Made available in DSpace on 2015-04-09T12:28:30Z (GMT). No. of bitstreams: 0 Previous issue date: 2014-01-20Bitstream added on 2015-04-09T12:47:17Z : No. of bitstreams: 1 000812898_20151231.pdf: 92770 bytes, checksum: 0df57f7179ed95ec8efbafd81fe6d5d8 (MD5) Bitstreams deleted on 2016-01-04T10:26:42Z: 000812898_20151231.pdf,. Added 1 bitstream(s) on 2016-01-04T10:28:33Z : No. of bitstreams: 1 000812898.pdf: 1511298 bytes, checksum: 9d02e9cf06fbfd1a1e72871704b47797 (MD5) / Este trabalho investiga as estratégias narrativas utilizadas por Jonathan Safran Foer no romance Extremely Loud & Incredibly Close (2005), a fim de verificar como o autor avalia o episódio dos ataques terroristas de 11 de setembro. A tragédia representa o início de um novo período da História dos Estados Unidos e tem sido tema de publicações em diversas áreas. Este estudo examina, por meio da jornada empreendida pelo menino Oskar, de apenas nove anos, cujo pai foi vítima dos atentados, a forma como os acontecimentos do passado são transformados em fatos históricos relevantes, os sistemas que permitem a abordagem da História por meio de várias perspectivas, e a presença do trauma como elemento de ligação entre História e Literatura. Focalizando primordialmente o narrador, o pequeno Oskar, a análise perseguirá sua jornada em Nova York à procura de respostas para a morte de seu pai naquele dia catastrófico, tratado por Oskar como the worst day. Serão também analisados os usos de imagens, espaços em branco, as escritas com sobreposição e o diálogo com a tecnologia e mensagens codificadas, como SMS, que estão presentes no romance. A fundamentação teórica desta discussão será baseada em textos de McHale (1992), Lyotard (1990), Jameson (2007), Santiago (2002), Connor (2000), White (1994), Le Goff (2003), e Hutcheon (1991) / This thesis investigates the narrative strategies used by Jonathan Safran Foer in Extremely Loud & Incredibly Close (2005) in order to verify how the author evaluates the episode of the terrorist attacks of 9/11. The tragedy is the beginning of a new period in the history of the United States and has been the subject of publications in several fields. This study examines, through the journey taken by the nine-year-old boy Oskar, whose father was a victim of the 9/11 attacks, how the events of the past are transformed into relevant historical facts, systems that allow the treatment of History through multiple perspectives, and the presence of trauma as a conection between History and Literature. Primarily focusing on the narrator, little Oskar, the analysis will pursue his journey in New York looking for answers to the death of his father on that catastrophic day, treated by Oskar as “the worst day”. The use of images, blanks, written with overlapping and dialogue with technology and coded messages such as SMS, which are present in the novel, will also be analyzed. The theoretical basis of this discussion includes texts by McHale (1992), Lyotard (1990), Jameson (2007), Santiago (2002), Connor (2000), White (1994), Le Goff (2003) and Hutcheon (1991)

