Outcomes after stroke: Basic and instrumental activities of daily living, community reintegration and generic health status

This study describes the discharge destination, basic and instrumental activities of daily living (ADL), community reintegration and generic health status of people after stroke, and explored whether sociodemographic and clinical characteristics were associated with these outcomes. Participants were 51 people, with an initial stroke, admitted to an acute hospital and discharged to the community. Admission and discharge data were obtained by chart review. Follow-up status was determined by telephone interview using the Modified Barthel Index, the Assessment of Living Skills and Resources, the Reintegration to Normal Living Index, and the Short-Form Health Survey (SF-36). At follow up, 57% of participants were independent in basic ADL, 84% had a low risk of experiencing instrumental ADL difficulties, most had few concerns with community reintegration, and SF-36 physical functioning and vitality scores were lower than normative values. At follow up, poorer discharge basic ADL status was associated with poorer instrumental ADL and community reintegration status, and older participants had poorer instrumental ADL, community reintegration and physical functioning. Occupational therapists need to consider these outcomes when planning inpatient and post-discharge intervention for people after stroke.

A case study of the resolution of paediatric dysphagia following brainstern injury: clinical and instrumental assessment

The coexistance of a swallowing impairment can severely impact upon the medical condition and recovery of a child with traumatic brain injury [ref.(1): Journal of Head Trauma Rehabilitation 9 (1) (1994) 43]. Limited data exist on the progression or outcome of dysphagia in the paediatric population with brainstem injury. The present prospective study documents the resolution of dysphagia in a 14-year-old female post-brainstem injury using clinical, radiological and endoscopic evaluations of swallowing. The subject presented with a pattern of severe oral-motor and oropharyngeal swallowing impairment post-injury that resolved rapidly for the initial 12 weeks, slowed to gradual progress for weeks 12-20, and then plateaued at 20 weeks post-injury. Whilst a clinically functional swallow was present at 10 months post-injury, radiological examination revealed a number of residual physiological impairments, reduced swallowing efficiency, and reduced independence for feeding, indicating a potential increased risk for aspiration. The data highlight the need for early and continued evaluation and intensive treatment programs, to focus on the underlying physiological swallowing impairment post-brainstem injury, and to help offset any potential deleterious effects of aspiration that may affect patient recovery, such as pneumonia. (C) 2003 Elsevier Ltd. All rights reserved.

Perceptual and instrumental evaluation of voice and tongue function after carotid endarterectomy

Objective: Laryngeal and tongue function was assessed in 28 patients to evaluate the presence, nature, and resolution of superior recurrent laryngeal and hypoglossal nerve damage resulting from standard open primary carotid endarterectomy (CEA). Methods. The laryngeal and tongue function in 28 patients who underwent CEA were examined prospectively with various physiologic (Aerophone II, laryngograph, tongue transducer), acoustic (Multi-Dimensional Voice Program), and perceptual speech assessments. Measures were obtained from all participants preoperatively, and at 2 weeks and at 3 months postoperatively. Results. The perceptual speech assessment indicated that the vocal quality of roughness was significantly more apparent at the 2-week postoperative assessment than preoperatively. However, by the 3-month postoperative assessment these values had returned to near preoperative levels, with no significant difference detected between preoperative and 3-month postoperative levels or between 2-week and 3-month postoperative levels. Both the instrumental assessments of laryngeal function and the acoustic assessment of vocal quality failed to identify any significant difference on any measure across the three assessment periods. Similarly, no significant impairment in tongue strength, endurance, or rate of repetitive tongue movements was detected at instrumental assessment of tongue function. Conclusions: No permanent changes to vocal or tongue function occurred in this group of participants after primary CEA. The lack of any significant long-term laryngeal or tongue dysfunction in this group suggests that the standard open CEA procedure is not associated with high rates of superior recurrent and hypoglossal nerve dysfunction, as previously believed.

