Oestrogen decline during the menopause leads to decline in cognitive performance because oestrogen receptor sites are found in the prefrontal cortex and hippocampus of the female brain, areas associated with memory and attention functions. Extensive research over the past two decades has tested the effects of administering Hormone Replacement Therapy (HRT) to maintain oestrogen levels. MRI studies have shown improvements in hippocampal volume and frontal functions with HRT, but evidence for associated improvements in verbal memory performance has been mixed. Some studies have even found detrimental effects of HRT, leading to the suggestion of a critical period for HRT administration relative to menopause. Oestrogen receptor sites are found in frontal brain regions associated with working memory (WM) functions including attention. These functions have been researched less than verbal memory, but with similarly mixed findings. The research reported in this thesis tested the critical period hypothesis in relation to WM. Study one tested the prediction that HRT will benefit WM if the therapy is initiated during the peri-menopause, and will harm it if initiated post-menopause. A naturalistic sample of 121 women were recruited, comprising women who varied in the time they had begun taking HRT, and menopausal status-matched controls who had never taken HRT. Participants completed three tests of WM span and the Sustained Attention to Response Task (SART) on two occasions 12 months apart. WM performance supported the critical period hypothesis, with women who had begun the therapy after the menopause displayed worsened WM capacity when compared to peri-menopausal initiators and post-menopausal women with no history of HRT use. At one year follow up, postmenopausal HRT users were still underperforming compared to peri-HRT initiators and those in the post-menopausal stage with no history of HRT use. No significant differences were identified between groups on the SART. The effects of natural supplements on physical symptoms of the menopause have been researched, but there is little research on their effects on cognitive symptoms and none specifically testing the critical period hypothesis. Study two tested the effects of soya isoflavones on WM during peri- and post-menopausal stages. One hundred and twelve peri- and post-menopausal women were randomly allocated to receive either placebo or 100mg soya supplement in capsules daily for three months. Participants and researcher were blind to this allocation. Participants completed two tests of WM span and two Sustained Attention (SA) tasks at baseline, after three months of soya/placebo, and after a further three months without supplement. There was no effect of isoflavones on cognition, regardless of time of initiation of the supplement. This thesis offers a unique contribution to the literature, by establishing empirically that HRT may have long-lasting benefits for WM if administered in the peri-menopause period, and detriments if taken post-menopause. There was no evidence that administration of soya-based phytoestrogens for three months peri- or post-menopause replicated these effects of HRT on cognition.

The purpose of this study was to describe involvement in everyday activities for people with opioid replacement therapy. To answer the purpose, an empirical qualitative design was chosen that is appropriate for capturing a person's own thoughts, feelings, experiences, experiences and opinions and the world in which he lives with the person's own words. Data were collected through interviews with people who have opioid replacement therapy. The collected data consisted of six interviews analyzed based on a latent qualitative content analysis. Analysis of data resulted in an overall theme; Living in life does not survive life and four categories; A struggle to adapt to something new and find structure in everyday life. To dare to believe in his ability. To get professional support along the way. The importance of the social environment for breaking old life. The result showed that involvement in everyday activities is a major challenge and a struggle that depends both on the support people receive from care and social services in their change process, their confidence in their own ability and how to succeed in creating a new identity and how the social environment around them look. Conclusions that can be deduced from the results of the study can give implications for people who have opioid replacement therapy to help build new life in addition to receiving medication. It is a struggle to adapt and create a new identity and in that work, occupational therapy can perform an important role. / Syftet med denna studie var att beskriva engagemang i vardagliga aktiviteter för personer med läkemedelsassisterande behandling vid opiatberoende. För att besvara syftet valdes en empirisk kvalitativ design som är lämpligt för att fånga en persons egna tankar, känslor, upplevelser, erfarenheter och åsikter och den värld den lever i med personens egna ord. Data insamlades genom intervjuer med personer som har läkemedelsassisterande behandling vid opiatberoende. Insamlad data bestod av sex intervjuer som analyserades utifrån en latent kvalitativ innehållsanalys. Analys av data resulterade i ett övergripande tema; Att leva i livet inte överleva livet och fyra kategorier; En kamp att anpassa sig till något nytt och finna struktur i vardagen. Att våga tro på sin förmåga. Att få professionellt stöd på vägen. Den sociala miljöns betydelse för att kunna bryta med det gamla livet. Resultatet visade att engagemang i vardagliga aktiviteter är en stor utmaning och en kamp som både beror på vilket stöd personerna får av vård och socialtjänst i sin förändringsprocess, deras tilltro till sin egen förmåga och hur det lyckas skapa en ny identitet samt hur den sociala miljön runt dem ser ut.  Slutsatser som kan dras utifrån studiens resultat kan ge implikationer för att personer som har läkemedelsassisterande behandling vid opiatberoende vill ha hjälp med att bygga upp det nya livet utöver att de får mediciner. Det är en kamp att anpassa sig och skapa en ny identitet och i det arbetet kan arbetsterapi spela en viktig roll.

