The sex hormone testosterone supports male reproduction. However, testosterone is hypothesized to suppress immune activity, resulting in a tradeoff between energetic investment in reproductive effort and immune function. The Immunocompetence Handicap Hypothesis (ICHH) therefore argues that testosterone-linked masculine traits honestly signal health status to prospective mates, as only uninfected males should be able to maintain high testosterone levels. Still, this proposed tradeoff remains poorly tested among human men, especially among natural fertility populations experiencing high infectious disease burdens. This dissertation therefore tested the ICHH among indigenous Shuar men of Amazonian Ecuador. Specifically, this project examined testosterone variation patterns and assessed how male investment in reproductive effort is associated with reproductive success and immune function. The first study tested testosterone level variation among Shuar men in relation to body composition, age, and style of life factors. This study demonstrated that age and BMI interactions shape testosterone levels in complex ways, such that the relationship between body composition and testosterone profile varies throughout the life course. The second study investigated whether individual reproductive success was significantly influenced by masculine trait development and parasite load. These results failed to support the hypotheses that masculine traits increased reproductive success or honestly signaled lack of parasitic disease. Instead, a significant positive association was observed between a composite score of masculine traits and Ascaris lumbricoides infection load; suggesting that male investment in reproductive effort may increase parasitic infection risk. The final study assessed whether testosterone levels were negatively associated with four measures of immune function (parasite load, C-Reactive Protein [CRP], Immunoglobulin-G [IgG], and Immunoglobulin-E [IgE]). Testosterone levels were inversely associated with CRP levels and a positive relationship between testosterone levels and Trichuris trichiura infection load was documented, suggesting increased investment in reproductive effort may suppress some aspects of immune function and increase parasite burden. Overall, these studies fail to support the ICHH, but do indicate a context-dependent tradeoff between energetic investment in male reproductive effort and some aspects of immune function; thereby demonstrating complex interactions between physical characteristics, physiological processes, and immune activity in human men. This dissertation includes unpublished, co-authored material.

Analysis of vibration transmission and reflection in beam-like engineering structures requires better predictive models to optimise structural behaviour further. Numerous studies have used flexural and longitudinal structural wave motion to model the vibrational response of angled junctions in beam-like structures, to better understand the transmission and reflection properties. This study considers a model of a variable joint angle which joins two semi-infinite rectangular cross-section beams. In a novel approach, the model allows for the joint to expand in size as the angle between the two beams is increased. The material, geometric and dynamics properties were consistently being considered. Thus, making the model a good representation of a wide range of angles. Predicted results are compared to an existing model of a joint between two semi-infinite beams where the joint was modelled as a fixed inertia regardless of the angle between the beams, thus limiting its physical representation, especially at the extremes of angle (two beams lay next to each other at 180 degree joint). Results from experimentation were also compared to the modelling, which is in good agreement for the range of angles investigated. Optimum angles for minimum vibrational power transmission are identified in terms of the frequency of the incoming flexural or longitudinal wave. Extended analysis and effect of adding stiffness and damping (rubber material) at the joint are also reported.

Philosophiae Doctor - PhD / The sexual behaviour of youths is believed to play a role in the spread of SexuallyTransmitted Infections (STIs) and Reproductive Tract Infections (RTIs). This study examinesthe determinants of youth sexual behaviours and knowledge of reproductive tract infections (RTIs) and sexually transmitted infections (STIs) in Malawi. It explores rural/urbandifferentials in sexual behaviours using indicators such as early sexual initiation, multiplesexual partnerships, and non-use of condoms, in order to establish policy recommendationstoward improving sexual behaviour among youths. The Malawi Demographic Health Survey2010 data was used. Out of a sample of 2987 males and 9559 females aged 15-24 years,5652 females and 1405 males (condom use), 675 females and 511 males (inconsistentcondom use), 6470 females and 2026 males (multiple sexual partnerships (MSP)), and 15217females and 1405 males (early sexual debut) were filtered in the study.Chi-square and logistic regression techniques were performed to test for association betweensexual behaviour indicators and socio-demographic variables. The prevalence of non-use ofcondom was higher among catholic females (OR=1.11), lower among Muslim males (OR=0.81) and higher among CCAP females (OR=1.19). Muslim females were (OR=1.42) more likely to initiate sexual activities early, while Muslim males were (OR= 0.57) less likelyto initiate sexually activities early. Females in the central region (OR=1.51) and catholicmales (OR=1.63) were more likely to have more sexual partners.Encouraging these young people to be faithful to one uninfected partner, abstinence fromsexual activities, use condoms consistently and delay sexual initiation will help curb the spread of STIs in Malawi.

