A influência de duas mochilas sobre a cinemática da coluna de crianças

This study aimed to analyze the effect of backpack load carriage over the spine. The studies that have investigated load carriage using backpacks have analyzed the lower limb dynamics and have not focused on the spine. In addition, the strategies applied by children may differ from adults as the relative weight differs between adolescents and adults. Methods: Ten schoolboys (13.9 ± 0.6 years-old; 1.53 ± 0.05 m; 44.9 ± 3.3 kg) volunteered to participate after their parents sign an informed consent form. Participants walked in a treadmill during approximately 15 minutes carrying a specially built backpack with a load that corresponded to 0.10 and 20% BW. A number of landmarks were placed over the subjects back and allowed reconstruction of the spinal profiles in the sagittal and frontal planes. The relation between the segments formed between acromium markers and the posterior superior iliac crest markers was used as a spinal rotation index. The maximum, minimal, mean and range of motion of the thoracic and lumbar regions and the whole spine were analyzed. The gait cycle was applied to normalize the gait cycle. Results indicated differences between the two loads (10%BW and 20%BW). A number of changes in the spinal kinematics was found. In the saggital plane the range of movement was unaltered, although there was an increased in the flexion, which was interpreted as a compensatory strategy to counteract the effect of the load. These results are in line with the idea that the use of a backpack increases anterior leaning of the trunk, but are in disagreement with the notion that pronounced changes in the range of motion occur. Carrying a backpack did not produce a clear effect over the variables selected to identify thoracic and lumbar spine regions in the sagittal plane. Conclusion: Carrying a load that corresponded to 20%BW influences spinal kinematics in all planes of movements. These changes may impose an important change in posture and stress applied over the posterior aspect of the vertebral column. The slow walking speed used in the present study may have not induced large changes in the kinematics of the vertebral column as in other studies in which walking was performed in greater speeds. Thus, it is suggested that weight of the backpack is not the only factor that determines the movements of the vertebral column.Este estudo visou analisar o efeito do carregamento de cargas por meio de mochilas sobre a coluna. Os estudos que investigaram o carregamento de cargas utilizando mochilas têm analisado a dinâmica de membros inferiores e não tem focado a coluna vertebral. Em adição, as estratégias aplicadas por crianças podem diferir visto que as cargas relativas podem diferir entre adolescentes e adultos. Métodos: dez escolares (13,9 ± 0,6 anos; 1,53 ± 0,05 m; 44,9 ± 3,3 kg) foram voluntários para participar do estudo após seus pais consentirem e assinarem um formulário livre e esclarecido. Os participantes caminharam em uma esteira. Durante aproximadamente 15 minutos carregando uma mochila especialmente feita que correspondia a 0,10 e 20% do peso corporal. Um número de marcas corporais foi colocada nas costas dos sujeitos que permitiram a reconstrução dos perfis da coluna nos planos sagital e frontal. A relação entre os segmentos formados pelas marcas entre os acrômios e as cristas ilíacas foi usada como um índice de rotação da coluna. Os valores máximos, mínimos, médios e as amplitudes de movimento das regiões torácica e lombar e a coluna toda foram analisados. O ciclo da marcha foi normalizado pelo contato sucessivo de dois contatos do calcanhar com o solo. Resultados indicaram diferenças entre as cargas (10 e 20% PC). Um número de mudanças na cinemática da coluna foi encontrada. No plano sagital a amplitude de movimento permaneceu inalterada, todavia, houve um aumento na flexão a qual foi interpretada como uma estratégia compensatória em resposta ao efeito da carga. Os resultados estão em linha com a idéia que o uso de mochilas aumenta a inclinação anterior do tronco, mas em discordância com a noção que pronunciadas mudanças na amplitude de movimento ocorrem. O carregamento de cargas não produz um efeito claro sobre as variáveis selecionadas para identificar as alterações nas regiões lombar e torácica no plano sagital. Conclusão: o carregamento de cargas que correspondem a 20% PC influenciam a cinemática da coluna em todos os planos de movimento. Essas mudanças podem impor importantes mudanças sobre a postura e o estresse aplicado sobre os aspectos anteriores e posteriores da coluna vertebral. A baixa velocidade de deslocamento usada no presente estudo podem não ter induzido grandes mudanças na cinematica da coluna vertebral, como demonstrado em outros estudos que usaram maiores velocidades de deslocamento. Desta forma, sugere-se que o peso da mochila não é o único ator que determina os movimentos da coluna vertebral

