The purpose of this mixed-methods case study was to examine teachers’ beliefs toward in-grade retention in a K-2 school. This study focused on how teachers acquire beliefs regarding grade retention, and their knowledge of research regarding the effectiveness of retention. Witmer, Hoffman and Nottis (2004) contend that teacher beliefs toward grade retention may not be based on research, but on peer influence, past practice, or administrative policy. Quantitative and qualitative data were collected to examine teacher beliefs in a K- 2 school. Quantitative data were collected through the Teacher Opinion Survey (TOS) and Personal Experiences and Retention Practices (PERP). A total of ten K-2 teachers volunteered to complete the survey instruments. Additionally, six K-2 teachers and the school principal were interviewed to collect qualitative data. Data were analyzed to triangulate the findings. This study concluded that teachers continue to retain students as a remedy for academic failure, contrary to what some researchers like Shepard and Smith (1989), who decried that schools were continuing the practice of retention despite research findings that indicated little or no academic achievement is gained though retention. Findings further indicated that teachers disagreed that retention failed to improve achievement, failed to inspire students to buckle down and behave better, and failed to develop students’ social adjustment and self-concept.

No description available.

No description available.

Implantes osseointegrados vêm sendo utilizados com sucesso para restaurar a função e a estética de pacientes desdentados totais e parciais, no entanto, apesar do alto índice de sucesso, a literatura apresenta uma série de complicações da técnica. Apesar da falta de consenso sobre qual a melhor maneira de se restaurar implantes múltiplos adjacentes, a confecção de próteses unitárias vem sendo sugerida e praticada por muitos profissionais. O objetivo deste trabalho foi verificar, pela técnica fotoelástica (qualitativa e quantitativa), o comportamento biomecânico de coroas unitárias sobre implantes hexágono interno com pilar UCLA. Foram confeccionadas coroas cimentadas e parafusadas, simulando a reabilitação da área posterior da mandíbula com e sem a presença de elemento dental distal aos implantes. Foram analisados, também, a liga metálica da infraestrutura (Ni-Cr-Ti ou Ni-Cr) e o tipo de material para revestimento estético (cerâmica ou resina). Foram confeccionados modelos fotoelásticos simulando espaço protético com ausência de segundo pré-molar e primeiro molar, reabilitado com coroas sobre implantes. Três modelos de pontas de aplicação de carga foram utilizados para produzir quatro diferentes condições de carregamento na superfície oclusal das coroas: 1 -puntiforme obtido com uma ponta simples para carregamento no pré-molar ou no molar com 5kgf; 2 puntiforme simultânea obtido por uma ponta dupla para carregamento das duas coroas ao mesmo tempo com 10kgf; 3 - oclusal distribuído obtido com uma ponta que simulou a oclusão antagonista com 10kgf. Após a aplicação das cargas, foram obtidos registros fotográficos para análise qualitativa e posteriormente foi realizada a análise quantitativa em três pontos na região cervical e um ponto na região apical de cada implante. De acordo com os resultados obtidos pode-se concluir que o uso de ligas de Ni-Cr-Ti ou Ni-Cr não interferiu na transmissão de tensões. Coroas revestidas em resina, de modo geral, geraram maior concentração de tensões em torno dos implantes quando comparadas às coroas revestidas em cerâmica. As coroas parafusadas provocaram maior tensão em torno dos implantes quando comparadas às coroas cimentadas. A presença do dente com ponto de contato efetivo à distal das coroas sobre implantes favoreceu a distribuição de tensões. / Osseointegrated implants have been successfully used to restore function and esthetic to fully and partially edentulous patients; however, regardless of the high success, the literature reveals some complications of the technique. Despite the lack of consensus about what is the better way to restore multiple adjacent implants, the use of single crowns have been suggested and practiced by many professionals. The purpose of the present study was to verify, using photoelastic analysis (qualitative and quantitative), the biomechanical behavior of single crowns on internal hexagon implants with UCLA abutment. Cement and screw-retained crowns was fabricated simulating the rehabilitation of posterior mandible area with or without the presence of a dental element distal to the implants. The metal framework alloys (Ni-Cr-Ti or Ni- Cr) and the esthetic veneering materials (ceramic or resin) was, also, analyzed. Photoelastic models were made simulating the missing of the second pre-molar and the first molar, rehabilitated with implant-supported crowns. Three models of loading application tips were used to produce different conditions of loading on crowns occlusal surface: 1 punctiform obtained with a simple tip for loading over premolar or molar with 5 Kgf; 2 simultaneous punctiform obtained with a Double tip for loading over both crowns in the same time with 10 Kgf; 3 distributed occlusal obtained with a tip simulating the antagonist occlusion with 10 Kgf. After loading application photographic records were obtained for qualitative analysis, and in sequence, quantitative analysis was realized in three cervical points and one point in the apical area of each implant. According to the obtained results, it was concluded that the use of Ni-Cr-Ti or Ni-Cr alloys did not interfere in stress transmission. Resin veneered crowns, generally generated higher concentration of stress around the implants when compared to ceramic veneered crowns. Screw-retained crowns promoted higher stress around the implants when compared to cement-retained crowns. The presence of teeth with effective interproximal contact distal to implantsupported crowns improved the stress distribution.

