Satisfação e impacto da saúde oral na qualidade de vida em pacientes reabilitados com prótese total dupla

Introduction: The rehabilitation of edentulous patients is one of the main challenges of Dentistry. Objective: To assess the satisfaction and the impact of oral health on quality of life of patients rehabilitated with conventional complete dentures in both arcades. Method: A clinical trial with 25 patients rehabilitated with CCD was conducted. The impact of oral health in individuals quality of life was evaluated through the Brazilian version of the OHIP-Edent and the patient satisfaction was evaluated using a specific questionnaire. The instruments were applied before and 3 months after rehabilitation. Results: There was a statistically significant improvement (p <0.001) on the impact of the quality of life of the denture users after the new rehabilitation. The analysis of 4 OHIP domains also showed statistically significant improvement (p <0.001). The final overall satisfaction with the dentures was statistically superior to initial satisfaction (p <0.001). The analysis of the specific aspects of satisfaction with CCD after 3 months of rehabilitation also showed significant results in the improvement of every aspect. Conclusion: Patients disappointed with their dentures, have their quality of life improved after the new rehabilitation, reducing the negative impact of the prostheses on oral health, and improving their satisfaction with the rehabilitation.

Atividade eletroencefalográfica de pacientes com acidente vascular cerebral na aprendizagem motora de um jogo baseado em realidade virtual

Stroke is the leading cause of long-term disability among adults and motor relearning is essential in motor sequelae recovery. Therefore, various techniques have been proposed to achieve this end, among them Virtual Reality. The aim of the study was to evaluate electroencephalographic activity of stroke patients in motor learning of a virtual reality-based game. The study included 10 patients with chronic stroke, right-hande; 5 with left brain injury (LP), mean age 48.8 years (± 4.76) and 5 with injury to the right (RP), mean age 52 years (± 10.93). Participants were evaluated for electroencephalographic (EEG) activity and performance while performing 15 repetitions of darts game in XBOX Kinect and also through the NIHSS, MMSE, Fugl-Meyer and the modified Ashworth scale. Patients underwent a trainning with 45 repetitions of virtual darts game, 12 sessions in four weeks. After training, patients underwent reassessment of EEG activity and performance in virtual game of darts (retention). Data were analyzed using ANOVA for repeated measures. According to the results, there were differences between the groups (PD and PE) in frequencies Low Alpha (p = 0.0001), High Alpha (p = 0.0001) and Beta (p = 0.0001). There was an increase in alpha activation powers and a decrease in beta in the phase retention of RP group. In LP group was observed increased alpha activation potency, but without decrease in beta activation. Considering the asymmetry score, RP group increased brain activation in the left hemisphere with the practice in the frontal areas, however, LP group had increased activation of the right hemisphere in fronto-central areas, temporal and parietal. As for performance, it was observed a decrease in absolute error in the game for RP group between assessment and retention (p = 0.015), but this difference was not observed for LP group (p = 0.135). It follows then that the right brain injury patients benefited more from darts game training in the virtual environment with respect to the motor learning process, reducing neural effort in ipsilesionais areas and errors with the practice of the task. In contrast, patients with lesions in left hemisphere decrease neural effort in contralesionais areas important for motor learning and showed no performance improvements with practice of 12 sessions of virtual dart game. Thus, the RV can be used in rehabilitation of stroke patients upper limb, but the laterality of the injury should be considered in programming the motor learning protocol.

Observação da ação na reabilitação do membro superior de pacientes com acidente vascular cerebral: uma revisão sistemática com metanálise