Abstract The preverbal vocalisation up to the first word, feeding skills as well as motor development until the first steps of ELBW preterm infants without disability were compared in this descriptive study to those of healthy full-term infants. In addition, preverbal and feeding skills were studied in relation to gross motor movement patterns. The preverbal development of preterm infants proceeded according to the same temporal schedule as that of full-term infants, however, preterm infants failed to produce several vocalisation skills that full-term infants presented. The preterm infants increased their vocalisation slower than the full-term infants in the beginning of each of the developmental stages. The difference between the preterm and the full-term infants grew when approaching syllables, syllable combinations, and words. The preterm infants reached the first word approximately two months later than the full-term infants. The suckling of preterm infants was either disorganised or dysfunctional, while normal or disorganised in the case of full-term infants. The preterm infants reached the spoon-feeding skills approximately at the same (corrected) ages as the full-term infants, but the transitions to new stages were difficult. Half of the preterm infants suffered from feeding problems while only two of the full-term infants had feeding problems. Both the preterm and full-term infants reached vocalisation and feeding skills in relation to gross motor movement patterns earlier than assumed according to the predominant clinical knowledge. The vocalisation and feeding skills did not seem to be dependent upon the gross motor development. / Tiivistelmä Tässä kuvailevassa tutkimuksessa tarkasteltiin tiiviissä seurannassa erittäin ennenaikaisina ja pienipainoisina syntyneiden lasten esileksikaalista ääntelyä ensisanaan asti sekä syömistaitojen ja motoriikan kehitystä ensiaskeliin asti. Tuloksia verrattiin terveiden, täysiaikaisina syntyneiden lasten vastaaviin taitoihin. Lisäksi ääntelyn ja syömisen kehitystä tarkasteltiin suhteessa karkeamotoristen taitojen kehitysaikatauluun. Ennenaikaisesti syntyneiden lasten ääntely kehittyi saman aikataulun mukaan kuin täysiaikaisten lasten ääntely. Ennenaikaisesti syntyneet lapset jättivät kuitenkin väliin taitoja, jotka täysiaikaisina syntyneet lapset saavuttivat. Siirryttäessä uusille ääntelyn ja kielen kehitystasoille ennenaikaisina syntyneiden lasten ääntelyn määrä lisääntyi hitaammin kuin täysiaikaisina syntyneiden lasten ääntelyn määrä. Ero ennenaikaisina ja täysiaikaisina syntyneiden lasten kehityksessä kasvoi lähestyttäessä tavuja, tavuyhdistelmiä ja sanoja. Ennenaikaisesti syntyneet lapset saavuttivat ensisanavaiheen kaksi kuukautta täysiaikaisia lapsia myöhemmin. Ennenaikaisina syntyneiden lasten syömisen taidoissa havaittiin, että varhainen imeminen oli joko jäsentymätöntä tai poikkeavaa, kun täysiaikaisina syntyneillä se oli puolestaan normaalia tai jäsentymätöntä. Ennenaikaisina syntyneet lapset oppivat käsittelemään soseita ja kiinteitä ruokia samassa (korjatussa) iässä kuin täysiaikaisina syntyneet lapset, mutta siirtyminen kehitysvaiheesta toiseen tuotti vaikeutta. Puolet ennenaikaisista lapsista kärsi syömisvaikeuksista. Sen sijaan täysiaikaisina syntyneistä lapsista kahdella todettiin syömisen vaikeutta. Sekä ennenaikaisina että täysiaikaisina syntyneet lapset oppivat ääntelyn ja syömisen taitoja ennen tiettyjä karkeamotorisia liikemalleja, joiden on vallitsevan kuntoutuskäsityksen mukaisesti oletettu edeltävän näiden taitojen saavuttamista. Ääntelyn ja syömisen taidot eivät siis näyttäneet olevan riippuvaisia karkeamotoriikan kehityksestä.

