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1
Wiggill, Magrita Nicolene. "Francois Bloemhof se Slinger-slinger : 'n leserkundige evaluering met verwysing na Afrikaanslesende tieners / Magrita Nicolene Wiggill". Thesis, Potchefstroom University for Christian Higher Education, 2001. http://hdl.handle.net/10394/3691.
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In 1996 Francois Bloemhof's teenage fiction, Slinger-slinger, was a prize-winner in the
beginners' category of the Sanlam competition for fiction for youth. The book was
acclaimed because of the open manner in which the author wrote about sensitive
themes such as hetero- and homosexuality, promiscuity, divorce, incest, tense family
relationships, and drug and alcohol abuse. The main theme of Slinger-slinger is
teenage sexual aspects, such as the sexual awakening and identity of teenagers.
In 1998 a sensation was caused in the media as upset parents, teachers and other
adults protested against the inclusion of Slinger-slinger in the ATKV's Children's
Book Award, category 13-15 years of age. Two conflicting opinions about Slingerslinger
could be distinguished: one group was of the opinion that the sexual theme
and strong language were not suited for teenage fiction, while the other group was of
the opinion that teenagers needed to read about realistic themes to prepare them for
the real world. No comments were published about the opinions of the supposed
readers, namely teenagers.
Steenberg (1988:168-172), Van der Westhuizen (1989:5-7) and Van Zyl (1990:17)
wrote that teenagers read to fulfil their needs. Teenagers' reading needs are directly
connected to their emotional, cognitive and physical developmental stages.
The aim of the study
The aim of this study is firstly to evaluate Slinger-slinger according to the elements of
the reader study model to determine whether it addresses the reading needs and
interests of teenage readers; and secondly to ascertain whether teenagers liked
Slinger-slinger.
Research procedures and methodology
A study of the literature was done in order to determine the reading needs and
developmental tasks of teenagers, and the role that teenage fiction can play in their
development to adulthood. Together with this background study, an evaluation
model, containing story elements viewed from a reader study perspective, as well as
criteria for the evaluation of the handling of sexual aspects in teenage fiction, was
developed to determine whether Slinger-slinger is successful teenage fiction.
In the empirical study the above-mentioned evaluation model for teenage fiction were
applied to Slinger-slinger. In the second part of the empirical study a questionnaire
was compiled to obtain the opinions of teenage readers about the success of Slinger-slinger
as a whole, as well as the success of the handling of the sexual aspects. The
questionnaire also served to obtain information about the reading needs of teenage
readers in regard to realistic teenage fiction and teenage fiction with a sexual theme.
Conclusion
It is concluded that Francois Bloemhof's Slinger-slinger succeeds as realistic teenage
fiction because it answers to the reading needs of teenage readers. Bloemhof
succeeded in his handling of the sexual aspects in Slinger-slinger an in doing so
fulfils teenager's reading and information needs, and thus assists them on their way
to maturity.
The questionnaire ascertained that the teenage readers who participated in the study
were of the opinion that Slinger-slinger is a successful and interesting teenage book,
and that they would like to read more realistic Afrikaans teenage fiction such as
Slinger-slinger.Thesis (M.Bibl.)--Potchefstroom University for Christian Higher Education, 2002.
2
Sescu, Carmen. "Experimental and Computational Study on Liquid Atomization by Slinger Injector". University of Toledo / OhioLINK, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=toledo1310163402.
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Jones, Nicholas Scott. "A Parametric Study of Micro Atomizing Nozzles on a Rotary Fuel Slinger". University of Toledo / OhioLINK, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=toledo1404656856.
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Malatkar, Jayanth. "Droplet trajectory and breakup modeling with comparisons to previous investigators' experimental results for slinger atomizers". Toledo, Ohio : University of Toledo, 2010. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=toledo1271266573.
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Thesis (M.S.)--University of Toledo, 2010.Typescript. "Submitted to the Graduate Faculty as partial fulfillment of the requirements for the Master of Science Degree in Mechanical Engineering." "A thesis entitled"--at head of title. Title from title page of PDF document. Bibliography: p. 90-94.
5
Yu, Jinwoo. "En applikation som skapar slingor av ljudinspelningar". Thesis, Linköpings universitet, Medie- och Informationsteknik, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-174844.
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En applikation för mobila enheter skapades för en målgrupp som bestod av barn i åldern 6–10 år.Applikationen ingick som en del av en större applikation som hette Clappen, som bestod av fleramindre applikationer. Clappen utvecklades av forskningsinstitutet RISE Interactive på uppdrag avÖstergötlands sjukhusclowner, som arbetar med att besöka barn på sjukhus i Östergötland. Med lek,gestaltning och musik ger Östergötlands sjukhusclowner barnen en paus i vardagen. Clappens syftevar att förlänga närvaron av clownerna på sjukhuset.Applikationen som beskrivs i detta examensarbete hade som syfte att tillåta barn att skapa musikutan att behöva ha taktkänsla eller förmågan att sjunga i korrekt tonhöjd. Funktionalitet för inspelningimplementerades i applikationen och varje inspelning korrigerades med följande ljudmanipulationer:filtrering, analys med Fast Fourier Transform, sample slicing, tonhöjdsbyte med en fasvokoder, fadeoch kvantisering. Det grafiska gränssnittet utvecklades med följande metoder: fältstudie, effektkarta,prototyper, designmetoden “Crazy eights“ och användartest. Resultatet blev ett grafiskt gränssnitt somtilltalade målgruppen och som enligt användartestet var snabbt och enkelt för målgruppen att lära sig.Examensarbetet är utfört vid Institutionen för teknik och naturvetenskap (ITN) vid Tekniska högskolan, Linköpings universitet
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Nagavarapu, Shasank. "Measuring Biomechanical Loads on the spine during Patient Lifting Sling Application and Removal: Assessing the effects of Work Method, Patient Weight and Bed Height". The Ohio State University, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=osu1440270675.
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Thungström, Sara. "Aktivitetsslingan". Thesis, KTH, Arkitektur, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-188184.
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Aktivitetsslingan Alla barn föds med en stark nyfikenhet att utforska världen. Inom Reggio Emilia pedagogiken finns en filosofi att varje barn besitter hundra olika språk. Det vill säga att varje barn har oändligt många sätt att uttrycka sig på för att lära sig och förstå sin omgivning. I förskolan Slingan ligger fokus på lärandet genom sinnen och ett ständigt utforskande av omvärlden. Genom förskolans tre våningar löper en krokig rörelse i form av en aktivitetsslinga. Den omfattar förskolans gemensamma utrymmen så som entrén, trappor, korridorer, rörelserum, bibliotek och ateljé. I slingan sker varierande aktiviteter för barnen samtidigt som den kopplar ihop förskolans övriga rum och avdelningar. Tanken är att aktivitetsslingan ska uppmuntra barnens olika sinnen samtidigt som det blir en plats för barn i varierande åldrar att mötas och integrera med varandra. Runt varje hörn finns en ny spännande plats att utforska och slingan blir på så sätt till en upptäcktsfärd genom förskolan. Hela huset yttre form är en strikt kub i kontrast till den inre krokiga rörelseslingan. Där slingan rör sig återspeglas även i förskolans fasad i form av stora glaspartier i väggar och tak. Fönstren ger på så vis förbipasserande en inblick i förskolans inre aktiviteter.The Activity loop All children are born with a strong curiosity to explore the world. In Reggio Emilia pedagogy every child is seen to possess a hundred different languages. That will say that every child has infinitely ways to express themselves in order to learn and understand their surroundings. Across the preschool, a winding movement is running trough the building. Its a form of an activity loop where the idea is to activate the children´s different senses. The loop includes common areas such as the entrance hall, stairs, corridors, play area, library and atelier. The activity loop contains various activities but is at the same time a connection trough the preschool other rooms and departments. The idea with the activity loop is to encourage children´s senses while it also becomes a place for children of varying ages to meet and integrate with each other. Around every corner there will be a new and exciting place to explore. The exterior is shaped as a strict cube in contrast to the inner winding loop. Where the loop goes it also reflects in the preschool´s facade in form of large windows. The windows also provide passersby a glimpse into the preschool´s inner activities.
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Kahn, Julie. "Biomechanics of Patient Handling Slings Associated with Spinal Cord Injuries". Scholar Commons, 2013. http://scholarcommons.usf.edu/etd/4702.
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Pressure ulcers and related skin integrity threats are a significant problem in current transfer/transport systems used for spinal cord injury patients. To understand this problem twenty-three different slings with varying type, material, and features were analyzed in hopes to identify at-risk areas for skin integrity threats such as pressure ulcers. Population samples included non-disabled (otherwise referred to as "healthy") volunteers as well as SCI patients from the James A. Haley Veterans Hospital. High resolution pressure interface mapping was utilized to directly measure the interface pressures between the patient and sling interface. Overall results provide relevant feedback on the systems used and to suggest a particular type of sling that might reduce and possibly minimize skin integrity threats as well as extend safe patient handling guidelines with sling use. It was found that the highest interface pressures convened along the seams of the sling, regardless of manufacturer or type.
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Rebecca, Magyar. "Håltavla för upphängning av Irislights : Produktutveckling av uppfästningskonstruktion för LED-slinga". Thesis, Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:kau:diva-44397.
