Reconstrucción de rotura crónica de tendón distal del bíceps braquial: a propósito de un caso

Las roturas inveteradas o crónicas del tendón distal del bíceps braquial son infrecuentes. Su tratamiento supone un reto importante por el grado de retracción y deficiente calidad del tendón y músculo lesionados, que en ocasiones obligan al empleo de injertos para tratar de restaurar la anatomía y mejorar los resultados funcionales. La tasa de complicaciones en las reparaciones de roturas crónicas es mayor con respecto a las reparaciones de lesiones agudas. Presentamos el caso de una reparación quirúrgica de una rotura crónica de 3 meses de evolución mediante la utilización de aloinjerto liofilizado de Aquiles.Chronic or inveterate disruptions of the distal biceps brachii are uncommon. Treatment remains a major challenge by shrinkage and poor quality of the injured tendon and muscle, which sometimes require the use of grafts to try to restore the anatomy and improve the functional outcomes. The rate of complications in surgical treatment of chronic tears is more than the repairs of acute injuries. We report the case of a surgical reconstruction of a chronic tear three months of evolution using lyophilized Achilles allograft

Sedimentological and palaeohydrological characterization of Late Pleistocene and Holocene tufa mound palaeolakes using trenching methods in the Spanish Pyrenees

Lakes developed in the inner depressions of tufa mounds are rare geomorphic features and still poorly understood. Sedimentation in this unusual type of endorheic lake with a very restricted catchment area is highly sensitive to environmental and hydrological changes. The Isona tufa mound complex, north-eastern Iberian Peninsula, is associated with the discharge zone of a confined artesian aquifer and comprises 11 tufa mounds consisting of an annular rimstone enclosing a central depression filled with lake deposits. Data gathered from trenches excavated in four palaeolakes located within three different morphostratigraphic units permitted a precise analysis of the geometrical characteristics and stratigraphic relationships of the deposits and provided a sedimentation model for the Late Quaternary infilling of the spring-fed lakes. The work illustrates that trenches allow a precise characterization of the stratigraphic arrangements, lateral facies changes and deformation structures, which are not apparent in studies relying solely on borehole records, and facilitate sampling for dating and geochemical analyses. The five sedimentary facies described represent different evolutionary stages of the lakes, including: (i) carbonate-rich palustrine deposits probably related to periods with strong hydrological seasonality; (ii) massive highly bioturbated organic ooze; (iii) banded organic carbonate-rich facies associated with an increase in the regional effective moisture; (iv) finegrained quartz-rich aeolian/slope-wash sediments; and (v) colluvial facies deposited following the desiccation of the lakes located at higher altitudes. Geochemical and sedimentological analyses of the lacustrine sequences provided information on the palaeohydrological evolution of the Isona tufa mound complex and the palaeoenvironmental conditions of the area over the last 28 ka. Radiometric dating suggests that deposition occurred simultaneously at ca 22 ka in palaeolakes situated at different elevations. A drop in the piezometric level prompted by the opening of springs at lower altitudes probably caused the deactivation of the upper springs and the desiccation of the lakes. Arid conditions prevailed in the area during the Late Glacial and the early Holocene (28·0 to 8·5 ka BP). More humid conditions recorded from 8·5 to 4·2 ka and again since 1·7 ka are in accordance with palaeoenvironmental reconstructions available in the Western Mediterranean since the Last Glacial Maximum

Identifying the boundaries of sinkholes and subsidence areas via trenching and establishing setback distances

One of the most effective mitigation strategies in sinkhole areas is the exclusion of sinkholes and their vicinity to construction. The application of this preventive measure requires precise mapping of the boundaries of the areas affected by subsidence and the establishment of adequate setback distances, which is an important policy issue with significant economic implications. Through the investigation of several buried sinkholes in the mantled evaporite karst of the Ebro Valley by trenching, this work illustrates that the actual extent of the subsidence areas may be much larger than that inferred from surface mapping and geophysical surveys. The objective and accurate subsurface information acquired from trenches on the outer edge of the deformed ground revealed sinkhole radii 2–3 times larger than initially estimated, increasing one order of magnitude the sinkhole area. Trenches can therefore help to reduce mapping uncertainties and the size of setbacks. Moreover, the trenching technique, in combination with geochronological data and retrodeformation analyses, provides critical information on the subsidence phenomena and the characteristics of the sinkholes relevant to hazard assessment. Since recommended setback distances found in the existing literature are highly variable and rather arbitrary, we include a discussion here on the main factors that should be considered when defining setback zones for sinkholes

