Introdução: A gastrostomia percutânea endoscópica (PEG) é utilizada como via de nutrição para pacientes sem capacidade de utilizar a via oral para manter ingestão suficiente. A disfagiaé uma das principais razões para a indicação da PEG, sendo geralmente atribuída a processos neurodegenerativos. Diferentes técnicas e tipos de sonda são utilizadas para confecção da PEG. A técnica de Tração é o método original, na qual a sonda é tracionada a partir de uma pequena incisão na parede abdominal, através a boca e do esôfago até estar posicionada junto da parede gástrica. A técnica de punção com gastropexia é uma variante da técnica de punção original, na qual a sonda não passa pela cavidade oral. Nesta técnica, após fixação do estômago na parede abdominal com uso de pontos, a sonda é introduzida diretamente através da parede abdominal sob visão endoscópica. De acordo com a técnica, diferentes modelos de sondas podem ser utilizadas, cada uma com diferentes tipos de retentores internos. Os retentores internos maiscomuns são: em forma de diamante, em forma de cogumelo, disco rígido e balão. Possivelmente, tanto a técnica de inserção como os modelos de sondas e retentores utilizados podem estar associados a diferentes desfechos. O objetivo deste estudo foi avaliar a incidência podem estar associados a diferentes desfechos. O objetivo deste estudo foi avaliar a incidência. Métodos: Foi realizada uma coorte histórica na qual foram incluídos todos os pacientes maiores de 18 anos submetidos à colocação de uma primeira PEG entre janeiro de 2010 e dezembro de 2015 no Hospital Moinhos de Vento, um hospital privado em Porto Alegre, sul do Brasil. Os dados foram coletados em formulário padronizado através de uma busca no sistema informatizado da Instituição. Para complementação dos dados foi realizada uma busca nos prontuários digitalizados, e em algumas situações realizado contato telefônico. Resultados: Foram identificados 245 pacientes, sendo 200 submetidos a técnica de tração (Pull) e 45 à técnica de punção com gastropexia (Push com gastropexia). A média da idade foi 80,3±13,3 anos. Cento e trinta e quatro (54,7%) pacientes eram do sexo feminino. O período médio de seguimento foi de 17,2±14,6 meses. A indicação mais comum foi doença neurodegenerativa (62,4%), seguido por acidente vascular cerebral (AVC) (16,3%). Todos os pacientes realizaram profilaxia com antibiótico no dia do procedimento. A mediana de dias de internação pós PEG foi de 8 dias. O modelo de sonda mais utilizado foi o retentor em forma de diamante (51,8/%). A colocação da PEG foi bem-sucedida em 99,6% dos casos. A mortalidade geral foi de 42,4% (104/245) durante o período de seguimento. Nenhum óbito foi atribuído diretamente a complicações relacionadas ao procedimento. Entretanto, três pacientes faleceram dentro de 48 horas após o procedimento: um por sepse respiratória, outro por parada cardiorrespiratória e o terceiro que realizou a PEG ambulatorial teve morte súbita no domicílio. A taxa de complicações (maiores ou menores) foi de 23,6%, sendo a mais frequente, a retirada acidental da sonda, que ocorreu em 17,1% dos pacientes em algum momento do seu seguimento. Não foi observada diferença entre as técnicas de realização da PEG gastrostomia com a incidência desta complicação. O tempo até a retirada acidental da sonda foi menor entre os pacientes cujas sondas tinham o retentor interno em forma de diamante em relação aos demais retentores (p = 0,02). Sepultamento do retentor interno (Buried Bumper Syndrome) ocorreu em 5,4% dos casos, todos submetidos a técnica de tração (p = 0,08). Pacientes portadores de sonda com retentor em forma de diamante apresentaram maior incidência de complicações gerais (p = 0,02) e de retirada acidental (p = 0,01), comparativamente aos pacientes portadores de sondas com outros tipos de retentor. Conclusões: A PEG é uma técnica segura, com baixa taxa de mortalidade diretamente associada ao procedimento. Entretanto, devido a população na qual o procedimento é realizado, a mortalidade geral é elevada. Complicações menores são frequentes, independentemente da técnica ou tipo de sonda utilizada, porém a técnica e o tipo de sonda parecem associadas a um perfil diferente de complicações. Perspectivas: O desenvolvimento da técnica, o desenvolvimento de materiais com melhor perfil de segurança e, especialmente, o aprimoramento das orientações e cuidados pós-gastrostomia são necessários para reduzir a incidência de complicações em pacientes submetidos a esse tipo de procedimento. Novos estudos comparando de maneira prospectiva e randomizada diferentes técnicas e modelos de sonda são necessários para determinar se há uma técnica ou modelo a ser utilizado como primeira escolha.