A Research Report submitted to the Faculty of Science, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Science. Johannesburg, 2016 / Maintenance of technical systems aims at retaining their reliability and availability, restoring their capability of continuing their operation in case they have failed. A number of reliability and maintenance policies that play a significant role in reducing system failures and in making cost-effective decisions on whether to repair or replace a system will be examined in great detail. This research report places greater emphasis on the total repair cost (TRC) limit policy and compares it with other polices like the economic lifetime (EL) policy. The maintenance cost rate will be used to obtain the optimal parameters. When a system fails, it is replaced with an identical unused one if the total repair cost goes beyond a pre-determined repair cost limit by a preventive replacement if in the time period (0, v) no failure forces a replacement of the system. Else, a repair is carried out. / M T 2016

Este trabalho tem como objetivo analisar a influência provocada pelas políticas de substituição de objetos em caches na Web. Isso é feito por meio da investigação das políticas existentes na literatura, considerando um estudo de caracterização de carga, de avaliação de desempenho e de comparação do uso dessas políticas. Para realizar a avaliação das políticas é utilizado um simulador de caches para a Web. Durante a pesquisa, foi desenvolvida uma nova política, denominada MeMoExP. Ela utiliza os conceitos de Média Móvel para otimizar HR e BHR. As simulações realizadas mostraram que a MeMoExP segue a mesma tendência da política FBR, tida como eficiente na literatura. Finalmente, são expostas algumas ponderações sobre as idéias apresentadas nos capítulos componentes desta dissertação, além de serem apresentadas as contribuições provenientes desta pesquisa e alguns trabalhos futuros propostos a partir desta dissertação. / This work aims to analise the influence of the replacement policies on web caches. This is carried out by investigating the policies found at the literature, considering an study of load characterization and performance assessment as well as a comparison between the policies' usage. All the experiments are done using a web cache simulator. During the research, it was developed a new policie, called MeMoExp. It utilizes the concept of Moving Exponencial Average to optimize the HR and BHR metrics. The simulation studies showed that the MeMoExP policie follows the same tendency than the FBR metric, which is considered efficient in the literature. Finally, some considerations about the ideas presented in the dissertation are exposed. The contributions of this research work are presented and some future works are proposed.

