Introdução: Considerando-se a crescente tendência da utilização de próteses sobre implantes tanto em nossa população quanto em âmbito mundial, ganha importância o estudo das diversas condições envolvidas na longevidade e funcionalidade dessas peças para os indivíduos em geral. Objetivo: Determinar a ocorrência de alterações patológicas associadas a próteses totais implantadas e correlacioná-las a variáveis individuais, das peças protéticas e à participação de leveduras do gênero Candida nesses indivíduos. Metodologia: Pacientes portadores de próteses sobre implantes foram avaliados no momento da remoção das peças para controle e manutenção, após anuência com os termos do consentimento livre e esclarecido. Os participantes tiveram seus fluxos salivares totais avaliados inicialmente. Após a remoção das próteses, as peças foram avaliadas tecnicamente (próteses, implantes, parafusos e abutments), a boca examinada clinicamente, as condições da mucosa subjacente às próteses foram anotadas, e eventuais lesões associadas às próteses foram avaliadas e tratadas. Paralelamente foi realizada coleta de material para exame micológico de dois sítios - mucosa sob a prótese e base da prótese. O material foi coletado com auxílio de swabs e transferido a placas com meio de cultura diferencial (Chromagar®) para observação de crescimento e identificação de leveduras. Resultados: Foram coletados dados referentes a 91 participantes e 102 próteses sobre implantes. Trinta e quadro homens e 57 mulheres com idade média de 66,6 anos. Quatro overdentures, 72 protocolos inferiores e 26 superiores. Nenhum participante apresentou hipossalivação. Candida spp foram identificadas em 70,3% das arcadas inferiores e 85,7% das arcadas superiores. O tempo de uso das próteses interferiu na porcentagem de identificação das leveduras. Candida albicans foi a principal espécie identificada (93% dos casos positivos). Outras espécies identificadas foram: Candida glabrata, C. kruzei e C. tropicalis. Técnicas de higienização adicionais à escovação convencional reduziram a contaminação pelos fungos, enquanto hábitos de fumar ou consumir bebidas alcoólicas a aumentaram. Inflamação em mucosa relacionou-se positivamente à presença de Candida em mucosa e próteses. Oito participantes foram submetidos a intervenções cirúrgicas para remoção de processos proliferativos inflamatórios (8,8%). Foram avaliados 532 implantes, registrando-se perda de 1,13% deles e necessidade de reaperto em 271 parafusos (50,1%). Os dados foram analisados de forma descritiva e submetidos a testes estatísticos adequados ao tipo de dados obtidos. Conclusões: Os resultados obtidos nesta investigação sugerem que os cirurgiões dentistas que trabalham na área da Implantodontia devem rever seus protocolos de orientação aos pacientes e regimes de manutenção das próteses totais sobre implantes, a fim de manter a saúde dos indivíduos, prevenir lesões inflamatórias nos tecidos orais e proporcionar longevidade à reabilitação. / Introduction: Considering the increasing tendency of the use of prostheses on implants in both our population and worldwide, it is important to study the several conditions involved in the longevity and functionality of these parts for individuals in general. Aim: To determine the occurrence of pathological changes associated with full-arch implant-supported fixed prostheses and to correlate them with individual variables, prosthetic specimens and the participation of Candida yeasts in these individuals. Methodology: Patients with full-arch implant-supported fixed prostheses and overdentures were evaluated at the time of removal of the parts for control and maintenance, after consent with the terms of free and informed consent. The participants had their total salivary flows initially evaluated. After the removal of the prosthesis, the pieces were evaluated technically (prostheses, implants, screws and abutments), the mouth examined clinically, the conditions of the mucosa underlying the prostheses were noted, and any lesions associated with the prostheses were evaluated and treated. In parallel, material was collected for mycological examination of two sites - mucosa under the prosthesis and base of the prosthesis. The material was collected with the help of swabs and transferred to plates with differential culture medium (Chromagar®) for observation of growth and identification of yeasts. Results: Data were collected on 91 participants and 102 implants. Thirty-one men and 57 women with mean age of 66.6 years. Four overdentures, 72 in the lower arch and 26 in the upper arch. No participant presented hyposalivation. Candida spp. were identified in 70.3% of the lower arches and 85.7% of the upper arches. The time of use of the prostheses interfered in the percentage of identification of the yeasts. Candida albicans was the main species identified (93% of the positive cases). Other species identified were: Candida glabrata, C. kruzei and C. tropicalis. Hygiene techniques in addition to conventional brushing reduced fungal contamination, while smoking or drinking increased. Inflammation in mucosa was positively related to the presence of Candida in mucosa and prostheses. Eight participants underwent surgical interventions to remove proliferative inflammatory processes (8.8%). A total of 532 implants were evaluated, with a loss of 1,13% of them and the need to re-tighten 271 screws (50.1%). Data were analyzed descriptively and submitted to statistical tests appropriate to the type of data obtained. Conclusions: The results obtained in this research suggest that dental surgeons working in the implantology area should review their patient orientation protocols and maintenance of full-arch implant-supported fixed prostheses in order to maintain the health of individuals, prevent inflammatory lesions in tissues oral and provide longevity to rehabilitation.