All future Extremely Large Telescopes (ELTs) will be segmented. However, as their size grows, they become increasingly sensitive to external disturbances, such as gravity, wind and temperature gradients and to internal vibration sources. Maintaining their optical quality will rely more and more on active control means. This thesis studies active optics of segmented primary mirrors, which aims at stabilizing the shape and ensuring the continuity of the surface formed by the segments in the face of external disturbances.<p><p>The modelling and the control strategy for active optics of segmented mirrors are examined. The model has a moderate size due to the separation of the quasi-static behavior of the mirror (primary response) from the dynamic response (secondary, or residual response). The control strategy considers explicitly the primary response of the telescope through a singular value controller. The control-structure interaction is addressed with the general robustness theory of multivariable feedback systems, where the secondary response is considered as uncertainty.<p><p>Scaling laws allowing the extrapolation of the results obtained with existing 10m telescopes to future ELTs and even future larger telescopes are addressed and the most relevant parameters are highlighted. The study is illustrated with a set of examples of increasing sizes, up to 200 segments. This numerical study confirms that scaling laws, originally developed with simple analytical models, can be used in confidence in the preliminary design of large segmented telescopes. / Doctorat en Sciences de l'ingénieur / info:eu-repo/semantics/nonPublished

This thesis is focused on fatigue behaviour of aluminium alloy 2024-T351 in low cycle and extremely low cycle fatigue regime. Test specimens were firstly subjected to quasi-static tensile and compression tests to establish basic mechanical properties of the experimental material. Fatigue tests were conducted in strain-control mode, when cyclic plastic response and S-N curves were determined. All of the experiments were conducted at room temperature. Shapes of mechanical hysteresis loops are dependent on the strain amplitude and clearly exhibit cyclic plasticity of the alloy. Cyclic deformation curve was fitted by power regression function and subsequently compared with the tensile test. Experimental data of the S-N curves were fitted by Manson-Coffin and Wöhler-Basquin law. The discrepancy of the fatigue data was observed in the extremely low cycle fatigue regime. Based on this phenomenon, new regression function was used to overcome shortening of fatigue life in the extremely low cycle regime.

Abstrakt Bakgrund: Sverige är idag världsledande gällande överlevnaden hos extremt underburna barn. Den högspecialiserade vården i Sverige är centraliserad till regionsjukhus vilket leder till att flertalet av dessa barn behöver transporteras från hemsjukhus till regionsjukhus för fortsatt vård. Motiv: Föräldrars känslor i samband med att deras barn behöver neonatal intensivvård är väl studerat i tidigare forskning både internationellt och nationellt. Då det finns begränsat med kunskap angående dessa föräldrars behov av stöd i samband med flytt av deras extremt underburna barn till annat sjukhus finns det möjligheter till förbättring inom området. Syfte: Syftet med studien var att belysa vilket stöd föräldrar till extremt underburna barn önskade när deras barn behövde flyttas till en annan neonatalavdelning på ett annat sjukhus.Metod: Studien genomfördes som en kvalitativ enkätstudie med öppna frågor med empirisk design. Enkäterna analyserades via en kvalitativ innehållsanalys med induktiv ansats av Elo &amp; Kyngnäs. Föräldrarna (n=63) rekryterades via ett strategiskt urval från hela Sverige. Resultat: Resultatet delas in i två huvudkategorier; ”Föräldrars behov av förberedelser inför flytt till annat sjukhus” samt ”Föräldrars behov av emotionellt och personligt stöd”. Resultatet visar att det finns ett stort behov av stöd hos föräldrarna för att minimera de negativa upplevelser som kan uppstå då deras extremt underburna barn behöver flyttas till en annan neonatalavdelning. Föräldrarna beskriver att de önskar få information om avdelningen de flyttar till avseende rutiner och faciliteter samt när flytt förväntas ske och att denna information idag är bristfällig. Föräldrarna beskriver även att deras känslor och upplevelser behöver bli bekräftade av personalen och att behovet av en kontaktperson är stort. Konklusion: Resultatet belyser vilket stöd föräldrar efterfrågar i samband med flytt av sitt extremt underburna barn vilket skapar möjligheter för en framtida utveckling av neonatalvården. Implementering av stödjande vårdrutiner samt förbättrat samarbete mellan sjukhusen skulle öka möjligheterna för en förbättrad föräldraupplevelse och därmed minskad psykisk ohälsa. / AbstractBackground: Sweden is world-leading when it comes to survival rates among extremely preterm infants. Highly specialized care units are centralized to regional hospitals, resulting in that many extremely preterm infants need to be moved from their home hospital to a regional hospital for additional care. Motive: Parents' emotions when their extremely preterm infant requires neonatal intensive care is a well-studied area in both national and international studies. The authors therefore believe that there is a reason for further research regarding parents’ need for support in connection to the relocation of their extremely preterm infant to another hospital. Since there is limited research regarding the needs of these parents, there are opportunities for improvement in the area.Aim: The purpose of this study was to illustrate what support parents of extremely preterm infants need when their infant needs to be moved to another neonatal unit at another hospital. Methods: The study was conducted as a qualitative questionnaire study with open questions with empirical design. The questionnaires were analysed using a qualitative content analysis with an inductive approach by Elo &amp; Kyngnäs. The parents (n=63) were recruited via a strategic selection from all over Sweden.Result: The result is divided into two main categories; “Parents’ need for preparation when moving to another hospital” and “Parents’ need for emotional and personal support”. The result shows that there is a great need for support among parents to minimize the negative experiences that can occur when their extremely preterm infant needs to be moved to another neonatal unit. The parents describe that they wish to receive more information about routines and facilities at the unit they are moving to, and then the move is expected to take place. The parents also describe that their feelings and experiences could be further confirmed by the staff and that they have a need for establishing a relation with a contact person. Conclusion: The result highlights what support parents request in relation to transportation of their extremely preterm infant, creating opportunities for further improvements in neonatal care. Implementation of supportive care routines and improved collaboration between hospitals could increase the opportunities for an improved parental experience and by that reduced mental illness.