O presente trabalho apresenta um plano de substituição de tubulações do sistema de distribuição de água da Região Metropolitana de São Paulo (RMSP), utilizando um sistema de informações geográficas (SIG), que permitiu o relacionamento de dados do cadastro físico das tubulações com informações de reparos de vazamentos. Foram criados grupos de tubulações de mesmo material e, em alguns casos, de um mesmo período de implantação, para a definição de taxas anuais de substituição a partir da previsão de quebras futuras e da determinação do tempo ótimo de substituição das tubulações. Os resultados obtidos indicam que a vida média das tubulações apresenta um valor inferior ao verificado em países desenvolvidos. Assim, a taxa anual de substituição de tubulações, devendo oscilar entre 1,25 e 2%, será superior à média dos países desenvolvidos, que gira em torno de 0,5 a 1%, considerando que a idade média das tubulações varie entre 100 e 200 anos. / The following study presents a pipes replacement plan for the water distribution system of the Metropolitan Region of Sao Paulo (MRSP), using a geographic information system (GIS), which allowed the relation between the data of the water mains and the information about leakage repairs. Water main groups of the same material were created and, in some cases, of the same installation period, for the definition of yearly replacement rates based on the future breaks forecast and determination of the water mains optimal replacement timing. The results obtained suggest that the water mains average life, show a lower value than the one verified in developed countries. Thus, the water mains year replacement rate, witch should range from 1.25 to 2%, will be higher than the average in developed countries, witch is about 0.5 and 1%, considering that water mains mean age varies between 100 and 200 years.

Background: Current smoking-cessation medicines can assist smokers to quit, but have limited efficacy. Supplementing them with a replacement for the sensory and behavioural aspects of smoking, which are hypothesised to act as secondary reinforcers, could in theory help to alleviate urges to smoke and withdrawal, and may assist smoking cessation. Methods: Three studies were conducted to examine sensorimotor replacement (SMR) effects. The first two employed a cross-over design to assess the effects of two SMR products, nicotine-free electronic cigarettes (ECs) and de-nicotinised cigarettes (DNCs), on short-term withdrawal, urges to smoke, and user acceptability. Study 1 (N= 35), compared EC to a stress ball (SB) to control for behavioural distraction and Study 2 (N=41) tested whether SMR effects were ‘dose dependent’ by comparing DNCs with ECs. The final study was part of a randomised controlled trial (N= 200) of DNCs in combination with standard treatment. It examined whether SMR effects on abstinence are moderated by scores on a ‘behavioural’ dependence measure (GN-SBQ). Results: The EC was preferred over the SB, and alleviated urge to smoke more than SB, but the effect was modest and short-lived. The DNC and EC had similar effects acutely, but DNC suppressed urges to smoke and withdrawal to a somewhat greater extent over a day of abstinence. DNCs combined with standard smoking-cessation treatment improved short-term abstinence regardless of GN-SBQ scores. Conclusion: SMR effects on urge and withdrawal alleviation were modest and a ‘dose response’ effect was not clearly established. An attempt to identify smokers for whom SMR may be of particular benefit was not successful. SMR however, was perceived as helpful and appealing, and results from the trial suggest that adding SMR may enhance existing treatments. It was proposed that rather than directly alleviating urges/withdrawal, SMR may operate as a coping tool in ‘high-risk’ situations, by providing an alternative to smoking.

Periacetabular osteolysis is a significant complication following total hip replacement surgery. It is believed to be caused by wear debris and high fluid pressures within the joint capsule. To investigate the mechanisms by which high fluid pressures are generated in total hip replacement, a physical model of the hip joint was constructed, the Acetabular Pressure Transmission Rig (APTR). An aluminium chamber held the bone analogue, a polyurethane hemisphere with a 52mm acetabular cavity, and the prosthetic components, a 28mm femoral head and various uncemented cups, were inserted without press-fit to simulate cup loosening. A synovial fluid analogue was introduced into the chamber through an elevated reservoir. Rigid transmission tubes conducted fluid pressures from the cup-cavity interface to external transducers. The APTR was loaded under various conditions and the pressures produced by the loading regimes were analysed. Pressures over 35kPa, previously shown by other groups to cause osteolysis, were measured within the APTR, reaching a maximum of 131.3kPa measured at the pole of the cup. Changes in load application led to pressure changes within the APTR, with higher loading frequency and magnitude leading to higher median pressure amplitudes. The presence of different component features, such as screw holes in the metal shell, was also shown to affect periacetabular pressures. Tests with a fibrous rim interposed between the prosthetic cup and the test cavity showed an 88% reduction in periacetabular pressures, as the increased rim interference between cup and cavity prevented fluid ingress behind the cup. A larger initial separation between the loading head and the acetabular cup caused a significant increase in measured pressures, with a 0.15mm increase in head-cup separation producing a 53% increase in pressures measured at the pole of the cup. Pressure differentials between different transducer sites indicated the ability for fluid flow behind the cup, which can be related in vivo to the movement of particulate debris to periacetabular bone. The APTR was able to measure clinically significant pressures and to analyse the effects of modifying component and loading characteristics with currently available prosthetic components. This makes the rig useful in a clinical context, as it has been shown to be capable of testing a broad range of component types under a wide range of conditions. Its use will ensure new prostheses and fixation modes can be designed in such a way as to eliminate the damaging fluid pressures currently observed in artificial hip joint replacements.