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Rapporten behandlar ett examensarbete för högskoleingenjörsprogrammet inom innovationsteknik och design, utfört av Rebecca Magyar. Uppdragsgivare för projektet var Home Structures Sweden AB och arbetet riktade sig till det egna varumärket Irislights med Peter Nordin som handledare på företaget. Irislights är en produkt som består av en LED-slinga för inomhusbruk. Produkten är tänkt att vara kreativ för kunden färg- och formmässigt vilket låter kunderna själva kombinera handgjorda bomullsbollar som fästs kring en diod på slingan. Projektets huvudsakliga uppgift var att generera en lösning för fästning av befintlig produkt med avseende på kundernas behov i att hänga upp slingan. Den valda lösningen ska ge kunden utrymme för att utnyttja sin egen kreativitet. Arbetet utgick ifrån designprocessen där en förstudie var inledande fas för arbetets uppbyggnad. Förstudien innefattade en kartläggning av kommande trender inom inrednings- och belysningsbranschen, undersökning av kundernas behov och reflekterande arbete kring framtidens inredningsuttryck. Undersökning av teknik ingick även i förstudien för att få mer information kring befintlig produkt samt krav denna kom att ställa på det framtagna koncept som rapporten berör. Eftersom nuvarande produkt och den framtagna upphängningskonstruktionen ska samverka med varandra kommer uppställda krav vara av betydelse för utformningen. Ifrån detta skapades idéer som sedan genererades fram till slutgiltigt produkt förslag. Den valda utformningen presenteras genom skisser, CAD-konstruktion, ritningar samt en skalenlig prototyp. Ett materialval gjordes även på produkten i materialvals programmet CES EduPack för att ge förslag på ett miljövänligt alternativ sett till framställning av materialet vid preliminär produktion.This report describes a Bachelor Theisis of Science in Innovation and Design, conducted by Rebecca Magyar. The project was carried out for Home Structures Sweden AB directed to their own brand Irislights with Peter Nordin as task manager. The existing product Irislights consists of one product, a LED trail for indoor use. The product is supposed to be creative in terms of color and pattern and let the customers combine and create a personalized light trail. The project's main task was to generate a fastening function for the existing product with consideration to customer needs. Also develop the chosen soulution with oppurtunity to provide the customer oppurtunity to us their own creativity. The implementation of the work was based on a survey of future trends in interior design and in the lightning industry, also by analysing customer needs. Requirements was developed after creating understanding about the existing technology in Irislights which affected the chosen concept so it could be practicable in reality. Based on a feasibility study ideas was created which generated a final product suggestion. The chosen concept was presented through sketches, a modell in 3D-CAD , CAD-drawings and a full-scale prototype. The selection of material was also made in the program CES EduPack to give suggestions on an environmentally friendly alternative in terms of energy consumption in the primary production of a material.
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Souza, Ricardo Santos 1982. "Estudo biomecânico comparativo entre dispositivos de fixação de mini slings em modelo murino ex-vivo = Biomechanical study comparing fixation devices of mini slings in murine model ex vivo". [s.n.], 2014. http://repositorio.unicamp.br/jspui/handle/REPOSIP/312988.
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Orientadores: Paulo César Rodrigues Palma, Cássio Luís Zanettini RiccettoDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: Introdução e hipótese: O implante de slings corresponde ao padrão atual de tratamento da incontinência urinária de esforço. Para sua eficácia, exigem um mecanismo de ancoragem adequado. O objetivo deste estudo foi comparar as características biomecânicas de sistemas de fixação de dois modelos de mini slings atualmente disponíveis no mercado (Ophira® e Mini Arc®) por meio de teste de tração uniaxial em modelo murino ex vivo. Materiais e Métodos: Os dispositivos de ancoragem dos mini sling foram implantados cirurgicamente na parede abdominal de 15 ratos divididos em três grupos de cinco animais. Estes grupos foram sacrificados de acordo com a data pós implante em 7, 14 e 30 dias. Na sequência, extraia-se em bloco a parede abdominal de cada animal contendo os dispositivos de fixação. Este material era submetido a teste de tração até o despreendimento do sistema de ancoragem a partir do tecido leito de implante. Foram determinadas a medida da carga máxima (N) e deformação total (mm) até a avulsão. Os resultados foram comparados por meio do teste t de Student e o valor de p 5% foi considerado significativo. Resultados: O sistema de fixação do mini sling Ophira® em comparação ao Mini Arc® exigiu maior carga máxima para avulsão do tecido abdominal nos 3 períodos avaliados com significância estatística: 7º dia, 5,14 ± 0,69 N versus 4,11 ± 0,81 N (p 0,037), 14º dia 10,64 ± 0,81 N contra 9,02 ± 0,54 N (p 0,001) e no 30º dia 18,76 ± 1,48 N versus 14,85 ± 1,28 N (p < 0,001), respectivamente. Quanto ao deslocamento ocorrido durante a tração, o Ophira® desenvolveu maior deflexão significante em todos os momentos avaliados: no dia 7, 11,14 ± 0,53 mm enquanto o Mini Arc® 7,89 ± 1,01 mm (p 0,001), no dia 14 15,80 ± 0,95 mm versus 12,49 ± 1,43 mm (p < 0,001) e no trigésimo dia os valores foram 23,95 ± 1,38 mm contra 18,24 ± 0,50 mm (p < 0,001), respectivamente. Conclusão: O dispositivo de ancoragem do mini sling Ophira® proporcionou melhor fixação à parede abdominal murina em relação ao do Mini Arc®. Este resultado foi mantido mesmo no período pós-operatório tardio
Abstract: Introduction and hypothesis: Slings are currently the standard treatment for stress urinary incontinence. To be effective, they require an adequate anchoring system. The aim of this study is compare the biomechanical features of fixation systems of two mini slings models currently available on the market (Ophira¿ and Mini Arc¿). Materials and Methods: Anchoring devices of each sling were surgically implanted in the abdominal wall of 15 rats divided into three groups of five animals. These groups are formed according to the date of post implant euthanasia on 7, 14 and 30 days. Each abdominal wall was extracted in block containing the mini sling fixation device and was submitted to a tensile strength test for measure the maximum load and total deflection until device avulsion from the tissue. The results were compared using Student test t and a 5% cut off was considered significant. Results: The Ophira¿ mini sling fixation system demanded a greater maximum load compared to the Mini Arc¿ for avulsion of abdominal tissue in 3 evaluation periods with statistical significance: 7th day, 5.14 ± 0.69 versus 4.11 ± N 0,81 N (p 0.037), on day 14 10.64 ± 0.81 N versus 9.02 ± 0.54 N (p 0.001) and on day 30 18.76 ± 1.48 N versus 14.85 ± 1.28 N (p <0.001), respectively. Regarding the displacement occurred during traction, the Ophira¿ has developed significant higher deflection at all times evaluated: on day 7, 11.14 ± 0.53 mm while the Mini Arc¿ 7.89 ± 1.01 mm (p 0.001), on day 14 15.80 ± 0.95 versus 12.49 mm ± 1.43 mm (p <0.001) and on day 30 the values were 23.95 ± 1.38 mm vs. 18.24 ± 0.50 mm (p <0.001), respectively. Conclusion: The Ophira¿ mini sling anchoring device provided better fixation to the host tissue site compared to the Mini Arc¿ device in rats. This outcome were maintained even in the late post operative period
Mestrado
Fisiopatologia Cirúrgica
Mestre em Ciências
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Winckler, Jorge Antonio. "Estudo comparativo entre tela de polypropylene e cinta de aponeurose no tratamento da incontinência urinária feminina". reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2009. http://hdl.handle.net/10183/16364.
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Introdução: A incontinência urinária de esforço da mulher (IUE), perda involuntária de urina, é um problema social e de higiene, tem alta prevalência e diversas técnicas cirúrgicas foram realizadas para sua correção. Esse estudo usou a técnica de sling de aponeurose do reto abdominal como padrão para comparar a técnica de sling com tela de polypropylene. Método: De 2000 a 2007, 158 mulheres foram submetidas à cirurgia com sling de aponeurose do reto abdominal para IUE, média de idade 55 anos (37-69), e usado como padrão para comparação com 316 mulheres submetidas à cirurgia com sling de polypropilene, média de idade 55 anos (36-69). Em todas foi realizado anamnese, exame físico e estudo urodinâmico. Resultados: O tempo médio de seguimento foi de 3,65 e 3,56 anos, respectivamente. O grupo aponeurose apresentou cura da IUE em 128 (81.0%), melhora em 23 (14,6%) e falha em 7 (4,4%). O grupo polypropylene apresentou cura em 281 (88,9%), melhora em 23 (7,3%) e falha em 10 (3,2%) (p=0,083). Do grupo aponeurose, 7 (4,4%), tiveram extrusão vaginal/infecção: destas 2 (28,6%) com resolução espontânea e 5 (71,4%), remoção cirúrgica (p=0,877). Do grupo polypropylene, 15 (4,7%) tiveram extrusão vaginal/infecção, das quais 5 (31,2%) com resolução espontânea e 11 (68,8%) com remoção cirúrgica, (p=0,899). Urgência foi verificada em 19 (12%) no grupo aponeurose e 28 (8.9%) no grupo polypropylene (p=0,320). Foi realizado uretrólise em até 60 dias por retenção urinária em 6 mulheres (3,8%) do grupo aponeurose e em 7 (2,2%), do grupo polypropylene, (p=0,374). Os escores do questionário de qualidade de vida (ICIQ - SF) foram melhores no grupo polypropylene em relação ao grupo aponeurose (p=0,024). Conclusões: O uso de tela de polypropylene nesse estudo mostrou ser uma alternativa efetiva para confecção do sling para IUE da mulher, tem baixo custo, melhora qualidade de vida, bem como os resultados e taxas de complicações são comparáveis ao uso de aponeurose do reto abdominal.