Articulatory function following traumatic brain injury in childhood: A perceptual and instrumental analysis

Primary objective: To investigate the articulatory function of a group of children with traumatic brain injury (TBI), using both perceptual and instrumental techniques. Research design: The performance of 24 children with TBI was assessed on a battery of perceptual (Frenchay Dysarthria Assessment, Assessment of Intelligibility of Dysarthric Speech and speech sample analysis) and instrumental ( lip and tongue pressure transduction systems) assessments and compared with that of 24 non-neurologically impaired children matched for age and sex. Main outcomes: Perceptual assessment identified consonant and vowel imprecision, increased length of phonemes and overall reduction in speech intelligibility, while instrumental assessment revealed significant impairment in lip and tongue function in the TBI group, with rate and pressure in repetitive lip and tongue tasks particularly impaired. Significant negative correlations were identified between the degree of deviance of perceptual articulatory features and decreased function on many non-speech measures of lip function, as well as maximum tongue pressure and fine force tongue control at 20% of maximum tongue pressure. Additionally, sub-clinical articulatory deficits were identified in the children with TBI who were non-dysarthric. Conclusion: The results of the instrumental assessment of lip and tongue function support the finding of substantial articulatory dysfunction in this group of children following TBI. Hence, remediation of articulatory function should be a therapeutic priority in these children.

DA RAZÃO MONOLÍTICA À RAZÃO TRANSVERSAL. ITINERÁRIO DA FORMAÇÃO TEOLÓGICA ECUMÊNICA EM ABYA-YALA 1980-2000

Esta pesquisa trata do itinerário de uma estratégia de formação teológica ecumênica surgida no arcabouço de uma organização de cunho protestante. Desde as suas origens intuiu-se que esta estratégia poderia ser desenvolvida mediante o apóio a teologias contextuais incipientes na época. Esse processo compreende um período de vinte anos, entre 1980 e 2000, durante o qual é possível identificar duas grandes etapas. A primeira, sob o nome de Fundo Especial para a Educação Teológica Ecumênica na América Latina (FEPETEAL), aconteceu entre 1980 e 1988. Da sua criação participou um movimento plural, limitado ao âmbito protestante. Embora tivesse a melhor boa vontade no que se refere ao objetivo, o FEPETEAL ficou o tempo todo enredado no repasse de verbas para evitar o colapso dos seminários ecumênicos. Além disso, esta etapa ficou marcada por certo elitismo ecumênico , aliás, de feição masculinizante. A segunda etapa, herdeira orgânica da primeira, chamou-se Comunidade de Educação Teológica Ecumênica Latino-Americana e Caribenha (CETELA), de 1988-2000. Desta vez, o impacto de um movimento amplo e plural presente em várias instituições teológicas mais novas e em algumas das antigas transformou a organização a ponto de criar uma Nova CETELA a partir de 1993. No seu bojo aparecem como protagonistas diversos pensamentos teológicos comprometidos com as reivindicações de setores longamente marginalizados de Abya-Yala, por razões étnicas, culturais, sociais, religiosas e de gênero. Este movimento fazia parte de processos que a partir de horizontes pluriculturais resistiam ao pensamento único da lógica neoliberal. Da interface produzida entre estes setores emergentes, os velhos representantes da TL e a necessidade das instituições teológicas de terem uma oferta educativa encarnada na diversidade da região surgiu uma proposta ecumênica nova. Trata-se de assumir a transversalidade como instrumento hermenêutico que possibilite a transformação intersubjetiva entre saberes diferentes, como resultado de uma tarefa teológico/pedagógica. PALAVRAS/CONCEITOS-CHAVE: Instituições teológicas; sujeitos/artífices teológicos; razão monolítica; razão transversal/transversalidade; Abya-Yala; formação teológica ecumênica.

