Submitted by Biblioteca Digital de Teses e Disserta????es (sdi@ucb.br) on 2017-11-08T13:42:46Z No. of bitstreams: 1 CamilaGabrielMeirelesDissertacao2013.pdf: 1149081 bytes, checksum: 8e6c517bee29e8690be7248afcf7bc72 (MD5) / Approved for entry into archive by Biblioteca Digital de Teses e Disserta????es (sdi@ucb.br) on 2017-11-08T13:43:03Z (GMT) No. of bitstreams: 1 CamilaGabrielMeirelesDissertacao2013.pdf: 1149081 bytes, checksum: 8e6c517bee29e8690be7248afcf7bc72 (MD5) / Made available in DSpace on 2017-11-08T13:43:03Z (GMT). No. of bitstreams: 1 CamilaGabrielMeirelesDissertacao2013.pdf: 1149081 bytes, checksum: 8e6c517bee29e8690be7248afcf7bc72 (MD5) Previous issue date: 2013-01-01 / This study aims to understand, from a comparative perspective, the perception of children / adolescents and their families on institutional care. Based on a qualitative approach, we performed the case study of four teenagers, two of whom were still welcomed institutionally and two had returned to the care of their families. As for the procedures used, individual interviews were conducted with children and adolescents and with members of the family group, more specifically mothers, and complementary technique was employed in the preparation of drawings to support the interview one of the teenagers. The results indicated that the members of the families interviewed have different perceptions between themselves, both on the protective measure of institutional care much about the institution under which the protective measure was performed. Family members interviewed tended to justify the measure as a host factor and need to protect their children, who might have access to basic social rights such as food, shelter and education. However, the perception of those members of the institution where the research took place was extremely negative and meant as a factor of "risk" to their children, exemplified by the sale and use of drugs by teenagers in the shelter. Unlike the members of the families surveyed, interviews of children and adolescents have not offered support for the measure perception host as a protective factor. However, their perceptions coincided regarding unprotected offered by the host unit where the research was conducted. In this sense, the perceptions of children and teenagers on the institution-researched exacerbated the representation of host unit as equivalent to a prison unit without control over drug use, an environment unwelcoming and cold, with rules that more resemble a scheme prison. Data from this study highlight the challenge of units that receive institutional care adolescents under socio remain in its mission of "protection unit" and not become "unit socioeducation". / Este estudo tem o objetivo de compreender, numa perspectiva comparativa, a percep????o de crian??as/adolescentes e suas fam??lias sobre o acolhimento institucional. Com base em uma abordagem qualitativa, foi realizado o estudo de caso de quatro adolescentes, sendo que dois deles estavam ainda acolhidos institucionalmente e dois j?? haviam retornado aos cuidados de seus familiares. Quanto aos procedimentos utilizados, foram realizadas entrevistas individuais com crian??as e adolescentes e com membros do grupo familiar, mais especificamente com m??es, e complementarmente foi empregada a t??cnica da elabora????o de desenhos para dar suporte ?? entrevista de um dos adolescentes. Os resultados indicaram que os membros das fam??lias entrevistadas possuem percep????es diferenciadas entre si mesmos, tanto sobre a medida protetiva de acolhimento institucional quanto sobre a institui????o abrigo onde a medida protetiva foi executada. Os membros das fam??lias entrevistadas tenderam a justificar a medida de acolhimento como uma necessidade e fator de prote????o de seus filhos, que poderiam ter acesso a direitos sociais b??sicos, como alimenta????o, abrigo e educa????o. Contudo, a percep????o desses membros sobre a institui????o onde a pesquisa se realizou foi extremamente negativa e significada como um fator de ???risco??? para seus filhos, exemplificada com a venda e o uso de drogas pelos adolescentes dentro do abrigo. Diferentemente dos membros das fam??lias pesquisadas, as entrevistas das crian??as e adolescentes n??o ofereceram suporte para percep????o da medida de acolhimento como fator de prote????o. Contudo, suas percep????es coincidiram em rela????o ?? desprote????o oferecida pela unidade de acolhimento onde a pesquisa foi realizada. Nesse sentido, as percep????es das crian??as e adolescentes sobre a institui????o-pesquisada exacerbaram a representa????o da unidade de acolhimento como equiparada a uma unidade prisional sem controle sobre o uso de drogas, um ambiente pouco acolhedor e frio, com regras que mais lembram um esquema de pris??o.

