MScEng / Thesis (MScEng (Mechanical and Mechatronic Engineering))--University of Stellenbosch, 2009. / In this project the shape and attachment method of tissue leaflets for a percutaneous aortic valve is designed and tested as a first prototype. Bovine and kangaroo pericardium was tested and compared with natural human valve tissue by using the Fung elastic constitutive model for skin. Biaxial tests were conducted to determine the material parameters for each material. The constitutive model was implemented using finite element analysis (FEA) by applying a user-specified subroutine. The FEA implementation was validated by simulating the biaxial tests and comparing it with the experimental data. Concepts for different valve geometries were developed by incorporating valve design and performance parameters, along with stent constraints. Attachment techniques and tools were developed for valve manufacturing. FEA was used to evaluate two concepts. The influence of effects such as different leaflet material, material orientation and abnormal valve dilation on the valve function was investigated. The stress distribution across the valve leaflet was examined to determine the appropriate fibre direction for the leaflet. The simulated attachment forces were compared with suture tearing tests performed on the pericardium to evaluate suture density. In vitro tests were conducted to evaluate the valve function. Satisfactory testing results for the prototype valves were found which indicates the possibility for further development and refinement.

O Sistema Único de Saúde apresenta a descentralização da gestão das ações de saúde como uma das principais estratégias para a reorganização do setor. O poder municipal se apresenta como o principal responsável pela prestação da assistência da atenção à saúde, garantindo os princípios da universalidade e da integralidade do atendimento em todos os níveis da atenção. As Normas Operacionais Básicas e as Normas de Assistência à Saúde estabeleceram os mecanismos que impulsionaram o processo de descentralização das ações de saúde. O Estado do Ceará iniciou o processo de descentralização das ações de saúde para os municípios ao aderir ao Programa de Sistemas Unificados e Descentralizados de Saúde (SUDS). O estudo descreve este processo de descentralização, com ênfase na microrregião de Baturité, a partir da descentralização político-administrativa, da organização da regionalização e hierarquização como a identificação de mudanças no processo de atenção à saúde, a partir das ações de atenção à saúde da mulher, à saúde da criança, de controle de tuberculose e de controle de hipertensão O referencial do estudo foi a base normativa da Norma Operacional de Assistência à Saúde - 2001 (NOAS/ 2001). As condições oferecidas aos municípios para efetivar a descentralização das ações de saúde contribuíram para uma melhor estruturação dos serviços de saúde, resultado numa maior cobertura em ações básicas a partir da estratégia da Saúde da Família, e melhor organização da atenção em termos de hierarquização e regionalização como maior percentual de aplicação de recursos financeiros próprio. / The Brazilian Unified Health System presents the decentralization of management of health actions as one of the main strategies for reorganization of the sector. City Hall proves to be the main agent accountable for provision of health care support, guaranteeing the principles of universality and completeness of services at all levels of care. The Basic Operational Norms and Health Care Norms established the mechanisms which drove the process of decentralization of health actions. The state of Ceará began the process of decentralization of health actions to municipal administrations upon adhering to the Unified Health System (SUDS). This study describes this process of decentralization, with emphasis on the Baturité District, in terms of its political-administrative decentralization, organization of regionalization and ranking as identification of changes in the process of health care, based on health care services for women, children, tuberculosis control and control of high blood pressure. The benchmark for the study was the normative framework of the Health Care Operational Norms - NOAS/2001. The conditions offered to municipal administrations to perform decentralization of healthcare contributed to improvement in the Family Health structure, resulting in greater coverage in basic care from the standpoint of Family Health and better organization of care in terms of hierarchy and regionalization such as best percentage of investment of own financial resources.