Orientador: Kester Carrara / Banca: Sandra Regina Gimeniz-Paschoal / Banca: Sandra Leal Calais / Resumo: Estudos sobre prevenção de doenças sexualmente transmissíveis e gravidez precoce em populações jovens demonstram que esse público apresenta, cada vez mais, melhor nível de conhecimento sobre as doenças e sobre o uso do preservativo. Entretanto, ainda é relativamente alto o número de jovens que não usam o preservativo durante as relações sexuais. Apesar de a Análise do Comportamento possuir um considerável potencial para auxiliar na compreensão dos processos culturais, ainda são escassos os trabalhos em Análisedo Comportamento possuir um considerável potencial para auxiliar na compreensão dos processos culturais, ainda são escassos os trabalhos em Análise do Comportamento com enfoque sobre a cultura. O presente estudo objetivou identificar e descrever características do uso de preservativos e possíveis variáveis controladoras desse comportamento em estudantes com idades entre 13 e 18 anos. Para tanto foram analisadas regras que agiam como estímulos discriminatvos antecedentes aos comportamentos de usar ou não preservativo, bem como consequências de punição ou reforçamento disponibilizadas pelos pais ou responsáveis e por serviços de saúde. Participaram da pesquisa 191 adolescentes, de ambos os sexos, estudantes de uma escola da rede pública da cidade de Bauru. Os dados foram coletados por meio de um questionário estruturado, elaborado e aplicado pela própria pesquisadora. Do total den estudantes, 83% se encontravam na faixa de 14 a 16 anos, sendo 92 do sexo masculino e 99 do sexo feminino. Em relação às famílias, 75% dos participantes residiam com cerca de 3 a 5 pessoas, sendo 43% familias nucleares.Quanto à experiência sexual, 65 participantes declararam já ter tido relações sexuais. Destes, 51 afirmaram terem usado preservativo durante a primeira relação sexual. Apenas 27 adolescentes declararam uso em todas as relações e somente... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Studies on prevention of sexually transmitted diseases and premature pregnancy in young populations demonostrate that this public has increasingly improved knowledge about diseases and the use of condoms. However, it is still relatively high the number of young people who do not use condoms during sex. Althrough behavior analysis has a considerable potential to assist in the understanding of cultural processes there are still very few studies in behavior analysis with a focus on culture. This study aimed to identify and describe characteristics of condom use and possible behavior controlling variables in students aged between 13 and 18 years old. Therefore, some rules have been analyzed, and they acted as discriminative stimuli prior to the behavior of using condoms or not, as well as consequential punishment and reinforcement provided by parents or guardians and health services. 191 teenagers, of both sexes, from a public school in the city of Bauru, took part in the survey. Data were collected using a structure questionnaire, which was prepared and applied by the researcher herself. Of all students 83% were aged from 14 to 16 years, 92 male and 99 female. Concerning the families, 75% of the participants live with 3 to 5 people, 43% of those are nuclear families. As for the sexual experience, 65 participants said they had had sex. Of these, 51 report having used a condom using the first intercourse. Only 27 teens reported using condoms in all relationships and only 23 reported talking to their parther about condom use. Faced with situations where it is necessary to use condoms, only 18 students market all alternatives. "When it is using other methods", "when it is healthy" and "when there is love" were not market by, respectively, 77%, 58% and 66% of the sample. Receiving information from their parents about... (Complete abstract click electronic access below) / Mestre

p. 1-112 / Submitted by Santiago Fabio (fabio.ssantiago@hotmail.com) on 2013-04-24T21:04:41Z No. of bitstreams: 1 11111111111.pdf: 829006 bytes, checksum: d72adf5912d3d4a5a6ab9659a04a516d (MD5) / Approved for entry into archive by Maria Creuza Silva(mariakreuza@yahoo.com.br) on 2013-05-04T17:26:41Z (GMT) No. of bitstreams: 1 11111111111.pdf: 829006 bytes, checksum: d72adf5912d3d4a5a6ab9659a04a516d (MD5) / Made available in DSpace on 2013-05-04T17:26:41Z (GMT). No. of bitstreams: 1 11111111111.pdf: 829006 bytes, checksum: d72adf5912d3d4a5a6ab9659a04a516d (MD5) Previous issue date: 2008 / Introducción: El control de las infecciones causadas por geohelmintos está basado en la administración periódica de drogas antihelmínticas a los grupos de alto riesgo, particularmente a niños en edad escolar que viven en áreas endémicas. Existen datos limitados sobre la efectividad de tratamientos antihelmínticos periódicos a largo plazo en la prevalencia de infecciones por geohelmintos particularmente desde programas operacionales. Objetivo: El presente estudio investigó el impacto de 17 años de tratamiento en masa con un antihelmíntico de amplio espectro, la