Background: Jet injectors are advantageous over needle injectors by eliminating sharps hazards. The Government Accountability Office estimates 29% preventable sharp injuries with an estimated direct cost of more than $500 million out of the CDC's reported incidence of 385,000 needle stick injuries per year among US hospital healthcare workers. Yet the forces required to set and trigger devices using spring mechanisms for medication delivery have not been explored. This laboratory experiment measured forces exerted by healthcare workers (HCWs) using a particular jet injector approved by FDA in 2011. Objectives: In order to quantify the ergonomic impact on HCWs using a needle-free injector, the first objective was to evaluate the dynamic forces required to activate the trigger injector button and the reset station for the injector, with their respective means, for each of the parameters studied. The second objective was to compare these forces to those required to use four previously analyzed retractable intramuscular syringes with needles. Finally, the third objective was to assess potential psychophysics ergonomic impact on HCWs with use of these devices to formulate future design changes and recommendations for manufacturers and HCWs, respectively. Methods: This laboratory experiment was conducted through a multi-disciplinary team approach. It included a total of 136 trials (10 validation trials, 116 experimental trials and 10 padded trials for soft tissue simulation), which were conducted using the PharmaJetTM Injector. A force gauge and a load cell were integrated into the triggering setup and reset station, correspondingly, enabling force measurements to be obtained directly from the human-machine interfaces. These force data allowed for observations of force profiles in time by the healthcare worker as researcher while preparing for and administering injections. Data collection used three software applications for force conversions and data manipulation. Data were analyzed using descriptive statistics and analytical results by using ANOVA for the trigger injector & reset station with multiple comparison tests for parametric and non-parametric distributions, respectively. Results: The descriptive results indicated an average force for triggering the injector in the 116 trials was 15.92 lbs. (70.8 N) with a range of 9.77-26.46 lbs. (43.46-117.69 N). The measured forces for the reset station ranged from 5.35-82.78 lbs. (5.35-368.22 N) with an average of 25.32 lbs. (112.62 N) (SD 12.36). Spurious findings presented with tensile forces to fill the syringes resulting in hand strain in the first metacarpal joint after repetitive pinprick motion. The analytical results showed an ANOVA for trigger injector with a parametric-normal distribution with an F (2,133) Ratio 10.0472, p- value (F) 0.0001<0.05, showing statistical significance and with a Tukey's comparison test showing a significant difference in between the means of the padded trials vs. the validation & experimental trial groups. The ANOVA for the reset station showed a Kruskal Wallis H-statistic of 0.2568, p-value (H) 0.8795>0.05 presenting NO statistical significance with a Dunn's comparison test confirming NO difference in between the medians or mean ranks of all three groups. Conclusions: Triggering the injector and resetting the station required considerable effort in comparison to activating 4 retractable intramuscular syringes with needles from our previous studies, the range of mean forces were 3.63-17 lbs (16.19-77.53 N) for those syringes with the trigger injector maximum voluntary force of 71 N being above the recommend 56.6 N.The jet injector required more force per effort than 2 (4.4x) syringes & similar to other 2 syringes (0.9x) previously tested when considering the compression forces related with the trigger injector. Additional vector forces (displacement & gripping of reset station) could increase the cumulative effort affecting different musculoskeletal components when the whole components of the procedure are taken into account. Suggestions for the manufacturer regarding design changes to facilitate HCWs' use of this device are warranted, since some of the summation forces during the 12 mini-steps could be avoided to achieve a higher efficiency. This information may be useful for health care facilities when choosing devices to protect their workers from ergonomic injuries.

The Master’s thesis deals with development of universal equipment for testing and measurement operating forces of car seats. It describes tests applied on car seats and shows a few examples of equipment for testing. The design part of the thesis deals with development of multipurpose testing equipment using of Modular Function Deployment™ approach. The design of the equipment is done in 5 steps according to mentioned approach. The final part of the thesis includes a risk analysis of the new device and conclusion.

