O ultra-som de baixa intensidade tem demonstrado ser um recurso acelerador do processo de consolidação óssea em fraturas. Este estudo experimental investigou a influência da estimulação ultra-sônica de baixa intensidade no processo de reparo ósseo em fraturas de tíbias tratadas por meio de fixação flexível. O estudo foi desenvolvido no laboratório de Bioengenharia da FMRP da Universidade de São Paulo Campus de Ribeirão Preto, utilizando 20 coelhos machos adolescentes da raça Nova Zelândia, que foram submetidos a uma osteotomia no terço médio da tíbia e tratados com fixador externo unilateral. Após o procedimento cirúrgico os animais foram divididos em três grupos: controle com n = 7 (membro contralateral, não fixado), grupo controle lesão com n = 7 (fixados e mantidos em gaiolas) e grupo ultra-som com n = 7, que recebeu estimulação com equipamento de ultra-som de baixa intensidade (30mW/'CM POT.2') e ciclo de trabalho de 1/5. No final de 20 dias de tratamento suas tíbias foram retiradas e submetidas a ensaio mecânico de torção. Na avaliação das propriedades mecânicas torque máximo e rigidez, não foi observada diferença significativa (p '< OU =' 0,05) entre os grupos estimulados e controle lesão. Estes resultados sugerem que a estimulação ultra-sônica de baixa intensidade aplicada ao reparo de fraturas na presença de fixação flexível não influencia a velocidade e o padrão de consolidação da fratura / The low-intensity ultrasound has demonstrated to be an accelerator device on the process of recovering of bone fractures. This experimental study investigated the influence of the low-intensity ultrasound stimulation on the process of bone repairing of fractures of tibia treated with flexible fixator. The study was developed at the FMRP Bioengineering laboratory, of the University of Sao Paulo, campus of Ribeirao Preto, using 20 teenager male rabbits from the New Zealand breed which were subjected to an osteomy in the median third of the tibia and treated with an unilateral external fixator. After the surgical procedure the animals were divided into three groups: control with n = 7 (paw contralateral, not fixed), group control injury with n = 7 (fixed and kept in cages) and group ultrasound with n = 7, that received stimulation with low-intensity ultrasound equipment (30mW/'CM POT.2') and duty cycle 1/5. At the end of 20 days of treatment, their tibia were removed and subjected to a mechanical twist test. At the evaluation of the mechanical properties: maximum torque and hardness, it was not observed significant differences (p '< OU =' 0,05) among the stimulated groups and the control injury. These outcomes suggest that the low-intensity ultrasound applied for fractures healing in the presence of flexible fixation does not have influence on the velocity nor the standard of the fracture recovering

Diante de pesquisas realizadas com o 5Ultra-som pulsado de baixa intensidade na regeneração de pele de ratos submetidos a queimaduras provocadas por calor (ALVES, 1988) e em pacientes portadores de úlceras tróficas de perna (HILÁRIO, 1993) se propôs estudar os efeitos do ultra-Som pulsado de baixa intensidade em pacientes com Mal de Hansen (MH) cujas manifestações cutâneas eram caracterizadas como o Mal Perfurante Plantar (MPP) e úlceras do tegumento, sendo que o emprego do ultra-som pulsado e de baixa intensidade mostrou-se eficaz na reparação das referidas lesões. O presente trabalho foi realizado em pacientes assistidos pelo Sistema Único de Saúde (SUS) na cidade de Bebedouro-SP lotados no setor de Vigilância Epidemiológica. A casuística constitui-se de seis pacientes apresentando MPP nos quais aplicou-se o ultra-som pulsado (U.S.P.) em uma freqüência de três vezes por semana no mesmo período circadiano. Os tratamentos tiveram duração variando entre vinte e quarenta minutos consoante a extensão das lesões cutânea. Independente do tempo das lesões não foi estabelecido previamente o número de aplicações a serem executadas, mas as aplicações foram realizadas até a obtenção da cicatrização total das lesões. A evolução das lesões até a cicatrização foi feita mediante o emprego de um software especialmente desenvolvido para tal finalidade e documentados fotograficamente. Não houve correlação entre o número de aplicações com o tamanho da lesão ou com o tempo decorrido do aparecimento das mesmas, embora a extensão e a forma das diferentes ulcerações não sejam equivalentes, quer no tempo de evolução, quer na profundidade das lesões, os resultados dos tratamentos com U.S.P. e de baixa intensidade mostraram-se segundo a metodologia de avaliação ser altamente