The objective of this study was to evaluate the cardiovascular effects and compare the analgesic efficacy intraoperative and postoperative provided by methadone administered via epidural (EP) or intramuscular (IM) in bitches submitted to total unilateral mastectomy surgery. For this it was used 12 female dogs anesthetized and randomly distributed into two groups of six animals each. In the first group the methadone was administered via epidural, after anesthetic stabilization (GEP) and another group, methadone was administered via intramuscular in the pre-anesthetic medication (GIM). In the first part of the study evaluated heart rate (HR), respiratory rate (RR), systolic blood pressure (SBP), mean arterial pressure (MAP), diastolic blood pressure (DBP), carbon dioxide released at the end of expiration (ETCO 2) and arterial blood gas analysis. Both FC when FR and blood gas analysis did not show significant changes. The GIM had higher values in all pressure ratings (DAP, MAP and SAP), but within the parameters for the species. The GIM had higher values in all pressure ratings (DAP, MAP and SAP), but within the range for the species. Both routes of administration showed little change in the evaluated parameters, however the epidural demonstrated greater anesthetic and analgesic stability for this procedure. In the second part of the study, the postoperative analgesia was measured by pain scales at the University of Melbourn, Visual Analogue Scale (VAS) and Glasgow Simplified Composed Measure pain scale. It also evaluated serum concentration of cortisol, lactate and glucose. Difference was observed between the groups only in the T6 Melbourn scale and analgesic rescue at T2 to the animals of the GIM. Cortisol presented a significant enhancement in the first hour in both groups and the remaining analyzes did not demonstrate differences. The administration of methadone epidural provided higher postoperative analgesia period that intramuscular administration showing to be the best option for this procedure. For both steps, the mean scores were submitted to statistical analysis by Kruskal-Wallis test to the groups between the different moments and Wilcoxon to compare the groups within each time. The Scott-Knott post-test was used for comparison in pairs at 5% significance level. After observing of the study in its two steps can be concluded that both methadone administered via epidural as intramuscular are secure in the perioperative period because does not cause significant changes in the physiological parameters. However the epidural proved to have a more efficient analgesia during surgery and post-operative period, in which we observed a greater analgesia period which makes it a safe and the best route for satisfactory analgesia in the procedure and in the studied species. / O objetivo do presente estudo foi avaliar os efeitos cardiovasculares e comparar a eficácia analgésica transoperatória e pós-operatória proporcionada pela metadona administrada pela via epidural (EP) ou pela via intramuscular (IM) em cadelas submetidas à cirurgia de mastectomia unilateral total. Para tanto foram utilizadas 12 cadelas anestesiadas e distribuídas aleatoriamente em dois grupos compostos de seis animais cada. Em um grupo foi administrado metadona via epidural após estabilização anestésica (GEP) e em outro grupo a metadona foi administrada via intramuscular na medicação pré-anestésica (GIM). Na primeira parte do estudo foram avaliados frequência cardíaca (FC), frequência respiratória (f), pressão arterial sistólica (PAS), pressão arterial média (PAM), pressão arterial diastólica (PAD), tensão de dióxido de carbono ao final da expiração (ETCO2) e hemogasometria do sangue arterial. Tanto a FC, quanto f e hemogasometria não apresentaram alterações significativas. O GIM apresentou valores mais altos em todas as avaliações das pressões (PAD, PAM e PAS), porém dentro dos parâmetros para a espécie. As duas vias de administração demonstraram poucas alterações nos parâmetros avaliados, entretanto a via epidural demonstrou maior estabilidade anestésica e analgésica para esse procedimento. Na segunda parte do estudo, a analgesia pós-operatória foi avaliada pelas escalas de dor da Universidade de Melbourn, Escala Visual Analógica (EVA) e escala de dor de Medida Composta de Glasgow Simplificada. Avaliou-se também concentração sérica de cortisol, lactato sérico e glicemia. Foi observada diferença entre os grupos somente no T6 pela escala de Melbourn, e resgate analgésico no T2 para os animais do GIM. O Cortisol apresentou aumento significativo na primeira hora de avaliação em ambos os grupos e as demais análises não demonstraram diferenças. A administração de metadona via epidural proporcionou maior período de analgesia pós-operatória que a administração intramuscular sendo a melhor opção para esse procedimento. Para ambas as etapas as médias dos escores foram submetidas a análise estatística pelos testes Kruskall-Wallis para os grupos entre os diferentes momentos e Wilcoxon para comparar os grupos dentro de cada tempo. O pós-teste de Scott-Knott foi utilizado para comparação aos pares ao nível de 5% de significância. Após a observação do estudo em suas duas etapas pode-se concluir que tanto a metadona administrada pela via epidural quanto a via intramuscular são seguras no período transoperatório por não causar alterações significativas nos parâmetros fisiológicos estudados, entretanto a via epidural se mostrou mais eficiente em relação a analgesia tanto nesse período quanto no período pós-operatório, onde foi possível observar um maior período analgésico, tornando-a uma via segura para no procedimento e espécie estudados.

