931 resultados para Unilateral Neglect


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This report presents the results of a study exploring the law and practice of mandatory reporting of child abuse and neglect in the Northern Territory. Government administrative data over a decade (2003-2012) were accessed and analysed to map trends in reporting of different types of child abuse and neglect (physical abuse, sexual abuse, emotional abuse, and neglect) by different reporter groups (e.g., police, teachers, doctors, nurses, vs family members, neighbours), and the outcomes of these reports (whether investigated, and whether substantiated or not). The study was funded by the Australian Government and administered through the Government of Victoria.

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This report presents the results of a study exploring the law and practice of mandatory reporting of child abuse and neglect in Queensland. Government administrative data over a decade (2003-2012) were accessed and analysed to map trends in reporting of different types of child abuse and neglect (physical abuse, sexual abuse, emotional abuse, and neglect) by different reporter groups (both mandated reporters e.g., teachers, doctors, nurses, and non-mandated reporters e.g., family members, neighbours), and the outcomes of these reports (whether investigated, and whether substantiated or not). The study was funded by the Australian Government and administered through the Government of Victoria.

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This report presents the results of a study exploring the law and practice of mandatory reporting of child abuse and neglect in South Australia. Government administrative data over a decade (2003-2012) were accessed and analysed to map trends in reporting of different types of child abuse and neglect (physical abuse, sexual abuse, emotional abuse, and neglect) by different reporter groups (both mandated reporters e.g., police, teachers, doctors, nurses; and non-mandated reporters e.g., family members, neighbours), and the outcomes of these reports (whether investigated, and whether substantiated or not). The study was funded by the Australian Government and administered through the Government of Victoria.

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This report presents the results of a study exploring the law and practice of mandatory reporting of child abuse and neglect in Tasmania. Government administrative data over a nine year period (2004-2012) were accessed and analysed to map trends in reporting of different types of child abuse and neglect (physical abuse, sexual abuse, emotional abuse, and neglect) by different reporter groups (both mandated reporters e.g., police, teachers, doctors, nurses; and non-mandated reporters e.g., family members, neighbours), and the outcomes of these reports (whether investigated, and whether substantiated or not). The study was funded by the Australian Government and administered through the Government of Victoria.

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This report presents the results of a study exploring the law and practice of mandatory reporting of child abuse and neglect in Victoria. Government administrative data over a decade (2003-2012) were accessed and analysed to map trends in reporting of different types of child abuse and neglect (physical abuse, sexual abuse, emotional abuse, and neglect) by different reporter groups (both mandated reporters e.g., police, teachers, doctors, nurses; and non-mandated reporters e.g., family members, neighbours), and the outcomes of these reports (whether investigated, and whether substantiated or not). The study was funded by the Australian Government and administered through the Government of Victoria.

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This report presents the results of a study exploring the law and practice of mandatory reporting of child abuse and neglect in Western Australia. Government administrative data over a decade (2003-2012) were accessed and analysed to map trends in reporting of different types of child abuse and neglect (physical abuse, sexual abuse, emotional abuse, and neglect) by different reporter groups (e.g., police, teachers, doctors, nurses, family members, neighbours), and the outcomes of these reports (whether investigated, and whether substantiated or not). The study was funded by the Australian Government and administered through the Government of Victoria.

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Data on the influence of unilateral vocal fold paralysis on breathing, especially other than information obtained by spirometry, are relatively scarce. Even less is known about the effect of its treatment by vocal fold medialization. Consequently, there was a need to study the issue by combining multiple instruments capable of assessing airflow dynamics and voice. This need was emphasized by a recently developed medialization technique, autologous fascia injection; its effects on breathing have not previously been investigated. A cohort of ten patients with unilateral vocal fold paralysis was studied before and after autologous fascia injection by using flow-volume spirometry, body plethysmography and acoustic analysis of breathing and voice. Preoperative results were compared with those of ten healthy controls. A second cohort of 11 subjects with unilateral vocal fold paralysis was studied pre- and postoperatively by using flow-volume spirometry, impulse oscillometry, acoustic analysis of voice, voice handicap index and subjective assessment of dyspnoea. Preoperative peak inspiratory flow and specific airway conductance were significantly lower and airway resistance was significantly higher in the patients than in the healthy controls (78% vs. 107%, 73% vs. 116% and 182% vs. 125% of predicted; p = 0.004, p = 0.004 and p = 0.026, respectively). Patients had a higher root mean square of spectral power of tracheal sounds than controls, and three of them had wheezes as opposed to no wheezing in healthy subjects. Autologous fascia injection significantly improved acoustic parameters of the voice in both cohorts and voice handicap index in the latter cohort, indicating that this procedure successfully improved voice in unilateral vocal fold paralysis. Peak inspiratory flow decreased significantly as a consequence of this procedure (from 4.54 ± 1.68 l to 4.21 ± 1.26 l, p = 0.03, in pooled data of both cohorts), but no change occurred in the other variables of flow-volume spirometry, body-plethysmography and impulse oscillometry. Eight of the ten patients studied by acoustic analysis of breathing had wheezes after vocal fold medialization compared with only three patients before the procedure, and the numbers of wheezes per recorded inspirium and expirium increased significantly (from 0.02 to 0.42 and from 0.03 to 0.36; p = 0.028 and p = 0.043, respectively). In conclusion, unilateral vocal fold paralysis was observed to disturb forced breathing and also to cause some signs of disturbed tidal breathing. Findings of flow volume spirometry were consistent with variable extra-thoracic obstruction. Vocal fold medialization by autologous fascia injection improved the quality of the voice in patients with unilateral vocal fold paralysis, but also decreased peak inspiratory flow and induced wheezing during tidal breathing. However, these airflow changes did not appear to cause significant symptoms in patients.