ivermectina, usada para el control de la oncocercosis, en la parevalencia e intensidad de infección por geohelmintos en niños escolares. Métodos: Un estudio transversal fue conducido en comunidades que han recibido tratamientos anuales o bianuales y comunidades adyacentes que no han recibido dicho tratamiento en dos cantones de la Provincia de Esmeraldas en Ecuador. Una única muestra de heces fue colectada de cada niño y fue examinada usando las técnicas de Kato Katz y por concentración con formol-éter. Datos sobre los factores de riesgo para las infecciones por geohelmintos fueron colectadas por medio de cuestionarios aplicados a los padres. Resultados: Un total de 3563 niños en edad escolar (6-16 años) de 31 comunidades tratadas y 27 comunidades no tratadas fueron investigados. El tratamiento con ivermectina tuvo un efecto significante en la prevalencia (ORadj= 0,06; IC 95%: 0,03-0,14) y en la intensidad de la infección (RPadj=0,28; IC 95%: 0,11-0,70) por Trichuris trichiura pero no se observó dicho efecto en la infección por Ascaris lumbricoides o uncinarias. Conclusión: Tratamientos con ivermectina anuales y bianuales por un periodo de alrededor de 17 años tuvieron un efecto significante en la infección por T. trichiura pero no sobre otras infecciones por geohelmintos. La adición de una segunda droga antihelmíntica, tal como el albendazol, sería necesaria para obtener un efecto a largo plazo en la infección por A. lumbricoides en áreas altamente endémicas. / Salvador

Submitted by Ana Maria Fiscina Sampaio (fiscina@bahia.fiocruz.br) on 2012-11-19T18:02:20Z No. of bitstreams: 1 Ana Gabriela Travassos. Prevalencia de infecções...pdf: 1770536 bytes, checksum: 441f7de704dcce48197a2de3df993352 (MD5) / Made available in DSpace on 2012-11-19T18:02:20Z (GMT). No. of bitstreams: 1 Ana Gabriela Travassos. Prevalencia de infecções...pdf: 1770536 bytes, checksum: 441f7de704dcce48197a2de3df993352 (MD5) Previous issue date: 2012 / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, Bahia, Brasil / Avaliar a prevalência de infecções sexualmente transmissíveis (IST) em gestantes infectadas pelo HIV e estimar os fatores de riscos associados acompanhadas no ambulatório de pré-natal no Centro Estadual Especializado em Diagnóstico, Assistência e Pesquisa (CEDAP), em Salvador, Bahia. Metodologia: Este é um estudo transversal, realizado no período de 01 de outubro de 2010 a 30 de setembro de 2011.Foram convidadas a participar as gestantes que procuraram atendimento no ambulatório de pré-natal do CEDAP. Foram excluídas as pacientes que utilizaram antibióticos há menos de 30 dias, apresentaram complicações obstétricas na primeira consulta como ameaça de abortamento, de parto prematuro e ruptura prematura de membranas. As participantes foram entrevistadas em relação à história sócio-epidemiológica e clínica e testadas para HBsAg,anti HCV,anti HTLV I/II,VDRL,captura híbrida para Chlamydia trachomatis,cultura para Neisseria gonorrhoeae,Mycoplasma hominis e Ureaplasma urealyticum,citologia oncótica para pesquisa de HPV.Obtidas contagens de Linfócitos TCD4 + e carga viral do HIV em amostra sanguínea. Nossa principal variável de desfecho foi a presença de qualquer IST. Resultados: Eram elegíveis 76 gestantes, destas 63 (82,9%) participaram do estudo. A média de idade das pacientes foi de 28,2 anos (16 - 40 anos), e de 19 semanas de idade gestacional ao chegar ao serviço.Foi feito o diagnóstico de pelo menos uma das IST estudadas além do HIV em 23/63 (36,5%) das pacientes.A freqüência dos diagnósticos foi HPV (15,0%), Chlamydia trachomatis (11,1%), sífilis (9,5%), hepatite C (8,1%), HTLV I/II(3,4%), hepatite B (3,2%), Mycoplasma hominis (2,1%) e Ureaplasma urealyticum (2,1%).Não houve diagnóstico de Neisseria gonorrhoeae.Não foi encontrada associação entre as variáveis sócio-epidemiológicas e a presença de IST nas gestantes estudadas.A contagem de linfócitos T CD4<500 cels/mm3 (p= 0,047) e carga viral>1000 cópias (p=0,027) foram associadas à presença de IST.Discussão: A presença de IST em gestantes infectadas pelo HIV é freqüente. Devido a não existência de associação com variáveis sócio-epidemiológicas recomenda-se que todas as gestantes infectadas pelo HIV devem ser investigadas. A associação com baixa imunidade e carga viral aumentada sugere dificuldade de acesso ao acompanhamento adequado. É necessária triagem precoce de IST no cuidado da gestante infectada pelo HIV para evitar um maior prejuízo do sistema imunológico e diminuir a transmissão vertical destas infecções / To evaluate the prevalence of sexually transmitted infections (STI) in HIV infected pregnant women and to estimate the risk factors associated in HIV infected pregnant women followed at the prenatal care in the State Center Specializing in Diagnosis, Care and Research (CEDAP), in Salvador, Bahia. Methodology: This is a cross-sectional study conducted from 1 October 2010 to 30 September 2011. The women who sought prenatal care at CEDAP were invited to participate in the study. We excluded patients who used antibiotics for less than 30 