O Sistema Único de Saúde apresenta a descentralização da gestão das ações de saúde como uma das principais estratégias para a reorganização do setor. O poder municipal se apresenta como o principal responsável pela prestação da assistência da atenção à saúde, garantindo os princípios da universalidade e da integralidade do atendimento em todos os níveis da atenção. As Normas Operacionais Básicas e as Normas de Assistência à Saúde estabeleceram os mecanismos que impulsionaram o processo de descentralização das ações de saúde. O Estado do Ceará iniciou o processo de descentralização das ações de saúde para os municípios ao aderir ao Programa de Sistemas Unificados e Descentralizados de Saúde (SUDS). O estudo descreve este processo de descentralização, com ênfase na microrregião de Baturité, a partir da descentralização político-administrativa, da organização da regionalização e hierarquização como a identificação de mudanças no processo de atenção à saúde, a partir das ações de atenção à saúde da mulher, à saúde da criança, de controle de tuberculose e de controle de hipertensão O referencial do estudo foi a base normativa da Norma Operacional de Assistência à Saúde - 2001 (NOAS/ 2001). As condições oferecidas aos municípios para efetivar a descentralização das ações de saúde contribuíram para uma melhor estruturação dos serviços de saúde, resultado numa maior cobertura em ações básicas a partir da estratégia da Saúde da Família, e melhor organização da atenção em termos de hierarquização e regionalização como maior percentual de aplicação de recursos financeiros próprio. / The Brazilian Unified Health System presents the decentralization of management of health actions as one of the main strategies for reorganization of the sector. City Hall proves to be the main agent accountable for provision of health care support, guaranteeing the principles of universality and completeness of services at all levels of care. The Basic Operational Norms and Health Care Norms established the mechanisms which drove the process of decentralization of health actions. The state of Ceará began the process of decentralization of health actions to municipal administrations upon adhering to the Unified Health System (SUDS). This study describes this process of decentralization, with emphasis on the Baturité District, in terms of its political-administrative decentralization, organization of regionalization and ranking as identification of changes in the process of health care, based on health care services for women, children, tuberculosis control and control of high blood pressure. The benchmark for the study was the normative framework of the Health Care Operational Norms - NOAS/2001. The conditions offered to municipal administrations to perform decentralization of healthcare contributed to improvement in the Family Health structure, resulting in greater coverage in basic care from the standpoint of Family Health and better organization of care in terms of hierarchy and regionalization such as best percentage of investment of own financial resources.

The Ryan White HIV/AIDS Program (RWHAP) provides HIV-related medical and support services for uninsured and underinsured people living with HIV (PLWH) in the United States. In addition to HIV-related medical care, the program provides medical nutrition therapy and food assistance. The role of nutrition in the health of PLWH is well-documented, especially in resource poor areas; however, the role of medical nutrition therapy and food assistance provided through the RWHAP in resource rich areas is not well documented. This study addressed the association between the nutrition services of food assistance and medical nutrition therapy and the HIV-related health outcomes of viral suppression, retention in care, and CD4 counts. The behavioral model for vulnerable populations was used as the theoretical foundation for this quantitative cross-sectional study. A sample of 428 RWHAP clients was used from the Ryan White Services Report data. Pearson's chi-square was used to examine the association between medical nutrition therapy (MNT) and viral suppression. Findings indicated statistically significant associations between MNT and viral suppression, retention in care and any nutrition service (food assistance, MNT, or both), and MNT and retention in care. Implications for social change include emphasizing the role of nutrition services in HIV-related health outcomes for PLWH in resource rich areas.

Since the war on drugs in the 1980s, the United States has seen an exponential rise in the number of imprisoned individuals. This increase has been particularly dramatic for women. Nationwide, the population of women in prison has grown by 834% over the past 40 years, more than double the growth rate of men. Compared with incarcerated men, women in prison have higher rates of substance abuse, histories of physical and sexual abuse, mental illness, infectious disease and chronic illness. Most women in prison are defined by a challenging intersection of lower socioeconomic status and largely racial, ethnic, and minority gender status. This combination of identity factors both contributes to their health disparities and influences their experiences with health care. Given that the majority of women in prison are of reproductive age, gynecological care is a central aspect of women’s overall health care. However, women in prison are a small minority of the overall incarcerated population, and because of this, their gender-specific health needs are frequently unacknowledged. Using a feminist epistemology, this qualitative multiple case study provides an examination of the experiences of women before prison and in prison with gynecological care and prison staff’s experiences providing this care. The Gelberg Andersen Behavioral Model for Vulnerable Populations is adapted here for the study of women in prison. The model explains factors enabling and impeding women’s utilization of health care services, including previous health care experiences, prison infrastructure, and personal autonomy. Women in contact with the criminal justice system face difficulties accessing health care both outside and inside prison. Barriers on the outside included lack of health insurance, being addicted to drugs, and prioritizing children’s needs first. On the inside women cited a lack of confidentiality, the absence of trust in providers, and the inability to participate in treatment decision-making. In the case of women in prison, multiple external oppressions result in internalized negative beliefs. Such feelings of powerlessness, lack of control, curtailed agency, and threatened self-worth ultimately influence how women experience gynecological care in prison. Policy, practice and research implications are provided to meet the gender specific health needs of women in prison.