O PAPEL DA EDUCAÇÃO FÍSICA NA ESCOLA PÚBLICA DE TEMPO INTEGRAL, DA SECRETARIA DE EDUCAÇÃO DO ESTADO DE SÃO PAULO Um estudo preliminar

Em nosso trabalho, preocupamo-nos em tratar um dos componentes que consideramos essenciais para ajudar no desenvolvimento do projeto da escola de tempo integral, a saber, a importância do papel que a prática de atividades físicas desempenha no contexto. Para tanto, buscamos conhecer as peculiaridades do projeto Escola de Tempo Integral da Secretaria da Educação do Estado de São Paulo e os benefícios educacionais que ele proporciona, traçando posteriormente as benesses que a Educação Física pode oferecer e argumentando a este respeito. No contexto do ensino regular tradicional brasileiro, a Educação Física desfruta de pouca credibilidade, sendo popularmente considerada uma matéria secundária, assim como o profissional por ela responsável. Acreditamos, com mais razão do que para a escola regular, que a viabilidade da Escola de Tempo Integral dependa sobremaneira da maior participação e apoio da Educação Física, haja vista que o aluno passará mais tempo dentro dos estabelecimentos de ensino e seria esperado que o aumento da carga horária levasse a uma queda na produtividade das horas posteriores de estudo. Partindo desse ponto de vista, a educação física pode trazer benefícios no tocante à ética, cultura, saúde e sociabilidade, tidos como secundários em relação aos estudos de caráter mais instrumental, por exemplo, matemática, português e ciências.(AU)

Dynamic learning as entrepreneurial action in the context of open innovation:an instrumental case from a communities-of-practice perspective

Recent scholarly discussion on open innovation put forward the notion that an organisation's ability to internalise external knowledge and learn from various sources in undertaking new product development is crucial to its competitive performance. Nevertheless, little attention has been paid to how growth-oriented small firms identify and exploit entrepreneurial opportunities (i.e. take entrepreneurial action) related to such development, in an open innovation context, from a social learning perspective. This chapter, based on an instrumental case-firm, demonstrates analytically how learning as entrepreneurial action takes place, drawing on situated learning theory. It is argued that such learning is dynamic in nature and is founded on specific organising principles that foster both inter- and intracommunal learning. © 2012, IGI Global.

The influence of socio-cultural environments on the performance of nascent entrepreneurs:an instrumental variable approach

The importance of informal institutions and in particular culture for entrepreneurship is a subject of ongoing interest. Past research has mostly concentrated on cross-national comparisons, cultural values, and the direct effects of culture on entrepreneurial behavior, but in the main found inconsistent results. The present research adds a fresh perspective to this research stream by turning attention to community-level culture and cultural norms. We hypothesize indirect effects of cultural norms on venture emergence. Specifically that community-level cultural norms (performance-based culture and socially-supportive institutional norms) impact important supply-side variables (entrepreneurial self-efficacy and entrepreneurial motivation) which in turn influence nascent entrepreneurs’ success in creating operational ventures (venture emergence). We test our predictions on a unique longitudinal data set (PSED II) tracking nascent entrepreneurs venture creation efforts over a 5 year time span and find evidence supporting them. Our research contributes to a more fine-grained understanding of how culture, in particular perceptions of community cultural norms, influences venture emergence. This research highlights the embeddedness of entrepreneurial behavior and its immediate antecedent beliefs in the local, community context.

Development of Procedures of Recognition of Objects with Usage Multisensor Ontology Controlled Instrumental Complex

The ontological approach to structuring knowledge and the description of data domain of knowledge is considered. It is described tool ontology-controlled complex for research and developments of sensor systems. Some approaches to solution most frequently meeting tasks are considered for creation of the recognition procedures.

Variables affecting the collection and preservation of human scent components through instrumental and biological evaluations

