On étudie les fonctions multivaluées vers un espace de Hilbert. Après avoir introduit unebonne notion de p énergie, on donne une définition possible d’espace de Sobolev et on prouveun théorème d’existence des p minimiseurs. Puis on considère les fonctions bivaluées de deuxvariables, stationnaires pour les déformations au départ et à l’arrivée. On démontre qu’ellessont localement lipschitziennes et on utilise cette régularité pour montrer la convergence fortedans W1,2 vers leur unique éclatement en un point. L’ensemble de branchement d’une tellefonction est la réunion localement finie de courbes analytiques qui se rencontrent en faisantdes angles égaux. Nous donnons aussi un exemple de fonction discontinue et stationnaireseulement pour les déformations au départ.Dans un deuxième temps, on prouve qu’il n’existe pas de rétraction uniformément continuede l’espace des champs vectoriels continus vers le sous-espace de ceux dont la divergence estnulle en un sens distributionnel. On généralise ce résultat en toute codimension en utilisant lanotion de m charge et à tout ensemble X ⊂ Rn vérifiant une hypothèse géométrique mineure. / We study multiple valued functions with values in a Hilbert space. We introduce a possibledefinition of Sobolev spaces and the rightful notion of p energy. We prove the existence of pminimizers. Then we consider two-valued real functions of two variables which are stationarywith respect to both domain and range transformations. We prove their local Lipschitzcontinuity and use it to establish strong convergence in W1,2 to their unique blow-up at anypoint. We claim that the branch set of any such function consists of finitely many real analyticcurves meeting at nod points with equal angles. We also provide an example showing thatstationarity with respect to domain transformations only does not imply continuity.In a second part, we prove that there does not exist a uniformly continuous retractionfrom the space of continuous vector fields onto the subspace of vector fields whose divergencevanishes in the distributional sense. We then generalise this result using the concept of mcharges on any subset X _ Rn satisfying a mild geometric condition, there is no uniformlycontinuous representation operator for mcharges in X.

Doctor of Philosophy / Department of Statistics / Gary L. Gadbury / High-throughput metabolite analysis is an approach used by biologists seeking to identify the functions of genes. A mutation in a gene encoding an enzyme is expected to alter the level of the metabolites which serve as the enzyme’s reactant(s) (also known as substrate) and product(s). To find the function of a mutated gene, metabolite data from a wild-type organism and a mutant are compared and candidate reactants and products are identified. The screening principle is that the concentration of reactants will be higher and the concentration of products will be lower in the mutant than in wild type. This is because the mutation reduces the reaction between the reactant and the product in the mutant organism. Based upon this principle, we suggest a method to screen the possible lipid reactant and product pairs related to a mutation affecting an unknown reaction. Some numerical facts are given for the treatment means for the lipid pairs in each treatment group, and relations between the means are found for the paired lipids. A set of statistics from the relations between the means of the lipid pairs is derived. Reactant and product lipid pairs associated with specific mutations are used to assess the results. We have explored four methods using the test statistics to obtain a list of potential reactant-product pairs affected by the mutation. The first method uses the parametric bootstrap to obtain an empirical null distribution of the test statistic and a technique to identify a family of distributions and corresponding parameter estimates for modeling the null distribution. The second method uses a mixture of normal distributions to model the empirical bootstrap null. The third method uses a normal mixture model with multiple components to model the entire distribution of test statistics from all pairs of lipids. The argument is made that, for some cases, one of the model components is that for lipid pairs affected by the mutation while the other components model the null distribution. The fourth method uses a two-way ANOVA model with an interaction term to find the relations between the mean concentrations and the role of a lipid as a reactant or product in a specific lipid pair. The goal of all methods is to identify a list of findings by false discovery techniques. Finally a simulation technique is proposed to evaluate properties of statistical methods for identifying candidate reactant-product pairs.

Nous considérons un système mécanique en vibration non linéaire, pour lequel nous fournissons une solution approchée par l'utilisation des développements multiples échelles; nous proposons d'abord une étude avec double échelles puis avec triple échelles où nous comparons les deux approches. Une preuve rigoureuse de ces développements a été faite. L'étude de la stabilité de la solution est nécessaire pour montrer la convergence au voisinage de la résonance. Un lien entre l'amplitude de la réponse vibratoire et la fréquence du système en vibration libre a été mis en évidence. / We consider small solutions of a vibrating mechanical system with smooth non-linearities for which we provide an approximate solution by using multiple scale analysis; we first use a double scale analysis; in order to improve the approximation, then we perform a triple scale analysis; a rigorous proof of convergence of the triple scale method is included; for the forced response, a stability result is needed in order to prove convergence in a neighborhood of a primary resonance. The amplitude of the response with respect to the frequency forcing is described and it is related to the frequency of a free periodic vibration.

