O objetivo deste estudo foi analisar os ruídos das articulações temporomandibulares (ATM) e a atividade eletromiográfica (EMG) dos músculos masseteres (MM) e temporais anteriores (TA) nos momentos pré e pós correção da mordida cruzada posterior funcional (MCPF) por meio da expansão rápida da maxila (ERM) com o uso do aparelho ortopédico Haas modificado. A amostra foi composta por 20 crianças (entre 6 e 12 anos de idade, de ambos gêneros) portadoras de MCPF. A eletrovibratografia (EVG) avaliou a presença de ruídos articulares. A eletromiografia (EMG) foi analisada nas situações clínicas de máxima contração voluntária em máxima intercuspidação habitual e mastigação habitual, direita e esquerda nos momentos pré tratamento (T1) e após três meses da finalização da ERM (T2). Os resultados mostraram que: não houve diferença estatística nos ruídos articulares entre o lado afetado e não afetado pela MCPF nos momentos T1 e T2, houve uma melhora do ruído articular com diminuição no pico de amplitude da vibração do lado da MCPF na comparação dos lados não afetados pela MCPF. No teste da EMG a avaliação em repouso e no teste funcional não mostrou diferenças estatisticamente significantes entre lado afetado e não afetado pela MCPF. Houve diferença estatística nas mastigações direita e esquerda tanto para MM como para os TA na mastigação do lado da MCPF sendo que atividade EMG aumentou para estes músculos no T1 do lado não afetado. Na comparação entre o lado afetado e não afetado, os MM e os TA aumentaram sua atividade EMG no T1 na mastigação do lado da MCPF e somente o MM apresentou aumento da atividade EMG na mastigação do lado não afetado pela MCPF. Na comparação entre os lados de MCPF no T1 com T2 e na comparação entre os lados não afetados pela MCPF na avaliação da mastigação de ambos os lados o MM apresentou aumento da atividade EMG nos momentos T1 e T2, com diferenças estatísticas significantes. Em conclusão, o tratamento precoce da ERM diminui a intensidade dos ruídos articulares do lado afetado pela MCPF e gera um equilíbrio nas funções mastigatórias após tratamento ortopédico da MCPF. Estes achados indicam que o tratamento precoce da MCPF favorece a obtenção de condições morfológicas e funcionais adequadas para um melhor desenvolvimento do sistema estomatognático. / The objective of this study was to analyze the temporomandibular joint (TMJ) noise and the electromyographic (EMG) activity of the masseter (MM) and anterior temporal (TA) muscles at the moments before and after correction of functional posterior crossbite (MCPF) by rapid expansion of the maxilla (ERM) with the use of the modified Haas orthopedic device. The sample consisted of 20 children (between 6 and 12 years of age, of both genders) with MCPF. Electrovibratography (EVG) evaluated the presence of joint noises. Electromyography (EMG) was analyzed in the clinical situations of maximum voluntary contraction in maximal habitual intercuspation and habitual chewing, right and left at the pre-treatment (T1) moments and after three months of the completion of ERM (T2). The results showed that: there was no statistical difference in articular noise between the affected and unaffected side of the MCPF at moments T1 and T2, there was an improvement in articular noise with a decrease in the peak of vibration amplitude on the MCPF side in the comparison of the non- affected side of the MCPF. In the EMG test, the evaluation at rest and in the functional test did not show statistically significant differences between the affected and non-affected side of the MCPF. There was a statistically significant difference in right and left chewing for both MM and TA in chewing on the MCPF side and EMG activity increased for these muscles in T1 on the unaffected side. In the comparison between the affected and unaffected side, MM and TA increased their EMG activity in T1 in chewing on the MCPF side and only MM showed increased EMG activity in chewing on the side not affected by MCPF. In the comparison between the MCPF sides in T1 with T2 and in the comparison between the sides not affected by MCPF in the chewing evaluation of both sides, the MM showed an increase in EMG activity at moments T1 and T2, with significant statistical differences. In conclusion, early treatment of MRE reduces the intensity of articular noises on the MCPF affected side and generates a balance in masticatory functions after orthopedic treatment of MCPF. These findings indicate that the early treatment of MCPF favors the achievement of morphological and functional conditions adequate for a better development of the stomatognathic system.

Doença de Parkinson é um distúrbio neurológico, crônico e progressivo que promove alterações motoras com acometimento funcional da musculatura estriada esquelética. Este estudo avaliou a força de mordida molar, atividade eletromiográfica e espessura dos músculos temporal, masseter e esternocleidomastoideo de indivíduos com e sem a doença de Parkinson. Participaram 24 indivíduos, faixa etária entre 50 e 70 anos, distribuídos em dois grupos: com a doença de Parkinson, seguindo os estágios I e III de incapacidade da escala de Hoehn e Yahr, média ± DP 66,16 ± 3,37; n = 12 (GP) e sem a doença, média ± DP 65,83 ± 3,01; n = 12 (GC). Foi utilizado o dinamômetro digital Kratos na análise da força de mordida molar máxima direita e esquerda. O eletromiógrafo MyoSystem BR1 foi usado para captação do sinal eletromiográfico nas condições posturais da mandíbula em repouso, lateralidade direita e esquerda, protrusão, apertamento dental em contração voluntária máxima com e sem Parafilm M®. A imagem da espessura muscular foi mensurada por meio do ultrassom Sono Site Titan nas condições de repouso e apertamento dental em contração voluntária máxima. Os dados obtidos foram tabulados e submetidos à análise estatística (SPSS 21.0, teste t de student; p ≤0,05). A atividade eletromiográfica e espessura muscular revelaram diferenças significantes em quase todos os músculos durante as condições posturais mandibulares entre GP e GC (p≤0,01 e p≤0,05). Essas diferenças também foram observadas na força de mordida molar máxima direita e esquerda (p≤0,01). O GP apresentou maior atividade EMG, maior espessura dos músculos temporais, menor espessura dos músculos masseteres e esternocleidomastoideos e menor força de mordida molar máxima. O entendimento de que a doença de Parkinson está associada com a função prejudicada do sistema estomatognático é extremamente importante para os profissionais da área da saúde na tomada de decisões relacionadas ao tratamento funcional reabilitador. / Parkinson\'s disease is a neurological, chronic and progressive disorder that promotes motor alterations with functional impairment of the skeletal striated musculature. This study evaluated the molar bite strength, electromyographic activity, and thickness of the temporal, masseter and sternocleidomastoid muscles of individuals with and without Parkinson\'s disease. Twenty-four individuals, aged between 50 and 70 years old, were divided into two groups: with Parkinson\'s disease, following stages I and III of Hoehn and Yahr disability, mean ± SD 66.16 ± 3.37; n = 12 (GP) and without the disease, mean ± SD 65.83 ± 3.01; n = 12 (GC). The Kratos digital dynamometer was used to analyze the maxillary right and left molar bite force. The MyoSystem BR1 electromyograph was used to capture the electromyographic signal at postural conditions of the resting mandible, right and left laterality, protrusion, maximum voluntary contraction, with and without Parafilm M®. The image of muscular thickness was measured by means of the Sono Site Titan ultrasound in the conditions of rest and dental tightening in maximum voluntary contraction. Data were tabulated and submitted to statistical analysis (SPSS 21.0, student t-test; p≤0.05). The electromyographic activity and muscle thickness revealed significant differences in almost all muscles during mandibular postural conditions between PG and CG (p≤0.01 and p≤0.05). These differences were also observed in the right and left maximal molar bite force (p≤0.01). The PG presented higher EMG activity, a greater thickness of the temporal muscles, lower thickness of the masseter and sternocleidomastoid muscles, and a lower maxillary bite force. The understanding that Parkinson\'s disease is associated with the impaired function of the stomatognathic system is extremely important for health professionals in making decisions related to functional rehabilitative treatment.

