Nous nous intéressons aux méthodes de contrôle de vibrations de modèles réduits de structures à n degrés de liberté, sismiquement isolées au niveau de la base par des systèmes d'isolation mixte.Le mouvement provoqué par une sollicitation sismique horizontale a lieu dans le plan vertical.Nous avons construit un problème de contrôle semi-actif de systèmes incertains soumis à des perturbations inconnues, mais bornées. Dans le langage de l'automatique, il s'agit d'un problème d'atténuation de perturbations.Le résultat principal de cette thèse porte sur la construction d'une version modifiée des résultats de Leitmann et de ses collaborateurs sur la stabilisation de systèmes non linéaires incertains. Le théorème proposé repose sur une loi de commande par retour d'état qui assure en boucle fermée les propriétés de "uniform boundedness" et "uniform ultimate boundedness".En particulier, il peut être appliqué à la résolution de problèmes de contrôle semi-actif, qui sont actuellement traités en génie parasismique.L'objectif du contrôle est d'améliorer le comportement (i.e. la réponse) de structures isolées pour faire face aux perturbations externes, c'est-à-dire les séismes. Plusieurs points différencient notre problème de la majorité que l'on trouve dans la littérature: (i) on ne s'intéresse pas seulement à la protection de la structure isolée, mais aussi aux équipements situés à l'intérieur de la structure, et (ii) au lieu d'utiliser des indicateurs de performance habituels exprimés en termes de déplacement relatif de la base versus des accélérations absolues des planchers, nous utilisons uniquement le spectre de plancher en pseudo-accélération, comme il a été proposé dans des travaux précédents par Politopoulos et Pham. Ce travail est une tentative d'utiliser explicitement les spectres de plancher comme critère de performance.Concernant la procédure d'application, plusieurs étapes intermédiaires ont été détaillées:(i) modélisation de signaux sismiques;(ii) réglage des paramètres de la loi de commande utilisant la théorie des vibrations;(iii) validation et test du comportement en boucle fermée à travers des simulations numériques: pour des raisons de simplicité, on se limite au cas n=2.Cette procédure peut être utilisée sur des structures en industrie nucléaire, mais aussi en génie civil.D'autres sujets traités incluent une tentative d'utiliser les outils temps-fréquence, et en particulier la distribution de Wigner-Ville, pour la synthèse de lois de commande, en espérant pouvoir mieux contrôler les composants transitoires des signaux de perturbation (les entrées) et des variables d'état (les sorties). / Vibration attenuation control designs are proposed for reduced plant models consisting of n-degree-of-freedom base seismically-isolated structures (i.e., a specific type of earthquake-resistant design), modeled by uncertain nonlinear systems and subjected to one-dimensional horizontal ground acceleration (i.e. the earthquake signal), treated as unknown disturbance but assumed to be bounded.In control systems literature, this is a perturbation attenuation problem.The main result of this PhD is the development of a modified version of Leitmann and co-authors' classical result on the stabilization of uncertain nonlinear systems. The proposed theorem consists of a bounded nonlinear feedback control law that is capable of ensuring uniform boundedness and uniform ultimate boundedness in closed-loop. In particular, it can be applied to solving semi-active control design problems, which are currently dealt with in earthquake engineering.The control objective is to improve the behavior (i.e. response) of mixed base-isolated structures to external disturbance, namely earthquakes. What differentiates our problem from the majority to be found in the literature is that: (i) attention is being paid to the protection of equipment placed inside the structure an not only to the structure itself; (ii) instead of using regular performance indicators expressed in terms of relative base displacement versus floors accelerations, we use solely the pseudo-acceleration floor response spectra, as it was proposed in previous recent works by Politopoulos and Pham.Actually, this work is an attempt to explicitly use floor response spectra as performance criterion.Concerning the application procedure, some of the topics that were detailed are:(i) modeling of earthquake signals;(ii) tuning of control law parameters based on vibration theory;(iii) validation and testing of the closed-loop behavior using numerical simulations: for simplicity reasons, we take n=2.This procedure can be used on structures of both nuclear industry as well as civil engineering.Other topics include an attempt to using time-frequency concepts and in particular the Wigner-Ville distribution to the control law design procedure, in order to better control transitory components of both perturbation (the input) and state variables signals (the output).

