Efectividad clínica de la intervención terapéutica sobre la mano con realidad virtual en sujetos hemipléjicos: revisión sistemática

Objetivo Revisar de forma sistemática y realizar una evaluación critica de las diferentes publicaciones existentes sobre el uso de la realidad virtual como elemento rehabilitador en la mano. Estrategias de búsqueda Se ha realizado una búsqueda en la base de datos Medline completada con búsquedas en Google Schoolar. Se ha limitado la búsqueda a 10 años de extensión, idiomas: inglés y español. Selección de estudios: se ha centrado sobre aquellos artículos relacionados con la realidad virtual y la rehabilitación funcional de la mano en el accidente cerebrovascular. Síntesis de resultados Debido a la falta de homogeneidad, no ha sido posible evaluar metodológicamente mediante instrumento Caspe. Se detectaron 200 artículos de los cuales 12 cumplen los criterios de selección de los mismos. Dichos artículos han sido agrupados en relación con diferentes criterios como son: tipo de estudio, sistema de evaluación utilizado, periféricos usados o resultados obtenidos entre otros. Conclusiones No se ha obtenido una homogeneidad conjunta sobre los artículos, por ello se debe continuar realizando avances en este ámbito. A pesar de ello, los entornos de realidad virtual pueden ser un instrumento válido para la recuperación funcional de la mano en los accidentes cerebrovasculares, no siendo aptos como elemento único rehabilitador. Abstract in English Objective To make a systematic review and critical assessment of the different existing publications on the use of virtual reality as an element in rehabilitation of the hand. Search Method A search was made in the Medline database completed with searches in Google Schoolar. The search was limited to a period of ten years, and English and Spanish languages. Study selection The study was focused on those articles related to virtual reality and the functional rehabilitation of the hand in stroke. Synthesis of results It was not possible to perform a methodological evaluation using the Caspe instrument due to lack of homogeneity. Two hundred 200 articles were found. Of these, 12 met the criteria for their selection. These articles were grouped in relation to different criteria such as: type of study, assessment system used, hardware used or outcomes results obtained, among others. Conclusions Joint homogeneity was not obtained for the articles. Therefore, progress must still be made in this area. In spite of this, virtual reality environments can be a valid tool for functional recovery of the hand in strokes but they are not adequate for use as a single rehabilitative treatment element.

Contribución de la fuerza y el dolor en la función del paciente con artrosis trapecio metacarpiana. Estudio transversal

Objetivo Establecer una posible relación entre la fuerza (Jamar), el dolor (EVA) y la capacidad funcional referida por el paciente (DASH) determinando en qué grado influyen unas en otras. Estudio observacional transversal analítico. Participantes Muestra de 72 pacientes que presentaban una artrosis trapecio metacarpiana grado 2-3 de Eaton. Los pacientes fueron reclutados cuando acudían a la Unidad de Cirugía de mano. Método Se realizaron mediciones de fuerza de agarre, pinza, valoración del dolor y funcionalidad, y se establecieron las correlaciones entre cada una de ellas. Resultados El modelo más significativo para la función (R2 =0.83) incluye la variable dolor y la fuerza. Pero es la fuerza punta contra punta la que presenta una mayor correlación con el cuestionario DASH (B-estandarizado: –57). Respecto al dolor, influye en todas las mediciones de fuerza realizadas con el dinamómetro, siendo también la fuerza de la pinza punta contra punta la que presenta una mayor correlación. Conclusiones Los hallazgos corroboran que existe una correlación significativa entre la función referida por el paciente y variables que podemos medir en consulta, como la fuerza del puño y la pinza. Pero también esta correlación es significativa entre las variables función y dolor entre sí, pero es la pinza punta contra punta la que presenta una mayor asociación con el cuestionario DASH. Abstract in English Objective To assess the relationship between muscle strength (Jama), and pain (VAS) levels with hand function (DASH) in patients with trapeziometarcapal osteoarthritis. Cross-sectional study. Participants Sample of 72 patients with osteoarthritis stage 2-3 (Eaton) and trapeziometacarpal osteoarthritis. Patients were recruited when they came to the Hand Surgery Unit. Method Grip strength, pinch, pain and hand function were measured, and correlation and regression coefficients between them were obtained. Results For function, the most significant model (R2 = 0.83) included pain and strength. But it is tip to tip pinch force which has a stronger relationship with DASH (Standardized B: –57) questionnaire. Pain also influenced strength measured with the dynamometer but it was tip to tip pinch force that was the most affected. Conclusions Findings confirm that there is a significant correlation between function referred by the patient and variables that can be measured in the clinic such as grip strength and pinch. The correlation between pain intensity and function was also significant, but tip to tip pinch strength had the greatest impact on the function.