This thesis proposes a privacy protection framework for the controlled distribution and use of personal private data. The framework is based on the idea that privacy policies can be set directly by the data owner and can be automatically enforced against the data user. Data privacy continues to be a very important topic, as our dependency on electronic communication maintains its current growth, and private data is shared between multiple devices, users and locations. The growing amount and the ubiquitous availability of personal private data increases the likelihood of data misuse. Early privacy protection techniques, such as anonymous email and payment systems have focused on data avoidance and anonymous use of services. They did not take into account that data sharing cannot be avoided when people participate in electronic communication scenarios that involve social interactions. This leads to a situation where data is shared widely and uncontrollably and in most cases the data owner has no control over further distribution and use of personal private data. Previous efforts to integrate privacy awareness into data processing workflows have focused on the extension of existing access control frameworks with privacy aware functions or have analysed specific individual problems such as the expressiveness of policy languages. So far, very few implementations of integrated privacy protection mechanisms exist and can be studied to prove their effectiveness for privacy protection. Second level issues that stem from practical application of the implemented mechanisms, such as usability, life-time data management and changes in trustworthiness have received very little attention so far, mainly because they require actual implementations to be studied. Most existing privacy protection schemes silently assume that it is the privilege of the data user to define the contract under which personal private data is released. Such an approach simplifies policy management and policy enforcement for the data user, but leaves the data owner with a binary decision to submit or withhold his or her personal data based on the provided policy. We wanted to empower the data owner to express his or her privacy preferences through privacy policies that follow the so-called Owner-Retained Access Control (ORAC) model. ORAC has been proposed by McCollum, et al. as an alternate access control mechanism that leaves the authority over access decisions by the originator of the data. The data owner is given control over the release policy for his or her personal data, and he or she can set permissions or restrictions according to individually perceived trust values. Such a policy needs to be expressed in a coherent way and must allow the deterministic policy evaluation by different entities. The privacy policy also needs to be communicated from the data owner to the data user, so that it can be enforced. Data and policy are stored together as a Protected Data Object that follows the Sticky Policy paradigm as defined by Mont, et al. and others. We developed a unique policy combination approach that takes usability aspects for the creation and maintenance of policies into consideration. Our privacy policy consists of three parts: A Default Policy provides basic privacy protection if no specific rules have been entered by the data owner. An Owner Policy part allows the customisation of the default policy by the data owner. And a so-called Safety Policy guarantees that the data owner cannot specify disadvantageous policies, which, for example, exclude him or her from further access to the private data. The combined evaluation of these three policy-parts yields the necessary access decision. The automatic enforcement of privacy policies in our protection framework is supported by a reference monitor implementation. We started our work with the development of a client-side protection mechanism that allows the enforcement of data-use restrictions after private data has been released to the data user. The client-side enforcement component for data-use policies is based on a modified Java Security Framework. Privacy policies are translated into corresponding Java permissions that can be automatically enforced by the Java Security Manager. When we later extended our work to implement server-side protection mechanisms, we found several drawbacks for the privacy enforcement through the Java Security Framework. We solved this problem by extending our reference monitor design to use Aspect-Oriented Programming (AOP) and the Java Reflection API to intercept data accesses in existing applications and provide a way to enforce data owner-defined privacy policies for business applications. / Im