days, had obstetric complications in the first visit such threatened abortion, premature labor and premature rupture of membranes. Participants were interviewed regarding socio-epidemiological and clinical history and tested for HBsAg, anti HCV, anti HTLV I/II, VDRL, Chlamydia trachomatis Hybrid capture, Neisseria gonorrhoeae, Mycoplasma hominis and Ureaplasma urealyticum culture, Pap smear to detect HPV. CD4+ lymphocytes counts and HIV viral load obtained in blood sample. Our main outcome variable was the presence of any STI. Results: Of 76 eligible women, 63 (82.9%) participated. The mean age of patients was 28.2 years (16-40 years), and gestational age on arrival in the service was 19 weeks. The diagnosis of at least one of sexually transmitted infections other than HIV studied in 23/63 (36.5%) patients. The frequency of diagnoses was HPV (15.0%), Chlamydia trachomatis (11.1%), syphilis (9.5%), hepatitis C (8.1%), HTLV I / II (3.4%), hepatitis B (3.2%), Mycoplasma hominis (2.1%) and Ureaplasma urealyticum (2.1%). There was no diagnosis of Neisseria gonorrhoeae. No association was found between socio-demographic variables and the presence of STIs in pregnant women studied. The CD4 T lymphocyte count below 500 cells/mm3 (p = 0.047) and viral load> 1000 copies (p = 0.027) was associated with the presence of STI. Discussion: STI are frequent in pregnant women infected with HIV. Therefore, the lack of socio-epidemiologic association recommends that all HIV pregnant women should be investigated. The association with low immunity and viral load suggests increased difficulty of access to appropriate monitoring. Thus, it is necessary in early screening for STI care of pregnant women infected with HIV to prevent further damage to the immune system and to decrease the transmission of these infections.

The study deals with ways to protect students of the Faculty of Health and Social University of South Bohemia in České Budějovice against sexually transmitted diseases. The group consisted of students of the Faculty of Health and Social University of South Bohemia . The aim of this work consists in monitoring students' knowledge of Health and Social Faculty of sexually transmitted diseases and mapping the extent of health students from the Faculty of Health and Social sexually transmitted diseases. The theoretical part describes the evolution of human sexual behavior. It describes the characteristics of the different stages of development issues and pitfalls of each of these periods. The practical part monitors the students' knowledge about sexually transmitted diseases, while also monitoring their sexual behavior and surveyed coverage of girls against cervical cancer . As a tool of data collection method was used questioning, which was carried out using a questionnaire. Quota for the research was to study the JU Faculty, students , elected to field ZSF JU and the form of study. The whole research was preceded by partial study , which was supposed to verify all stages of research tools and data collection, sample survey and analysis.

Submitted by MARIANA ALICE DE OLIVEIRA IGNÁCIO null (mariana_spock@hotmail.com) on 2016-04-22T17:06:55Z No. of bitstreams: 1 Dissertação versão FINAL.pdf: 2436988 bytes, checksum: 95c6027b367778ba65a0ef6391f081ed (MD5) / Approved for entry into archive by Juliano Benedito Ferreira (julianoferreira@reitoria.unesp.br) on 2016-04-26T18:12:07Z (GMT) No. of bitstreams: 1 ignacio_mao_me_bot.pdf: 2436988 bytes, checksum: 95c6027b367778ba65a0ef6391f081ed (MD5) / Made available in DSpace on 2016-04-26T18:12:07Z (GMT). No. of bitstreams: 1 ignacio_mao_me_bot.pdf: 2436988 bytes, checksum: 95c6027b367778ba65a0ef6391f081ed (MD5) Previous issue date: 2016-02-25 / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Apenas em 2011 com a Política Nacional de Saúde Integral de LGBT (Lésbicas, Gays, Bissexuais, Travestis e Transexuais) foram propostos mecanismos de gestão para atingir maior equidade no Sistema Único de Saúde (SUS), com especial atenção às demandas e necessidades em saúde da população LGBT e, assim, das mulheres que fazem sexo com mulheres (MSM) brasileiras. A literatura nacional e internacional é escassa no que se refere às prevalências e fatores associados às infecções sexualmente transmissíveis (IST) e aids entre estas, o que justifica a presente investigação. Esta tem por objetivos traçar o perfil sociodemográfico, comportamental e clínico de MSM, estimar a prevalência de IST, de alterações da microbiota vaginal, de lesões precursoras do câncer de colo do útero e identificar fatores associados à vaginose bacteriana (VB), IST e papiloma vírus humanos (HPV). Trata-se de estudo transversal e analítico, que integra estudo mais amplo sobre acesso a serviços de saúde e saúde sexual e reprodutiva de MSM. Foi desenvolvido com amostra intencional de 100 MSM, provenientes do município de Botucatu/SP e microrregião que atenderam ao chamado para participação da pesquisa por meio de redes de sociabilidade, meios de comunicação de massa, serviços de saúde e convite de participantes