Orientador: Jose Ricardo Albergaria Barbosa / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-04T03:21:31Z (GMT). No. of bitstreams: 1 Luna_AnibalHenriqueBarbosa_M.pdf: 8812225 bytes, checksum: 08ad7a117ec4977c4d2b22e6093a6a82 (MD5) Previous issue date: 2005 / Resumo: Reabilitações na região posterior da maxila são geralmente confrontadas com atrofia óssea, associada à pneumatização do seio maxilar, impedindo a instalação de implantes de comprimento adequado. A cirurgia de elevação do seio maxilar foi introduzida na literatura em 1980, por Boyne & James, para permitir a instalação de implantes osseointegráveis nesta região, apresentando desde então algumas modificações que resultam em diferentes índices de sucesso e de complicações. Este estudo retrospectivo envolveu uma análise de 72 pacientes tratados em um período de 06 anos pela Área de Cirurgia Buco-Maxilo-Facial da Faculdade de Odontologia de Piracicaba - Unicamp. A amostra foi representada por um total de 91 seios maxilares, que receberam elevação associada a diferentes materiais de preenchimento para instalação de 101 implantes. Um total de 70 implantes (69,3%) foi instalado em um segundo procedimento cirúrgico, com um tempo médio decorrido desde a elevação de 9,88± 4,27 meses. Em 13 pacientes (18,5%) a reabilitação implanto-suportada foi abortada. Um total de 35 pacientes (48,61%) encontra-se em fase de reabilitação; 24 pacientes (33,33%) encontram-se reabilitados com próteses implanto-suportadas coroas unitárias, próteses fixas ou overdentures - com um tempo médio de acompanhamento de 25,54 ± 23,75 meses. O índice de sucesso neste período foi de 88,24% / Abstract: Rehabilitation of the posterior maxilla is often impaired by bone atrophy, associated with maxillary sinus pneumatization, preventing the installation of implants of ideal length. Maxillary sinus elevation was first introduced in the literature in 1980, by Boyne & James, as an attempt to allow the placement of osseointegrated implants in this region, and several modifications have been presented resulting in different success and complication rates. This retrospective study involved an analysis of 72 patients treated during a period of 6 years in the Oral and Maxillofacial Surgery Area, Piracicaba Dental School - Unicamp. The sample was represented by 91 maxillary sinuses that had been subjected to elevation associated with different grafting materiais, for the installation of 101 implants. In 13 patients (18.50%), implantsupported rehabilitation had been aborted; in 35 patients (48.61%), it had not been finished; 24 patients (33.33%) had already received rehabilitation with implant-supported prostheses unitary crowns, fixed prostheses or overdentures - with a mean follow-up period of 25.54 ± 23.75% months. The success rate in this period was 88.24% / Mestrado / Cirurgia e Traumatologia Buco-Maxilo-Faciais / Mestre em Clínica Odontológica

Bakgrund: Det har i vissa fall varit märkbart att patienter med idiopatisk normaltrycks hydrocefalus (iNPH) upplever att förväntat shuntbehandlingsresultat inte uppnåtts och de rapporterar försämring vid den postoperativa uppföljningen trots att standardiserade tester inte visar i den riktningen. Det har också visat sig att rehabiliteringsinsatserna varierat för patienterna allt från strukturerade rehabiliteringsperioder på exempelvis geriatrisk rehabiliteringsenhet till i princip ingen rehabilitering alls. Syfte: Att beskriva vilka förväntningar personer med iNPH har på behandling med shunt och hur de ser på sin egen roll i rehabiliteringsprocessen. Metod: Kvalitativ, deskriptiv design med manifest och induktiv ansats. Datainsamlingen skedde genom semistrukturerade intervjuer med sju patienter med iNPH preoperativt. Resultat: Det fanns en samstämmighet bland informanterna kring förväntningar på shuntbehandlingsresultatet. De rörde den symtomtriad (gång och balansstörning, överaktiv urinblåsa samt kognitiv nedsättning) som ofta finns vid iNPH. Varierade beskrivningar gavs på hur symtomen påverkade informanterna. Det fanns också en uppfattning bland informanterna att de hade ett eget ansvar i rehabiliteringsprocessen och förslag framkom på vad de själva kunde bidra med i processen men också olika hinder för att utöva fysisk aktivitet beskrevs. Slutsats: Förväntningar på shuntbehandlingsresultat behöver diskuteras med patienten (ibland även anhörig) inför shuntbehandling redan vid beslut om