Our bodies are arguably one of the most intimate things we will ever know. But the comfort of our own physical boundaries can be altered in various ways. In this analysis, we will look at how vision contributes to the sense of owning a body by analysing six abnormal conditions: the rubber hand illusion, phantom limbs, somatoparaphrenia, the body-swap illusion, out-of-body experiences, and heautoscopy. Examinations of these experimental or pathological conditions has granted a greater understanding of body-ownership. It was discovered that vision plays different modulatory roles, being more intricately involved in full-body ownership than in part-body ownership. Vision appears to be highly connected to self-location and first-person perspective, which both are contributing factors in projecting the sense of ownership to an external location. In part-body ownership, however, vision can be overruled by other senses, such as proprioception. Though it is still able to contribute to the illusion of projecting ownership and proprioceptive displacement to a rubber hand.

The ever-changing demands of working life pose considerable challenges to higher education. The literature indicates that traditional forms of university instruction positioned a deficit model of teaching and learning, which is embedded in a logical positivist paradigm, as authoritative in the production of ‘experts’ who possess legitimate knowledge. However, in professional practice, health practitioners often deal with ill-defined problems. If health practitioners are to be prepared properly for their future careers, the development of reflective thinking should be an integral component of professional education courses. The aim of this study was to explore the public narratives on existing teaching and learning practices in higher education, orthotics/prosthetics and psychology, and to examine the authority of these narratives in the unfolding stories of students and the facilitator in a pilot applied psychology course designed for orthotist/prosthetist professionals. There is a paucity of psychological research in orthotic/prosthetic practice and further research in this domain is needed, particularly from a qualitative approach. A story map was used to integrate the methodology of personal experience methods and narrative analysis into one model that represents the voice of public and private narratives in a specific temporality of past, present and future. The analysis of public and private texts revealed the narrative themes of teaching and learning, co-constructing knowledge, reflection-on-practice, disability, community of concern and agency. A critical psychology and social constructionist approach is proposed to facilitate reflective clinical practice in a psychology module for orthotics and prosthetics. In a collaborative learning community, the lived experiences, knowledge, skills, and desires that invited orthotist/prosthetists into this helping field are honoured. In addition, they are encouraged to reflect on the value of professional interventions by using pragmatic criteria of whether an approach fits or is useful for a client, rather than relying on some abstract notion of ‘truth’. / Thesis (PhD (Psychology))--University of Pretoria, 2007. / Psychology / unrestricted

