RESUMEN
The decline in neuromusculoskeletal capabilities of older adults can affect motor control, independence, and locomotion. Because the elderly population is increasing worldwide, assisting independent mobility and improving rehabilitation therapies has become a priority. The combination of rehabilitation robotic devices and virtual reality (VR) tools can be used in gait training to improve clinical outcomes, motivation, and treatment adherence. Nevertheless, VR tools may be associated with cybersickness and changes in gait kinematics. This paper analyzes the gait parameters of fourteen elderly participants across three experimental tasks: free walking (FW), smart walker-assisted gait (AW), and smart walker-assisted gait combined with VR assistance (VRAW). The kinematic parameters of both lower limbs were captured by a 3D wearable motion capture system. This research aims at assessing the kinematic adaptations when using a smart walker and how the integration between this robotic device and the VR tool can influence such adaptations. Additionally, cybersickness symptoms were investigated using a questionnaire for virtual rehabilitation systems after the VRAW task. The experimental data indicate significant differences between FW and both AW and VRAW. Specifically, there was an overall reduction in sagittal motion of 16%, 25%, and 38% in the hip, knee, and ankle, respectively, for both AW and VRAW compared to FW. However, no significant differences between the AW and VRAW kinematic parameters and no adverse symptoms related to VR were identified. These results indicate that VR technology can be used in walker-assisted gait rehabilitation without compromising kinematic performance and presenting potential benefits related to motivation and treatment adherence.
Asunto(s)
Marcha , Realidad Virtual , Humanos , Fenómenos Biomecánicos/fisiología , Marcha/fisiología , Masculino , Femenino , Anciano , Dispositivo Exoesqueleto , Locomoción/fisiología , Caminata/fisiología , Andadores , Robótica/métodosRESUMEN
To characterize maxillofacial, otorhinolaryngological and oral manifestations of Hansen's disease (HD), we conducted a cross-sectional study in 21 current patients attending the Unidade Básica de Saúde de Jardim América, Espírito Santo, Brazil and 16 former patients resident at Pedro Fontes Hospital using data from computed tomography imaging, rhinoscopy, and oroscopy. Maxillofacial characteristics were compared with 37 controls. Differences in bone alterations across the three groups were determined mainly by severe resorption/atrophy being more frequent in former HD patients, with severe resorption/atrophy of the anterior alveolar process of maxilla in 50.0% (8/16) of former patients, 28.6% (6/21) of current patients and 10.8% (4/37) of controls and of nasal bones and aperture in 31.3% (5/16) of former patients compared with 0/21 current patients and two controls. There were no substantial differences in otorhinolaryngological and oroscopic findings between the two patient groups. HD patients had more tooth loss than the age-matched control group. Maxillofacial, otorhinolaryngological and oroscopic finding scores were strongly correlated only in current HD patients. Correlation between otorhinolaryngological and maxillofacial scores suggests that protocols for HD patient assessment and follow-up could include otorhinolaryngological evaluation, with radiological imaging where necessary, subject to replication of our findings in a larger study.
Asunto(s)
Lepra , Atrofia , Brasil , Estudios Transversales , Humanos , Lepra/diagnóstico por imagenRESUMEN
Este artigo tem o objetivo de avaliar o processo de aprimoramento e acompanhamento das variáveis envolvidas na consolidação do Progama Mais Médicos para o Brasil (PMMB) na Bahia, bem como a gestão da informação associada aos avanços tecnológicos. A pesquisa é de natureza qualitativa e do tipo estudo de caso. Os dados pertinentes ao monitoramento e planejamento estratégico do PMMB, no estado da Bahia, foram coletados mensalmente, a partir das bases de dados do Ministério da Saúde, Ministério da Educação e municípios, para serem agrupados em uma planilha eletrônica do Microsoft Excel, por meio do recurso Power Business Intelligence (Power BI), programa que está em constante modificação, permitindo visualizar a qualquer momento as variáveis desejadas. Assim, a distribuição de médicos atuantes no PMMB, no território baiano, corrobora os estudos que apontam o crescimento do provimento de médicos, sobretudo nas regiões mais isoladas, pobres e vulneráveis. A construção dos painéis, realizada pela captação e sistematização de diferentes fontes de dados relativos à gestão do PMMB na Bahia, permitiu avaliar: a distribuição dos médicos atuantes no PMMB na Bahia, as regiões de maior concentração de médicos, a porcentagem dos municípios contemplados pelo programa, a distribuição da rede de apoio no estado da Bahia, a distribuição dos cursos de medicina no estado e as regiões que realizam teleconsultorias. Por meio desta pesquisa, foi possível concluir que o número de médicos destinados à atenção de saúde nas populações mais carentes e isoladas vem aumentando gradativamente, embora ainda seja insufuciente. Além disso, pode-se concluir que a gestão da informação associada aos avanços tecnológicos podem servir como instrumento de monitoramento e avaliação na área da saúde.