The aim of this work is to find out why the structure of the market for sexual services changed in the years 1999 -- 2009 : why did the number of erotic clubs and the sex workers in clubs and on streets decrease and why did the number of sex workers in apartments increase? The change in nationality of composition of consumers and the development of internet are main factors of the changes. A high correlation proved to be between the number of sex workers and the number of tourists. Because of economic convergence tourists can buy less sexual services than in past whereas Czech can buy more. Other question is why earnings of sex workers are higher in comparison with wages of the women with the comparable education. The main factor is a social stigmatization.

<div>Prediction of player performance is a key component in the construction of baseball team rosters. Traditionally, the problem of predicting seasonal plate appearance outcomes has been approached univariately. That is, focusing on each outcome separately rather than jointly modeling the collection of outcomes. More recently, there has been a greater emphasis on joint modeling, thereby accounting for the correlations between outcomes. However, most of these state of the art prediction models are the proprietary property of teams or industrial sports entities and so little is available in open publications.</div><div><br></div><div>This dissertation introduces a joint modeling approach to predict seasonal plate appearance outcome vectors using a mixed-effects multinomial logistic-normal model. This model accounts for positive and negative correlations between outcomes both across and within player seasons. It is also applied to the important, yet unaddressed, problem of predicting performance for players moving between the Japanese and American major leagues.</div><div><br></div>This work begins by motivating the methodological choices through a comparison of state of the art procedures followed by a detailed description of the modeling and estimation approach that includes model t assessments. We then apply the method to longitudinal multinomial count data of baseball player-seasons for players moving between the Japanese and American major leagues and discuss the results. Extensions of this modeling framework to other similar data structures are also discussed.<br>

By means of a Monte Carlo study, this paper investigates the relative performance of Listwise Deletion, the EM-algorithm and the default algorithm in the MICE-package for R (PMM) in estimating regression coefficients under a left truncated covariate with missing values. The intention is to investigate whether the three frequently used missing data techniques are robust against left truncation when missing values are MCAR or MAR. The results suggest that no technique is superior overall in all combinations of factors studied. The EM-algorithm is unaffected by left truncation under MCAR but negatively affected by strong left truncation under MAR. Compared to the default MICE-algorithm, the performance of EM is more stable across distributions and combinations of sample size and missing rate. The default MICE-algorithm is improved by left truncation but is sensitive to missingness pattern and missing rate. Compared to Listwise Deletion, the EM-algorithm is less robust against left truncation when missing values are MAR. However, the decline in performance of the EM-algorithm is not large enough for the algorithm to be completely outperformed by Listwise Deletion, especially not when the missing rate is moderate. Listwise Deletion might be robust against left truncation but is inefficient.

