411 |
Medida dos parâmetros respiratórios na admissão da UTI pode predizer necessidade de suporte ventilatório, tempo de internação e mortalidade / Measurement of respiratory parameters at ICU admission can predict the necessity for ventilatory support, length of stay and mortalityManara, Marcos Antonio 30 April 2009 (has links)
INTRODUÇÃO: Existe uma dúvida na literatura médica se a monitorização respiratória do paciente crítico internado na Unidade de Terapia Intensiva contribuiria para melhora de seu prognóstico. OBJETIVO: Avaliar de maneira prospectiva se a mensuração de parâmetros respiratórios na admissão dos pacientes em ventilação espontânea na Unidade de Terapia Intensiva estaria relacionada com a necessidade de suporte ventilatório, duração da internação dos pacientes na UTI e com a mortalidade hospitalar. MÉTODOS: Foram avaliados prospectivamente 195 pacientes admitidos respirando espontaneamente (37,4% do total das admissões no período do estudo) na Unidade de Terapia Intensiva Adultos do Hospital Israelita Albert Einstein. No momento da admissão, foram medidos o VC espontâneo, a FR, a Pimax, a Pemax, FiO2, SpO2 , FC e foi investigado se o paciente apresentava causa pulmonar para a insuficiência respiratória. Os pacientes foram acompanhados até a alta hospitalar ou óbito. Um modelo de regressão logística por etapas progressivas e um modelo de regressão linear múltipla foram aplicados para avaliação das associações entre os parâmetros mensurados à entrada dos pacientes na UTI e a necessidade de suporte ventilatório, tempo de internação na UTI e mortalidade intrahospitalar. RESULTADOS: A média de idade dos 195 pacientes foi de 62,36±18,67, 77 mulheres. Trinta dos 195 pacientes necessitaram de suporte ventilatório (15,38%) e 20 pacientes morreram durante sua internação no hospital (10,25%). O tempo médio de internação na UTI foi de 5,1±5,8 dias. O modelo de regressão logística selecionou a Pimax (OR=1,04, p=0,018), doença respiratória primária (OR=2,8, p=0,036), FC (OR=1,03, p=0,022) e FiO2 (OR=1,04, p=0,043) como as variáveis relacionadas à necessidade de suporte ventilatório e o volume corrente espontâneo inicial (OR=0,92, p=0,000) como a variável relacionada à mortalidade intrahospitalar. O modelo de regressão linear múltipla selecionou a FC (Coeficiente=0,005, p=0,000), FR (Coeficiente =0,009, p=0,004), VC (Coeficiente = - 0,006, p=0,000) e sexo (Coeficiente =0,128, p=0,009) como as variáveis relacionadas ao tempo de internação na UTI. CONCLUSÃO: Em pacientes admitidos na UTI respirando espontaneamente, uma FC aumentada, necessidade de altas FiO2, Pimax diminuída e a presença de doença respiratória primária estiveram relacionadas com necessidade de suporte ventilatório. Pacientes do sexo masculino, com uma FC aumentada, FR aumentada e um baixo VC espontâneo apresentaram tempo de internação prolongado na UTI. A mensuração de VC espontâneo diminuído à admissão na UTI esteve fortemente relacionada a um aumento da mortalidade hospitalar. / INTRODUCTION: There is a doubt in the medical literature if the patients respiratory monitoring at ICU admission could improve their prognosis. OBJECTIVE: To measure respiratory parameters in patients admitted at ICU in spontaneous ventilation and relate them to the necessity of ventilatory support, length of ICU stay and hospital mortality. METHODS: We prospectively evaluated 195 patients admitted to the Adult ICU of the Albert Einstein Hospital in spontaneous ventilation (37.4% of total study period admissions). At ICU entry, we measured tidal volume (TV), respiratory rate (RR), maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), FiO2, SpO2, heart rate (HR) and we verified if the patient had a primary pulmonary disease. The patients were followed till hospital discharge or death. A stepwise logistic regression and multiple linear regression models were built to evaluate the relation of the respiratory parameters at ICU entry and the necessity of ventilatory support, ICU length of stay and intra-hospital mortality. RESULTS: The 195 patients mean age was 62.36±18.67, 77 females. Thirty of 195 patients needed ventilatory support (15.38%) and 20 died in the hospital (10.25%). The mean ICU length of stay was 5.1±5.8 days. The logistic regression model selected MIP (OR=1.04, p=0.018), primary respiratory disease (OR=2.8, p=0.036), HR (OR=1.03, p=0.022) and FiO2 (OR=1.04, p=0.043) as the variables related to the necessity of ventilatory support and the initial TV (OR=0.92, p=0.000) as the variable related to intra-hospital mortality. The multiple linear regression model selected the HR (Coefficient=0.005, p=0.000), RR (Coefficient =0.009, p=0.004), VT (Coefficient = - 0.006, p=0.000) and sex (Coefficient =0.128, p=0.009) as the variables related to the ICU length of stay. CONCLUSION: In spontaneous ventilated patients at ICU admission, a higher HR, higher FiO2, a lower MIP and a primary respiratory diagnosis were related to the necessity of ventilatory support. Male patients with a higher HR, higher RR and lower TV had a prolonged ICU length of stay. The initial measurement of a low spontaneous TV was strongly related to an increase in hospital mortality.