satisfatório para o tratamento de lesões cutâneas decorrente da Hanseníase / Based on researches carried out with the low intensity pulsed ultrasound on the regeneration of burned rat skin previously exposed to heat and on legs trophic ulcers we proposed to study the effects of the low intensity pulsed ultrasound on Hansen’s disease patients whose cutaneous manifestations were characterized as the MPP. The study was carried out on six patients supported by the Public Health Care System (SUS/PHCS) in the city of Bebedouro- SP, crowded on the Epidemiological Observation ward. The low intensity pulsed ultrasonic radiation administrations were carried out three times a week on the same circadian. Irradiation time varied from twenty to forty minutes according to the extension of the lesion. The number of the administrations, which were carried out until the complete lesion cicatrisation in all patients, was not previously stipulated. Evaluation of cicatrisation was carried out making use of software and photographs taken at the beginning of the treatment and after every ten administrations of the pulsed ultrasound until the complete ulcers cicatrisation. It was not observed any correlation between number of ultrasound applications and area of the lesion or age of them. Although extension and shape were not equivalent, according to these results, pulsed low intensity ultrasound can be considered as an adjunctive treatment for cutaneous manifestations of Hansen’s disease

The purpose of this essay was to explore how library staff work with the creation of a teen space. We have taken into consideration teen’s spatial needs and how the library staff have worked to satisfy these needs, as well as how the space can be designed to minimize conflicts that can occur between different library attendees. The method that’s been used was semi-structured interviews with library staff from four different libraries who’ve worked with creating or renovating a teen space. The results show that young library patrons use the examined teen spaces both as a retreat- and interaction space. Results show that teens are in need of a free zone where they can be themselves, express their opinions, be creative and explore. To satisfy this need the library staff have worked with the room’s placement and spatial barriers, furniture and equipment. Despite this the analyzed teen spaces cannot be fully considered free zones because they are not completely free from adult supervision. At the libraries where conflict arose between teens and other visitors, the teen space was set apart and screened off from the rest of the library spaces. These actions demonstrate that spatial solutions are not enough to solve conflicts, but rather the staff at these libraries would have to work with their own attitude towards teens as well as with the library visitors´. Results imply that it is not impossible to create a free zone for teens and at the same time design a space that encourages low-intensity meetings. Two of the examined libraries have in fact managed to create a low-intensity meeting place on a smaller scale. Results also indicate that good human and social conditions are just as important as the teen space to make the library into a functioning meeting place. The study demonstrates that teens' participation is an important requirement in the procedures if a library is going to be successful with their renovation. Teens contribute in fact with meaningful information of how their own room should be designed.

京都大学 / 新制・課程博士 / 博士(人間健康科学) / 甲第23426号 / 人健博第93号 / 新制||人健||6(附属図書館) / 京都大学大学院医学研究科人間健康科学系専攻 / (主査)教授 山田 重人, 教授 林 悠, 教授 森本 尚樹 / 学位規則第4条第1項該当 / Doctor of Human Health Sciences / Kyoto University / DFAM

LGBTQ+-youth under the age of 18 is a vulnerable group with few accessible meeting-places. We wanted to examine the library’s role in facilitating a meeting-place for this group, through qualitative interviews with various library personnel. The in-terviews were analyzed using Braun &amp; Clarkes (2006) process for thematic analysis. Audunson’s definition of the library as a low-intensity meeting place was used as basis for our understanding of the function of the public library. The result indicated that the library personnel focused more on creating safe spaces for LGBTQ+ youth, rather than a meeting place specifically. We identified four themes used to create these spaces: knowledge about the group and their needs, activities aimed at the group, an ability to establish social connections with the individual people and a clearly visible position in favor of LGBTQ+-rights.

