Visual strategies used during the performance of an obstacle course

Vision is the sense that provides precise information about one’s position in the environment in relation to objects. The visual system is essential to guide people safely when moving around in the environment. The perception that an individual gets from a particular scene of her/his surroundings is accomplished by eye movements. The current study aims to identify differences in visual strategies between 15 women and 15 men within the age range of 18-24 years, who have been given a task to walk through an obstacle course drawn on the laboratory´s floor. They should start and finish at a predefined location. Twelve pylons were used as obstacles to be avoided during the walking.The participants' eye movements were recorded using the Mobile Eye model 1.35. The Wilcoxon-Mann-Whitney Test was used for the statistical analysis. Significant differences occurred between men and women, in the duration of fixations: the men spend more time observing the finishing area than women (z=-1.929, p=.054); and in the number of fixations: before starting the task, the men fixate more often the middle phase of the obstacle course (z=-2.085, p=.037). Once they commence, the women fixate more the points outside the obstacle course than the men (z=-2.093, p=.036).

Effects of Cobalt Chloride in Junctional Epithelium and Reduced Enamel Epithelium of the Rat Maxillary First Molar

Cobalt is one of the main components of cast metal alloys broadly used in dentistry. It is the constituent of 45 to 70% of numerous prosthetic works. There are evidences that metal elements cause systemic and local toxicity. The purpose of the present study was to evaluate the effects of cobalt on the junctional epithelium and reduced enamel epithelium of the first superior molar in rats, during lactation. To do this, 1-day old rats were used, whose mothers received 300mg of cobalt chloride per liter of distilled water in the drinker, during lactation. After 21 days, the rat pups were killed with an anesthetic overdose. The heads were separated, fixed in ""alfac"", decalcified and embedded in paraffin. Frontal sections stained with hematoxylin and eosin were employed. Karyometric methods allowed to estimate the following parameters: biggest, smallest and mean diameters, D/d ratio, perimeter, area, volume, volume/area ratio, eccentricity, form coefficient and contour index. Stereologic methods allow to evaluate: cytoplasm/nucleus ratio, cell and cytoplasm volume, cell number density, external surface/basal membrane ratio, thickness of the epithelial layers and surface density. All the collected data were subjected to statistic analysis by the non-parametric Wilcoxon-Mann-Whitney test. The nuclei of the studied tissues showed smaller values after karyometry for: diameters; perimeter, area, volume and volume/area ratio. Stereologically, it was observed, in the junctional epithelium and in the reduced enamel epithelium, smaller cells with scarce cytoplasm, reflected in the greater number of cells per mm3 of tissue. In this study, cobalt caused epithelial atrophy, indicating a direct action on the junctional and enamel epithelium.

Seasonal variations of ventricular arrhythmia clusters in defibrillator recipients

BACKGROUND: Clustering ventricular arrhythmias are the consequence of acute ventricular electrical instability and represent a challenge in the management of the growing number of patients with an implantable cardioverter-defibrillator (ICD). Triggering factors can rarely be identified. OBJECTIVES: Several studies have revealed seasonal variations in the frequency of cardiovascular events and life-threatening arrhythmias, and we sought to establish whether seasonal factors may exacerbate ventricular electrical instability leading to arrhythmia clusters and electrical storm. METHODS: Two hundred and fourteen consecutive defibrillator recipients were followed-up during 3.3 +/- 2.2 years. Arrhythmia cluster was defined as the occurrence of three or more arrhythmic events triggering appropriate defibrillator therapies within 2 weeks. Time intervals between two clusters were calculated for each month and each season, and were compared using Kruskal-Wallis test and Wilcoxon-Mann-Whitney test with Bonferroni adjustment. RESULTS: During a follow-up of 698 patient years, 98 arrhythmia clusters were observed in 51 patients; clustering ventricular arrhythmias were associated with temporal variables; they occurred more frequently in the winter and spring months than during the summer and fall. Accordingly, the time intervals between two clusters were significantly shorter during winter and spring (median and 95% CI): winter 16 (5-19), spring 11.5 (7-25), summer 34.5 (15-55), fall 50.5 (19-65), P = 0.0041. CONCLUSION: There are important seasonal variations in the incidence of arrhythmia clusters in ICD recipients. Whether these variations are related to environmental factors, change in physical activity, or psychological factors requires further study.