às pessoas de seu convívio, no período de janeiro a novembro de 2015. As variáveis independentes estudadas foram sociodemográficas, consumo de substâncias, comportamento e práticas sexuais, antecedentes clínico-ginecológicos, queixas e exame ginecológico e as variáveis de desfecho foram ter IST, HPV e VB. Os dados foram obtidos pelas pesquisadoras envolvidas no estudo mãe, por meio de entrevista, exame ginecológico e coleta de sangue periférico para diagnósticos da Infecção pelo HIV, sífilis e hepatite B. Realizou-se coleta de amostras do conteúdo vaginal para realização do exame microscópico direto corado pelo método de Gram, que permitiu o diagnóstico de alterações da microbiota vaginal e candidose vaginal; coleta de secreção cervical para pesquisa de Chlamydia trachomatis, Neisseria gonorrhoeae e de papiloma vírus humano (HPV) por reação em cadeia da polimerase e citologia cérvicovaginal convencional, que diagnosticou lesões pré-neoplásicas e Trichomonas vaginalis. Para análise dos dados empregou-se estatística descritiva e as associações foram verificadas por regressão logística múltipla. Foram ajustados modelos de regressão logística para conhecer as variáveis que mais influenciaram no aparecimento das afecções do trato genital inferior. Predominaram as MSM que se encontravam na faixa etária de 20 a 49 anos (79,0%), brancas (74,0%), não casadas ou sem união estável (60,0%), com mais de 8 anos de estudo (93,0%), inseridas no mercado de trabalho (75,0%), que tinham histórico de relação sexual com homens na vida (66,6%), que não utilizavam regularmente proteção nas relações sexuais (85,8) e praticavam sexo após consumo de álcool(63,0%). A prevalência total de IST foi de 35,0%, sendo a infecção pelo HPV a mais prevalente (32,6%), com genótipos mais frequentes 56 e 84, seguida pela cervicite clamidiana (3,3%), infecção pelo HIV (2,0%), T. vaginalis(1,1%) e Sífilis (1,0%). Não foram encontrados casos de N. gonorrhoeae e Hepatite B. Quase a metade das mulheres incluídas no estudo (47,5%) apresentou alterações na microbiota vaginal, sendo mais prevalente a VB (36,2%), seguida da flora II (8,5%) e candidose vaginal (4,2%). A prevalência encontrada de lesão intra-epitelial escamosa de baixo grau (LSIL) foi de 2,3%. Os fatores associados às IST foram: não ser casada ou sem união estável [OR=3,76(IC:95%: 1,14–12,43); p=0,030], uso de acessórios [OR=3,87(IC:95%: 1,14–13,16); p=0,030] e número de homens com quem se relacionou sexualmente no último ano [OR=7,99 (IC:95%: 1,51–42,44); p=0,015]. Para infecção pelo HPV a única variável independentemente associada foi não ser casada ou não ter união estável [OR=4,84 (IC 95%: 1,49–15,71), p=0,009]. As associações encontradas para o desfecho VB foram whiff test positivo [OR=14,00 (IC 95%: 2,76-71,14), p=0,001] e pH vaginal > 4,5 [OR=9,90(IC 95%:1,57-62,33), p=0,015]. Tomados em conjunto, os dados deste estudo permitem concluir que as MSM participantes tinham elevada vulnerabilidade às IST/aids, confirmada pelas elevadas prevalências de algumas infecções e alterações da microbiota vaginal. Sugere a necessidade de assistência à saúde dessas mulheres de maneira individualizada, voltada para saúde sexual e reprodutiva, pautada em ações preventivas e educativas, com vistas ao seu cuidado integral. Neste sentido, com base nos resultados obtidos foi elaborado E-book educativo, em forma de história em quadrinhos, contendo informações sobre IST, formas de prevenção específicas para MSM, cuidados com a higiene íntima, importância de realizarem exames ginecológicos de rotina, que permitem diagnóstico e tratamento precoce de IST e direitos sexuais e reprodutivos. Este pode ser acessado no link: http://www.hcfmb.unesp.br/pesquisas/informacoespaciente/. / Only in 2011 through the National Policy for Comprehensive Health of LGBT, management mechanisms to reach more equity in unifed health system were proposed focusing mainly the demands and necessities of such population, i.e., women who make sex with women. The present paper aims to fill a gap in the national and international literature concerning prevalences and factors related to STI. The aim of this research is to design the sociodemographic, behavioral and clinical profile of WSW, the changes in vaginal microbiota and of precursor factors associated to bacterial vaginosis, STI and HPV. It is a cross sectional and analytical study covering, in a comprehensive way ,the access to health services and sexual and reproductive health of WSW. It was a non-radomized study with 100 WSW from Botucatu - SP and surrounding regions who answered the call from social media, mass communication means, health services and friends or acquaintances from January to November,2015. The independent variables studied were sociodemographic, substance consumption, behavior and sexual practices, clinical-gynecological examination and complaints and the outcome variables were STI, HPV, BV. Data was obtained by the researchers involved in the main study, through interviews, gynecological exams and blood tests to diagnose HIV, syphilis and hepatitis