Al Qaeda killings, posttraumatic stress, and the Gothic together triangulate a sizable space in recent American fiction that is still largely uncharted by critics. This thesis maps that shared territory in four novels written between 2005 and 2007 by writers who were born in America, and whose protagonists are the survivors in New York City after the World Trade Center falls. Published in the city of their tragedy and reviewed in its media, the novels surveyed here include Don DeLillo’s _Falling Man_ (2007), Jonathan Safran Foer’s _Extremely Loud and Incredibly Close_ (2005), Lynne Sharon Schwartz’s _The Writing on the Wall_ (2005), and Jess Walter’s _The Zero_ (2006). The thesis issues a challenge to the large number of negative and dismissive reviews of the novels under consideration, making a case that under different criteria, shaped by trauma theory and psychoanalysis, the novels succeed after all in making readers feel what it was to be alive in September 2001, enduring the posttraumatic stress for months and years later. The thesis asserts that 9/11 fiction is too commonly presented in popular journals and scholarly studies as an undifferentiated mass. In the same critical piece a journalist or an academic may evaluate narratives in which unfold a terrorist's point of view, a surviving or a dying New York City victim's perspective, and an outsider's reaction set thousands of miles away from Ground Zero. What this thesis argues for is a separation in study of the fictive strands that meditate on the burning towers, treating the New York City survivor story as a discrete body. Despite their being set in one of the most known cities of the Western world, and the terrorist attack that they depict being the most- watched catastrophe ever experienced in real-time before, these fictions have not yet been critically ordered. Charting the salient reappearing conflicts, unsettling descriptions, protagonist decay, and potent techniques for registering horror that resurface in this New York City 9/11 fiction, this thesis proposes and demonstrates how the peculiar and affecting Gothic tensions in the works can be further understood by trauma theory, a term coined by Cathy Caruth in Unclaimed Experience (1996: 72). Though the thesis concentrates on developments in trauma theory from the mid 1990s to 2015, it also addresses its theoretical antecedents: from the earliest voices in the late nineteenth and early twentieth centuries that linked mental illness to a trauma (Charcot, Janet, Breuer, Freud), to researchers from mid-twentieth century (Adler, Lindemann) who studied how catastrophe affects civilian minds not previously trained to either fight war or withstand cataclysm. Always keeping at the fore the ancient Greek double-meaning of trauma as both unhealing “wound” and “defeat,” the thesis surveys tenets of the trauma theorists from the very first of those who studied the effects on civilian survivors of disaster (of what is still the largest nightclub fire in U.S. history, which replaced front page coverage of World War II for a few days: the Cocoanut Grove blaze in Boston, 1942) up to those theorists writing in 2015. The concepts evolving behind trauma theory, this thesis demonstrates, provide a useful mechanism to discuss the surprising yearnings hiding behind the appearance of doppelgängers, possession ghosts, terrorists as monsters, empty coffins, and visitants that appear to feed on characters’ sorrow, guilt, and loneliness within the novels under discussion. This thesis reappraises the dominant idea in trauma studies of the mid-1990s, namely that trauma victims often cannot fully remember and articulate their physical and psychic wounds. The argument here is that, true to the theories of the Caruthian school, the victims in these novels may not remember and express their trauma completely and in a linear fashion. However, the victims figured in these novels do relate the horrors of their memory to a degree by letting their narration erupt with the unexpectedly Gothic images, tropes, visions, language, and typical contradictions, aporias, lacunae, and paradoxes. The Gothic, one might say, becomes the language in which trauma speaks and articulates itself, albeit not always in the most cogent of signs. One might easily dismiss these fleeting Gothic presences that characters conjure in the fictions under consideration as anomalous apparitions signalling nothing. However, this thesis interrogates these ghostly traces of Gothicism to find what secrets they hold. Working from the insights of psychoanalysis and its post-Freudian re-inventers and challengers, it aims to puzzle out the dimensions of characters’ mourning in its “traumagothic” reading of the texts. Characters’ use of the Gothic becomes their way of remembering, a coded language to the curious. This thesis holds that unexpressed grief and guilt are the large constant in this grouping of novels. Characters’ grief articulation and guilt release, or the desire for symbolic amnesia, take paths that the figures often were suspicious of before 9/11: a return to organized religion, a belief in spirits, a call for vengeance, psychotherapy, substance abuse, splitting with a partner, rampant sex with nearby strangers, torture of suspects, and killing. All the earnest attempts through the above means by the characters to express grief, vent rage, and alleviate survivor guilt do so without noticeable success. True closure towards their trauma is largely a myth. No reliable evidence surfaces from the close reading of the texts that those affected by trauma ever fully recover. However, as this thesis demonstrates, other forms of recompense come from these searches for elusive peace and the nostalgic longing for the America that has been lost to them.