Este estudio tiene como objetivo evaluar el proceso de mejora y seguimiento de las variables involucradas en la consolidación del Programa Más Médicos (PMM) en Bahía (Brasil), así como la gestión de la información asociada a los avances tecnológicos. La investigación es de carácter cualitativo, de tipo estudio de caso. Los datos relevantes para el seguimiento y la planificación estratégica del PMM en el estado de Bahía fueron recopilados mensualmente de las bases de datos del Ministerio de Salud, del Ministerio de Educación y municipios, para ser agrupados en una hoja de cálculo de Microsoft Excel, a través del recurso Power BI que se modifica constantemente, lo que permite ver las variables en cualquier momento. Así, la distribución de los médicos que actúan en el PMM en el amplio territorio de Bahía corrobora estudios que apuntan al crecimiento de la oferta de médicos, especialmente en las regiones más aisladas, pobres y vulnerables. La construcción de los paneles, realizada a partir de la captura y sistematización de diferentes fuentes de datos, relacionados con la gestión del PMM de Bahía, permitió evaluar: la distribución de los médicos que actúan en el PMM de Bahía, las regiones con mayor concentración de médicos, el porcentaje de municipios cubiertos por el programa, la distribución de la red de apoyo en el estado de Bahía, la distribución de los cursos de medicina en el estado, y las regiones que realizan teleconsultas. Esta investigación permite concluir que el número de médicos dedicados a la atención de la salud en las poblaciones más necesitadas y aisladas ha ido aumentando paulatinamente, aunque aún es insuficiente. Además, se concluye que el manejo de la información asociada a los avances tecnológicos puede servir como una herramienta de seguimiento y evaluación en salud.
This qualitative case study evaluates the improvement and monitoring processes concerning the variables involved in the consolidation of the More Doctors Program (PMM) in Bahia, Brazil, as well as the management of information associated with technological advances. Data relevant for monitoring and strategic planning the PMM in the state were collected monthly from the Ministry of Health, Ministry of Education and municipalities databases, and then grouped in a Microsoft Excel spreadsheet using power BI, an everchanging software that allow us to view the desired variables at any time. The results on the distribution of PMM doctors in the broad territory of Bahia corroborate studies that point to an increased supply of physicians, especially in more isolated, poorer and vulnerable regions. The panels developed by capturing and systematizing different data sources regarding PMM management in Bahia allowed to evaluate: the distribution of PMM doctors in the state, the regions with the highest concentration, the percentage of municipalities covered by the program, the distribution of the support network within the state, the distribution of medical undergraduate programs in the state; the regions that offer teleconsultations. In conclusion, the number of physicians offering health care to the poorest and most isolated populations has been increasing gradually, but remains insufficient. Moreover, the management of information associated with technological advances can serve as a monitoring and evaluation instrument in health care.
Asunto(s)
Planificación Estratégica , Desarrollo Tecnológico , Monitoreo del Ambiente , Atención a la Salud , Consorcios de SaludRESUMEN
O objetivo deste trabalho é relatar a experiência do Projeto de extensão universitária, "Cuida!", desenvolvido pelo Núcleo de Estudos sobre Drogas do Ceará e parceiros. O "Cuida!" envolve ações de cuidado em saúde direcionadas a trabalhadoras sexuais, com foco na Redução de Danos e na integralidade da atenção em saúde. Dentre as ações desenvolvidas estão:1) Testagem rápida de HIV/IST; 2) Consultas com profissionais da saúde; 3) Orientações sobre o acesso a políticas públicas; 4) Rodas de conversas e oficinas com diferentes temáticas. O "Cuida!" teve como resultado a ampliação do vínculo e do diálogo das mulheres com as equipes dos equipamentos, além do fortalecimento das estratégias de Redução de danos que passaram a ser referência de cuidado no território. Apostando em conhecer a vida que re-existe, toda proposta de cuidado foi assentada em um projeto ético-político, potencializando assim os processos de experimentação e resistência produzido pelas e com as mulheres. (AU)
The objective ofthis work is to report the experience of the University Extension Project, "Cuida!", Developed by the Center for Drug Studies in Ceará and partners. "Cuida!" it involves health care actions directed at sex workers, with a focus on Harm Reduction and comprehensive health care. Among the actions developed are: 1) Rapid HIV /STI testing; 2) Consultations with health professionals; 3) Guidelines on access to public policies; 4) Conversation circles and workshops with different themes. "Cuida!" the result was the expansion of the bond and dialogue of women with the equipment teams, in addition to strengthening the harm reduction strategies that have become a reference for care in the territory. Betting on knowing the life that re-exists, every care proposal was based on an ethical-political project, thus enhancing the processes of experimentation and resistance produced by and with women. (AU)
El objetivo de este trabajoes dar a conocer la experiencia del Proyecto de Extensión Universitaria "¡Cuida!", Desarrollado por el Centro de Estudios sobre Drogas de Ceará y socios. "¡Cuídate!" se trata de acciones de atención de la salud dirigidas a las trabajadoras sexuales, con un enfoque en la Reducción de Daños y la atención integral de la salud. Entre las acciones desarrolladas se encuentran: 1) Prueba rápida de SIDA/IST; 2) Consultas con profesionales de la salud; 3) Lineamientos sobre acceso a políticas públicas; 4) Círculos de conversación y talleres con diferentes temáticas. "¡Cuídate!" el resultado fue la ampliación del vínculo y el diálogo de las mujeres con los equipos de equipos, además de fortalecer las estrategias de reducción de daños que se han convertido en un referente de atención en el territorio. Apostando por conocer la vida que reexiste, toda propuesta de cuidado se basó en un proyecto ético-político, potenciando así los procesos de experimentación y resistencia producidos por y con las mujeres. (AU)
Asunto(s)