Rahmen der Dissertation wurde ein Framework für die Durchsetzung von Richtlinien zum Schutz privater Daten geschaffen, welches darauf setzt, dass diese Richtlinien oder Policies direkt von den Eigentümern der Daten erstellt werden und automatisiert durchsetzbar sind. Der Schutz privater Daten ist ein sehr wichtiges Thema im Bereich der elektronischen Kommunikation, welches durch die fortschreitende Gerätevernetzung und die Verfügbarkeit und Nutzung privater Daten in Onlinediensten noch an Bedeutung gewinnt. In der Vergangenheit wurden verschiedene Techniken für den Schutz privater Daten entwickelt: so genannte Privacy Enhancing Technologies. Viele dieser Technologien arbeiten nach dem Prinzip der Datensparsamkeit und der Anonymisierung und stehen damit der modernen Netznutzung in Sozialen Medien entgegen. Das führt zu der Situation, dass private Daten umfassend verteilt und genutzt werden, ohne dass der Datenbesitzer gezielte Kontrolle über die Verteilung und Nutzung seiner privaten Daten ausüben kann. Existierende richtlinienbasiert Datenschutztechniken gehen in der Regel davon aus, dass der Nutzer und nicht der Eigentümer der Daten die Richtlinien für den Umgang mit privaten Daten vorgibt. Dieser Ansatz vereinfacht das Management und die Durchsetzung der Zugriffsbeschränkungen für den Datennutzer, lässt dem Datenbesitzer aber nur die Alternative den Richtlinien des Datennutzers zuzustimmen, oder keine Daten weiterzugeben. Es war daher unser Ansatz die Interessen des Datenbesitzers durch die Möglichkeit der Formulierung eigener Richtlinien zu stärken. Das dabei verwendete Modell zur Zugriffskontrolle wird auch als Owner-Retained Access Control (ORAC) bezeichnet und wurde 1990 von McCollum u.a. formuliert. Das Grundprinzip dieses Modells besteht darin, dass die Autorität über Zugriffsentscheidungen stets beim Urheber der Daten verbleibt. Aus diesem Ansatz ergeben sich zwei Herausforderungen. Zum einen muss der Besitzer der Daten, der Data Owner, in die Lage versetzt werden, aussagekräftige und korrekte Richtlinien für den Umgang mit seinen Daten formulieren zu können. Da es sich dabei um normale Computernutzer handelt, muss davon ausgegangen werden, dass diese Personen auch Fehler bei der Richtlinienerstellung machen. Wir haben dieses Problem dadurch gelöst, dass wir die Datenschutzrichtlinien in drei separate Bereiche mit unterschiedlicher Priorität aufteilen. Der Bereich mit der niedrigsten Priorität definiert grundlegende Schutzeigenschaften. Der Dateneigentümer kann diese Eigenschaften durch eigene Regeln mittlerer Priorität überschrieben. Darüber hinaus sorgt ein Bereich mit Sicherheitsrichtlinien hoher Priorität dafür, dass bestimmte Zugriffsrechte immer gewahrt bleiben. Die zweite Herausforderung besteht in der gezielten Kommunikation der Richtlinien und deren Durchsetzung gegenüber dem Datennutzer (auch als Data User bezeichnet). Um die Richtlinien dem Datennutzer bekannt zu machen, verwenden wir so genannte Sticky Policies. Das bedeutet, dass wir die Richtlinien über eine geeignete Kodierung an die zu schützenden Daten anhängen, so dass jederzeit darauf Bezug genommen werden kann und auch bei der Verteilung der Daten die Datenschutzanforderungen der Besitzer erhalten bleiben. Für die Durchsetzung der Richtlinien auf dem System des Datennutzers haben wir zwei verschiedene Ansätze entwickelt. Wir haben einen so genannten Reference Monitor entwickelt, welcher jeglichen Zugriff auf die privaten Daten kontrolliert und anhand der in der Sticky Policy gespeicherten Regeln entscheidet, ob der Datennutzer den Zugriff auf diese Daten erhält oder nicht. Dieser Reference Monitor wurde zum einen als Client-seitigen Lösung implementiert, die auf dem Sicherheitskonzept der Programmiersprache Java aufsetzt. Zum anderen wurde auch eine Lösung für Server entwickelt, welche mit Hilfe der Aspekt-orientierten Programmierung den Zugriff auf bestimmte Methoden eines Programms kontrollieren kann. In dem Client-seitigen Referenzmonitor werden Privacy Policies in Java Permissions übersetzt und automatisiert durch den Java Security Manager gegenüber beliebigen Applikationen durchgesetzt. Da dieser Ansatz beim Zugriff auf Daten mit anderer Privacy Policy den Neustart der Applikation erfordert, wurde für den Server-seitigen Referenzmonitor ein anderer Ansatz gewählt. Mit Hilfe der Java Reflection API und Methoden der Aspektorientierten Programmierung gelang es Datenzugriffe in existierenden Applikationen abzufangen und erst nach Prüfung der Datenschutzrichtlinie den Zugriff zuzulassen oder zu verbieten. Beide Lösungen wurden auf ihre Leistungsfähigkeit getestet und stellen eine Erweiterung der bisher bekannten Techniken zum Schutz privater Daten dar.