O objetivo principal do estudo é comparar o teste em 3 pontos com braquetes com o teste de resistência ao deslizamento utilizando um novo dispositivo que realiza a mensuração simultânea do coeficiente de atrito, das forças e dos momentos nos braquetes de ancoragem e da força de desativação no braquete desalinhado, exercidos por fios ortodônticos. Os objetivos secundários foram desenvolver o dispositivo e comparar, no teste em 3 pontos: (i) a influência, nas grandezas e no coeficiente de atrito cinético, da variação da simetria nas distâncias inter-braquetes, do tipo de braquete de ancoragem (canino ou 2º pré-molar), do deslocamento (3 ou 5mm) do braquete central, do sentido do desalinhamento (vestibular ou lingual) do braquete central e da marca de fio-braquete; (ii) as 3 formas de cálculo do coeficiente de atrito cinético; (iii) os 10 ciclos, para vestibular ou lingual, para verificar se eles são semelhantes ou não entre si. Foram utilizados braquetes autoligáveis (dentes 13, 14 e 15) e fios 0.014\'\' NiTi e CuNiTi das marcas Aditek e Ormco. O teste de resistência ao deslizamento foi realizado no desalinhamento lingual, nos dois deslocamentos e na configuração simétrica. O teste em 3 pontos com braquetes foi realizado no desalinhamento lingual e vestibular, nos dois deslocamentos e na configuração simétrica e assimétrica. Por meio da ANOVA, foram comparados, entre os dois tipos de teste: (A) as grandezas e o coeficiente de atrito e (B) o coeficiente de atrito gerado apenas no braquete de 2º pré-molar. Utilizando-se do mesmo teste estatístico foram comparados, no teste em 3 pontos com braquetes: (A) na configuração simétrica, algumas grandezas e o coeficiente de atrito advindos da variação da marca de fio-braquete, do deslocamento, do desalinhamento e do tipo de braquete; (B) algumas grandezas e o coeficiente de atrito gerados na configuração simétrica e assimétrica; (C) os valores das 3 formas de cálculo do coeficiente de atrito na configuração simétrica; e (D) algumas grandezas e o coeficiente de atrito encontrados nos 10 ciclos. Resultados: (A) a maioria dos valores das grandezas e do coeficiente de atrito gerados pelos dois tipos de teste foram diferentes estatisticamente; (B) o braquete de 2º pré-molar apresentou valores de coeficiente de atrito diferentes entre os dois tipos de teste; (C) na configuração simétrica, as variáveis foram estatisticamente significantes na maioria dos casos para as grandezas analisadas e para o coeficiente de atrito; (D) houve diferença entre a configuração simétrica e assimétrica; (E) o coeficiente de atrito baseado nas duas normais e na força de atrito se aproximou mais da realidade clínica e foi sensível à variação da geometria da relação fio-braquete; e (F) os 10 ciclos para lingual foram semelhantes entre si em 70% dos casos e os 10 ciclos para vestibular foram diferentes em 57% dos casos. Conclusões: o teste em 3 pontos com braquetes é diferente do teste de resistência ao deslizamento; a variação das configurações geométricas e da marca de fio-braquete pode influenciar nos valores das grandezas e do coeficiente de atrito cinético; os 10 ciclos para lingual foram mais semelhantes entre si que os 10 ciclos para vestibular. / The main objective of the study is to compare the three-bracket bending test with the resistance to sliding test using a new device that performs simultaneous measurement of coefficient of friction, the forces and moments on the anchor brackets and deactivation force in misaligned bracket, exercised by orthodontic wires. Secondary objectives were to develop the device and compare, in the three-bracket bending test: (i) the influence, on the physical quantities and on the kinetic friction coefficient, of the variation of the symmetry in the inter-bracket distance, of the type of anchor bracket (canine or 2nd premolar), of displacement (3 or 5mm) and misalignment (buccal or lingual) of the central bracket, and of the wire and bracket brand; (ii) the three ways to calculate the coefficient of kinetic friction; (iii) the 10 cycles, for buccal or lingual, to see if they are similar or not. Self-ligating brackets were used (teeth 13, 14 and 15) and wires 0.014 \'\' NiTi and CuNiTi of Aditek and Ormco brands. The resistance to sliding