Trabajo Sexual/psicología , Salud de la Mujer , Integralidad en Salud , Accesibilidad a los Servicios de Salud , Brasil , Política de SaludRESUMEN
Background More than four million people today live with Hansen's disease, and 200,000 new cases are diagnosed every year. Lifetime effects of Hansen's disease manifest as changes to bones of the face, hands and feet, resulting in physical impairment, secondary complications and facial changes that can be detrimental to quality of life, particularly among the elderly. Aims This study aimed to perform a detailed characterization of rhinomaxillary syndrome and its clinical manifestations in older persons treated in the past for Hansen's disease. Methods This was a cross-sectional study to characterize rhinomaxillary syndrome among older persons (age 60+ years) resident at Pedro Fontes Hospital, Cariacica, Espírito Santo, Brazil. Computed tomography images were examined with three-dimensional reconstructions to assess alterations to maxillofacial bones according to criteria for radiological rhinomaxillary syndrome. Participants were examined to assess facial alterations according to criteria for clinical rhinomaxillary syndrome. Results Rhinomaxillary syndrome was investigated in 16 participants (ten females and six males), median age 70 (range 60-89) years, age at diagnosis 20 (6-43) years and time since diagnosis 46 (26-70) years. Four participants fully met radiological rhinomaxillary syndrome criteria, four partially. All participants with full radiological rhinomaxillary syndrome presented with facial changes which met criteria for clinical rhinomaxillary syndrome, including "saddle nose" (loss of nasal dorsal height and shortened length of nose, due to cartilaginous and/or bone collapse), concave middle third of the face with sunken nose, maxillary retrognathia and inverted upper lip. Limitations Clinical histories were incomplete for some participants because records were lost at the hospital over time. Conclusion Until Hansen's disease is eliminated from endemic countries, persons affected will continue to present with rhinomaxillofacial alterations caused by Mycobacterium leprae infection. Clinical protocols for assessment and long-term care need to include otorhinolaryngological evaluation, mainly to prevent secondary complications. When rhinomaxillofacial bone changes are suspected, this evaluation should be supported by computed tomography imaging, if available.
Asunto(s)
Lepra , Calidad de Vida , Anciano , Anciano de 80 o más Años , Estudios Transversales , Cara , Femenino , Humanos , Lepra/diagnóstico , Lepra/diagnóstico por imagen , Masculino , Persona de Mediana Edad , SíndromeRESUMEN
OBJECTIVE: This study examines the changes in anxiety and depression scores of 84 patients subjected to aortic or iliac aneurysm correction with no previous psychiatric history. METHODS: Patients were referred to the evaluation using the Beck Anxiety and Depression Inventories no more than 3 days before surgery (i.e., preoperative [Pre-Op]), 30 days after revascularization (i.e., Early postoperative [PO]), and at least 6 months after revascularization (i.e., Late PO). RESULTS: Mean anxiety scores declined from baseline at both the Early (mean difference: 2.75, p<0.001) and Late PO (mean difference: 2.74, p=0.001). The depression levels showed no significant variation in either evaluation (Early PO; mean difference: -0.84, p>0.05, Late PO: 0.87, p=0.05). A more severe degree of anxiety at baseline was related to better anxiety results both in the Early PO (p=0.041) and Late PO (p=0.008). An endovascular technique was related to the improvement in depression symptoms in the Early PO (p=0.01) but the worsening of the symptoms in the Late PO (p=0.033). CONCLUSIONS: Patients subjected to aortoiliac aneurysm corrections have a higher incidence of anxiety and depressive symptoms. Anxiety symptoms, but not the depressive ones, improved considerably following the successful treatment. The formal psychiatric evaluation may be beneficial for patients with less improvement in the symptom.
Asunto(s)
Aneurisma de la Aorta Abdominal , Implantación de Prótesis Vascular , Procedimientos Endovasculares , Aneurisma Ilíaco , Ansiedad/etiología , Aneurisma de la Aorta Abdominal/cirugía , Depresión/etiología , Humanos , Aneurisma Ilíaco/cirugía , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
OBJECTIVES: This study aims to examine the changes in anxiety and depression scores in 138 patients with critical limb ischemia (rest pain or gangrene) who had no previous psychiatric history, at 30 days and 6 months after surgical revascularization. METHODS: Patients were submitted to a questionnaire-based evaluation using the Beck Anxiety and Depression Inventories before surgery (no more than three days before surgery) ("Pre-Op"), 30 days after surgical revascularization ("Early PO") and at least 6 months after surgical revascularization ("Late PO"). The cut-off scores for depression were (1) < 10, no depression or minimal depression; (2) 10â18, mild to moderate depression; (3) 19â29, moderate to severe depression; and (4) 30â63, severe depression. The cut-off scores for anxiety were (1) < 8, no anxiety or minimal anxiety; (2) 8â15, mild anxiety; (3) 16â25, moderate anxiety; and (4) 26â63, severe anxiety. RESULTS: No perioperative mortality was observed 30 days after surgical revascularization. Thirty-nine (28.2%) patients underwent major (above-ankle) amputation within 30 days. Mean anxiety and depression scores, respectively, declined from 12.48 ± 9.74 (mean ± SD) and 16.92 ± 12.48 preoperatively to 4.89 ± 7.04 and 6.52 ± 9.36 postoperatively (P<0.001, both). Anxiety and depression scores were not significantly affected by preoperative comorbidities (systemic arterial hypertension, diabetes mellitus, previous stroke, and smoking), affected arterial territory (aortoiliac, femoropopliteal, or infrapopliteal), or surgical technique (open surgery vs endovascular therapy). Only patients undergoing amputation within 30 days showed no improvement in depressive symptoms. CONCLUSIONS: Patients with critical limb ischemia have a high incidence of anxiety and depressive symptoms, which improve considerably after successful surgical revascularization. Major amputation was associated with a lack of improvement in depression scores. A formal psychiatric evaluation may be beneficial in patients who show no improvement in depressive symptoms.