Implantes osseointegrados vêm sendo utilizados com sucesso para restaurar a função e a estética de pacientes desdentados totais e parciais, no entanto, apesar do alto índice de sucesso, a literatura apresenta uma série de complicações da técnica. Apesar da falta de consenso sobre qual a melhor maneira de se restaurar implantes múltiplos adjacentes, a confecção de próteses unitárias vem sendo sugerida e praticada por muitos profissionais. O objetivo deste trabalho foi verificar, pela técnica fotoelástica (qualitativa e quantitativa), o comportamento biomecânico de coroas unitárias sobre implantes hexágono interno com pilar UCLA. Foram confeccionadas coroas cimentadas e parafusadas, simulando a reabilitação da área posterior da mandíbula com e sem a presença de elemento dental distal aos implantes. Foram analisados, também, a liga metálica da infraestrutura (Ni-Cr-Ti ou Ni-Cr) e o tipo de material para revestimento estético (cerâmica ou resina). Foram confeccionados modelos fotoelásticos simulando espaço protético com ausência de segundo pré-molar e primeiro molar, reabilitado com coroas sobre implantes. Três modelos de pontas de aplicação de carga foram utilizados para produzir quatro diferentes condições de carregamento na superfície oclusal das coroas: 1 -puntiforme obtido com uma ponta simples para carregamento no pré-molar ou no molar com 5kgf; 2 puntiforme simultânea obtido por uma ponta dupla para carregamento das duas coroas ao mesmo tempo com 10kgf; 3 - oclusal distribuído obtido com uma ponta que simulou a oclusão antagonista com 10kgf. Após a aplicação das cargas, foram obtidos registros fotográficos para análise qualitativa e posteriormente foi realizada a análise quantitativa em três pontos na região cervical e um ponto na região apical de cada implante. De acordo com os resultados obtidos pode-se concluir que o uso de ligas de Ni-Cr-Ti ou Ni-Cr não interferiu na transmissão de tensões. Coroas revestidas em resina, de modo geral, geraram maior concentração de tensões em torno dos implantes quando comparadas às coroas revestidas em cerâmica. As coroas parafusadas provocaram maior tensão em torno dos implantes quando comparadas às coroas cimentadas. A presença do dente com ponto de contato efetivo à distal das coroas sobre implantes favoreceu a distribuição de tensões. / Osseointegrated implants have been successfully used to restore function and esthetic to fully and partially edentulous patients; however, regardless of the high success, the literature reveals some complications of the technique. Despite the lack of consensus about what is the better way to restore multiple adjacent implants, the use of single crowns have been suggested and practiced by many professionals. The purpose of the present study was to verify, using photoelastic analysis (qualitative and quantitative), the biomechanical behavior of single crowns on internal hexagon implants with UCLA abutment. Cement and screw-retained crowns was fabricated simulating the rehabilitation of posterior mandible area with or without the presence of a dental element distal to the implants. The metal framework alloys (Ni-Cr-Ti or Ni- Cr) and the esthetic veneering materials (ceramic or resin) was, also, analyzed. Photoelastic models were made simulating the missing of the second pre-molar and the first molar, rehabilitated with implant-supported crowns. Three models of loading application tips were used to produce different conditions of loading on crowns occlusal surface: 1 punctiform obtained with a simple tip for loading over premolar or molar with 5 Kgf; 2 simultaneous punctiform obtained with a Double tip for loading over both crowns in the same time with 10 Kgf; 3 distributed occlusal obtained with a tip simulating the antagonist occlusion with 10 Kgf. After loading application photographic records were obtained for qualitative analysis, and in sequence, quantitative analysis was realized in three cervical points and one point in the apical area of each implant. According to the obtained results, it was concluded that the use of Ni-Cr-Ti or Ni-Cr alloys did not interfere in stress transmission. Resin veneered crowns, generally generated higher concentration of stress around the implants when compared to ceramic veneered crowns. Screw-retained crowns promoted higher stress around the implants when compared to cement-retained crowns. The presence of teeth with effective interproximal contact distal to implantsupported crowns improved the stress distribution.