Sinkholes in hypogene versus epigene karst systems, illustrated with the hypogene gypsum karst of the Sant Miquel de Campmajor Valley, NE Spain

The Garrotxa-Banyoles artesian aquifer system in NE Spain includes zones with epigene and hypogene evaporite karst and sinkhole development. The sinkhole fields related to hypogene evaporite dissolution are associated with the discharge zones of the aquifer, where groundwater from a confined limestone rises traversing an overlying gypsum formation capped by thick marls. This work analyses the sinkhole field developed in the Sant Miquel de Campmajor Valley (SMCV), a discharge area of the aquifer, where a cartographic inventory including 94 sinkholes has been produced. Sinkholes in this hypogene gypsum karst are mainly large caprock-collapse sinkholes rooted in deep-seated cavities generated by interstratal hypogene karstification, as corroborated by an electrical resistivity imaging (ERI) survey. They show a non-clustered distribution within the sinkhole field and the variations in size and density across the area are mainly controlled by the thickness of the marl caprock. The magnitude and frequency relationships of the sinkholes can be modelled with a high goodness of fit with a log-normal function, like in other regions of the world. However, in this deep-seated hypogene system the depressions show much larger dimensions. Potential differences between the sinkholes developed in hypogene and epigene karst environments are discussed, including their distribution with respect to the groundwater flow system, their spatial patterns and dimensions

Evaluating susceptibility of karst dolines (sinkholes) for collapse in Sango, Tennessee, USA

Dolines or sinkholes are earth depressions that develop in soluble rocks complexes such as limestone, dolomite, gypsum, anhydrite, and halite; dolines appear in a variety of shapes from nearly circular to complex structures with highly curved perimeters. The occurrence of dolines in the studied karst area is not random; they are the results of geomorphic, hydrologic and chemical processes that have caused partial subsidence, even total collapse of the land surface, when voids and caves are present in the bedrock and the regolith arch overbridging these voids is unstable. In the study area, the majority of collapses occur in the regolith (bedrock cover) that bridges voids in the bedrock. Because these collapsing dolines can damage property and cause even the loss of lives, there is a need to develop methods for evaluating karst hazards; such methods can be used by planners and practitioners for urban and economic development, especially in regions with a growing population. The purpose of this project is threefold: 1) to develop a karst feature database, 2) to investigate critical indicators associated with doline collapse, and 3) to design a doline susceptibility model for potential doline collapse based on external morphometric data. The study revealed the presence of short range spatial dependence in the distribution of the dolines’ morphometric parameters such as circularity, geographic orientation of the main doline axes and the length-to-width doline ratios; therefore, geostatistics can be used to spatially evaluate the susceptibility of the karst area for doline collapse using the probability of occurrence of these critical parameters. The partial susceptibility estimates were combined into final spatial probabilities enabling the identification of areas where undetected dolines may cause significant hazards

Kasvattajien näkemyksiä lapsilähtöisyydestä ja sen toteuttamisesta Kruununmaan päivähoidossa