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Slinker, Eva Havas. "Snake River : a personal search". PDXScholar, 1990. https://pdxscholar.library.pdx.edu/open_access_etds/4138.
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This thesis includes twenty landscape paintings, primarily oil on canvas, inspired by a trip to the Hell's Canyon Country of the Snake River.
The search for a personal idiom necessitated introspection, and the visual interpretation of the recalled experience required that formal issues of painting be synthesized to communicate the essential response to the landscape. The images progress from the depiction of deep space to compositions of the component parts of the landscape: trees, water, and rock.
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Coletti, Silvia Helena. "Avaliação do tratamento da incontinência urinária com sling fascial associado à histerectomia vaginal". Universidade de São Paulo, 2007. http://www.teses.usp.br/teses/disponiveis/5/5139/tde-20022009-140144/.
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Foram estudados, prospectivamente, por um período médio de 4,9 anos, os resultados do tratamento de 31 mulheres com incontinência urinária e afecção benigna do útero que foram submetidas à cirurgia de sling fascial associada à histerectomia vaginal, atendidas na Clínica Ginecológica do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, no período de fevereiro de 2000 a outubro de 2006. O objetivo foi avaliar os resultados do tratamento comparando-se os diagnósticos urodinâmicos pré- e pós-tratamento. As mulheres foram submetidas à cirurgia de histerectomia vaginal, para tratamento da afecção benigna do útero e sling fascial para correção da incontinência urinária. Realizou-se estudo urodinâmico no pré- e pós-tratamento, para avaliação da taxa de cura da incontinência urinária e do comportamento vesical nas fases de enchimento e esvaziamento, os quais foram avaliados por meio dos parâmetros urodinâmicos de fluxometria e cistometria. Na fluxometria avaliou-se o fluxo urinário máximo, fluxo urinário médio e volume de urina residual e na cistometria, determinou-se a capacidade vesical no 1° desejo miccional, capacidade vesical máxima e a pressão vesical necessária para ocorrer ou não a perda de urina. Os resultados mostraram, em relação á fluxometria diminuição significante do fluxo máximo, tendência à diminuição do fluxo médio e redução significante do volume de urina residual. Em relação à cistometria, houve aumento estatisticamente significante da capacidade vesical no 1° desejo miccional, da capacidade vesical máxima e valor da pressão vesical necessária para avaliar a presença ou não de perda urinária. Com relação ao diagnóstico urodinâmico, foi demonstrada a cura da incontinência urinária em 96,8% dos casos. Avaliando-se os parâmetros de cura objetiva da incontinência urinária, em seguimento de 4,9 anos, podemos inferir que o tratamento da incontinência urinária de esforço pode ser realizado simultaneamente, quando houver também, a indicação de histerectomia vaginalWe studied, prospectively, for a 4.9 years period the results of the treatment of 31 women with urinary incontinence and benign uterine disease that were submitted the surgery fascial sling associated to vaginal hysterectomy, the patients were all treated in the Gynecology Department of the Clinic Hospital of the University of Sao Paulo, in the period between February 2000 to October 2006. The objective was evaluate the results of the treatment comparing the urodinamic diagnosis pre and post treatment. All women were submitted to vaginal hysterectomy for treatment of benign uterine disorders and to facial sling to treat the urinary incontinence. An urodinamic study was performed pre and post treatment to define the rate of cure of the urinary incontinence and vesical behaviour in the filling and emptying fases, witch will evaluate through urodinamic parameters of flowmetry and cystometry, In the flowmetry were evaluated maximum urinary flow, medium urinary flow and residual urinary volume; and in the cystometry were determinated the bowel capacity in the first urinary desire, maximum bowel capacity in the first urinary desire, maximum bowel capacity and the needed bowel pressure to occur or not the urinary loss. The results showed in relation to the flowmetry significant reduction of the maximum flow, medium flow and urinary residual volume. In relation to cystometry we demonstrated an increase statistically significant in the vesical capacity in the first miccional desire, in the maximum bowel capacity and the value of the bowel pressure to evaluate the presence or not of urinary lost. In relation to the urodimanic diagnosis we could demonstrate the cure of urinary incontinence in 96.8% of cases. Evaluating the parameters of objective cure of urinary incontinence, in a follow up of 4.9 years, we can affirm that the treatment of urinary incontinence should be always be together with the vaginal hysterectomy when it is needed
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Gonçalves, de Lucena Roberto. "Utilização do biopolímero de cana-de-açúcar como novo material para sling pubo vaginal: análise estereológica". Universidade Federal de Pernambuco, 2007. https://repositorio.ufpe.br/handle/123456789/3159.
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Previous issue date: 2007Introdução e Objetivos: O entendimento universal que os slings sub-uretrais representam o padrão-ouro no tratamento da incontinência urinária feminina, leva a busca de um material heterólogo adequado para esta finalidade. Um polissacarídeo extracelular obtido por síntese a partir do melaço de cana-de-açúcar produzido no Laboratório de Microbiologia Experimental da Universidade Federal Rural de Pernambuco. Depois de purificado, é um produto transformado em uma película estável, sendo utilizado em diversos protocolos desenvolvidos pelos grupos de pesquisa, os quais estão servindo de base para diversas aplicações clínicas. O objetivo deste estudo é analisar os resultados da interação do biopolímero com o hospedeiro, analisando a reação inflamatória causada pelo novo material, utilizando a ferramenta da estereologia para sua quantificação e comparando com material sintético de comportamento já conhecido. Materiais e Métodos: Foram utilizadas 40 (quarenta) ratas, variando de 200 a 300 gramas, que foram anestesiadas conforme protocolo do núcleo de cirurgia experimental do Departamento de Cirurgia. Nos grupos A e B, foi utilizado o sling de biopolímero e, nos grupos C e D, tela de prolene. O sacrifício foi realizado após 30 e 90 dias. Após o sacrifício, a bexiga e uretra eram retiradas em bloco, junto com a parede abdominal anterior, para que, após a fixação com formol 10% tamponado, fossem realizadas secções com zona de interesse na região sub-uretral e inserção do sling na parede abdominal. As lâminas foram coradas com hematoxilina eosina e picro sirius. Resultados e conclusões: O material implantado mostrou-se absolutamente inerte e preservado na região implantada. Não observamos alteração morfológica ao nível da membrana de celulose, porém nas suas adjacências, vimos discretas reação tipo corpo estranho, que foram encontradas eventualmente. Em algumas áreas, observou-se processo de neovascularização, quando avaliado quantitativamente, e verificou-se presença de maior quantidade de fibras colágenas na região sub uretral no grupo que utilizou o sling de polímero. Na região sub aponeurótica, foi observada presença de colágeno semelhante entre os grupos sem significância estatística. A membrana de biopolímero mostrou-se no presente estudo, ser material estável, de fácil manipulação, com reação tissular mínima, com boa incorporação ao hospedeiro. Ocorre maior reação inflamatório na região sub uretral, porém sem causar erosão
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Mostafa, Alyaa. "Evaluation of single incision mini-slings in surgical management of female stress urinary incontinence". Thesis, University of Aberdeen, 2014. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=217882.
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Objectives: To compare single incision mini-slings (SIMS) versus standard mid-urethral sling (SMUS) in the surgical management of female stress urinary incontinence (SUI) with regards; efficacy, safety and cost-effectiveness. Methods: A multicentre randomised controlled trial (RCT) comparing SIMS-Ajust® with SMUS-TVT-OTM (1-year follow-up) was performed. In addition, a systematic review and meta-analysis of RCTs comparing SIMS versus SMUS (1-3 years follow-up) was performed, incorporating the results of the RCT. Both studies assessed post-operative pain, time to return to normal activities and work, patient-reported and objective cure rates, peri-operative complications and impact on pre-operative urgency, women's quality of life (QoL), sexual function and cost effectiveness. Results: For the RCT, 137 women were randomised (SIMS-Ajust® [n=69] vs. TVT-OTM [n=68]). The SIMS Ajust® group had significantly lower post-operative pain-profile within the first four weeks (p <0.001). There were no significant differences in patient-reported success rate (p >0.999), objective success rate (p >0.999) or re-operation rates (p= 0.721) at 1-year follow-up. For the systematic review, 670 articles were identified, and 26 RCTs (n=3308 women) were included. After excluding RCTs evaluating TVT-SecurTM (recently withdrawn from clinical practice), there were no significant differences between SIMS and SMUS in patient-reported cure rates (RR 0.94, 95% CI 0.88, 1.00) and objective cure rates (RR 0.98, 95% CI 0.94, 1.01) at a mean follow-up of 18.6 months. SIMS had significantly lower post- 1 operative pain scores (WMD -2.94; 95% CI -4.16, -1.73), and earlier return to normal activities and work (WMD -5.08; 95% CI -9.59, -0.56; and WMD -7.20; 95% CI -12.43, -1.98, respectively). Conclusion: Adjustable anchored SIMS-Ajust® appears to have more favourable recovery, pain and cost effectiveness outcomes than SMUS-TVT-OTM, whilst having similar effectiveness outcomes, at 1-year follow-up. Generally, SIMS appear to have equivalent outcomes compared with SMUS at a mean follow-up of 18-months, in terms of patient-reported cure, objective cure and impact on women's QoL and sexual function. Consequently, SIMS represent a promising group of procedures in the treatment of women with SUI, and merits further research especially in terms of longer term outcomes.