O uso de novos materiais na construção civil combinado com a alta tecnologia dos processos construtivos pode conduzir à redução de custo e melhoria no comportamento da estrutura. Recentemente, em função da corrosão das barras de aço dentre outros fatores, muitos pesquisadores têm sugerido a utilização de barras não-metálicas como substituição das barras aço nas estruturas em concreto. Além das barras não-metálicas permitirem cobrimentos menores e possibilitarem menor custo de manutenção, outras vantagens no seu uso podem ser citadas, tais como: pequeno peso específico, alta resistência à tração, não condutibilidade elétrica, térmica e magnética, entre outras. Este trabalho analisa o comportamento da aderência entre barras de GFRP (barras de fibra de vidro impregnada por polímero) e o concreto, por meio de uma revisão bibliográfica e ensaios de arrancamento padronizados, segundo o RILEM-FIP-CEB (1973). Foram consideradas as influências dos parâmetros como a resistência à compressão do concreto e o diâmetro da barra de GFRP. Com base nos resultados experimentais, buscou-se comparar o comportamento de aderência barra de GFRP-concreto e barra de aço-concreto, além da verificação das formulações para previsão da resistência de aderência segundo códigos normativos e a literatura técnica, para estruturas armadas com barras de aço e barras de FRP. Posteriormente, realizou-se a análise numérica da aderência, por meio do método dos elementos finitos. Nos modelos experimentais de arrancamento pode-se perceber a influência das propriedades mecânicas e da conformação superficial das barras de GFRP no comportamento da aderência, apresentando menores resistências de aderência quando comparadas às barras de aço de diâmetro similar. O valor da resistência de aderência determinado experimentalmente foi maior que o valor proposto pelos códigos normativos. Os modelos numéricos não representaram satisfatoriamente o comportamento experimental, visto que se trata de uma simulação numérica linear e o comportamento experimental força x deslocamento é não-linear. / The use of new materials in civil construction combined with high technology processes leads to improvements in many aspects, like cost reductions and better structural behavior. Recently, due to corrosion of the steel bars, among other factors, many researchers have been suggesting the use of non-metallic bars as a substitution of the steel reinforcement in concrete structures. Besides, the non-metallic bars allow smaller clear cover and make possible lower maintenance cost, other advantages can be mentioned, such as: low specific weight, high tensile strength, electrical, thermal and magnetic non-conductivities, and others. This work analyzes the bond behavior between GFRP bars (Glass Fiber Reinforced Polymer bars) and concrete, through state-of-art and standard pull-out tests, according to RILEM-FIP-CEB (1973). The influence of some parameters, as compressive concrete strength and GFRP bar diameter, was considered. Based on the experimental results, it was aimed at comparing the bond behavior of the GFRP-concrete bar with the steel-concrete bar, in addition to the verification of bond strength formulations established by the standards codes and the bibliography for structures reinforced with steel bars and FRP bars. Further, the bond numerical analysis was carried out through finite elements. In the pull-out tests, the influence of mechanical properties and superficial conformation on the GFRP bars was observed in the bond behavior, presenting smaller bond strength than the steel bars of similar diameter. The value of the experimental bond strength was larger than the value proposed by standards codes. The numerical models did not represent well the experimental behavior given that a linear numerical simulation was considered, but, actually, the experimental load x slip behavior is non-linear.