In certain European countries and the United States of America, canines have been successfully used in human scent identification. There is however, limited scientific knowledge on the composition of human scent and the detection mechanism that produces an alert from canines. This lack of information has resulted in successful legal challenges to human scent evidence in the courts of law. ^ The main objective of this research was to utilize science to validate the current practices of using human scent evidence in criminal cases. The goals of this study were to utilize Headspace Solid Phase Micro Extraction Gas Chromatography Mass Spectrometry (HS-SPME-GC/MS) to determine the optimum collection and storage conditions for human scent samples, to investigate whether the amount of DNA deposited upon contact with an object affects the alerts produced by human scent identification canines, and to create a prototype pseudo human scent which could be used for training purposes. ^ Hand odor samples which were collected on different sorbent materials and exposed to various environmental conditions showed that human scent samples should be stored without prolonged exposure to UVA/UVB light to allow minimal changes to the overall scent profile. Various methods of collecting human scent from objects were also investigated and it was determined that passive collection methods yields ten times more VOCs by mass than active collection methods. ^ Through the use of polymerase chain reaction (PCR) no correlation was found between the amount of DNA that was deposited upon contact with an object and the alerts that were produced by human scent identification canines. Preliminary studies conducted to create a prototype pseudo human scent showed that it is possible to produce fractions of a human scent sample which can be presented to the canines to determine whether specific fractions or the entire sample is needed to produce alerts by the human scent identification canines. ^

Prevalência e fatores associados à síndrome da fragilidade em idosos: inquérito populacional em Campina Grande-PB

The frailty syndrome is a geriatric medical condition of vulnerability resulting in the decline of physiological reserves, characterized by high-risk consequences as falls, disability, hospitalization, institutionalization and death. Although the presence of comorbidities is not always accompanied by fragility, this presence could also indicate an increased risk of adverse health events, taking the elderly to a greater likelihood of becoming brittle due to the physical limitations that may occur with emergence of diseases, which are strongly predictive of Fragility Syndrome. This study aimed to assess the prevalence of frailty syndrome in the elderly and associated factors. The specific objectives were to identify the prevalence of frailty syndrome in the elderly and their associations with demographic, economic, health, functional and psychological; identify the reasons for the prevalence of frailty syndrome with the demographic profile, health problems, use of legal drugs and problems with sleep of older people. The study was cross-sectional and composed of 385 elderly aged 65 or more. Multivariate Poisson regression models were used to check conditions associated with fragility and determine the prevalence ratio (α = 0.05). The prevalence of fragility was 8.7% and pre-fragility of 50.4%. Fragile and pre-frail elderly presented, bigger and increasing prevalence ratio for marital status, difficulty in performing instrumental activities of daily living, old age, involuntary loss of stool, depression and negative affect. Elderly people who do not work have a higher prevalence of fragility, as well as those who reported having had a stroke / stroke / ischemia, those who suffered falls in the last 12 months and those with sleep problems. It is considered that the results, together with other available in the literature, can contribute to the understanding of the fragility epidemiology and also in the implementation of specific programs aimed at reducing the prevalence of frailty, optimizing the quality of life. It is suggested that future programs have special attention to the profiles of elderly people who have not yet developed fragility, i.e., pre-fragile. This could prevent the elderly from becoming frail.

A razão embotada: ensaios de crítica literária

A obra "A razão embotada: ensaios de crítica literária", de autoria do prof. Andrey Pereira de Oliveira, do Departamento de Letras da UFRN, é composta por 14 ensaios que discorrem acerca de obras das literaturas brasileira e universal. Os textos tiveram uma primeira publicação em livros coletivos, revistas acadêmicas ou anais de congressos científicos e passaram por adaptações para reunião neste volume.

Sequências de Fibonacci e a Razão Áurea - aplicações no ensino básico

This thesis aims to present a study of the Fibonacci sequence, initiated from a simple problem of rabbits breeding and the Golden Ratio, which originated from a geometrical construction, for applications in basic education. The main idea of the thesis is to present historical records of the occurrence of these concepts in nature and science and their influence on social, cultural and scientific environments. Also, it will be presented the identification and the characterization of the basic properties of these concepts and howthe connection between them occurs,and mainly, their intriguing consequences. It is also shown some activities emphasizing geometric constructions, links to other mathematics areas, curiosities related to these concepts and the analysis of questions present in vestibular (SAT-Scholastic Aptitude Test) and Enem(national high school Exam) in order to show the importance of these themes in basic education, constituting an excellent opportunity to awaken the students to new points of view in the field of science and life, from the presented subject and to promote new ways of thinking mathematics as a transformative science of society.

Pointing as an Instrumental Gesture: Gaze Representation Through Indication

Peer reviewed