|
412 |
Estudo comparativo da carga de trabalho de enfermagem em Unidades de Terapia Intensiva Geral e Especializadas, segundo o Nursing Activities Score (NAS) / Comparative study of nursing workload in general and specialized Intensive Care Units, according to Nursing Activities Score (NAS)Queijo, Alda Ferreira 25 February 2008 (has links)
Trata-se de um estudo de corte transversal, descritivo-comparativo, que teve como objetivo analisar a carga de trabalho de enfermagem em Unidades de Terapia Intensiva geral e especializadas, segundo o Nursing Activities Score (NAS). Os dados foram coletados em quatro Unidades de Terapia Intensiva (UTIs), sendo uma geral (UTI G), uma cardiológica (UTI C) e duas neurológicas (UTI N) de um hospital geral, privado, de porte extra, localizado no município de São Paulo. Participaram do estudo 300 pacientes admitidos nas UTIs, com permanência mínima de 24 horas, no período de 21/08/2006 a 05/10/2006, sendo 100 pacientes de cada unidade. Neste estudo, as UTIs N foram consideradas uma única unidade. Foram coletados dados demográficos e clínicos e aplicados os instrumentos Simplified Acute Physiology Score (SAPS II), Logistic Organ Dysfunction System (LODS) e o Nursing Activities Score (NAS) das primeiras 24 horas de internação na unidade, respectivamente para a medida da gravidade, disfunção orgânica e carga de trabalho de enfermagem. O tratamento dos dados foi feito por meio de estatística descritiva e inferencial. A relação entre as variáveis foi analisada por meio do coeficiente de correlação de Spearman e para a comparação das médias foram utilizadas os testes de Mann Whitney, Krusskal-Wallis e Tukey. A análise conjunta das variáveis foi feita por meio de regressão linear múltipla. As UTIs G, C e N foram homogêneas em relação ao gênero (p=0,12) e tempo de internação (p=0,65), porém diferiram em relação à idade (p=0,01), procedência (p=0,055), tipo de internação (p=0,00) e condição de saída (p= 0,007). A UTI G apresentou pacientes com risco de mortalidade SAPS II (RM SAPS II) e risco de mortalidade LODS (RM LODS), comparativamente maiores do que a UTI C (p=0,00) e UTI N (p=0,00). Quanto à carga de trabalho de enfermagem a UTI N apresentou, em média, menor carga do que a UTI C (p=0,02) e a UTI G (p= 0,03). A análise comparativa do escore NAS com as variáveis demográficas e clinicas, mostrou que não houve diferença quanto à idade, procedência e tipo de internação. Pacientes que foram a óbito nas UTIs G e N, e do sexo masculino na UTI C apresentaram, em média, maior carga de trabalho de enfermagem. A correlação entre a média do escore NAS e as variáveis quantitativas mostrou moderada correlação com a gravidade (r=0,55; p=0,00) e disfunção orgânica (r=0,48; p=0,00) apenas na UTI G. A única variável com correlação moderada nas três UTIs foi tempo de internação (p=0,00). Foram fatores associados a carga de trabalho de enfermagem na UTI G, o RM SAPS II e idade; na UTI C, o RM SAPS II, gênero, idade e RM LODS; e na UTI N, o RM SAPS II e idade. Os resultados obtidos nesta investigação fornecem subsídios para a adequação de recursos humanos em UTI podendo beneficiar pacientes, profissionais e instituições hospitalares / A transversal descriptive and comparative study analyzed the nursing workload in general and specialized Intensive Care Unit (ICU), according to Nursing Activities Score (NAS). The data were collected in four ICU: one General unit (ICU G), one Cardiovascular unit (ICU G) and two Neurological unit (ICU N) of a general, private, extra-large hospital, in São Paulo city. Three hundred patients admitted in the UTIs had participated of the study, with 24-hour minimum lenght of stay (LOS) in the ICU, from 08/21/2006 to 10/05/2006. It was included 100 patients of each unit. ICU N had been considered an only unit. There had been collected demographic and clinical data and applied the instruments Simplified Acute Physiology Score (SAPS II), Logistic Organ Dysfunction System (LODS) and the Nursing Activities Score (NAS) of the first 24 hours in the unit, respectively for measuring the severity of illness, the organic failure and the nursing workload. Data were analyzed by means of descriptive and inferencial statistics. The relation between the variables was made by means of Spearman´s coefficient correlation and for the comparison of the averages it had been used the tests of Mann Whitney, Krusskal-Wallis and Tukey. ICU G, ICU C and ICU N had been homogeneous in relation to gender (p=0,12) and lenght of stay (p=0,65), however had differed in relation to the age (p=0,01), origin (p=0,055), type of treatment (p=0,00) and discharge (p = 0,007). UTI G presented higher risk of mortality SAPS II (RM SAPS II) and risk of mortality LODS (RM LODS), comparativily to ICU C (p=0,00) and UTI N (p=0,00). About the nursing workload, ICU N presented, in average, lower values than ICU C (p=0,02) and UTI G (p = 0,03) means. The comparative analysis of NAS score and the demographic and clinical variables showed difference in age, origin and type of treatment. Patients who died in ICU G and N and male in ICU C had presented, in average, higher nursing workload. The correlation between the NAS score and the quantitative variables showed moderate correlation with the severity of illness (r=0,55; p=0,00) and organic failure (r=0,48; p=0,00) only in ICU G. The only variable with moderate correlation in the three ICU was LOS (p=0,00). The factors associated with nursing workload in ICU G were RM SAPS II and age; in ICU C, RM SAPS II, gender, age and RM LODS; and in ICU N, RM SAPS II and age. The results provide the possibility of adequacy of human resources in ICU in order to benefit patients, professionals and hospitals