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Thiel, Marcelo. "Analise quantitativa da fibrose e semiquantitativa da reação inflamatoria de quatro diferentes slings sinteticos". [s.n.], 2006. http://repositorio.unicamp.br/jspui/handle/REPOSIP/308661.
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Orientadores: Cassio Luis Zanettini Riccetto, Paulo Cesar Rodrigues PalmaTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
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Resumo: OBJETIVOS: Analisar quantitativamente, com método estereológico, a densidade de fibras colágenas formadas após implante de quatro diferentes tipos de sling;verificar por análise histopatológica a reação inflamatória. MATERIAS E MÉTODOS: Realizou-se o estudo em 70 ratas da raça Wistar, divididas em 3 grupos (A,B,C): No grupo A (30 ratas) implantou-se uma faixa de silicone e outra de submucosa intestinal suína, de 8x 4 mm, no tecido subcutâneo da parede abdominal. No grupo B (30 ratas), implantou-se, da mesma maneira, uma faixa de copolímeros de poligalactina com ácido poliglicólico e outra de polipropileno monofilamentar, de 8x 4 mm. Sutura com fio de nylon 5/0, fixou as faixas e, no grupo C (10 ratas), denominado controle, realizou-se dissecção do subcutâneo e aplicação do mesmo fio, sem implante de material. A coloração de Picro-Sirius, empregada apenas no 90° dia de pós-operatório, permitiu análise das fibras colágenas e a de Hematoxilia-eosina, o estudo histopatológico da reação inflamatória. Nos dias 7, 30 e 90 de pós-operatório, sacrificaram-se 10 ratas de cada grupo. RESULTADOS: No 7° dia, todos os materiais induziram moderada reação inflamatória, sem diferença com o controle. No 30° dia, os copolímeros de poligalactina com ácido poliglicólico apresentaram a menor reação inflamatória, sem diferença com o controle. Neste período, polipropileno monofilamentar e silicone produziram inflamação moderada, enquanto que na submucosa intestinal suína, a intensidade foi severa. No 90° dia, a reação inflamatória, nos copolímeros de poligalactina com ácido poliglicólico, foi maior que antes, porém menor do que a do polipropileno monofilamentar e silicone, que permaneceram semelhantes entre si. Novamente, o grau de inflamação na submucosa intestinal suína continuou o maior de todos. Na análise estereológica, a densidade. de fibras colágenas dos copolímeros de poligalactina com ácido poliglicólico e polipropileno monofilamentar foi significativamente menor (61 % e 65% respectivamente) do que o silicone (85%) e submucosa intestinal suína (86%). CONCLUSÕES: Polipropileno monofilamentar foi o melhor material inabsorvível, pois induziu menos reação inflamatória que os outros materiais testados. Como a submucosa intestinal suína foi completamente removida, a intensa reação fibrótica que produz, toma-se útil, e responsável pelo suporte suburetral após a cirurgia
Abstract: OBJECTIVES: To analyse quantitatively, using stereological methods, the density of the collagen fibres induced by four types of sling materials, and verify by a histopathological analysis the corresponding inflammatory reaction, as fibrosis secondary to sling implantation is considered responsible for restoring urethral support and re-establishing continence in women with stress urinary incontinence, and new synthetic materials that promote adequate fibrosis with the least intensity and duration have been proposed to substitute the aponeurotic sling. MATERIALS AND METHODS: The study comprised 70 isogenic white Wistar rats divided into three groups: group A (30 rats) had 8 x 4 mm strips of silicone and porcine small intestine submucosa (SIS) implanted in the abdominal subcutaneous tissues; group B (30 rats) had 8 x 4 mm strips of polycaprolactone and polylactic acid copolymers and monofilament polypropylene (PLP) implanted the abdominal subcutaneous layer; while a control group of 10 rats had dissection and suturing with 5/0 Nylon in the abdominal subcutaneous layer, as used to fix the strips in the other rats. Picro-Sirius staining was used to assess collagen fibres, and haematoxylin-eosin for the histopathological study. At 7, 30 and 90 days after surgery, 10 rats from each group were killed and assessed. RESULTS: Afier 7 days all the materials induced a moderate inflammatory reaction that did not differ from that in the control group. At 30 days there was no difference between the control and polycaprolactone and polylactic acid copolymers, having the least inflammatory reaction. PLP and silicone produced a moderate inflammatory reaction, while the porcine SIS induced a more intense reaction. At 90 days there was a more intense inflammatory reaction in polycaprolactone and polylactic acid copolymers than before but it was less than with PLP and silicone, which again were no different. During this period the inflammatory reaction induced by SIS was greater. The stereological analysis indicated that collagen fibres induced by polycaprolactone and polylactic acid copolymers and PLP were less dense (61% and 65%, respectively), and significant1y less than with silicone (85%) and SIS (86%). CONCLUSION: PLP was the best nonabsorbable material as it induced a less intense inflammatory reaction than the other tested materials. As porcine SIS was completely absorbed the intense fibrosis induced is useful, as it is exclusively responsible for the urethral support later after surgery
Doutorado
Cirurgia
Mestre em Cirurgia
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COUTINHO, Carmem Lúcia Cavalcanti. "Desenvolvimento de tela transobturatória polimérica para uso na técnica de sling". Universidade Federal de Campina Grande, 2015. http://dspace.sti.ufcg.edu.br:8080/jspui/handle/riufcg/991.
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A técnica sling pela via transobturadora é eficaz para o tratamento de mulheres com Incontinência Urinária de Esforço e apresenta elevada taxa de cura e melhora da qualidade de vida com baixos índices de complicações. Este trabalho teve como objetivo desenvolver e confeccionar, uma tela de policaprolactona, para uso na técnica de Sling e realizar análises comparativas deste material com a tela de polipropileno, utilizada comercialmente. A pesquisa foi desenvolvida no Laboratório de Avaliação e Desenvolvimento de Biomateriais do Nordeste – CERTBIO. Utilizouse duas amostras de tela, uma confeccionada no CERTBIO e outra de uso comercial. Foram avaliadas as composições químicas e físicas das telas de Policaprolactona (PCL) e Polipropile no (PP), através das técnicas de: Espectroscopia na Região de Infravermelho com Transformada de Fourier (FTIR), Difração de Raios X (DRX) e Microscopia Eletrônica de Varredura (MEV), Tensão superficial, Ensaios Mecânicos de Tração e Teste de Citotoxicidade. Pode-se comprovar pela análise de FTIR, que o material formador das telas era apenas de polipropileno e policaprolactona. A análise de DRX corroborou com os resultados obtidos na análise de FTIR, que indicavam que o material das telas tratava de PP e PCL, apresentando um espectograma característico d estes polímeros. Também, através da análise de DRX, foi possível observar o grau de cristalinidade indicando o PP que possui maior grau de cristalinidade que o PCL. Pode-se comprovar também, que o PP possui maior resistência mecânica que o PCL, verificando assim que o PP é mais frágil e quebradiço do que o PCL. A análise de tensão superficial mostrou que as duas telas possuem molhabilidade parcial devido as cavidade presentes na superfície das telas. A biocompatibilidade dos compostos foi confirmada com o teste de Citotoxicidade.
The sling technique by transobturator approach is effective for the treatment of women with Stress Urinary Incontinence and has a high cure rate and improved quality of life with low complication rates. This work aimed to develop and produce, polycaprolactone, screen for use in Sling surgery and to perform comparative analyses of this material with a polypropylene bladder, used commercially. The survey was developed in the laboratory of evaluation and development of Biomaterials in the Northeast-CERTBIO. Two samples were used to screen; a made in the laboratory and another used commercially. Been evaluated physical and chemical compositions of the Polycaprolactone (PCL) and Polypropylene (PP) screens, through the following techniques: infrared Spectroscopy in the region with a Fourier transform (FTIR), x-ray Diffraction (XRD) and scanning electron microscopy (SEM), surface tension, traction mechanical essays and Cytotoxicity test. You can check by the FTIR analysis, that the trainer material of fabrics was just poliproplieno and polycaprolactone, for examining the computer spectrogram. The XRD analysis corroborated with the results obtained in the FTIR analysis, which indicated that the material was PP screens and PCL, showing a characteristic you might like to look of these polymers. Also, through the analysis of DRX, it was possible to o bserve the degree of crystallinity indicating the PP has higher degree of crystallinity the PCL. One can prove that the PP has higher mechanical strength than the PCL, checking so that the PP is more brittle than the PCL. The analysis of surface tension showed that both screens have partial wettability due to cavity present on the surface of the canvas. The biocompatibility of the compounds has been confirmed with the Cytotoxicity test and it showed low cytotoxicity in two screens.
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Viecelli, Camila Finger. "Tratamento cirúrgico para incontinência urinária : resultados das cirurgias de Burch e de Sling realizadas no Hospital de Clínicas de Porto Alegre". reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2010. http://hdl.handle.net/10183/25120.
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Leslie, Scott. "Robosling: Does an Autologous Vascularised Bladder Neck Sling Improve Continence Outcomes Following Radical Robotic Prostatectomy?" Thesis, The University of Sydney, 2021. https://hdl.handle.net/2123/25932.