Submitted by Sara Ribeiro (sara.ribeiro@ucb.br) on 2018-04-18T16:59:11Z No. of bitstreams: 1 AngelitaGiovanaCaldeiraDissertacao2017.pdf: 2000891 bytes, checksum: b54fc8fc1c7bd3e7df44fce2dbeb0a25 (MD5) / Approved for entry into archive by Sara Ribeiro (sara.ribeiro@ucb.br) on 2018-04-18T16:59:27Z (GMT) No. of bitstreams: 1 AngelitaGiovanaCaldeiraDissertacao2017.pdf: 2000891 bytes, checksum: b54fc8fc1c7bd3e7df44fce2dbeb0a25 (MD5) / Made available in DSpace on 2018-04-18T16:59:27Z (GMT). No. of bitstreams: 1 AngelitaGiovanaCaldeiraDissertacao2017.pdf: 2000891 bytes, checksum: b54fc8fc1c7bd3e7df44fce2dbeb0a25 (MD5) Previous issue date: 2017-12-11 / Home care of the population in the Federal District (DF) is carried out nowadays by the Regional Centers for Home Care (NRAD's), located in the seven health regions of the Federal District, which provide care for all age groups, including the population in study - the elderly. The care takes place through a multiprofessional team, having the nurse important role in the program. The objective of this research was to describe the profile of the elderly assisted by the Home Care Program (PID) of the Regional Nucleus of Home Care (NRAD) of the South - Gama - DF health region from 2006 to 2016. This is a longitudinal study, descriptive, exploratory, quantitative approach with data from the medical records of the elderly patients admitted to the program. As a result, it was found that the female population (50.6%), married (52.5%), retired (68.8%), brown (57.5%), and the most prevalent age group is elderly people, that is, between 80 and 89 years (31.2%). The Catholic religion was the most dominant (56.9%), as well as the naturalness of the northeastern region (62.5%). The knowledge of the program was through the hospital (78.8%). The most evident reasons for hospitalization were neoplasias (43.7%), followed by Stroke (22.5) with prevalence longer than 180 days (44.3%). As diseases associated with Systemic Arterial Hypertension (SAH) and Diabetes Mellitus (DM) were the most frequent (56.2% and 25.0%). The most developed procedures were the verification of vital signs (99.3%), oximetry (88.1%), monitoring of capillary glycemia (65.6%), followed by dressing (37.5%), venous puncture (36.8%) and nasoenteric catheter, bladder of relief and delay (15.0%, 13.1% and 8.1%). At the time of admission, the main drug class in use was antihypertensive (51.8%) and 81 patients (50.6%) used 5 or more drugs. In conclusion, home hospitalization is of utmost importance to the elderly person affected by pathologies, where knowing the patient attended assists in their better follow-up, in addition to performing care that seeks to achieve the well-being of the patient in question. / O atendimento domiciliar da popula????o no Distrito Federal (DF) ?? realizado nos dias atuais pelos N??cleos Regionais de Aten????o Domiciliar (NRAD???s), situados nas sete regi??es de sa??de do DF, os quais realizam a assist??ncia de todas as faixas et??rias, incluindo a popula????o em estudo ??? os idosos. O atendimento ocorre atrav??s de uma equipe multiprofissional, tendo o enfermeiro papel importante no programa. O objetivo desta pesquisa foi descrever o perfil dos idosos atendidos pelo Programa de Interna????o Domiciliar (PID) do N??cleo Regional de Aten????o Domiciliar (NRAD) da regi??o de sa??de sul - Gama -DF, de 2006 a 2016. Trata-se de um estudo longitudinal, descritivo, explorat??rio, de abordagem quantitativa com dados dos prontu??rios dos pacientes idosos admitidos/atendidos no programa. Como resultado encontrou-se que a popula????o usu??ria deste servi??o, ?? em sua maioria do sexo feminino (50,6%), casada (52,5%), aposentada (68,8%), cor parda (57,5%) e a faixa et??ria mais prevalente ?? a de idosos com idade mais avan??ada, ou seja, entre 80 a 89 anos (31,2%). A