For over 20 years occupational therapists have been using functional capacity evaluations to provide information about individuals’ ability to work after a musculoskeletal injury. An important component of these evaluations is the determination of the clients’ level of effort during the assessment. Only when a client puts forth high effort are the results considered an accurate measure of their work ability. This qualitative study explored therapists’ perception of the process of determining effort. Consistent with the literature, the results show that effort is a complex construct that is not easily defined, understood, or consistently assessed in practice. The participants in this study spoke about their own struggles defining, explaining, and assessing effort within the medico-legal context of an insurance system. The study results suggest support is needed for clinicians to navigate multiple client contexts, and the term ‘effort’ needs to be conceptualized in line with current knowledge about disability.

Submitted by JOSIANE SANTOS DE OLIVEIRA (josianeso) on 2018-04-04T16:01:54Z No. of bitstreams: 1 Gabriela Birk Hansen_.pdf: 1946837 bytes, checksum: d7659caad65551dfc9cfab033f4cbe1b (MD5) / Made available in DSpace on 2018-04-04T16:01:54Z (GMT). No. of bitstreams: 1 Gabriela Birk Hansen_.pdf: 1946837 bytes, checksum: d7659caad65551dfc9cfab033f4cbe1b (MD5) Previous issue date: 2017-08-21 / Nenhuma / O presente estudo tem como objetivo apresentar a evolução do financiamento a projetos de exportação de bens e serviços de infraestrutura por empresas brasileiras, com financiamento do BNDES a partir de 1998 até 2016. Para tanto, a partir de uma análise descritiva, é quantificada a evolução da carteira de financiamento destes projetos, analisando os diferentes destinos das exportações, as garantias oferecidas – CCR/ALADI e FCE/FGE, além de relacionar as condições das concessões dos financiamentos dos projetos com as condições econômicas e políticas do cenário nacional e internacional. No período analisado, foram 154 operações de exportação de bens e serviços de infraestrutura, num total de 575 desembolsos para 13 países em 2 continentes. O montante financiado no período soma US$ 14,7 bilhões. Destes, em valores, 33% foram para o Continente Africano (Angola, Gana e Moçambique), 20% para Costa Rica, Cuba, Guatemala e Honduras. A maior fatia, 47%, foi financiada para os países da América do Sul signatários da ALADI. Observou-se que o CCR, exclusivo dos países da ALADI, foi usado inicialmente na concessão dos primeiros financiamentos de projetos, estando em desuso nos dias atuais, mesmo contando com as vantagens da transferibilidade, conversibilidade e aceitação irrevogável dos bancos centrais. As demais operações são todas garantidas pelo SCE/FGE. Observa-se um aumento gradativo no volume de recursos financiados pelo BNDES a partir de 2003. Com mudanças na política externa do governo federal brasileiro, entre 2007 e 2014 houve uma ênfase maior nas relações com países do Continente Africano, especialmente Angola, e países da América do Sul. / The present study aims to present the financing evolution to export projects of infrastructure goods and services by Brazilian companies, with BNDES financing from 1998 to 2016. For this purpose, from a descriptive analysis, the evolution of the financing portfolio of these projects is quantified, analyzing the different export destinations, the guarantees offered - CCR / ALADI and FCE / FGE, as well as to relate the conditions of the project financing concessions with the economic and political conditions of the national and international scenario. In the analyzed period, there were 154 export operations of infrastructure goods and services, in a total of 575 disbursements to 13 countries in 2 continents. The amount financed in the period amounts to US $ 14.7 billion dollars. Of these, 33% went to the African Continent (Angola, Ghana and Mozambique), 20% to Costa Rica, Cuba, Guatemala and Honduras. The largest share, 47%, was financed for the South American countries signatories to ALADI. It was observed that the CCR, exclusive of the ALADI countries, was initially used in the granting of the first projects financing, being in disuse these days, even with the advantages of transferability, convertibility and irrevocable acceptance of the central banks. All other operations are guaranteed by the SCE/FGE. There is a gradual increase in the volume of resources financed by the BNDES from 2003. With changes in the foreign policy of the Brazilian federal government, between 2007 and 2014 there was a greater emphasis on relations wit the African Continent countries, especially Angola and South America countries.

