Objetivo. Valorar la eficacia de dos tratamientos de Fisioterapia en pacientes con artropatía hemofílica de codo, rodilla o tobillo. Participantes. 31 pacientes con artropatía hemofílica fueron aleatoriamente asignados a 3 grupos: 11 (terapia manual), 10 (Fisioterapia educativa) y 10 (control). Intervención. Durante 12 semanas, se realizaron dos tratamientos: uno con terapia manual (2 sesiones semanales); y otro con sesiones educativas y ejercicios domiciliarios diarios. Tres evaluadores enmascarados, evaluaron: movilidad, fuerza y perímetro muscular, dolor y calidad de vida. Resultados. La terapia manual mejoró la movilidad y dolor articular, manteniéndose tras el seguimiento. La Fisioterapia educativa mejoró: flexión de rodilla, perímetro de gemelos y calidad de vida. El grupo control no mostró diferencias. Ningún paciente tuvo hemartrosis durante el estudio. Conclusión. La terapia manual es eficaz para mejorar el recorrido articular y el dolor en la artropatía hemofílica. La Fisioterapia educativa mejora la calidad de vida. Ambos tratamientos no provocan hemartrosis. / Abstract Aim. To evaluate the efficacy of two Physiotherapy treatments in patients with elbow, knee or ankle haemophilic arthropathy. Participants. 31 patients with haemophilic arthropathy were randomly allocated to study groups: 11 (manual therapy), 10 (educational Physiotherapy) and 10 (control). Intervention. For 12 weeks, were carried out two treatments: one with manual therapy (two weekly sessions); and other with educational sessions and daily home exercises. Three blinded reviewers assessed movement, strength and muscle perimeter, pain and quality of life. Results. Manual therapy improved movement and joint pain. At follow-up improvements were maintained. Educational Physiotherapy improved: knee flexion, twins perimeter and quality of life after treatment. In control group there was no difference. No patient had haemarthrosis throughout the study. Conclusions. Manual therapy is effective in improving of range of movement and joint pain in hemophilic arthropathy. Educational Physiotherapy improves quality of life. Both modalities of Physiotherapy not cause haemarthrosis.

Dopamine (DA) drives incentive learning: learning which is elicited through rewarding stimuli. Irregularities in DA activity are associated with various psychological disorders. Glycogen synthase kinase-3β (GSK3β), a molecule downstream of DA receptors, has been implicated in mediating dopaminergic behaviour, and unbalanced DA activity is associated with concomitant irregularities in GSK3β signaling. Inhibition of this molecule has been noted to attenuate behavioural sensitization, and decrease psychotomimetic behaviour in animals. Few studies have assessed the role of GSK3β in the conditioned place preference (CPP) paradigm, which evaluates the rewarding properties of substances and has been used to model psychosis. CPP can be examined through either acquisition or expression paradigms, which look at the active learning process vs. the recall of learned information respectively. We tested the hypothesis that selective inhibition of GSK3β with SB 216763 will differentially and dose-dependently affect the acquisition and expression of amphetamine (AMPH) CPP, as well as attenuate AMPH locomotor activity in acquisition. All drugs and vehicles were administered via intra-cranial microinfusions into the nucleus accumbens. AMPH was administered at a dose of 20.0 μg/0.5 μl/side. SB 216763 was tested at four doses (0.03, 0.30, 3.00, & 5.00 μg/0.5 μl/side) in both acquisition and expression. We found administering SB 216763 at all doses to attenuate AMPH CPP and locomotor activity in acquisition. At doses 0.30, 3.00, & 5.00 μg/0.5 μl/side, SB 216763 also blocked AMPH CPP at expression. These results lend support to GSK3β’s involvement in incentive learning and DA-mediated behaviours, and suggest its inhibition may differentially affect the acquisition and expression of AMPH CPP. / Thesis (Master, Psychology) -- Queen's University, 2014-01-03 15:41:20.989