religi??o cat??lica foi a mais dominante (56,9%), assim como, a naturalidade proveniente da regi??o nordeste (62,5%). O conhecimento do programa foi atrav??s do hospital (78,8%). Os motivos da interna????o mais evidentes no programa foram as neoplasias (43,7%), seguidas do Acidente Vascular Encef??lico ??? AVE (22,5%), com tempo de interna????o prevalente maior que 180 dias (44,3%). Como doen??as associadas ?? Hipertens??o Arterial Sist??mica (HAS) e Diabetes Mellitus (DM) foram as mais encontradas (56,2% e 25,0%). Os procedimentos mais desenvolvidos pela Enfermagem foram a verifica????o dos sinais vitais (99,3%), oximetria (88,1%), monitoriza????o da glicemia capilar (65,6%), seguidos de curativo (37,5%), pun????o venosa (36,8%) e sonda nasoent??rica, vesical de al??vio e demora ( 15,0%, 13,1% e 8,1%). No momento da admiss??o, a principal classe medicamentosa em utiliza????o foi a de anti-hipertensivos (51,8%) e 81 pacientes (50,6%) faziam uso de 5 ou mais medicamentos. Concluindo, a interna????o domiciliar ?? de suma import??ncia ao idoso acometido por patologias, onde conhecer o paciente atendido auxilia no seu melhor acompanhamento, al??m da realiza????o de cuidados que buscam alcan??ar o bem estar do paciente em quest??o.

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Solar assisted heat pump (SAHP) systems have been widely applied in domestic hot water (DHW) production due to their sustainability and stability in operations. However, their performance efficiency requires further improvement using advanced technologies such as energy storage with phase change materials (PCM) and optimal system controls. Undoubtedly, employing PCMs for latent heat storage (LHS) application has a great potential to improve a solar thermal application performance. Despite this fact, the use of PCM in this area is quite limited due to the poor thermal conductivity of available PCMs. Therefore, heat transfer enhancement is one of the essential strategies that can overcome this obstacle. Accordingly, a test rig of a new indirect expansion solar assisted heat pump (IDX-SAHP) system has been designed, built and instrumented. The system can handle heating capacity up to 9 kW. The IDX-SAHP system consists of three operational loops: solar thermal, solar-air assisted heat pump and load profile. A 2 kW PCM heat exchanger (HX) was purposely designed and installed in the system solar thermal loop to store solar energy, when applicable, and release heat when required by the heat pump. The PCM HX is employed with a novel heat transfer enhancement method. The maximum coefficient of performance (COP) of the IDX-SHAP system reached 4.99 during the sunny day with the PCM (HX) integration. However, the maximum energy saving was achieved during the cloudy day with the PCM HX integration. Moreover, the proposed heat transfer enhancement method has been modelled through CFD package and validated with the experimental results. This allows a clear understanding of the reasons for the longer discharging process compared with the charging process. Furthermore, the inlet flow rate and temperature variation of the PCM HX was simulated during charging and discharging processes. The optimum inlet flow rate for this application was found at 0.1 kg/s while the optimum inlet temperature was found at 40°C. Meanwhile, the whole system was modelled by the coupling of TRNSYS, EES and CFD to investigate the potential and advantages of using the system in locations with rich solar intensity such as Cairo and Madrid. The simulation shows that the solar thermal operation loop was called more frequently in these locations. This had a significant impact on the system energy consumption, especially during winter. The maximum COP and solar performance factor (SPF) of the modelled system were 5.3 and 0.83 respectively.