[pt] A presente dissertação tem por objetivo geral identificar os impactos provocados nas relações familiares quando ocorre determinação judicial da modalidade de Guarda Unilateral com Visita Livre. Quanto aos objetivos específicos, são os seguintes: conhecer os principais fatores que influenciam a escolha na guarda unilateral com visitas livres, abordando as legislações e características pertinentes; identificar as implicações emocionais provocadas pela guarda unilateral no cotidiano do país, contextualizando as características socioeconômicas dos casais de Manaus, que formam a clientela do EAJ; levantar o perfil das famílias com modalidade de Guarda Unilateral com Visitas Livres, atendidas no EAJ, no período de julho a dezembro de 2009. O sistema de guarda unilateral tem por objetivo fazer com que a criança fique sob a guarda de um dos cônjuges, enquanto ao outro é concedido o direito de visita e é atribuída a obrigação financeira para o sustento e educação desses filhos. O foco da pesquisa foi compreender, a partir dos relatos dos pais separados ou divorciados, que praticam a modalidade de Guarda Unilateral com Visitas Livres – que tiveram sentenças expedidas pelo Juízo de Direito das Varas de Família e do Núcleo de Conciliação de Família (TJAM), da cidade de Manaus. A coleta e análise foram feitas em dois momentos: Na fase inicial foi realizado contato com a coordenação do curso de Direito e Coordenação do EAJ, do Uninorte. Depois do levantamento do número total de atendimentos realizados no período descrito, foram selecionados 10% dos casos; esta seleção foi feita de forma aleatória. Num segundo momento, foi utilizada a entrevista semi-estruturada. As entrevistas foram gravadas, transcritas e posteriormente analisadas. Cabe salientar que os resultados encontrados nesta dissertação respondem ao escopo de pesquisa e possibilitaram algumas respostas sob importantes questões sobre a eficácia da guarda unilateral através do acolhimento do EAJ. / [en] This thesis aims at identifying the impacts on family relationships when there is judicial determination of the mode of Guard with Unilateral Visit Free. The specific objectives are: to ascertain the main factors influencing the choice in unilateral guard with free visits, addressing the pertinent laws and characteristics; identify the emotional implications caused by unilateral guard in the country day by day, contextualizing the socioeconomic characteristics of Manaus couples, who seek for the EAJ (Juridical Assistance Office); raise the profile of families with Free visits Unilateral Guard attending by EAJ (Juridical Assistance Office) in the period from July to December 2009. The unilateral guard system intend to cause the child to remain in the custody of one spouse, while the other one is given the right to visit and is given the financial obligation for the maintenance and education of these children. The focus of the research was to understand the reports of separated or divorced parents – who practice Unilateral Guard with Free Visits, who had sentences issued by Center for Family Conciliation Court Law Judge (TJAM) of Manaus. Data collection and analysis were done in two stages: In the initial phase it was made contact with the coordination of law course and EAJ Coordination of the Uninorte University. After lifting the total number of visits in the period described, we selected 10% of cases, this selection was made randomly. Secondly, we used semi-structured interview. The interviews were taped and transcribed and then analyzed. It should be noted that the results found in this work respond to the scope of this research and turn possible to answer important questions about the effectiveness of the unilateral guard with free visit through the EAJ patronage.