Induction machines are the most widely used type of electrical machines because of their robustness, simplicity, and relatively low cost. However, the small airgap in the induction machine makes them more susceptible to Unbalanced Magnetic Pull (UMP). This is because the magnitude of the UMP is a function of the degree of eccentricity, which is the ratio between the length of misalignment and the mean airgap length. The bearing-related failure accounts for approximately 41% of the total failures of induction machines; the percentages of bearing-related failure would be higher for applications in a harsher environment. In this thesis, the UMP caused by rotor eccentricity is investigated, because a small degree of rotor eccentricity is unavoidable due to the manufacturing tolerance and 80% of the mechanical faults could cause rotor eccentricity in electrical machines. When the rotor is not at the centre of the stator, the eccentric rotor causes an uneven airgap around the rotor, in which the magnetic permeance with the higher harmonics content will be created. The magnetomotive force (MMF) produces additional pole-pair ±1 magnetic flux around the airgap. The interaction between each magnetic flux with its pole pair ±1 magnetic flux produces UMP. As only the magnetic flux that crosses the airgap causes UMP, the magnetic flux is categorised into magnetising flux and airgap leakage flux, because both types of flux possess different characteristics at a different rotor slip. As the airgap leakage flux is difficult to calculate analytically, an empirical method is proposed to estimate the UMP caused by the airgap leakage flux. Then, the UMP caused by the magnetising flux can also be estimated by using the empirical method. The parameters for the empirical method can be found by using either the FEA or the experimental results. The damping effect of the magnetising flux in a parallel connected rotor bar is discussed and a damping coefficient is introduced to explain this scenario. The damping coefficient can also be used to calculate the UMP in a steady state analysis. UMP comparisons between the cage rotor and wound rotor induction machines are made. The wound rotor has a much higher UMP because the pole-specific wound rotor could not damp the additional pole pair ±1 magnetic flux. Therefore, a damper winding at the stator slot is also proposed in order to damp the UMP by producing a counteracting flux. In addition, analytical equations have also been derived for different scenarios, such as static eccentricity, dynamic eccentricity, axial-varying eccentricity, and skew rotor bars. Finite Element Analysis (FEA) and experimental work are used to demonstrate the derived analytical equation. Furthermore, the power losses caused by the rotor eccentricity are investigated. Iron losses, copper losses, and frictional loss are discussed and compared with both the analytical equation and the FEA results. In order to reduce the UMP in the induction machines, the two proposed methods are the slip control method and damper windings topology. The slip control method utilises the non-linearity characteristic of the UMP at different rotor slip. To find the optimum operating slip with the lowest UMP, the UMP/Torque ratio is introduced. The characteristics of the UMP/Torque ratio varies with the type and design of the induction machines. However, this method is only applicable when the machine is lightly loaded, because the magnetising flux is limited by the capped terminal voltage and the core saturation of the machine. For the damper winding topology, a circulating current flowing in the damper winding could produce a counteracting flux to damp the UMP. The proposed damper windings configuration is only suitable for the induction machine with an even pole pair number. Finally, comparisons between both UMP reduction methods are made.

The operational advantages of a pull system are very well documented. These advantages include not only operational efficiency and quality, but also the enhancement of the customer oriented of the organization. The objective of this field study is to examine the applicability and potential advantages of a pull operational system in a mid-size manufacturing organization. Philosophies, tools, and concepts of Just-in-Time, Theory of Constraints, Business Process Re-engineering, and Root Cause Analysis are used to analyze the existing operational system, to identify its weaknesses, and finally to re-engineer it to be more consistent with a pull operational system. The results of this field study appear to be consistent with reported findings in the literature. The results point to both operational gains and customer related benefits which can be attributed to the pull operational system philosophy. Conclusions and recommendations are presented and discussed in light of their practical and theoretical implications.

No description available.

This research tests the value of push and pull communication on Facebook in the first effort to test the validity of the Pub Principle and Social Intrusion Theory. This theory explains how audiences engage in a tug-of-war with commercial forces during mass communication and that commercial messaging is ultimately dependent upon the acceptance or rejection of its intended audience. The pub principle explains that social media is unlike traditional mass media and that the rules commercial forces must play by are different than for other mass media. Using a mixed-method approach, this research confirms the validity of this principle and theory. It finds that Facebook users spend significantly less time looking at push content like paid advertisements than at pull content like fan pages. This research also shows that audiences prefer dealing with pull content over push content on Facebook. The Pub Principle and Social Intrusion Theory are therefore supported by this research.

This review article examines previous weightlifting literature and provides a rationale for the use of weightlifting pulling derivatives that eliminate the catch phase for athletes who are not competitive weightlifters. Practitioners should emphasize the completion of the triple extension movement during the second pull phase that is characteristic of weightlifting movements as this is likely to have the greatest transference to athletic performance that is dependent on hip, knee, and ankle extension. The clean pull, snatch pull, hang high pull, jump shrug, and mid-thigh pull are weightlifting pulling derivatives that can be used in the teaching progression of the full weightlifting movements and are thus less complex with regard to exercise technique. Previous literature suggests that the clean pull, snatch pull, hang high pull, jump shrug, and mid-thigh pull may provide a training stimulus that is as good as, if not better than, weightlifting movements that include the catch phase. Weightlifting pulling derivatives can be implemented throughout the training year, but an emphasis and de-emphasis should be used in order to meet the goals of particular training phases. When implementing weightlifting pulling derivatives, athletes must make a maximum effort, understand that pulling derivatives can be used for both technique work and building strength–power characteristics, and be coached with proper exercise technique. Future research should consider examining the effect of various loads on kinetic and kinematic characteristics of weightlifting pulling derivatives, training with full weightlifting movements as compared to training with weightlifting pulling derivatives, and how kinetic and kinematic variables vary between derivatives of the snatch.