As transformações no modelo de assistência ao parto e nascimento e a criação de Centros de Parto Normal (CPN) no âmbito do Sistema Único de Saúde (SUS) remetem à importância de explorar a assistência ao parto neste contexto. O presente estudo teve o objetivo de compreender e descrever as crenças e os valores que norteiam as práticas dos profissionais em um CPN. Foi utilizada a abordagem qualitativa de pesquisa e o método etnográfico em um CPN de uma maternidade pública localizada na cidade de Osasco, Estado de São Paulo, Brasil. Os dados foram coletados por meio do processo de observação participante e de entrevistas etnográficas. Foram entrevistados todos os membros da equipe profissional, composta por enfermeiro obstetra, técnico de enfermagem, médico obstetra e médico neonatologista, que estavam diretamente envolvidos na assistência ao parto, e os gestores da instituição. A análise indutiva e interpretativa dos dados resultou em quatro subtemas culturais, que correspondem a cada uma das categorias profissionais: Enfermeira obstetra: Este CPN não é como deveria ser: inúmeros obstáculos dificultam a prestação da assistência humanizada ao parto; Técnicas de enfermagem: Fazendo o que é possível: satisfação com a assistência que é prestada mediante superação de muitas dificuldades; Médico obstetra: Um árduo cotidiano que impede o desenvolvimento da assistência desejada; Médico neonatologista: Dificuldades existem porque são comuns no serviço público, mas há satisfação em relação à assistência prestada no CPN. Destes subtemas culturais emergiu o tema cultural Entre o idealizado e o possível: os limites na assistência humanizada ao parto, que representa o cotidiano da assistência ao parto no CPN que foi foco desta pesquisa. As limitações para o desenvolvimento da assistência humanizada ao parto estavam relacionadas, não somente aos problemas relativos à precariedade da estrutura física e de recursos humanos ou aos déficits provocados pelo financiamento insuficiente da assistência ao parto. Estavam envolvidos também as crenças e os valores dos profissionais e o seu grau de envolvimento com a filosofia de humanização da assistência ao parto. Contatou-se que a efetivação da assistência humanizada ao parto, como preconizada pelos organismos nacionais e internacionais, depende da superação das inúmeras dificuldades descritas neste estudo. Um grande desafio deste âmbito está representado pela necessidade de articulação entre a grade curricular dos cursos da área da saúde com os fundamentos da Medicina Baseada em Evidências Científicas. Portanto, é de fundamental importância a existência de serviços exemplares, que prestam assistência humanizada ao parto, para os estudantes de graduação e para os profissionais. / The transformation in the model of childbirth assistance and the creation of Birth Centers within the Brazilian Unified Health System referred to the importance of exploring the delivery assistance. This study aimed to understand and describe the beliefs and values that guide the practice of professionals in a Birth Center. We used a qualitative research approach and ethnographic method was developed in a Birth Center in a public hospital at the city of Osasco, São Paulo, Brazil. Data were obtained through the process of participant observation and ethnographic interviews. We interviewed all members of the professional team consisting of nurse midwife, technical nurse assistant, obstetrician and neonatologist physician, who were directly involved in delivery care and management of the institution. The inductive analysis and interpretation of data resulted in four sub-cultural themes, which correspond to each of the professions: nurse midwife: \"The Birth Center is not as it should be, many obstacles interfere on a humanized assistance of a childbirth; Technical nurse assistant: \"Doing what is possible: satisfaction with the giving assistance throught overcoming many difficulties\"; Obstetrician Doctor: \"A hard routine restrains the development of a good assistance; Medical neonatologist:\" Difficulties exist because they are common in the public service, but there is a satisfaction in relation to the assistance provided at the Birth Center. \" From sub-cultural themes emerged a cultural theme \"Between the idealized and the possible: the limits in the humanized delivery care\", which represents the everyday care delivery in the Birth Center that was the focus of this research. The limitations for the development of humanized childbirth were related not only to problems related to the precarious physical infrastructure and human resources or deficits caused by insufficient funding of childbirth care. They were also involved in the beliefs and values of professionals and their degree of involvement with the philosophy of humanization of childbirth care. It was noted that the effectiveness of humanized delivery care, as recommended by national and international organizations, depends on overcoming the several difficulties described in this study. A major challenge in this context is represented by the need to articulate the courses academic subjects in the health field with the fundamentals of Scientific Evidence-Based Medicine. Therefore it is very importante to the existence of exemplary service to the graduate students and professionals.

Este trabalho apresenta um estudo geral sobre o dimensionamento e verificação de pilares esbeltos de concreto armado solicitados por flexão composta oblíqua, levando-se em consideração as não-linearidades física (o material não segue a lei de Hooke) e geométrica (análise em 2ª ordem). É abordado também o dimensionamento de seções isoladas no Estado Limite Último de ruptura. É admitida seção transversal de forma poligonal qualquer, assim como disposição da armadura também arbitrária. O efeito de carregamento de longa duração (fluência) é levado em consideração. A relação tensão-deformação do concreto é geral, admitida como uma seqüência de polinômios de graus arbitrários. Vários algoritmos detalhados e rotinas computacionais são apresentados. / This work presents a general study on the design and veriflcation of slender reinforced concrete columns, subjected to axial force and biaxial bending, considering material and geometric non-linearities (material doesn\'t fit Hooke law and second order analysis). It is also treated the design of cross sections in the ultimate strength. It is considered a general poligonal cross section, with any reinforcement distribuition. The creep effect is also taken into account. The concrete stress-strain curve is anyone since it can be represented as a sequence of any degree polinomiuns. Detailed calculation and computational routines are given too.