Os seios maxilares são os maiores seios paranasais e seu desenvolvimento apresenta uma variabilidade entre os indivíduos, já que sofre um processo de expansão progressiva durante a vida toda, principalmente nos casos de perdas dentárias, provocando pneumatização do seio em direção ao rebordo alveolar, reduzindo sua altura. Quando essa altura óssea alveolar residual é insuficiente, uma cirurgia de levantamento de seio pode ser realizada para ganhar altura óssea e posterior instalação de implantes dentários. Em alguns casos, podem apresentar variações anatômicas, levando ao insucesso da técnica cirúrgica, por desconhecimento ou falta de planejamento através de exames complementares. Para evitar esse tipo de acidentes e complicações em implantodontia é preciso a ajuda de exames complementares para um melhor planejamento cirúrgico e protético, como é o caso da tomografia computadorizada de feixe cônico, que fornece imagens em três dimensões, possibilitando uma melhor avaliação do seio maxilar. Portanto, o objetivo deste estudo foi descrever as diferentes variações anatômicas apresentadas no seio maxilar em pacientes edêntulos total e parcial da região posterior da maxila, realizar mensurações do osso alveolar residual, paredes do seio e determinar a relação da artéria alveolar superior posterior com o seio maxilar, através da avaliação de tomografia computadorizada de feixe cônico disponíveis nos arquivos de imagens digitais do departamento de Cirurgia, Estomatologia, Patologia e Radiologia da Faculdade de Odontologia de Bauru da Universidade de São Paulo FOB/USP. / The maxillary sinus is the largest of the paranasal sinuses and its development presents a variability among the individuals, since it undergoes a process of progressive expansion during the whole life, mainly in the cases of dental losses, provoking pneumatization of the sinus toward the alveolar ridge, reducing your Height. When this residual alveolar bone height is insufficient, a sinus lift surgery can be performed to gain bone height and subsequent installation of dental implants. In some cases, they may present anatomic variations, leading to the failure of the surgical technique, due to lack of knowledge or lack of planning through complementary tests. To avoid such accidents and complications in implantology, it is necessary the help of complementary examinations for a better surgical and prosthetic planning, as is the case of conical beam CT, which provides images in three dimensions, allowing a better evaluation of the maxillary sinus. Therefore, the objective of this study was to describe the different anatomical variations presented in the maxillary sinus in total and partial edentulous patients of the posterior maxillary region, to perform measurements of the residual alveolar bone, sinus walls and to determine the relation of the posterior superior alveolar artery with the sinus maxillary, through the evaluation of conical beam computed tomography available in the digital images archives of the Department of Surgery, Stomatology, Pathology and Radiology of the Faculty of Dentistry of Bauru of the University of São Paulo FOB / USP.

Made available in DSpace on 2015-12-03T18:33:07Z (GMT). No. of bitstreams: 1 Virginia_Prestes_Bernardes_Camillo.pdf: 841849 bytes, checksum: 5e36432262fd5944c6116a5c3ad3cbe2 (MD5) Previous issue date: 2014-03-06 / The present work has investigated from the point of view of the financial education, if the university??s students are a potential market for the popularization of equities investment and if the creation of a brokerage office, or something similar, within the educational environment, would be feasible. To achieve the general and specific objectives, it has been done interviews with managers from the educational area, managers from the capital market, and research through a questionnaire survey with students with a higher education and also a review of the literature related to financial education. The results of the research indicated that there are huge student??s interest in learning financial education; the creation of a brokerage office, or similar, within the university area was well received by educational managers as well as capital market managers, with the only requirement to combine financial practice to the theory given by the academy. It is intended that this research provides guidance popularization actions, both by the exchange as well as stockbrokers and investment agents, emphasizing the importance of bringing knowledge about finance to the people so we can have a solid foundation in the country of aware investors / O presente trabalho investigou do ponto de vista da