This PhD thesis is based on the Spanish sample of the International “Cultural and Psychosocial Influences on Disability” (CUPID) study. This multicentre study is coordinated by Professor David Coggon at the University of Southampton (UK) and the project focuses on 47 occupational groups (nurses, office workers and manual workers) from 18 countries. At the beginning, it was planned that each participating country would include the three occupational groups mentioned before. However, the Spanish sample of the study was composed only by nurses and office workers; due to logistic reasons, it was not possible to access local postal workers who carried out sorting mail tasks. This dissertation aims to assess the importance of health beliefs, mental health, and somatising tendency as predictors of incidence and persistence of musculoskeletal pain and to investigate if these psychological risk factors primarily influence the development and persistence of pain, or whether their impact is more on the disability that musculoskeletal pain causes. Dataset was collected in the workplace, both at baseline (between November 2007 and February 2010), and again after a follow-up interval of 12 months, at four hospitals (Badalona Serveis Assistencials, Consorci Sanitari Integral, Consorci Hospitalari Parc Taulí and Parc de Salut Mar) and a university (Universitat Pompeu Fabra) in Barcelona. To be included in the study, participants had to be aged 20–59 years and been in their current job for ≥12 months. Written informed consent was obtained from all who agreed to take part, and the Parc de Salut Mar Ethics Committee of Barcelona and the Health and Safety Committee of each participating centre approved the study. The baseline and follow-up questionnaires were originally drafted in English, translated into Spanish, and then checked by independent back-translation. Participants were asked at baseline about socio-demographic and lifestyle characteristics, current working conditions, health beliefs concerning pain, mental health, somatising tendency and musculoskeletal pain in the past month and past year at six different anatomical areas (back, neck, and shoulders, elbows, wrists/hands, and knees). Pain was classed as disabling if it made ≥1 specified everyday activities difficult or impossible. At 12-month follow-up, pain in the past month and associated disability was again ascertained. Log binomial and multilevel multinomial logistic regression models were used to explore associations of baseline risk factors with pain outcomes at follow-up. / Esta tesis doctoral está basada en la muestra española del Estudio Internacional “Cultural and Psychosocial Influences on Disability” (CUPID) Este estudio multicéntrico es coordinado por el Profesor David Coggon de la Universidad de Southampton (Reino Unido), y el proyecto se centra en 47 grupos ocupacionales (enfermeras, trabajadores de oficina y trabajadores manuales) de 18 países. Al principio estaba previsto que cada país participante incluiría los tres grupos de trabajo antes mencionados. Sin embargo, la muestra española del estudio CUPID está compuesta sólo por enfermeras y trabajadores de oficina; por razones logísticas, no fue posible acceder a los trabajadores de correos que realizaban tareas de clasificación de correo. Esta tesis doctoral tiene como objetivo evaluar la importancia de las creencias sobre la salud, salud mental, y la tendencia a somatizar como predictores de la incidencia y persistencia de dolor músculo-esquelético y para investigar si estos factores de riesgo psicológicos influyen principalmente en el desarrollo y la persistencia del dolor, o si su impacto es más en la discapacidad que provoca el dolor músculo-esquelético. El conjunto de datos del estudio se recogió en el lugar de trabajo, tanto al inicio del estudio (entre Noviembre de 2007 y Febrero de 2010), como después de un intervalo de seguimiento de 12 meses, en cuatro hospitales (Badalona Serveis Assistencials, Consorci Sanitari Integral, Consorcio Hospitalario Parc Taulí y el Parc de Salut Mar) y una universidad (Universitat Pompeu Fabra) en Barcelona. Para ser incluidos en el estudio, los participantes debían tener entre 20 a 59 años y haber estado en su puesto de trabajo por lo menos los últimos 12 meses. Se obtuvo consentimiento informado escrito en todos aquellos que aceptaron participar, y proyecto fue aprobado por el Comité de Ética del Parc de Salut Mar en Barcelona y el Comité de Seguridad y Salud de cada centro participante. Tanto los cuestionarios basales como del seguimiento fueron redactados originalmente en Inglés, traducido al español, y luego retro-traducido al inglés. Los participantes fueron entrevistados al inicio del estudio sobre sus características socio-demográficas y de estilo de vida, condiciones de trabajo actuales, salud mental y tendencia a somatizar, creencias sobre la salud aplicables al dolor y la presencia de dolor músculo-esquelético en el último mes y en el último año en seis zonas anatómicas diferentes (espalda, cuello, hombros, codos, muñecas/manos y rodillas). El dolor fue clasificado como discapacitante si se reportaban 1 o más actividades cotidianas difíciles o imposibles de realizar. A los 12 meses de seguimiento, se volvió a entrevistar a los participantes sobre la presencia de dolor en el último mes y la discapacidad asociada. Se utilizaron modelos de regresión log-binomial y logística multinomial multinivel para explorar las asociaciones de los factores de riesgo basales con el dolor al seguimiento.