Christopher John Haines. / Thesis (M.D.)--Chinese University of Hong Kong, 1996. / Includes bibliographical references (leaves 239-279). / LIST OF TABLES --- p.xviii / LIST OF FIGURES --- p.xxi / LIST OF ABBREVIATIONS --- p.xxii / Chapter CHAPTER1 --- INTRODUCTION --- p.1 / Problems related to the menopause / Research plan / Chapter CHAPTER2 --- OVERVIEW --- p.15 / Introduction / Atherosclerosis and the lipid profile / Coronary artery disease and lipid abnormalities in women / "Exogenous oestrogens, progestogens and coronary artery disease " / Lipoprotein (a) / Chapter CHAPTER3 --- GENERAL METHODOLOGY --- p.134 / Recruitment of cases / Pharmacokinetics / Data collection and analysis of samples / Ethical considerations / Chapter CHAPTER4 --- STUDY I -THE SHORT TERM EFFECTS OF ORAL OESTROGEN --- p.157 / Crossover analysis of effects of oral oestrogen on lipoprotein (a) and other lipoproteins / Relationship between lipoprotein (a) and other lipids and lipoproteins / Chapter CHAPTER5 --- STUDY II -THE SUSTAINED EFFECTS OF ORAL OESTROGEN --- p.186 / Analysis of prolonged effects of oral oestrogen on lipoprotein (a) and other lipids and lipoproteins / Chapter CHAPTER6 --- STUDY III -THE EFFECTS OF COMBINED CYCLICAL HORMONE REPLACEMENT THERAPY --- p.196 / Analysis of effect of combined cyclical hormone replacement therapy on lipoprotein (a) and other lipids and lipoproteins / Comparison between sampling during oestrogen alone and combined phase of treatment / Chapter CHAPTER7 --- STUDY IV -THE EFFECTS OF PERCUTANEOUS OESTROGEN --- p.214 / Analysis of effect of percutaneous on lipoprotein (a) and other lipids and lipoproteins / Chapter CHAPTER8 --- SUMMARY AND CONCLUSIONS --- p.228 / BIBLIOGRAPHY --- p.239