For ecological reasons, the current main challenge of the automotive industry is to reduce the fuel consumption of vehicles and then emissions of greenhouse gas. In this context, steelmakers and automotive manufacturers decided for some years now to join their efforts to promote the development and use of advanced high strength steels such as TRIP steels. A combination of high strength and large elongation is obtained thanks to the TRansformation Induced Plasticity (TRIP) effect. However, improvement of the mechanical properties is still possible, especially by the refinement of the matrix. In this work, two main ways were followed in order to reach improved properties. The classical way consisting of the annealing of cold-rolled samples and an innovative way consisting of obtaining the desired microstructure by direct hot rolling of the samples. In the classical way, this refinement can be obtained by acting on the chemical composition (with such alloying elements like Cu and Nb). It was observed that complete recrystallisation of the ferrite matrix is quite impossible in presence of Cu precipitates. In addition, if the ferrite recrystallisation is not completed before reaching the eutectoid temperature, the recrystallisation will be slowed down by a large way. An innovative heat treatment consisting in keeping the copper in solid solution in the high-Cu steel was developed. Therefore, ferrite recrystallises quite easily and very fine ferrite grains (~1µm) were obtained. In the innovative way, the effects of hot-rolling conditions on TRIP-assisted multiphase steels are of major importance for industrial practice and could open new dimensions for the TRIP steels (i.e. thanks to precipitation mechanisms leading to additive strengthening). Impressive mechanical properties (true stress at maximum load of 1500 MPa and true strain at uniform elongation of 0.22) were obtained with a relatively easy thermomechanical process, the role played by Nb being essential.

A austenita retida está sempre presente na microestrutura de camada cementada de aços, em maior ou menor quantidade. Como é uma fase dúctil comparada à martensita, sua presença tem sido alvo de muita controvérsia. Este trabalho apresenta um estudo sobre a influência da austenita retida na propagação de trincas curtas por fadiga em camada cementada de aço SAE 8620. Foram feitos ensaios de fadiga por flexão em quatro pontos, a temperatura ambiente, em corpos de prova sem entalhe com três níveis de amplitude de tensão e razão de tensões de 0,1. Através de diferentes ciclos de cementação e tratamentos térmicos, foram obtidas camadas cementadas com quatro níveis de austenita retida na microestrutura. O teor de austenita retida foi medido através da técnica de difração de Raios-X. Trincas superficiais foram monitoradas por meio da técnica de réplicas de acetato. Como resultados foram obtidos tamanho de trinca em função do número de ciclos e taxa de crescimento de trincas curtas. Corpos de prova com maiores níveis de austenita retida apresentaram maior vida em fadiga. / The retained austenite is always present in case carburized steel microstructure in small or high percentages. Since it is a ductile phase, its presence has long been a controversial subject. The influence of retained austenite on short fatigue crack propagation in case carburized SAE 8620 steel was studied in this work. Four-point-bend fatigue tests were carried out at room temperature in specimens without notch using three levels of stress range and a stress ratio of 0.1. Four different amount of retained austenite in the case carburized microstructure were obtained through different cycles of carburizing and heat treating. The retained austenite content was measured by X-ray technique, and the surface short crack growth was monitored by means of acetate replication technique. Crack length versus number of cycles and crack growth rate versus mean crack length were obtained as results. Specimens with higher levels of retained austenite in the carburized case showed longer fatigue life.