educa????o financeira, se o p??blico universit??rio representa um mercado potencial para a populariza????o do investimento em renda vari??vel e se a cria????o de um escrit??rio de corretora, ou algo semelhante, dentro do ambiente educacional seja vi??vel. Para atingir os objetivos geral e espec??ficos foram realizadas entrevistas com gestores da ??rea de educa????o, gestores do mercado de capitais, pesquisa por meio de question??rio com alunos do ensino superior e revis??o da bibliografia relacionada ?? educa????o financeira. O resultado das pesquisas indicou que h?? claro interesse dos alunos em aprender educa????o financeira; a cria????o de um escrit??rio de corretora, ou similar, dentro de faculdades foi bem recebida tanto por gestores da ??rea educacional quanto do mercado de capitais, tendo como principal requisito aliar a pr??tica financeira ?? teoria ministrada pela academia, evitando-se eventuais conflitos de interesse. Pretende-se que esta pesquisa norteie a????es de populariza????o, tanto por parte da bolsa como tamb??m de corretoras de valores, agentes de investimentos e, finalmente, institui????es de ensino superior, enfatizando a import??ncia de levar conhecimento sobre finan??as ?? popula????o para que possamos ter no pa??s uma s??lida base de investidores conscientes

No mercado mundial existe uma visível tendência de tornar as obras mais industrializadas e racionalizadas com o objetivo de reduzir os desperdícios, acelerar a velocidade de execução das obras e garantir maior qualidade às mesmas. A adoção de elementos estruturais com certo grau de industrialização pode trazer benefícios em relação aos custos, à mão de obra, ao tempo de execução e ao impacto ambiental. Neste contexto, as estruturas mistas de aço e concreto satisfazem essa necessidade, pois tanto os elementos de aço quanto os elementos de concreto podem ser pré-fabricados, ficando apenas as etapas de içamento e montagem a serem realizadas na obra, reduzindo o uso de fôrmas e escoramentos. Os pisos mistos de aço e concreto de pequena altura caracterizam-se pelo embutimento da laje de concreto na altura do perfil de aço, sendo a principal vantagem, em relação ao piso misto convencional, a redução da altura total do composto. Portanto, este trabalho tem como objetivo analisar o comportamento de pisos mistos de aço e concreto de pequena altura com laje alveolar em concreto protendido por meio de ensaios de cisalhamento direto (push-out test) e de flexão. Na solução proposta, a transferência de esforços entre o perfil de aço e a laje alveolar foi feita por meio de conectores tipo pino com cabeça e concreto moldado no local. Os resultados demonstraram-se promissores em termos de comportamento do piso misto de pequena altura, aumentando significativamente a rigidez do sistema em relação à viga de aço isolada. Em complemento, foi desenvolvida uma simulação numérica dos modelos físicos ensaiados utilizando o pacote computacional DIANA®, fundamentado no método dos elementos finitos, na qual o modelo numérico representou adequadamente o comportamento dos pisos mistos de pequena altura, permitindo análises paramétricas. / On the world market, there is a visible tendency to turn buildings construction more industrialized and rationalized in order to reduce waste, accelerate the construction speed and ensure higher quality to them. The adoption of structural elements with a degree of industrialization can bring benefits regarding costs, labor, construction time and environmental impact. In this context, steel and concrete composite structures satisfy this need, since steel and concrete elements can be prefabricated, with only lifting and mounting steps to be performed on site, reducing use of formwork and shoring. A type of slim floor system consists in precast concrete hollow core slabs supported on the lower flange of steel beams. The major advantage of this solution, compared to conventional composite beam, is reducing the overall height of the floor. Therefore, this study aims to analyze the behavior of slim floor with prestressed concrete hollow core slabs through push-out and bending tests. In the proposed solution, the transfer of forces between steel beam and hollow core slabs was made by stud bolts and cast on site concrete. The obtained results proved to be promising in terms of slim floor behavior, significantly increasing the system stiffness regarding the isolated steel beam. In addition, a numerical modeling of the studied slim floor system was developed, using finite element based software DIANA®, in which the numerical model adequately represented the behavior of the composite beam, allowing parametric analysis.