This thesis explores the question how unilateral conduct can create, vary or discharge obligations in English private law and how unilateral conduct is regulated. First, it is explained that the reason for asking this question follows from the candidate’s background in a civil law jurisdiction, in which unilateral juridical acts are regarded a category of legally relevant behaviour. After observing the obstacles in English law to the recognition of the civil law concept of unilateral juridical acts, a number of examples of unilateral conduct are identified that create legal effect. The focus of the thesis is on examples of unilateral conduct that create, vary or discharge obligations. English law allows the creation of obligations by unilateral conduct only in very specific instances. It is observed that unilateral conduct can create or transfer property rights. The different approach is explained primarily by deeply rooted distinction in English law between words and acts. Subsequently, the thesis discusses how unilateral conduct is regulated. For some issues, notably interpretation, revocability and the intention to create legal effect, similar rules apply to the different examples of unilateral conduct. For other issues, especially mistake and form requirements, the rules diverge. It is concluded that unilateral conduct forms a category of legally relevant behaviour in English law. This category is divided in unilateral conduct that creates obligations, quasi-contractual unilateral conduct that varies or discharges obligations and unilateral voluntary property transactions. Whereas quasi-contractual unilateral conduct is closely related to contracts and should thus generally be regulated in a manner similar to contracts, the unilateral voluntary property transaction is a distinct concept, to which specific rules apply.

Background. Handball is a fast paced sport, with high velocity movements performed in a predominantly unilateral plane. In order to make training as specific as possible to on court movements, resistance training programmes should involve exercises that reflect the speed and stance of how they will be performed during gameplay however, working velocities are rarely prescribed due to the lack of research in the area. Aim. The aim of this study was (1) to determine the effect of three different training modes; unilateral high velocity (UHV), bilateral high velocity (BHV) and bilateral slow velocity (BSV) on vertical loaded and unloaded jumps, sprint, agility and balance. (2) To determine if any of these interventions had more of an effect when compared to each other. Methods. 29 women from four teams in the Swedish Elitserien participated in a 16-week intervention study. Teams were assigned to either UHV, who performed unilateral exercises with a high intended movement velocity, BHV, bilateral exercises at a high intended movement velocity, or BSV, who continued their regular bilateral slow velocity training. Power was assessed pre- and post-intervention by loaded vertical squat jump and countermovement jump (CMJ) both unilaterally and bilaterally. Performance assessments were conducted through 20m Sprints, agility T-test and Y-balance test. Effect sizes were calculated to determine the magnitude of differences from pre- to post-intervention in three training modes. One-way ANOVA determined if the group interactions were significant. Results. All three training modes increased their power output to varying levels and effect sizes. The UHV group demonstrated large effect sizes for all improvements in power output, whilst the BHV and BSV groups ranged from trivial to large. UHV got significantly faster at reaching time to peak velocity in unilateral and bilateral measures compared to both BHV and BSV (p=<0.05). Conclusion. The results suggest that a 16-week resistance training intervention regardless of stance improves power however to varying magnitudes. The high velocity groups showed greater improvements in measures of power and performance. This study suggests that resistance training at a high intended movement velocity may be beneficial for improving power and performance in elite women’s handball players.