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Prostate cancer is commonly diagnosed in Australian men owing to widespread use of PSA testing. In appropriate patients, radical prostatectomy is an effective treatment option with good long-term oncological outcomes. However, the morbidity associated with functional complications including urinary incontinence and sexual dysfunction remain a significant concern for men when deciding between surgery or other treatment options.
Although recovery of continence 12 months following radical prostatectomy is high (60-93%), early continence rates are significantly lower (32-84%) and can negatively impact quality of life. Post-operative incontinence is predominantly a result of damage to the urethral sphincter due to surgical dissection, cautery and traction on the continence mechanisms with subsequent intrinsic sphincter deficiency. Improved understanding of operative pelvic anatomy has allowed better preservation of these continence mechanisms and there are a large number of publications describing various intraoperative surgical techniques to reduce incontinence.
One such surgical concept is the use of Slings at the time of radical prostatectomy to promote continence post-operatively. Chapter 1 of my thesis is a systematic review and meta-analysis of the current literature on the use of intraoperative slings at the time of radical prostatectomy. This review was registered with PROSPERO and written in accordance with PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols). Five randomised controlled trials and five retrospective cohort studies were included with various sling material used including, rectus fascia, small intestinal submucosa, vas deferens, Denonvillier’s fascia, median umbilical ligament and retrotrigonal muscular layer. The meta-analysis concluded that intraoperative sling procedures during radical prostatectomy may promote early return of continence compared to having no sling, however there are no long-term differences.
Chapter 2 of my thesis describes the technique and preliminary outcomes of a novel intraoperative sling developed to improve post-prostatectomy continence. This sling, the RoboSling, differs from previously described slings in that it is an autologous, fascial sling harvested from the well-vascularised peritoneum on the posterior aspect of the bladder, then placed underneath the bladder neck and hitched to the inguinal ligaments of Cooper with v-loc sutures. By tensioning the RoboSling, the bladder neck, perineal body and urethrovesical anastomosis are supported in order to improve post-operative continence. In this non- randomised cohort study, using prospectively collected data from the prostate cancer database at Royal Prince Alfred Hospital (RPAH), we compared the outcomes of 30 patients who had the novel RoboSling performed at the time of robotic-assisted radical prostatectomy (RARP) with 163 patients who underwent robotic-assisted radical prostatectomy without the sling. This study found that improved rates of continence were achieved in the RoboSling group both at 3 months as well as 12 months. Furthermore, this was without a higher complication rate and there was no deleterious effect on oncological outcomes.
These promising results were the impetus for developing a randomised controlled trial (RCT) in order to provide Level 1 evidence on the outcomes of the novel RoboSling technique. Chapter 3 of my thesis is the protocol of the RoboSling RCT that was approved by the Sydney Local Health District Human Research Ethics Committee in 2018. The study aims to recruit 120 patients with localised prostate cancer undergoing RARP at Royal Prince Alfred Hospital. At the time of submitting this thesis, 40 patients have been enrolled in the study.
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GOURDEAU, FLORENCE. "Naissance anormale de l'artere pulmonaire gauche (sling) : a propos de deux cas". Bordeaux 2, 1988. http://www.theses.fr/1988BOR25352.
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Sousa, Antonio de Pádua Silva. "TÉCNICA DE SLING: AVALIAÇÃO DOS RESULTADOS COMPARANDO FAIXA DE POLIPROPILENO INDUSTRIALIZADA E ARTESANAL". Universidade Federal do Maranhão, 2008. http://tedebc.ufma.br:8080/jspui/handle/tede/1118.
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Previous issue date: 2008-10-19This study proposes to evaluate the results post stress urinary incontinence surgery (SUI) using the Sling technique and utilizing a range of polypropylene sub urethral manually manufactured (Marlex®), and laboratory made (Advantage®), comparing the results in both groups and prostheses costs. The sample used was of 39 women carriers of SUI resulting from hyper mobility of the bladder neck and/or sphincteric incompetence determined by clinical evaluation and urodynamic studies. The criterion considered was the exclusion of diabetes mellitus, previous extended pelvic surgeries and previous radiotherapy. The patients were split in 2 groups. Group 1 Patients from the department of Urology at the University Hospital of the Federal University of Maranhao (19 patients) and Group 2 Patients from private clinics (20 patients). Group 1 used the manually manufactured polypropylene sub urethral while group 2 used the laboratory made. Patients were evaluated in between thirty, sixty and ninety days post surgery comparing the following variables: Average surgery time, hospitalization time, difficulty to urinate, length of time using the post surgery probe, normalization of urinary jet, involuntary urine loss, level of satisfaction regarding the surgery, urodynamic alterations and probe costs. The average surgery time was of 43 25 in Group 1 and 51 42 Group 2. As to difficulty to urinate post surgery, in Group I, one hundred percent (100%) of the patients presented no difficulties while in Group 2; ninety four point seven percent (94.7%) were able to urinate properly. Regarding the probe use one hundred percent (100%) of the patients from both groups were free from it by the end of this study. All patients from both groups presented normal urinary jet during the last evaluation. In Group 1 one hundred percent (100%) of the patients did not accuse urine loss, while in Group 2 it was ninety four point seven percent (94.7%) at the ninetieth day. The level of satisfaction was of one hundred percent (100%) of the patients from Group 1 while one patient in Group 2 considered the surgery unsuccessful. The evaluation urodynamic presented non inhibit contraction of low vesical pressure in eleven point one percent (11.1%) in Group 1 and ten point five percent (10.5%) in Group 2. There were no complications in both groups. Occurrences observed: burning micturition and urinary urgency spontaneously disappeared by the end of this study and did not have any relations with sub urethral meshes. We can conclude the use of polypropylene mesh (Marlex ®) manually manufactured can also be used in Sling surgeries, saving on resources and having similar results to the use of the laboratory made version.
Este trabalho se propõe avaliar os resultados pós-operatórios da cirurgia de incontinência urinária de esforço (IUE), pela técnica de Sling, utilizando-se faixa de polipropileno suburetral de fabricação artesanal (Marlex®) e industrializada (Advantage®). comparando os resultados em ambos os grupos e o custo das próteses. A amostra foi de 39 mulheres portadoras de IUE resultante de hipermobilidade do colo vesical e/ou incompetência esfincteriana feita pela avaliação clinica e estudo urodinamico. Foram considerados critério de não inclusão diabetes mellitus, passado de cirurgias pélvicas ampliadas e radioterapia prévia. As pacientes foram dividas em grupos: Grupo I oriundas do Serviço de Urologia do Hospital Universitário da Universidade Federal do Maranhão (19 pacientes) e Grupo II pacientes provenientes da Clinica Privada (20 pacientes). No Grupo I, utilizou-se tela artesanal e no Grupo II, tela industrializada. As pacientes foram avaliadas com trinta, sessenta e noventa dias de pós-operatório comparando-se as seguintes variáveis: tempo médio de cirurgia,tempo de internação, dificuldade para urinar, tempo de permanência de sonda no pós-operatório, normalização do jato urinário, perda urinária involuntária, grau de satisfação em relação à cirurgia, alteração urodinâmica e custo das próteses. O tempo médio de cirurgia foi de 43 25 no Grupo I e 51 42 no Grupo II. O tempo médio de internação foi de 52hs8min horas no Grupo I e de 49hs14min no grupo II. Quanto à dificuldade de urinar no pós-operatório, no Grupo I, 100% das pacientes nada referiam no final da observação e no Grupo II, 94,7% urinavam bem. No que concerne ao uso de sonda, em ambos os grupos, 100% das pacientes estavam livre desta ao fim da observação. Todas as pacientes de ambos os grupos apresentavam jato urinário normal na ultima avaliação. No Grupo I, 100% das pacientes não referiam perda urinária e no Grupo II 94,7% no 90º dia pós-operatório. O grau de satisfação foi de 100% nas pacientes do Grupo I, enquanto no Grupo II uma paciente referiu insucesso. A avaliação urodinâmica demonstrou Contração Não Inibida (CNI) de baixa pressão em 11,1% no Grupo I e em 10,5% no Grupo II. Não houve complicação importante em ambos os grupos. As intercorrências observadas: ardência miccional e urgência urinária desapareceram espontaneamente ao final da observação não tinham relação com o material das faixa suburetrais.Conclui-se que a utilização de alça de polipropileno (Marlex ®) de fabricação artesanal pode de ser utilizada nas cirurgias de Sling, com economia de recursos e com resultados semelhantes àqueles observados com a utilização das alças industrializadas.
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Pearson, William Gordon Jr. "A two-sling mechanism of hyolaryngeal elevation in the pharyngeal phase of swallowing". Thesis, Boston University, 2012. https://hdl.handle.net/2144/12585.