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The neurotoxic potential of intravenous administered benzylpenicillin (BPC) was studied in rabbits with intact blood-CNS barriers and rabbits with experimental E. coli meningitis. At onset of epileptogenic EEG activity or seizures, serum, CSF and brain tissue were collected for assay of BPC. Based on the fact that, in tissues, BPC seems to remain extracellularly, brain concentrations of BPC were expressed as brain tissue fluid (BTF) levels, calculated as lOx the concentration in whole brain tissue. Neurotoxicity could be precipitated in all rabbits. In normal rabbits BTF levels of BPC were considerably higher than those in CSF indicating a better penetration across the blood-brain barrier (BBB). BPC penetrated better to CSF and BTF in meningitic rabbits than in normal controls, suggesting some degree of damage of the BBB concomitant with meningeal inflammation. E. coli meningitis did not increase the neurotoxicity of BPC. In control rabbits the intracistemal injection of saline resulted in some degree of pleocytosis. Unmanipulated animals are therefore preferable as controls. Epileptogenic EEG-changes was the most precise of the two variables used for demonstration of neurotoxicity. EEG-changes were therefore used as neurotoxicity criterion in the following rabbit experiments. To evaluate the effect of uraemia alone and uraemia plus meningitis on the neurotoxity of BPC in rabbits, cephaloridine was used to induce uraemia. Meningitis was induced by intracistemal inoculation of a cephalosporinresistant strain of E. cloacae. Untreated  rabbits were used as controls. Uraemia resulted in increased BTF penetration of BPC, possibly explained by permeability changes in the BBB and/or decreased binding of BPC to albumin. Uraemia did not result in increased penetration of BPC into the CSF of non-meningitic rabbits. Uraemic non-meningitic rabbits had the highest BTF levels of BPC at the criterion, indicating that cephaloridine-induced renal failure increased the epileptogenic threshold in these rabbits. The combination of uraemia and meningitis increased the neurotoxicity of BPC since the criterion was reached at considerably lower BTF levels of BPC. Meningitis, either alone or together with uraemia, did not increase the neurotoxicity in comparison to control rabbits. Higher BTF levels of BPC were found in meningitic rabbits than in controls with intact blood-CNS barriers at onset of EEG-changes. In all groups of rabbits there was a pronounced variability of BPC levels in the CSF while the intra-group variations in BTF levels were much smaller. Thus, BTF and not CSF levels were decisive for the neurotoxicity of BPC. Using   the same EEG-model, the neurotoxic potential of imipenem/cilastatin (I) and a new penem derivative, FCE 22101 were compared in a cross-over study. Both I and FCE 22101 were significantly more neurotoxic than BPC. While BTF levels of the three antibiotics could be detected in all tested rabbits, detectable CSF levels were only found in one of twelve rabbits treated with I or FCE 22101, indicating that BTF concentrations rather than CSF ones are decisive for neurotoxicity of ß-lactam antibiotics. The EEG-model used was found to be a suitable model for cross-over studies of intravenously administered antibiotics. Using the "silent-second" as EEG-threshold, a CNS interaction between intraperitoneally administered BPC and intravenous thiopental was demonstrated in rats. The most probably site for this interaction is the organic acid transport system out of the CNS. Thiopental distribution in the rat brain seemed to depend not only on its lipid solubility. / <p>Diss. (sammanfattning) Umeå : Umeå universitet, 1988, härtill 5 uppsatser.</p> / digitalisering@umu