|
413 |
Tempo médio de assistência de enfermagem em Unidade de Terapia Intensiva Pediátrica / Average time of nursing care in Pediatrics Intensive Care UnitGuimarães, Caroline Pereira 20 February 2015 (has links)
Introdução: A literatura nacional e internacional oferece parâmetros para dimensionar pessoal de enfermagem em unidades de pacientes adultos. Contudo, existe uma lacuna de conhecimento no que se refere à proposição de indicadores de tempo de cuidado para atender os pacientes em unidades de assistência pediátrica, o que dificulta a operacionalização dos métodos de dimensionamento nessa área. Objetivo: Identificar o tempo médio de assistência de enfermagem, por paciente, nas 24 horas, utilizado para assistir o paciente pediátrico internado na área de Terapia Intensiva Pediátrica (UTIP) da Unidade de Terapia Intensiva Pediátrica e Neonatal (UTIPN) do Hospital Universitário da Universidade de São Paulo (HU-USP), segundo o grau de dependência da equipe de enfermagem. Método: Estudo descritivo, observacional, transversal, de natureza quantitativa, realizado na UTIP da UTIPN do HU-USP. Participaram da pesquisa todos os profissionais de enfermagem que trabalharam na UTIP e todos os pacientes internados, no período de 03 a 09 de novembro de 2014. A pesquisa foi desenvolvida em quatro etapas: identificação das atividades realizadas na assistência ao paciente pediátrico internado na UTIP; mapeamento das atividades em intervenções da Nursing Intervention Classification (NIC); validação do mapeamento das atividades em intervenções da NIC e mensuração do tempo médio de assistência despendido no cuidado ao paciente pediátrico, segundo o grau de dependência da equipe de enfermagem. Resultados: Obteve-se 4824 amostras de intervenções/atividades realizadas pelos profissionais de enfermagem, sendo 1440 realizadas por enfermeiros e 3384 por técnicos/ auxiliares de enfermagem. As intervenções realizadas com maior frequência foram DOCUMENTAÇÃO (13,6%), Administração de MEDICAMENTOS (9,35%) e Troca de informações sobre cuidados em SAÚDE (6,1%). Os profissionais despenderam 30,5% do seu tempo em intervenções de cuidado direto, 45% em intervenções de cuidado indireto, 20,8% em atividades de tempo pessoal, 2,3% em atividades associadas e 1,4% em outras. A produtividade média da equipe correspondeu à 79,2%, considerado um índice excelente, de acordo com os critérios de avaliação indicados na literatura. As intervenções com os maiores tempos médios de execução foram TRANSPORTE intra-hospitalar, Desenvolvimento de FUNCIONÁRIOS; Cuidados com CATETER central de inserção periférica (PICC); TRANSPORTE inter-hospitala; PRECEPTOR: estudante; Supervisão de FUNCIONÁRIOS e ENSINO: processo da doença. O tempo médio de assistência utilizado para atender os pacientes, nas 24 horas, correspondeu à 8,3 horas na categoria de cuidado intermediário, 13,1 horas na categoria alta dependência, 9,6 na categoria de cuidado semi-intensivo e 13,9 horas na categoria de cuidado intensivo, cujos valores possuem a mesma distribuição daqueles preconizados pelo COFEN. Conclusão: A identificação dos tempos médio de assistência dispensados aos pacientes, segundo o grau de dependência da equipe de enfermagem, constitui importante contribuição para a superação das dificuldades que envolvem o processo de dimensionamento de profissionais na área de pediatria / Introduction: The national and international literature offers parameters to dimension nursing staff in adult patients units. However, there is a knowledge gap in relation to the proposition of time of care indicators to assist patients in pediatric units, making it difficult to operationalization of design methods in this area. Objective: To identify the average time of nursing care per patient within 24 hours, used to assist the hospitalized pediatric patients in the area of Pediatric Intensive Care Unit (UTIP) of the Intensive Care Unit Pediatric and Neonatal (UTIPN) of the University Hospital of University of São Paulo (HU-USP), according to the degree of dependence on the nursing team. Method: This is a descriptive, observational, transversal, quantitative study, developed in the UTIP of UTIPN the HU-USP. All nurses who worked in the UTIP and all hospitalized patients, from 03 to 13 November 2014 participated in the survey. The research was developed in four stages: identification nursing care activities to assists the hospitalized pediatric patient in the UTIP; mapping activities in interventions of Nursing Intervention Classification (NIC); validation of the mapping of activities in NIC interventions and measurement of the average time spent in the assistance of pediatric patients hospitalized, according to the degree of dependence of the nursing staff. Results: 4824 samples of interventions / activities performed by nursing professionals was collected, 1440 performed by nurses and 3384 by