A vida sexual no pós-parto é influenciada pelas mudanças anatômicas, hormonais, da estrutura familiar e do relacionamento com o parceiro. A redução do desejo e o medo do retorno da atividade sexual são comuns. A episiotomia parece ter impacto negativo e interferir na função sexual das mulheres neste período. Objetivo: Identificar a existência de evidências sobre o efeito da episiotomia na função sexual da mulher no pós-parto. Método: Revisão Sistemática realizada por meio da metodologia do Instituto Joanna Briggs (JBI). A pergunta desta revisão sistemática foi: a episiotomia interfere na função sexual da mulher nos 24 meses após o parto? A estratégia PICOs para a revisão foi a seguinte: P (participantes): mulheres até 24 meses após o parto vaginal de todas as paridades;I (intervenção): mulheres que tiveram parto normal com episiotomia; C (controles): mulheres que tiveram parto normal e não receberam episiotomia; O (resultados): função sexual avaliada por meio de da pontuação do Female Sexual Function Index (FSFI), tempo de retorno à atividade sexual e dispareunia;S (estudos): estudos observacionais, de coorte e transversais. Foram utilizados os descritores e as estratégias de busca específicas para cada uma das bases de dados a seguir: CINAHL, Embase, LILACS, Proquest, PubMed, ScienceDirect, Scopus e Web of Science. Os artigos selecionados segundo a estratégia PICOs foram submetidos aos critérios de análise crítica de qualidade e seus dados foram extraídos com o auxílio do JBI Meta Analysis of Statistics Assessment and Review Instrument (MAStARI), para estudos quantitativos. Cada artigo foi avaliado por dois revisores. Após a extração dos dados dos estudos os resultados foram apresentados em forma narrativa pois todas as metanalises realizadas apresentaram p<0,05 para o teste de heterogeneidade. Resultados: 784 publicações foram identificadas, 11 foram submetidas à avaliação critica, e seis estudos foram incluídos na revisão sistemática. Os dados dos estudosnão apresentaram diferença estatística significativa na função sexual com seis semanas, três e seis meses entre os grupos, o tempo de retorno à atividade sexual foi menor para mulheres que tiveram parto vaginal sem episiotomia em comparação com as que tiveram episiotomia em três estudos.Adispareunia foi analisada em apenas um estudo e apresentou maior proporção em mulheres com episiotomia, porém, sem diferença estatística. Conclusão: A realização da episiotomia pode retardar a retomada da atividade sexual no pós-parto. Os estudos com abordagem quantitativa não apresentaram evidências sobre o efeito da episiotomia na função sexual mensurada por meio do FSFI e na ocorrência de dispareunia. Sugere-se a realização de revisão de estudos qualitativos para se estudar a influência da episiotomia no pós-parto a partir das narrativas das mulheres. / The postpartum sex life is influenced by anatomical, hormonal, changes in family structure and the relationship with the partner. The reduction of desire, fear and the resumption of sexual activity are common. The episiotomy appears to provide negative consequence with sexual function of women in this period. Aim: The objective was to identify the existence of evidence on the effect of episiotomy on sexual function of women in the postpartum period. Method: This is a Systematic Review performed under Joanna Briggs Institute methodology (JBI). The question of this Systematic Review was: Does Episiotomy interferes with women sexual function in the 24 months after childbirth? The PICOs strategy for the review were as follows: P (participants): women up to 24 months after vaginal delivery of all parities. I (intervention): women who delivered vaginally with episiotomy; C (control): women who had normal delivery and did not receive episiotomy; O (results): Sexual Function assessed by Female Sexual Function Index, time to resumption of sexual activity and dyspareunia. S (studies): observational, cohort and cross-sectional studies. Descriptors and specific search strategy for each of the databases below have been applied: CINAHL, EMBASE, LILACS, Proquest, PubMed, ScienceDirect, Scopus and Web of Science. The selected articles according to Strategy PICOS were subjected to critical analysis criteria for quality and data were extracted with the aid of JBI Meta Analysis of Statistics Assessment and Review Instrument-MAStARI, for quantitative studies. Each article was assessed by two reviewers. After extracting data the outcomes were presented through narrative form due to all meta-analysys presente. Results: 784 articles were identified, 11 were subjected to critical evaluation, and these six studies were included in the systematic review. The studies did not present statistical significant difference regarding to sexual function at six weeks, three and six months between the groups, the time of resumption of sexual activity was lower for women who had vaginal delivery without episiotomy compared with those who had episiotomy in three studies. Dyspareunia was analyzed in only one study and had high proportion among women with episiotomy, however, with no statistical difference. Conclusion: The use of episiotomy may delay the resumption of sexual activity postpartum. Studies with quantitative approach presented no evidence on the effect of episiotomy in sexual function assessed by the FSFI and the occurrence of dyspareunia. We suggest including a review of qualitative studies to study the influence of postpartum episiotomy from the narratives of women.