Dans cette thèse, nous présentons la conception, le développement et le test de trois systèmes de reconnaissance automatique de cibles (ATR) visant à reconnaître des avions non-coopératifs, c’est-à-dire des avions ne fournissant par leur identité, en utilisant des signaux de radars passifs bistatiques. Les radars passifs bistatiques utilisent un ou plusieurs émetteurs d’opportunité (déjà présents sur le terrain), avec des fréquences allant jusqu’à 1 GHz pour les émetteurs considérés ici, et un ou plusieurs récepteurs déployés par le gestionnaire du système et non-colocalisés avec les émetteurs. Les seules informations utilisées sont les signaux réfléchis sur les avions et les signaux directement reçus qui sont tous les deux collectés par le récepteur, quelques informations concernant l’émetteur, et la configuration géométrique du radar bistatique.Les trois systèmes ATR que nous avons construits utilisent respectivement les images radar, les surfaces équivalentes radar (SER) complexes bistatiques et les SER réelles bistatiques. Nous utilisons des données acquises soit sur des modèles d’avions placés en chambre anéchoique à l’ONERA, soit sur des avions réels en utilisant un banc d’essai bistatique consistant en un émetteur VOR et un récepteur basé sur la radio-logicielle (SDR), et que nous avons déployé aux alentours de l’aéroport d’Orly. Nous décrivons d’abord la phénoménologie radar pertinente pour notre problème ainsi que les fondements mathématiques pour la dérivation de la SER bistatique d’un objet, et pour la construction d’images radar d’un objet.Nous utilisons deux méthodes pour la classification de cibles en classes prédéfinies : les arbres extrêmement aléatoires (extra-trees) et les méthodes de sous-espaces. Une caractéristique-clé de notre approche est que nous divisons le problème de reconnaissance global en un ensemble de sous-problèmes par décomposition de l’espace des paramètres (fréquence, polarisation, angle d’aspect et angle bistatique) en régions. Nous construisons un classificateur par région.Nous validons en premier lieu la méthode des extra-trees sur la base de données MSTAR, composée d’images radar de véhicules terrestres. Ensuite, nous testons cette méthode sur des images radar d’avions que nous avons construites à partir des données acquises en chambre anéchoique. Nous obtenons un pourcentage de classification allant jusqu’à 99%. Nous testons ensuite la méthode de sous-espaces sur les SER bistatiques (complexes et réelles) des avions que nous avons extraits des données de chambre anéchoique. Nous obtenons un pourcentage de classification allant jusqu’à 98%, avec des variations suivant la fréquence, la polarisation, l’angle d’aspect, l’angle bistatique et le nombre de paires émetteur-récepteur utilisées. Nous testons enfin la méthode de sous-espaces sur les SER bistatiques (réelles) extraites des signaux acquis par le banc d’essai déployé à Orly. Nous obtenons une probabilité de classification de 82%, avec des variations suivant l’angle d’aspect et l’angle bistatique. On a donc démontré dans cette thèse que l’on peut reconnaitre des cibles aériennes à partir de leur SER acquise en utilisant des signaux de radars passifs bistatiques. / We present the design, development, and test of three novel, distinct automatic target recognition (ATR) systems for the recognition of airplanes and, more specifically, non-cooperative airplanes, i.e. airplanes that do not provide information when interrogated, in the framework of passive bistatic radar systems. Passive bistatic radar systems use one or more illuminators of opportunity (already present in the field), with frequencies up to 1 GHz for the transmitter part of the systems considered here, and one or more receivers, deployed by the persons managing the system, and not co-located with the transmitters. The sole source of information are the signal scattered on the airplane and the direct-path signal that are collected by the receiver, some basic knowledge about the transmitter, and the geometrical bistatic radar configuration. The three distinct ATR systems that we built respectively use the radar images, the bistatic complex radar cross-section (BS-RCS), and the bistatic radar cross-section (BS-RCS) of the targets. We use data acquired either on scale models of airplanes placed in an anechoic, electromagnetic chamber or on real-size airplanes using a bistatic testbed consisting of a VOR transmitter and a software-defined radio (SDR) receiver, located near Orly airport, France. We describe the radar phenomenology pertinent for the problem at hand, as well as the mathematical underpinnings of the derivation of the bistatic RCS values and of the construction of the radar images.For the classification of the observed targets into pre-defined classes, we use either extremely randomized trees or subspace methods. A key feature of our approach is that we break the recognition problem into a set of sub-problems by decomposing the parameter space, which consists of the frequency, the polarization, the aspect angle, and the bistatic angle, into regions. We build one recognizer for each region. We first validate the extra-trees method on the radar images of the MSTAR dataset, featuring ground vehicles. We then test the method on the images of the airplanes constructed from data acquired in the anechoic chamber, achieving a probability of correct recognition up to 0.99.We test the subspace methods on the BS-CRCS and on the BS-RCS of the airplanes extracted from the data acquired in the anechoic chamber, achieving a probability of correct recognition up to 0.98, with variations according to the frequency band, the polarization, the sector of aspect angle, the sector of bistatic angle, and the number of (Tx,Rx) pairs used. The ATR system deployed in the field gives a probability of correct recognition of $0.82$, with variations according to the sector of aspect angle and the sector of bistatic angle.