Alleviation of chronic venous leg ulcers with a hand-held dielectric barrier discharge plasma generator (PlasmaDerm(®) VU-2010): results of a monocentric, two-armed, open, prospective, randomized and controlled trial (NCT01415622).

BACKGROUND Cold atmospheric plasma (CAP, i.e. ionized air) is an innovating promising tool in reducing bacteria. OBJECTIVE We conducted the first clinical trial with the novel PlasmaDerm(®) VU-2010 device to assess safety and, as secondary endpoints, efficacy and applicability of 45 s/cm(2) cold atmospheric plasma as add-on therapy against chronic venous leg ulcers. METHODS From April 2011 to April 2012, 14 patients were randomized to receive standardized modern wound care (n = 7) or plasma in addition to standard care (n = 7) 3× per week for 8 weeks. The ulcer size was determined weekly (Visitrak(®) , photodocumentation). Bacterial load (bacterial swabs, contact agar plates) and pain during and between treatments (visual analogue scales) were assessed. Patients and doctors rated the applicability of plasma (questionnaires). RESULTS The plasma treatment was safe with 2 SAEs and 77 AEs approximately equally distributed among both groups (P = 0.77 and P = 1.0, Fisher's exact test). Two AEs probably related to plasma. Plasma treatment resulted in a significant reduction in lesional bacterial load (P = 0.04, Wilcoxon signed-rank test). A more than 50% ulcer size reduction was noted in 5/7 and 4/7 patients in the standard and plasma groups, respectively, and a greater size reduction occurred in the plasma group (plasma -5.3 cm(2) , standard: -3.4 cm(2) ) (non-significant, P = 0.42, log-rank test). The only ulcer that closed after 7 weeks received plasma. Patients in the plasma group quoted less pain compared to the control group. The plasma applicability was not rated inferior to standard wound care (P = 0.94, Wilcoxon-Mann-Whitney test). Physicians would recommend (P = 0.06, Wilcoxon-Mann-Whitney test) or repeat (P = 0.08, Wilcoxon-Mann-Whitney test) plasma treatment by trend. CONCLUSION Cold atmospheric plasma displays favourable antibacterial effects. We demonstrated that plasma treatment with the PlasmaDerm(®) VU-2010 device is safe and effective in patients with chronic venous leg ulcers. Thus, larger controlled trials and the development of devices with larger application surfaces are warranted.

Efficacy of a progressive walking program and glucosamine sulphate supplementation on osteoarthritic symptoms of the hip and knee: a feasibility trial

Introduction: Management of osteoarthritis (OA) includes the use of non-pharmacological and pharmacological therapies. Although walking is commonly recommended for reducing pain and increasing physical function in people with OA, glucosamine sulphate has also been used to alleviate pain and slow the progression of OA. This study evaluated the effects of a progressive walking program and glucosamine sulphate intake on OA symptoms and physical activity participation in people with mild to moderate hip or knee OA. Methods: Thirty-six low active participants (aged 42 to 73 years) were provided with 1500 mg glucosamine sulphate per day for 6 weeks, after which they began a 12-week progressive walking program, while continuing to take glucosamine. They were randomized to walk 3 or 5 days per week and given a pedometer to monitor step counts. For both groups, step level of walking was gradually increased to 3000 steps/day during the first 6 weeks of walking, and to 6000 steps/day for the next 6 weeks. Primary outcomes included physical activity levels, physical function (self-paced step test), and the WOMAC Osteoarthritis Index for pain, stiffness and physical function. Assessments were conducted at baseline and at 6-, 12-, 18-, and 24-week follow-ups. The Mann Whitney Test was used to examine differences in outcome measures between groups at each assessment, and the Wilcoxon Signed Ranks Test was used to examine differences in outcome measures between assessments. Results: During the first 6 weeks of the study (glucosamine supplementation only), physical activity levels, physical function, and total WOMAC scores improved (P<0.05). Between the start of the walking program (Week 6) and the final follow-up (Week 24), further improvements were seen in these outcomes (P<0.05) although most improvements were seen between Weeks 6 and 12. No significant differences were found between walking groups. Conclusions: In people with hip or knee OA, walking a minimum of 3000 steps (~30 minutes), at least 3 days/week, in combination with glucosamine sulphate, may reduce OA symptoms. A more robust study with a larger sample is needed to support these preliminary findings. Trial Registration: Australian Clinical Trials Registry ACTRN012607000159459.