B. Vaginal samples were collected for gram staining to diagnose changes in vagibal microbiota; cervical sample collection to investigate Chlamydia Trachomatis and HPV through PCR and oncotic cytology to screen pre-neoplasic lesions Trichomonas. Descripitive statistics was used for data analysis and associations were estimated by multiple regression. In order to know the variable which influenced the occurrence of genital infections, adjustments were made in multiple regression models. The most frequent findings were among WSW within the age range 20 to 49 years-old (79.0%), white (74.0%), single (60.0%); with more than 8 years of conventional education (93.0%) , in the job market (75.0%), who had unprotected sex (85.5%) and those who had sex after alcohol consumption (63.0%). Total prevalence of STI was 35%, being HPV the most prevalent (32.6%), with the most frequent genotype being 56 and 84, followed by chlamidia infection (3.3%), HIV infection (2.0%), T. V. (1.1%) and syphilis (1.0%). Neisseria Gonorrhoeae and Hepatites B were not found. Almost half of the women (47.5%) presented changes in the vaginal microbiota, more frequently VB (36.2%) followed by flora II (8.5%) and candidiasis (4.2%). The prevalence of low grade squamous intraepithelial lesion (LSIL) was 2.3%. The factors associated to STI were: to be single, [OR=3.76 (CI:95%: 1.14–12.43); p=0.030], use of sex toys [OR=3.87(CI:95%: 1.14–13.16); p=0.030], and number of male partners in the previous year [OR=7.99 (CI:95%: 1.51–42.44); p=0.015]. As to HPV infection the only variable independently associated was to be single [OR=4.84 (CI: 95%: 1.49–15.71), p=0.009]. The associations found for VB outcome were positive whiff test [OR=14.00 (CI: 95%: 2.76-71.14), p=0.001] and vaginal pH > 4.5 [OR=9.90(CI: 95%:1.57-62.33), p=0.015]. Considered as whole, these data lead to conclusion that the individuals of this study presented high vulnerability to STI/AIDS, as shown by the high prevalence of some infections and changes in the vaginal microbiota. This study clearly shows the need for a specific health assistance to these women, focusing their sexual and reproductive life, thus promoting prevention and education in a holistic approach. Based on these findings, an educational Ebook was written bringing information on STI, prevention specific for WSW, hygiene care, sexual and reproductive rights and the importance of periodical gynecological examinations, which will allow for early diagnosis and treatment of STI. It can be accessed at the link: http://www.hcfmb.unesp.br/pesquisas/informacoespaciente/. / FAPESP: 2015/04224-6

Researchers are trying to find a solution for reducing the vibration of the engine with minimum changes to the engine mounts. Several researches and main giant car companies have presented valuable effort in these areas but still new research is needed to improve the control system. The present research carried out a comprehensive study of the state of art methods to suppress unwanted vibration from the engine to the passenger cars. This research was designed based on the objective of the Trelleborg Company to investigate the influence of Active Vibration Control (AVC) on the real engine. Therefore, this thesis tried to challenge the vibration problem with practical engineering approach by implementing different types of controllers experimentally and applying them on the real petrol engine. Inversing controlling technique and PID controller tuned with different methods (Ziegler Nichols and tyreus-luyben) have been tested here on two separate platforms; unbalanced DC motor and petrol engine. In addition, as a requirement of the study, the resonance frequency and related mode shapes of the system was investigated experimentally. It is also shown that using suitable filters can help elimination of high frequency noises in the control signals. This study experimentally tests PID controller with mentioned tuned methods on a real engine with this specific setup for the first time. A new scheme was developed with "mode shapes specific controller system", according to which the shaker position and the controller parameters were specified according to the system mode shapes. The result of applying controllers shows that both control methods have a similar effect on vibration reduction. A 33% - 37% reduction on DC motor achieved in different frequencies (20Hz, 37.5Hz and 46.2Hz) with different control methods, and about 10% reduction on petrol engine at resonance frequency while the shaker IV40 (with max 30N force) was placed on the chassis. For reducing the vibration transmitted from the engine to the chassis, for the first time the shaker was placed on the engine (unlike in previous studies where the shaker was placed on the chassis). Using shaker IV40 placed on the engine results in a 20% reduction in vibration transmission, which is a significant improvement in comparison with having the shaker on the chassis. The optimum result was achieved using shaker IV45 (Max 50N force), which yielded a vibration reduction of 33%.