Asunto(s)
Ansiedad/epidemiología , Depresión/epidemiología , Isquemia/cirugía , Enfermedad Arterial Periférica/cirugía , Procedimientos Quirúrgicos Vasculares/efectos adversos , Adulto , Anciano , Anciano de 80 o más Años , Amputación Quirúrgica , Ansiedad/diagnóstico , Ansiedad/psicología , Brasil/epidemiología , Enfermedad Crítica , Depresión/diagnóstico , Depresión/psicología , Femenino , Humanos , Incidencia , Isquemia/diagnóstico , Isquemia/epidemiología , Masculino , Salud Mental , Persona de Mediana Edad , Enfermedad Arterial Periférica/diagnóstico , Enfermedad Arterial Periférica/epidemiología , Estudios Prospectivos , Medición de Riesgo , Factores de Riesgo , Índice de Severidad de la Enfermedad , Factores de Tiempo , Resultado del Tratamiento , Procedimientos Quirúrgicos Vasculares/psicologíaRESUMEN
OBJECTIVE: To investigate the correlations among the extent of bone involvement, splenic volume, and quality of life in patients with Gaucher disease. MATERIALS AND METHODS: This was a descriptive, prospective cross-sectional study of 18 patients with Gaucher disease who underwent 3-T magnetic resonance imaging of both femurs and the lumbar spine. Semiquantitative analyses were performed on the basis of the bone marrow burden (BMB) score. We looked for linear relationships among the variables splenic volume, quality of life score, and BMB score. RESULTS: We identified a linear relationship between the BMB scores and splenic volume. The quality of life score showed no statistically significant relationship with splenic volume or the BMB score. CONCLUSION: The linear relationship between the BMB score and the splenic volume indicates that the extent of bone disease is greater in individuals with splenomegaly. No correlation was found between the BMB and quality of life scores, illustrating the insidious and silent progression of Gaucher disease.
OBJETIVO: Investigar a correlação entre a extensão do envolvimento ósseo, o volume esplênico e a qualidade de vida em pacientes com doença de Gaucher. MATERIAIS E MÉTODOS: Estudo descritivo, prospectivo e transversal de 18 pacientes com doença de Gaucher submetidos a ressonância magnética de 3-T de ambos os fêmures e da coluna lombar. Análise semiquantitativa foi feita utilizando o escore bone marrow burden (BMB). Correlação linear foi estudada para as variáveis volume esplênico, qualidade de vida e escore BMB. RESULTADOS: Uma correlação linear entre os escores BMB e volume esplênico foi demonstrada. Em relação ao índice de qualidade de vida, não foi observada correlação estatisticamente significante nem com o volume esplênico e nem com o escore BMB. CONCLUSÃO: Nosso estudo demonstrou uma correlação linear entre o escore BMB e o volume esplênico, correspondendo a maior extensão de doença óssea em indivíduos com maior esplenomegalia. Nenhuma correlação foi encontrada entre o escore BMB e a qualidade de vida, indicando a natureza insidiosa e a progressão silenciosa da doença de Gaucher.
RESUMEN
Rocky retreats are limited and geologically constrained resources for rock-dwelling nocturnal lizards. Such lizards should seek retreats that offer thermoregulatory benefits without the risk of overheating during the day, and that protect from predation. For cold-adapted species where air temperature is frequently lower than optimum temperature for performance, factors influencing retreat-site selection and whether future warmer conditions will force superficial rock slabs to be abandoned on hot days remain poorly known. Here, we predicted that retreats selected by a nocturnally foraging, cool-temperate gecko from southern New Zealand would be thermally heterogeneous and that future warmer temperature will force lizards to abandon daytime retreats on hot days. We sampled loose rock slabs (potential retreats) in a tussock-grassland site in all seasons. We measured seasonal rock temperature profiles and field body temperature (Tb) of captured geckos using thermography and quantified the physical characteristics of each potential retreat. We found that both physical characteristics and rock temperatures determine choice of retreats. Field Tb of lizards positively correlated with retreat and air temperatures. Also, retreat temperatures, including those of the substrate below the rock slabs, showed complex heterogeneity enabling lizards to choose microsites within retreats to achieve preferred body temperatures intermittently. Observed seasonal shifts in characteristics of occupied rocks imply that lizards choose retreats to maximise warmth in spring, minimise risk of overheating (remain below voluntary thermal maximum, VTmax) in summer and avoid freezing over winter. Our study demonstrates the importance of microclimatic conditions in influencing retreat-site selection. Climate warming might lead to seasonal changes in use of rock slabs and possibly be beneficial initially, but longer-term implications need to be examined.