Distribution of conjunctival ultraviolet autoflourescence in a population-based study : the Norfolk Island Eye Study

OBJECTIVE: The objective of this study was to describe the distribution of conjunctival ultraviolet autofluorescence (UVAF) in an adult population. METHODS: We conducted a cross-sectional, population-based study in the genetic isolate of Norfolk Island, South Pacific Ocean. In all, 641 people, aged 15 to 89 years, were recruited. UVAF and standard (control) photographs were taken of the nasal and temporal interpalpebral regions bilaterally. Differences between the groups for non-normally distributed continuous variables were assessed using the Wilcoxon-Mann-Whitney ranksum test. Trends across categories were assessed using Cuzick's non-parametric test for trend or Kendall's rank correlation τ. RESULTS: Conjunctival UVAF is a non-parametric trait with a positively skewed distribution. Median amount of conjunctival UVAF per person (sum of four measurements; right nasal/temporal and left nasal/temporal) was 28.2 mm(2) (interquartile range 14.5-48.2). There was an inverse, linear relationship between UVAF and advancing age (P<0.001). Males had a higher sum of UVAF compared with females (34.4 mm(2) vs 23.2 mm(2), P<0.0001). There were no statistically significant differences in area of UVAF between right and left eyes or between nasal and temporal regions. CONCLUSION: We have provided the first quantifiable estimates of conjunctival UVAF in an adult population. Further data are required to provide information about the natural history of UVAF and to characterise other potential disease associations with UVAF. UVR protective strategies should be emphasised at an early age to prevent the long-term adverse effects on health associated with excess UVR.

Habilidades sociais, bem-estar psicológico e rendimento escolar

O propósito do presente estudo foi o de examinar o impacto da implementação de um programa de desenvolvimento de habilidades sociais no bem-estar psicológico (BEP) e no rendimento escolar numa amostra de estudantes adolescentes portugueses. Para aferir o BEP, foi utilizada a versão portuguesa de 30 itens para adolescentes das escalas de Ryff; o rendimento escolar foi aferido com recurso às avaliações finais de cada período letivo. O programa utilizado baseou-se no desenvolvimento das habilidades sociais de comunicação, assertividade e resolução de problemas, durante o ano letivo numa frequência semanal de 45 minutos nas aulas de Formação Cívica, em estudantes do 7º e 8º anos de escolaridade. Os dados longitudinais foram analisados através da estatística não paramétrica, recorrendo aos testes Wilcoxon-Mann-Whitney correlação de Spearman do programa SPSS®, versão 20.0. Os resultados mostram impacto do programa de desenvolvimento de habilidades sociais nas dimensões do BEP – autoaceitação, relações positivas com os outros, domínio do meio, crescimento pessoal, objetivos na vida e no BEP global em um ou mais momentos do pós teste. Os resultados demonstram igualmente correlações positivas entre as dimensões do BEP – autonomia, autoaceitação, domínio do meio, objetivos na vida e do BEP global e o rendimento escolar, em três ou mais momentos observados.

A Eficácia do Programa Fifa 11+ na Prevenção de Lesões em Atletas de Futebol Sub18

Introdução: No futebol, as lesões são da mais fulcral importância pelo que a sua prevenção se revela de extrema pertinência. A FIFA criou o FIFA 11+, um programa de prevenção de lesões, que revelou resultados positivos em equipas jovens tanto femininas como masculinas. No entanto, em Portugal, os resultados da sua implementação são escassos, principalmente em camadas jovens. Objetivo: Estudar a eficácia do programa FIFA 11+ na prevenção de lesões em atletas de futebol – sub 18. Métodos: O presente estudo quasi experimental teve como amostra uma equipa de 24 atletas, divididos voluntariamente em 2 grupos: o grupo experimental (GE) (n=12), e o grupo controlo (GC) (n= 12). Ambos os grupos realizaram os treinos normais sendo o grupo experimental sujeito adicionalmente ao programa FIFA 11+ duas vezes por semana, durante 12 semanas. Foi utilizado ainda o Orchard Sports Injury Classification System (OSICS-10) como sistema de classificação de lesões, sendo estas divididas em graves, moderadas, leves e mínimas. O teste Mann-Whitney foi utilizado para a comparação entre grupos, e o teste de Wilcoxon para a comparação intra grupo. Resultados: Quando comparados o GE com o GC em M0 não se observaram diferenças estatisticamente significativas (p=0.065), no número de lesões entre os grupos. O mesmo se verificou após a implementação do programa FIFA 11+ (p=1,000). Na comparação intra-grupo de M0 e M1 o grupo controlo não apresentou diferenças estatisticamente significativas (p=0,317) enquanto que no grupo experimental se observou que existiam significativamente menos lesões após a implementação do programa. (p=0,025). Conclusão: O programa FIFA 11+ parece ser indicado para a prevenção e diminuição de lesões desportivas em jogadores amadores de equipas sub-18, quando aplicado duas vezes por semana. Apesar disso, para eleger o programa como uma ferramenta de eleição na promoção da saúde, mais estudos são sugeridos utilizando uma amostra maior e se possível num período superior.

