ABSTRACT
INTRODUÇÃO: O desenvolvimento tecnológico em Audiologia possibilita a criação e aplicação de ferramentas voltadas à reabilitação da pessoa com deficiência auditiva. Todavia, os recentes avanços ainda não abrangem todas as competências necessárias para atender às demandas específicas de pessoas com múltiplas deficiências. OBJETIVO: Avaliar a tecnologia de rastreamento ocular como auxílio à intervenção interdisciplinar para a reabilitação auditiva de pessoas com múltiplas deficiências no Sistema Único de Saúde - SUS. MÉTODO: Trata-se de um estudo de caso, descritivo, exploratório, de natureza qualiquantitativa. Foram realizadas: elaboração de um banco de imagens e construção de um software para o gerenciamento de imagens;aplicação de pilotos para adequação da metodologia; aplicação dos procedimentos desenvolvidos na reabilitação auditiva em seis usuários com múltiplas deficiências. RESULTADOS: O software desenvolvido gerencia 244 imagens validadas,que utilizadas em conjunto com a tecnologia de rastreamento ocular,possibilitou a aplicação da entrevista social e anamnese otorrinolaringológica diretamente aos usuários, assim como, a avaliação audiológica básica,indicação de prótese auditiva, terapia fonoaudiológica e psicológica.As tecnologias propostas foram utilizadas de maneira interdisciplinar, e possibilitaram maior inserção dos usuários em seu processo terapêutico. CONCLUSÃO: Este estudo apontou que é viável a associação do software de imagens à tecnologia assistiva de rastreamento ocular para uso em uma parcela de pessoas com múltiplas deficiências, possibilitando obtenção de respostas e maior participação durante a realização dos procedimentos em saúde auditiva.
INTRODUCTION: The technological development in Audiology allows thecreation and application of tools for rehabilitation of hearing impaired subjects. However, recent advances still do not encompass all skills needed to meet the specific demands of people with multiple disabilities. PURPOSE: To evaluate the eyetracking technology as an aid to the interdisciplinary intervention for the auditory rehabilitation of people with multiple deficiencies in the Unified Public Health System. METHOD: This is a descriptive, exploratory, qualitative-quantitative casestudy. The steps were: elaboration of an image bank and construction ofsoftware for assistive communication using these images; dry-run evaluationsto adapt the methodology; application of the procedures developedin auditory rehabilitation in six users with multiple disabilities. RESULTS: The software developed managed 244 validated images, whichused in conjunction with ocular tracking technology, allowed the applicationof social interview and otorhinolaryngological anamnesis, directlyto the users, as well as the basic audiological evaluation, indication ofhearing aid, speech and psychological therapy. The proposed technologieswere used in an interdisciplinary way, and enabled the insertion ofthese users in their therapeutic process. CONCLUSION: This study showed that it is feasible to associate imaging software with assistive eyetracking technology for people with multipledisabilities. Improving user participation during the performance of auditory health procedures.
Subject(s)
Male , Female , Humans , Audiology , Mass Screening , Self-Help Devices , Rehabilitation , Software , Cerebral PalsyABSTRACT
One fundamental aspect of vertebrate embryonic development is the formation of the body plan. For this process, asymmetries have to be generated during early stages of development along the three main body axes: Anterior-Posterior, Dorso-Ventral and Left-Right. We have been studying the role of a novel class of molecules, the Cerberus/Dan gene family. These are dedicated secreted antagonists of three major signaling pathways: Nodal, BMP and Wnt. Our studies contribute to the current view that the fine tuning of signaling is controlled by a set of inhibitory molecules rather than by activators. In this context, the Cerberus-like molecules emerge as key players in the regulation and generation of asymmetries in the early vertebrate embryo.
Subject(s)
Body Patterning/physiology , Embryo, Nonmammalian/embryology , Xenopus laevis/embryology , Animals , Body Patterning/genetics , Chickens , Cytokines , Embryo, Nonmammalian/metabolism , Gene Expression Regulation, Developmental , Intercellular Signaling Peptides and Proteins/genetics , Intercellular Signaling Peptides and Proteins/physiology , Mice , Models, Biological , Nodal Protein/genetics , Nodal Protein/physiology , Proteins/genetics , Proteins/physiology , Signal Transduction/genetics , Signal Transduction/physiology , Vertebrates/embryology , Vertebrates/genetics , Xenopus Proteins/genetics , Xenopus Proteins/physiology , Xenopus laevis/geneticsABSTRACT
OBJETIVOS: avaliar, através da seleção e análise criteriosa de artigos, os efeitos das intervenções voltadas para a promoção do desempenho de atividades de vida diária, utilizadas por terapeutas ocupacionais, em crianças com paralisia cerebral. MÉTODOS: a busca na literatura foi realizada nas bases eletrônicas: Ovid, Medline, CINAHL e Lilacs, incluindo artigos publicados entre janeiro de 2001 e maio de 2006, nos idiomas inglês e português, utilizando os seguintes descritores: terapia ocupacional, paralisia cerebral e criança. Foram selecionados quatro estudos, seguindo critérios de inclusão pré-definidos, avaliados quanto à qualidade metodológica com a escala OTSeeker. RESULTADOS: a análise da qualidade metodológica dos estudos selecionados revelaram pontuações de magnitudes baixa à moderada na escala OTSeeker. Foram encontradas diferenças quanto ao tipo de intervenção utilizada para a promoção das atividades de vida diária, bem como dos desfechos investigados. CONCLUSÕES: a análise crítica dos artigos sugere que o contexto no qual a criança com paralisia cerebral está inserida parece ser um fator importante no seu desempenho funcional. A avaliação sistemática da literatura sobre os efeitos de intervenções de Terapia Ocupacional na promoção de atividades de vida diária em crianças com paralisia cerebral poderá contribuir para uma prática baseada em evidências, entre esses profissionais.