Background: stroke causes long-term impairments, limitation of activities and restriction in participation in daily life situations, especially for upper limb impairment (UL). Action Observation (AO) has been used for the rehabilitation of UL in these patients. It's a multisensory therapy which consists in observing a healthy subject performing a motor task, followed by physical practice. Objectives: assess whether the AO improves motor function of UL and dependence for activities of daily living (ADLs) of stroke patients or cause any adverse effects. Search methods: a search strategy was words and terms used for the identification of articles, in the following scientific basis Cochrane Central Register of Controlled Trials; MEDLINE; PsycINFO; CINAHL and LILACS. In addition to manual search of the references of articles and search for theses and dissertations in Portal Capes and LILACS. The identification of the studies was conducted from October to December 2015, being the last search on December 3. Selection criteria: randomised controlled trials (RCT) involving adults with stroke who had deficits in upper limb function and used AO as an intervention. Data collection and analysis: the data extracted from the studies were used to analyze the risk of bias, the effect of the treatment and the quality of the body of evidence. Main results: 6 studies were included, totaling 270 patients. The primary outcome analyzed was the motor function of MS. Were combined in meta-analyzes studies comparing AO versus placebo or an active control, considering the immediate and long-term effect (n=241). Regarding the motor function of the arm (5 trials), the estimated effect for the therapy was not significant. However, when considering the hand function estimating the effect was favorable to the group that conducted the AO, in short (mean difference = 6.93, 95% CI 1.48 to 12.39; P = 0.01) and long-term (mean difference = 7.57; 95% CI 1.34 the 13.80; p = 0.02). Unable to perform the analysis for functional dependency. The studies showed a low or uncertain risk of bias, but the quality of evidence the body was considered low and very low quality. Authors’ conclusions: AO was effective in improving hand function of stroke patients. Despite the low quality evidence that the use of OA in clinical practice should not be discouraged. RCT new studies should be conducted with greater methodological rigor and larger samples, covering important outcomes such as functional dependence for ADLs.

O centro de Fortaleza como lugar de moradia

The present study has the objective of analyzing how the ways of dwelling influences the uses and the functional and symbolic appropriations of the urban space in Fortaleza city center, through the perspective of the residents and their relation with the living place. Scenarios of development and degradation of its urban space have marked the city center of Fortaleza. The intensification of the commercial and services occupation promoted through the years, paradoxically, the valorization of the land price and the devalorization of the residential use. Thus, the residential occupation was consolidated in a discontinuous way, being concentrated mainly in the external limits of the historical core of the neighborhood. The research is structured over the delimitation of an area and the selection of multifamily residential buildings, built since the 1960s, close to the central core of the neighborhood. The spatial configuration analysis of the selected residential buildings, and their relations with the urban surroundings and the land uses, reveals different aspects related to the urban vitality, producing impacts over the ways of dwelling constituted by the daily life of the residents. The study of the ways of dwelling involves the comprehension that the dwelling is beyond the private residential boundaries and the functional occupation. The conceptual base of this research is developed over the perspective that the dwelling represents a fundamental aspect of the human condition, allowing the person to relate with the space in an essential way (HEIDEGGER, 2012). In this perspective of the dwelling, the space reunites the mental and the cultural, the social and the historical, being marked by simultaneous logics of the conceived, the perceived and the lived space (LEFEVBRE, 2006). The development of this study, over the point of view of the neighborhood residents, is inserted in the perspective of the lived space, related to the concept of place, understood as a qualitative phenomenon, giving essence and identity to the space. The place of dwelling, marked by coexistences, is one of the structural elements of the urban land use, and potential for the rehabilitation of the central areas in big cities. Therefore, the study starts from the hypothesis that the location, the nearby land uses and the spatial configuration of the residential buildings affect the ways of dwelling, in other words the residents dissolve the boundaries of the shelter and experience the urban space, from the dwelling place. The requalification of the dwelling is opposed to the residential space based in functionality, in hierarchy, in self sufficiency, in standardization and in the reproduction of the urban space, materialized in the dense contemporary residential buildings, that are unrelated to the city. The stages of the research involved the spatial configuration analysis of the selected residential buildings and their surrounding, the land use mapping and interviews with the residents. The collected data allowed verifying that the buildings are located in areas presenting heterogeneous land uses, with a great number of residents and users. However, these aspects are not sufficient to promote the vitality of the public spaces in the neighborhood, since the people movement in the streets is controlled by the opening hours of the predominant commercial use in the area. The word of the residents, collected in interviews, indicate that the conservation conditions of the public spaces and the insecurity influences their everyday relations with the place of dwelling, affecting fundamental aspects for the dwelling requalification in the central area of Fortaleza.