Quadriceps muscle weakness is a condition that can result from a wide variety of causes, from diseases like polio and multiple sclerosis to injuries of the head and spine. Individuals with weakened quadriceps often have difficulty supplying the knee-extension moments required during common mobility tasks. Existing powered orthoses that provide an assistive knee-extension moment are large and heavy, with power supplies that generally last less than two hours. A new device that provides a knee-extension-assist moment was designed to aid an individual with quadriceps muscle weakness to stand up from a seated position, sit from a standing position, and walk up and down an inclined surface. The knee-extension-assist (KEA) was designed as a modular component to be incorporated into existing knee-ankle-foot-orthoses (KAFO). The KEA consists of three springs that are compressed, as the knee is flexed under bodyweight, by cables that wrap around a sheave at the knee. The KEA returns the stored energy from knee flexion as an extension moment during knee extension. During swing or other non-weight bearing activities, the device is disengaged from the KAFO by decoupling the sheave from the KAFO knee joint, allowing free knee joint motion. A prototype was built and mechanically tested to determine KEA behaviour during loading and extension and to ensure proper KEA function. For biomechanical evaluation, able-bodied subjects used the prototype KEA while performing sit-to-stand, stand-to-sit, ramp ascent, and ramp descent tasks. The KEA facilitated sitting and standing, providing an average of 53 % of the required extension moment for the two participants, which allowed one participant to reduce quadriceps usage by 38 % and the other to perform sit-to-stand in a slower and more controlled manner that was not possible without the KEA. KEA use during ramp gait caused an overall increase in quadriceps activation by 76 %, on average, with use. Future efforts will be made to modify the design to improve functionality, especially for ramp gait, and to reduce device size and weight.

The objectives of the present body of work were 1) to evaluate the Personal Lift-Assist Device (PLAD) in terms of its effect on lifting technique, interjoint coordination, and whether sex modulates these effects and 2) to explore the use of principal component analysis (PCA) as a method to investigate lifting waveforms. Thirty participants (15M, 15F) completed a freestyle, symmetrical lifting protocol during which three-dimensional kinematics of the ankle, knee, hip, and lumbar and thoracic spine were collected using a two-camera Optotrak 3020 system. There were four testing conditions: a) with and b) without wearing the PLAD; and c) 0% load and d) 10% of maximum back strength load. All data were evaluated using PCA. In the first analysis, the relationship between the PLAD and lifting technique under a loaded condition was explored. Results showed that 8 PCs were significantly different between the PLAD/No PLAD conditions yet there were no significant effects of sex on any of the PCs. It was concluded that wearing the PLAD encourages a lifting technique that is reflective of a squat lift, independent of sex. In the second analysis, the PLAD’s effect on interjoint coordination patterns under both loaded and unloaded conditions was examined using the relative phase angle (RPA). It was found that there were no significant differences between device, sex, or load conditions on any of the PCs retained in the model. A novel approach to enhance interpretability of PCs was developed during this study. Finally, when the PLAD was not worn, male and female differences were further investigated under loaded and unloaded conditions. It was determined that when the load is individualized to personal strength characteristics, sex differences in lifting technique are negligible. This is a contradictory finding from previous research. Overall, the major contributions of this research are: support for the use of the PLAD in industry; the recommendation that load be selected based on individual strength characteristics for lifting research experimental design; the use of PCA as a method to effectively evaluate lifting waveforms; and the development of a novel approach to aid in the interpretation of principal components. / Thesis (Master, Kinesiology & Health Studies) -- Queen's University, 2010-08-18 09:35:19.142

Implantation of a left ventricular assist device (LVAD) is a potential treatment in terminal heart failure. Right ventricular (RV) failure is a severe complication in these patients and sometimes requires additional placement of a right ventricular assist device (RVAD). RVAD implantation, however, is an invasive treatment associated with both increased mortality and morbidity. The aim of this thesis was to study whether partial volume exclusion of the RV through a modified Glenn shunt or cavoaortic shunt could treat severe RV failure. The ultimate goal would be to use it as an alternative to a RVAD in RV failure during LVAD therapy. Swine were used as the model animal in all studies. In Study I, experimental RV failure was induced by ischemia, and verified by hemodynamic measurements and genetic expression. Treatment with a modified Glenn shunt reduced venous stasis and improved hemodynamics in general. In Study II, experimental RV failure was induced by the same method as in Study I. Treatment with a cavoaortic shunt in addition to LVAD therapy proved to reduce venous stasis and improved hemodynamics in general, which was feasible with preserved oxygen delivery despite cyanotic shunting. In Study III, experimental RV failure was induced by pulmonary banding, and verified by hemodynamic measurements and genetic expression. Treatment with a modified Glenn shunt reduced venous stasis but did not improve hemodynamics in general compared with a control group. In Study IV, the effects of LVAD therapy and subsequent treatment with a modified Glenn shunt on the normal RV function were studied. It demonstrated that LVAD therapy can put strain on the RV by increasing stroke work and end-diastolic volume, and that these effects can be reversed by treatment with a modified Glenn shunt during LVAD therapy. In conclusion, partial volume exclusion through a modified Glenn shunt or cavoaortic shunt is a feasible treatment of experimental RV failure. Thus, it could potentially be used as an alternative treatment to a RVAD in severe RV failure during LVAD therapy.