nursing assistants. The more frequently performed interventions were DOCUMENTATION (13.6%), MEDICATION managing (9.35%) and Exchange of information on HEALTH care (6.1%). The professionals spent 30.5% of their time on direct care interventions, 45% in indirect care interventions, 20.8% in personal time activities, 2.3% in associated activities and 1.4% in others. The average productivity of nursing staff corresponded to 79.2%, considered an excellent index, according to the criteria of evaluation listed in the literature. The interventions with the highest average execution time were intra-hospital TRANSPORT, Development of EMPLOYEES; Peripherally Inserted Central Catheter care (PICC); Inter-hospital TRANSPORT; PRECEPTOR: student; SUPERVISION and TEACHING: disease process. The average time of assistance used to assist patients within 24 hours, corresponded to 8.3 hours in the category of intermediate care, 13.1 hours in the high dependency category, 9.6 in semi-intensive care category and 13.9 hours in the intensive care category, whose values have the same distribution of those recommended by the COFEN. Conclusion: The identification of the average time of care provided to patients according to the degree of dependence on the nursing team, represents an important contribution to overcoming the difficulties involving the professional dimensioning in the pediatrics area
|
414 |
Análise dos biótopos da bacia hidrográfica do córrego Águas Espraiadas-São Paulo - SP / Analysis of the Biotopes in hidrographic basins from the stream Águas EspraiadasBlanes, Lucilia 17 August 2006 (has links)
A presente dissertação tem como objetivo discutir a importância da preservação ambiental em áreas urbanas. Nesse sentido, procedeu-se o estudo da impermeabilização de lotes urbanos inseridos em biótopos(unidades de paisagem) encontrados na bacia hidrográfica do córrego Águas Espraiadas, que se apresenta totalmente urbanizada. Realizou-se uma ampla caracterização ambiental e histórica da área estudada por meio da análise de lotes amostrais. Utilizou-se nesse trabalho o fator BAF (Fator de Biótopo de Área), cálculo utilizado no planejamento de áreas urbanizadas na cidade de Berlim (Alemanha). Este trabalho pretende oferecer subsídios para ações que levem à preservação de ambientes urbanos e uma melhor qualidade de vida urbana. / This work shows the importance of environmental preservation in urban areas. In this way, was developed the study of waterproofing of lots inserted in biotopes (units of landscape) found in the hydrographic basin of the Stream of Águas Espraiadas, which today is totally urbanized. A historical and ambiental characterization of the studied area was developed, through the analysis of variables of several lots. We use in this work a factor called BAF (Biotope Area Factor), calculation very used in the planning of Berlin city. This work intends to offer subsidies for the promotion of environmental preservation and for the best quality of urban life.
|
415 |
Estudo comparativo de pacientes neurocirúrgicos submetidos à traqueostomia precoce e tardia durante o período na unidade de terapia intensiva em um hospital terciário / Comparative study of neurosurgical patients submitted early and late tracheostomy during the period in the intensive care unit in a tertiary hospitalRamos, Michele de Cassia Santos 23 February 2015 (has links)
Aproximadamente 24% dos pacientes graves na unidade de terapia intensiva (UTI) são submetidos à traqueostomia (TQT), e a diminuição do trabalho respiratório, o desmame ventilatório precoce e facilidade na higiene brônquica são os benefícios mais comuns neste procedimento, porém são descritos em pacientes heterogêneos. O período da TQT precoce permanece controverso, mesmo que este procedimento seja descrito há séculos, e entre os pacientes que frequentemente requerem ventilação mecânica prolongada (VMP) estão os neurocirúrgicos e são susceptíveis ao desenvolvimento de complicações sistêmicas e pulmonares. Além disso, há poucos estudos sobre os benefícios da TQT precoce em pacientes neurocirúrgicos com características homogêneas e esses são retrospectivos. Não há relatos sobre o custo indireto e o desfecho hospitalar desse pacientes, portanto, o objetivo desse estudo foi analisar o tempo de ventilação mecânica invasiva (VMI), tempo de estadia na UTI em dias, tempo de estadia hospitalar em dias, custo indireto, ocorrência de complicações e o desfecho hospitalar em pacientes neurocirúrgicos submetidos à TQT precoce e tardia. Estudo prospectivo observacional, realizado no Instituto Central do hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, entre o período de Dezembro de 2009 a Junho de 2011. Foram incluídos os pacientes neurocirúrgicos admitidos na UTI, e submetidos à TQT após a intubação traqueal. Eles foram divididos em Grupo TQT Precoce (GTP): <= 7 dias de VMI e Grupo TQT Tardio (GTT): > 7 dias. Nível significativo adotado foi p<= 0,05. Foram incluídos 72 pacientes, 21 pacientes no GTP e 51 no GTT. A idade (GTP= 48, GTT= 51, p=0,101), gênero masculino (GTP= 16, GTT= 35, p=0,521), Apache II (GTP= 15, GTT= 15, p=0,700), Escala de Coma de Glasgow (GTP= 7, GTT= 7, p= 0,716) não apresentaram diferença entre os grupos. O GTP apresentou menor tempo de VMI (p < 0,001), tempo de estadia na UTI (p=0,001), tempo estadia no hospital (p=0,001) e custo indireto (p =< 0,001). A infecção nosocomial (IN) foi a complicação identificada, a IN sistêmica (p=0,088), IN pulmonar (pneumonia associada à ventilação mecânica (p=0,314), sobrevida (p=0,244) e o desfecho hospitalar mais comum (transferência para hospital de longa permanência) (p=0,320), não apresentaram diferença significativa entre os grupos. Em pacientes neurocirúrgicos, a TQT precoce reduziu o tempo de VMI, tempo de estadia na UTI, tempo de hospitalização e custo indireto. Porém não houve diferença na ocorrência de complicações e no desfecho hospitalar entre os grupos / Nearly 24% of the critically ill patients in intensive care unit (ICU) are submitted to tracheostomy (TQT), and the decrease the work of breathing, early weaning and pulmonary toilet are the most common benefits in this procedure, however these benefits are described in heterogeneous patients. The period of early TQT remains controversial, even if this procedure is described for centuries, and between the patients often require prolonged mechanical ventilation (PMV) are the neurosurgical and are susceptible to the development of systemic and pulmonary complications. In addition, there are few studies about the benefits of early TQT in neurosurgical patients with homogeneous characteristics and these are retrospective. There are no reports on the overhead and the hospital outcome of patients, therefore, the aim of this study was to analyze the duration of mechanical ventilation (MV), ICU length of stay (LOS) days, hospital LOS days, indirects costs, occurrence of the complications and patients discharge in neurosurgical submitted to early and late tracheostomy. Prospective, observational study, at the Central Institute of the Clinics Hospital, Medical School, University of São Paulo, from December 2009 until June 2011. Neurosurgical patients admitted at the ICU were included, and submitted to TQT after tracheal intubation were included. They were categorized in Early Tracheostomy Group (ETG) <= 7 days MV and Late Tracheostomy Group (LTG) > 7 days. Statistical analysis significance p < 0.05. 72 patients were included, 21 patients in ETG and 51 in LTG. Age (ETG= 48, LTG= 51, p=0.101), male (ETG 48, GTT= 51, p=0.521), Apache II (ETG= 15, LTG= 15, p=0.700), Glasgow coma scale (ETG= 7, LTG= 7, p= 0.716) no significant different between the groups. The ETG had shorter length of VM (p < 0.001), ICU LOS (p=0.001), hospital LOS (p=0.001) and indirects costs (p < 0.001). Nosocomial Infection (NI) was identificated complication, systemic NI (p=0.088), pulmonary NI (ventilator associated pneumonia- PAV) (p= 0.314), survival (p=0.244) and the most common hospital outcome (transfer to long-term care hospital) (p= 0.320), there were no significant difference between the groups. In neurosurgical patients, the early tracheostomy reduced length of MV, ICU LOS, hospital LOS and the indirects costs. However, there were no difference in the occurrence of complications and patient discharge between the groups
|
416 |
Respiratory physiotherapy in intensive care.January 1992 (has links)
by Alice Yee-men Jones (Nee Ho). / Thesis (M.Phil.)--Chinese University of Hong Kong, 1992. / Includes bibliographical references (leaves [196]-221). / Abstract --- p.i / Publications --- p.iii / Acknowledgement --- p.v / Chapter SECTION I --- INTRODUCTION / Chapter Chapter 1 --- General Introduction --- p.1 / Chapter 1.1 --- Objectives / Chapter 1.2 --- History & Advances in Chest Physiotherapy / Chapter 1.3 --- Problems of Chest Physiotherapy Research / Chapter 1.4 --- Plan of work / Chapter Chapter 2 --- Previous Studies in Chest Physiotherapy --- p.15 / Chapter 2.1 --- Chest Physiotherapy and oxygenation / Chapter 2.2 --- Chest Physiotherapy and sputum clearance / Chapter 2.3 --- Chest Physiotherapy and lung function / Chapter Chapter 3 --- "Chest Physiotherapy Practice in ICUs in Australia, the UK and Hong Kong" --- p.34 / Chapter SECTION II --- METHODS / Chapter Chapter 4 --- Measurement of Oxygenation --- p.55 / Chapter 4.1 --- Measurement of arterial oxygenation / Chapter 4.2 --- Indirect measurement of arterial oxygenation / Chapter Chapter 5 --- Respiratory Function Analysis --- p.66 / Chapter 5.1 --- Spirometry measurement / Chapter 5.2 --- Measurement of lung mechanics / Chapter Chapter 6 --- Transcutaneous Electrical Nerve Stimulation --- p.74 / Chapter SECTION III --- RESPIRATORY PHYSIOTHERAPY TECHNIQUES / Chapter Chapter 7 --- Effects of Percussion and Bagging on Static Lung Compliance --- p.80 / Chapter Chapter 8 --- Peak Expiratory Flow from two Breathing Circuits --- p.106 / Chapter Chapter 9 --- Peak Expiratory Flow in Tracheal Intubated Patients --- p.127 / Chapter SECTION IV --- PHYSIOTHERAPY AND PAIN MANA GEMENT IN ICU PATIENTS / Chapter Chapter 10 --- Transcutaneous Electrical Nerve Stimulation (TENS) following Thoracotomy --- p.142 / Chapter Chapter 11 --- TENS following Cholecystectomy --- p.154 / Chapter Chapter 12 --- TENS and Entonox --- p.167 / Chapter SECTION V --- SUMMARY AND CONCLUSIONS / Chapter Chapter 13 --- Summary --- p.185 / Chapter Chapter 14 --- Conclusion --- p.194 / Chapter SECTION VI --- REFERENCES --- p.197 / Chapter SECTION VII --- APPENDICES --- p.222
|
417 |