Antes de la adaptación al Espacio Europeo de Educación Superior (EEES), los fisioterapeutas sólo podían, en su misma disciplina, ampliar, adaptar o reciclar sus conocimientos con cursos de posgrado de título propio. Esta situación ha configurado una amplia y dispersa oferta formativa, en carácter y contenido, que ha comportado un panorama formativo poco estructurado y confuso. La falta de reconocimiento oficial de especialidades y las necesidades planteadas por un colectivo profesional con un marcado componente práctico, contribuye a esta dispersión en la formación de tercer ciclo. La adaptación al EEES ha posibilitado a las universidades proponer títulos oficiales en la oferta de cursos de posgrado en el ámbito de la Fisioterapia, hecho que puede ser relevante en la equiparación y ordenación, que debe de ayudar a su consolidación como disciplina científica. En este punto de adaptación al EEES se constata la necesidad de conocer con detalle la realidad de la oferta formativa de posgrado, para describirla según su modalidad, tipo de gestión y temática principal, tanto a nivel nacional como por CCAA. Para la obtención de este objetivo se plantea un estudio en dos fases. En la primera se realiza un vaciado, durante tres años académicos (2010-11, 2011- 12 y 2012-13), a través de las páginas web de las universidades españolas, de toda la Formación Continua (F.C), Posgrados de Título Propio (P.T.P) y Másteres Universitarios (M.U). En la segunda fase del estudio se ha elaborado un cuestionario propio, con el objetivo de conocer el interés para la formación de posgrado de los estudiantes de grado y posgrado de la Universitat Internacional de Catalunya, así como observar la relación con la oferta formativa y la distribución de los ámbitos de ejercicio profesional, en los estudiantes de posgrado.

El tractament estàndard de la fractura de maluc és la cirurgia precoç sota anestèsia raquídia . S'ha descrit un augment de les complicacions quan el tractament es posposa més enllà de les 48 hores, sigui quin sigui el motiu de la demora . El maneig dels pacients amb fractura de maluc que a més es troben en tractament amb antiagregants plaquetaris ha generat controvèrsia, perquè en limitar la possibilitat d'una anestèsia regional, es tendeix a demorar la intervenció per evitar el risc d'una anestèsia general . En aquest treball demostrem que el balanç entre el risc de demorar la intervenció fins corregir l' estat de antiagregació respecte al benefici d'un tractament quirúrgic precoç es decanta cap a aquesta segona opció, ja que no presenta major incidència ni gravetat de complicacions i obté menor mortalitat. Un altre resultat significatiu és la baixa concordança entre l'estat de antiagregació objectiu i l'esperat segons els antecedents farmacològics . / El tratamiento estándar de la fractura de cadera es la cirugía precoz bajo anestesia raquídea. Se ha descrito un aumento de complicaciones cuando el tratamiento se pospone más allá de las 48 horas, sea cual sea el motivo de la demora. El manejo de los pacientes con fractura de cadera que además se encuentran en tratamiento con antiagregantes plaquetarios ha generado controversia, porque al limitar la posibilidad de una anestesia regional, se tiende a demorar la intervención para evitar el riesgo de una anestesia general. En este trabajo demostramos que el balance entre el riesgo de demorar la intervención hasta corregir el estado de antiagregación respecto al beneficio de un tratamiento quirúrgico temprano se decanta hacia esta segunda opción, puesto que no presenta mayor incidencia ni gravedad de complicaciones y obtiene menor mortalidad. Otro resultado significativo es la baja concordancia entre el estado de antiagregación objetivo y el esperado según los antecedentes farmacológicos. / The standard treatment of a hip fracture is early surgery under spinal anaesthesia. An increase in complications is described when treatment is delayed beyond 48 hours, whatever the reason for the delay is. The management of patients with hip fractures and also treated with antiplatelet drugs has generated controversy as this situation entails a higher risk of performing a regional anaesthesia, so is tended to delay surgery to avoid the risk of a general anaesthesia. In this work we show that the balance between the risk of delaying surgery, just to correct the state of antiaggregation, regarding the benefit of early surgical treatment, lean towards the second option , since no increased incidence or severity of complications is described and it gets lower mortality. Another significant result is the poor agreement between the real and the expected aggregation related to patient’s history of antiplatelet drugs.

