxide ceramics facing electroplated gold copings.

Axial T2 mapping in intervertebral discs: a new technique for assessment of intervertebral disc degeneration

To demonstrate the potential benefits of biochemical axial T2 mapping of intervertebral discs (IVDs) regarding the detection and grading of early stages of degenerative disc disease using 1.5-Tesla magnetic resonance imaging (MRI) in a clinical setting.

Classification of intervertebral disk degeneration with axial T2 mapping

OBJECTIVE: The aim of this study was to establish an MRI classification system for intervertebral disks using axial T2 mapping, with a special focus on evaluating early degenerative intervertebral disks. MATERIALS AND METHODS: Twenty-nine healthy volunteers (19 men, 10 women; age range, 20-44 years; mean age, 31.8 years) were studied, and axial T2 mapping was performed for the L3-L4, L4-L5, and L5-S1 intervertebral disks. Grading was performed using three classification systems for degenerative disks: our system using axial T2 mapping and two other conventional classification systems that focused on the signal intensity of the nucleus pulposus or the structural morphology in sagittal T2-weighted MR images. We analyzed the relationship between T2, which is known to correlate with change in composition of intervertebral disks, and degenerative grade determined using the three classification systems. RESULTS: With axial T2 mapping, differences in T2 between grades I and II were smaller and those between grades II and III, and between grades III and IV, were larger than those with the other grading systems. The ratio of intervertebral disks classified as grade I was higher with the conventional classification systems than that with axial T2 mapping. In contrast, the ratio of intervertebral disks classified as grade II or III was higher with axial T2 mapping than that with the conventional classification systems. CONCLUSION: Axial T2 mapping provides a more T2-based classification. The new system may be able to detect early degenerative changes before the conventional classification systems can.

Traumatic extra-axial hemorrhage: correlation of postmortem MSCT, MRI, and forensic-pathological findings

PURPOSE: To evaluate the diagnostic accuracy of in situ postmortem multislice computed tomography (MSCT) and magnetic resonance imaging (MRI) in the detection of primary traumatic extra-axial hemorrhage. MATERIALS AND METHODS: Thirty forensic neurotrauma cases and 10 nontraumatic controls who underwent both in situ postmortem cranial MSCT and MR imaging before autopsy were retrospectively reviewed. Both imaging modalities were analyzed in view of their accuracy, sensitivity, and specificity concerning the detection of extra-axial hemorrhage. Statistical significance was calculated using the McNemar test. kappa values for interobserver agreement were calculated for extra-axial hemorrhage types and to quantify the agreement between both modalities as well as MRI, CT, and forensics, respectively. RESULTS: Analysis of the detection of hemorrhagic localizations showed an accuracy, sensitivity, and specificity of 89%, 82%, and 92% using CT, and 90%, 83%, and 94% using MRI, respectively. MRI was more sensitive than CT in the detection of subarachnoid hemorrhagic localizations (P = 0.001), whereas no significant difference resulted from the detection of epidural and subdural hemorrhagic findings (P = 0.248 and P = 0.104, respectively). Interobserver agreement for all extra-axial hemorrhage types was substantial (CT kappa = 0.76; MRI kappa = 0.77). The agreement of both modalitites was almost perfect (readers 1 and 2 kappa = 0.88). CONCLUSION: CT and MRI are of comparable potential as forensic diagnostic tools for traumatic extra-axial hemorrhage. Not only of forensic, but also of clinical interest is the observation that most thin blood layers escape the radiological evaluation.

A patient-specific finite element methodology to predict damage accumulation in vertebral bodies under axial compression, sagittal flexion and combined loads

Due to the inherent limitations of DXA, assessment of the biomechanical properties of vertebral bodies relies increasingly on CT-based finite element (FE) models, but these often use simplistic material behaviour and/or single loading cases. In this study, we applied a novel constitutive law for bone elasticity, plasticity and damage to FE models created from coarsened pQCT images of human vertebrae, and compared vertebral stiffness, strength and damage accumulation for axial compression, anterior flexion and a combination of these two cases. FE axial stiffness and strength correlated with experiments and were linearly related to flexion properties. In all loading modes, damage localised preferentially in the trabecular compartment. Damage for the combined loading was higher than cumulated damage produced by individual compression and flexion. In conclusion, this FE method predicts stiffness and strength of vertebral bodies from CT images with clinical resolution and provides insight into damage accumulation in various loading modes.