Formål: Formålet med studiet er at undersøge hvordan løb med en dagligdagsprotese og en løbespecifikprotese påvirker kinetik i nedre ekstremiteter hos mennesker med en transtibial-amputation.   Metode: Kinetisk data blev indsamlet ved løbetests, med begge proteser, med et motion capture system og kraftplader i et klinisk ganganalyse lab i Göteborg, Sverige. Deltagere(n=2) udførte løbetests i selvvalgt hastighed, iført refleksive markører. Vertikal GRF, fod progressions vinkel, adducerende/abducerende hofte- og knæmoment udvalgt til videre databehandling.   Resultat: Forskelle i hofte- og knæ adduktions moment og fod progressions vinkel blev observeret mellem de to protesetyper. Momenterne var mindre, når deltagerne løb med den løbespecifikke protese. Forskelle på den amputerede side og den kontralaterale side noteredes ved alle parametre uanset protesetype. Den kontralaterale side havde forøgede værdier sammenlignet med den amputerede side.   Konklusion: Grundet forsøgets størrelse kan vi ikke konkludere, at individer med unilateral amputation i nedre ekstremitet absorberer belastning bedre, når de løber med en løbespecifikprotese fremfor en dagligdagsprotese. / Aim: The aim of this study was to investigate how running with a daily-use prosthesis and a running specific prosthesis affects kinetics in the lower extremities when it comes to people with a transtibial amputation.   Method: Kinetic data was collected through running tests, using both type of prosthesis, with a motion capture system and force plates in a clinical gait lab in Gothenburg, Sweden. Participants (n=2) executed the running tests in a self-selected speed, while wearing reflective markers. Vertical ground reaction force, foot progression angle, hip- and knee moment were selected for data processing.   Results: Differences in hip- and knee adduction moment and foot progression angle were observed between the two types of prostheses. Moments were smaller when participants ran with running-specific prosthesis. Dissimilarity for the amputated side and the contralateral side were noted for all parameters regardless of type of prosthesis. The contralateral side had increased values compared to the amputated side.     Conclusion: Because of the sample size we cannot conclude that individuals with a unilateral lower body amputation absorb load more efficiently when running with a running-specific prosthesis rather than a daily-use prosthesis.

Aim: This review aims to describe the existing evidence base for using elevated vacuum suspension and pin-lock suspension systems in regards to fluctuations of limb volume, balance, effect on gait (spatial and temporal, kinematic, and kinetic data), and in-socket movement (pistoning and transverse forces). Background: There is a growing population with a TT amputation thus there is an increased demand for TT prosthetic solutions. There are a multitude of different suspension methods with different drawbacks and benefits. This review investigates elevated vacuum suspension (EVS) and pin-lock suspension systems. Method: A systematic search was conducted in Medline, PubMed, and Scopus, and included or excluded articles per the eligibility criteria. The chosen studies will be carefully read and critically appraised for their quality of evidence. Results: 13 articles were found that matched the eligibility criteria and aim, 5 articles included pin-lock suspension systems and 9 included EVS systems. 3 looked at limb volume fluctuation, 1 at balance, 4 at in-socket movement (transverse forces and pistoning), and 8 at the quality of gait (temporal and spatial, kinematic, and kinetic). Conclusion: Several of the articles included in this review indicate that EVS results in better performance on balance tests, higher velocity, and a more stable residual limb volume than other suspension systems. Furthermore, it was shown that prosthetic users with an EVS had more normal values in their ROM during gait and less in-socket movement. / Syfte: Den här litteraturöversikten syftar till att beskriva den befintliga evidensbasen för användning av aktivt vakuum-suspension och pinnlås suspension med avseende på fluktuationer i extremitetvolym, balans, effekt på gång (spatial och temporal, kinematisk, och kinetiska data) och rörelse i hylsan (vertikala och tvärkrafter). Bakgrund: Det finns en ökande population som genomgår en transtibial amputation alltså finns en ökad efterfrågan på transtibiala-proteslösningar. Det finns en mängd olika suspensionsmetoder med olika nackdelar och fördelar. Denna recension undersöker eleverad vakuum-suspesnion och pin-lås-suspension. Metod: En systematisk sökning genomfördes i Medline, PubMed och Scopus och inkluderade eller exkluderade artiklar enligt behörighetskriterierna. De valda studierna kommer att läsas noggrant och kritiskt bedömas för deras metodologiska kvalité. Resultat: 13 artiklar hittades som matchade behörighetskriterierna och syftet. 5 artiklar undersökte pin-lås-suspension och 9 undersökte aktivt vakuum-suspension. 3 tittade på volymfluktuationer i extremiteterna, 1 på balans, 4 på rörelse i socket (vertikala och tvärkrafter) och 8 på kvaliteten på gång (temporal och rumslig, kinematisk och kinetisk). Slutsats: Denna litteraturöversikt visade att aktiv vakuum resulterar i att prestera bättre vid balanstester, har högre hastighet och en stabilare extremitet volym än andra suspensionsmetoder. Vidare fann man att protesanvändare med ett aktivt vakuum hade fler normala värden i sitt rörelseomfång under gång och har mindre vertikala krafter i hylsan.