O centro de Fortaleza como lugar de moradia

The present study has the objective of analyzing how the ways of dwelling influences the uses and the functional and symbolic appropriations of the urban space in Fortaleza city center, through the perspective of the residents and their relation with the living place. Scenarios of development and degradation of its urban space have marked the city center of Fortaleza. The intensification of the commercial and services occupation promoted through the years, paradoxically, the valorization of the land price and the devalorization of the residential use. Thus, the residential occupation was consolidated in a discontinuous way, being concentrated mainly in the external limits of the historical core of the neighborhood. The research is structured over the delimitation of an area and the selection of multifamily residential buildings, built since the 1960s, close to the central core of the neighborhood. The spatial configuration analysis of the selected residential buildings, and their relations with the urban surroundings and the land uses, reveals different aspects related to the urban vitality, producing impacts over the ways of dwelling constituted by the daily life of the residents. The study of the ways of dwelling involves the comprehension that the dwelling is beyond the private residential boundaries and the functional occupation. The conceptual base of this research is developed over the perspective that the dwelling represents a fundamental aspect of the human condition, allowing the person to relate with the space in an essential way (HEIDEGGER, 2012). In this perspective of the dwelling, the space reunites the mental and the cultural, the social and the historical, being marked by simultaneous logics of the conceived, the perceived and the lived space (LEFEVBRE, 2006). The development of this study, over the point of view of the neighborhood residents, is inserted in the perspective of the lived space, related to the concept of place, understood as a qualitative phenomenon, giving essence and identity to the space. The place of dwelling, marked by coexistences, is one of the structural elements of the urban land use, and potential for the rehabilitation of the central areas in big cities. Therefore, the study starts from the hypothesis that the location, the nearby land uses and the spatial configuration of the residential buildings affect the ways of dwelling, in other words the residents dissolve the boundaries of the shelter and experience the urban space, from the dwelling place. The requalification of the dwelling is opposed to the residential space based in functionality, in hierarchy, in self sufficiency, in standardization and in the reproduction of the urban space, materialized in the dense contemporary residential buildings, that are unrelated to the city. The stages of the research involved the spatial configuration analysis of the selected residential buildings and their surrounding, the land use mapping and interviews with the residents. The collected data allowed verifying that the buildings are located in areas presenting heterogeneous land uses, with a great number of residents and users. However, these aspects are not sufficient to promote the vitality of the public spaces in the neighborhood, since the people movement in the streets is controlled by the opening hours of the predominant commercial use in the area. The word of the residents, collected in interviews, indicate that the conservation conditions of the public spaces and the insecurity influences their everyday relations with the place of dwelling, affecting fundamental aspects for the dwelling requalification in the central area of Fortaleza.

Desenvolvimento de um exoesqueleto para movimentação/reabilita-ção de paraplégicos

People bedridden by paralysis/motor disability are subject to several problems due to lack of movement. Then, it is necessary to use equipments that enable the people bedridden stand up and walk, so as to reduce the problems due to lack of movement and the time of rehabilitation, impacting directly on its quality of life. The aim of this work is the development of an exoskeleton to make the movement of people with paralysis / motor impairment in the lower limbs, without help of third parties, to be activated by the user. To provide support, stability and security to the deficient, it was decided to use a structure formed by four legs, being each leg consisting of a parallel chain. The gait was obtained by combining the movement of two mechanisms: crank/rocker, responsible for oscillatory motion of the leg, and cam/follower, responsible for the foot motion on the desired trajectory. To achieve the aim of this work was conducted a study about the types of exoskeletons for locomotion/rehabilitation of people with lower limb paralysis and presented a study on the movement of the lower limb joints. It also presented a mathematical model to obtain the desired path to the foot of the exoskeleton, the static model and the design of the structure elements. In the sequence is presented the simulation of movements of a people during the human gait, experimental tests and the comparison with the human gait developed by a people without disabilities.