Etapas del cambio en personas inactivas tras un programa de promoción de la actividad física en Atención Primaria

Objetivo El objetivo del estudio fue evaluar las Etapas del cambio en relación con la actividad física y el estado de salud general entre personas que participaron en un Programa de promoción de la actividad física (PPAF) de 12 semanas frente a un grupo control. Diseño Ensayo clínico aleatorizado. Participantes Noventa y ocho personas inactivas de ambos sexos con una edad media de 62,82 años procedentes de 2 centros de Atención Primaria del Distrito Sanitario Costa del Sol. Intervención Un PPAF organizado en grupos y siguiendo los criterios del Colegio Americano de Medicina del Deporte, 2 sesiones semanales de 60 min durante 12 semanas. Mediciones principales La variable principal de resultado fue resistencia al cambio en relación con la actividad física. La variable secundaria fue el estado de salud general (componentes físicos y mentales), determinado con el cuestionario de salud general SF12. Resultados Se encontraron diferencias significativas en las etapas del cambio a favor del grupo experimental (p < 0,05). No se encontraron diferencias estadísticamente significativas entre grupos después de la intervención en el estado general de salud. Conclusión Las etapas del cambio se modificaron en las personas inactivas que realizaron el PPAF en Atención Primaria. Futuros estudios son necesarios para identificar qué factores del entorno de los participantes influyen en la resistencia al cambio de la actividad física. Abstract Objective This study has aimed to evaluate the stages of change in relation to physical activity and overall health status among persons who participated in a 12-week Physical activity promotion program (PAPP) compared to a control group. Design Randomized clinical trial. Participants The study included 98 inactive persons of both sexes with a mean age of 62.82 years from 2 of Primary Care Centers of the Malaga Health Care District. Interventions A PAPP organized in groups according to the American College of Sports Medicine criteria including two weekly sessions of 60 minutes each for 3 months. Main measures The primary outcome was to assess resistance to change in relation to physical activity. The secondary variable was overall health (physical and mental components) determined with the SF12 general health questionnaire. Results Significant differences were found in the stages of change (P<.05). There were no significant differences found in general health status improvement in regards to the initial assessment. Conclusion The stages of change were modified in the inactive persons who carried out the PAPP in Primary Care. Future studies are needed to identify which environmental factors influence the resistance to change in physical activity of the participants.

Adolescent sexual behavioral intentions measurement: A gender approach in the Colombian Caribbean region [Medición de la Intención en la Actividad Sexual en Adolescentes: una Aproximación de Acuerdo al Género del Caribe Colombiano]

The study of 1777 male and female adolescent students of 11-19 years in the Colombian Caribbean had two objectives: development and validation of two reproductive health intention scales and analyze gender differences. The pilot of the scale consisted of 8 items and was reduced to 6, to check the reliability and validity using factor analysis and principal components with VARIMAX rotation yielded two factors: Intention and Intention Risk Protection, explained between 69.4% and 70% respectively. In the male Protection Intent (M = 3.87 and SD = 1.29) and risk (M = 2.56 and SD = 1.18) obtained an alpha between 0.74 and 0.86, and in Protection of Intent to female (M = 3.49 and SD = 1.35) and risk (M = 1.50 and SD = 0.89) ranged between 0.78 and 086. In conclusion, the reliability and structural stability are adequate and there are gender differences in the scales.