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The purpose of this dissertation was to study the applicability of minced autologous fascia graft for injection laryngoplasty of unilateral vocal fold paralysis (UVFP). Permanence of augmentation and host versus graft tissue reactions were of special interest. The topic deals with phonosurgery, which is a subdivision of the Ear, Nose and Throat-speciality of medicine. UVFP results from an injury to the recurrent or the vagal nerve. The main symptom is a hoarse and weak voice. Surgery is warranted for patients in whom spontaneous reinnervation and a course of voice therapy fails to improve the voice. Injection laryngoplasty is a widespread surgical technique which aims to restore glottic closure by augmenting the atrophied vocal muscle, and also by turning the paralyzed vocal fold towards midline. Currently, there exists a great diversity of synthetic, xenologous, homologous, and autologous substances available for injection. An autologous graft is perfect in terms of biocompatibility. Free fascia grafts have been successfully used in the head and neck surgery for decades, but fascia had not been previously applied into the vocal fold. The fascia is harvested from the lateral thigh under local anesthesia and minced into paste by scissors. Injection of the vocal fold is performed in laryngomicroscopy under general anesthesia. Three series of clinical trials of injection laryngoplasty with autologous fascia (ILAF) for patients with UVFP were conducted at the Department of Otorhinolaryngology of the Helsinki University Central Hospital. The follow-up ranged from a few months to ten years. The aim was to document the vocal results and possible morbidity related to graft harvesting and vocal fold injection. To address the tissue reactions and the degree of reabsoprtion of the graft, an animal study with a follow-up ranging from 3 days to 12 months was performed at the National Laboratory Animal Center, University of Kuopio. Harvesting of the graft and injection was met with minor morbidity. Histological analysis of the vocal fold tissue showed that fascia was well tolerated. Although some resorption or compaction of the graft during the first months is evident, graft volume is maintained well. When injected deep and laterally into the vocalis muscle, the fascia graft allows normal vibration of the vocal fold mucosa to occur during phonation. Improvement of voice quality was seen in all series by multiple objective parameters of voice evaluation. However, the vocal results were poor in cases where the nerve trauma was severe, such as UVFP after chest surgery. ILAF is most suitable for correction of mild to moderate glottic gaps related to less severe nerve damage. Our results indicate that autologous fascia is a feasible and safe new injection material with good and stable vocal results. It offers a practical solution for surgeons who treat this complex issue.

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We provide a model that bridges the gap between two benchmark models of strategic network formation: Jackson and Wolinsky' s model based on bilateral formation of links, and Bala and Goyal's two-way fl ow model, where links can be unilaterally formed. In the model introduced and studied here a link can be created unilaterally. When it is only supported by one of the two players the fl ow through the link suffers a certain decay, but when it is supported by both the fl ow runs without friction. When the decay in links supported by only one player is maximal (i.e. there is no flow) we have Jackson and Wolinsky 's connections model without decay, while when flow in such links is perfect we have Bala and Goyal' s two-way flow model. We study Nash, strict Nash and pairwise stability for the intermediate models. Efficiency and dynamics are also examined.