operation men också då patienten läggs in för behandlingen. Rehabiliteringsprocessen behöver också diskuteras med patienten såväl före shuntoperation som tidigt postoperativt. Detta är troligtvis mycket viktigt för att uppnå ett så optimalt behandlingsresultat som möjligt. / Background: It has been noticeable that some patients with idiopathic normal pressure hydrocephalus (iNPH) find the expected result of shunt treatment not  achieved and they report detoriation at postoperative follow-up even though standardized tests do not show results in that direction. It has also been shown that rehabilitation possibilities for patients varied, ranging from structured rehabilitation periods, e.g. at geriatric rehabilitation units to basically no rehabilitation at all. Objective: To describe what expectations patients with iNPH have on treatment with shunt and how they view their own role in the rehabilitation process. Method: A quality, descriptive design with manifest and inductive approach. The data collection was done by semi-structured interviews with seven patients with iNPH preoperative. Results: There was consensus among informants regarding the expectations on the result of shunt treatment. The expectations concerned the symptom triad (gait-and balance disturbance, urgency bladder and cognitive dysfunction) which often occurs in iNPH. Varied descriptions were given on how the symptoms had affected the informants. There was also an opinion among the informants that they had own responsibility for the rehabilitation process and suggestions were given on what they could contribute with in the process but also different obstacles for performing physical activities were described. Conclusion: Expectations on shunt treatment results need to be discussed with the patient (sometimes together with a relative) prior to shunt treatment, already when the patient is offered a shunt operation and also on the day before operation when the patient is in the neurosurgery clinic. The rehabilitation process also needs to be discussed with the patient before the shuntoperation as well as early postoperative. This is probably very important in order to achieve as optimal treatment results as possible.

1z1 Abstract: In this thesis, on selected examples of everyday life, I deal with the issue of reso- cialization of former political prisoners from the 1950s after their return from prison. On selected biographical narratives, I point to personal ways of reintegra- tion into society, whose main ideology was the cause of their persecution. From their memories I choose the basic sphereas of life such as family, personal and social life, employment and the issue of rehabilitation not only at the personal but also at the social level. A special chapter is also devoted to the descendants of former political prisoners, whose memories illustrate the view of everyday life after their imprisonment and the subsequent return of their parents and thus re- veal the real impact of persecution activities of the communist regime in Czecho- slovakia.

Ce travail décrit comment la qualité des soins prothétiques délivrés au sein du service d’odontologie du CHU de Clermont-Ferrand a été évaluée. Pour cela, la qualité des soins a été définie selon deux champs d’évaluation du concept développé par Avedis Donabedian : la procédure de soin et le résultat du soin. Deux domaines prothétiques ont été explorés : les réhabilitations prothétiques utilisant la technologie CFAO et les réhabilitations implantoprothétiques.Les procédures de soin prothétiques ont été évaluées cliniquement selon les indicateurs de la Fédération Dentaire Internationale pour les restaurations unitaires et les critères validés de succès implantaires. Cette évaluation permet la diffusion de pratiques de soin validées. Le relevé d’indicateurs a initié également une démarche d’Évaluation des Pratiques Professionnelles (EPP) en permettant aux praticiens de s’auto-évaluer vis-à-vis de référentiels issus de la littérature scientifique. L’évaluation du résultat du soin a été réalisée selon deux aspects. Dans un premier temps, la fonction masticatoire a été évaluée selon des critères objectifs (paramètres cinétiques et mesure de granulométrie du bol alimentaire). Dans un second temps, la qualité de vie en lien avec la santé bucco-dentaire et la satisfaction prothétique ont été évaluées en prenant en compte des critères subjectifs (questionnaires). Cet