Thesis (MA)--Stellenbosch University, 2003. / ENGLISH ABSTRACT: This research assignment deals with the breakdown in the Clausewitzian concept of the modern trinitarian structure of war. Martin Van Creveld in his book entitled, “The Transformation of War” written in 1991, discusses ‘Future War’ and the way in which wars will be fought. It will not be the highly technical interstate kind of war the West has been preparing for, but rather low intensity conflict where the lines between state, soldier and civilian become blurred, society becomes a war zone and the conflict becomes a more direct experience for the people. Colombia is a prime example of where this is occurring and the most salient manifestation of the low intensity conflict is the blurring of the lines between war and crime. There are left wing guerrillas fighting for social justice for the dispossessed population, but their tactics resemble crime and the government views them as terrorists. They run a self-sufficient organisation, one of the most profitable insurgent groups in the world largely funded through kidnap ransom payments. The right-wing paramilitaries are on a quest to cleanse Colombian society of the guerrillas and assassinate suspected guerrilla sympathisers. To complicate issues, both insurgent groups are involved in the drug trafficking trade, whether it be directly or by way of taxing land on which coca is grown. In this situation, war and crime have become inextricably linked and a distinction between the two is impossible on both practical and conceptual levels. However, if it is not crime and it is not war, but a complicated melange of the two, a new framework for analysis is required in order to attempt a solution. / AFRIKAANSE OPSOMMING: Hierdie navorsingsprojek gaan oor die ineenstorting van die Clausewitziaanse begrip van die moderne Trinitariese oorlogstruktuur. In sy boek, getiteld "The Transformation of War" wat in 1991 geskryf is, bespreek Martin van Creveld die 'toekomstige oorlog' en die wyse waarop oorloë gevoer staan te word. Dit sal nie die hoogs tegniese interstaatlike soort oorlog wees waarvoor die Weste hom voorberei nie, maar eerder 'n lae intensiteitskonflik waar die lyne tussen die staat, soldaat en burgerlike ineenvloei; die gemeenskap word 'n oorlogsone en die konflik word 'n direkte ervaring vir die bevolking. Kolombië is 'n goeie voorbeeld van waar dit besig is om plaas te vind en die mees kenmerkende manifestasie van die lae intenstiteitskonflik is die vervloeiing van die skeidslyne tussen oorlog en misdaad. Daar is linksgesinde guerrillas wat om sosiale geregtigheid veg namens die onteiende bevolking, maar hul taktiek kom voor soos misdaad; en die regering beskou hulle inderdaad as misdadigers. Hulle beheer 'n selfversorgende organisasie, een van die winsgewendste versetsgroepe in die wêreld wat tot 'n groot mate gefinansier word by wyse van ontvoering van mense, met die eis van lospryse vir vrybetaling. Die regsgesinde paramilitêre groepe is op 'n sending om die Kolombiaanse gemeenskap te suiwer van die guerrillas en bring vermeende guerrilla simpatiseerders om die lewe. Om sake te kompliseer, is albei opstandsgroepe betrokke in die dwelmsmokkelhandel, hetsy direk, of indirek by wyse van belasting op die grond waarop coca gekweek word. In hierdie situasie het oorlog en misdaad onteenseglik verweefd met mekaar geraak en is dit nie moontlik om enige onderskeid tussen hulle te tref op hetsy die praktiese of die konseptuele vlakke nie. Indien dit dan nie oorlog is nie en ook nie misdaad nie, maar wel 'n ingewikkelde verweefdheid van die twee, dan word 'n nuwe analitiese raamwerk vereis om te poog om 'n oplossing te vind.