Submitted by Juliane Andrade null (juenf_andrade@yahoo.com.br) on 2017-10-03T16:36:04Z No. of bitstreams: 1 julianeandrade.tese.pdf: 1611303 bytes, checksum: 04c4ad64a2c810065ae1a4358aa0ea67 (MD5) / Approved for entry into archive by Monique Sasaki (sayumi_sasaki@hotmail.com) on 2017-10-03T17:00:21Z (GMT) No. of bitstreams: 1 andrade_j_dr_bot.pdf: 1611303 bytes, checksum: 04c4ad64a2c810065ae1a4358aa0ea67 (MD5) / Made available in DSpace on 2017-10-03T17:00:21Z (GMT). No. of bitstreams: 1 andrade_j_dr_bot.pdf: 1611303 bytes, checksum: 04c4ad64a2c810065ae1a4358aa0ea67 (MD5) Previous issue date: 2017-09-06 / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Introdução: Vulnerabilidade é a possibilidade de a pessoa se expor ao adoecimento, considerando-se fatores individuais e coletivos, dividindo-se em três dimensões analíticas articuladas: a individual, a social e a programática. Em mulheres que fazem sexo com mulheres (MSM) a vulnerabilidade às infecções sexualmente transmissíveis (IST) perpassa por questões de luta por visibilidade social e política, diferença de gênero, padrão heteronormativo, despreparo profissional e o próprio desconhecimento sobre questões relativas à prevenção das IST/aids, ainda pouco estudadas no cenário nacional. Objetivo: Analisar a vulnerabilidade de mulheres que fazem sexo com mulheres às IST/aids. Método: Estudo transversal que integra estudo mais amplo sobre acesso a serviços de saúde e saúde sexual e reprodutiva de MSM. A amostra de 150 MSM residentes no interior Paulista foi constituída por meio da técnica de amostragem Bola de Neve, indicação de profissionais de saúde e liderança LGBT (Lésbicas, Gays, Bissexuais, Travestis e Transexuais) e por procura espontânea, a partir da divulgação do projeto nas redes de sociabilidade, comunicação de massa, serviços de saúde e grupos de ativismo. As variáveis estudadas foram classificadas mediante o referencial teórico da vulnerabilidade. Os dados foram obtidos de janeiro de 2015 a março de 2017, por meio da aplicação de questionário, exame ginecológico e coleta de sangue periférico. Para o diagnóstico das infecções pelo papiloma vírus humano, Chlamydia trachomatis e Neisseria gonorrhoeae empregou-se a reação em cadeia da polimerase, para confirmação do HIV (Vírus da Imunodeficiência Humana), os testes ELISA e Western Blot, para Hepatite B o ensaio ARCHITECT HBsAg. Para sífilis foi considerado resultado reagente a mulher que teve teste treponêmico e VDRL reagente ou os dois treponêmicos positivos, sem história de tratamento prévio adequado. A identificação do Trichomonas vaginalis se deu a partir da coloração de Papanicolaou. Para análise dos dados foi empregada a estatística descritiva e as associações foram verificadas por regressão logística múltipla e as comparações do escore de vulnerabilidade entre mulheres com e sem histórico de relação sexual com homens foram feitas por meio do teste de Mann-Whitney. Resultados: A mediana de idade das MSM investigadas foi de 26 anos (18-62), 74,7% eram brancas, 73,3% não unidas, 51,3% tinham 12 ou mais anos de estudo concluídos, 74% estavam inseridas no mercado de trabalho e 50,7% tinham renda per capta familiar maior que R$ 1.019,00. A maioria tinha história de relacionamento sexual com homens durante a vida (74,7%), entretanto, nos últimos doze meses, apenas 21,3% se relacionaram com homens. O diagnóstico de alguma IST foi constatado em 47,3% das mulheres. A análise de regressão logística multivariada apontou apenas variáveis da dimensão individual independentemente associadas às IST/aids: não ter realizado sorologia para IST/aids [OR=2,80 (1,13 – 6,94); p=0,027], ter histórico de IST [OR=4,00 (1,03–15,50); p=0,045] e ter tido relação sexual com homem nos últimos 12 meses [OR=8,65 (2,39–31,38); p=0,001]. Segundo a estratégia de análise do grau de vulnerabilidade adotada, nenhuma mulher investigada estava isenta, sendo que a vulnerabilidade programática foi a que apresentou maior mediana do escore de vulnerabilidade, 9,6 pontos (0-24) e a social, a menor, 7,5 pontos (0-19). As mulheres com ou sem histórico de relação sexual com homens na vida não diferiram quanto ao escore de vulnerabilidade na dimensão social e programática e aquelas que se relacionaram com homens na vida apresentaram maior escore na dimensão individual [10,0 (4,0–17,0 vs. 8,0 (4,0–13,0); p= 0,001]. As MSM que tiveram relação com homem nos últimos 12 meses tiveram maior escore de vulnerabilidade individual e social em comparação com aquelas sem este histórico [12,0 (6,0–17,0) vs. 9,0 (4,0–15,0); p=0,000 e 10,0 (0,0–19,0) vs. 5,0 (0,0–14,0); p=0,042, respectivamente] e não apresentaram diferença quanto ao escore de vulnerabilidade programática. Conclusão: As MSM investigadas apresentavam elevada vulnerabilidade às IST/aids nas três dimensões, confirmada pela alta prevalência dessas infecções, sugerindo necessidade de atenção individualizada e qualificada, com vistas à sua