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Thesis (Ph.D.)--Boston UniversityThe pharyngeal phase of swallowing is a complex function that transfers a bolus from the oral cavity through the hypopharynx into the esophagus. A critical event in this process is the elevation of the hyolaryngeal complex, which opens the upper esophageal sphincter and relocates the airway away from an oncoming bolus. The suprahyoid group of muscles (mylohyoid, geniohyoid, digastric, and stylohyoid) and thyrohyoid are thought to underlie this function. The role of a deeper posterior sling of muscles that is comprised of stylopharyngeus, salpingopharyngeus and palatopharyngeus has not been determined. This project aims to investigate a hypothesized two-sling mechanism for hyolaryngeal elevation in the pharyngeal phase of swallowing. The thesis begins with background information of the functional anatomy thought to underlie hyolaryngeal elevation followed by an outline of studies that validate the structure, function, and clinical relevance of the two-sling mechanism. A cadaver model is first used to calculate potential force vectors of the muscular slings. The function of the two-sling apparatus is then investigated in vivo by using muscle functional MRI to evaluate muscles active in swallowing and dynamic MRI to perform kinematic analysis on key anatomical landmarks that represent attachment sites of the two-sling mechanism. Finally, the clinical significance of the two-sling mechanism is demonstrated by comparing spatial and temporal measurements collected from fluoroscopic imaging studies of patients with normal swallowing ability and swallowing difficulty.
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Bahtijaragic, Merima, Monica Davidsson i Sandra Hedin. "Delaktighet : En kvalitativ studie om en delaktighetsmodell i kommunal verksamhet och hur den fungerar i praktiken". Thesis, Högskolan i Borås, Akademin för vård, arbetsliv och välfärd, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-10218.
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Denna studie har gjorts för att se hur en delaktighetsmodell i kommunal verksamhet fungerar i praktiken och om huvudsyftet, att ge personer med funktionsnedsättning ett ökat inflytande och en större delaktighet uppnås i realiteten. Detta då modellens utförande är tänkt att fungera utifrån ett nerifrån och upp perspektiv där personer med funktionsnedsättning själva ska ha möjlighet till inflytande och att få känna sig delaktiga i sin vardag. Forskning som finns om delaktighetsmodellen är begränsad men forskarna är eniga om att det finns en problematik kring bemötande och kommunikation gentemot de funktionsnedsatta och att detta kräver utbildning hos personal och vägledare. Vi har använt oss av en kvalitativ metod med semistrukturerade intervjuer utifrån ett fenomenologiskt perspektiv. Deltagarna i studien är chefer, personal och vägledare från kommunal verksamhet i Västra Götalands region och de arbetar med personer med funktionsnedsättning. De teorier vi använt oss av är Habermas kommunikationsteori och Foucaults maktteori. Frågeställningar som respondenterna fick reflektera över, var bland annat deras syn på vad delaktighet hos personer med funktionsnedsättning är för dem och om de upplever någon förändring i sitt bemötande. Vi har även haft ett intresse i att ta reda på om det är personerna med funktionsnedsättning själva som får bestämma vilka ämnen som anses relevanta att vara delaktiga i och om besluten de fattar verkligen träder i kraft. Förhållningssättet vi utgått ifrån har varit kritiskt med fokus på dialog, makt och dold makt. Vad som har framkommit i resultatet är att modellen har bidragit till ett förändrat arbetssätt hos personal. Makten har omfördelats mellan personal och brukare. Alla intervjupersoner tror på modellen men har farhågor över att modellen kommer att stanna upp och endast bidra med en tillfällig delaktighet, något som vi problematiserar i diskussionen.This study has been made to see how a participatory model of municipal activities works in practice and whether the main purpose, to give users greater influence and a greater participation is achieved in reality. This is because the model's design as a bottom -up perspective, where users themselves should have the opportunity to influence and to feel involved in their everyday lives. Even though the research about the participation model is limited the scientists agree that there is a problem about the behavior and communication to the clients, this will require training of staff and counselors. We have used a qualitative method of semi-structured interviews based on a phenomenological perspective. Study participants are managers, staff and counselors from local government activities in the Västra Götaland region, and they work with clients who have disabilities. The theories we have used is Habermas's communication theory and Foucault's power theory. Questions that respondents did reflect on included their views on the participation of the clients and if they experienced any change in the approach towards clients. We also had an interest in finding out whether it is the users themselves who should determine what themes they considered relevant to be involved in and if the decisions they make actually give effect. The approach we have assumed has been critical and of focus on dialogue, power and hidden power. What has emerged in the results is that the model has contributed to a changed approach of the staff. The power has been shifted between staff and clients. As we have problematized the discussion, all interviewees believe in the model but fear that the model will not be continued and only be a temporary activity.
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Carbonnier, Anders, i Ninni Martinsson. "Examining muscle activation for Hang Clean and three different TRX Power Exercises : A validation study". Thesis, Högskolan i Halmstad, Biomekanik och biomedicin, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-17754.
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Background: Resistance training has proven to increase athletic performance, traditionally barbell training and Olympic Lifting have been used for this purpose. Sling training has recently been developed as a complement or substitution to traditional resistance training. Research has shown an increase in sport specific athletic performance and core stability with sling training. TRX Suspension Trainer is a newly developed sling training tool and to date no independent research has been done with the TRX. Purpose: To examine and compare muscle activation using TRX and the Olympic Lifting movement Hang Clean. Methods: 32 senior high school male soccer players participated in the study. Surface electromyographic (sEMG) data were collected on mm.erector spinae (back), m.gluteus maximus (glutes), m.vastus lateralis (quadriceps), m.semitendinosus (hamstrings) and m.gastrocnemius caput laterale (calf). Surface EMG data was collected when the subjects performed five different exercises, Hang Clean, TRX Squat Jump, TRX Front Squat and TRX Power Pull. In addition a Squat Jump was used as reference. Results: A similar muscle activation was found between Hang Clean (674 µV), TRX Squat Jump (684 µV) and TRX Front Squat (691 µV). TRX Power Pull showed the highest activation for mm.erector spinae and m.gluteus maximus but the lowest when comparing total muscle activation for all measured muscles. Conclusion: The similar amount of muscular activation for Hang Clean, TRX Squat Jump and TRX Front Squat indicates that the TRX Suspension Trainer can be used as a complement, for experienced athletes, or a substitution, for novice athletes, to traditional strength training. Coaches and athletic trainers should acknowledge the need and the importance of resistance training for athletic performance.
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Matteini, Linda. "Proposta di traduzione di un estratto della graphic novel “Celtic Warrior: the Legend of Cú Chulainn” di Will Sliney". Bachelor's thesis, Alma Mater Studiorum - Università di Bologna, 2018.
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Con il presente elaborato si intendono analizzare le tecniche e le strategie che possono essere impiegate nella traduzione di fumetti, per poi metterne in pratica alcune nella proposta di traduzione di un estratto della graphic novel “Celtic Warrior: the Legend of Cú Chulainn”. L’elaborato è suddiviso in sette capitoli, attraverso i quali si cercherà di affrontare l’argomento in modo chiaro ed esaustivo. L’introduzione presenterà brevemente il lavoro e spiegherà i motivi che mi hanno portata a scegliere questo tema e quest’opera in particolare; il capitolo 2 illustrerà le caratteristiche generali del fumetto; il capitolo 3 tratterà gli aspetti specificamente legati alla traduzione; il capitolo 4 fornirà una presentazione dell’opera; il capitolo 5 presenterà la proposta di traduzione a cui seguirà il commento nel capitolo 6; da ultimo, nel capitolo 7, verranno esposte le conclusioni che sono state tratte attraverso la redazione di questo elaborato e la traduzione del suddetto estratto.
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Weber, Lebrun Emily Elise. "Factors Associated with Subjective Improvement Following Midurethral Sling Procedures for Stress Urinary Incontinence: A Masters Thesis". eScholarship@UMMS, 2010. https://escholarship.umassmed.edu/gsbs_diss/466.
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Background Female stress urinary incontinence (SUI) greatly affects quality of life. The midurethal sling (MUS) procedure has been widely accepted as the standard of care treatment for SUI, although there is little information regarding patients' subjective reports of symptom improvement.
Objectives The objective of this study was to identify clinical and demographic characteristics that predict subjective symptom improvement following MUS procedures in women with SUI.
Materials and Methods The study design was retrospective cohort. Subjects included women who underwent MUS between 2006 and 2008, returned mailed surveys and met our predefined inclusion criteria. Pre-operative data included demographics, prior surgery, co-morbid diseases, urodynamics and concomitant reconstructive surgery. Subjective improvement was measured by score improvement on the UIQ-7, UDI-6, the UDI stress subscale and Question 3 of the UDI, "Do you experience urine leakage related to physical activity, coughing, or sneezing?"
Results The mean age of the study sample was 57 years, parity was 2.5 and BMI was 28. Subjects with lower MUCP demonstrated more improvement on the UIQ-7. ΔUDI-6 stress subscale scores were more sensitive to symptom change than either the ΔUDI-6 or ΔUIQ-7. Older, menopausal subjects with urethral hypermobility and concomitant vaginal suspension showed less improvement than subjects without these characteristics. After controlling for urethral straining angle, PVR, menopause and time out from surgery, older age and concomitant vaginal suspension were associated with persistent post-op symptoms on the UDI-6 Question 3 and age remained the only variable associated with persistent symptoms on the UDI-6 stress subscale.
Conclusion Concurrent vaginal suspension and advancing age were risk factors for persistent symptoms following MUS procedures in patients with SUI. Symptoms may recur after 24 post-operative months. Clinicians are encouraged to provide additional preoperative counseling to those women who are at greatest risk for persistent symptoms.
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Barbosa, Ismael Motta. "Equipamentos de autoajuda: projeto e validação de um protótipo funcional para sustentação e movimentação de membros superiores". Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/18/18146/tde-09112017-095829/.