Efficient image/video restyling and collage on GPU. / CUHK electronic theses & dissertations collectionJanuary 2013 (has links)
創意媒體研究中,圖像/視頻再藝術作為有表現力的用戶定制外觀的創作手段受到了很大關注。交互設計中,特別是在圖像空間只有單張圖像或視頻輸入的情況下,運用計算機輔助設計虛擬地再渲染關注物體的風格化外觀來實現紋理替換是很強大的。現行的紋理替換往往通過操作圖像空間中像素的間距來處理紋理扭曲,原始圖像中潛在的紋理扭曲總是被破壞,因為現行的方法要麼存在由於手動網格拉伸導致的不恰當扭曲,要麼就由於紋理合成而導致不可避免的紋理開裂。圖像/視頻拼貼畫是被發明用以支持在顯示畫布上並行展示多個物體和活動。隨著數字視頻俘獲裝置的快速發展,相關的議題就是快速檢閱和摘要大量的視覺媒體數據集來找出關注的資料。這會是一項繁瑣的任務來審查長且乏味的監控視頻並快速把握重要信息。以關鍵信息和縮短視頻形式為交流媒介,視頻摘要是增強視覺數據集瀏覽效率和簡易理解的手段。 / 本文首先將圖像/視頻再藝術聚焦在高效紋理替換和風格化上。我們展示了一種交互紋理替換方法,能夠在不知潛在幾何結構和光照環境的情況下保持相似的紋理扭曲。我們運用SIFT 棱角特徵來自然地發現潛在紋理扭曲,並應用梯度深度圖復原和皺褶重要性優化來完成扭曲過程。我們運用GPU-CUDA 的並行性,通過實時雙邊網格和特徵導向的扭曲優化來促成交互紋理替換。我們運用基於塊的實時高精度TV-L¹光流,通過基於關鍵幀的紋理傳遞來完成視頻紋理替換。我們進一步研究了基於GPU 的風格化方法,並運用梯度優化保持原始圖像的精細結構。我們提出了一種能夠自然建模原始圖像精細結構的圖像結構圖,並運用基於梯度的切線生成和切線導向的形態學來構建這個結構圖。我們在GPU-CUDA 上通過並行雙邊網格和結構保持促成最終風格化。實驗中,我們的方法實時連續地展現了高質量的圖像/視頻的抽象再藝術。 / 當前,視頻拼貼畫大多創作靜態的基於關鍵幀的拼貼圖片,該結果只包含動態視頻有限的信息,會很大程度影響視覺數據集的理解。爲了便於瀏覽,我們展示了一種在顯示畫布上有效並行摘要動態活動的動態視頻拼貼畫。我們提出應用活動長方體來重組織及提取事件,執行視頻防抖來生成穩定的活動長方體,實行時空域優化來優化活動長方體在三維拼貼空間的位置。我們通過在GPU 上的事件相似性和移動關係優化來完成高效的動態拼貼畫,允許多視頻輸入。擁有再序核函數CUDA 處理,我們的視頻拼貼畫爲便捷瀏覽長視頻激活了動態摘要,節省大量存儲傳輸空間。實驗和調查表明我們的動態拼貼畫快捷有效,能被廣泛應用于視頻摘要。將來,我們會擴展交互紋理替換來支持更複雜的具大運動和遮蔽場景的一般視頻,避免紋理跳動。我們會採用最新視頻技術靈感使視頻紋理替換更加穩定。我們未來關於視頻拼貼畫的工作包括審查監控業中動態拼貼畫應用,並研究含有大量相機運動和不同種視頻過度的移動相機和一般視頻。 / Image/video restyling as an expressive way for producing usercustomized appearances has received much attention in creative media researches. In interactive design, it would be powerful to re-render the stylized presentation of interested objects virtually using computer-aided design tools for retexturing, especially in the image space with a single image or video as input. The nowaday retexturing methods mostly process texture distortion by inter-pixel distance manipulation in image space, the underlying texture distortion is always destroyed due to limitations like improper distortion caused by human mesh stretching, or unavoidable texture splitting caused by texture synthesis. Image/ video collage techniques are invented to allow parallel presenting of multiple objects and events on the display canvas. With the rapid development of digital video capture devices, the related issues are to quickly review and brief such large amount of visual media datasets to find out interested video materials. It will be a tedious task to investigate long boring surveillance videos and grasp the essential information quickly. By applying key information and shortened video forms as vehicles for communication, video abstraction and summary are the means to enhance the browsing efficiency and easy understanding of visual media datasets. / In this thesis, we first focused our image/video restyling work on efficient retexturing and stylization. We present an interactive retexturing that preserves similar texture distortion without knowing the underlying geometry and lighting environment. We utilized SIFT corner features to naturally discover the underlying texture distortion. The gradient depth recovery and wrinkle stress optimization are applied to accomplish the distortion process. We facilitate the interactive retexturing via real-time bilateral grids and feature-guided distortion optimization using GPU-CUDA parallelism. Video retexturing is achieved through a keyframe-based texture transferring strategy using accurate TV-L¹ optical flow with patch motion tracking techniques in real-time. Further, we work on GPU-based abstract stylization that preserves the fine structure in the original images using gradient optimization. We propose an image structure map to naturally distill the fine structure of the original images. Gradientbased tangent generation and tangent-guided morphology are applied to build the structure map. We facilitate the final stylization via parallel bilateral grids and structure-aware stylizing in real-time on GPU-CUDA. In the experiments, our proposed methods consistently demonstrate high quality performance of image/video abstract restyling in real-time. / Currently, in video abstraction, video collages are mostly produced with static keyfame-based collage pictures, which contain limited information of dynamic videos and in uence understanding of visual media datasets greatly. We present dynamic video collage that effectively summarizes condensed dynamic activities in parallel on the canvas for easy browsing. We propose to utilize activity cuboids to reorganize and extract dynamic objects for further collaging, and video stabilization is performed to generate stabilized activity cuboids. Spatial-temporal optimization is carried out to optimize the positions of activity cuboids in the 3D collage space. We facilitate the efficient dynamic collage via event similarity and moving relationship optimization on GPU allowing multi-video inputs. Our video collage approach with kernel reordering CUDA processing enables dynamic summaries for easy browsing of long videos, while saving huge memory space for storing and transmitting them. The experiments and user study have shown the efficiency and usefulness of our dynamic video collage, which can be widely applied for video briefing and summary applications. In the future, we will further extend the interactive retexturing to more complicated general video applications with large motion and occluded scene avoiding textures icking. We will also work on new approaches to make video retexturing more stable by inspiration from latest video processing techniques. Our future work for video collage includes investigating applications of dynamic collage into the surveillance industry, and working on moving camera and general videos, which may contain large amount of camera motions and different types of video shot transitions. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Li, Ping. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2013. / Includes bibliographical references (leaves 109-121). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts also in Chinese. / Abstract --- p.i / Acknowledgements --- p.v / Chapter 1 --- Introduction --- p.1 / Chapter 1.1 --- Background --- p.1 / Chapter 1.2 --- Main Contributions --- p.5 / Chapter 1.3 --- Thesis Overview --- p.7 / Chapter 2 --- Efficient Image/video Retexturing --- p.8 / Chapter 2.1 --- Introduction --- p.8 / Chapter 2.2 --- Related Work --- p.11 / Chapter 2.3 --- Image/video Retexturing on GPU --- p.16 / Chapter 2.3.1 --- Wrinkle Stress Optimization --- p.19 / Chapter 2.3.2 --- Efficient Video Retexturing --- p.24 / Chapter 2.3.3 --- Interactive Parallel Retexturing --- p.29 / Chapter 2.4 --- Results and Discussion --- p.35 / Chapter 2.5 --- Chapter Summary --- p.41 / Chapter 3 --- Structure-Aware Image Stylization --- p.43 / Chapter 3.1 --- Introduction --- p.43 / Chapter 3.2 --- Related Work --- p.46 / Chapter 3.3 --- Structure-Aware Stylization --- p.50 / Chapter 3.3.1 --- Approach Overview --- p.50 / Chapter 3.3.2 --- Gradient-Based Tangent Generation --- p.52 / Chapter 3.3.3 --- Tangent-Guided Image Morphology --- p.54 / Chapter 3.3.4 --- Structure-Aware Optimization --- p.56 / Chapter 3.3.5 --- GPU-Accelerated Stylization --- p.58 / Chapter 3.4 --- Results and Discussion --- p.61 / Chapter 3.5 --- Chapter Summary --- p.66 / Chapter 4 --- Dynamic Video Collage --- p.67 / Chapter 4.1 --- Introduction --- p.67 / Chapter 4.2 --- Related Work --- p.70 / Chapter 4.3 --- Dynamic Video Collage on GPU --- p.74 / Chapter 4.3.1 --- Activity Cuboid Generation --- p.75 / Chapter 4.3.2 --- Spatial-Temporal Optimization --- p.80 / Chapter 4.3.3 --- GPU-Accelerated Parallel Collage --- p.86 / Chapter 4.4 --- Results and Discussion --- p.90 / Chapter 4.5 --- Chapter Summary --- p.100 / Chapter 5 --- Conclusion --- p.101 / Chapter 5.1 --- Research Summary --- p.101 / Chapter 5.2 --- Future Work --- p.104 / Chapter A --- Publication List --- p.107 / Bibliography --- p.109
|
418 |
Studies of the relationship between the surface electromyogram, joint torque and impedanceDai, Chenyun 20 December 2016 (has links)
"This compendium-format dissertation (i.e., comprised mostly of published and in-process articles) primarily reports on system identification methods that relate the surface electromyogram (EMG)—the electrical activity of skeletal muscles—to mechanical kinetics. The methods focus on activities of the elbow and hand-wrist. The relationship between the surface EMG and joint impedance was initially studied. My work provided a complete second-order EMG-based impedance characterization of stiffness, viscosity and inertia over a complete range of nominal torques, from a single perturbation trial with slowly varied torque. A single perturbation trial provides a more convenient method for impedance evaluation. The RMS errors of the EMG-based method were 20.01% for stiffness and 7.05% for viscosity, compared with the traditional mechanical measurement. Three projects studied the relationship between EMG and force/torque, a topic that has been studied for a number of years. Optimal models use whitened EMG amplitude, combining multiple EMG channels and a polynomial equation to describe this relationship. First, we used three techniques to improve current models at the elbow joint. Three more features were extracted from the EMG (waveform length, slope sign change rate and zero crossing rate), in addition to EMG amplitude. Each EMG channel was used separately, compared to previous studies which combined multiple channels from biceps and, separately, from triceps muscles. Finally, an exponential power law model was used. Each of these improvement techniques showed better performance (P<0.05 and ~0.7 percent maximum voluntary contraction (%MVC) error reduction from a nominal error of 5.5%MVC) than the current “optimal” model. However, the combination of pairs of these techniques did not further improve results. Second, traditional prostheses only control 1 degree of freedom (DoF) at a time. My work provided evidence for the feasibility of controlling 2-DoF wrist movements simultaneously, with a minimum number of electrodes. Results suggested that as few as four conventional electrodes, optimally located about the forearm, could provide 2-DoF simultaneous, independent and proportional control with error ranging from 9.0–10.4 %MVC, which is similar to the 1-DoF approach (error from 8.8–9.8 %MVC) currently used for commercial prosthesis control. The third project was similar to the second, except that this project studied controlling a 1-DoF wrist with one hand DoF simultaneously. It also demonstrated good performance with the error ranging from 7.8-8.7 %MVC, compared with 1-DoF control. Additionally, I participated in two team projects—EMG decomposition and static wrist EMG to torque—which are described herein. "
