Modélisation des usages des dispositifs TICE dans l'éducation spécialisée des enfants et des adolescents ainsi que dans l'insertion des adultes victimes d'exclusion.<br />Notre approche clinique de l'informatique met l'ordinateur au service de la pédagogie et du transfert et donc, dans sa finalité, au service du sujet. Il s'agit de rompre avec les pratiques traditionnelles d'aide et d'éducation qui dérivent trop souvent sur des logiques de domination et d'assistance donc d'aliénation. Nous avons tenté de créer un environnement humain et technologique offrant à des personnes en difficulté un cadre favorisant l'autonomie et l'émancipation, ce qui nous paraissait la seule voie d'insertion véritablement stable.

Bone defects and fracture non-unions remain a substantial challenge for clinicians due to a high occurrence of delayed union or non-union requiring surgical intervention. The current grafting procedures used to treat these injuries have many limitations and further long-term complications associated with them. This has resulted in research efforts to identify graft substitution therapies that are able to repair and replace tissue function. Many of these tissue engineered products include the use of growth factors to induce cell differentiation, migration, proliferation, and/or matrix production. However, current growth factor delivery methods are limited by poor retention of growth factors upon implantation resulting in low bioactivity. These limiting factors lead to the use of high doses and frequent injections, putting the patients at risk for adverse effects. The goal of this work was to develop and evaluate the efficacy of BMP-2 delivery systems to improve bone regeneration. We examined two approaches for delivery of BMP-2 in this work. First, we evaluated the use of a self-assembling lipid microtube system for the sustained delivery of BMP-2. We determined that sustained delivery of BMP-2 from the lipid microtube system was able to enhance osteogenic differentiation compared to empty microtubes, however did not demonstrate a significant advantage compared to a bolus BMP-2 dose in vitro. Second, we developed and assessed the functionality of an affinity-based system to sequester BMP-2 at the implant site and retain bioactivity by incorporating heparin within a collagen matrix. Incorporation of heparin in the collagen matrix improved BMP-2 retention and bioactivity, thus enhancing cell-mediated mineralized matrix deposition in vitro. Lastly, the affinity-based BMP-2 delivery system was evaluated in a challenging in vivo bone repair model. Delivery of pre-bound BMP-2 and heparin in a collagen matrix resulted in new bone formation with mechanical properties not significantly different to those of intact bone. Whereas delivery of BMP-2 in collagen or collagen/heparin matrices had similar volumes of regenerated mineralized tissue but resulted in mechanical properties significantly less than intact bone properties. The work presented in this thesis aimed to address parameters currently preventing optimal performance of protein therapies including stability, duration of exposure, and localization at the treatment site. We were able to demonstrate that sustained delivery of BMP-2 from lipid microtubes was able to induce osteogenic differentiation, although this sustained delivery approach was not significantly advantageous over a bolus dose. Additionally, we demonstrated that the affinity-based system was able to improve BMP-2 retention within the scaffold and in vitro activity. However, in vivo implantation of this system demonstrated that only delivery of pre-complexed BMP-2 and heparin resulted in regeneration of bone with mechanical properties not significantly different from intact bone. These results indicate that delivery of BMP-2 and heparin may be an advantageous strategy for clinically challenging bone defects.

La dispersion de colorant dans des écoulements newtoniens ou rhéofluidifiants a été étudiée optiquement dans deux fractures modèles rugueuses et transparentes. L'évolution du front de déplacement est analysé en fonction du temps et de la vitesse moyenne $U$ . Pour des rugosités de parois monodisperses et distribuées aléatoirement, l'étalement du front est diffusif ($\Delta x \propto t^{0.5}$) et caractérisé par une dispersivité $l_d$. Aux faibles vitesses, $l_d \simeq$ cst: la dispersion est dominée par les fluctuations spatiales de la vitesse et est amplifiée pour les fluides rhéofluidifiants ; aux vitesses élevées, $l_d$ augmente avec $U$ à cause de la dispersion de Taylor mais plus faiblement pour les fluides rhéofluidifiants. Pour une fracture avec deux parois autoaffines complémentaires décalées perpendiculairement à $U$, des chenaux macroscopiques s'étendent sur toute la longueur de la fracture suivant $U$ : l'épaisseur globale du front augmente alors linéairement avec le temps et plus fortement dans le cas rhéofluidifiant (étalement advectif). La croissance de l'épaisseur locale du front est par contre diffusive et due à la dispersion de Taylor.

Thesis (M.S.)--Mississippi State University. Department of Clinical Sciences, College of Veterinary Medicine. / Title from title screen. Includes bibliographical references.