INTRODUÇÃO: Disfunções do assoalho pélvico incluem uma variedade de condições interrelacionadas, tais como prolapso de órgãos pélvicos (POP) e distúrbios urinários e defecatórios. Comumente, tais afecções são concomitantes, o que pode causar incômodo de forma significativa. Inúmeros questionários com foco nessas disfunções têm sido desenvolvidos e estão sendo utilizados em pesquisas, fornecendo informações importantes; porém, como geralmente possuem múltiplos itens, são muito complexos para serem utilizados na prática clínica. O \"Pelvic Floor Bother Questionnaire\" (PFBQ) foi delineado de forma a simplificar a identificação e o grau de incômodo relacionados a problemas comuns do assoalho pélvico, podendo ser usado na prática diária e para fins de pesquisa. Trata-se de um questionário de nove itens que avalia sintomas relacionados à incontinência urinária, urgência e frequência urinárias, dificuldade miccional, prolapso de órgãos pélvicos, evacuação obstruída, incontinência fecal e dispareunia. OBJETIVOS: Os objetivos foram validar uma versão do PFBQ adaptada para o português, assim como adapta-lo culturalmente para a língua portuguesa brasileira, atualizá-lo, e avaliar suas propriedades: confiabilidade, validade e capacidade de detectar mudanças. MÉTODOS: O PFBQ foi traduzido para o português (\"Forward Translation\") por dois tradutores independentes (sendo um deles um tradutor juramentado). Após consenso, essa versão foi traduzida para o inglês (\"Backward Translation\") por um terceiro tradutor independente. O questionário foi então testado por profissionais da saúde e em uma amostragem de 10 pacientes. Após estas etapas, a versão final do questionário foi obtida. Testes de validade foram então aplicados: confiabilidade interna, confiabilidade teste-reteste, validade dos itens e capacidade de resposta às mudanças. O PFBQ foi correlacionado com dados obtidos durante a anamnese, diários miccional e defecatório e exame pélvico, incluindo o \"Pelvic Organ Prolapse Quantification\" (POP-Q). Para avaliar a confiabilidade teste-reteste, cada paciente respondeu o PFBQ dentro de 1 semana a 10 dias. A capacidade de resposta às mudanças foi avaliada nas pacientes que completaram o questionário antes e após o tratamento. RESULTADOS: Entre fevereiro de 2014 e agosto de 2015, foram incluídas no estudo 147 pacientes com média de idade de 60,49 anos. As principais queixas foram: 12,2% incontinência urinária de esforço, 19% incontinência urinária mista, 6,1% perda urinária por urgência, 26,5% incontinência fecal, 18,4% evacuação obstruída e 17,7% POP (estádio 3 ou 4). O PFBQ demonstrou boa confiabilidade ( = 0,625, ICC = 0,981). Cada item do questionário apresentou concordância quase perfeita entre as avaliações (k = 0,895-1,00). O PFBQ correlacionou-se com o estadiamento do prolapso (p < 0,01), número de episódios de incontinência urinária e fecal (? = 0,791, p < 0,001; p = 0,780, p < 0,001) e evacuação obstruída (p = 0,875, p < 0,001). CONCLUSÕES O \"Pelvic Floor Bother Questionnaire\" em português é uma ferramenta confiável e válida que pode ser utilizada para a identificação e avaliação da gravidade/incômodo de vários sintomas do assoalho pélvico / INTRODUCTION Pelvic floor disorders include a variety of interrelated conditions, such as pelvic organ prolapse (POP), and urinary and defecatory dysfunction. Commonly, patients have concomitant pelvic disorders, which can significantly cause distress. Numerous surveys focusing on pelvic floor abnormalities have been developed and are being used, mainly in research settings. These instruments are mostly multi-item, and despite providing a rich source of information, are thus difficult to use in a clinical setting. Shorter questionnaires have been also validated, although most of them are specific for each disorder. Pelvic Floor Bother Questionnaire (PFBQ) was designed to identify the presence and degree of bother related to common pelvic floor problems, and can be used in clinical practice and for research purposes. It is a nine-item questionnaire that includes symptoms and bother related to urinary incontinence, urinary urgency and frequency, dysuria, pelvic organ prolapse, obstructed defecation, fecal incontinence, and dyspareunia. OBJECTIVE We aimed to update and validate a cross-culturally adapted version of the PFBQ in Portuguese. METHODS Translation and validation of the PFBQ was performed as follows: After conceptual analysis of the original questionnaire in English, the PFBQ was translated into Portuguese (\"Forward Translation\") by two independent translators (one certified translator). After a consensus was obtained, this version of the questionnaire was translated back into English (\"Backward Translation\") by an independent translator. The questionnaire was pilot tested on health care professionals and on 10 patients who were questioned about form and clarity of the questions. The final version of the questionnaire was obtained. Validity tests were then applied and included internal reliability, test-retest reliability, validity of the items and responsiveness to change. PFBQ was correlated with a structured clinical interview, bladder and fecal diaries and