Orientador: César Eduardo Fernades / Banca: Eliana Petri Nahas / Banca: Paulo Traiman / Banca: Luciano de Melo Pompei / Banca: Paula Andrea de Albuquerque Salles Navarro / Resumo: Avaliar comparativamente a eficácia da terapêutica de reposição hormonal (TRH) de baixa dose isolada ou associada à sinvastatina no comportamento de marcadores de risco cardiovasculares e do perfil lipídico e lipoprotéico em mulheres sintomáticas e com dislipidemia na pós-menopausa. Duzentas e quarenta e duas mulheres na pós-menopausa, sintomáticas e com dislipidemia foram randomizadas em três grupos de tratamento: A) estradiol (E2) 1mg/acetato de noretisterona (NETA) 0,5mg [E2/NETA] + sinvastativa 20mg; B) E2/NETA + placebo; e C) sinvastatina 20mg + placebo. A eficácia de cada tratamento foi avaliada pela melhora do perfil lipídico e lipoprotéico e dos sintomas climatéricos ao final de 16 semanas de tratamento. O colesterol total, o LDL-C, o colesterol não-HDL e a Apo B diminuíram de forma significativa (p<0,0001) ao final de 16 semanas no grupo que utilizou E2/NETA + sinvastatina e naquele tratado com sinvastatina + placebo. A relação Apo B/Apo A1 também apresentou redução significativa nestes dois grupos (p<0,0001 e p=0,0026 respectivamente). A Apo A1 diminuiu apenas no grupo que recebeu E2/NETA + sinvastatina (p=0,0055). O grupo E2/NETA + placebo não apresentou alterações significativas no perfil lipídico e lipoprotéico entre as visitas basal e final. Aquele que utilizou E2/NETA + sinvastatina apresentou redução significativa do HDL-C e da Apo A1 quando comparado às usuárias de sinvastatina + placebo (p=0,0233 e p=0,0231 respectivamente). No alívio dos sintomas climatéricos, os grupos que utilizaram E2/NETA foram superiores a sinvastatina + placebo. Em mulheres na pós-menopausa com dislipidemia, a associação de E2/NETA em baixa dose com sinvastatina aliviou os sintomas climatéricos de forma semelhante à observada com a E2/NETA isolada e melhorou o perfil lipídico e lipoprotéico de modo semelhante ao uso isolado da sinvastatina. O uso de E2/NETA sem ... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: To evaluate low-dose hormone therapy (HT) + simvastatin for vasomotor symptoms and cardiovascular risk markers. Symptomatic postmenopausal women (n=242) with dyslipidemia were randomized to one of three treatment groups: A) 1mg estradiol/0.5mg norethisterone acetate (E2/NETA) + 20mg simvastatin; B) E2/NETA + placebo; or C) 20mg simvastatin + placebo. Lipid and lipoprotein profiles and menopausal symptoms were evaluated after 16 weeks. Total cholesterol, LDL cholesterol, non-HDL cholesterol and Apo-B decreased (p<0.0001) in groups A and C, as did Apo-B/Apo-A1 (p<0.0001 and p=0.0026, respectively). Apo-A1 decreased only in group A (p=0.0055). HDL cholesterol and Apo-A1 were lower in A than C (p=0.0233 and p=0.0231, respectively). Relief of menopausal symptoms was better in A and B compared to C. HT + simvastatin were effective for the treatment of symptomatic postmenopausal women and improved the lipid profile similar to simvastatin alone. It also delivered an improvement in the simultaneous treatment of menopausal symptoms and dyslipidemia / Doutor

O presente trabalho apresenta um plano de substituição de tubulações do sistema de distribuição de água da Região Metropolitana de São Paulo (RMSP), utilizando um sistema de informações geográficas (SIG), que permitiu o relacionamento de dados do cadastro físico das tubulações com informações de reparos de vazamentos. Foram criados grupos de tubulações de mesmo material e, em alguns casos, de um mesmo período de implantação, para a definição de taxas anuais de substituição a partir da previsão de quebras futuras e da determinação do tempo ótimo de substituição das tubulações. Os resultados obtidos indicam que a vida média das tubulações apresenta um valor inferior ao verificado em países desenvolvidos. Assim, a taxa anual de substituição de tubulações, devendo oscilar entre 1,25 e 2%, será superior à média dos países desenvolvidos, que gira em torno de 0,5 a 1%, considerando que a idade média das tubulações varie entre 100 e 200 anos. / The following study presents a pipes replacement plan for the water distribution system of the Metropolitan Region of Sao Paulo (MRSP), using a geographic information system (GIS), which allowed the relation between the data of the water mains and the information about leakage repairs. Water main groups of the same material were created and, in some cases, of the same installation period, for the definition of yearly replacement rates based on the future breaks forecast and determination of the water mains optimal replacement timing. The results obtained suggest that the water mains average life, show a lower value than the one verified in developed countries. Thus, the water mains year replacement rate, witch should range from 1.25 to 2%, will be higher than the average in developed countries, witch is about 0.5 and 1%, considering that water mains mean age varies between 100 and 200 years.