This thesis fills in the gaps in the existing theory of wave phenomena in thick diffraction gratings at extreme angles of scattering, i.e. when the scattered wave propagates parallel or almost parallel to the grating boundaries. A consistent theory of a new type of Bragg scattering of bulk and guided optical modes in thick uniform and non-uniform, dissipative and non-dissipative, slanted periodic gratings has been developed. This type of scattering is called extremely asymmetrical scattering (EAS). One of the main distinctive features of EAS is the strong resonant increase of the scattered wave amplitude compared to the amplitude of the incident wave. Several unique combinations of strong resonances shaping a complex multi-resonant pattern of EAS in different types of gratings have been predicted and investigated theoretically and numerically. This includes the prediction of a new resonant wave effect in non-uniform gratings with varying phase – double-resonant EAS, the discovery of several sharp and strong resonances with respect to scattering angle in gratings with the scattered wave propagating almost parallel to the grating boundaries (grazing-angle scattering (GAS)) for the case of second-order scattering, and the prediction of a new type of eigenmode in gratings with second-order scattering (especially in gratings with large amplitude). In addition, several other important practical problems that may be crucial for the experimental observation and application of EAS and GAS have been solved. These are the determination of the tolerance of EAS to small grating imperfections, e.g., fluctuations of the grating amplitude, prediction of unusually high sensitivity of second-order EAS to small variations of mean structural parameters, determination of the effect of weak dissipation on EAS, etc. Physical reasons for the predicted resonances and effects are explained. In particular, the crucial role of the diffractional divergence for EAS and GAS has been revealed, especially for non-uniform gratings. Methods of analysis involve the approximate and rigorous approaches. The approximate method is based on understanding the role of the diffractional divergence in the geometry of EAS and the two-wave approximation (valid for any types of waves). The rigorous approach is based on the rigorous coupled-wave analysis (RCWA) and, in particular, the known enhanced T-matrix algorithm (by Moharam, et al.) that is numerically stable for narrow and wide gratings with arbitrary amplitude (valid only for bulk electromagnetic waves).

Submitted by isabela.moljf@hotmail.com (isabela.moljf@hotmail.com) on 2017-05-19T11:00:27Z No. of bitstreams: 1 mariadaconsolacaomagalhaes.pdf: 3358023 bytes, checksum: 11bd3472d372f91b765a67807ee928ff (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2017-05-19T14:32:48Z (GMT) No. of bitstreams: 1 mariadaconsolacaomagalhaes.pdf: 3358023 bytes, checksum: 11bd3472d372f91b765a67807ee928ff (MD5) / Made available in DSpace on 2017-05-19T14:32:48Z (GMT). No. of bitstreams: 1 mariadaconsolacaomagalhaes.pdf: 3358023 bytes, checksum: 11bd3472d372f91b765a67807ee928ff (MD5) Previous issue date: 2011-08-26 / É considerado um caso de morbidade materna extremante grave (MMEG) ou near miss uma mulher que quase foi a óbito, mas sobreviveu a complicação que ocorreu durante a gravidez, parto ou até 42 dias do término da gestação. Os critérios para identificação de casos de MMEG têm sido discutidos por diversos autores que levam em consideração as condições clínicas, laboratoriais e/ou manejo dos casos. Os sistemas de informação em saúde disponíveis atualmente no Brasil, tais como o SIH-SUS (Sistema de Informações Hospitalares do SUS), Sistema de informação sobre Nascidos vivos (SINASC) e Sistema de Informação sobre Mortalidade (SIM) contam com grande número de dados que poderiam contribuir para estudos da morbidade materna. Este trabalho tem como objetivos analisar a situação da morbimortalidade materna e infantil a partir dos Sistemas de Informações em Saúde; adequar os critérios de MMEG; identificar e analisar os casos de MMEG na base de dados do SIH-SUS visando subsidiar o planejamento das ações de saúde materna. Entre as 8620 mulheres residentes em Juiz de Fora, MG, no período de 2006 e 2007, internadas com causas codificadas dentro do Capítulo XV da CID-10 ou que receberam procedimentos obstétricos, 326 apresentaram alguma condição clínica e/ou procedimento selecionado como MMEG e uma foi a óbito. A taxa de mortalidade materna foi 12,0 por 100.000 mulheres. A letalidade 3,1 por mil mulheres e a prevalência de MMEG, 39,0 por 1000 mulheres. A média de tempo de internação foi de 3,5 e 10,5 dias para as mulheres sem e com