USER-GENERATED CONTENT AND CONSUMER EMPOWERMENT IN THE TRAVEL INDUSTRY: A USES & GRATIFICATIONS AND DUAL-PROCESS CONCEPTUALIZATION

User-Generated Content (UGC) on the World Wide Web has empowered travellers, enabling them to exchange opinions or experiences with others, and consequently, influencing their travel decisions. Travellers are able to make comments in a large variety of forms such as photos, videos, podcasts, ratings, reviews, articles and blogs. When people use the Internet to obtain travel information, they do research about the trip on the Internet, read and generate content and reviews, and interact with other travellers in social networks. This is empowering tourists by giving them the opportunity to receive and pass on recommendations of their travel experiences. Despite the importance of UGC in the travel industry, our understanding of how UGC empowers online consumer remains limited. By employing the Uses & Gratifications and Dual-Process Theories, we propose that Consumer Empowerment in the context of UGC can be formed through Content Empowerment, Social Empowerment and Process Empowerment

Present status for diagnosis and treatment of acute appendicitis in children: evaluation of 300 cases

BACKGROUND: In our clinical practice, we have observed that despite the great technological advances in diagnostic methods acute appendicitis still represents a problem in children, resulting in late diagnosis and treatment, and case of greater severity. Our objective is to assess the current state of diagnosis and treatment of acute appendicitis in children treated in two important referral hospitals of São Paulo (Brazil), over a 30 month's period. METHODS: The variables studied were: age, sex, clinical manifestations, time for the diagnosis to be established, the findings from physical examination and laboratory tests, surgical findings and antibiotic protocols, postoperative complications and hospital lenght of stay. RESULTS: In the present sample, of 300 children, 65% were boys and 35% girls, with an initial diagnosis of appendicitis being made in 63% of the cases. The signs and symptoms most frequently encountered were: abdominal pain in the right iliac fossa (85.3%) and peritoneal irritation in this region (82%). We identified leukocytosis in 83% of the patients and the urine analysis showed leukocyturia in 39.7% of the patients. Around 92.4% of the simple radiological studies of the abdomen produced images that were not specific to acute appendicitis. Ultrasonography studies diagnosed the disease in 80.1% of the cases. Various antibiotic schemes were used, although there was special attention towards Gram-negative and anaerobic bacteria. The main complication was infection of the surgical wound, and there was no mortality. The average hospital length of stay was 5 days. CONCLUSION: In spite of greater knowledge of acute appendicitis and greater refinement of laboratory and radiological techniques, the diagnosis is still delayed and disease constitutes a cause of great morbidity among pediatric age groups.OBJETIVOS: Avaliar o estado atual do diagnóstico e tratamento da apendicite aguda em crianças operadas em dois grandes hospitais quaternários da cidade de São Paulo, no período de 30 meses. MÉTODO: Nossa casuística constou de 300 crianças operadas por apendicite aguda no período de 1998 a 2000 (65% do sexo masculino e 35% feminino). Foram analisadas as variáveis idade, sexo, manifestações clínicas, tempo gasto para o diagnóstico, achados de exame físico, laboratoriais e cirúrgicos, antimicrobianos administrados, complicações pós-operatórias e tempo de internação. Utilizou-se o teste t de Student para avaliar duas variantes e Análise de Variâncias quando mais de duas. RESULTADOS: Diagnosticou-se inicialmente apendicite aguda em apenas 63% dos casos, tendo os 35% restantes, diagnóstico de abdome agudo cirúrgico. O tempo decorrido na realização do diagnóstico foi superior a 24 horas em 57,4% dos casos, denotando retardo importante na sua elaboração. Dor abdominal (85,3%) e irritação peritoneal (82%) em fossa ilíaca direita foram os sinais e sintomas mais freqüentes. Identificou-se leucocitose em 83% dos pacientes e leucocitúria em 39,7 %. Em 92,4% das radiografias simples de abdome encontramos imagens sugestivas de apendicite aguda. A ultra-sonografia abdominal foi diagnóstica em 80,1% dos casos. Utilizaram-se esquemas antimicrobianos especialmente para agentes gram-negativos e anaeróbicos. A principal complicação foi infecção da ferida cirúrgica, não tendo sido observada mortalidade no grupo. A média de internação foi de 5.2 e 6,0 dias para meninos e meninas respectivamente. CONCLUSÃO: Mesmo com melhor conhecimento sobre apendicite aguda, refinamento técnico, laboratorial, radiológico e uso de antibioticoterapia adequada, o tempo de para diagnóstico e a morbidade ainda se mantém alta na idade pediátrica.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Hospital Santa MarcelinaUNIFESP, EPM, Hospital Santa MarcelinaSciEL