Efeitos Imediatos da Mobilização com Movimento na Rotação Medial da Gleno-umeral em Jogadores de Andebol

Introdução: No andebol, o ombro é elevado numa amplitude superior a 90º e move-se com elevada velocidade de execução o que pode originar deslocação anterior da cabeça do úmero e diminuição da rotação medial. A técnica MWM pode ser uma mais valia na correção da falha posicional e recuperação da amplitude de movimento de rotação medial da articulação gleno-umeral. Objetivo: Este estudo teve como objetivo verificar os efeitos imediatos da técnica de MWM na amplitude de movimento de rotação medial da articulação gleno-umeral em jogadores de andebol. Métodos: O presente estudo, duplamente cego, é do tipo experimental. Foram incluídos no estudo 30 indivíduos do sexo masculino, jogadores de andebol, distribuídos, aleatoriamente, em dois grupos de 15, experimental e controlo. Em ambos os grupos foi avaliada a amplitude de movimento da rotação medial da gleno-umeral, em dois momentos, pré e pós intervenção. O grupo experimental foi submetido à técnica de MWM no movimento de rotação medial da gleno-umeral no membro dominante. Ao grupo de controlo, foi solicitada a realização do movimento ativo de rotação medial no membro dominante, o fisioterapeuta manteve os mesmos contactos manuais mas não aplicou pressão na cabeça do úmero. Para a comparação entre os grupos experimental e controlo recorreu-se ao teste de Mann-Whitney e para analisar diferenças entre os dois momentos, para cada grupo, foi utilizado o teste de Wilcoxon. Resultados: Foram encontradas diferenças significativas no grupo experimental e controlo, contudo essa diferença foi superior no grupo experimental. Após a intervenção, o grupo experimental apresentou amplitudes de rotação medial da gleno-umeral significativamente mais elevadas às do grupo de controlo (U=0,50; p <0,001). Conclusão: A técnica de MWM para rotação medial produziu um aumento significativo na amplitude desse movimento.

Clinical comparison between the bleaching efficacy of 37% peroxide carbamide gel mixed with sodium perborate with established intracoronal bleaching agent

Objective. The aim was to evaluate the bleaching efficacy of sodium perborate/37% carbamide peroxide paste and traditional sodium perborate/distilled water for intracoronal bleaching. Study design. Thirty patients with dark anterior teeth were divided into 2 groups (n = 15): group A: sodium perborate/ distilled water; and group B: sodium perborate/37% carbamide peroxide paste. The bleaching treatment limited each patient to the maximum of 4 changes of the bleaching agent. Initial and final color shades were measured using the Vita Lumin shade guide. Results. Data was analyzed with Wilcoxon test for initial and final comparison according to the bleaching agent, demonstrating efficacy of the bleaching treatment with both agents. Mann-Whitney test was used for comparison of the efficacy of the bleaching agents, showing that there was no significant difference between them. Conclusion. The sodium perborate/37% carbamide peroxide association for intracoronal bleaching has proven to be as effective as sodium perborate/distilled water. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 107: e43-e47)

Efeitos do treinamento de marcha sobre superfícies inclinadas em indivíduos com hemiparesia crônica: ensaio clínico controlado randomizado