O estudo teve como objetivos analisar as evidências disponíveis na literatura sobre o processo de contagem cirúrgica (compressas, instrumentos cirúrgicos e perfurocortantes) e analisar como ocorre o processo de contagem cirúrgica, segundo a opinião dos enfermeiros que atuam em unidades de centro cirúrgico de hospitais de uma cidade localizada no interior do Estado de São Paulo. Para alcançar os objetivos propostos, a pesquisa foi conduzida em duas fases: a elaboração de revisão integrativa e a condução de estudo descritivo. A busca dos estudos primários para inclusão na revisão integrativa foi realizada nas bases de dados PubMed, CINAHL e LILACS. A amostra da revisão integrativa foi composta de 28 estudos primários, agrupados em três categorias: fatores de risco para retenção de itens cirúrgicos, processo de contagem cirúrgica e uso de tecnologias para o aprimoramento do processo de contagem cirúrgica. A elaboração da revisão integrativa possibilitou a síntese de evidências sobre o processo de contagem cirúrgica, na qual foi possível detectar os fatores de risco para retenção de itens cirúrgicos, como o processo de contagem cirúrgica deve ser realizado, bem como por quem e quando; além do conhecimento das tecnologias adjuntas que podem aprimorar o processo de contagem manual. O estudo descritivo foi conduzido em 16 unidades de centro cirúrgico, com a participação de 55 enfermeiros que atuavam diretamente neste setor dos hospitais selecionados. Para a coleta de dados, foi elaborado instrumento submetido à validação aparente e de conteúdo por cinco juízes. Os participantes do estudo responderam a questões sobre o processo de contagem cirúrgica (compressas, instrumentos cirúrgicos e perfurocortantes): como era realizado, por quem e quando. Quando o enfermeiro indicou que, no serviço de saúde, não era executada a contagem de algum dos itens cirúrgicos investigados, solicitou-se a sua opinião de como deveria ser realizado determinado processo. Assim, 52 (94,5%) participantes responderam que o processo de contagem cirúrgica era realizado no seu local de trabalho e três (5,5%) não. A contagem de instrumentos cirúrgicos era realizada, de acordo com 55,8% dos enfermeiros (n=29); 88,5% (n=46) dos participantes afirmaram que o processo de contagem de compressas era executado e 48,1% (n=25) dos enfermeiros informaram a realização do processo de contagem de perfurocortantes. A Organização Mundial de Saúde preconiza como item para a segurança do paciente que o processo de contagem cirúrgica seja realizado em qualquer cirurgia, e o enfermeiro perioperatório tem papel fundamental neste processo e na prevenção de retenção de itens cirúrgicos. Esse profissional deve implementar protocolos de execução desse processo pautados em evidências recentes, na unidade de centro cirúrgico. Entretanto, para o processo de contagem cirúrgica ocorrer efetivamente na prática clínica, há necessidade de recursos humanos treinados e de dispositivos que auxiliem na contagem, como lousa na sala de operação, recipientes exclusivos para colocação de compressas e perfurocortantes, além do uso adequado de tecnologias como raios-X, compressas com código de barras e compressas com marcadores de radiofrequência. Assim, a instituição de saúde deve dar o suporte necessário para a adequada realização do processo de contagem cirúrgica / The aims of this study were to analyze the evidence of surgical count process (sponges, surgical instruments and sharps) available in literature and examine how the surgical count process takes place, according to the opinion of nurses working in surgical units of hospitals of a city in upstate São Paulo. The study was conducted in two phases: an integrative review and a descriptive study. The search for primary studies to be included in the integrative review was conducted in PubMed, CINAHL and LILACS databases. The integrative review sample consisted of 28 primary studies, grouped into three categories: risk factors for retained surgical items, surgical count process and using technologies to improve the surgical count. The integrative review allowed synthesizing the evidence on the surgical count process, which enabled to detect the risk factors for retained surgical items, how the process should be performed, as well as who should perform it and when; in addition to the identifying the knowledge of supporting technologies that could improve the manual counting process. The descriptive study was performed in 16 surgical units, counting with the participation of 55 nurses working directly in the referred unit of the selected hospitals. Data collection was performed using an instrument previously submitted to apparent and content validation by five judges. The participants answered questions regarding the surgical count process (sponges, surgical instruments and sharps): who performed it, how and when. Whenever nurses indicated that, at their health service, there were flaws in counting any of the investigated surgical items, they were asked about their opinion as to how the process should be performed. Fifty-two (94.5%) participants answered that