Asunto(s)
Regulación de la Temperatura Corporal , Cambio Climático , Lagartos/fisiología , Microclima , Temperatura , Animales , Femenino , Masculino , Nueva ZelandaRESUMEN
Abstract Objective: To investigate the correlations among the extent of bone involvement, splenic volume, and quality of life in patients with Gaucher disease. Materials and Methods: This was a descriptive, prospective cross-sectional study of 18 patients with Gaucher disease who underwent 3-T magnetic resonance imaging of both femurs and the lumbar spine. Semiquantitative analyses were performed on the basis of the bone marrow burden (BMB) score. We looked for linear relationships among the variables splenic volume, quality of life score, and BMB score. Results: We identified a linear relationship between the BMB scores and splenic volume. The quality of life score showed no statistically significant relationship with splenic volume or the BMB score. Conclusion: The linear relationship between the BMB score and the splenic volume indicates that the extent of bone disease is greater in individuals with splenomegaly. No correlation was found between the BMB and quality of life scores, illustrating the insidious and silent progression of Gaucher disease.
Resumo Objetivo: Investigar a correlação entre a extensão do envolvimento ósseo, o volume esplênico e a qualidade de vida em pacientes com doença de Gaucher. Materiais e Métodos: Estudo descritivo, prospectivo e transversal de 18 pacientes com doença de Gaucher submetidos a ressonância magnética de 3-T de ambos os fêmures e da coluna lombar. Análise semiquantitativa foi feita utilizando o escore bone marrow burden (BMB). Correlação linear foi estudada para as variáveis volume esplênico, qualidade de vida e escore BMB. Resultados: Uma correlação linear entre os escores BMB e volume esplênico foi demonstrada. Em relação ao índice de qualidade de vida, não foi observada correlação estatisticamente significante nem com o volume esplênico e nem com o escore BMB. Conclusão: Nosso estudo demonstrou uma correlação linear entre o escore BMB e o volume esplênico, correspondendo a maior extensão de doença óssea em indivíduos com maior esplenomegalia. Nenhuma correlação foi encontrada entre o escore BMB e a qualidade de vida, indicando a natureza insidiosa e a progressão silenciosa da doença de Gaucher.
RESUMEN
Resumo Trata-se de texto ensaístico que, tendo como fundamento o conceito de desamparo, critica tratamentos asilares e conclui enfatizando a importância de não nos deixarmos capturar por propostas encarceradoras. As reflexões envolvem dois tipos de argumentações: (a) argumentos de conjuntura ampla relacionados a volta do movimento asilar associado ao uso compulsivo de drogas e de políticas de abstinência; (b) argumentos relacionados a conjuntura micropolítica que nos afeta por advirem de nossa luta antimanicomial e da ética antiproibicionista. Tais conjunturas se congregam, nos impulsionando para que não recuemos diante dos quadros de violência extrema que se apresentam onde atuamos e sejamos politicamente criativos. O Acompanhamento Terapêutico pode ser essa vigorosa arte-clínica, alinhada à extinção de tratamentos asilares, se entende que nosso desamparo primordial nos funda em laços com humanos e não humanos e, em oposição aos manicomicidas (assassinos do desejo), não tratando como doentes aqueles que destoam em suas formas de viver.
Resumen Se trata de un ensayo que, a partir del concepto de desamparo, critica los tratamientos de asilo y concluye enfatizando la importancia de no dejarnos atrapar por propuestas de encarcelamiento. Las reflexiones involucran dos tipos de argumentos: (a) argumentos de amplio alcance relacionados con el retorno del movimiento asilar asociado al uso compulsivo de drogas y de políticas de abstinencia; (b) argumentos relacionados con la situación micropolítica que nos afecta ya que surgen de nuestra lucha anti-manicomio y ética antiprohibicionista. Esas situaciones se juntan, urgiéndonos a no retroceder ante la violencia extrema que se presenta en todos los lugares donde operamos y a ser políticamente creativos. El Acompañamiento Terapéutico puede ser este vigoroso arte-clínico, alineado con la extinción de los tratamientos de asilo, se entiende que nuestro desamparo primordial nos funda en lazos con humanos y no humanos y, en oposición a los manicomicidas (asesinos del deseo), no tratan como enfermos a aquellos que desatan en sus formas de vivir.
Abstract This essay is based on the concept of helplessness, it criticizes asylum treatments, and concludes by emphasizing the importance of not allowing ourselves to be captured by incarceration proposals. The reflections involve two types of arguments: (a) wide-ranging arguments related to the return of the asylum movement associated with compulsive use of drugs and abstinence policies; (b) arguments related to the micropolitical situation that affects us as they arise from our anti-asylum struggle and anti-prohibitionist ethics. Such situations come together, urging us not to retreat from the extreme violence that presents itself wherever we operate and to be politically creative. Therapeutic Accompaniment can be this vigorous clinical art, aligned with the extinction of asylum treatments, if we understand that our primordial helplessness is based on ties with human and non-human ties and, in opposition to manicomicides (murderers of desire), we do not treat as sick those who differ from the majority because of their ways of living.