pelvic exam, including \"Pelvic Organ Prolapse Quantification\" (POP-Q) examination. To assess test-retest reliability, each patient fulfilled a second copy of the PFBQ within 7 to 10 days. Responsiveness to change was accessed in patients who completed the questionnaire before and after treatment. RESULTS A total of 147 patients of a mean age 60,49 years were enrolled in the study between February 2014 and August 2015. Chief complains were as follows: 12,2% of patients had stress urinary incontinence, 19% mixed urinary incontinence, 6,1% detrusor instability, 26,5% fecal incontinence, 18,4% obstructed defecation and 17,7% had POP (stage 3 or 4). PFBQ demonstrated good reliability (alpha = 0,625; ICC = 0,981). There was a strong agreement beyond chance observed for each question (k = 0,895-1,00). PFBQ correlated with stage of prolapse (p < 0,01), number of urinary and fecal incontinence episodes ( = 0,791, p < 0,001; p = 0,780, p < 0,001), and obstructed defecation ( p =0,875, p < 0,001). CONCLUSIONS The PFBQ is a reliable and valid tool that can be easily used for the identification and severity/bother assessment of various pelvic floor symptoms

INTRODUÇÃO: Disfunções do assoalho pélvico incluem uma variedade de condições interrelacionadas, tais como prolapso de órgãos pélvicos (POP) e distúrbios urinários e defecatórios. Comumente, tais afecções são concomitantes, o que pode causar incômodo de forma significativa. Inúmeros questionários com foco nessas disfunções têm sido desenvolvidos e estão sendo utilizados em pesquisas, fornecendo informações importantes; porém, como geralmente possuem múltiplos itens, são muito complexos para serem utilizados na prática clínica. O \"Pelvic Floor Bother Questionnaire\" (PFBQ) foi delineado de forma a simplificar a identificação e o grau de incômodo relacionados a problemas comuns do assoalho pélvico, podendo ser usado na prática diária e para fins de pesquisa. Trata-se de um questionário de nove itens que avalia sintomas relacionados à incontinência urinária, urgência e frequência urinárias, dificuldade miccional, prolapso de órgãos pélvicos, evacuação obstruída, incontinência fecal e dispareunia. OBJETIVOS: Os objetivos foram validar uma versão do PFBQ adaptada para o português, assim como adapta-lo culturalmente para a língua portuguesa brasileira, atualizá-lo, e avaliar suas propriedades: confiabilidade, validade e capacidade de detectar mudanças. MÉTODOS: O PFBQ foi traduzido para o português (\"Forward Translation\") por dois tradutores independentes (sendo um deles um tradutor juramentado). Após consenso, essa versão foi traduzida para o inglês (\"Backward Translation\") por um terceiro tradutor independente. O questionário foi então testado por profissionais da saúde e em uma amostragem de 10 pacientes. Após estas etapas, a versão final do questionário foi obtida. Testes de validade foram então aplicados: confiabilidade interna, confiabilidade teste-reteste, validade dos itens e capacidade de resposta às mudanças. O PFBQ foi correlacionado com dados obtidos durante a anamnese, diários miccional e defecatório e exame pélvico, incluindo o \"Pelvic Organ Prolapse Quantification\" (POP-Q). Para avaliar a confiabilidade teste-reteste, cada paciente respondeu o PFBQ dentro de 1 semana a 10 dias. A capacidade de resposta às mudanças foi avaliada nas pacientes que completaram o questionário antes e após o tratamento. RESULTADOS: Entre fevereiro de 2014 e agosto de 2015, foram incluídas no estudo 147 pacientes com média de idade de 60,49 anos. As principais queixas foram: 12,2% incontinência urinária de esforço, 19% incontinência urinária mista, 6,1% perda urinária por urgência, 26,5% incontinência fecal, 18,4% evacuação obstruída e 17,7% POP (estádio 3 ou 4). O PFBQ demonstrou boa confiabilidade ( = 0,625, ICC = 0,981). Cada item do questionário apresentou concordância quase perfeita entre as avaliações (k = 0,895-1,00). O PFBQ correlacionou-se com o estadiamento do prolapso (p < 0,01), número de episódios de incontinência urinária e fecal (? = 0,791, p < 0,001; p = 0,780, p < 0,001) e evacuação obstruída (p = 0,875, p < 0,001). CONCLUSÕES O \"Pelvic Floor Bother Questionnaire\" em português é uma ferramenta confiável e válida que pode ser utilizada para a identificação e avaliação da gravidade/incômodo de vários sintomas do assoalho pélvico / INTRODUCTION Pelvic floor disorders include a variety of interrelated conditions, such as pelvic organ prolapse (POP), and urinary and defecatory dysfunction. Commonly, patients have concomitant pelvic disorders, which can significantly cause distress. Numerous surveys focusing on pelvic floor abnormalities have been developed and are being used, mainly in research settings. These instruments are mostly multi-item, and despite providing a rich source of information, are thus difficult to use in a clinical setting. Shorter questionnaires have been also validated, although most of them are specific for each disorder. Pelvic Floor Bother Questionnaire (PFBQ) was designed to identify the presence and degree of bother related to common pelvic floor problems, and can be used in clinical practice and for research purposes. It is a