aspect de l’évaluation des pratiques peut permettre d’argumenter des choix thérapeutiques. Par ailleurs, une évaluation médico-économique associée pourrait permettre de justifier sur le plan de la santé publique le recours à des thérapeutiques innovantes. / This work described the manner in which the quality of prosthetic dental care performed at the Clermont-Ferrand University Hospital was evaluated. In that context, quality of care was defined according to Avedis Donabedian's concept through two dimensions : process and outome of care. Two different fields, the CAD/CAM dental prosthetics rehabilitations and implantprosthodontics were assessed using this method. Assessment of dental care processes for both prosthetic fields were performed using a series of indicators, such as the International Dental Federation clinical evaluation criteria for restorations and criteria for implant success. Through this evaluation, validated dental care processes could be largely diffused amongst dental practitioners. Moreover, self-assessment by pratcitioners using indicators than can be measured against evidenced-based points of reference could set up an evaluation of professional practice procedure. Two aspects were explored to assess the care outcome. Firstly, the masticatory function was evaluated through the use of objective criteria (kinetic parameters and food bolus granulometry measurement). Secondly, the oral health related quality of life and the prosthetic satisfaction were assessed using subjective criteria (questionnaires). This particular aspect of practices’ evaluation could be a supporting argument to justify therapeutic options. Subsequently, associated medicoeconomic studies could argue in favor of choosing innovative therapeutic approaches within a public health context.

In der Geschichte Libanons sind Steinbrüche immer für die Gewinnung von Baumaterialien wie Sand, Kies, Steine, Zement usw. genutzt worden. Durch die Komplexität dieses Sektors im Libanon gibt es kaum verfügbare Daten, Erhebungen und Studien über Ausmaß und Auswirkungen der Abbautätigkeit. Deshalb behandelt die vorliegende Untersuchung eines der drängendsten Probleme und legt eine aktuelle Datenübersicht über die Steinbrüche vor. Es ist ein vollständiger und integrierter Überblick über die Steinbrüche im Libanon im Allgemeinen und das Problem ihre Rehabilitation im Besonderen unter Berücksichtigung des schwierigen Themas eines integrierten Steinbruchmanagements in einem nachhaltigen Konzept. Meilensteine und Etappen bei der Etablierung eines Rehabilitationsprogrammes werden auf unterschiedlichen Ebenen wie der öffentliche Sektor, der private Sektor und den öffentlichen Kommunen entwickelt. Um die Nachhaltigkeit des Rehabilitationskonzeptes aufzuzeigen, wurde ein Feldexperiment in einem ehemaligen Steinbruch nördlich von Beirut angelegt. Bei dieser Rehabilitation wurden in die aufgebrachte Bodenschicht Johannisbrotbäume (Ceratonia siliqua) aufgepflanzt. Durch diese Fallstudie konnte die Nachhaltigkeit der Maßnahme für das Management natürlicher Ressourcen geprüft, unterschiedliche Ergebnisse validiert und untersucht werden. / Throughout Lebanon’s history, quarries have been used as a means to extract essential construction materials such as sand, aggregates, stone masonry, cement, block stone, and others. Due to complexity of the quarry sector in Lebanon very few data are available, records and studies in this field are limited. Therefore, the presented research tackles one of Lebanon’s most pressing issues and represents the most updated database on quarries in Lebanon. A comprehensive and integrated overview of the quarries issue in Lebanon in general and the problem of rehabilitation in particular are given and the problematical topic of an integrated quarry planning within a sustainable development concept in Lebanon is pointed out. Milestones and landmarks toward the adoption of a setup needed for the proper rehabilitation approach at different levels as public sector, private sector and local communities are developed. In order to demonstrate the rehabilitation concept was realised a field experiment in a closed quarry northerly from Beirut. The rehabilitation was finalised by planting of carob trees (Ceratonia siliqua) in a layer of top soil. By this case study it was possible to address a sustainable procedure for natural resources management, examine and validate.