Structural damage estimation using dynamic data and multi-objective optimization

Peer reviewed

La place de la relation conjugale dans la réinsertion sociale des délinquants sous l’autorité des Services correctionnels du Québec

Rapport de stage présenté à la Faculté des arts et des sciences en vue de l’obtention du grade de Maître ès sciences (M.Sc.) en criminologie, option intervention

La place de la relation conjugale dans la réinsertion sociale des délinquants sous l’autorité des Services correctionnels du Québec

Rapport de stage présenté à la Faculté des arts et des sciences en vue de l’obtention du grade de Maître ès sciences (M.Sc.) en criminologie, option intervention

La evolución de un paratexto singular: las subscriptiones latinas

La historia de las subscriptiones latinas revela alteraciones tanto en su frecuencia como en el tipo de información que transmiten, y en consecuencia también en su función. En un primer momento proporcionan datos escuetos con una finalidad práctica: la identificación del contenido de un libro concreto. En la Antigüedad tardía su número aumenta y transmiten mayor volumen de información, pero sobre todo adquieren relevancia los individuos que las firman, convirtiéndose en un instrumento de autorrepresentación social. Sin embargo, en época posterior estas subscriptiones tardoantiguas se siguen copiando en nuevos manuscritos y pierden su relación inicial con un ejemplar concreto; se transforman en paratextos que contribuyen a dar prestigio, ya no a un libro singular, sino a un autor o una obra.

Ajustes razonables en la rehabilitación de polígonos de viviendas: aplicación al barrio Montserrat de Terrassa (Barcelona)

La introducción de ajustes razonables para facilitar la accesibilidad universal en los edificios de vivienda ha adquirido una gran relevancia desde la publicación de la Ley 8/2013 de 26 de Junio de rehabilitación, regeneración y renovación urbanas. La complejidad y coste de estos procesos no es fácil de conjugar con la atención a las necesidades funcionales y dimensionales que las personas con discapacidad y otros colectivos con limitaciones requieren. En este artículo se aborda este dilema y se aplica para el caso de la rehabilitación accesible de viviendas del Barrio Montserrat de Terrassa, Barcelona, representativo de tantos polígonos residenciales y obreros construidos en los años 50, 60 y 70 en España.

Long-term fish community response to a reach-scale stream restoration

At a global scale, aquatic ecosystems are being altered by human activities at a greater rate than at any other time in history. In recent years, grassroots efforts have generated interest in the restoration of degraded or destroyed aquatic habitats, especially small wetlands and streams where such projects are feasible with local resources. We present ecological management lessons learned from 17 years of monitoring the fish community response to the channel relocation and reach-level restoration of Juday Creek, a 3rd-order tributary of the St. Joseph River in Indiana, USA. The project was designed to increase habitat complexity, reverse the effects of accumulated fine sediment (< 2 mm diameter), and mitigate for the impacts of a new golf course development. The 1997 restoration consisted of new channel construction within two reaches of a 1.2-km section of Juday Creek that also contained two control reaches. A primary social goal of the golf course development and stream restoration was to avoid harm to the non-native brown trout fishery, as symbolic of community concerns for the watershed. Our long-term monitoring effort revealed that, although fine sediment increased over time in the restored reaches, habitat conditions have promoted the resurgence of native fish species. Since restoration, the fish assemblage has shifted from non-native Salmonidae (brown trout, rainbow trout) to native Centrarchidae (rock bass, largemouth bass, smallmouth bass). In addition, native, nongame species have remained stable or have increased in population abundance (e.g., Johnny darter, mottled sculpin). The results of this study demonstrate the value of learning from a restoration project to adjust management decisions that enhance environmental quality.