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O objetivo desse trabalho foi desenvolver um equipamento destinado a proporcionar a realização de exercícios terapêuticos, baseado numa abordagem sistemática de desenvolvimento de projeto orientado pelo usuário e obter um protótipo funcional. Por meio das técnicas de metodologia de projeto e dos fundamentos gerais de elementos de máquinas desenvolveram-se a fase do projeto conceitual, com interface ao projeto informacional de Souza (2016), e do projeto preliminar direcionado ao desenvolvimento de um protótipo funcional destinado à sustentação e movimentação dos membros superiores de indivíduos com disfunções motoras nos nestes membros. Devido a um conjunto de fatores provenientes dos mais diversos segmentos da sociedade, há uma demanda crescente com relação à atuação das diversas áreas da engenharia, que possam fornecer soluções tecnicamente viáveis e ainda, com um grau de personalização em massa destinadas às aplicações na área da saúde. A área de conhecimento denominada \"Tecnologia Assistiva\" (TA) inserida na área da saúde, atua principalmente no desenvolvimento de órteses, próteses e auxílio à mobilidade, desenhando fronteiras com questões de acessibilidade, com uso e adequação de produtos, bem como na atuação de áreas de habilitação e reabilitação promovendo qualidade de vida e inclusão social de indivíduos com algum tipo de deficiência ou mobilidade reduzida. Nesse trabalho, o uso de ferramentas de metodologia de projeto durante as discussões sobre o projeto informacional e a implementação do projeto conceitual, ambos de caráter interdisciplinar, permitiu estabelecer a interface entre decisões técnicas de engenharia e os requisitos do usuário. O usuário intermediário, responsável pela prescrição e avaliação do protótipo foi representado por uma amostra de terapeutas ocupacionais, que acompanharam o processo de desenvolvimento do projeto até a validação do protótipo funcional. Os resultados obtidos nesse trabalho foram: obtenção de uma lista de requisitos do usuário, que convertida em um conjunto de características técnicas permitiu o desenvolvimento do projeto orientado pelo usuário (Terapeutas Ocupacionais) e construção de um protótipo funcional. O equipamento de apoio aos exercícios terapêuticos proposto apresenta graus de inovação, quando comparado à equipamentos comerciais e patentes, principalmente: adequação à diferentes mobiliários em ambiente hospitalar e doméstico (camas, cadeiras, mesas); melhor processo de compactação do equipamento para armazenagem e transporte, feito por uma única pessoa; exercícios com os membros superiores: uni e bilateral e abertura completa dos membros superior no plano coronal por meio de guias lineares.This work presented the development of an apparatus whose objective is allow the therapeutic exercises, based on a systematic approach user-oriented design development, and fabricate a functional prototype. Based on design methodology and machine elements theory it was developed the conceptual and the preliminary design phase, based on the informational design phase of Souza (2016), to develop a functional prototype aimed to provide support and movement of the upper limbs of people with motor dysfunction in these members. Due to a range of factors from the various segments of society, there is increasing demand related to the performance of various areas of engineering, that can provide technically feasible solutions and with a degree of mass customization intended for applications in the health area. The knowledge area of \"Assistive Technology\" (AT) is inserted in the health area and acts mainly in the development of prostheses, orthoses and aid mobility, by drawing borders with accessibility issues, using and adjusting products, in addition to acting in habilitation and rehabilitation areas, which promote quality of life and social inclusion of individuals with a disability or reduced mobility. In this work, the use of design methodology tools during the discussion on the informational design and implementation of conceptual design, both interdisciplinary, revealed the interface between technical engineering decisions and user requirements. The intermediate user, responsible for evaluating the prototype was represented by sample occupational therapists, which prescribes and follows up the use of the mechanisms and/or equipment to end users. The main result of this work was a better definition of the user requirements that allowed obtaining design parameters focusing on occupational therapists as well as the development of a functional prototype. The main technical characteristics obtained through of the interactive and iterative processes along the informational, conceptual and preliminary design phases both prototype validation were: compaction of the device (related to storage and use for one or both arms of the user). Besides, the equipment allows possibility of adaptation to different furniture and environments: hospital, clinics, small treatment rooms, domestic bed, and chairs and use; rehabilitation exercises with positions of the upper limbs: uni- and bilateral and total movement of the upper limbs on coronal plane based on linear guides.
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Manente, Fernanda Dalphorno 1980. "Análise prospectiva do uso do mini sling - ophira 'MARCA REGISTRADA' para o tratamento da incontinência urinária de esforço feminina". [s.n.], 2011. http://repositorio.unicamp.br/jspui/handle/REPOSIP/312263.
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Orientadores: Viviane Hermann, Cássio Luiz Zanettini RiccettoDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: Introdução: Os slings sintéticos marcaram a transição do tratamento invasivo para o tratamento minimamente invasivo da incontinência urinária de esforço feminina. Técnicas igualmente eficazes, porém com menores riscos de complicações têm sido pesquisadas. Os mini-slings, utilizando incisão única e de acesso exclusivamente vaginal podem representar uma alternativa à técnica de sling tradicional. Objetivo: Avaliar a eficácia do mini sling Ophira para o tratamento da incontinência urinária de esforço feminina. Material e Método: Foram avaliadas 49 mulheres que compareceram ao Ambulatório de Uroginecologia do HC da UNICAMP no período de abril de 2008 a maio de 2009 com queixa clínica de incontinência urinária de esforço. Todas as pacientes foram submetidas a Estudo Urodinâmico pré-operatório e avaliadas através de história clínica, exame físico, urina I e urocultura, teste de esforço, Pad test de uma hora e aplicação do questionário de qualidade de vida UDI-6. A colocação de mini sling Ophira foi realizada sob anestesia local em regime ambulatorial com alta após micção espontânea. As avaliações subsequentes foram realizadas após seis dias e um, três, seis e 12 meses após o procedimento, compreendendo exame físico, Pad test de uma hora e aplicação do UDI-6. A cura objetiva foi avaliada através do Pad test e do teste de esforço. A cura subjetiva foi avaliada pela queixa clínica e pelo questionário de qualidade de vida. Resultados: A análise da percepção subjetiva dos resultados demonstrou que, após 12 meses de seguimento, 37 pacientes (76%) referiram cura da IUE e sete (14%) melhora. O escore do questionário UDI-6, inicialmente com média de 41,29, caiu para 7,24 após 12 meses de seguimento. O Pad test de uma hora apresentou queda de 6,2g no préoperatório para 1g após o término do acompanhamento. Apenas seis pacientes apresentavam teste de esforço positivo no seguimento de 12 meses. Não houve complicações intra-operatórias. Apenas um caso de dor pós-operatória foi observado. Obteve-se taxa de extrusão do sling de 12,2%. Conclusão: O mini sling Ophira representa uma alternativa cirúrgica segura e eficaz para o tratamento da incontinência urinária de esforço feminina, no período de tempo avaliado
Abstract: Introduction: The synthetic slings marked the transition from invasive treatment to minimally invasive treatment of stress urinary incontinence. Techniques equally effective but with fewer risks of complications have been proposed. The minislings, with single incision and accessing exclusively the vaginal route represents an alternative to tradicional sling technique. Objective: To evaluate the efficacy of mini sling Ophira for the treatment of stress urinary incontinence in women. Methods: We evaluated 49 women attending the outpatient clinic of Urogynecology at the HC/UNICAMP from April 2008 to May 2009 with clinical complaints of stress urinary incontinence. All patients were initially submitted to urodynamic investigation, clinical and physical evaluation, urine analysis, stress test, 1-hour pad test and UDI- 6 Quality of life questionnaire. Mini sling Ophira was placed under local anesthesia and patients were dismissed after spontaneous voiding. Evaluation was undertaken 6 days after surgery and 1, 3, 6 and 12 months follow-up. Objective cure was assessed by Pad test and stress test. Subjective cure was assessed by QoL questionnaire. Results: Subjective analysis demonstrated that, after 12 months, 37 (76%) of patients referred themselves as cured and 7 (14%) as improved. UDI score significantly dropped from 41.29 to 7.24 and 1 hour Pad-test significantly decreased from 6.2 g to 1.0 g. Only 6 patients had persistent positive stress test. No intra operative complications occurred and only one patient complained of pain. Mesh erosion rate was 12.2%. Conclusion: Mini sling Ophira represents a safe and effective alternative to female stress urinary incontinence treatment, should the results proved to be long lasting
Mestrado
Fisiopatologia Cirúrgica
Mestre em Ciências
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Lord, Helen Elizabeth. "A randomised controlled equivalence trial comparing tension-free vaginal tape (TVT) with suprapubic urethral support sling (SPARC)". University of Western Australia. Faculty of Medicine and Dentistry and Health Sciences, 2008. http://theses.library.uwa.edu.au/adt-WU2008.0086.