Abstrakt Bakgrund: Många människor tränar för välmående och hälsa, medan andra vill öka sin fysiska prestation och då är förbättring av konditionen en viktig del. Syfte: Syftet med denna studie var att undersöka individers skillnader i upplevd ansträngning efter att de följt ett högintensivt program (HIIT) jämfört med en grupp som följt ett lågintensivt träningsprogram. Design: Pilotstudie Material &amp; Metod: Undersökningen gjordes utifrån en kvantitativ ansats där populationen som bestod av två grupper, totalt 10 testpersoner fick utföra fysisk ansträngning under fyra veckor. Den ena gruppen fick utföra högintensiva träningspass (n=5) och den andra gruppen lågintensiva träningspass (n=5). Innan de utförde fyraveckorsprogrammet fick testpersonerna uppskatta sin upplevda ansträngning vid ett konditionstest. Samma test genomfördes sedan efter de fyra veckorna. Resultat: Två av fem deltagare som utförde det lågintensiva programmet skattade lägre på Borgs RPE-skala efter de fyra veckorna. Utav de som utförde det högintensiva programmet (HIIT) var det tre av fem som skattade lägre. Konklusion: För att kunna generalisera resultaten behöver denna studie genomföras på en större population då det i denna pilotstudie pga antalet deltagare sannolikt är slumpen som avgjort utfallet. / Abstract Background: A lot of people exercise for the sake of health and wellbeing while others want to improve their physical performance. Improving their cardio fitness is an important part of that. Objective: The objective of this study is to examine differences in perceived exertion after having followed a high intensity programme (HIIT) in comparison with a group that followed a low intensity training programme. Design: Pilot study Methods &amp; measures: The study was done with a quantitative approach where two groups of subjects, a total of 10 performed physical effort during four weeks. One group of 5 performed high intensity workouts and the other group of 5 low intensity workouts. Prior to performing the four week programme the subjects estimated their perceived exertion after a fitness test. The same test was then repeated after four weeks. Results: Two out of five subjects that followed the low intensity programme estimated lower on Borgs RPE scale after the four weeks. Out of those who followed the high intensity programme (HIIT), three out of five estimated lower. Conclusion: To be able to generalize the results from this study it needs to be performed on a larger population. The results of this pilot study due to the amount of participants are likely due to chance.

Queimaduras severas causam trauma às vítimas, pela perda de líquido corpóreo, injúria no sistema vascular cutâneo e demora na cicatrização das lesões. A irradiação com laser em baixa intensidade vem sendo estudada como tratamento alternativo, por ser uma terapia não-invasiva e capaz de acelerar o processo de cicatrização. O objetivo deste estudo foi avaliar os efeitos do laser de baixa potência (&lambda; = 660 nm) em queimaduras de pele por histomorfometria e fluxometria laser Doppler utilizando duas condições de irradiação. Trinta e seis animais com duas queimaduras criadas por vapor foram divididos em três grupos: no grupo dose fracionada (GF), as lesões foram irradiadas com dose de 1 J/cm2 nos dias 1, 3, 8 e 10; no grupo dose única (GU), as lesões foram irradiadas com dose de 4 J/cm2 no dia 1. O grupo controle (GC) não foi irradiado. O fluxo sanguíneo foi monitorado nos dias 3, 8, 10, 15 e 21 e três animais por grupo foram sacrificados nestes momentos. Os grupos irradiados mostraram um pico de vasos neoformados no dia 15, enquanto que o pico do GC foi no dia 21. O número de vasos no GC foi significantemente maior que GF e GU no dia 21. Com relação ao fluxo sangüíneo, os grupos irradiados mostraram um valor mais alto que o controle no dia 8, porém, sem diferenças significantes entre os grupos. Estes achados sugerem que o laser acelera a cicatrização de queimaduras, porém, sem diferenças significativas entre as doses estudadas. / Severe burn injuries cause extensive damage and are notoriously complicated by loss of body fluids, injury in the cutaneous vasculature and delayed wound healing. Low intensity laser therapy (LILT) has been studied as an alternative method since it is a non invasive treatment and is able to accelerate wound healing. The purpose of the present study was to evaluate the effects of LILT (&lambda; = 660 nm) in burned skin with two different doses by histomorphometry and laser Doppler flowmetry. Thirdy six male adult Wistar rats with two burns created on the back using water vapor were divided into 3 groups. In the fractioned dose laser group (GF), the lesions were irradiated with 1 J/cm2 on days 1, 3, 8 and 10; in the single dose laser group (GU), the lesions were irradiated with 4 J/cm2 on day 1. On control group (GC) lesions were not irradiated. The blood flow was measured on days 1, 3, 8, 10, 15 and 21 and three animals per group were sacrificed in these moments. Irradiated groups showed a peak of new blood vessels formation on day 15 while for GC the peak was on day 21. At this moment, the number of vessels in GC was significantly higher than GF and GS. Regarding to blood flux, irradiated groups displayed a higher value than GC on day 8, though no significant differences were observed. These findings suggest that LILT may accelerate skin repair, however, no significant differences were observed between the studied doses.