Background: Maximal voluntary occlusal bite force (MVOBF) is the maximal force applied by the jaw muscles in dental occlusion. MVOBF is one parameter for functional capacity of the jaw system.  Aim: To evaluate MVOBF in different positions in the bite and to evaluate possible intra-individual differences between sessions.  Methods: MVOBF was measured with an electronic bite force device, with transducers sensitive to force, in 20 healthy men (mean 24.5 years). Eligibility of participants was full dental occlusion, Angle Class I relation, no diagnosis according to Diagnostic criteria for temporomandibular disorders. The test included three repeated measurements on each site: first molar right, first molar left and central incisor, in random order, with test-retest study design. Unpaired T-test was used to test the MVOBF in different positions in the bite and paired T-test for possible intra-individual differences between sessions. A post hoc test for repeated measure one-way ANOVA was added.  Results: MVOBF in different positions in the bite was lower in the incisor area compared with the molar region (P<0.0001), but similar between right and left molar side (P=0.48 and P= 0.96, respectively). No intra-individual differences between sessions (molar right P= 0.40; molar left P= 0.81; incisor area P= 0.66). The intra-individual variability for repeated measurements showed variability for incisor area (P= 0.007), but not for molar right and left region (P=0.95 and P=0.49, respectively).  Conclusion: The results may provide reference values for MVOBF in young adult men, to be compared with men with pain or dysfunction in the jaw system.

Orientador: Ana Carolina Pero Vizoto / Resumo: O período de adaptação funcional com as próteses totais novas envolve uma série de problemas transitórios, e este período está diretamente relacionado com o sucesso ou falha do tratamento. O objetivo deste estudo foi avaliar a influência da altura do rebordo mandibular no padrão de movimentos mandibulares, na máxima força de mordida oclusal, na função mastigatória, na ingestão de nutrientes e na satisfação dos pacientes em diferentes estágios após a instalação de próteses totais convencionais novas. Vinte e oito indivíduos desdentados totais (RN, n=14, rebordos mandibulares normais; RR, n=14, rebordos mandibulares reabsorvidos) receberam novas próteses totais convencionais. Um cinesiógrafo foi utilizado para registrar os movimentos mandibulares durante a abertura e fechamento e a mastigação de um alimento teste. A máxima força oclusal foi mensurada com o auxílio de um gnatodinamômetro digital, o desempenho mastigatório foi avaliado por meio do método dos tamises e a habilidade mastigatória pela aplicação de questionário específico baseado em uma escala visual analógica (EVA de 100,0 mm), a satisfação foi avaliada por meio de um questionário. A ingestão de nutrientes foi avaliada por meio de diário alimentar de três dias, e posteriormente foi traduzido em valores nutricionais por meio da utilização da Tabela Brasileira de Composição de Alimentos. Essas avaliações foram conduzidas em momentos distintos: 24 horas, 30 dias, três meses e seis meses após a instalação das próteses t... (Resumo completo, clicar acesso eletrônico abaixo) / Doutor

Live (Direct) Supervision has always been key to training therapists. However, little research has been done to determine which type of direct supervision is most effective in changing therapist behavior. This study compared bug-in-the-ear (BITE), phone-in, and computer assisted (CA) supervision. The purpose of this study was to (a) complete functional analysis of each supervision type via an alternating feedback session, to determine each therapists' most effective form of supervision; (b) determine the effect of using the most-effective form of supervision on the therapists' adherence to treatment protocols during follow-up sessions; (c) determine the effect of therapist adherence on client in-session behaviors, and outcome assessments. Results of the functional analysis indicated that phone-in supervisory feedback was the least effective form of supervision. BITE and CA supervision were both found to be effective for at least one therapist. In follow-up sessions BITE supervision did not create sustained changes in overall adherence. CA feedback appeared to maintain overall therapist adherence. In affecting changes to client behavior and outcome scores BITE supervision gave mixed results. CA supervision created desired changes in client behaviors and outcome assessments. For practitioners in the field, this study demonstrates that client behavior does not improve without therapist intervention. Even when client behavior in session appears to be improving, marital distress may increase. This is especially true when therapist adherence does not improve. This study further demonstrates that when the therapists did not intervene appropriately the clients either worsened, or at best, stayed the same. When the therapists made even small improvements client behavior improved. Improving adherence to treatment protocols will always serve the best interest of the client.

