Modelação computacional do membro inferior humano para a reprodução da dinâmica da marcha com músculos: casos saudável e patológico

Dissertação de mestrado integrado em Engenharia BiomédicaA biomecânica do movimento compreende o estudo e análise do movimento realizado por seres vivos, quer seja para melhorar o seu desempenho ou prevenir e tratar lesões. O primeiro é amplamente aplicado ao estudo do desporto e ao auxílio prestado aos atletas para desempenhar um movimento pretendido. De modo a ajudar na prevenção e tratamento de lesões, a biomecânica visa providenciar conhecimento acerca das propriedades mecânicas dos tecidos humanos, das cargas mecânicas a que eles estão sujeitos durante o movimento e de terapias relacionadas com prevenção e reabilitação. Atua no sentido de auxiliar na projeção estratégias de reabilitação e dispositivos médicos de assistência. Este trabalho compreende o uso de um modelo biomecânico do membro inferior humano previamente desenvolvido por Geyer & Herr (2010). O modelo inclui a reprodução dos sistemas esquelético, muscular e neuronal humanos com o objetivo de produzir o movimento do modelo. Esta abordagem foi utilizada para estudar eventos que ocorrem a nível articular, considerando, por exemplo, a amplitude de movimento e os torques produzidos, durante uma marcha fisiológica e patológica com lesão do ligamento anterior cruzado (LAC). Esta patologia está associada a atividades, tais como o basquetebol, envolvendo mudanças rápidas na direção combinadas com aceleração e desaceleração do corpo. Estas ações causam lesões do LAC e por vezes levam à sua rutura, provocando a necessidade de procedimentos de reabilitação e cirúrgicos para melhorar a qualidade de vida dos pacientes. Para o modelo biomecânico saudável, considerando os ângulos das juntas, os resultados apresentam uma concordância muito boa com a literatura. Os dados cinéticos demonstram algumas semelhanças, bem como discrepâncias. O torque da articulação do tornozelo é o que mais se aproxima da literatura, enquanto que o torque da anca e do joelho apresentam diferenças tanto em magnitude (maior do que o esperado), como em forma. Os padrões de ativação muscular também apresentam diferenças quando comparados com a literatura. Sugestões são dadas para minimizar estas ocorrências. A implementação da patologia consistiu na diminuição do torque produzido pelos músculos (quadríceps e hamstrings) afetados pela lesão do ligamento anterior cruzado após reconstrução cirúrgica. A variável mais próxima da literatura é a força vertical de reação com o solo, enquanto que os restantes dados cinéticos diferem. Sugestões são dadas de forma a equivaler mais os resultados com a literatura.Biomechanics of movement comprises the study and analysis of the movement performed by living beings, whether by improving its performance or by preventing and treating injury. The former is extensively applied to understanding sports and to help athletes performing a desired movement. In order to help preventing and treating injury, biomechanics aims at providing knowledge on the mechanical properties of human tissues, the mechanical loads they feel during movement, and on therapies related to prevention and rehabilitation. It acts to help design rehabilitation procedures and assistive medical devices. This work comprises the use of a biomechanical model of the human lower limb previously developed by Geyer & Herr (2010). The model possesses the reproduction of the human skeletal, muscular and neural systems in order to produce the model’s movement. This approach was used to study the events occurring at joint level, regarding, for instance, its range of motion and produced torques, during physiological and anterior cruciate ligament (ACL) pathological gait. This gait pathology is associated with activities, such as basketball, involving rapid changes in direction combined with acceleration and deceleration of the body. These actions cause ACL injuries and sometimes lead to its rupture, provoking the need for surgical and rehabilitation procedures to improve the patient’s life quality. For the healthy biomechanical model, regarding the joints’ angles, the results present very good agreement with results found in literature. The kinetic data show some similarities, as well as discrepancies. The ankle joint torque is the closest to literature findings, whilst the hip and knee joint torque present differences both in magnitude (higher than expected) and in shape. The muscular activation patterns also present differences when compared to literature. Suggestions are made in order to minimize these occurrences. The implementation of pathology consisted in diminishing the torque produced by the muscles (quadriceps and hamstrings) affected by an anterior cruciate ligament injury after its surgical reconstruction. The variable closer to literature findings is the vertical ground reaction force, whilst the other kinetic and kinematic data differ. Suggestions are made in order to make the results more equivalent to literature

Análise multitemporal do uso e cobertura do solo da região de influência do Parque Nacional da Chapada dos Veadeiros