The measurement of intraocular pressure over positive soft contact lenses by rebound tonometry [Medición de la presión intraocular sobre lentes de contacto blandas positivas, mediante tonometría de rebote]

Purpose To investigate if the accuracy of intraocular pressure (IOP) measurements using rebound tonometry over disposable hydrogel (etafilcon A) contact lenses (CL) is affected by the positive power of the CLs. Methods The experimental group comprised 26 subjects, (8 male, 18 female). IOP measurements were undertaken on the subjects’ right eyes in random order using a Rebound Tonometer (ICare). The CLs had powers of +2.00D and +6.00D. Measurements were taken over each contact lens and also before and after the CLs had been worn. Results The IOP measure obtained with both CLs was significantly lower compared to the value without CLs (t test; p<0.001) but no significant difference was found between the two powers of CLs. Conclusions Rebound tonometry over positive hydrogel CLs leads to a certain degree of IOP underestimation. This result didn’t change for the two positive lenses used in the experiment, despite their large difference in power and therefore in lens thickness. Optometrists should bear this in mind when measuring IOP with the rebound tonometer over plus power contact lenses.

Energetics of rare earth manganese perovskites A1-xA ' xMnO3 (A = La, Nd, Y and A ' = Sr, La) systems

High temperature reaction calorimetry using molten lead berate as solvent has been used to study the thermochemistry of NdMnO3, YMnO3, La1-xSrxMnO3 (with 0 < x < 0.5), and Ln(0.5)Ca(0.5)MnO(3) (with Ln = La, Nd, Y), The enthalpies of formation of these multicomponent oxides from their binary constituents have been calculated from the measured enthalpy of drop solution, The energetic stability of the perovskite depends on the size of the A cation, The enthalpy of formation of YMnO3 (smallest A cation) is more endothermic than those of NdMnO3 and LaMnO3. The energetics of the perovskite also depends on the oxidation state of the B site's ions. In the La1-xSrxMnO3 system, the energetic stability of the structure increases with the Mn4+/Mn3+ ratio, The new values of the enthalpies of oxidations, with reliable standard entropies, were used to plot the phase stability diagram of the lanthanum-manganese-oxygen system in the temperature range 300-1100 K, The LaMnO3/MnO phase boundary evaluated in this study agrees with the one published by Atsumi et nl. calculated from thermogravimetric and conductivity measurements.

Structure and magnetotransport properties of the layered manganites REl.2Srl.8Mn,07(R E = La, Pr, Nd)

We have examined the magnetotransport properties and the structure, by Rietveld refinement of powder X-ray data, of the phases RE(1.2)Sr(1.8)Mn(2)O(7) (RE = La, Pr, Nd). We find that on cooling, La1.2Sr1.8Mn2O7 undergoes a transition to a nearly perfect ferromagnet with 90% magnetization at 1.45 T, as reported by earlier workers, but the Pr and Nd phases show only a small magnetization that grows gradually as the temperature is decreased. There seems to be significant correlation between electrical transport and the Jahn-Teller elongation of the apical Mn-O bonds in these systems. The elongation of the apical Mn-O bonds forces the nine-coordinate rock-salt site to be occupied preferentially by the smaller rare-earth-metal cations. This preferential occupation is reliably obtained from the X-ray refinement. All three title phases show a magnetoresistance ratio of about 4(corresponding to a magnetoresistance, [R(0)-R(H)]/R(0), of about 75%) at a field of 7 T and temperatures around 100 K.

He II spectra of La, Ce and Yb: Novel features in the valence band region

He II photoelectron spectra of La, Ce and Yb show features which cannot be explained in terms of single electron excitations. It is proposed that these are due to formation of electron-hole paris.

Huellas de Eros y Thánatos en la narrativa de Diamela Eltit : La palabra en movimiento en el juego entre tropos, metáforas y deconstrucciones lingüísticas