Following unilateral stroke there is significant loss of function in the body side contralateral to the damage and a robust degenerative-regenerative cascade of events in both hemispheres. It is natural to compensate for loss of function by relying more on the less-affected body side to accomplish everyday living tasks (e.g. brushing teeth, drinking coffee). This is accompanied by a “learned disuse” of the impaired side thought to occur due to repeated experience with its ineptness. However, as investigated in these studies, it may also be due to brain changes instigated by experience with the intact body side. The central hypothesis of these dissertation studies is that experience with the intact forelimb, after unilateral sensorimotor cortex (SMC) damage, disrupts functional recovery with the impaired forelimb and interferes with peri-lesion neural plasticity. Following unilateral ischemic lesions, rats were trained on a skilled reaching task with their intact (less-affected) forelimb or received control procedures. The impaired forelimb was then trained and tested on the same skilled reaching task. Intact forelimb experience worsened performance with the impaired forelimb even when initiated at a more delayed time point following lesions. Intact forelimb training also reduced peri-lesion expression of FosB/ΔFosB, a marker of neuronal activation, and caudal forelimb motor map areas compared to animals without intact forelimb training. It was further established that it is focused training of the intact forelimb and not experience with this limb per se, as animals trained with both forelimbs in an alternating fashion did not exhibit this effect. Transections of the corpus callosum blocked the maladaptive effect of intact forelimb experience on impaired forelimb recovery, suggesting a disruptive influence of the intact hemisphere onto the lesion hemisphere that is mediated by experience. Together these dissertation studies provide insight into how experience with the less-affected, intact body side, can influence peri-lesion neural plasticity and recovery of function with the impaired forelimb. The findings from these studies suggest that compensatory use of the less-affected (intact) body side following unilateral brain damage is not advantageous if the ultimate goal is to improve function in the impaired body side. / text

Submitted by Alice Rocha (rochaalice@yahoo.com.br) on 2012-08-30T01:25:38Z No. of bitstreams: 1 BUANI.pdf: 6422556 bytes, checksum: dadda644b304bcdf1640dba4d7047923 (MD5) / Made available in DSpace on 2012-08-30T01:25:38Z (GMT). No. of bitstreams: 1 BUANI.pdf: 6422556 bytes, checksum: dadda644b304bcdf1640dba4d7047923 (MD5) / Made available in DSpace on 2013-05-09T21:50:23Z (GMT). No. of bitstreams: 3 BUANI.pdf.txt: 423827 bytes, checksum: a7162d7e7d03b96d13ec3ff3f2f99241 (MD5) license.txt: 346 bytes, checksum: 6440c47a50909adf871d5cc0caf0b4f9 (MD5) BUANI.pdf: 6422556 bytes, checksum: dadda644b304bcdf1640dba4d7047923 (MD5) Previous issue date: 2012-08-29 / O trabalho trata da administração internacional no Kosovo, com a proposta de analisar a situação atual face à declaração unilateral de independência de 17 de fevereiro de 2008. Parte-se de uma análise histórica e dos conflitos dos Bálcãs, com a intervenção internacional de 1998-1999, para compreender a estrutura internacional montada na região, principalmente as atividades da Missão Interina das Nações Unidas para o Kosovo (MINUK) e da Organização do Tratado do Atlântico Norte (OTAN). A MINUK apresenta-se como tentativa de operação de reconstrução de estruturas da província, com objetivos indefinidos desde o início: encaminhar o Kosovo à independência ou a uma autonomia sob supervisão internacional. Essa indefinição reflete-se no plano jurídico, sem que haja um pronunciamento do Conselho de Segurança sobre a situação atual. A diversidade de atores, os interesses divergentes das grandes potências, a seqüência de desrespeito às normas e aos princípios internacionais tornam a análise do assunto complexa, um desafio ao direito internacional no mundo contemporâneo, com a chance de que o Kosovo sobreviva como Estado dentro de uma perspectiva européia.