Pollution is the single largest cause of transmission/distribution line outages, next to lightning, which result in expensive power outages. A major significance of the problem is that it can repeatedly occur even at normal working voltages. As a result, it has become the most detrimental factor affecting the safe operation of extra and ultra high voltage (EHV/UHV) transmission lines and substations. In reality, the phenomenon of pollution-induced flashover is a very complex, and vexatious problem that continues to challenge high voltage engineers even today. In spite of knowing this phenomenon for the past several decades, a solution has remained still elusive. Although there exist some remedial measures, there are associated limitations, which will become evident on long runs. The guaranteed solution seems to be the washing and cleaning of insulators for which utilities spend significant amount of money. Therefore, there is a need to develop a suitable mitigation technique which is cost effective and yield better performance in the field. Motivated by this, the present study is undertaken and it essentially aims to seek simple alternative solutions for the problem for strings with ceramic insulator discs. All the ten types (normal and anti fog) ceramic insulators, which are commonly employed in our country, are considered in the study. Amongst the several controllable and uncontrollable physical quantities leading to the pollution flashover phenomena, the maximum surface field identified as on of the major influencing factor. In fact, the field concentration near the pin can lead to early formation of dry band and scintillation/partial arcs. Considering this, it is intended to seek possible minimization of the maximum surface field occurring at the pin region. This is expected to yield enhanced pollution/contamination flashover strength and in addition, show an improvement in normal operation. The intended study requires a detailed knowledge on field distribution. However, the required data is found to be rather scarce. In view of this a detailed study on field distribution is taken up for all the ten types of disc insulators used in our country. For the problem under investigation, the governing equation has been identified for both clean and polluted conditions along with pertinent boundary conditions. Considering the open geometry nature of the problem along with presence of multiple dielectrics, Surface Charge Simulation (SCSM) methodology was found to be most suitable and hence adopted for the work. In particular, the Galerkin method with piecewise linear interpolation function is employed in the formulation. The method employed and the codes developed are verified with suitable examples. First, a detailed quantification of the field distribution under clean conditions is made for all the ten types of discs in single disc and string configuration. Subsequently, the task of reducing the maximum surface field gradient, which occurs at the pin, is attempted. Several consideration lead to an artificial extension of pin as one of best feasible choice. However, any attempt to extend the pin would lead to some reduction in total creepage length, possible enhancement of bulk stress in air and enhancement of stress in triple junction. After a careful study, involving several experimental trials, a novel field control element (FCE) is developed both for normal and anti-fog types of insulator discs. From the electric field simulation study, it is shown that the use of field control element for uniform pollution deposition prevailing under laboratory test conditions yields a significant reduction of maximum surface field for discs by about 47 to 54%. Similarly a reduction of about 37% to 55% in case of 3-disc string (for 33 kV class), 30% to 52% in case of 9-disc string (for 132 kV class), 27% to 52% in case of 14-disc string (220 kV class), 27% to 54% in case of 23/20 disc string (for 400 kV class) and 41% to 48% in case of 35/29 disc strings (for 765kV class) is achieved respectively for different strings. It is anticipated that this will lead to retardation in inception of scintillations/partial arcs, which in turn can reduce the risk of pollution induced flashover. Subsequently, it was aimed to experimentally evaluate the impact of field control element on the performance of disc/string under normal and that during polluted conditions. For this a national level unique artificial pollution test facility as per the international standards has been established for conducting pollution studies on disc insulator/strings up to 132kV system voltage (The rating of test source: 150kV/2A,100kV/3A,50kV/6A of 300kVA). Experimental investigations for the normal operation involving dry and wet power frequency flashover strengths, lightning impulse strength, radio interference level (RIV), visible discharge inception (Corona) level and voltage distribution along the string are carried out. The study showed that with the insertion of field control element, performance under normal condition is maintained and in fact noticeably improved in certain cases. Subsequently pollution flashover strength is evaluated using solid layer and cold fog methods. The pollution flashover strength exhibited an overall improvement 15 to 20% for all types of discs considered in the study. Similarly an improvement of 16 to 19% and 12-14% is observed for 3-disc string and 6-disc string respectively. The reasons for relatively lower gain in the pollution flashover strength as compared to reduction in maximum surface field are investigated. In particular, the reduction in improvement with number of discs in a string is dealt with. The non-uniform wet-ting against highly non-uniform drying of insulator surface and discs in a string, are identified as the cause for deviation. For an experimental verification of the same, the pollution layer resistance of individual discs in a 3-disc string is measured prior to and immediately after flashover. It is shown that the resistances of the different units become grossly different even though initial values were substantially the same. The values measured immediately after flashover show that the resistance of the top unit develops voltage enough to result in its flashover and subsequently, the flashover of the whole string. In summary, the main contribution of the present work is the development of novel field control element (FCE) for both normal and anti-fog type of ceramic disc insulators, which will enhance their pollution flashover strength. The actual cost of these elements is estimated to be about 1-2% of the cost of the disc, while the gain in strength is shown to be more than 12 - 20%.

The master´s thesis deals with the value added tax in the area of fixed establishment. The thesis is divided into two main parts. The first part of the thesis defines the concept of fixed establishment and key EU legislations by which fixed establishments are governed. I investigate practical aspects and problems created by fixed establishment. The second part of the thesis includes a complex analysis of the actual judgments of the European Court of Justice, and their treatment of issues arising from the relationship between fixed establishment and their head office. The thesis shows the difficulties within application of VAT on intercompany transactions in cases where the fixed establishment is a member of the group for the purposes of value added tax.

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