test was conducted on the lingual misalignment, on both displacements and on symmetrical configuration. The three-bracket bending test was held at the lingual and vestibular misalignment, at both displacements and at the symmetrical and asymmetrical configuration. Through ANOVA, were compared, between the two types of tests: (A) the quantities and the coefficient of friction and (B) the coefficient of friction generated only in the second premolar bracket. Using the same statistical test were compared, in three-bracket bending test: (A) in symmetrical configuration, the quantities and the coefficient of friction arising from the variation in the wire and bracket brands, displacement, misalignment and the type of bracket; (B) the quantities and the coefficient of friction generated by the symmetric and asymmetric configuration; (C) the values of the three ways of calculating friction coefficient; and (D) the quantities and the coefficient of friction encountered in 10 cycles. Results: (A) most of the values of the quantities and the coefficient of friction generated by the two types of test were statistically different; (B) the 2nd premolar bracket showed different friction coefficient values between the two types of test; (C) in the symmetrical configuration, the variables were statistically significant in the most of cases for quantities and the friction coefficient; (D) was found difference between symmetric and asymmetric configuration; (E) the friction coefficient based on both normal forces and frictional force was closer to the clinical reality and was sensitive to variations in the geometry of the wire-bracket relationship; and (F) the 10 cycles for lingual were similar in 70% of cases and the 10 cycles for buccal desalignment were different in 57% of cases. Conclusions: The three-bracket bending test is different from the resistance to sliding test; the variation of geometric configurations and wire and bracket brands may influence the values of the quantities and the coefficient of kinetic friction; the 10 cycles for lingual were more similar to each other than the 10 cycles for buccal.

O objetivo principal do estudo é comparar o teste em 3 pontos com braquetes com o teste de resistência ao deslizamento utilizando um novo dispositivo que realiza a mensuração simultânea do coeficiente de atrito, das forças e dos momentos nos braquetes de ancoragem e da força de desativação no braquete desalinhado, exercidos por fios ortodônticos. Os objetivos secundários foram desenvolver o dispositivo e comparar, no teste em 3 pontos: (i) a influência, nas grandezas e no coeficiente de atrito cinético, da variação da simetria nas distâncias inter-braquetes, do tipo de braquete de ancoragem (canino ou 2º pré-molar), do deslocamento (3 ou 5mm) do braquete central, do sentido do desalinhamento (vestibular ou lingual) do braquete central e da marca de fio-braquete; (ii) as 3 formas de cálculo do coeficiente de atrito cinético; (iii) os 10 ciclos, para vestibular ou lingual, para verificar se eles são semelhantes ou não entre si. Foram utilizados braquetes autoligáveis (dentes 13, 14 e 15) e fios 0.014\'\' NiTi e CuNiTi das marcas Aditek e Ormco. O teste de resistência ao deslizamento foi realizado no desalinhamento lingual, nos dois deslocamentos e na configuração simétrica. O teste em 3 pontos com braquetes foi realizado no desalinhamento lingual e vestibular, nos dois deslocamentos e na configuração simétrica e assimétrica. Por meio da ANOVA, foram comparados, entre os dois tipos de teste: (A) as grandezas e o coeficiente de atrito e (B) o coeficiente de atrito gerado apenas no braquete de 2º pré-molar. Utilizando-se do mesmo teste estatístico foram comparados, no teste em 3 pontos com braquetes: (A) na configuração simétrica, algumas grandezas e o coeficiente de atrito advindos da variação da marca de fio-braquete, do deslocamento, do desalinhamento e do tipo de braquete; (B) algumas grandezas e o coeficiente de atrito gerados na configuração simétrica e assimétrica; (C) os valores das 3 formas de cálculo do coeficiente de atrito na configuração simétrica; e (D) algumas grandezas e o coeficiente de atrito encontrados nos 10 ciclos. Resultados: (A) a maioria dos valores das grandezas e do coeficiente