Introdução: A avaliação da assistência prestada é uma das condições básicas para promover a qualidade dos serviços de saúde. Obter dados a respeito do bem estar segundo a perspectiva da mulher permite corrigir inadequações e melhorar a qualidade da assistência ao parto. Objetivo da pesquisa: Esta pesquisa teve o objetivo de adaptar culturalmente e validar as propriedades psicométricas da Escala de Bienestar Materno em Situación de Parto (BMSP 2) para a língua portuguesa (Brasil).Metodologia: Trata-se de um estudo do tipo metodológico aprovado pelo Comitê de Ética em Pesquisa da Escola de Enfermagem da Universidade de São Paulo, sob o parecer nº 170.412. A adaptação cultural desta Escala, que foi produzida por enfermeiras obstétricas chilenas, foi feita conforme recomendações da literatura científica pertinente: tradução da BMSP2 para a língua portuguesa; retrotradução para língua de origem do instrumento; avaliação por um comitê de juízes; pré-teste da versão adaptada e aplicação da versão final em português. Os dados foram coletados no período de dezembro de 2012 a março de 2013 em um Hospital-Escola, situado na Zona Norte do Município de São Paulo. Participaram do estudo, 500 mulheres que receberam assistência ao parto normal na Instituição. A validade de face e conteúdo foi avaliada pelo comitê de juízes; para a validade de constructo foi realizada a análise fatorial; a validade de constructo convergente foi avaliada através do Teste de Correlação de Pearson entre a BMSP 2 e o domínio satisfação com a vida da Escala de Bem Estar Subjetivo; a validade de constructo divergente foi avaliada por meio de teste para comparação de grupos distintos. A confiabilidade foi avaliada pela consistência interna de seus itens (Alfa de Cronbach). O nível de significância adotado foi de 0,05. Resultados: A maioria das participantes do estudo vivia com o parceiro, possuía idade de 26,7 anos em média, era da cor branca, tinha entre nove e 11 anos de estudo e era do lar. Em relação às características obstétricas, 36,2% era multigesta, 28% estava na segunda gestação e 35,8% era primigesta, com idade gestacional entre 39 e 39 semanas e 6 dias (33,8%). Na avaliação das propriedades psicométricas, a análise fatorial apresentou um agrupamento diferente do encontrado pelos autores da versão original do instrumento, demonstrando a necessidade de desenvolver novos estudos objetivando propor nova distribuição fatorial para a versão brasileira desta escala. A validade de constructo convergente apresentou correlação positiva com o domínio satisfação com a vida da EBES. Na validade de constructo divergente foi obtida uma relação significante com algumas características sociodemográficas e clinico obstétricas. Com relação à confiabilidade, foi obtido um valor adequado para a consistência interna da versão adaptada da BMSP 2 (Alfa de Cronbach 0,93). Conclusão: A versão adaptada para o português da BMSP 2 mostrou-se válida e confiável na amostra estudada. Novos estudos necessitam ser realizados para testar essas propriedades em outros grupos de pacientes brasileiras. / Introduction: To evaluate the effects of health care on women`s wellness during childbirth is possible with the use of scales based on women`s perception of care. To establish the quality of these assessments is required by using a valid and cultural scale to make possible to achieve the desired improvements on outcomes of midwifery care. Objectives: The aims of this study were to translate the Chilean scale Mother`s Wellness during Childbirth to Brazilian Portuguese and to evaluate its reliability and validity. Method: This quantitative study followed five steps of cultural adaptation of the scales: translation of the scale to Brazilian Portuguese; back-translation to Spanish; assessment by a judge´s committee, scale pre-test and the application of the final version of the scale. The data were collected from December, 2012 to March, 2013 in a Brazilian University Hospital. A total of 500 women who had childbirth in this institution participated in this study. The face validity and content validity was assessed by an expert´s committee; the factor analysis was performed using the construct validity, the convergent validity was tested using the Pearson´s Correlation Test between Mother`s Wellness during Childbirth and Subjective Welfare Scale; and the divergent validity test was used to compare different groups. The reliability of the scale`s final version was assessed through internal consistency of its items using Cronbach\'s Alpha.The significance level was 0.05. Results: Women aged 26.7, were white, had a partner, had nine to 11 years of study and were housewives. Most women were multiparous, with gestational age between 39 weeks and 39 weeks and six days. The factorial analysis of scale showed a cluster difference in relation to the original scale indicating the need to explore better new distribution factors for the portuguese version of the scale. The convergent construct validity was positively correlated with life satisfaction domain of Subjective Welfare Scale and the divergent construct validity had a significant relationship with sociodemographic obstetric characteristics. The reliability of the Portuguese version of Mother`s Wellness during Childbirth was adequate for internal consistency observed with Cronbach\'s alpha value (0.93). Conclusion: Portuguese version of Mother`s Wellness during Childbirth is valid and reliable for this studied sample.