No description available.

Sensory feedback possesses the possibility of adding a new dimension to many applications, including, but not limited to, prosthetics and surgical robots for improved control, virtual reality for incorporation of another sense, and phantom limb pain reduction for amputees. Electrotactile stimulation provides a compact, light-weight, energy efficient, highly responsive, and non-invasive option for sensory feedback; however, it has been found to commonly elicit unnatural or uncomfortable sensations for the user. To address this issue, this thesis was designed to test the impact of the different electrotactile stimulus parameters – current amplitude and polarity, pulse width, frequency, and waveform – on the user’s perceived sensation and afferent neural response. The relationship between sensation and neural response was also analysed. The aim of this thesis was to create guidelines to assist in the design and use of electrotactile stimulation. Neural data and matching psychophysical data from one healthy subject and purely psychophysical data from three others were gathered while applying electrotactile stimulations of different parameter combinations on the dorsal side of the hand or lower arm. Significant (p < 0.05) correlations and differences were found in all three relationships between electrotactile stimulus parameters, primary afferent response, and perceived sensation. Current (specifically negative) or pulse width control in monophasic waveforms were deemed most appropriate in applications that relay information through varying intensity. However, monophasic waveforms produced more discomfort, rendering biphasic waveforms more suitable when mild, local, and more natural sensations are of greater importance. Surprisingly, the data also suggested higher sensitivity to positive currents. While lower values of current amplitude and pulse width increased neural spike count, stimulus frequency could reliably control neural firing at all tested frequencies. Spike counts were moderately to strongly correlated with perceived intensity; however, practically identical neural responses could elicit different sensations. High current pulses at low frequencies induced spikes with the shortest latency – but with greater risk of discomfort. Due to limitations in sample size, generalisability is limited, and this thesis should be considered a pilot study to guide future investigations. The results suggest that recording from single and multiple afferent nerve fibres simultaneously would improve the understanding of the neural population response to electrotactile stimuli. Moreover, the one-to-one neural response to electrotactile stimuli raised the question of whether an electrotactile stimulation based on a natural spike pattern could replicate the original sensation. A future study testing this hypothesis may find a new approach to designing painless electrotactile stimulations for sensory feedback use. / Sensorisk återkoppling har möjlighet att drastiskt förbättra många användningsområden, t.ex. genom att bidra till enklare kontroll av proteser och kirurgiska robotar, mer verklighetstrogna VR-spel, och minskade fantomsmärtor hos patienter med amputeringar. Elektrisk hudstimulering erbjuder ett kompakt, lätt, energisnålt, hög-responsivt och icke-invasivt alternativ för sensorisk återkoppling – dock framkallar denna metod ofta onaturliga och obehagliga förnimmelser för användaren. Detta examensarbete bemöter detta problem genom att undersöka effekten av stimuleringsparametrar som strömstyrka, pulsbredd, frekvens och vågform på försökspersonens upplevda förnimmelse samt den afferenta nervresponsen. Även relationen mellan förnimmelse och nervrespons analyserades. Examensarbetets ändamål var att skapa riktlinjer för att förenkla designen och användandet av elektrisk hudstimulering. Nervdata med matchande psykofysiska data samlades från en frisk försöksperson, samt enbart psykofysiska data från tre andra, under olika elektriska hudstimuleringar (med varierande parametervärden) på handens dorsala sida eller på underarmen. Signifikanta (p < 0.05) korrelationer och skillnader fanns i alla tre relationer mellan parametrarna för elektrisk hudstimulering, primärafferent respons och upplevd förnimmelse. Kontroll av ström (i synnerhet negativ) eller pulsbredd i monofasisk vågform visade sig vara mest fördelaktigt i applikationer där information kommuniceras till användaren genom att variera den upplevda intensiteten. Dock skapade denna vågform mer obehag, och bifasiska vågformer bedömdes mer passande då milda, lokala, och mer naturliga förnimmelser är av högre värde. Positiv ström upplevdes, förvånande, starkare än negativ. Vid låga värden på ström och pulsbredd var dessa faktorer viktiga gällande antalet aktionspotentialer (AP), men stimuleringsfrekvensen kunde kontrollera antalet AP vid alla frekvenser. Mängden AP var måttligt till starkt korrelaterad med upplevd intensitet – samtidigt kunde praktiskt taget identiska nervresponser vara kopplade till olika förnimmelser. Lågfrekvent stimulering med hög ström hade kortast latenstid, men högre risk för obehag. P.g.a. lågt antal försökspersoner är generaliserbarheten begränsad och detta examensarbete bör beaktas som en förstudie för att guida framtida forskning. Resultaten från denna studie antyder att en tydligare bild av populationsresponsen skulle kunna skapas genom samtidig läsning av ett flertal enskilda nervfibrer samtidigt. Det faktum att varje stimulering kunde ge upphov till en AP väckte frågan: kan ett stimuleringsmönster baserat på en naturlig nervrespons återskapa den ursprungliga förnimmelsen? En studie som testar denna hypotes har möjligheten att finna ett nytt tillvägagångssätt för att skapa smärtfri elektrisk hudstimulering för sensorisk återkoppling.