Production de la sécurité, rationalité et gouvernance locale : une ethnographie urbaine à Douala et Yaoundé (Cameroun)

Cette thèse se penche sur la rationalité sécuritaire qui organise les villes de Douala et Yaoundé. En effet, l’insécurité urbaine devient une question très préoccupante, encore plus dans les villes des pays du Sud notamment les villes camerounaises où la recrudescence de la criminalité et de la violence ont donné lieu à des initiatives de sécurisation de la part de l’État et de la population. Sur le plan de la théorie, plusieurs approches nous permettent de nous projeter dans l’environnement sécuritaire des villes à l’étude. Nous considérons les villes de Douala et Yaoundé comme des lieux de production culturelle où se construisent à la faveur des migrations, à partir de diverses cultures et de comportements issus des villages d’origine, des formes d’identités hybrides et des territoires urbains diversifiés. Cela donne donc à réfléchir sur les modes de gouvernance locale, à l’échelle des quartiers, dans le but de comprendre les modalités d’encadrement de cette dynamique culturelle urbaine. Dans le même ordre d’idées, la gouvernance locale fait appel aux acteurs, dans leurs rôles et leurs logiques. Ces logiques s’observent dans leurs dimensions cognitives et leurs rapports avec l’espace. Les dimensions cognitives évoquent les perceptions, le vécu et les représentations subjectives qui sont associées à l’insécurité. Ainsi, le sentiment d’insécurité, la peur, la marginalisation, la violence et la criminalisation sont des phénomènes qui laissent entrevoir des populations défavorisées, victimes d’insécurité. C’est à côté de ces dernières que se manifestent les logiques d’acteurs associées à l’espace, qui ouvrent l’observation sur l’informalité et la ségrégation non seulement comme instruments de contrôle de l’espace urbain, mais également comme cadres de production d’espaces sécurisés. L’informalité et la ségrégation sont aussi favorables au développement des identités, à la construction d’utopies, ces visions mélioratives qui motivent et transforment les acteurs. Ce sont ces logiques d’acteurs dans leurs rapports avec l’espace qui justifient les initiatives de sécurisation. Finalement, c’est dans cette dynamique de transformation que les acteurs entrent en processus de subjectivation pour se produire comme sujets. Sur le plan méthodologique, cette thèse repose sur une ethnographie critique et comparative de la sécurité et sur l’approche de l’action sociale, qui invite à s’attarder aux interactions sociales, pour rendre compte de la rationalité sécuritaire. Étudier la sécurité requiert de s’attarder à l’échelle des quartiers, objets principaux de la sécurisation et espaces d’expression de l’informalité. Les quartiers sont encadrés par les chefferies urbaines, dont les systèmes de gestion constituent la gouvernance locale. Face à la question de la sécurité, cette gouvernance se prononce entre autres en fonction de son identité, de sa culture et de ses représentations. Elle côtoie les logiques étatiques dont les techniques et les stratégies d’organisation matérialisent les politiques de sécurité. Douala et Yaoundé présentent des approches populaires de sécurisation qui diffèrent sur le plan de l’organisation locale des quartiers et du tempérament populaire. Elles se rapprochent par les logiques d’acteurs et la motivation que ces derniers ont à se produire en sujets. La recherche a permis de constater qu’une forme de rationalité régit l’ensemble des dynamiques et des stratégies de production de la sécurité qui ont cours à Douala et Yaoundé. Cette rationalité passe par une pluralité de logiques de sécurité, elles-mêmes tributaires de nombreux phénomènes qui contribuent à la production de l’insécurité, mais aussi à celle de la sécurité. En effet, les migrations de la campagne vers la ville, l’informalité, la ségrégation et la présence de gangs locaux sont des réalités urbaines qui donnent une forme particulière à l’insécurité, mais invitent également à une réadaptation des techniques et des groupes d’acteurs impliqués dans la production de la sécurité. Il ressort que la rationalité sécuritaire, cette intelligence de gouvernement qui s’organise dans les dispositifs de l’offre publique de sécurité, suscite aussi dans les procédés des acteurs populaires, des techniques d’identification aux forces de l’ordre. Dans son processus, elle aboutit à la production de sujets sécurisés et de sécurité. En saisissant les productions humaines comme des activités innovantes, nous comprenons que la sécurisation procède par rapprochement entre les forces de l’ordre et les populations, par la mise en oeuvre de mécanismes mis en place pour répondre à la menace mais aussi par la « confiscation de la sécurité » pour les besoins d’une élite. Ensuite, elle représente une instance de subjectivation où l’innovation se matérialise et où les acteurs se réalisent, créent la sécurité et recréent la ville. Finalement, cette thèse révèle une pluralité de logiques de sécurité construites autour d’une même rationalité sécuritaire.