morbidade, respectivamente. O tempo de internação maior que quatro dias foi 13 vezes mais alto entre as mulheres que apresentaram MMEG. A razão de prevalência para permanência do recém-nascido após alta da mãe, ter filhos nascidos mortos e óbito da criança antes da alta da mãe foi mais elevada entre as mulheres com MMEG, respectivamente 2,52, 4,86 e 4,41. As variáveis tempo de internação, número de internações e filhos nascidos mortos mostraram-se como fatores preditores para a MMEG na análise de regressão logística (p < 0,001). Entre os procedimentos/condições selecionados os mais frequentes foram a transfusão de hemoderivados, “permanência a maior” e pré-eclampsia grave/eclampsia, com prevalências de morbidades específicas de 15,7/1000, 9,5/1000 e 8,2/1000, respectivamente. A razão de prevalência de MMEG encontrada e as prevalências específicas de transfusão de hemoderivados e pré-eclampsia grave/eclampsia são achados consistentes com a literatura existente e demonstram que o uso de associação de algumas tabelas do SIH-SUS tem grande potencial para identificação dos casos de MMEG. O critério utilizado para identificação dos casos é factível e pode contribuir para a vigilância da morbimortalidade materna e para ampliar o conhecimento sobre os aspectos que a envolve, contribuindo assim para a melhoria na qualidade da assistência à mulher no período gravídico-puerperal. / An extremely severe maternal morbidity (ESMM) case, or near miss, is one in which the woman almost died due to gestation/delivery-related problems, or any problem occurring up to 42 days after the end of gestation, but survived because of the care received or sheer chance. The criteria for identification of ESMM cases have been discussed by several authors, who take into account clinical and laboratory features and/or case management. Health information systems available in Brazil, such as the Hospital Information System (Sistema de Informações Hospitalares – SIH-SUS), Live-birth Information System (Sistema de Informações sobre Nascidos Vivos – SINASC) and Mortality Information System (Sistema de Informações sobre Mortalidade – SIM) comprise a large number of data, which could contribute to studies on maternal morbidity. This study aimed to: assess maternal and childhood morbimortality from the SIH-SUS, adequate the ESMM criteria, and identify and analyze the ESMM cases within the SIH-SUS database, with a focus on the planning of maternal health interventions. Of the 8620 women living in Juiz de Fora, MG, Brazil, admitted to hospital with a diagnosis belonging to chapter XV of the ICD-10, or who underwent an obstetric procedure, in the period 2006-2007, 326 had a clinical condition and/or procedure selected as ESMM, with 1 death. Maternal mortality rate was 12.0/100,000 women. Case-fatality rate was 3.1/1,000 women, and ESMM rate was 39.0/1,000 women. Mean hospital stay length ranged from 10.5 to 3.5 days, for women with and without ESMM, respectively. Hospital stay length over 4 days was 13 more likely for ESMM women. Prevalence ratios of newborn hospital stay after the mother`s discharge, stillbirth, and child`s death before the mother`s discharge were higher for ESMM women, being 2.52, 4.86, and 4.41, respectively. The variables hospital stay length, number of admissions, and number of stillbirths were predictors of ESMM on logistic regression analysis (p < 0.001). Of the selected procedures/conditions, the most frequent ones were blood derivatives transfusion, longer hospital stay, and severe pre-eclampsia/eclampsia, with specific morbidity prevalence rates of 15.7/1,000, 9.5/1,000 and 8.2/1,000, respectively. The ESMM prevalence ratio found and the specific prevalence rates of blood derivatives transfusion and severe pre-eclampsia/eclampsia are consistent with literature data, and show that the association use of the SIH-SS tables has significant potential to identify ESMM cases. The criterion used for case identification is feasible and may contribute to maternal morbimortality surveillance, increasing our knowledge about its associated features and contributing to better prenatal/puerperal care.

The diploma thesis deals with an analysis of internal forces of B4 reinforced construction of an office building. Analysis takes into account interaction with subsoil and when designing structural parts of the building, different requirements for fire resistance of a structure are taken into account. A Dlubal RFEM 5.17 program was used for finite element analysis, and model functionality verification was performer by using a summation of moments method. The thesis deals with the design and assessment of a point-supported slab, column, inner and external walls.