nine-item questionnaire that includes symptoms and bother related to urinary incontinence, urinary urgency and frequency, dysuria, pelvic organ prolapse, obstructed defecation, fecal incontinence, and dyspareunia. OBJECTIVE We aimed to update and validate a cross-culturally adapted version of the PFBQ in Portuguese. METHODS Translation and validation of the PFBQ was performed as follows: After conceptual analysis of the original questionnaire in English, the PFBQ was translated into Portuguese (\"Forward Translation\") by two independent translators (one certified translator). After a consensus was obtained, this version of the questionnaire was translated back into English (\"Backward Translation\") by an independent translator. The questionnaire was pilot tested on health care professionals and on 10 patients who were questioned about form and clarity of the questions. The final version of the questionnaire was obtained. Validity tests were then applied and included internal reliability, test-retest reliability, validity of the items and responsiveness to change. PFBQ was correlated with a structured clinical interview, bladder and fecal diaries and pelvic exam, including \"Pelvic Organ Prolapse Quantification\" (POP-Q) examination. To assess test-retest reliability, each patient fulfilled a second copy of the PFBQ within 7 to 10 days. Responsiveness to change was accessed in patients who completed the questionnaire before and after treatment. RESULTS A total of 147 patients of a mean age 60,49 years were enrolled in the study between February 2014 and August 2015. Chief complains were as follows: 12,2% of patients had stress urinary incontinence, 19% mixed urinary incontinence, 6,1% detrusor instability, 26,5% fecal incontinence, 18,4% obstructed defecation and 17,7% had POP (stage 3 or 4). PFBQ demonstrated good reliability (alpha = 0,625; ICC = 0,981). There was a strong agreement beyond chance observed for each question (k = 0,895-1,00). PFBQ correlated with stage of prolapse (p < 0,01), number of urinary and fecal incontinence episodes ( = 0,791, p < 0,001; p = 0,780, p < 0,001), and obstructed defecation ( p =0,875, p < 0,001). CONCLUSIONS The PFBQ is a reliable and valid tool that can be easily used for the identification and severity/bother assessment of various pelvic floor symptoms

Made available in DSpace on 2014-07-29T15:25:18Z (GMT). No. of bitstreams: 1 Thais Rocha Assis.pdf: 1508618 bytes, checksum: c0ca5bbd2f8029dd1eb1bbb7691113bc (MD5) Previous issue date: 2012-04-16 / This study consists of two scientific papers. The first aimed at investigating the effects of an individualized and supervised exercise program to strengthen pelvic floor muscles (PFM) in the postpartum period of multiparous women, and verify the correlation between two methods used to assess muscle strength. The second paper aimed at verifying the perception that puerperal women have regarding the alterations to their vaginal area and sex life after childbirth and after a PFM exercise program. To achieve these goals, an open clinical trial was performed on the first study, while the second conducted an exploratory and descriptive study. The final sample consisted of 23 puerperal women divided into two groups: intervention group (IG, n=11) and control group (CG, n=12). In IG, the puerperal women participated in an eight-week PFM exercise program, twice a week. In CG, the puerperal women did not receive any recommendations regarding exercises. PFM strength was assessed by digital vaginal palpation using the modified Oxford Scale and perineometer. The statistical analysis of the first article was performed using the following tests: Fisher s Exact Test, Chi-squared Test, Student s t-test, Kolmogorov Smirnov test for the two samples, and Pearson s Correlation Coefficient. Significance was defined as p < 0.05. On the second paper, categories were established and content analysis was performed. The participants mean age in IG was 24 ± 4.56 years, and 25.33 ± 4.03 years in CG (p=0.465). By completing the PFM exercise program, a significant difference was observed between the groups in the two muscle strength assessments (p&#61500;0.001). The two methods used to assess muscular strength showed significant correlation in both assessments (1st assessment: r = 0.889 with p <0.001; 2nd assessment: r = 0.925 with p <0.001). In terms of the participants perception regarding any vaginal alteration in the late postpartum period, the most frequent reports in both groups were those related to the category perception of low vaginal tonus . Fourteen weeks into the postpartum period, at the end of the exercise program, the participants in IG presented more reports in the category perception of increased vaginal tonus and greater control over the PFM and those in the CG, in the category feels that the vagina is back in the same condition as before pregnancy . Finally, the exercise program resulted in a significant increase in PFM strength in puerperal women and showed positive effects on the perineal area and in the sex life of the participants. Good correlation was observed between digital vaginal palpation and perineometer, which indicates that