The purpose of this investigation was to determine the existence of bilateral strength and force-production asymmetry and evaluate possible differences based on sex, as well as strength level. Asymmetry was assessed during weight-distribution (WtD) testing, unloaded and lightly loaded static- (SJ) and countermovement-jump (CMJ) testing, and isometric midthigh-pull (IMTP) strength testing. Subjects included 63 athletes (31 male, 32 female) for WtD, SJ, and CMJ tests, while 129 athletes (64 male, 65 female) participated in IMTP testing. Independent-samples t tests were used to determine possible differences in asymmetry magnitude between males and females, as well as between strong and weak athletes. Cohen d effect-size (ES) estimates were also used to estimate difference magnitudes. Statistically different asymmetry levels with moderate to strong ESs were seen between males and females in WtD, 0-kg SJ (peak force [PF]), 20-kg SJ (peak power [PP]), 0-kg CMJ (PF, PP, net impulse), and 20-kg CMJ (PF), but no statistical differences were observed in IMTP variables. Dividing the sample into strong and weak groups produced statistically significant differences with strong ES estimates in IMTP PF and rate of force development, and many ESs in jump symmetry variables increased. The results of this investigation indicate that females may be more prone to producing forces asymmetrically than males during WtD and jumping tasks. Similarly, weaker athletes displayed more asymmetry than stronger athletes. This may indicate that absolute strength may play a larger role in influencing asymmetry magnitude than sex.

Although public transit bus accounts for only a small percentage of the mode share for transportation in Florida, the annual passenger miles were over 1 billion with over 200 million passenger trips in 2005. These numbers warrant close attention to be paid to the safety of public transit vehicles. Despite the relatively low occurrence of fatalities and bus crashes, each crash of a high occupancy vehicle such as a public transit bus could expose more people to injury than a private automobile crash. Bus crashes also have a significant impact on the automobiles that are involved. Since a high percentage of bus crashes in Florida are caused by rear-end collisions with private automobiles, improving the signage and lighting that will allow buses to move back into traffic safely is very important for bus safety and operations. This paper uses bus operator surveys, crash data, and field studies to develop recommendations for lighting and signage on the back of the bus, roadway signs and revised Florida legislations. Improved signage and lighting will help the bus move back into traffic safely, decrease bus delay and improve bus operations however it must be accompanied by laws and law enforcement.

High teacher turnover has become a serious problem globally, in many international schools, and is a growing concern in segments of the East Asia Regional Council of Schools (EARCOS). This persistent problem has a detrimental effect on student learning and upsets the culture of school communities. Herzberg's motivation-hygiene theory served as the framework for this qualitative case study research that examined the perceptions of EARCOS international overseas-hire teachers, to determine their beliefs regarding high teacher turnover in international schools. These questions gave direction to this study: What factors do international teachers in EARCOS member schools believe contribute to high teacher turnover in international schools? What do international teachers in EARCOS member schools believe is the result of high teacher turnover in international schools? What steps do international teachers in EARCOS member schools believe should be taken to reduce high turnover in international schools? Purposeful homogenous sampling was used to identify 8 focus group interview participants from the entire pre-K-12 international overseas-hire teacher population from the 149 EARCOS member schools. Coded data were examined, analyzed, and categorized into themes related to Herzberg's motivation-hygiene theory. Member checking, peer debriefing, and external auditing were used to add validity to the research study. The analysis of the data and findings revealed that lack of effective mentorship, lack of administrative leadership support, and ineffective systems are the major contributors to international teacher turnover in international schools. A white paper was developed and constructed from the themes that emerged from this study and presented to EARCOS member school administrators, to potentially use to address the issue of increasing international overseas-hire teacher turnover rates in international schools. This acquired knowledge could lead to positive social change that can influence the practices, structural procedures, and policies of EARCOS and other international school systems related to teacher turnover.