A terapia foto-dinâmica consiste na irradiação luminosa de um determinado tecido ou microorganismo previamente exposto à ação de um corante foto-sensibilizador. Ela é eficazmente utilizada em neoplasias e em processos infecciosos. No entanto, poucos estudos avaliam o efeito desta terapia em reparação tecidual. Estes trabalhos mostram resultados que variam entre satisfatórios e não-satisfatórios. Além disso, os estudos que envolvem a terapia com laser em baixa intensidade e a terapia foto-dinâmica em reparação tecidual preocupam-se, na maioria das vezes, com a organização e quantificação dos componentes da matriz extra-celular. Estudar o epitélio, em contrapartida, por meio das proteínas expressas pelos queratinócitos é igualmente importante, sabendo-se que a reparação da ferida depende também da organização e proliferação das células epiteliais. Este trabalho avaliou a reparação tecidual de excisões realizadas em dorso de ratos submetidas à irradiação com laser em baixa intensidade ou terapia foto-dinâmica mediada pelo corante azul de metileno. Para tal, realizou-se a análise morfológica e histomorfológica das feridas em determinados tempos experimentais, além da análise imunoistoquímica das citoqueratinas 10 e 14 e p63. Os resultados mostraram que a reparação tecidual foi favorecida com a irradiação laser em baixa intensidade, o que foi confirmado através das análises morfológica e histo-morfológica que mostraram fechamento prévio da ferida para este grupo experimental. Além disso, a expressão de citoqueratina 10 na língua epitelial formada nas feridas pertencentes ao grupo Laser precedeu a expressão da mesma nos outros grupos, o que indicou uma maturação acelerada do epitélio para este grupo. O grupo da terapia foto-dinâmica não apresentou aceleração da reparação tecidual bem como não a prejudicou. Isto sugere que a reparação tecidual frente à irradiação laser é diferente daquela encontrada com a terapia foto-dinâmica. Além disso, não houve atraso da reparação tecidual com a terapia foto-dinâmica, sugerindo que esta terapia foi segura e que devem ser consideradas suas vantagens em situações de infecção. / The photodynamic therapy involves delivering visible light of the appropriate wavelength into a tissue or microorganism previously exposed to a photo-sensitive dye. Its use is widely spread between neoplastic and infeccious diseases. Nevertheless, its effects upon wound healing has not yet been completely verified and the few studies concerning this subject present whether good or bad results. In addition, studies that involve low intensity laser therapy or photodynamic therapy on wound healing concern mostly on the organization and quantification of the extracellular matrix components. Studying the epithelium, on the other hand, by the keratinocyte expressed proteins is equally important, once the wound healing depends also of the organization and proliferation of the epithelial cells. This study evaluated the wound healing of excisions performed on the back of rats submitted to low intensity laser therapy or photodynamic therapy mediated by methylene blue dye. Morphological and histo-morphological analysis of the wounds in pre-determined periods were performed, as well as immunohistochemistry of citokeratins 10 and 14 and p63. The results showed that the wound healing was enhanced by the low intensity laser therapy, which was confirmed by the morphological and histomorphological analysis. The wound closure was previously seen for the laser group. The citokeratin 10 expression on the epithelial tongue of the wounds that belong to the laser group preceded the expression in the other groups, which indicated an accelerated maturation of this epithelium. The photodynamic therapy group did not present accelerated wound healing but did not present any delay as well. This suggests that the wound healing found for the laser group differs from that found for the photodynamic therapy group. Moreover, the lack of delay presented by the photodynamic therapy suggests a safe therapy with advantages regarding disinfection that should be considered in specific situations.