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Documento de trabajo

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Em roedores, as vibrissas são detectores táteis que desempenham papel importante na exploração espacial do ambiente e na discriminação de texturas. No córtex somatosensorial, os campos receptivos de cada uma das vibrissas estão organizados no hemisfério contralateral em colunas discretas denominadas barris. A lesão unilateral dos barris produz um comportamento assimétrico caracterizado pela redução no uso da vibrissa contralateral à lesão na exploração do ambiente, assimetria esta que diminui progressivamente na medida em que os animais são repetidamente testados. Em ratos, este comportamento, normalmente medido pelo número de vezes que os animais encostam as vibrissas na parede de um campo aberto, tem se mostrado uma ferramenta importante em estudos de plasticidade e recuperação funcional após lesões corticais. Contudo, em camundongos com lesões unilaterais dos barris, o registro dos toques das vibrissas na parede tem levado a resultados contraditórios. Esse trabalho tem por objetivo principal o estabelecimento de um modelo comportamental para avaliação da recuperação funcional após lesões unilaterais dos barris do córtex somatosensorial em camundongos. Para tanto, o sentido dos deslocamentos realizados próximos às quinas do campo aberto foi registrado em camundongos Suíços machos submetidos à criolesão unilateral dos barris foi avaliado em três estudos independentes. No primeiro estudo, demonstramos que no grupo Criolesado houve um predomínio dos deslocamentos em sentido contralateral na primeira vez em que foram testados no campo aberto e este resultado foi independente do fato de na primeira sessão ter sido realizada um ou nove dias após a cirurgia. Além disso, demonstramos que o predomínio de deslocamentos em sentido contralateral foi diminuindo na medida em que os animais eram repetidamente testados no campo aberto. No segundo estudo, demonstramos que os animais do grupo Criolesado que foram previamente submetidos a cinco sessões experimentais no campo aberto não apresentaram, após a cirurgia, diferenças entre os deslocamentos realizados em sentido ipsolateral e contralateral à lesão. Já no terceiro estudo, demonstramos que os animais do grupo Criolesado que não foram previamente testados no campo aberto apresentam um predomínio de deslocamentos em sentido contralateral, mesmo quando o teste foi realizado 48 dias após a lesão unilateral dos barris. Nossos dados sugerem que o sentido dos deslocamentos próximo às quinas do campo aberto pode ser uma ferramenta importante para avaliar a recuperação das lesões unilaterais nos barris do córtex somatosensorial. Além disso, para avaliar a recuperação funcional após a lesão unilateral dos barris do córtex somatossensorial, sem o viés da habituação à situação do teste, os animais devem ser testados apenas uma vez

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Em humanos, uma série de estudos vem sugerindo que o hemisfério esquerdo é particularmente importante no controle e execução de movimentos. De modo geral, lesões no hemisfério esquerdo promovem déficits motores mais pronunciados que lesões semelhantes no hemisfério direito. Neste trabalho utilizamos a hemisferectomia unilateral para avaliar a contribuição de cada hemisfério na função motora em camundongos. Camundongos Suíços adultos foram submetidos a hemisferectomia unilateral direita (HD) ou esquerda (HE) ou aos procedimentos de controle. Quinze dias após cirurgia, a coordenação motora de cada animal foi avaliada no teste da locomoção forçada em cilindro giratório (Rotarod). A latência para a queda do grupo controle foi significativamente maior que a do grupo HD e não diferiu da do grupo HE. Para auxiliar a interpretação dos resultados obtidos no ROTAROD, uma parte dos animais foi submetida a uma bateria adicional de testes comportamentais na seguinte seqüência: teste de campo aberto, avaliação qualitativa da assimetria sensório-motora, teste da grade elevada e teste de suspensão pela cauda. De modo interessante, no teste da grade elevada, enquanto o grupo HD apresentou o desempenho da pata traseira esquerda (contralateral à lesão) significativamente pior que o da direita, os grupos Controle e HE não apresentaram diferenças entre as duas patas traseiras. De modo análogo ao observado em humanos, nossos resultados sugerem uma ação assimétrica dos hemisférios cerebrais no controle da função motora em camundongos.

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Trata-se de dissertação elaborada com o escopo de identificar os efeitos da denúncia unilateral exercida no âmbito dos tipos contratuais instrumentalizados ao processo de distribuição de bens e serviços, a partir do exame das diferenças tipológicas entre cada um deles. Aludidos tipos contratuais correspondem ao de agência, de representação comercial autônoma, de concessão comercial e de franquia, cujos contornos ainda são frutos de intenso debate doutrinário. No ordenamento pátrio, enquanto alguns tipos contratuais não sofreram regulamentação legal, outros tais como o de agência, de representação comercial autônoma, de concessão comercial de veículos autores e de franquia são regulados legislativamente, em fenômeno a que não se assiste em nenhum outro ordenamento da família romano-germânica. A construção da disciplina de tais consequências jurídicas transpassa pela delimitação do âmbito de incidência de cada um desses regimes legais, os quais podem atribuir consequências jurídicas próprias. Os tipos de agência e de representação comercial são equivalentes, o que permite tratá-lo de maneira conjunta, enquanto aqueles de concessão comercial e de franquia, a despeito de apresentarem diferenças relevantes, também podem ser examinados em conjunto pela similar estruturação dos interesses, a despeito de apresentarem peculiares leis regulando-os. Após realizado o exame legislativo e tipológico, examinou-se o impacto do princípio da boa-fé objetiva na determinação dos efeitos desencadeados pela resilição unilateral exercida pelo produtor nos contratos por tempo indeterminado, assim como a influência da previsão do parágrafo único do art. 473 do Código Civil na delimitação desses corolários jurídicos no que tange aos tipos contratuais analisados. Realizado essa investigação, constatou-se que, conquanto existam inúmeros fatores que distanciem, de um lado, os tipos de agência e de representação comercial autônoma e, de outro, de concessão comercial e de franquia, os efeitos desencadeados pela denúncia unilateral são semelhantes, próximos àqueles das relações de duração e nas quais existe estreita confiança.