Design para a valorização de indústrias regionais: readaptação do cobertor de papa da Guarda

A sociedade está espontaneamente em constante transformação e isso reflete-se na cultura de um povo e no artesanato, sendo primordial o desenvolvimento de produtos que acompanhem essa mudança. O artesanato insere-se de forma natural em ambientes locais, absorvendo e caracterizando a cultura e identidade de uma região, contudo com o passar do tempo tem havido uma deterioração cultural, levando à desvalorização do artesanato e até ao desaparecimento de identidades culturais, de saberes e artes ancestrais. O presente projeto tem como objetivo a valorização e readaptação do Cobertor de Papa, um produto artesanal fabricado exclusivamente na Guarda, através da simbiose entre o design e o artesanato. O design tem vindo a afirmar-se com uma mais-valia, ou seja um instrumento imprescindível para a afirmação do artesanato. Esta ligação entre o design e o artesanato é vital para a preservação e revitalização das técnicas e saberes obsoletos, assim como para o desenvolvimento de produtos contemporâneos, impregnados de memórias e cultura, mas que respondem às necessidades da sociedade atual. É o saber e a técnica do artesão conexo com a criatividade e inovação do design, que diferencia estes produtos dos produtos industriais, massificados, sem identidade, tornandoos únicos, especiais e próprios. Pretende-se assim criar novos produtos, com base no Cobertor de Papa, salvaguardando a produção artesanal, as raízes culturais deste povo, através dos caminhos da inovação e criatividade. Evidenciando sempre a valorização, a preservação e revitalização das técnicas utilizadas nesta arte e transmitindo os conhecimentos para que estes não se percam no tempo. Há uma intensão de ajudar a posicionar o Cobertor de Papa no mercado atual, satisfazendo as necessidades da sociedade e do consumidor vigente, com o intuito de enaltecer esta arte, bem como as suas estirpes e essência.

Reciclaje de pavimentos : estudio de las ventajas económicas del reciclaje en frío in situ de pavimentos asfalticos

En los procesos de mantenimiento y rehabilitación de pavimentos, se deben definir los objetivos, bien sea para realizar unas reparaciones superficiales sobre daños generados por el agua como consecuencia de fallas en los drenajes, o bien realizar una intervención sobre la estructura buscando recuperarla a sus condiciones de diseño originales, la cual se realiza con el proceso de reciclaje el cual tiene en cuenta las características físico-químicas de los materiales existentes los cuales se consideran sufrieron el adecuado proceso que les permitió hacer parte de la estructura. Existiendo cuatro tipos de reciclaje de los cuales se realiza una descripción general de cada proceso, el presente trabajo se concentra en el análisis técnico – económico del proceso ―In situ‖ en frio, método utilizado en la rehabilitación de la vía Sopetrán - Puente de Occidente, en el Departamento de Antioquia, en una longitud de 13 Km. El presente estudio se realiza verificando el cumplimiento de las especificaciones a nivel nacional que para estos procesos estableció el Instituto Nacional de Vías (INVIAS) y verificando el cumplimiento de las normas IDU ET-2005. El reciclaje ―in situ‖ en frio tiene ventajas ecológicas (no necesita afectar las eventuales fuentes de materiales de la zona), económico (bajos costos comparados con reconstrucción) y técnico (los equipos para este proceso han presentado importantes avances tecnológicos) lo cual permitió su aplicación en la vía mencionada, lo cual con la adición de un agente estabilizador (cemento para el presente estudio) permite recuperar las condiciones iniciales de diseño de la estructura intervenida. El árbol de decisiones es una herramienta utilizada para el análisis y selección de la mejor opción de estructura a realizar teniendo en cuenta calidad y costos. El presente trabajo termina con un análisis detallado de las condiciones existentes, revisión de las diferentes opciones de intervención y el estudio económico de las diferentes alternativas de estructura de pavimento para la rehabilitación de la vía referida.