INTRODUÇÃO: A atuação de uma equipe de reabilitação junto à Estratégia Saúde da Família (PSF), iniciada na cidade de São Paulo no ano de 2001, inaugura um serviço singular de atenção a pessoas com deficiência na atenção básica. Tal projeto tem como objetivo estabelecer uma cultura de defesa dos direitos da pessoa com deficiência na busca do desmonte dos processos de exclusão social, construindo intervenções que articulem a prevenção de deficiências, reabilitação e educação por meio de ações intersetoriais (Fichino et al, 2008). Essa pesquisa visa conhecer e analisar aspectos da organização do trabalho desse serviço, à luz de aspectos do referencial teórico da gestão da operação de serviços. MÉTODO: Pesquisa qualitativa do tipo estudo de caso baseada nos princípios de Yin (2003) que combinou diferentes procedimentos de coleta de dados (pesquisa documental, entrevistas semi-estruturadas e aplicação de questionários). Foram realizadas sete entrevistas com trabalhadores de uma equipe de reabilitação no ano de 2007. Cada fonte de evidência recebeu tratamento diferenciado tendo em vista a finalidade de sua utilização e posteriormente foi realizado um diálogo dos resultados obtidos para construção de uma cadeia de evidências sobre a qual se construiu o estudo do caso. RESULTADOS: Foi verificado nesse estudo que o conceito do serviço pesquisado não se consolidou devido às mudanças nas políticas públicas de saúde que ancoravam essa experiência e a falhas no projeto do serviço, como por exemplo, o não detalhamento da organização do trabalho. Isso teve impacto para os trabalhadores que diante da fluidificação do conceito do serviço passam a organizar suas ações a partir de estratégias individuais ou de demandas pontuais se remetendo pouco aos pressupostos que fundamentam o serviço. Para os gestores tal quadro resulta na dificuldade de alinhar suas expectativas com o serviço realizado de fato. CONCLUSÃO: O hiato que existe entre a operação e o conceito precisa ser preenchido em duas vias: uma aproximando as proposições teóricas presentes no conceito do serviço da realidade cotidiana de quem desempenha o trabalho; e, na direção oposta, reforçando as premissas do projeto pelo refinamento e incorporação dessas pelos profissionais de linha de frente e gestores / The performance of a rehabilitation team together with the Family Health Program (FHP), begun in the city of São Paulo in 2001, launches a unique service to attend people with deficiencies in primary care. Such service aims to establish a consciousness of protection of the rights of disabled people in order to dismantle the process of social exclusion by creating actions to promote the prevention of disabilities as well as education and rehabilitation through intersectorial interventions. This research seeks to understand and analyze aspects of the work organization of this rehabilitation team based on the theoretical framework of the service operation management. METHODS: Qualitative research conducted by means of case study following Yins principles (2003) which combined different procedures for data collection (desk research, semistructured interviews and questionnaires). Seven interviews were conducted with employees of a team of rehabilitation in 2007. Each source of evidence received a differentiated treatment according to the purpose of its use. And, later, the results obtained were compared for the construction of a chain of evidences on which a case study was built. RESULTS: It has been verified in this study that the concept of the service was not consolidated due to: 1. changes in public health policies that anchored this experience; 2. flaws in the project of the service, such as, the lack of detailing the work organization. These results had an impact on the workers who, before the weakening of the concept of the service, began to base their actions on individual strategies or specific demands, referring very little to the directives that ground the service. For the managers such situation is result of a difficulty to align their expectation with the actual service. CONCLUSION: The gap that exists between the operation and the concept needs to be completed in a two-way street. One way, approaching the theoretical propositions in the concept of the service from the daily reality of who performs the work. And, on the other way, reinforcing the premises of the project by the refinement and incorporation of the front-line professionals and managers