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With the new technological advances on the eve of the end of the 19th century, a multitude of intrinsic and extrinsic instructional media became available to both teachers and pupils. For effective use of the available instructional media it became increasingly necessary to become both audio and visually literate in order to interpret and understand messages from audio-visual materials/instructional media. This, however, confronted teachers with the urge to become more acquainted with the ways of how to address media selection and integration in a proper way. History as a subject taught at school lends itself to the application of instructional media in a variety of forms. Since the selection of the appropriate or the available media for the teach• ing situation is no easy task, a literature study was undertaken with the purpose of identifying factors that become apparent from media selection models and that need to be considered when instructional media are selected for the teaching of history. Apart from the prob• lem of the lack of an instructional media selection model designed specifically for history teaching, it was possible to propose suitable guidelines based on research findings for the selection of instructional media for history teaching. As far as the empirical research contained in chapter three is concerned, a questionnaire has been developed to determine to what extent history teachers in the present school situation use instructional media, and whether the media available is used effectively. A random sample of fifty (50) schools in the northern region of the Free State was used. Teachers with three years or more experience were asked to complete the questionnaire. An evaluation of the situation was created from the results. One of the most important findings was that a limited number of teachers received training in the effective use of instructional media, or in instructional media science. It appears that the choice of instructional media is considered no easy task by them. Chapter four is devoted to the practical application of instructional media in the teaching of history at the junior secondary level. There lessons have been prepared according to the model that has been developed in this project, which contain aspects of the new outcomes based on education. During the process a selection of media has also been made, ranging from what would be applicable in a school that is fairly adequately equipped with media, to schools that are only partially equipped with media. The study is concluded with a synthesis of all the findings as set out in chapters one through four, where the applicable guidelines for the teaching of history are confirmed. / Thesis (MEd (Vakdidaktiek))--PU vir CHO, 1997

With the new technological advances on the eve of the end of the 19th century, a multitude of intrinsic and extrinsic instructional media became available to both teachers and pupils. For effective use of the available instructional media it became increasingly necessary to become both audio and visually literate in order to interpret and understand messages from audio-visual materials/instructional media. This, however, confronted teachers with the urge to become more acquainted with the ways of how to address media selection and integration in a proper way. History as a subject taught at school lends itself to the application of instructional media in a variety of forms. Since the selection of the appropriate or the available media for the teach• ing situation is no easy task, a literature study was undertaken with the purpose of identifying factors that become apparent from media selection models and that need to be considered when instructional media are selected for the teaching of history. Apart from the prob• lem of the lack of an instructional media selection model designed specifically for history teaching, it was possible to propose suitable guidelines based on research findings for the selection of instructional media for history teaching. As far as the empirical research contained in chapter three is concerned, a questionnaire has been developed to determine to what extent history teachers in the present school situation use instructional media, and whether the media available is used effectively. A random sample of fifty (50) schools in the northern region of the Free State was used. Teachers with three years or more experience were asked to complete the questionnaire. An evaluation of the situation was created from the results. One of the most important findings was that a limited number of teachers received training in the effective use of instructional media, or in instructional media science. It appears that the choice of instructional media is considered no easy task by them. Chapter four is devoted to the practical application of instructional media in the teaching of history at the junior secondary level. There lessons have been prepared according to the model that has been developed in this project, which contain aspects of the new outcomes based on education. During the process a selection of media has also been made, ranging from what would be applicable in a school that is fairly adequately equipped with media, to schools that are only partially equipped with media. The study is concluded with a synthesis of all the findings as set out in chapters one through four, where the applicable guidelines for the teaching of history are confirmed. / Thesis (MEd (Vakdidaktiek))--PU vir CHO, 1997