La evaluación de la calidad de la atención sanitaria se ha basado durante mucho tiempo en la aplicación de estándares profesionales de calidad científico-técnica, y actualmente se está tendiendo cada vez más a integrar la percepción de calidad de los pacientes. La historia clínica ha sido la fuente de datos más utilizada para dicha evaluación. Ante la presencia de limitaciones, surge el informe del usuario como una nueva fuente de datos para evaluar si determinados estándares profesionales diagnósticos o terapéuticos se están aplicando, y como posible fuente de información capaz de proporcionar información objetiva acerca de las percepciones de los pacientes sobre sus experiencias asistenciales. Diversos informes han sido desarrollados en el ámbito médico y ninguno en el ámbito de la Fisioterapia. El principal objetivo de esta tesis ha sido construir y validar un informe del usuario capaz de medir calidad científico-técnica y calidad percibida en pacientes con cervicalgia. / The evaluation of the quality of health care has been based for a long time in the application of professional standards of scientific-technical quality, and is now leaning more and more to integrate the perceived quality of the patients. The medical history has been the source of data used for this assessment. In the presence of constraints, user report comes as a new source of data to assess whether specific diagnostic or therapeutic professional standards are being applied and as a possible source of information capable of providing objective information about the perceptions of patient’s care experiences. Several reports have been developed in the medical field but none in the field of Physiotherapy. The main objective of this thesis is to construct and validate a user report, able to measure quality scientific-technical and perceived quality in patients with neck pain.

El equilibrio corporal y tono muscular de las extremidades se encuentran comprometidos en los pacientes con hemiparesia, así mismo son factores que conllevan al paciente a tener riesgo de caídas y que en consecuencia afectan el proceso de rehabilitación y actividades de vida diaria. Determina la relación que existe entre el equilibrio corporal y el tono muscular de las extremidades en pacientes hemiparéticos del departamento de medicina física y rehabilitación del Hospital Nacional Hipólito Unanue. Realiza un estudio de enfoque cuantitativo, alcance correlacional, diseño no experimental (observacional), transversal y prospectivo. Se efectuó en el departamento de medicina física y rehabilitación del Hospital Nacional Hipólito Unanue en el distrito del Agustino (Lima), en los meses de diciembre del 2017, enero y febrero del 2018, con un total de 63 pacientes hemiparéticos (23 mujeres y 40 hombres). Para la valoración del equilibrio corporal se utilizó la escala de equilibrio de Berg; y para la valoración del tono muscular de las extremidades se utilizó la escala de Ashworth Modificada. Encuentra que el mayor porcentaje de pacientes hemiparéticos con equilibrio corporal pobre se relacionó con grado 2 de tono muscular de las extremidades en un 83%, en cuanto al equilibrio corporal moderado el 63.2% se relacionó con grado 1+ de tono muscular y el mayor porcentaje de pacientes con equilibrio corporal bueno se relacionó con grado 1 de tono muscular en un 52.6%. La prueba estadística que se utilizó para comprobar la hipótesis fue la Correlación de Spearman y se trabajó a un nivel de significancia de 5% (0.05). El equilibrio corporal y el tono muscular de las extremidades mostraron moderada correlación (p=0.000). La comparación de medias entre las variables sugiere una relación de tipo negativa. Concluye que existe moderada relación entre el equilibrio corporal y el tono muscular de las extremidades en pacientes hemiparéticos del departamento de medicina física y rehabilitación del Hospital Nacional Hipólito Unanue (Rho= -0.469). / Tesis

Orientador: José Elias Tomazini / Banca: Luiz Fernando Costa Nascimento / Banca: Jose Geraldo Trani Brandão / Banca: Carlos Alberto Chaves / Banca: Eurico Arruda Filho / Resumo: No corpo humano o sistema ósteo-articular dá a sustentação ao corpo humano e sobre ele o sistema muscular e outros tecidos que compõem o aparelho locomotor. Apesar da flexibilidade existente nos músculos, o estudo clássico da biomecânica considera os membros do aparelho locomotor humano como sendo corpos rígidos. Para analisar e estudar tais sistemas, os vários componentes devem ser identificados e suas propriedades físicas determinadas, a fim de se obter as equações que regem o seu movimento. Tal procedimento pode ser feito utilizando-se o modelo multicorpo, para o qual, neste trabalho, foi empregado o método de Kane. Os dados de entrada, como forças no pé durante a marcha, foram coletados por meio de uma plataforma de força, acoplada a uma esteira ergométrica que utilizou extensômetros, e, simultaneamente, com o auxílio de LEDS, foi possível obter dados da filmagem. Para este modelo físico foram utilizados programas, tais como AutoLev, Excel, AutoCad e Fortran. De posse do modelo, foram feitas as análises comparativas dos torques e forças verticais e horizontais no quadril e joelho de amputados e não-amputados, bem como a análise estatística não-paramétrica nos dois grupos, utilizando-se o método de Mann Whitney, com significância de 10≤α%, na qual foi constatado que os torques no quadril dos amputados são estatisticamente diferentes dos torques dos não-amputados; já no joelho esta diferença ocorre em 50% do passo. Não foram encontradas diferenças significativas nas forças entre os dois grupos, exceto em alguns instantes do ciclo da marcha na força cortante. / Abstract: The osteo-articulate system is what gives the sustenance to the body and to the muscular and other tissue system that compose the locomotor apparel. In spite of the existent flexibility in the muscles, the classic study of the biomechanics considers the members of the human locomotor apparel as being rigid bodies. To analyze and to study such systems, the various components should be identified and their physical properties determined, in order to obtain the equations that govern their movement. Such procedure can be made using the multi-body model, for which, in this work, the method of Kane was used. The entrance data, as forces under the foot during the march, were collected using a platform of force, which is a treadmill with extensometers, and, simultaneously, with the aid of LEDS, it was possible to obtain data of the filming. For this physical model programs were used, such as: AutoLev, Excel, AutoCad and Fortran. By utilizing the model, it was possible to make the comparative analyses of the torques and vertical and horizontal forces in the hip and knee of amputee and no amputee, and also the nonparametric statistical analysis using Mann Whitney's method, with value of 10≤α%, in which was verified that the torques in the hip of those amputees are different to the no amputee; in the knee this difference happens in between 50% of the steps. There were not found significant differences of forces among the two groups, there were exceptions in some moments of the gait cycle at the shear force. / Doutor