INTRODUÇÃO: A atuação de uma equipe de reabilitação junto à Estratégia Saúde da Família (PSF), iniciada na cidade de São Paulo no ano de 2001, inaugura um serviço singular de atenção a pessoas com deficiência na atenção básica. Tal projeto tem como objetivo estabelecer uma cultura de defesa dos direitos da pessoa com deficiência na busca do desmonte dos processos de exclusão social, construindo intervenções que articulem a prevenção de deficiências, reabilitação e educação por meio de ações intersetoriais (Fichino et al, 2008). Essa pesquisa visa conhecer e analisar aspectos da organização do trabalho desse serviço, à luz de aspectos do referencial teórico da gestão da operação de serviços. MÉTODO: Pesquisa qualitativa do tipo estudo de caso baseada nos princípios de Yin (2003) que combinou diferentes procedimentos de coleta de dados (pesquisa documental, entrevistas semi-estruturadas e aplicação de questionários). Foram realizadas sete entrevistas com trabalhadores de uma equipe de reabilitação no ano de 2007. Cada fonte de evidência recebeu tratamento diferenciado tendo em vista a finalidade de sua utilização e posteriormente foi realizado um diálogo dos resultados obtidos para construção de uma cadeia de evidências sobre a qual se construiu o estudo do caso. RESULTADOS: Foi verificado nesse estudo que o conceito do serviço pesquisado não se consolidou devido às mudanças nas políticas públicas de saúde que ancoravam essa experiência e a falhas no projeto do serviço, como por exemplo, o não detalhamento da organização do trabalho. Isso teve impacto para os trabalhadores que diante da fluidificação do conceito do serviço passam a organizar suas ações a partir de estratégias individuais ou de demandas pontuais se remetendo pouco aos pressupostos que fundamentam o serviço. Para os gestores tal quadro resulta na dificuldade de alinhar suas expectativas com o serviço realizado de fato. CONCLUSÃO: O hiato que existe entre a operação e o conceito precisa ser preenchido em duas vias: uma aproximando as proposições teóricas presentes no conceito do serviço da realidade cotidiana de quem desempenha o trabalho; e, na direção oposta, reforçando as premissas do projeto pelo refinamento e incorporação dessas pelos profissionais de linha de frente e gestores / The performance of a rehabilitation team together with the Family Health Program (FHP), begun in the city of São Paulo in 2001, launches a unique service to attend people with deficiencies in primary care. Such service aims to establish a consciousness of protection of the rights of disabled people in order to dismantle the process of social exclusion by creating actions to promote the prevention of disabilities as well as education and rehabilitation through intersectorial interventions. This research seeks to understand and analyze aspects of the work organization of this rehabilitation team based on the theoretical framework of the service operation management. METHODS: Qualitative research conducted by means of case study following Yins principles (2003) which combined different procedures for data collection (desk research, semistructured interviews and questionnaires). Seven interviews were conducted with employees of a team of rehabilitation in 2007. Each source of evidence received a differentiated treatment according to the purpose of its use. And, later, the results obtained were compared for the construction of a chain of evidences on which a case study was built. RESULTS: It has been verified in this study that the concept of the service was not consolidated due to: 1. changes in public health policies that anchored this experience; 2. flaws in the project of the service, such as, the lack of detailing the work organization. These results had an impact on the workers who, before the weakening of the concept of the service, began to base their actions on individual strategies or specific demands, referring very little to the directives that ground the service. For the managers such situation is result of a difficulty to align their expectation with the actual service. CONCLUSION: The gap that exists between the operation and the concept needs to be completed in a two-way street. One way, approaching the theoretical propositions in the concept of the service from the daily reality of who performs the work. And, on the other way, reinforcing the premises of the project by the refinement and incorporation of the front-line professionals and managers

This thesis focuses on managing stress overload in social services of social rehabilition for clients with mental disorders. The goal is to clarify the resources of the overburdened of the social service managers from the view of the managers. This thesis is divided into teoretical and empirical part, in witchteh conducted research and its results are described. Teretical part defines mental disorders and discusses possible characterizations and manifestation of behaviour within people with mentaldiseases. Nongaverment nonprofit organization and their management are disorders. An important part of thesis is chapter dealing with stress overload with focus on social service managers. All chapters of the theoretival part are based on knowledges from literature. The empirical part focuses on the conducted research with discovered sources of overload of social service managers as a focal point. Research design comes from qualitative methods. In-depth interviews were conducted with several social service managers; based on these, the areas of stress in their profession were identified in three main parts, managers in general, specifical for particular social service and overload from concurrend and cumulation of previous domain. Keywords: mental disordes, executive, social services of social...