redução. Assim, os dados da presente investigação podem proporcionar à Enfermagem e a outros profissionais de saúde elementos que facilitem a sistematização do cuidado a esse grupo populacional, permitindo intervenções que considerem as três dimensões da vulnerabilidade, implicando maior potencial de transformação do processo-saúde-doença. / Vulnerability is the possibility of exposing oneself to illness, considering individual and collective factors, divided into three articulated analytical dimensions: individual, social and programmatic. In women who have sex with women (MSM), vulnerability to sexually transmitted infections (STI) is based on issues of struggle for social and political visibility, gender difference, heteronormative pattern, health care unpreparedness and lack of knowledge about STI /aids prevention, which has been little explored in the national scenario. Objective: To analyze the vulnerability of women who have sex with women to STI /aids. Method: A cross-sectional (transversal) study integrating a broader research project related to MSM access to health services and sexual and reproductive health. The sample of 150 MSM residents in countryside of Sao Paulo province was constituted by means of the snowball sampling technique, in a referral chain among healthcare professionals and LGBT leadership (Lesbian, Gay, Bisexual, Transvestite and Transsexual) and by spontaneous demand, from the disclosure of the Project in social networks, media, health services and activism groups. The variables studied in the present research were classified according to the theoretical reference of vulnerability. The data were obtained from January 2015 to March 2017 through the application of questionnaires, gynecological examinations and peripheral blood collections. For the diagnosis of human papillomavirus infections, Chlamydia trachomatis and Neisseria gonorrhoeae, the polymerase chain reaction was used to confirm HIV (Human Immunodeficiency Virus), ELISA and Western blot tests, for Hepatitis B the ARCHITECT HBsAg assay. For syphilis diagnosis, women whose treponemal and VDRL reagent test or the two treponemics positive, without a history of adequate pretreatment, was considered a reagent result. The identification of Trichomonas vaginalis occurred from the staining of cervical smear. Descriptive statistics were used for analysis of the data and associations were verified by multiple logistic regression and comparisons, using Mann-Whitney test, of the vulnerability score between women with and without a history of sexual intercourse with men. Results: The median age of the MSM investigated was 26 years (18-62), 74.7% were white, 73.3% single, 51.3% were school educated for 12 or more years, 74% were employed or self-employed and 50.7% had per capita family monthly income greater than R $ 1,019.00. The majority had a history of sexual intercourse with men during their lifetime (74.7%), however, in the last twelve months, only 21.3% had sexual intercourse with men. The diagnosis of some STI was found in 47.3% of the women. Multivariable logistic regression analysis showed only variables of individual dimension independently associated with STI /aids: no serology for STI /aids [OR = 2.80 (1.13 - 6.94); P = 0.027], have a history of STI [OR = 4.00 (1.03-15.50); P = 0.045] and had had sexual intercourse with men in the last 12 months [OR = 8.65 (2.39-31.38); P = 0.001]. According to the vulnerability analysis strategy adopted, all women investigated were vulnerable, and the programmatic vulnerability was the one with the highest median vulnerability score of 9.6 (0-24) and the social, the lowest, 7.5 points (0-19). Women with or without a history of sexual intercourse with men in their life did not differ on the vulnerability score in social and programmatic dimensions; and those who have sexual intercourse with men in their life had a higher score in the individual dimension [10,0 (4,0-17 , 0 vs. 8.0 (4.0-13.0), and p = 0.001. Moreover, MSM that had a relationship with men in the last 12 months had a higher individual and social vulnerability score than those without this history [12.0 (6.0-17.0) vs. 9.0 (4.0-15.0), p = 0.000 and 10.0 (0.0-19.0) vs. 5.0 (0.0 - 14.0); p=0.042, respectively] without programmatic vulnerability score differences. Conclusion: The MSM investigated presented high vulnerability to STI /aids in all three dimensions, confirmed by the high prevalence of these infections. This outcome suggests the need for individualised and qualified healthcare programme aiming the reduction of MSM vulnerability. Therefore, the results of the present investigation can provide nurse-led care and other healthcare professionals criteria to facilitate the systematization of care to this group, allowing interventions that consider the three dimensions of vulnerability, contributing in great potential, for transformation of the health-disease process. / FAPESP: 2015/14769-0