Väitöskirja analysoi espanjan kielen dekonstruktioita ruumiin metaforista ja troopeista koostuvassa aineistossa chileläisen kirjailijan Diamela Eltitin (1949 -) neljässä romaanissa: Lumpérica (1983), Vaca sagrada (1991), El infarto del alma (1994) ja Los trabajadores de la muerte (1998). Näkökulma on kielen muutoksessa Eltitin proosassa 1980- ja 1990-luvuilla alkaen kokeellisesta huippuvaiheesta 1983, jolloin hän julkaisi esikoisromaaninsa Lumpérica. Tutkimus korostaa Eltitin romaanien historiallista arvoa, kirjallisuuden tapaa murtaa kielen rakenteita ja sitä miten tämä murros kytkeytyy taideteoreettiseen muutokseen kulttuuridiskursseissa. Tutkimus tarkastelee Eltitin kehityskaarta kenraali Augusto Pinochetin sotilasvallankaappauksesta 1973 halki sotilashallituksen kauden (1973-1990) aina kansalaisyhteiskunnan vahvistumiseen ja vuoteen 1998. Tutkimus analysoi ruumiin troopeista ja metaforista koostuvaa tutkimusaineistoa lingvistiikan, kirjallisuustieteen, historian ja sukupuolen tutkimuksen monitieteisessä viitekehyksessä. Sen vuoksi väitöskirja liittyy espanjalaisen filologian, yleisen kirjallisuustieteen, Latinalaisen Amerikan tutkimuksen ja naistutkimuksen oppiaineisiin. Kolme tärkeintä oppiteoreettista runkoa ovat lingvistinen strukturalismi, dekonstruktio ja feministiset kirjallisuusteoriat. Dekonstruktiivinen lähestymistapa tekstiin korostaa kielen merkityksen muodostumisen filosofista perustaa. Se pyrkii selvittämään, miten merkitys muodostuu kirjoittajan, tekstin ja lukijan välillä. Tekstikritiikki koostuu semanttisesta ja dekonstruktiivisesta tekstianalyysistä, jonka metodologisen mallin perusta on tanskalaisen kielitieteilijän Louis Hjelmslevin (1899-1965) kielitieteellinen malli. Väitös ei käytä mallia suoraan, vaan soveltaa sitä kaunokirjallisuuden tutkimukseen. Oppiteoreettisen viitekehyksen osalta tutkimus sijoittuu strukturalismin ja poststrukturalismin murrokseen. Tutkimus korostaa Eltitin radikaalia muotokieltä ja teatraalisuutta, hänen kielensä visuaalisuutta ja ruumiin metaforien eroottista jännitettä, mikä ilmenee mm. falloksen metaforaksi tulkitun hehkuvan valon kuvissa romaanissa Lumpérica. Vanhat kreikkalaiset myytit Éros ja Thánatos kasvavat esille länsimaisen taidehistorian perinteestä ja kontekstualisoituvat uusiksi kielikuviksi Chilen kirjallisessa maaperässä. Ne muodostavat Eltitin taiteellisen tuotannon pysyvän aihepiirin ja luovat teoksiin synkkää ja karua virettä sekä tummia ja eroottisia sävyjä. Tutkimus osoittaa, että Eltit dekonstruoi kieltä, mutta dekonstruktiot eivät ole jatkuvia eivätkä samanlaisia kaikissa romaaneissa. Kielellisten dekonstruktioiden variaatio on laaja eikä Eltit murra kielen syntaktisia ja morfologisia rakenteita kaikissa teksteissään. Tutkimuksen perusteella väitän, että Eltitin kirjoituksesta puhuttaessa useat tutkijat käyttävät epämääräisesti dekonstruktio-termiä. Useiden tutkijoiden toteamus dekonstruktiosta Diamela Eltitin kirjallisessa tuotannossa pysyvänä piirteenä on epätäsmällinen. Sen sijaan dekonstruktiivinen kirjoitus tarkoittaa Eltitillä laajasti vaihtelevaa lähestymistapaa kieleen, mikä ilmenee kehityslinjana hänen tuotannossaan ja eri tavoin jokaisessa teoksessa.