Trabalho de Conclusão de Curso (graduação)—Universidade de Brasília, Instituto de Ciências Humanas, Departamento de Geografia, 2015.O atual cenário de ocupação antrópica no bioma cerrado demonstra o quanto as sociedades contemporâneas já produziram e ainda produzem impactos relacionados à degradação do meio natural. A região de influência do Parque Nacional da Chapada dos Veadeiros (RIPNCV), localizada ao nordeste do estado de Goiás, possui grande representatividade no cenário da conservação do bioma cerrado. Além de possuir uma unidade de conservação integral, o Parque Nacional da Chapada dos Veadeiros, a região detêm uma quantidade considerável de unidades de organização do território que atribuem certo valor à preservação do cerrado. No entanto, a RIPNCV vem sendo alvo da expansão da fronteira agrícola. O emprego do plantio de grãos substitui valiosas riquezas naturais e a paisagem é tomada por vastas planícies de lavoura. Um dos meios para avaliar esta dinâmica é através da construção de mapas de uso e cobertura do solo. Considerando que este tipo de mapa temático colabora para auxiliar a gestão pública para o planejamento territorial, o objetivo desse estudo foi avaliar a espacialização do uso e cobertura do solo na RIPNCV. Através de técnicas de sensoriamento remoto, foi possível desenvolver um mapa de uso e cobertura do solo na escala de 1:60.000 para cada ano da série estudada, os períodos corresponderam aos anos de 1984, 2000 e 2015. Os municípios que compõem a região e algumas unidades de organização do território também foram analisadas individualmente. A partir da classificação pelo método de interpretação visual, foi observado que nos últimos trinta e um anos houve uma perda de 231.058 ha de vegetação natural. Além disso, os usos de cobertura antrópica correspondem a 32,43% de todo o território estudado e que este aumento se repete, em diferentes proporções, nas escalas municipais.The influence area of Chapada dos Veadeiros National Park (RIPNCV), located at the northeastern State of Goias, is of great relevance for cerrado’s biome preservation. Antropic occupation at cerrado biome shows how contemporary societies have produced and still produce environmental damages. Besides having full protection units – The National Park of Chapadas dos veadeiros – the area holds a considerable amount of organizational territory units, which accounts for the cerrado biome protection. Nevertheless, RIPNCV is being target of the agricultural boundaries expansion. Grains plantation replaces valuable natural wealth, and farming landscape takes vast plains. One of the means to assess such dynamics over geographical space changes is through solo usage and coverage maps design. Aware that the suggested thematic map cooperates with public management in territorial planning, the aim of this study was to assess spatial usage and coverage at RIPNCV. Through remote sensing it was feasible to develop a soil usage and coverage map at the scale of 1:60.000 for every year of the spotted serie, which are the years of 1984, 2000 and 2015. Municipalities which are part of RIPNCV and some organizational territory units have also been analised individually. Taking the visual analysing method as a starting point, a 231.58 hectares natural vegetation loss was observed over the last 30 years. Furthermore antropic coverage use corresponds to 32, 43% of all the area studied, and such increase is also replicated in diferente proportions on municipalities scales

Impact of health concepts on healthcare-seeking practices of low-income population in South Coast of Bahia, Brazil / Impacto dos conceitos de saúde nas práticas de busca de atenção à saúde da população de baixa renda no litoral sul da Bahia, Brasil

Objective: By using geospatial and social perspectives, this paper aimed to show the most prevalent health self-concepts among inhabitants living near a specific community health centre in South Bahia, Brazil, in order to investigate the importance of social determinants and the association between health concepts and self-care habits. Methodology: A descriptive research based on the quantitative approach of using qualitative variables was carried out by using Chi-square and Cramer's V tests. A semi-structured questionnaire was administered to participants (N= 501) with geographic coordinates recorded for geospatial analysis. Results: The most prevalent health concepts were the positive and the most addressed care habits were of those in the ‘common sense’ category (p = 0.01). The associations with health concepts were considered statistically significant in terms of age (p = 0.001), level of education (p = 0.0004), and household income (p = 0.0125), and an additional criterion of presence or absence of any disease (p = 0.001). The majority of participants (n=323, CI 122–460 p<0.001) reported they have known the precise location of the community healthcare unit. However, those who lived a greater distance from the unit were unaware of its location. Conclusions: Our results on geospatial analysis corroborate the importance of space planning as an additional social framework for measuring the performance of health policy. Our findings suggest that a more structured and better planning based on health self-concepts and of health service promotion could drive effective strategies that would promote health outcomes in the low- and middle-income communities

Oportunidades Económicas dos Mercados Voluntários de Carbono no Contexto das Políticas Agrícola e Florestal

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Hospitalização de idosos e a atuação da enfermagem: análise da produção cientifica brasileira