Les anomalies de croissance maxillo-faciale résultent de variations du processus normal de croissance. Après les caries, elles représentent les problèmes bucco-dentaires les plus fréquents chez les jeunes et peuvent entraîner des troubles fonctionnels (mastication, phonation, respiration), esthétiques et parfois psychologiques. Le traitement orthodontique vise à corriger les anomalies de croissance maxillo-faciale. L’objectif de cette thèse est de rechercher des facteurs de risque précoces d’anomalies de croissance maxillo-faciale et d’étudier le rôle des facteurs socio-économiques, culturels et géographiques de l’accès au traitement orthodontique en France. Les enfants de la cohorte EPIPAGE, qui avait inclus toutes les naissances survenues entre 22 et 32 semaines d’aménorrhée dans neuf régions françaises en 1997, ont été examinés à 5 ans. Nous avons étudié les relations entre les caractéristiques néonatales et la déformation du palais à 5 ans chez 1711 enfants. Le sexe masculin, le petit âge gestationnel, le petit poids pour l’âge gestationnel et peut-être l’intubation de longue durée sont identifiés comme des facteurs de risque de déformation du palais à 5 ans chez les grands prématurés ; de plus, les enfants avec des déficiences neuro-motrices semblent particulièrement à risque. La cohorte mère-enfant EDEN, a inclus des femmes enceintes en 2002-2003 et leur enfant à la naissance. Nous avons recherché les facteurs de risque précoces de l’occlusion postérieure inversée et de la béance antérieure chez 422 enfants de 3 ans. En plus d’une tétine encore utilisée à 3 ans et de la respiration buccale qui sont des facteurs connus, un nouveau facteur de risque d’occlusion postérieure inversée en denture temporaire est mis en évidence : la prématurité. Enfin, l’étude chez les 5988 enfants et les adolescents de l’enquête sur la santé et la consommation de soins en France réalisée par l’Insee en 2002-2003, enquête transversale sur échantillon représentatif de la population vivant en France, montre que 23% des 12-15 ans ont un traitement orthodontique. En plus du facteur économique, le moindre recours au traitement orthodontique est aussi lié à l’environnement social et culturel moins favorisé de l’enfant, à l’absence de couverture complémentaire et à l’habitation en zone rurale.En conclusion, pour mieux comprendre les inégalités dans le traitement orthodontique, il faudrait en évaluer les besoins en amont. Nous avons étudié des facteurs liés à la présence d’anomalies de croissance maxillo-faciale à des âges très jeunes afin de pouvoir identifier tôt des enfants à risque de ces anomalies. Il est nécessaire de vérifier leur évolution pour savoir si elles sont de réels marqueurs précoces de besoin en traitement orthodontique. / Malocclusions are due to variations of normal process of growth. Besides caries, they are the most common oral problems encountered by children and teenagers. They may lead to oral dysfunction (in chewing, speaking and breathing), esthetic and sometimes psychological issues. Orthodontic treatment aims at correcting malocclusions.The purpose of this thesis is to investigate early risk factors for malocclusions and to analyze the role of socioeconomic, cultural and geographic factors in access to orthodontic treatment in France. In the EPIPAGE cohort study, which included all live births between 22 and 32 weeks of gestation in 9 French regions in 1997, 1711 children were examined at 5 years. We explored the relations between neonatal characteristics and alteration of palatal morphology at 5 years. Male sex, low gestational age, small for gestational age and maybe intubation of long duration were identified as risk factors for alteration of palatal morphology et 5 years in very preterm children; children with neuromotor deficiencies seem particularly at risk. The mother-child EDEN cohort included pregnant women in 2002-2003 and their child at birth. We investigated early risk factors for posterior crossbite and anterior open bite in 422 3-year-old children. In addition to ongoing pacifier sucking habit at 3 years and mouth breathing, which are well-known risk factors, prematurity appears to be a new risk factor for posterior crossbite in temporary dentition. Finally, the French survey on health and care consumption, carried out in 2002-2003 in a representative sample of 5988 children and teenagers, shows that 23% of the 12-15 years old have an orthodontic treatment. Besides the economic factor, the less orthodontic treatment uptake is related to a less privileged social environment, to the absence of supplementary insurance and to living in a rural area.In conclusion, to understand inequalities in orthodontic treatment better, orthodontic treatment need should be evaluated first. We investigated factors related to malocclusions at very young ages, which could help to early identify children at risk. The assessment of how these early malocclusions would evolve is therefore needed in order to control if those malocclusions are indeed early markers for orthodontic treatment need.