vaginal palpation can be used in clinical practice, considering it is an inexpensive method that demonstrated significant correlation with an objective method, i.e. perineometer. / Este trabalho consta de dois artigos científicos. O primeiro teve como objetivos investigar o efeito de um programa individualizado e supervisionado de exercícios para o fortalecimento dos músculos do assoalho pélvico (MAP) no pós-parto de multíparas e verificar a correlação entre dois métodos de medida de força muscular. O segundo teve como objetivo verificar a percepção das puérperas sobre mudanças na região vaginal e na vida sexual após o parto e após um programa de exercícios para os MAP. Para alcançar estes objetivos, conduziu-se um ensaio clínico aberto no primeiro artigo e um estudo exploratório e descritivo no segundo artigo. A amostra final foi de 23 puérperas divididas entre dois grupos: grupo intervenção (GI, n=11) e grupo controle (GC, n=12). As puérperas do GI participaram de um programa de exercícios para os MAP durante oito semanas, com frequência de duas vezes por semana. As puérperas do GC não receberam nenhuma orientação quanto a exercícios. A força dos MAP foi medida por meio da palpação vaginal digital utilizando a Escala de Oxford Modificada e do perineômetro. A análise estatística do primeiro artigo foi realizada através dos seguintes testes: Teste Exato de Fisher, Teste Qui Quadrado, teste t-Student, teste Kolmogov Smirnov para duas amostras e Coeficiente de Correlação de Pearson. Foi considerado como significativo p < 0,05. No segundo artigo, estabeleceram-se categorias e foi realizada a análise de conteúdo. A média de idade das participantes do GI foi de 24 ± 4,56 anos e do GC foi de 25,33 ± 4,03 anos (p=0,465). Ao final do programa de exercícios para os MAP, verificou-se diferença significativa entre os grupos nas duas medidas da força muscular (p&#61500;0,001). Os dois métodos de medida da força muscular apresentaram correlação significativa nas duas avaliações (1ª avaliação: r = 0,889 sendo p <0,001; 2ª avaliação: r = 0,925 sendo p <0,001). Quanto à percepção de mudança vaginal no pós-parto tardio, os relatos mais frequentes, em ambos os grupos, foram os relacionados à categoria percepção de tônus vaginal diminuído . Após 14 semanas de pós-parto, ao final do programa de exercícios, as participantes do GI apresentaram maior número de relatos na categoria percepção de aumento do tônus vaginal e maior controle sobre os MAP e as do GC, na categoria sensação de que a vagina voltou ao estado pré-gravídico . Por fim, o programa de exercícios resultou em aumento significativo da força dos MAP em puérperas e mostrou efeitos positivos na região perineal e na vida sexual das participantes. Verificou-se boa correlação entre a palpação vaginal digital e o perineômetro, indicando que a palpação vaginal pode ser utilizada na prática por ser um método de baixo custo e que demonstrou uma correlação significativa com um método objetivo, o perineômetro.

Caregivers injure their backs more than workers in any other industry. Efforts to reduce injuries have been on-going for decades with limited results. Mechanical lift devices have been incorporated into clinical practice over the past 30 years to reduce the risk of injury from patient lifting. Yet injury rates remain high. The use of mechanical lifts may be partly to blame. While these devices assist with lifting patients, they also introduce new activities that result in caregivers experiencing unsafe loading on the spine. We measured loads on the lower back during manoeuvres of the two most common lift types (overhead and floor) as well as during sling insertion. A new device called SlingSerterTM was evaluated for use in the clinical environment. We also investigated spine shrinkage as a measurement tool for estimating cumulative load. Caregivers worked alone and in pairs for both lift maneuvering and sling insertion activities. Overhead lift use resulted in much lower loads than floor lift use. We conclude caregivers can safely operate overhead lifts alone, while floor lift use remained unsafe even with two caregivers. Less-experienced caregivers had higher loads than more-experienced counterparts when using floor lifts. There was no corresponding effect of experience with overhead lift use and we found this to be a further benefit of overhead lifts over floor lifts. Most caregivers exceeded the safe limit for spine compression during sling insertion, though a single caregiver was at no higher risk of injury than two caregivers working together. Clinicians who tested SlingSerterTM agreed the device would be useful in clinical practice, particularly with bariatric patients and other special patient populations that are difficult to roll or turn. Finally, we investigated a novel method for estimating cumulative load based on spine shrinkage. There is growing recognition that excess cumulative load may be responsible for back injury. We found the variability in spine shrinkage was too large to estimate cumulative load directly. However, the technique may still be useful for determining the relative importance of the load from different activities to the cumulative total.