O laser de baixa intensidade tem sido utilizado atualmente como terapia alternativa para alívio da dor em disfunções musculares e articulares por induzirem um efeito analgésico, antiinflamatório e biomodulador das funções fisiológicas celulares. O objetivo desse estudo foi avaliar o efeito do laser de GaAlAs (780nm) na dor à palpação dos músculos masseter e temporal anterior e articulação temporomandibular (ATM), amplitude dos movimentos mandibulares e atividade eletromiográfica dos músculos masseter e temporal anterior em pacientes com disfunção temporomandibular (DTM). As aplicações foram feitas no músculo temporal e masseter e na ATM 2 vezes/semana (durante 4 semanas). 48 pacientes com dor miofascial e artralgia distribuídos aleatoriamente entre tratamento real e placebo e entre doses energéticas de 25 J/cm² e 60 J/cm² foram avaliados utilizando-se uma Escala Analógica Visual (VAS) e um paquímetro digital antes, imediatamente após a última aplicação e 30 dias após o tratamento com laser. A eletromiografia de superfície foi realizada em máximo apertamento voluntário em rolos de algodão e máximo apertamento voluntário em posição intercuspidal antes e após a laserterapia. Os resultados mostraram que não houve diferença estatística significante na atividade eletromiográfica na comparação entre os grupos antes e após o tratamento com laser. Em relação à dor na palpação, houve diferença significante antes e após o tratamento em todos os grupos. A diminuição dos níveis de dor muscular foi mais acentuada nas pontas ativas, entretanto, não houve diferença estatística significante entre o grupo real e placebo. A dor articular mostrou melhora significante apenas na palpação do pólo lateral da ATM direita nos grupos ativos. A amplitude dos movimentos mostrou melhora no grupo ativo, principalmente, na dose de 60 J/cm². Em conclusão, o laser de baixa intensidade não promoveu mudanças na atividade eletromiográfica. Embora tenha sido encontrada uma superioridade da terapia laser em relação aos grupos placebos, não houve diferença estatística significante entre todos os grupos. / Low intensity laser have been used currently as an alternative pain-relief therapy for muscle and joint pain since it induces analgesic, anti-inflammatory and biomodulation effects of the physiological cell functions. The purpose of this study was to evaluate the effect of GaAlAs laser (780nm) on pain to palpation of the masseter and anterior temporalis muscles and the temporomandibular joint (TMJ), amplitude of the mandibular movements and electromyographic activity of the masseter and anterior temporalis muscles in patients with temporomandibular disorders (TMD). The laser was applied on the temporalis, masseter muscles and TMJ twice a week (during four weeks). Forty-eight patients with miofascial pain and arthralgia were randomly assigned between real and placebo treatment and between the energetic doses of 25 J/cm² and 60 J/cm², and were evaluated using Visual Analogue Scale (VAS) and digital paquimeter before, immediately after the final application, and 30 days after the laser treatment. Surface electromyography was performed with maximum voluntary clench on cotton rolls and maximum voluntary clench in intercuspal before and after laser therapy. The results show there were no significant statistical differences in the electromyographic activity between the groups before and after laser treatment. As to the pain at palpation, there was a significant difference before and after treatment in every group. There were sharper reductions in muscle pain level for the active probes; however, there was no significant statistical difference between the real and placebo groups. Joint pain showed significant improvement only in the palpation of the lateral pole of right TMJ in the active groups. The amplitude of the movements showed improvement in the active group, mainly, in the dose of 60 J/cm². As conclusion, low intensity laser did not promote any changes in the electromyographic activity. Although this study has found a superiority of laser therapy over placebo, there were no statistically significant differences between all groups.