Among the therapeutic approaches that can be used to achieve this goal is the gait training on sloping surfaces, but there are few scientific findings that elucidate the results of this practice. OBJECTIVE: To evaluate the effects of training on sloping surfaces on the gait of subjects with chronic hemiparesis. MATERIALS AND METHODS: A controlled, randomized, blinded clinical trial was conducted. Concluded the study twenty-four subjects with age between 40 and 70 years (54,91±9,3). Their neurological function, functional independence, motor function and balance assessed, besides the gait evaluation through kinemetry. The subjects were allocated into two groups: control group (CG) underwent gait training on treadmill with partial body weight support (PBWS) without inclination; and the experimental group (EG) submitted to gait training on treadmill with PBWS and inclination of 10%. Twelve training sessions were performed. The paired t Student test and Wilcoxon test were used in statistical analysis to compare findings before and after training for each group, and the t student test for independent samples and Mann-Whitney.test were used to compare the to groups. RESULTS: After training within-group changes were observed on balance recovery, motor function and functionality, in both experimental conditions. The EG showed changes after training on speed, stride length, step length of paretic and non-paretic side, paretic single support, double support time and non-paretic swing time. The CG the differences were detected on double support, paretic single support and hip range of movement. The EG showed better results when compared to CG on the variables: speed (p=0,034), non-paretic single support (p=0,02) and paretic swing time (p=0,02). CONCLUSION: gait training on sloping surfaces represents a promising strategy for gait training of subjects with chronic hemiparesis since it is can influence a greater number of gait variables, when compared with gait training on flat surface

Expressão imuno-histoquímica das proteínas IFN-γ e TGF-β1 em cistos radiculares e cistos dentígeros

Odontogenic cysts are pathologic cavities covered by odontogenic epithelium and filled by liquid, desquamated cells or other materials. The intraosseous lesions, such as radicular cyst and dentigerous cyst, present a potential of expansion capable of promoting the destruction of the surrounding osseous tissue. The mechanisms related to this process of expansion are the proliferation of cystic epithelium, the increase of the osmolarity of the cystic fluid and the synthesis of reabsorption factors such as IFN-γ and TGF-β1. The aim of this study was to evaluate and compare the immunohistochemical expression of IFN-γ and TGF-β1 between radicular cysts and dentigerous cysts in order to understand the role and behavior of these proteins in the expansion of these cysts. We selected 20 cases of radicular cyst and 20 cases of dentigerous cyst chosen from the files of UFRN s Laboratory of Oral Pathology. After analyzing the clinical data, the cases underwent the routine staining technique (HE) and immunohistochemistry for the appearance of IFN-γ and TGF-β1 in the epithelium and capsule of these cysts. The statistical analysis using the Mann-Whitney test revealed no statistically significant difference in immunoexpression of IFN-γ between the epithelium (p = 0.565) and capsules (p = 0.414) of radicular cysts and dentigerous cysts. Moreover, there was no statistically significant difference of immunoexpression of TGF-β1 between the epithelium (p = 0.620) and capsules (p = 0.056) of radicular cysts and dentigerous cysts. The Wilcoxon test revealed no statistically significant difference between IFN-γ and TGF-β1 imunoexpressions in the epithelium (p = 0.225) and capsules (p = 0.370) of radicular cysts. There was no statistically significant difference between IFN-γ and TGF-β1 imunoexpressions in the epithelium (p = 0.361) of dentigerous cysts. However, there was a statistically significant difference between IFN-γ and TGF-β1 immunoexpressions in the capsule (p = 0.001) of dentigerous cysts, being TGF-β1 the factor which presented the most significant immunoexpression. Given these results, we conclude that there was no difference in immunohistochemical expression of IFN-γ and TGF-β1 between radicular and dentigerous cysts and that TGF-β1 was more significant than the IFN-γ in the capsule of dentigerous cysts

Avaliação clínica da resposta do tratamento periodontal não-cirúrgico (Full mouth desinfection) de pacientes diabéticos e não diabéticos