Quadriceps muscle weakness is a condition that can result from a wide variety of causes, from diseases like polio and multiple sclerosis to injuries of the head and spine. Individuals with weakened quadriceps often have difficulty supplying the knee-extension moments required during common mobility tasks. Existing powered orthoses that provide an assistive knee-extension moment are large and heavy, with power supplies that generally last less than two hours. A new device that provides a knee-extension-assist moment was designed to aid an individual with quadriceps muscle weakness to stand up from a seated position, sit from a standing position, and walk up and down an inclined surface. The knee-extension-assist (KEA) was designed as a modular component to be incorporated into existing knee-ankle-foot-orthoses (KAFO). The KEA consists of three springs that are compressed, as the knee is flexed under bodyweight, by cables that wrap around a sheave at the knee. The KEA returns the stored energy from knee flexion as an extension moment during knee extension. During swing or other non-weight bearing activities, the device is disengaged from the KAFO by decoupling the sheave from the KAFO knee joint, allowing free knee joint motion. A prototype was built and mechanically tested to determine KEA behaviour during loading and extension and to ensure proper KEA function. For biomechanical evaluation, able-bodied subjects used the prototype KEA while performing sit-to-stand, stand-to-sit, ramp ascent, and ramp descent tasks. The KEA facilitated sitting and standing, providing an average of 53 % of the required extension moment for the two participants, which allowed one participant to reduce quadriceps usage by 38 % and the other to perform sit-to-stand in a slower and more controlled manner that was not possible without the KEA. KEA use during ramp gait caused an overall increase in quadriceps activation by 76 %, on average, with use. Future efforts will be made to modify the design to improve functionality, especially for ramp gait, and to reduce device size and weight.

At an annual cost of over thirty billion dollars annually, the diagnosis and management of heart failure is one of the most significant public health concerns of the twenty first century, as nearly twenty percent of Americans will develop some form of heart failure in their lifetime. The incidence of newly diagnosed heart failure has remained stable over the last several years at approximately 650,000 diagnoses per year; however, due to several contributing factors the prevalence has continued to rise despite substantial advancements in interventional therapies. The three most significant contributing factors to the rising heart failure prevalence have been identified as 1) significant advancements in technology and medical intervention have dramatically improved the survival rate of those experiencing acute coronary events. This has resulted in a greater number of patients who then progress to chronic heart failure. 2) The management of those with chronic heart failure has been dramatically improved which has allowed those with the disease to live longer and 3) heart failure is in large part a disease associated with advancing age. As the population in the United States and other developed countries continue to grow, such a strong association will inevitably result in a rapidly increasing prevalence. Current clinically therapies for managing heart failure can be categorized into three major groups: pharmaceutical therapy, mechanical circulatory support, or cell-based therapy. Pharmaceutical therapies are used in the earlier stages of disease progression or to manage symptoms and comorbidities of later stage heart failure. Mechanical circulatory support is often implemented when the disease progresses to a more severe state, where volume and / or pressure overload of the ventricles is present. Many modalities of mechanical circulatory support serve as a bridge to transplant, as the only long-term treatment of advanced decompensated heart failure is cardiac transplantation. The third category of treatments for HF is cell-based or stem cell therapies. These therapies are still in their infancies but hold significant potential of cardiac regeneration and reversal of the pathologic remodeling associated with heart failure. While the management of the early stages of heart failure have improves, addressing end-stage failure remains a significant obstacle in resolving the U.S. of the heart failure epidemic. The use of ventricular assist devices (VADs) has improved the management of end-stage failure over the last few decades, but VADs serve mostly as a bridge to transplant, so eventually a donor organ and cardiac transplantation is required. As the population continues to grow, the number of patients in need of a donor heart will increase, leading to an even larger discrepancy between the number of donor organs available and those in severe need. While advancements in VAD technology have reduced potential complications and increased the duration and effectiveness of the mechanical circulatory support, a long-term permanent treatment is still very much in need. Cell-based cardiac therapy or cardiac stem cell therapy holds the greatest potential to solving this age-old problem. The ability to not only regenerate dead or damaged tissue in the heart but also reverse pathologic remodeling due to heart failure could cure millions of patients of heart failure, returning them to a healthy, fully functioning state. The last decade has shed much light on the potential of stem cell therapies, but also has illuminated significant barriers to creating a clinically acceptable treatment. While these barriers seem tall, it is crucial that much time and resources be invested into stem cell therapies for cardiac applications as they hold the greatest potential to being able to effectively treat, rather than manage, those with heart failure. In addition to regenerating dead of damaged myocardium, stem cell technology has the potential to grow an entire organ that is patient specific in its origin, and would fully alleviate having to wait for an available donor organ. The ability to grow an entire organ in the lab, which can later be transplanted, would forever change the way medicine is practiced, while saving millions if not billions of lives worldwide.