Caregivers injure their backs more than workers in any other industry. Efforts to reduce injuries have been on-going for decades with limited results. Mechanical lift devices have been incorporated into clinical practice over the past 30 years to reduce the risk of injury from patient lifting. Yet injury rates remain high. The use of mechanical lifts may be partly to blame. While these devices assist with lifting patients, they also introduce new activities that result in caregivers experiencing unsafe loading on the spine. We measured loads on the lower back during manoeuvres of the two most common lift types (overhead and floor) as well as during sling insertion. A new device called SlingSerterTM was evaluated for use in the clinical environment. We also investigated spine shrinkage as a measurement tool for estimating cumulative load. Caregivers worked alone and in pairs for both lift maneuvering and sling insertion activities. Overhead lift use resulted in much lower loads than floor lift use. We conclude caregivers can safely operate overhead lifts alone, while floor lift use remained unsafe even with two caregivers. Less-experienced caregivers had higher loads than more-experienced counterparts when using floor lifts. There was no corresponding effect of experience with overhead lift use and we found this to be a further benefit of overhead lifts over floor lifts. Most caregivers exceeded the safe limit for spine compression during sling insertion, though a single caregiver was at no higher risk of injury than two caregivers working together. Clinicians who tested SlingSerterTM agreed the device would be useful in clinical practice, particularly with bariatric patients and other special patient populations that are difficult to roll or turn. Finally, we investigated a novel method for estimating cumulative load based on spine shrinkage. There is growing recognition that excess cumulative load may be responsible for back injury. We found the variability in spine shrinkage was too large to estimate cumulative load directly. However, the technique may still be useful for determining the relative importance of the load from different activities to the cumulative total.

The purpose of this thesis is to develop a model to enhance the effectiveness of machining centers with multi-pallet automatic pallet changers (APCs). From critical literature review no existing theories within this field were found. The multi-pallet APC allows multi-setups and a more flexible sequencing of jobs. The model together with the developed heuristic scheduling algorithm with the objective to minimize the total weighted tardiness can be used to plan in n jobs on m pallets in a shop-floor. The right maintenance policy ensures a high availability, which together with the program guarantees a high level of utilization of the machinery. Consequently the effectiveness will be enhanced. A case study approach was used to test the model at Växjöfabriken in Sweden, which treats cast material. The results of this case study are a more effective utilization of the machines with decreased tardiness costs, increased customers’ satisfaction and goodwill of the company. The contribution of this thesis is a model with a flexible, adjustable and expandable heuristic scheduling algorithm, which can be applied in all manufacturing companies using machining centers with multi-pallet APCs. / Syftet med denna uppsats är att utveckla en modell för att förbättra effektiviteten av maskincentra med automatiska palletväxlare (APCs) för multi-palleter. När en kritisk litteratursökning genomfördes hittades inga relevanta teorier inom det aktuella området. Multi-pallet APC tillåter att många jobb kan förberedas samtidigt och gör planeringen av jobben mer flexibel. Modellen, tillsammans med den utvecklade heuristiska planeringsalgoritmen med målet att minimera den totala viktade förseningen, kan användas för att planera in n jobb med m palleter på ett verkstadsgolv. Rätt underhålls policy försäkrar en hög tillgänglighet vilket tillsammans med programmet garanterar en hög utnyttjandenivå av maskinerna. Som följd kommer effektiviteten att höjas. En fallstudie utfördes på Växjöfabriken i Sverige för att utvärdera modellen, på företaget efterbehandlas gjutgods. Resultatet från denna fallstudie blev ett effektivare utnyttjande av maskinerna, med minskade förseningskostnader, ökad kundtillfredställelse och goodwill för företaget. Denna uppsats bidrar med en modell och en flexibel, anpassningsbar och utvecklingsbar heuristisk planeringsalgoritm, vilken kan användas i alla industriföretag som använder maskincentra med multi-pallet APCs.