Asunto(s)
Terapéutica , Internamiento Obligatorio del Enfermo Mental , Centros de Tratamiento de Abuso de Sustancias , Desamparo AdquiridoRESUMEN
Este trabalho apresenta parte dos resultados de uma pesquisa cujo objetivo foi mapear alguns dos efeitos de estratégias higienístico-urbanísticas da política de guerra às drogas na cidade de Cuiabá, Mato Grosso. Para tanto, utiliza-se das crônicas como narrativa de pesquisa para evidenciar como as políticas de guerra às drogas produzem práticas de mortificação social, num processo de seletividade penal. Em análise, argumentamos que o uso de drogas nos leva a uma problemática central que diz respeito ao modo como coabitamos nas cidades. Cidades fragmentadas, separadas por guetos e por marcadores sociais, muradas material e simbolicamente. As ruas se tornam um território em disputa desigual, onde urge uma ética, em vez de práticas de moralização e mortificação.
This paper presents part of the results of a research whose objective was to map some of the effects of hygienic-urban strategies of the War on Drugs policy in the city of Cuiabá, Mato Grosso. For that, chronicles are used as a research narrative to show how drug war policies produce practices of social mortification, in a process of criminal selectivity. In analysis, we argue that the use of drugs leads us to a central problem that concerns the way we cohabit in the cities. Fragmented cities, separated by ghettos and social markers, materially and symbolically walled. The streets become a territory in unequal dispute, where an ethics is urged, instead of practices of moralization and mortification.
Este trabajo presenta parte de los resultados de una investigación, cuyo objetivo fue mapear algunos de los efectos de estrategias higienistas-urbanísticas de la política de Guerra a las Drogas en la ciudad de Cuiabá, Mato Groso. Para ello, utiliza crónicas como narrativas de investigación para evidenciar como las políticas de guerra a las drogas producen prácticas de mortificación social en un proceso de selectividad penal. En el análisis, argumentamos que el uso de drogas nos lleva a una problemática central que se refiere al modo como cohabitamos en las ciudades. Ciudades fragmentadas, separadas por guetos y por marcadores sociales, muradas material y simbólicamente. Las calles se hacen un territorio en disputa desigual, donde urge una ética, al envés de prácticas de moralización y mortificación.
Asunto(s)
Preparaciones Farmacéuticas , Drogas Ilícitas , Política Pública , Planificación Social , Trastornos Relacionados con Sustancias , OcupacionesRESUMEN
PURPOSE: To evaluate the 3-dimensional (3D) zero echo time (ZTE) magnetic resonance imaging (MRI) technique and compare it with 3D computed tomography (CT) for the assessment of the glenoid bone. METHODS: ZTE MRI using multiple resolutions and multislice CT were performed in 6 shoulder specimens before and after creation of glenoid defects and in 10 glenohumeral instability patients. Two musculoskeletal radiologists independently generated 3D volume-rendered images of the glenoid en face. Post-processing times and glenoid widths were measured. Inter-modality and inter-rater agreement was assessed. RESULTS: Intraclass correlation coefficients (ICCs) for inter-modality assessment showed almost perfect agreement for both readers, ranging from 0.949 to 0.991 for the ex vivo study and from 0.955 to 0.987 for the in vivo patients. Excellent interobserver agreement was found for both the ex vivo (ICCs ≥ 0.98) and in vivo (ICCs ≥ 0.92) studies. For the ex vivo study, Bland-Altman analyses for CT versus MRI showed a mean difference of 0.6 to 1 mm at 1.0-mm3 MRI resolution, 0.3 to 0.6 mm at 0.8-mm3 MRI resolution, and 0.3 to 0.6 mm at 0.6-mm3 MRI resolution for both readers. For the in vivo study, Bland-Altman analyses for CT versus MRI showed a mean difference of 0.6 to 0.8 mm at 1.0-mm3 MRI resolution, 0.5 to 0.6 mm at 0.8-mm3 MRI resolution, and 0.4 to 0.8 mm at 0.7-mm3 MRI resolution for both readers. Mean post-processing times to generate 3D images of the glenoid ranged from 32 to 46 seconds for CT and from 33 to 64 seconds for ZTE MRI. CONCLUSIONS: Three-dimensional ZTE MRI can potentially be considered as a technique to determine glenoid width and can be readily incorporated into the clinical workflow. LEVEL OF EVIDENCE: Level II, development of diagnostic criteria (consecutive patients with consistently applied reference standard and blinding).