Darbo objektas: kineziterapijos poveikis. Darbo tikslas: Nustatyti šlaunies raumenų jėgos, apimties ir judesių amplitudės pokyčius, taikant kineziterapiją, patyrus šlaunikaulio lūžį su poslinkiu ir be jo. Darbo uždaviniai: 1. Nustatyti ir palyginti šlaunies raumenų jėgą, patyrus šlaunikaulio lūžį su poslinkiu ir be jo, po 24 dienų kineziterapijos. 2. Nustatyti ir palyginti klubo sąnario judesių amplitudę, patyrus šlaunikaulio lūžį su poslinkiu ir be jo, prieš kineziterapiją, po 12 ir 24 dienų kineziterapijos. 3. Nustatyti ir palyginti šlaunies raumenų apimtį ir skausmą, patyrus šlaunikaulio lūžį su poslinkiu ir be jo, prieš kineziterapiją, po 12 ir 24 dienų kineziterapijos. 4. Įvertinti judėjimo funkciją ir savarankiškumą, patyrus šlaunikaulio lūžį su poslinkiu ir be jo, prieš kineziterapiją, po 12 ir 24 dienų kineziterapijos. Išvados: 1. 24 dienų kineziterapija turėjo teigiamą poveikį šlaunies raumenų jėgai patyrus šlaunikaulio lūžį su poslinkiu ir be jo. 2. 24 dienų kineziterapija turėjo teigiamą poveikį šlaunies lenkimo amplitudei patyrus šlaunikaulio lūžį su poslinkiu ir be jo. Patyrus šlaunikaulio lūžį be poslinkio, po kineziterapijos šlaunies lenkimo amplitudė buvo didesnė. 3. 24 dienų kineziterapija neturėjo reikšmingo poveikio šlaunies apimčiai ir skausmui patyrus šlaunikaulio lūžį su poslinkiu ir be jo. 4. 24 dienų kineziterapija neturėjo reikšmingo poveikio funkciniui mobilumui ir savarankiškumui patyrus šlaunikaulio lūžį su poslinkiu ir be jo. / The Object: effects of physiotherapy. Aim of study: To determine thigh muscle strength and circumferences, hip amplitude of the movements changes in patients after femur fractures with and without displacement using physiotherapy. Goals of study: 1. To determine and compare thigh muscle strenght after femur fracture with and without displacement after 24 days of physiotherapy. 2. To determine and compare hip amplitude of the movements after femur fracture with and without displacement before physiotherapy, after 12 and 24 days of physiotherapy. 3. To determine and compare thigh circumferences and pain after femur fracture with and without displacement before physiotherapy, after 12 and 24 days of physiotherapy. 4. To assess movement mobility and independence after femur fracture with and without displacement before physiotherapy, after 12 and 24 days of physiotherapy. Conclusions: 1. 24 days of physiotherapy had a positive effect on thigh muscle strength suffered femur fracture with and without displacement. 2. 24 days of physiotherapy had a positive effect on thigh flexion amplitude suffered femur fracture with and without displacement. Suffered femur fracture without displacement, the thigh flexion amplitude was higher after physiotherapy. 3. 24 days of physiotherapy hadn’t significant effect on thigh circumferences and pain suffered femur fracture with and without displacement. 4. 24 days of physiotherapy hadn‘t significant effect on movement mobility and... [to full text]

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2007. / Härtill 4 uppsatser.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2006. / Härtill 4 uppsatser.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2006. / Härtill 4 uppsatser.