The current global economic paradigm, centred on growth, is a significant barrier in the transition towards a sustainable society. Business-as-Usual companies operating within this paradigm are perceived to prosper at the expense of society and environment which is not viable on a finite planet. The need to rethink the purpose of business is inevitable as maximising shareholder value, has been deemed insufficient to create asustainable society. This study aimed to explore: how business models can be used to create value that supports Strategic Sustainable Development. Previous research proposed that the concept of Business Models for Sustainability helps business place sustainability at the core of all consideration. A qualitative research was chosen for which we employed the Framework for Strategic Sustainable Development and combined a literature review with an investigation of three expert groups to answer our research question. Our findings showed that, compared to other value forms, system value is the most appropriate concept for businesses striving towards sustainable development. Based on our findings, six themes emerged that businesses need to address to accelerate the speed of change towards sustainability. To make a relevant contribution to the intended audience,a prototype has been developed based on our findings.

Orientador: Claudio Alexandre Gobatto / Banca: Eliete Luciano / Banca: René Brenzikofer / Resumo: No modelo de natação para ratos, a associação das intensidades de exercício determinadas por meio da lactacidemia com as suas respectivas sobrecargas são passíveis de crítica, uma vez que a quantificação dos pesos atados ao animal pode não representar efetivamente o esforço real do animal para sua manutenção na superfície da água, devido a esta metodologia sofrer influência da densidade corporal e dos padrões de nado apresentados pelos animais. O principal objetivo desse estudo foi desenvolver um modelo de natação atada para roedores o qual permitiu a determinação direta e em tempo real da força de nado realizada pelo animal e verificar a possível existência de diferentes padrões de nado. Além disso, foi feita a discriminação da densidade corporal em animais controles e induzidos à obesidade, com intuito de destacar consistentemente a influência da flutuabilidade na natação. Foram utilizados 24 rattus norvegicus albinus, machos, com 150 dias de idade, divididos em animais controles e induzidos à obesidade por meio da redução de ninhada somada a uma dieta hiperlipídica. Os animais tiveram a densidade corporal determinada por meio de um aparato de pesagem hidrostática utilizando um sistema de aquisição de dados. Posteriormente todos os ratos foram avaliados no teste de máxima fase estável de lactato adaptado para natação atada. Por meio do modelo experimental de indução a obesidade, foi possível induzir aumento significativo do peso e volume corporal, alem da redução da densidade corporal dos animais no grupo obeso. As avaliações de animais controles e obesos revelaram a influência significativa da densidade corporal na determinação das intensidades de exercício, principalmente quando as cargas foram expressas em valores absolutos. Estudos que fazem uso do modelo de natação para ratos, principalmente de caráter longitudinal... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: In the swimming model for rats, the association between the blood lactate concentration with the exercise intensity could be criticized once the workload quantification could not represent effectively the effort performed by the rat to keep himself on the surface, due to it be affected by the body density and the swimming patterns present by the animals. Thus, the mainly objective of this study was develop a apparatus for tethered swimming for rats, that allows the monitoring of swimming force during all exercise time and to verify the existence of different sorts of swimming patterns. 24 male rattus novergicus albinus, with 150 days of age were used, divided in control and obese induced animals by a nest reduction and hyper-lipid diet. All animals had their body density determined by hydrostatic weighing with an acquiring data device. Later the animals were evaluated in maximal lactate steady state test adapted to the tethered swimming. Was possible to induce significant weight and body volume increase in the obese group beside the reduction of the body density. The assessment of control and obese animals reveled significant body density influence in the workload determination, mainly when the workload was expressed in absolute values. Tethered swimming model allowed the investigation of statistic parameters of the data signal, which showed that the signal amplitude varied in function of the intensity, however the dispersion did not. Also the visual analyses of the force kinetic allowed the identification of 4 swimming patterns and the speculation about the reason and consequences of it incidence. Therefore animals that present such swimming patterns which can influence the assessment should be removed from the sample. Studies that make use of the swimming model for rats, mainly those of longitudinal duration or that make use of interventions that may change the animal's body composition...(Complete abstract click electronic access below) / Mestre