Tem sido demonstrado que o diabetes influencia no desenvolvimento e progressão da doença periodontal. Acredita-se ainda que há uma relação bi-direcional entre o Diabetes Mellito e a Doença Periodontal. Por isso, o tratamento periodontal pode responder de forma diferente em pacientes com e sem o quadro de diabetes. O objetivo desse estudo foi avaliar clinicamente o efeito da terapia periodontal não cirúrgica em pacientes com periodontite e diabetes mellito (grupo teste) e sem o quadro de diabetes (grupo controle). Para isso, realizou-se o tratamento periodontal não-cirúrgico FMSRP (Full mouth Scalling and Root Planing) e verificou-se os parâmetro clínicos periodontais (profundidade de sondagem, nível clínico de inserção, mobilidade, índice gengival e índice de placa) no início do estudo e após 3 meses. Na análise estatística, o paciente foi considerado como unidade de análise (p<0,05). Para as variáveis categóricas utilizou-se o teste de Fisher. Nas comparações inter-grupo, foi utilizado o Mann-Whitney Test e para comparações intra-grupo (baseline e três meses) utilizou-se o Teste de Wilcoxon. Participaram 26 pacientes no grupo controle e 14 no grupo teste. O índice de placa era 71,20% no início do estudo para o grupo teste e ficou 47,12% no fim; já no controle, os valores eram de 48,52% passando para 37,50%. E o índice gengival no grupo teste no baseline era 42,67 diminuindo para 26,81 e no grupo controle diminuiu de 41,36 para 30,62. A profundidade de sondagem foi no grupo teste 2,71mm passando para 2,40mm; já no controle, os valores foram de 2,84mm diminuindo para 2,55mm. O grupo controle ganhou 0,34 mm de inserção e o grupo teste perdeu 0,44mm de inserção. A recessão gengival aumentou 0,33mm no grupo teste e 0,04mm no grupo controle após os 3 meses. Houve diferença significativa inter-grupo para o índice de placa e gengival no baseline, também foi encontrado na recessão após 3 meses; já intra-grupo verificou-se diferença significativa para todas as variáveis, exceto para o nível clinico de inserção e mobilidade. Quando se categorizou a profundidade de sondagem em ≤3mm, >3 e≤6mm e >6mm, não foi encontrado diferença entre os grupos, mas verificou-se diferença significativa entre os períodos tanto para o grupo teste como para o controle. A hemoglobina glicada no grupo controle foi de 5,90% e no teste aumentou de 7,79% para 8,10%. Portanto, verifica-se que há uma melhora dos parâmetros clínicos periodontais em ambos os grupos, contudo não se verificou uma diferença significativa entre eles. Não obstante, o FMSRP promove um efeito benéfico em relação à condição de saúde periodontal, melhora dos parâmetros clínicos periodontais, em curto prazo (3 meses) tanto em indivíduos diabéticos como em não diabéticos, não sendo possível observar um melhor quadro glicêmico nos diabéticos

Desempenho de escolares com dislexia do desenvolvimento em tarefas fonológicas e silábicas

OBJETIVO: caracterizar o desempenho em tarefas fonológicas e silábicas de escolares com dislexia do desenvolvimento e comparar estes achados com o desempenho de discentes com bom desempenho escolar. MÉTODOS: participaram do estudo 26 alunos de oito a 12 anos de idade, de ambos os sexos, de 2ª. a 4ª. séries do Ensino Fundamental municipal na cidade de Marilia-SP, divididas em GI: composto por 13 escolares com dislexia atendidos no Centro de Estudos da Educação e Saúde - CEES/UNESP e GII: composto por 13 alunos com bom desempenho acadêmico, pareados segundo sexo, idade e escolaridade com o GI. Como procedimento foi utilizada a Prova de Consciência Fonológica - Instrumento de Avaliação Seqüencial - CONFIAS. Os resultados foram analisados estatisticamente pelo Teste Mann-Whitney (comparação entre os grupos) e Teste dos Postos Sinalizados-Wilcoxon (comparação entre as variáveis). RESULTADOS: os resultados evidenciaram diferença estatisticamente significante, sugerindo melhor desempenho do GII em relação ao GI quanto às tarefas fonêmicas e silábicas. O GI apresentou diferença estatisticamente significativa nas tarefas silábicas e fonêmicas, com melhor desempenho nas primeiras. Entre os escolares do GII não houve grande diferença estatística entre tarefas silábicas, apenas entre tarefas fonêmicas. CONCLUSÃO: o estudo concluiu que escolares com dislexia do desenvolvimento apresentam dificuldades quanto à identificação de rima e produção de palavras com o som dado, apontando para um déficit em acessar os códigos e as representações fonológicas.