Asunto(s)
Imagenología Tridimensional/métodos , Imagen por Resonancia Magnética/métodos , Tomografía Computarizada Multidetector/métodos , Escápula/diagnóstico por imagen , Articulación del Hombro/diagnóstico por imagen , Adulto , Huesos/patología , Cadáver , Femenino , Humanos , Masculino , Persona de Mediana Edad , Variaciones Dependientes del Observador , Articulación del Hombro/patología , Adulto JovenRESUMEN
Robotic assistive devices are able to enhance physical stability and balance. Smart walkers, in particular, are also capable of offering cognitive support for individuals whom conventional walkers are unsuitable. However, visually impaired individuals often need additional sensorial assistance from those devices. This work proposes a smart walker with an admittance controller for guiding visually impaired individuals along a desired path. The controller uses as inputs the physical interaction between the user and the walker to provide haptic feedback hinting the path to be followed. Such controller is validated in a set of experiments with healthy individuals. At first, users were blindfolded during navigation to assess the capacity of the smart walker in providing guidance without visual input. Then, the blindfold is removed and the focus is on evaluating the human-robot interaction when the user had visual information during navigation. The results indicate that the admittance controller design and the design of the guidance path were factors impacting on the level of comfort reported by users. In addition, when the user was blindfolded, the linear velocity assumed lower values than when did not wear it, from a mean value of 0.19 m/s to 0.21 m/s.
Asunto(s)
Dispositivos de Autoayuda , Retroalimentación , Humanos , Locomoción , Andadores , CaminataRESUMEN
We describe a case of nasal myiasis in an 89-year-old Brazilian patient affected by leprosy with severe nasal sequelae. An initial treatment comprising sinusectomy combined with nasal endoscopy removed more than 300 larvae, supplemented by systemic treatment using oral and topical ivermectin and levofloxacin. Infestation recurred after 2 months, was treated similarly, and resolved completely. The case could be attributed to severe nasal leprosy sequelae, with a lack of sneezing reflex, painless ulceration, atrophic rhinitis (ozena), and inability to clean the nose properly due to hand and nose impairment. This case illustrates the importance of long-term medical follow-up of patients with leprosy sequelae.
Asunto(s)
Lepra/complicaciones , Miasis/diagnóstico , Miasis/patología , Rinitis Atrófica/complicaciones , Administración Tópica , Anciano de 80 o más Años , Combinación Amoxicilina-Clavulanato de Potasio/uso terapéutico , Antibacterianos/uso terapéutico , Humanos , Insecticidas/administración & dosificación , Insecticidas/uso terapéutico , Ivermectina/administración & dosificación , Ivermectina/uso terapéutico , Masculino , Miasis/cirugíaRESUMEN
O Guia de Gestão Autônoma de Medicação (GAM), originalmente canadense e com versão brasileira publicada em 2012, se configura como um dispositivo que visa a contribuir para que sujeitos em tratamento de saúde se responsabilizem pelo seu próprio cuidado singularizado. Este texto narra pesquisa desenvolvida na cidade de Fortaleza (CE) com a GAM. Buscou-se potencializar esse instrumento para ações de saúde, por meio da composição experimental do Guia GAM, nomeado de GAM@. Uma peculiaridade de nossa experimentação é utilizar a GAM no cuidado de pessoas que fazem uso abusivo e/ou compulsivo de substâncias (drogas), em um CAPS-ad. A pesquisa tem quatro etapas e, neste texto, relatamos as duas primeiras: os estudos preliminares e a composição experimental GAM@. Indicamos como o material foi estruturado, quais os pressupostos teóricos orientaram essa produção e seus conteúdos principais.
The Autonomous Medication Management Guide (GAM) originally Canadian and with Brazilian version published in 2012, is configured as a device that aims to contribute to subjects in health treatment to be responsible for their own unique care. This text narrates research developed in the city of Fortaleza (CE) with GAM. We sought to enhance this instrument for health actions through the experimental composition of the GAM Guide, named GAM@. A peculiarity of our experimentation is to use GAM in the care of people who use substance abuse (or drugs) in a CAPS-ad. The research has four stages and in this text we report on the first two: preliminary studies and the experimental composition GAM@. We indicate how the material was structured, which theoretical assumptions guided this production and its main contents.
La Guía de Administración de Medicamentos Autónomos (GAM), originalmente canadiense y con versión brasileña publicada en 2012, está configurada como un dispositivo que tiene como objetivo contribuir a los sujetos en el tratamiento de salud para que sean responsables de su propio cuidado único. Este texto narra la investigación desarrollada en la ciudad de Fortaleza (CE) con GAM. Buscamos potenciar este instrumento para acciones de salud a través de la composición experimental de la Guía GAM, llamada GAM@. Una peculiaridad de nuestra experimentación es usar GAM en el cuidado de personas que usan abuso de sustancias (o drogas) en un anuncio de CAPS. La investigación tiene cuatro etapas y en este texto informamos sobre las dos primeras: estudios preliminares y la composición experimental GAM@. Indicamos cómo se estructuró el material, qué supuestos teóricos guiaron esta producción y sus principales contenidos.
Asunto(s)
Humanos , Autocuidado , Trastornos Relacionados con Sustancias/terapia , Autonomía Personal , Investigación Cualitativa , Servicios de Salud Mental , Brasil , Trastornos Mentales/tratamiento farmacológicoRESUMEN
O objetivo principal deste trabalho é construir reflexões sobre hormônios, a partir de aproximações teóricas e metodológicas com as produções de autores/as alinhados/as à Teoria Ator-Rede (TAR). Apresentaremos, inicialmente, de forma breve, os pressupostos da Teoria Ator-Rede e como seus questionamentos sobre os binarismos subjetivo X objetivo, humano X não-humano podem contribuir para as pesquisas em Psicologia. Em sequência analisaremos os usos da TAR em uma pesquisa sobre a atuação de hormônios em uma rede heterogênea, e como estes não-humanos se tornaram elementos centrais na sutentação do binarismo de sexo (homem/mulher). Concluímos que a articulação de conceitos e postulados da TAR possibilitam a produção de estudos na Psicologia que ampliem o seu foco e passem a envolver outros atuantes que não sejam humanos.