Laurea-ammattikorkeakoulu Tiivistelmä Hyvinkää Sosiaalialan koulutusohjelma Laakso, Juuli Mielityinen, Sini Kasvattajien näkemyksiä lapsilähtöisyydestä ja sen toteuttamisesta Kruununmaan päivähoidossa Vuosi 2015 Sivumäärä 59 Opinnäytetyömme käsittelee lapsilähtöisyyttä ja sen toteuttamista. Tätä avaamme yhteistyökumppanimme, Kruununmaan päivähoidon, kasvattajien ja muiden työntekijöiden näkemyksiin pohjautuen. Opinnäytetyömme tavoitteena on herätellä työntekijöitä pohtimaan omaa toimintaansa sekä nostaa esiin mahdollisia hyviä käytäntöjä ja kehittämistarpeita varhaiskasvatuksen arjessa. Keskeisimpiä tutkimuskysymyksiämme on kolme ja ne ovat: Millaisia käsityksiä kasvattajilla on lapsilähtöisyydestä? Millaisia eroavaisuuksia löytyy kasvattajien lapsilähtöisyyden käsityksistä? Miten lapsilähtöisyyden toteutumista painotetaan ja miten se ilmenee yhteistyöpäiväkodin arjessa? Opinnäytetyömme on laadullinen tutkimus, jossa on myös määrällisen tutkimuksen piirteitä. Toteutimme tutkimuksen suljetuista ja avoimista kysymyksistä koostuvana kyselytutkimuksena kasvattajille ja muille työntekijöille lapsilähtöisyydestä sekä sen toteutumisesta heidän näkökulmastaan. Kyselyn jaoimme vuoden 2014 syksyllä 25 työntekijälle ja vastausprosentiksi saimme 48 % eli yhteensä 12 vastausta. Tuloksissa ilmenee, että lapsilähtöisyys käsitteenä näyttää merkitsevän kasvattajille hyvin samankaltaisia asioita. Käsitykset muuttuvat työkokemuksen ja iän myötä entistä lapsilähtöisemmäksi. Kaikki kasvattajat luultavasti kokevat toimivansa lapsilähtöisesti, mutta toiminnassa tämä painottuu monin eri tavoin. Esimerkiksi lapsilähtöisyyteen liittyvien käsitteiden monimutkaisuus aiheuttaa paljon kysymyksiä. Lapsilähtöisyydestä keskustellaan ja sitä painotetaan ammatillisessa koulutuksessa, varhaiskasvatustyön arjessa sekä lisäkoulutuksissa ja näitä asioita onkin hyvä pohtia aika ajoin. Varhaiskasvatussuunnitelmat sisältävät painotuksen lapsilähtöisyydestä. Esimerkiksi lapsen viihtyvyys päivähoidossa kertoo siitä, onko toiminta aidosti lapsilähtöistä. Kehittämisideoita ja hyviä käytäntöjä lapsilähtöisyyden toteuttamiseen varhaiskasvatuksessa ovat muun muassa kiireettömyyttä ja lapsen osallisuutta tukevan ilmapiirin luominen. Toivomme, että valmis opinnäytetyömme avaisi ja herättäisi Kruununmaan päivähoidossa sekä varhaiskasvatuksessa yleensä laajalti keskustelua sekä mahdollisesti antaisi näkökulman tulevaisuuden kehittämistyölle. Jatkoa ajatellen teemaa voisi tutkia lasten näkökulmaan ja kokemuksiin pohjautuen. Asiasanat: varhaiskasvatus, lapsilähtöisyys, lapsen hyvinvointi, lapsen yksilöllinen huomiointi, kasvattajan rooli.Laurea University of Applied Sciences Abstract Hyvinkää Degree Programme in Social Services Laakso, Juuli Mielityinen, Sini Educators’ views on child-centeredness and its fulfillment in Kruununmaa daycare Year 2015 Pages 59 Our thesis deals with child-centeredness and its fulfillment. We approach this based on our cooperation partner, Kruununmaa’s daycare, educators’ and other employees’ view. The aim of our thesis is to awaken employees to reflect on their own action and highlight possible good ways to act and the need for development in everyday life of early childhood education. Our three main research questions are: What kind of views do educators have on child-centeredness? What kind of differences is there between educators’ views on child-centeredness? How child-centerednesses fulfillment is highlighted and how does it appear in everyday life of our cooperation partner daycare. Our thesis is qualitative research which includes also aspects of quantitative research. We implemented the research as a survey for educators and other employees about their point of view on child-centeredness and its fulfillment. The survey consisted of closed and open questions. We gave surveys to 25 employees in autumn 2014. The response percent was 48 % so we got 12 responses in total. The results indicate that child-centeredness as a concept seems to mean similar things to ed-ucators. Educators’ ideas change to being more child-centered along with work experience and age. All educators probably feel that they act child-centerednessly but in action this is emphasized in many different ways. For example complication of concepts related to child-centeredness causes many questions. There is a discussion about the emphasis of child-centeredness on professional education, everyday life of early childhood education and further training and it’s good to reflect on these things now and then. Early Childhood Education and Care (ECEC) includes emphasis about child-centeredness. For example a child’s comfort level of of being in a daycare tells if the action is really child-centered. Ideas on development about child-centerednesses fulfillment in early childhood education are amongst other things able to create an atmosphere that supports unhurriedness and a child’s participation. We hope that the finished thesis could raise conversation widely in Kruununmaa daycare and early childhood education generally and that in future the development could possibly be based on our thesis. In future this theme could be further studied based on the children’s point of view and their experiences. Keywords: early childhood education, child-centeredness, child’s welfare, child’s individual observation, educator’s rol