La modernización entre cafetales : San José, Costa Rica, 1880-1930

This work examines the urban modernization of San José, Costa Rica, between 1880 and 1930, using a cultural approach to trace the emergence of the bourgeois city in a small Central American capital, within the context of order and progress. As proposed by Henri Lefebvre, Manuel Castells and Edward Soja, space is given its rightful place as protagonist. The city, subject of this study, is explored as a seat of social power and as the embodiment of a cultural transformation that took shape in that space, a transformation spearheaded by the dominant social group, the Liberal elite. An analysis of the product built environment allows us to understand why the city grew in a determined manner: how the urban space became organized and how its infrastructure and services distributed. Although the emphasis is on the Liberal heyday from 1880-1930, this study also examines the history of the city since its origins in the late colonial period through its consolidation as a capital during the independent era, in order to characterize the nineteenth century colonial city that prevailed up to 1890 s. A diverse array of primary sources including official acts, memoirs, newspaper sources, maps and plans, photographs, and travelogues are used to study the initial phase of San Jose s urban growth. The investigation places the first period of modern urban growth at the turn of the nineteenth century within the prevailing ideological and political context of Positivism and Liberalism. The ideas of the city s elite regarding progress were translated into and reflected in the physical transformation of the city and in the social construction of space. Not only the transformations but also the limits and contradictions of the process of urban change are examined. At the same time, the reorganization of the city s physical space and the beginnings of the ensanche are studied. Hygiene as an engine of urban renovation is explored by studying the period s new public infrastructure (including pipelines, sewer systems, and the use of asphalt pavement) as part of the Saneamiento of San José. The modernization of public space is analyzed through a study of the first parks, boulevards and monuments and the emergence of a new urban culture prominently displayed in these green spaces. Parks and boulevards were new public and secular places of power within the modern city, used by the elite to display and educate the urban population into the new civic and secular traditions. The study goes on to explore the idealized image of the modern city through an analysis of European and North American travelogues and photography. The new esthetic of theatrical-spectacular representation of the modern city constructed a visual guide of how to understand and come to know the city. A partial and selective image of generalized urban change presented only the bourgeois facade and excluded everything that challenged the idea of progress. The enduring patterns of spatial and symbolic exclusion built into Costa Rica s capital city at the dawn of the twentieth century shed important light on the long-term political social and cultural processes that have created the troubled urban landscapes of contemporary Latin America.

La coordination et les phrases juxtaposées en français

Coordination and juxtaposed sentences The object of this study is the examination of the relations between juxtaposed clauses in contemporary French. The matter in question is sentences which are composed of several clauses adjoined without a conjunction or other connector, as in: Je détournai les yeux, mon c ur se mit à battre. The aim of the study is to determine, which quality is the relation in these sentences and, on the other hand, what is the part of the coordination there. Furthermore, what is this relation of coordination, which, according to some grammars, manifests through a conjunction of coordination, but which, according to some others is marked in juxtaposed sentences through different features. The study is based on a corpus of written French from literary and journalistic text sources. Syntactic, semantic and textual properties in the clauses are discussed. The analysis points to differences so, it has been noted, in each case, if one of the clauses is affirmative and the other negative and if in the second clause, the subject has not been repeated. Also, an analysis has been made on the ground of the tense, mode, phrase structure type, and thematic structure, taking into account, in each case, if the clauses are identical or different. Punctuation has been one of the properties considered. The final aim has been to eliminate gradually, based on the partition of properties, subordinate sentences, so that only the hard core of coordinate sentences remains. In this way, the coordination could be defined similarly as the phoneme is defined as a group of distinctive features. The quantitative analyses have led to the conclusion that the sentences which, from a semantic point of view, are interpreted as coordinating, contain the least of these differences, while the sentences which can be considered as subordinating present the most of these differences. The conditions of coordination are, in that sense, hierarchical, so that the syntactic constraints have to make room for semantic, textual and cognitive factors. It is interesting to notice that everyone has the ability to produce correct coordinating structures and recognize incorrect coordinating structures. This can be explained by the human ability to categorize which has been widely researched in the semantic of prototype. The study suggests that coordination and subordination could be considered as prototypical cognitive categories based on different linguistic and pragmatic features.

Structure informationnelle et constructions du kabyle : Etude de trois types de phrase dans le cadre de la grammaire constructionnelle