The main objective of this paper is to produce reflections on hormones, from theoretical and methodological approximations with the productions of authors aligned to the Theory-Actor Network (TAR). We will initially present briefly the assumptions of the Actor-Network Theory and how its questions about subjective binary X objective, human non-human X can contribute to research in Psychology. In a sequel, we will look at the uses of ART in research on the role of hormones in a heterogeneous network, and how these nonhumans became central elements in the sutentation of male / female binarism. We conclude that the articulation of concepts and postulates of ART make it possible to produce studies in Psychology that broaden their focus and involve other actors that are not human.
El objetivo principal de este articulo es presentar refelxion es sobre hormonios desde aproximaciones teóricas y metodológicas con las producciones de autores / as alineados a la Teoría Actor-Red (TAR). En el caso de la Teoría Actor-Red y como sus cuestionamientos sobre los binarismos subjetivo X objetivo, humano X no humano pueden contribuir a las investigaciones en Psicología. En secuencia analizaremos los usos de la TAR en una investigación sobre la actuación de hormonas en una red heterogénea, y cómo estos no humanos se convirtieron en elementos centrales en la sutentación del binarismo de sexo (hombre / mujer). Concluimos que la articulación de conceptos y postulados de la TAR posibilita la producción de estudios en la Psicología que amplíen su enfoque y pasen a involucrar a otros actores que no sean humanos.
Asunto(s)
Psicología/métodos , Investigación , HormonasRESUMEN
This work presents a multimodal cognitive interaction strategy aiming at walker-assisted rehabilitation therapies, with special focus on post-stroke patients. Such interaction strategy is based on monitoring user's gait and face orientation to command the displacement of the smart walker. Users are able to actively command the steering of the walker by changing their face orientation, while their lower limbs movement affect the walker's linear velocity. The proposed system is validated using a smart walker and the results obtained point to the feasibility of employing such cognitive interaction in rehabilitation therapies.
Asunto(s)
Cognición/fisiología , Rehabilitación de Accidente Cerebrovascular , Caminata/fisiología , Femenino , Humanos , MasculinoRESUMEN
Este artigo tem o objetivo de apresentar o Programa de Pós-Graduação em Psicologia da Universidade Federal do Ceará (PPGP-UFC), abordando suas especificidades, seus aspectos históricos, suas linhas de pesquisa e as temáticas nelas trabalhadas. Além disso, são destacados os projetos e as ações de intercâmbios nacionais e internacionais, os impactos sociais e sua relevância socioacadêmica, bem como os desafios que se apresentam na atualidade. O programa procura articular a prática de pesquisa com os desdobramentos advindos da extensão universitária, já que prioriza em sua política de produção de conhecimento a tematização de fenômenos sociais que se apresentam especialmente no contexto nordestino. Ressalta-se, ainda, como tal especificidade tem contribuído tanto para a consolidação de laboratórios vinculados às linhas de pesquisa do programa, quanto para a sua inserção social, com vistas a contribuir para o desenvolvimento local e regional. Por fim, são indicados os principais desafios enfrentados pelo programa no contexto atual.
This article aims to present the Post Graduate Program in Psychology of the Federal University of Ceará (PPGP-UFC), addressing its specificities, its historical aspects, its lines of research and the themes worked on them. In addition, projects and actions for national and international exchanges, social impacts and their socio-academic relevance, as well as current challenges are highlighted. The Program seeks to articulate the practice of research with developments arising from university extension, as it prioritizes in its policy of knowledge production the thematization of social phenomena, especially in the context of the Brazilian Northeast. It is noteworthy also how such specificity has contributed both to the consolidation of laboratories linked to the research lines of the PPGP-UFC, as well as to their social inclusion in order to contribute to local and regional development. Finally, the main challenges faced by the Program in the current context are indicated.
Este artículo pretende presentar el Programa de Posgrado en Psicología de la Universidad Federal de Ceará (PPGP-UFC), con sus especificidades, abordando sus aspectos históricos, su estructura en términos de líneas de investigación y temas, proyectos y acciones de intercambios nacionales e internacionales, impactos sociales y su relevancia socio-académica, así como los desafíos que se presentan. El programa busca articular la práctica de la investigación con los desarrollos derivados de la extensión universitaria, ya que prioriza en su política de producción de conocimiento la tematización de los fenómenos sociales que se presentan, especialmente en el contexto de la Región Nordeste de Brasil. El texto señala, todavia, que esta especificidad constitutiva del Programa ha contribuido tanto a la consolidación de los laboratorios vinculados a las líneas de investigación del PPGP-UFC, como a su inserción social volcada al desarrollo local y regional. Finalmente, se indican los principales desafíos identificados en el contexto actual.