Made available in DSpace on 2015-05-14T12:56:07Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 801421 bytes, checksum: 4440d1e021758c701533d36507d5edd3 (MD5) Previous issue date: 2009-12-11 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Ocular trauma is a relatively frequent condition in Urgency and Emergency Services, being many times associated to facial skeleton fractures. This study aims to evaluate the prevalence of ocular lesions in patient victims of facial trauma involving maxilla or zygomaticomaxillary complex. This is a prospective, cross-sectional study, composed of facial trauma victims subjects admitted to an Oral and Maxillofacial Surgery Service of Emergency and Trauma Hospital - Senador Humberto Lucena (João Pessoa - PB), from may to october 2009. The sample consisted of 100 patients. The mean age was 32,54 years. The most common etiology of trauma was motorcycle accident (41%), followed by physical aggression (14%). The most commom type of fracture was zygomaticomaxillary complex fracture, 26 patients in group 1 and 20 in group 2 and the prevalence of maxillary fractures was Le fort I in 8, Le Fort II in 4 and Le Fort III in 10 patients. Presence of fracture and concomintant ocular lesion represented 83% of all patients with ocular lesion. Subconjunctival hemorrhage was the most common lesion (43%), followed by Lack of the pupillary reflex (5%), reduction visual acuity (5%) and diplopia (2%). Facial trauma involving maxilla and zygomaticomaxillary complex associated to fractures of these structures increases the prevalence of ocular lesion. / O trauma ocular é uma condição relativamente frequente em Serviços de atendimento a Urgência e Emergência, estando muitas vezes associado à fraturas do esqueleto facial. Este estudo tem o objetivo de avaliar a prevalência de lesões oculares em vítimas de trauma facial envolvendo a maxila e/ou complexo zigomático-maxilar. É um estudo do tipo prospectivo, transversal, em pacientes que deram entrada no Serviço de Cirurgia e Traumatologia Buco- Maxilo-Facial do Hospital de Emergência e Trauma - Senador Humberto Lucena (João Pessoa - PB), durante o período de maio a outubro de 2009. A amostra consistiu em 100 pacientes com idade média de 32,54 anos. A etiologia mais frequente do trauma foi acidente motociclístico (41%), seguido por agressão física (14%). O tipo de fratura mais frequente foi do complexo zigomatico-maxilar, tendo o grupo 1: 26 pacientes e o grupo 2: 20. Quanto às fraturas de maxila, as Le Fort I corresponderam à 8, Le Fort II à 4 e Le Fort III à 10. Os pacientes com fratura e lesão ocular concomitante representaram 83% de todos os pacientes com lesão ocular. Hemorragia subconjuntival foi a lesão ocular mais freqüente (43%), seguida por diminuição do reflexo pupilar (5%), diminuição da acuidade visual (5%) e diplopia (2%). Concluiu-se que o trauma facial envolvendo maxila e complexo zigomático-maxilar associado à fratura dessas estruturas aumentam a prevalência de lesões oculares.

Les réservoirs carbonatés sont exploités pour leur réserve d’eau potable, de ressource géothermique ou le stockage géologique du dioxyde de carbone. Ces réservoirs sont difficiles à caractériser à cause d’une histoire diagénétique souvent complexe. Cette thèse offre de nouvelles perspectives sur la caractérisation des propriétés pétrophysiques et élastiques des calcaires urgoniens de Provence. Une approche intégrée et multi-échelle est proposée pour caractériser les propriétés pétrophysiques et élastiques des carbonates. Cette étude est basée sur des mesures de vitesse d’ondes P (Vp) et S (Vs) à l’échelle du laboratoire (centimètre–décimètre) et du terrain (mètre–décamètre). En laboratoire, les Vp et Vs ainsi que l’anisotropie sont mesurées sur des plugs et sur des carottes, en utilisant différentes fréquences centrales ultrasonores. Sur le terrain, l’approche consiste à mesurer les Vp et Vs entre deux puits distant de 2 m sur une profondeur de 14 m. Les mesures sont ensuite interprétées en fonction de la géologie observée aux échelles macro- et microscopiques. Les principaux résultats montrent que les Vp et Vs moyennes sont indépendantes de l’échelle de mesure, car elles sont dictées par la porosité. L’anisotropie causée par les fractures (15%) et les hétérogénéités (5%) se manifestent par une variabilité autour des vitesses moyennes. L’approche adoptée ici a permis de définir les interactions entre les propriétés de la matrice, les hétérogénéités, les fractures et les propriétés élastiques des roches carbonatées. Elle a montré que les propriétés élastiques tout comme les structures géologiques varient en fonction de l’échelle. / Carbonate reservoirs are also exploited for water production, geothermal energy, and carbon geological storage. Their Geophysical characterization remains challenging because of complex diagenetic history. This work offers new insights into the characterization of petrophysical, and elastic properties of the Urgonian limestones in the Provence region. An integrated multi-scale approach is proposed to characterize carbonate rocks petrophysical and elastic properties. This study relies on P- and S-wave velocity (Vp and Vs) measurements carried out at laboratory (centimeter–decimeter) and field (meter–decameter) scales. Laboratory scale Vp, Vs, and anisotropy are measured on plugs and cores, while on the field they are measured between two boreholes (crosshole) over a distance of 2 m and 14 m depth. The measurements are then compared to the geology from the macro- to the microscopic scale. The main results show that the average Vp and Vs are porosity related, and are independent from scale. Anisotropy caused by fractures (15%) and heterogeneities (5%) is responsible for variations around the mean velocities. The approach adopted during this work has enabled to scope out the interplay between matrix properties, heterogeneity, fracturing, and elastic properties in carbonate rocks. It has shown that the elastic properties evolve with scale as well as the geological structures.