No description available.

Bionic devices for reestablishing or augmenting users' capabilities (e.g., bionic prostheses or exoskeletons) are becoming increasingly common. While prior research examined how such devices affect others' perceptions of their users, little is known about how these devices affect users' self-image and -perception, and the corresponding theory is scarce. To account for this gap, we conducted semi-structured interviews with users of bionic upper limb prostheses to obtain insights into their self- and meta-perceptions. Results of our qualitative analysis indicate that using bionic prostheses influences the social (self-) perception of bionics users in multiple ways, such that users describe themselves as being seen as more competent by others and treated differently after receiving the bionic prosthesis in comparison to simpler models. Results imply a somewhat complex dual identity among users in the sense that the bionic device instills competence, but disability-related feelings of stigma are present simultaneously. Despite being exploratory, our findings thus indicate that using bionic devices affects users' self-perception, stereotypes, and interpersonal perceptions. The ongoing proliferation of restoring devices and the introduction of augmenting technologies in future work contexts, for example, might thus have unintended social consequences that need to be accounted for.

The heterogeneous field of posthuman theory allows for an account of community under the convergence of late capitalism and high technology and its spread to a global scale. Spanning bioconservative fears of a potential loss of agency and a human ‘essence’ through advances in technology, ‘transhumanist’ hopes for a biological transformation that would fulfil liberal goals for human development, as well as postmodern, feminist interpretations of the posthuman as instantiating a liberating break with liberal ideology and patriarchal structures, theories of the posthuman offer a productive starting point for exploring the transformations in understandings of human subjectivity and community at the turn of the twenty-first century. Placing the concept of community against a background of past totalitarianism and a possible future of an uncontested globalised neoliberal regime that high technology risks intensifying, the present study enquires into the possibility of a community that would escape the metaphysical logic of mastery subtending both past and present models of community and suggests that problematizing representations of the creation of what a strand in contemporary philosophy terms a non-totalising ‘communauté désoeuvrée’ and implicit proposals not for the revival of community as a teleological ‘oeuvre’, but for its rewriting may be found in works by Maurice G. Dantec, Michel Houellebec, and Antoine Volodine, works which have been labelled posthuman themselves by virtue of their incorporation of posthuman themes or structures that come in the shape of representations and problematisations of high technology and its intersection with late capitalism and narrative structures that mimic or subvert conceptions of subjectivity that can loosely be termed posthuman. These novelists write in a context of an ideological, technological, and commercial constraint that hampers literary and political agency and which is problematized both implicitly and explicitly in the use these writers make of representations of violence and literary strategies such as irony, ambiguity, and hermeticism. These representations and strategies, it will be suggested, could be read as subtle attempts to bypass those constraints and restore the potential of literary production to comment on and even intervene in the creation of community in a posthuman age.