Made available in DSpace on 2016-04-29T13:31:52Z (GMT). No. of bitstreams: 1 Sandra Regina Schewinsky.pdf: 10477872 bytes, checksum: f45db26602df9ae0747a68ec5641c178 (MD5) Previous issue date: 2008-05-05 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The objective of this study is to the verify the following hypoteses: a) creative imagination stimulation reduces the memory déficits in persons who have suffered a Traumatic Brain Injury (TBI), b) the stimulation creative imagination and the memory déficits reduction are associated with the conscience level increase these persons. Many persons with TBI, mainly young people, have neuropsychological outcomes like by the memory and conscience. This ressearch is subsidized by basic concepts of social psychology presented in the work of Lev Semenovich Vygotsky, Alexander Romanovich Luria, Alexei Leontiev and from the reflections of George Mead, since these authors have analyzed the development of human psychological function though the perspective of society and culture. From this theoretical referential, the following aspects and analytical categories are detached, in agreement with the objectives of this study; the individual social genesis, human communication, creative imagination, memory, conscience, concepts formation and proximal development zone. It follows the nearly experimental orientation characterized by the case study, two young people attended in rehabilitation process, including a psychological treatment at the Department of Psychology, Division of Rehabilitation Medicine, Hospital das Clínicas, School of Medicine, University of São Paulo. The research consists in a psychological evaluation, in continuation the attendance whose objective is to stimulate the creative imagination of the person, with single activities and two persons participation, reinforcing the advantage of the work with Vygotsky s concept of proximal development zone, ending with the post-treatment psychological evaluation. The results suggest that the treatment for stimulation the imagination between the variables is inverse the increase in one of them reduces the other one, and the conscience has a synthesizings function for all the others, will be increased in this association. The research strengthens also the theoretical concepts of the mentioned authors above that mental functions act in interrelation and not isolately. The present study can collaborate with the psychological therapeutics which includes the neuropsychological rehabilitation / Esta pesquisa tem o objetivo de verificar as seguintes hipóteses: a) a estimulação da imaginação criativa diminui os déficits de memória em pessoas que sofreram Traumatismo Crânio Encefálico (TCE), b) a estimulação da imaginação criativa e a diminuição dos déficits de memória estão associadas à elevação do nível de consciência dos sujeitos vítimas de TCE. Um elevado número de pessoas, principalmente jovens, acometidas por esse traumatismo sofre de alterações neuropsicológicas, aquelas que afetam a memória e a consciência entre outras. Subsidiam esta investigação conceitos básicos da psicologia social extraídos da obra de Lev Semenovich Vygotsky, Alexander Romanovich Luria, Alexei Leontiev e das reflexões de George Mead, visto que esses autores analisaram o desenvolvimento das funções psicológicas humanas da perspectiva da sociedade e da cultura. Desse referencial teórico são destacados os seguintes aspectos e categorias analíticas, em consonância com os objetivos da pesquisa: gênese social do indivíduo, comunicação humana, imaginação criativa, memória, consciência, formação de conceitos e zona de desenvolvimento proximal. Esta pesquisa segue o delineamento quase-experimental caracterizado pelo estudo de caso, tendo dois jovens como sujeitos que realizaram processo de reabilitação incluindo o tratamento psicológico na Divisão de Medicina de Reabilitação do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. A pesquisa consiste em avaliação psicológica, seguindo-se, então, o tratamento propriamente dito com objetivo de estimular a imaginação criativa dos sujeitos, incluindo atividades individuais e em dupla, reforçando a vantagem de se trabalhar com o conceito de zona de desenvolvimento proximal de Vygotsky, finalizando-se com a avaliação psicológica pós-tratamento. Os resultados sugerem que o tratamento de estimular a imaginação criativa trouxe benefícios aos sujeitos da pesquisa, confirmando as hipóteses de que a estimulação da imaginação está associada à redução dos déficits de memória, ou seja, a associação entre as variáveis é inversa, o aumento de uma diminui a outra, e que a consciência como função sintetizadora de todas as outras será aumentada nessa associação. O trabalho fortalece ainda os pressupostos dos autores citados de que as funções mentais atuam interrelacionadas, antes do que isoladamente. Pretende-se que a pesquisa presente possa colaborar com a terapêutica psicológica que engloba a reabilitação neuropsicológica