The presence of artificial light at night (ALAN) is one of many contributing factors to global change today. The spectral range of ALAN can also alter the potential effects of light pollution in certain contexts which creates an exceptionally complex cascade of impacts. The purpose of this thesis was to examine the interactions of various environmental factors including ALAN on biological variables, locomotor activity and corticosterone concentration, of two species of rodent. This was accomplished by manipulating the environmental factors; environmental enrichment, temperature and lighting in captivity. A pilot field study was also conducted in order to test the future feasibility of incorporating information garnered from the laboratory study into larger scale real world experiments. The two species were collected from the field and was subsequently subjected to various light cycles, during which locomotor activity was monitored and urinary corticosterone stress hormone was assessed. Results showed that Micaelamys namaquensis, a nocturnal species, reacted favourably to the addition of enrichment by increasing activity levels whereas Rhabdomys dilectus, a diurnal species decreased activity levels while improving the strength of entrainment. Both M. namaquensis and R. dilectus decreased activity during a light cycle which simulated natural dawn and dusk patterns of light. The two species reacted differently when a 24hr ambient temperature cycle was introduced, with M. namaquensis increasing its locomotor activity and R. dilectus decreasing overall activity. M. namaquensis decreased its average activity in response to ALAN and did not show any difference in reaction towards different types of light at night. R. dilectus on the other hand increased its activity under ALAN but also showed no preference between different spectra of light at night. While corticosterone concentrations were monitored during all the environmental factor experiments, fluctuations in hormone concentrations were noted, however found to be statistically non-significant. Thus, only speculations could be made regarding the impacts of the various environmental factors on the stress physiology of M. namaquensis and R. dilectus. These results highlight the importance of considering species specific outcomes even under virtually identical circumstances. Understanding the impacts of environmental factors is crucial in order to extrapolate laboratory-based findings into real world experiments. This work can be used to further understand the impacts of different environmental factors on the circadian systems of nocturnal and diurnal rodent species as well as the potential implication of ALAN under various environmental conditions. In future, this can be combined into a large-scale field experiment in order to monitor the impacts of light pollution using the methodology elucidated during the pilot study. The results of this study show that the impacts of ALAN can be incredibly diverse and specific to the species in which they are examined. / Dissertation (MSc)--University of Pretoria, 2019. / Zoology and Entomology / MSc / Unrestricted

A major advantage of having behavior controlled by a circadian clock is that the organism may be able to anticipate, rather than respond to, important daily events in its environment. Here, we describe the behavioral rhythms of locomotor activity and web building in the orb-weaving spider Cyclosa turbinata (Walckenaer, 1841). Web building occurs late in the scotophase, in absolute darkness, and is initiated and completed before lights-on under light:dark cycles in the laboratory. This scheduling presumably enables web-building to occur under the cover of darkness, thereby avoiding visual predators. Locomotor activity occurs predominantly in the dark with a sharp peak within one hour after lights-off and a broader peak occurring before lights-on. The locomotor activity rhythm free runs under constant dark and constant temperature conditions, thus indicating endogenous circadian control. Evidence from the free running rhythm suggests that the first peak under light:dark cycles is a result of masking but that the second peak is attributable to the endogenous circadian oscillator. The period of the free run is exceptionally short, about 19 hours. In comparison with locomotor activity, web building is quite sporadic under constant dark conditions, making detection of periodicities difficult and, therefore, whether web-building is under endogenous circadian control or is driven by exogenous factors remains unresolved.