the surgical count process was performed at their workplace whereas three (5.5%) stated it was not. According to 55.8% of nurses (n=29) surgical instruments were counted; 88.5% (n=46) of participant reported that the sponges count process was performed, and 48.1% (n=25) informed that sharps were counted. The World Health Organization recommends the surgical count process as a patient safety item, and that it should be performed in every surgery, with the perioperative nurse playing a key role in this process as well as in avoiding the retained surgical items. Nurses should implement protocols for performing this procedure in the surgical unit, supported by recent evidence. Nevertheless, to ensure the surgical count process is effective, the staff must be properly trained and specific devices to assist the counting procedure must be made available, such as keeping whiteboards operating room, as well as exclusive containers for placing sponges and sharps, in addition to an appropriate utilization of supporting technologies such as X- rays, bar-coded sponges and radio frequency tagged sponges. Thus, health institutions should provide the necessary support for an effective surgical count process

O afrouxamento dos parafusos protéticos é descrito na literatura como uma das complicações mais frequentes das próteses sobre implantes. Durante sua confecção, os profissionais sentem necessidade de remover várias vezes as próteses e/ou componentes protéticos, soltando e re-apertando os parafusos repetidamente. O principal objetivo deste trabalho foi avaliar a variação do torque de remoção de parafusos de fixação de pilares protéticos a implantes osteointegráveis após sucessivos ciclos de parafusamento e desparafusamento. Outro objetivo foi avaliar a influência do hexágono da base do pilar no torque de remoção dos parafusos. Para isso, foram utilizados 20 implantes de plataforma regular com hexágono externo e 20 pilares protéticos sextavados, que foram parafusados aos implantes com um parafuso de titânio, aplicando-se a este um torque de 32Ncm, por meio de um torquímetro digital. Os conjuntos implante/pilar/parafuso foram divididos em dois grupos: (1) pilares cujo hexágono da base foram removidos e (2) pilares convencionais, com hexágono na base. Cada conjunto recebeu uma restauração provisória e foi submetido a ciclagem mecânica por 15 minutos. Depois, os parafusos foram removidos, medindo-se o torque de remoção. Esta sequência foi repetida dez vezes e então o parafuso foi trocado por outro sem uso, e mais um ciclo foi realizado. Uma análise de regressão linear demonstrou nos dois grupos uma queda do torque de remoção do parafuso ao longo dos repetidos ciclos de inserção/remoção. A comparação entre os coeficientes da regressão nos dois grupos não revelou diferença entre eles. Também não houve diferença entre as médias das 5 últimas repetições e o 11 ciclo, com o parafuso novo. Concluiu-se que (1) repetidos parafusamentos e desparafusamentos promoveram a diminuição progressiva do torque de remoção dos parafusos, (2) a troca do parafuso por outro sem uso após dez ciclos de inserção/remoção não aumentou sua resistência ao afrouxamento, e (3) a remoção do hexágono da base do pilar protético não exerceu nenhum efeito sobre o torque de remoção do parafuso. / Screw loosening is one of the most common problems of implant-retained prostheses. During their confection, dentists need to remove and re-install them several times, loosening and re-tightening the screws repeatedly. The first purpose of this study was to evaluate the effects of repeated insertion/removal cycles on the removal torque of retaining prosthetic screws. The second purpose was to evaluate the influence of the hexagon of the abutment on the removal torque. For that, 20 regular external hex implants were used and 20 hexagonal abutments were tightened to the implants with a titanium alloy screw, with an insertion torque of 32Ncm, given by a digital torque gauge. The implant/abutment/screw assemblies were divided into two groups: (1) abutments with no hexagon on the base and (2) abutments with an hexagon on the base. Each assembly received a provisional restoration and was submitted to mechanical loading cycles for 15 minutes. After this, the screws were removed and the removal torque measured. This sequence was repeated ten times and then, the screw was changed for a new one, and another cycle was done. Linear regression analysis was performed and showed that removal torque values tended to decrease as the number of insertion/removal cycles increased, for both groups. Comparisons of the slopes and the intercepts between the two groups showed no statistic difference between them. There was also no difference between the mean values of last 5 cycles and the 11th cycle. It was concluded that (1) repeated insertion/removal cycles promoted gradual reduction in removal torque of screws, (2) changing screw by a new one after ten insertion/removal cycles did not increase resistance to loosening, and (3) removal of the hexagon of the abutment base had no effect on the removal torque of the screw.