Cross-education of strength is a neural adaptation defined as the increase in strength of the untrained contralateral limb after unilateral training of the opposite homologous limb. The neural mechanisms of the effect have remained elusive, although it appears to be a motor learning adaptation. Despite cross-education of strength being an inter-limb effect, no previous study has determined the influence of handedness and the direction of transfer (dominant to non-dominant or the reverse). Arguably, this is partly responsible for massive variation in the literature regarding the magnitude of the effect. The primary purpose of this document is to attempt to determine the central and peripheral neuro-physiological mechanisms controlling cross-education of muscular strength. Prior to determining the mechanisms of the effect, the influence of handedness and the preferred direction of transfer for cross-education of strength must be addressed. The secondary purpose is to determine the preferential direction of transfer of cross-education of strength in order to isolate the circumstances in which the effect is more pronounced. Two experiments were necessary to meet these objectives. <p>Experiment 1: The purpose was to determine the effect of the direction of transfer on cross-education in right-handed individuals. Subjects were randomized into a left-hand training (LEFT), right-hand training (RIGHT), or non-training control (CON) group. Strength training was 6 weeks of maximal isometric ulnar deviation, 4 times per week. The change in strength in the untrained limb was greatest in the RIGHT group (39.2%; p<.01), whereas no significant changes in strength were observed for the untrained limb of the LEFT group (9.3%) or for either of the CON group limbs (10.4% and 12.2%). There were no changes in muscle thickness of untrained limbs compared to CON. Changes in untrained limb EMG were not different compared to CON. Cross-education with hand strength training occurs only in the right-to-left direction of transfer in right-handed individuals. Cross-education of arm muscular strength is most pronounced to the non-dominant arm. <p>Experiment 2: The purpose of this study was to determine the central and peripheral mechanisms of cross-education of strength after actual and imagery training. Subjects were randomized into an actual training, imagery training, or non-training control group. A sub-sample of 8 subjects (4 actual, 4 imagery training) had brain activity during exercise assessed with functional magnetic resonance imaging (fMRI). Strength training was 6 weeks of maximal isometric handgrip ulnar deviation (Biodex) of the right arm, 4 times per week. Actual training was highly effective for increasing strength in trained (45.3%; p<.01) and untrained (47.1%; p<.01) limbs. Imagery training and control groups had no increases in strength for either arm. Muscle thickness increased only in the trained arm of the actual group (8.4%; p<.001). After actual training, there was an increase in activation of contralateral sensorimotor cortex and left temporal lobe during actual contractions with the untrained left arm (p<.001). Actual training was associated with a significantly greater change in agonist muscle activation pooled over both limbs, compared to the imagery and control groups (p<.05). Cross-education of strength is only significant after actual training, indicating that peripheral feedback is necessary for the effect. Cross-education of strength is accompanied by changes in cortical activation indicative of motor learning and the retrieval of memory of movement acquired by the trained limb. <p>General Conclusion: The neuro-physiological mechanism of cross-education of strength is that changes in cortical activation indicative of motor learning occur in both brain hemispheres after unilateral training. Cross-education of strength is influenced by strength asymmetries related to handedness, and the preferential direction of transfer is from dominant to non-dominant limb. Cross-education is a motor learning adaptation also reliant on peripheral feedback during training.

Humans possess the ability to generate an incredible degree of complex, highly skilled, and coordinated movements. Although much is known about the anatomical and physiological components of upper limb movement, the exact means by which these different areas coordinate is still far from understood. The ability to perform symmetrical, bimanual tasks with ease suggest a default coupling between mirror motor regions – a default coupling that is perceptible in unilateral movements. During intended unimanual movement in the upper limbs, bilateral changes to motor cortex output occur. The purpose of this study was to investigate the neural underpinnings of these bilateral changes and investigate the involvement of intracortical inhibitory circuits. Previous studies have shown that transcallosal connections between cortical representations of the intrinsic muscles of the hands are relatively sparser than the more proximal muscles of the upper limbs. It was hypothesized that differential responses in overall motor output or intracortical inhibition to ipsilateral muscle activation between the FDI and ECR could infer the involvement of transcallosal pathways; although interhemispheric transfer was not directly investigated in this thesis. Two studies used focal transcranial magnetic stimulation (TMS), specifically paired-pulse protocols, to investigate changes in short-interval intracortical inhibition (SICI) and long-interval intracortical inhibition (LICI) in response to contraction of contralateral homologous muscle groups to the inactive test muscle. Also, the response to activation of a non-homologous, but spatially close, muscle was investigated. Lastly, two muscle groups were investigated, a distal, intrinsic muscle of the hand (first dorsal interosseous) and a relatively more proximal muscle of the upper limb (extensor carpi radialis). These studies revealed that at low levels of force generation, unilateral isometric contractions facilitate ipsilateral mirror motor representations and reduce local GABA¬A receptor mediated inhibition. Notably, while similar facilitation occurred in both the distal and proximal effectors, decreases in SICI were much more robust in the ECR. Findings from this thesis provides insight into the neural mechanisms governing bilateral changes with unilateral movement and is important in the guiding the focus of future research.