Este trabalho apresenta a implementação de um sistema de velocimetria de imagens de partícula (VIP) para estudo do escoamento do sangue em um dispositivo de assistência ventricular para uso pediátrico (DAVP). O sistema VIP implementado é constituído por uma fonte de iluminação composta por um par de lasers de Nd:YAG (pulso de aproximadamente 18mJ de energia e duração de 5ns), um sistema óptico contendo duas lentes convergentes, uma câmera CCD e uma câmara para visualização. O DAVP estudado foi construído em acrílico transparente e é constituído de uma câmara de sangue e uma câmara pneumática, divididas por uma membrana flexível. A câmara sanguínea possui dois orifícios dotados de válvulas de tecido biológico para a entrada e saída de sangue. A câmara pneumática é conectada a um gerador de pulsos de pressão positiva. O fluido foi semeado com esferas de poliestireno (10 \"mu\" de diâmetro). Foram determinadas as distribuições de velocidades instantâneas nas freqüências de batimento de 80, 100 e 120 bpm em três campos (65 mm x 65mm) da câmara paralelos à membrana e um campo situado no canal de entrada do DAVP, usando correlação cruzada com base na transformada rápida de Fourier. Um gerador de pulsos foi utilizado para sincronizar a detecção das imagens pelo sistema VIP com as fases de interesse no ciclo de bombeamento. Na freqüência de batimentos de 80 bpm as velocidades máximas foram de 1,94 m/s no canal de entrada durante o período de enchimento e 1,66 m/s nas regiões próximas à membrana durante o período de ejeção. Em 100 bpm, as velocidades máximas foram de 1,68 m/s no canal de entrada e 1,15 m/s nas regiões próximas a membrana. As distribuições de velocidades instantâneas mostram a ocorrência de pequenos vórtices, principalmente durante a fase de enchimento. Estes vórtices apresentam grande variabilidade ciclo-a-ciclo produzindo turbulências no fluxo e tensões de Reynolds elevadas. No ciclo a 80 bpm, ) parte da energia cinética turbulenta é dissipada devido à desaceleração do fluxo na câmara sanguínea antes do inicio da fase de ejeção. Isto ocorre para as freqüências de 100 e 120 bpm. A máxima tensão de Reynolds foi observada no canal de entrada do DAVP no valor de 222 N/m2 durante o enchimento, persistindo por 25 ms. No plano da membrana a maior tensão encontrada foi igual a 250 N/m2 durante o enchimento, persistindo por 25 ms. O campo de velocidades media contém vórtices permanentes durante a fase de enchimento que influenciam significativamente o fluxo na câmara e cujo numero aumenta com a freqüência de batimentos, provocando aumento de turbulências. Estes resultados indicam que existe maior possibilidade de ocorrer o processo de hemólise durante o enchimento do que durante a ejeção. Vetores com baixas velocidades foram observados na região compreendida entre os canais de entrada e saída do fluxo na câmara sanguínea no período de ejeção, sugerindo a possibilidade de ocorrer à formação de trombos nesta. / --