No description available.

The purpose of this thesis is to examine the filmography of Korean filmmaker Bong Joon-ho [Pong Chun-ho], and to provide a limited textual analysis of each film divided across two categories: the “explicitly ecological” and “implicitly ecological”. The intent is to, by viewing all of Bong’s films leading up to his critical and commercial success Parasite, argue that Parasite is as much an environmental film as it is critical of neoliberalism and globalization, both of which are common readings of not only Parasite, but all of Bong’s work.The findings are that while Parasite avoids overt and exaggerated displays of eco-destruction visible in his Sci-fi films, the film still displays a conscious environmental awareness. The rainstorm featured in the second act of the film can be viewed not only through a local lens as an example of the dichotomy between wealthy and poor families in South Korea as it pertains to environmental crises, but as a microcosm of how climate change stands to impact the financially disenfranchised across the globe as climate shifts continue to grow. / Syftet med denna uppsats är att undersöka den koreanska regissören Bong Joon-hos filmografi och genom en begränsad analys av varje enstaka film, uppdelade i kategorierna ”explicit ekologiska” och ”implicit ekologiska” filmer. Avsikten är att genom en genomgång av alla Bongs filmer upp till publik och kritikersuccén Parasit argumentera för att Parasit är lika mycket en ekologisk film som den är en kritik av globalisering och neoliberalism, uppfattningar som förekommer ofta när det Bongs filmer diskuteras.Slutsatsen är att även om Parasit undviker lika storskaliga och överdrivna exempel av ekologisk förstörelse som i hans science-fictionfilmer så visar filmen fortfarande upp en ekologisk medvetenhet. Regnstormen som förekommer i filmens andra akt kan ses inte bara som ett exempel på skillnaden på hur rika och fattiga familjer i Sydkorea hanterar ekologiska kriser, men kan även tolkas som ett mikrokosm av hur klimatförändringar kommer påverka de finansiellt utsatta världen över allteftersom de förvärras.

No description available.

Increasing use is being made of various types of scientific evidence in court. The general requirement for the admissibility of such evidence is relevance. Although expert evidence is considered to be opinion evidence, it is admissible if it can assist the court to decide a fact in issue; provided that it is also reliable. In South Africa, the initial wide judicial discretion to either admit or exclude unconstitutionally obtained evidence, has developed into a more narrowly defined discretion under the final Constitution. Examples of scientific evidence, namely, DNA evidence, fingerprints, psychiatric evidence, bite-mark evidence and polygraph evidence are considered and problems inherent in the presentation of such evidence in courts in various jurisdictions are highlighted. An investigation of the presentation and evaluation of evidence in both the accusatorial and inquisitorial systems seems to indicate that the adversarial procedure has a marked influence on the evaluation of evidence / Criminal & Procedural Law / LL.M. (Law)