de atrito gerados pelos dois tipos de teste foram diferentes estatisticamente; (B) o braquete de 2º pré-molar apresentou valores de coeficiente de atrito diferentes entre os dois tipos de teste; (C) na configuração simétrica, as variáveis foram estatisticamente significantes na maioria dos casos para as grandezas analisadas e para o coeficiente de atrito; (D) houve diferença entre a configuração simétrica e assimétrica; (E) o coeficiente de atrito baseado nas duas normais e na força de atrito se aproximou mais da realidade clínica e foi sensível à variação da geometria da relação fio-braquete; e (F) os 10 ciclos para lingual foram semelhantes entre si em 70% dos casos e os 10 ciclos para vestibular foram diferentes em 57% dos casos. Conclusões: o teste em 3 pontos com braquetes é diferente do teste de resistência ao deslizamento; a variação das configurações geométricas e da marca de fio-braquete pode influenciar nos valores das grandezas e do coeficiente de atrito cinético; os 10 ciclos para lingual foram mais semelhantes entre si que os 10 ciclos para vestibular. / The main objective of the study is to compare the three-bracket bending test with the resistance to sliding test using a new device that performs simultaneous measurement of coefficient of friction, the forces and moments on the anchor brackets and deactivation force in misaligned bracket, exercised by orthodontic wires. Secondary objectives were to develop the device and compare, in the three-bracket bending test: (i) the influence, on the physical quantities and on the kinetic friction coefficient, of the variation of the symmetry in the inter-bracket distance, of the type of anchor bracket (canine or 2nd premolar), of displacement (3 or 5mm) and misalignment (buccal or lingual) of the central bracket, and of the wire and bracket brand; (ii) the three ways to calculate the coefficient of kinetic friction; (iii) the 10 cycles, for buccal or lingual, to see if they are similar or not. Self-ligating brackets were used (teeth 13, 14 and 15) and wires 0.014 \'\' NiTi and CuNiTi of Aditek and Ormco brands. The resistance to sliding test was conducted on the lingual misalignment, on both displacements and on symmetrical configuration. The three-bracket bending test was held at the lingual and vestibular misalignment, at both displacements and at the symmetrical and asymmetrical configuration. Through ANOVA, were compared, between the two types of tests: (A) the quantities and the coefficient of friction and (B) the coefficient of friction generated only in the second premolar bracket. Using the same statistical test were compared, in three-bracket bending test: (A) in symmetrical configuration, the quantities and the coefficient of friction arising from the variation in the wire and bracket brands, displacement, misalignment and the type of bracket; (B) the quantities and the coefficient of friction generated by the symmetric and asymmetric configuration; (C) the values of the three ways of calculating friction coefficient; and (D) the quantities and the coefficient of friction encountered in 10 cycles. Results: (A) most of the values of the quantities and the coefficient of friction generated by the two types of test were statistically different; (B) the 2nd premolar bracket showed different friction coefficient values between the two types of test; (C) in the symmetrical configuration, the variables were statistically significant in the most of cases for quantities and the friction coefficient; (D) was found difference between symmetric and asymmetric configuration; (E) the friction coefficient based on both normal forces and frictional force was closer to the clinical reality and was sensitive to variations in the geometry of the wire-bracket relationship; and (F) the 10 cycles for lingual were similar in 70% of cases and the 10 cycles for buccal desalignment were different in 57% of cases. Conclusions: The three-bracket bending test is different from the resistance to sliding test; the variation of geometric configurations and wire and bracket brands may influence the values of the quantities and the coefficient of kinetic friction; the 10 cycles for lingual were more similar to each other than the 10 cycles for buccal.