Additional cognitive deficits, including impairments in spatial working memory and/or saccadic remapping processes, have recently been implicated in unilateral neglect – a neurological condition classically characterized as a disorder of attention. The interactions between saccadic remapping and three memory processes (position memory, object memory and object-location binding) were investigated in healthy young (n=27) and elderly (n=20) participants to establish a baseline of comparison for future use with neglect patients and to study the effects of aging on these processes. In a computerized task, participants were instructed to first detect a target, and then hold in memory either its position, identity or both over a delay period. Subsequently, participants were tested on their memory for that particular task. The saccadic remapping component was introduced at the onset of the delay period with the fixation cross shifting either to the left, or right, requiring participants to remap the visual array into either right or left space, or remaining in the centre of the screen (i.e., no remapping condition). In the position memory and object-location binding task, a consistent cost to memory performance was found when remapping right only for the young participants. Overall the elderly did not perform any of the tasks involving a position memory component as well as the young participants and showed spatial asymmetries in the target detection task. The lack of an effect of remapping in the elderly group may be due to a general decrement in performance. These results are discussed in terms of hemispheric asymmetries and cognitive theories of aging.

Humans possess the ability to generate an incredible degree of complex, highly skilled, and coordinated movements. Although much is known about the anatomical and physiological components of upper limb movement, the exact means by which these different areas coordinate is still far from understood. The ability to perform symmetrical, bimanual tasks with ease suggest a default coupling between mirror motor regions – a default coupling that is perceptible in unilateral movements. During intended unimanual movement in the upper limbs, bilateral changes to motor cortex output occur. The purpose of this study was to investigate the neural underpinnings of these bilateral changes and investigate the involvement of intracortical inhibitory circuits. Previous studies have shown that transcallosal connections between cortical representations of the intrinsic muscles of the hands are relatively sparser than the more proximal muscles of the upper limbs. It was hypothesized that differential responses in overall motor output or intracortical inhibition to ipsilateral muscle activation between the FDI and ECR could infer the involvement of transcallosal pathways; although interhemispheric transfer was not directly investigated in this thesis. Two studies used focal transcranial magnetic stimulation (TMS), specifically paired-pulse protocols, to investigate changes in short-interval intracortical inhibition (SICI) and long-interval intracortical inhibition (LICI) in response to contraction of contralateral homologous muscle groups to the inactive test muscle. Also, the response to activation of a non-homologous, but spatially close, muscle was investigated. Lastly, two muscle groups were investigated, a distal, intrinsic muscle of the hand (first dorsal interosseous) and a relatively more proximal muscle of the upper limb (extensor carpi radialis). These studies revealed that at low levels of force generation, unilateral isometric contractions facilitate ipsilateral mirror motor representations and reduce local GABA¬A receptor mediated inhibition. Notably, while similar facilitation occurred in both the distal and proximal effectors, decreases in SICI were much more robust in the ECR. Findings from this thesis provides insight into the neural mechanisms governing bilateral changes with unilateral movement and is important in the guiding the focus of future research.