OBJECTIVES: to evaluate, by means of a careful search for and analysis of articles, the effects of interventions used by occupational therapists to improve the performance of everyday activities in children with cerebral palsy. METHODS: the search for literature on the subject was conducted using the electronic databases Ovid, Medline, CINAHL and LILACS, and covered articles published between January 2001 and May 2006, in English or Portuguese, using the following keywords: occupational therapy, cerebral palsy, and child. Four studies were selected, according to previously determined inclusion criteria, and these were evaluated for their methodological quality using the OTSeeker scale. RESULTS: the analysis of the methodological quality of the selected studies revealed scores from low to moderate on the OTSeeker scale. There were differences in relation to the type of intervention used to promote everyday activities, and regarding the outcomes that were investigated. CONCLUSIONS: the context in which the child with cerebral palsy is living seems to be an important factor in his/her functional performance. The systematic evaluation of the literature on the effects of Occupational Therapy interventions in promoting everyday activities in children with cerebral palsy may contribute to evidence-based practices among these health professionals.
Subject(s)
Humans , Child , Activities of Daily Living , Occupational Therapy , Cerebral Palsy/therapyABSTRACT
During early mouse development, the TGFbeta-related protein Nodal specifies the organizing centers that control the formation of the anterior-posterior (A-P) axis. EGF-CFC proteins are important components of the Nodal signaling pathway, most likely by acting as Nodal coreceptors. However, the extent to which Nodal activity depends on EGF-CFC proteins is still debated. Cripto is the earliest EGF-CFC gene expressed during mouse embryogenesis and is involved in both A-P axis orientation and mesoderm formation. To investigate the relation between Cripto and Nodal in the early mouse embryo, we removed the Nodal antagonist Cerberus 1 (Cer1) and simultaneously Cripto, by generating Cer1;Cripto double mouse mutants. We observed that two thirds of the Cer1;Cripto double mutants are rescued in processes that are severely compromised in Cripto(-/-) embryos, namely A-P axis orientation, anterior mesendoderm and posterior neuroectoderm formation. The observed rescue is strongly reduced in Cer1;Cripto;Nodal triple mutants, suggesting that Nodal can signal extensively in the absence of Cripto, if Cer1 is also inhibited. This signaling activity drives A-P axis positioning. Our results provide evidence for the existence of Cripto-independent signaling mechanisms, by which Nodal controls axis specification in the early mouse embryo.
Subject(s)
Body Patterning/physiology , Epidermal Growth Factor/physiology , Membrane Glycoproteins/physiology , Neoplasm Proteins/physiology , Transforming Growth Factor beta/physiology , Activin Receptors, Type I/genetics , Activin Receptors, Type I/physiology , Animals , Body Patterning/genetics , Cytokines , Embryonic Development/genetics , Embryonic Development/physiology , Epidermal Growth Factor/deficiency , Epidermal Growth Factor/genetics , Female , Gastrulation/genetics , Gastrulation/physiology , Gene Expression Profiling , Gene Expression Regulation, Developmental , In Situ Hybridization , Intercellular Signaling Peptides and Proteins/genetics , Intercellular Signaling Peptides and Proteins/physiology , Membrane Glycoproteins/deficiency , Membrane Glycoproteins/genetics , Mice , Mice, Inbred C57BL , Mice, Knockout , Neoplasm Proteins/deficiency , Neoplasm Proteins/genetics , Nodal Protein , Organizers, Embryonic/physiology , Pregnancy , Proteins/genetics , Proteins/physiology , Signal Transduction/genetics , Signal Transduction/physiology , Transforming Growth Factor beta/geneticsABSTRACT
Correct establishment of the left/right (L/R) body asymmetry in the mouse embryo requires asymmetric activation of the evolutionarily conserved Nodal signaling cascade in the left lateral plate mesoderm (L-LPM). Furthermore, the presence of Nodal in the node is essential for its own expression in the L-LPM. Here, we have characterized the function of cerl-2, a novel Nodal antagonist, which displays a unique asymmetric expression on the right side of the mouse node. cerl-2 knockout mice display multiple laterality defects including randomization of the L/R axis. These defects can be partially rescued by removing one nodal allele. Our results demonstrate that Cerl-2 plays a key role in restricting the Nodal signaling pathway toward the left side of the mouse embryo by preventing its activity in the right side.