Laryngocele: a cause of upper airway obstruction

SummaryLaryngoceles are abnormal dilatations of the laryngeal saccule, which rises between the ventricular folds, the base of the epiglottis and the inner surface of the thyroid cartilage. Clinical symptoms are rare, and the find of asymptomatic laryngoceles in pathology studies are frequent. Sometimes it is presented as cervical swelling causing airway obstruction in need of emergency intervention. In this study, we report a case of upper airway obstruction due to laryngocele treated by emergency tracheotomy and we review of the literature. Laryngocele complications include infection (pyocele formation), pathogens aspirations with subsequent bronchitis and pneumonia and upper airway obstruction, as in the case reported. Despite being benign tumors, laryngoceles cause relevant airway obstruction. Correct diagnosis and proper treatment can preclude emergencies as it happened to our patient hereby reported

48P. User-Generated Content and Perceived Control: A Pilot Study of Empowering Consumer Decision Making

There is growing interest in understanding of how User-Generated Content (UGC) empowers online consumer behavior. In this paper, we explore the relationships between Consumer Empowerment and Perceived Control (mediated by Self-Efficacy) over the decision making process using UGC. The results of this study reveal that Perceived Control has an influence on intention to use UGC. The findings also suggest that Consumer Empowerment has the capacity to influence Perceived Control, both directly (primarily via Content Empowerment), and indirectly (via Social Empowerment and Process Empowerment, mediated by Self-Efficacy, which in turn influences Perceived Control)

Front crawl arm stroke trajectories of physically impaired swimmers: A preliminary study

© 2019 Elsevier Masson SAS. Introduction: This study evaluated three-dimensional kinematic parameters of the front crawl stroke in physically impaired swimmers across a range of functional classification levels. Facts and Results: Eight highly-trained competitive swimmers (5 male and 3 female) from IPC classes S5 to S9 performed 50 m maximal front crawl trials while being video-taped by six cameras (four under- and two above water). The most distal point of the right upper limb was manually digitised at 50 Hz to allow three-dimensional reconstruction of the limb's trajectory through the water. Conclusion: The stroke presented large inter-swimmer variability, reflecting individual characteristics and severity of the impairment. The swimmers who combined shallow and narrow stroke movements produced a shorter trajectory. This study provides swimmers and coaches with an overview of the kinematic characteristics of a range of physically impaired swimmers

Packing Circles Within Circular Containers: A New Heuristic Algorithm For The Balance Constraints Case

In this work we propose a heuristic algorithm for the layout optimization for disks installed in a rotating circular container. This is a unequal circle packing problem with additional balance constraints. It proved to be an NP-hard problem, which justifies heuristics methods for its resolution in larger instances. The main feature of our heuristic is based on the selection of the next circle to be placed inside the container according to the position of the system's center of mass. Our approach has been tested on a series of instances up to 55 circles and compared with the literature. Computational results show good performance in terms of solution quality and computational time for the proposed algorithm.36227930