Information structure and Kabyle constructions Three sentence types in the Construction Grammar framework The study examines three Kabyle sentence types and their variants. These sentence types have been chosen because they code the same state of affairs but have different syntactic structures. The sentence types are Dislocated sentence, Cleft sentence, and Canonical sentence. I argue first that a proper description of these sentence types should include information structure and, second, that a description which takes into account information structure is possible in the Construction Grammar framework. The study thus constitutes a testing ground for Construction Grammar for its applicability to a less known language. It constitutes a testing ground notably because the differentiation between the three types of sentences cannot be done without information structure categories and, consequently, these categories must be integrated also in the grammatical description. The information structure analysis is based on the model outlined by Knud Lambrecht. In that model, information structure is considered as a component of sentence grammar that assures the pragmatically correct sentence forms. The work starts by an examination of the three sentence types and the analyses that have been done in André Martinet s functional grammar framework. This introduces the sentence types chosen as the object of study and discusses the difficulties related to their analysis. After a presentation of the state of the art, including earlier and more recent models, the principles and notions of Construction Grammar and of Lambrecht s model are introduced and explicated. The information structure analysis is presented in three chapters, each treating one of the three sentence types. The analyses are based on spoken language data and elicitation. Prosody is included in the study when a syntactic structure seems to code two different focus structures. In such cases, it is pertinent to investigate whether these are coded by prosody. The final chapter presents the constructions that have been established and the problems encountered in analysing them. It also discusses the impact of the study on the theories used and on the theory of syntax in general.

La contextualisation du discours radiophonique par des moyens prosodiques. L’exemple de cinq grands philosophes français du XXe siècle

"Radiodiskurssin kontekstualisointi prosodisin keinoin. Esimerkkinä viisi suurta ranskalaista 1900-luvun filosofia" Väitöskirja käsittelee puheen kontekstualisointia prosodisin keinoin. Toisin sanottuna työssä käsitellään sitä, miten puheen prosodiset piirteet (kuten sävelkulku, intensiteetti, tauot, kesto ja rytmi) ohjaavat puheen tulkintaa vanhastaan enemmän tutkittujen sana- ja lausemerkitysten ohella. Työssä keskitytään seitsemään prosodisesti merkittyyn kuvioon, jotka koostuvat yhden tai usean parametrin silmiinpistävistä muutoksista. Ilmiöitä käsitellään sekä niiden akustisten muotojen että tyypillisten esiintymisyhteyksien ja diskursiivisten tehtävien näkökulmasta. Aineisto koostuu radio-ohjelmista, joissa puhuu viisi suurta ranskalaista 1900-luvun filosofia: Gaston Bachelard, Albert Camus, Michel Foucault, Maurice Merleau-Ponty ja Jean-Paul Sartre. Ohjelmat on lähetetty eri radiokanavilla Ranskassa vuosina 1948–1973. Väitöskirjan tulokset osoittavat, että prosodisesti merkityt kuviot ovat moniulotteisia puheen ilmiöitä, joilla on keskeinen rooli sanotun kontekstualisoinnissa: ne voivat esimerkiksi nostaa tai laskea sanotun informaatioarvoa, ilmaista puhujan voimakasta tai heikkoa sitoutumista sanomaansa, ilmaista rakenteellisen kokonaisuuden jatkumista tai päättymistä, jne. Väitöskirja sisältää myös kontrastiivisia osia, joissa ilmiöitä verrataan erääseen klassisessa pianomusiikissa esiintyvään melodiseen kuvioon sekä erääseen suomen kielen prosodiseen ilmiöön. Tulokset viittaavat siihen, että tietynlaista melodista kuviota käytetään samankaltaisena jäsentämiskeinona sekä puheessa että klassisessa musiikissa. Lisäksi tulokset antavat viitteitä siitä, että tiettyjä melodisia muotoja käytetään samankaltaisten implikaatioiden luomiseen kahdessa niinkin erilaisessa kielessä kuin suomessa ja ranskassa. Yksi väitöskirjan osa käsittelee pisteen ja pilkun prosodista merkitsemistä puheessa. Tulosten mukaan pisteellä ja pilkulla on kummallakin oma suullinen prototyyppinsä: piste merkitään tyypillisesti sävelkulun laskulla ja tauolla, ja pilkku puolestaan sävelkulun nousulla ja tauolla. Merkittävimmät tulokset koskevat kuitenkin tapauksia, joissa välimerkki tulkitaan prosodisesti epätyypillisellä tavalla: sekä pisteellä että pilkulla vaikuttaisi olevan useita eri suullisia vastaavuuksia, ja välimerkkien tehtävät voivat muotoutua hyvin erilaisiksi niiden prosodisesta tulkinnasta riippuen.