|
419 |
”I know you know I’m not religious, but I am REALLY not religious” : En studie gällande interkulturella relationer på film med fokus på religion som konfliktskapande – exemplet judendomen / ”I know you know I’m not religious, but I am REALLY not religious” : A study of intercultural relationshipss on film with a focus on religion as conflict-generating - the example of JudaismSandelin, Amanda January 2019 (has links)
The purpose of this essay is to examine how movies portray Judaism in movies made for a large audience. The study used four movies ranging from the year 2009-2018 and that were categorized in different genres with the aim of investigating how relationships that involve people from different religious backgrounds get into conflicts and how these are resolved. The study’s main research question was why the characters in the movies get involved with conflict regarding religion and a textual analysis where the movies functioned as text was used as the method. To present the results the method of excerpt commentary units as known by Emerson was used. The analysis showed that one of the reasons why conflicts are created regarding Judaism is because one part of the relationship lacks in knowledge regarding the religion. Because of this the person ridicules and makes derogatory comments to the other person in the relationship, to the point where conflict is created because the other person in the relationship does not feel respected. The study also showed that these particular conflicts were resolved by the person learning more about the others religion which lead to a more understanding standpoint in the relationship. The analysis also showed that another big reason for conflict in the relationships regarding Judaism was that both parties felt pressure from outside sources, such as family, friends or other significant people. This caused the relationship to suffer because neither person in the relationship would stand up to these outside forces and instead they took it out on the relationship.
|
420 |
Matemáticas de formas de vida de agricultores do município de Santo Antônio da PatrulhaOliveira, Sabrina Silveira de 02 March 2011 (has links)
Submitted by Maicon Juliano Schmidt (maicons) on 2015-04-06T13:35:18Z
No. of bitstreams: 1
Sabrina Silveira de Oliveira.pdf: 2120834 bytes, checksum: 38260a45e0f4fc7b71b9e3b499fccf41 (MD5) / Made available in DSpace on 2015-04-06T13:35:18Z (GMT). No. of bitstreams: 1
Sabrina Silveira de Oliveira.pdf: 2120834 bytes, checksum: 38260a45e0f4fc7b71b9e3b499fccf41 (MD5)
Previous issue date: 2011-01-31 / Milton Valente / UNISINOS - Universidade do Vale do Rio dos Sinos / A Dissertação teve como objetivo estudar os jogos de linguagem praticados por agricultores do município de Santo Antônio da Patrulha, ao fazerem medições lineares e de superfície, examinando suas semelhanças de família e também as semelhanças que mantêm com os jogos de linguagem da matemática escolar. As ferramentas teóricas do estudo advêm da Etnomatemática em seus entrecruzamentos com as teorizações de Michel Foucault e as ideias de Wittgenstein em sua obra Investigações Filosóficas. O material de pesquisa consiste em entrevistas realizadas com duas famílias de agricultores, observações de um dos agricultores em suas atividades laborais e exame das primeiras certidões de compra e venda de imóveis do Município. A análise desse material mostrou que marcadores associados às condições climáticas estão presentes nas práticas de plantar e colher; os agricultores utilizam a unidade "tamina" em suas medições lineares e de superfície; houve movimentos de resistência no período de imposição do sistema métrico decimal naquele município do sul do Brasil; a aprendizagem de jogos de linguagem envolvendo o uso da unidade "tamina" ocorre através da transmissão oral e de observações; e na forma de vida escolar tais jogos de linguagem não eram/são transmitidos. / This dissertation intends to study the language games used by farmers in the town of Santo Antônio da Patrulha when taking linear and surface measurements, by examining family resemblances and also the similarities they have with the language games used in mathematics as a school subject. The theoretical tools in this study stem from Ethnomathematics in its crossings with the theories of Michel Foucault and Wittgensteins ideas presented in his book Philosophical Investigations. The research data consists of interviews with two farming families, one of these farmers observations about his work activities, and the analysis of the first certificates of sale of real property issued in Santo Antônio da Patrulha. The analysis of this data suggests that markers associated with climatic conditions are present in the practices of planting and harvesting; farmers use the unit known as tamina in their linear and surface measurements; there were resistance movements during the imposition of the metric system in this town of southern Brazil; language games involving the use of the unit named tamina are learned through oral transmission and observation; and in the form of school life, such language games were /are not taught.
|
Page generated in 0.0708 seconds