Esta es una revisión integrativa que tiene como objetivo evaluar la producción científica relacionada con la hospitalización de los ancianos y actividades de enfermería en Brasil, entre 2007 y 2011, en las publicaciones de la Biblioteca Virtual en salud-BVS Redalyc y Scielo, por el cruce de los descriptores: anciano, hospitalización y enfermería. Fueran evidenciadas tres categorías temáticas: Perfil de morbilidad y mortalidad de los ancianos, Actuación de la enfermería frente al anciano hospitalizado y Percepción de ancianos hospitalizados sobre el envejecimiento y la muerte. Los resultados mostraron la necesidad de más investigaciones que aborden el proceso de salud y enfermedad, la muerte y el morir desde la perspectiva de los ancianos hospitalizados, además de la participación familiar en el cuidado y la interacción del hospital con los servicios de atención primaria en salud.This is an integrative review that aims to assess the scientific literature related to the hospitalization of the elderly and nursing activities in Brazil, between 2007 and 2011, in the universe of Virtual Health Library, Redalyc and Scielo, from crossing of the descriptors: elderly, hospitalization and nursing. Were shown three thematic categories: Profile of morbidity and mortality of elderly, Nursing work front of the elderly hospitalized and Perception of elderly hospitalized about aging and death. The results showed the need for more research that address the process of health and illness, death and dying from the perspective of the elderly hospitalized, in addition to the family participation in care and the interaction of the hospital with the services of primary health care.Esta é uma revisão integrativa que tem como objetivo avaliar a produção científica relacionada à hospitalização de idosos e a atuação da enfermagem no Brasil, entre 2007 e 2011, nas publicações da Biblioteca Virtual em Saúde – BVS, Redalyc e Scielo, a partir do cruzamento dos seguintes descritores: idoso, internação hospitalar e enfermagem. Foram evidenciadas três categorias temáticas: Perfil de morbidade e mortalidade de idosos, Atuação da enfermagem frente ao idoso hospitalizado e Percepção do idoso internado sobre o envelhecimento e a morte. Os resultados apontaram a necessidade de mais pesquisas que abordem o processo de saúde e doença, a morte e o morrer na perspectiva do idoso internado, além da relação da participação familiar no cuidado e a interação do hospital com os serviços de atenção primária à saúde

A novel methodology to restrict the range of motion of human articulations

The human movement has long been a subject of extensive investigation by many authors, involving a vast interest in both clinical and sports applications. The use of biomechanical models of the human body can greatly contribute to the advancement of the body of knowledge in this scientific field as they provide rigorous information on several key biomechanical parameters. Thus, the modeling of human articulations must realistically reproduce their behavior and, therefore, to consider a restricted range of motion (RoM). The RoM is influenced by the bony structures adjacent to the articulations and by the physiological characteristics of the connective tissues, such as muscles and ligaments, surrounding them. This parameter varies amongst subjects and according to the type and anatomical location of each articulation. However, in the multibody systems methodology, the violation of the RoM for a particular joint can be clearly noted if geometrically ideal joints are used. This occurs since no additional constraints are introduced in the joint’s formulation to prevent it from acquiring unfeasible positions. To provide a solution for this problem, in this work, a novel methodology to restrict the RoM of human articulations is proposed within the framework of multibody systems methodologies. Joint resistance moments are applied to simulate the passive resistant behavior of the connective tissues existing around human articulations and to prevent physiologically unfeasible positions of the contiguous bony structures. A three-dimensional biomechanical model of the human lower leg and foot is used as a demonstrative example of application of the proposed methodology, focusing on the ankle articular complex. The results compare the dynamic behavior of the model with and without the application of the joint resistance moments and lead to the conclusion that the proposed methodology allows the correct restriction of the joints’ RoM, while preserving the mechanical energy of the system

Current evidence on biomechanical modeling for the analysis of crutch-assisted gait

Crutches are utilized as a mean of locomotion by patients with a variety of long-term disabilities, such as cerebral palsy or spinal cord injury. These assistive devices help reducing the load imposed on the injured lower extremities, while allowing an upright posture. However, crutch-assisted gait places a considerable repetitive effort on the upper extremities (UE), which are not adapted to weight-bearing tasks, thus contributing to the onset of secondary health conditions. Due to the raising significance of this problem, the research on biomechanical modeling strategies for the analysis of the loads imposed on the UE during crutch-assisted gait has been growing. The resulting scientific knowledge may provide promising options for the improvement of crutch design based on patients’ biomechanical outcomes and, thus, a detailed evaluation of this topic is strongly warranted. This has been the main motivation for preparing this review, which provides a comprehensive discussion and summary of the biomechanical modeling strategies currently available in the literature used to study crutch-assisted gait. PubMed, Scopus, and Web of Science electronic databases were searched on July 2021, and 18 studies, dated from 1985 to 2021, were included. Six studies used commercial software (OpenSim or Anybody), while the remaining developed in-house codes. Fifteen studies considered three-dimensional biomechanical models, among which six focused on the UE, eight modeled the entire human body and one did not provide this information. Musculoskeletal models were considered only in 17% of all studies. Three strategies were used to incorporate crutches on the biomechanical models, namely defining this assistive devices as a rigid body independent of the forearm/hand, imposing a position constraint on the glenohumeral joint, and using an arm/crutch or forearm/crutch system as a single rigid body. Forces exerted on the glenohumeral, elbow and wrist articulations during swing-through crutch gait were double the ones during reciprocal gait