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[Truncated abstract] Approximately 35% of women worldwide have stress incontinence, which is defined as involuntary leakage of urine on effort, exertion, or on sneezing and coughing. There are various surgical techniques for stress incontinence; however, minimally invasive operations are increasingly being chosen by surgeons and their patients. Of these procedures, tension-free vaginal tape (TVT) has a cure rate of approximately 90% and is now perceived as the standard technique for stress incontinence. Reported complications of TVT include arterial laceration, bladder perforation, bowel perforation, de novo urgency, dyspareunia, excessive blood loss, haematoma, nerve injuries, urethral erosion, urge incontinence, urinary tract infection, vascular injury, vaginal mesh erosion, voiding dysfunction and death. Suprapubic urethral support sling (SPARC) is a very similar minimally invasive operation and early indications suggested that the success rate for treating stress incontinence was expected to be identical or better than those obtained with the earlier TVT approach, with possibly fewer adverse perioperative events. Our trial sought to establish equivalence between TVT and SPARC in relation to short-term complications and efficacy. OBJECTIVES The primary outcome was bladder perforation. Secondary outcomes were blood loss, voiding difficulty, urgency, and cure of stress incontinence symptoms. METHOD A randomised controlled one-sided equivalence trial (RCT) was conducted in Perth, Western Australia during 2003 and 2004 by researchers in the School of Population Health, University of Western Australia (UWA) and King Edward Memorial Hospital (KEMH). Patients were recruited from the public Urology/Urogynaecology Clinic at the primary women's hospital and the consultant surgeons' private practices. ... However, acute urinary retention requiring a return to theatre to loosen the tape (TVT 0%, SPARC 6.5%; OR: [infinity], 95% CL: 2.2, [infinity]; p=0.002) and subjective short-term cure (TVT 87.1%, SPARC 76.5%; OR: 2.07, 95% CL: 1.13, 3.81; p=0.03) were statistically significantly different. CONCLUSIONS The results are consistent with clinical equivalence between TVT and SPARC in relation to the incidence of bladder perforation. No statistically significant difference was found between TVT and SPARC in blood loss, urgency or short-term objective cure of stress incontinence at the six week post-discharge visit to the surgeon. However, the tapes were more difficult to adjust correctly in SPARC procedures and a statistically significant number of patients required a return to theatre for loosening of the tape (TVT 0/147, 0% and SPARC 10/154, 6.5%, p=0.002). Compared with SPARC, TVT was statistically significantly higher for subjective short-term cure. In ii relation to vaginal mesh erosion, TVT was lower than SPARC, though not statistically significantly. Overall, voiding difficulty (loosening of the tape), urgency and vaginal mesh erosion were the most important clinical problems. This randomised controlled trial demonstrates the importance of testing new devices which appear to be similar, but which may have clinically relevant differences. A follow up study to assess the long-term efficacy of tension-free vaginal tape and suprapubic urethral support sling and associated complications is planned.
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Lind, Emelie, i Emma Åsén. "Kom så bär jag dig : en studie om föräldrars upplevelse av att bära sitt barn medhjälp av bärdon". Thesis, Högskolan Väst, Avdelningen för omvårdnad - avancerad nivå, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:hv:diva-12450.
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Becoming a parent is a lifechanging event that can be demanding in todays' stressful living. Carrying babies with baby-carrier/baby-slings is becoming more and more acceptable in the society. To meet the requirements of promoting health and growth among children the nurse need greater understanding of parent's experiences of carrying their babies close with the help of a baby-carrier or baby-sling. The aim of this study was to exam parent's experience of carrying their child with the help of a baby-carrier or baby-sling. In this qualitative study eleven parents were interviewed with the help of a semi-structured question guide. Content analyse where used as a method and two themes emerged; Parent-perspective and Child-perspective. The parent's perception of using a baby-carrier or baby-sling was that it is a tool in everyday life as well as a good way to promote bonding and attachment. Parents need information about carrying babies with the help of a baby-carrier or baby-sling and desire it from healthcare professionals. The nurse specialist has a great responsibility in promoting good cooperation with parents and to promote health and growth for the children. It is therefore important that the nurse encourages parents to have their babies close. Using a baby-carrier or baby-sling is an easy tool that can help parents to have their baby close.
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Locali, Priscila Katsumi Matsuoka. "Avaliação do impacto do tratamento da incontinência urinária oculta na correção de prolapso genital estádio 3 e 4: revisão sistemática e metanálise". Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/5/5139/tde-20092016-161128/.
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Mulheres com prolapso genital estádio 3 e 4 são consideradas de risco para desenvolver incontinência urinária de esforço após a correção cirúrgica do prolapso. A provável explicação para estas pacientes manterem-se, subjetivamente, continentes seria porque o prolapso poderia gerar um acotovelamento na uretra ou compressão da mesma. O objetivo do estudo foi avaliar o impacto de procedimentos anti-incontinência durante a correção cirúrgica de prolapso genital estádio 3 e 4 em mulheres sem sintomas de incontinência urinária de esforço. Método: Realizou-se revisão sistemática com ensaios clínicos. A casuística incluiu mulheres com prolapso genital estádio 3 e 4 sem sintomas clínicos de incontinência urinária de esforço. O desfecho primário foi a presença de incontinência urinária ou necessidade de tratamento para incontinência urinária. Os resultados serão apresentados com o risco relativo, com 95% de intervalo de confiança. Resultados: Inicialmente, 5618 estudos foram identificados com a estratégia de busca, mas apenas oito preencheram os critérios de inclusão. Realizou-se metanálise com as variáveis em comum dos estudos que tivessem mesma escala de quantificação. Observou-se que realizar qualquer procedimento anti-incontinência no mesmo momento do tratamento cirúrgico do prolapso não reduziu a incidência de incontinência urinária no pós-operatório (RR 0.61; 95%CI 0.34-1.10]). Todavia, quando os procedimentos são analisados separadamente, encontraram-se resultados distintos. O subgrupo de pacientes submetidas ao sling retropúbico foi o único que diminuiu a incidência de IUE (RR 0.09; 95%CI 0.02-0.36). Conclusão: O tratamento profilático em mulheres com prolapso genital estádio 3 e 4 com sling retropúbico reduziu a incidência de IUEWomen with high-grade pelvic organ prolapse (POP) are considered at risk of developing postoperative stress urinary incontinence (SUI) once the prolapse has been repaired The probable explanation for the patients to remain subjectively continent, is that POP can affect the urethra by urethral kinking or compression. Our objective was to evaluate the impact of anti-incontinence procedures during surgical POP correction stage 3 and 4 in women with no symptoms for stress urinary incontinence. Methods: A systematic review of randomized trials was performed. The subjects were women with severe POP and no symptoms of SUI. The primary outcomes were UI or treatment for this condition after the surgical procedure. The results were presented as relative risk (RR), with 95% confidence interval (95%CI). Results: Initially, 5618 studies were identified by the search strategy, but only eight trials met the inclusion criteria. We performed a meta-analysis with common variables of studies and with the same scale of quantification. We found that performing an anti-incontinence procedure at the same time of prolapse repair did not reduce the incidence of (SUI) post-operatively (RR 0.61; 95%CI 0.34-1.10]). However, when the types of anti-incontinence procedure were analyzed separately, we found different results. The subgroup of patients who underwent a retropubic sling surgery was the only one that benefited from the antiincontinence procedure, with a decrease in the incidence of SUI (RR 0.09; 95%CI 0.02- 0.36). Conclusions: A prophylactic treatment of women with severe POP using retropubic sling reduced the risk of SUI
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Pinheiro, Raimundo CÃsar. "AnÃlise do impacto da correÃÃo cirÃrgica na qualidade de vida de 26 pacientes com incontinÃncia urodinÃmica de esforÃo". Universidade Federal do CearÃ, 2004. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=549.
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Conselho Nacional de Desenvolvimento CientÃfico e TecnolÃgicoCoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior
A IncontinÃncia UrodinÃmica de EsforÃo à problema comum com impacto na qualidade de vida das pacientes. OBJETIVO:Comparar a qualidade de vida de 26 pacientes com incontinÃncia urodinÃmica de esforÃo antes e apÃs a correÃÃo cirÃrgica. A qualidade de vida foi avaliada com o QuestionÃrio de Impacto de IncontinÃncia e o InventÃrio de Estresse Urogenital, formas reduzidas . CASUÃSTICA e MÃTODO:Durante o perÃodo de marÃo de 2001 a dezembro de 2002 , quatorze pacientes foram submetidas à cirurgia de correÃÃo por tÃcnica de sling vaginal e doze pacientes realizaram uretrocistopexia de Burch. RESULTADOS: Com um seguimento pÃs-operatÃrio com mediana de nove meses (variaÃÃo de quatro a 22 meses) observou-se uma taxa de cura objetiva em vinte e cinco pacientes (96,2%), taxa de cura subjetiva em dezessete pacientes (65,4%), tendo vinte e cinco pacientes (96,2%) relatado cura ou melhora.Observaram-se no pÃs-operatÃrio trÃs casos de urgÃncia miccional , pacientes que realizaram cirurgia de Burch, duas pacientes com padrÃo miccional obstrutivo que haviam realizado cirurgia de sling e uma paciente que apresentou piora do quadro da incontinÃncia. Quanto Ãs caracterÃsticas demogrÃficas do grupo foram observadas:mediana de idade das pacientes de 56 anos (variaÃÃo de 41 a 77 anos), Ãndice de massa corpÃrea com mediana de 25 (variaÃÃo de 20 a 34). A paridade variou de zero a oito partos vaginais com mediana de trÃs partos. O tempo de internaÃÃo variou de dois a quatro dias com mediana de trÃs dias. No momento da alta hospitalar vinte e duas pacientes (84,6%) apresentaram resÃduo urinÃrio menor ou igual a 100ml. Quatro pacientes apresentaram volume residual urinÃrio maior que 100ml, uma que realizou cirurgia de Burch e trÃs que realizaram cirurgia de sling. A pressÃo de perda aos esforÃos no prÃ-operatÃrio apresentou mediana de 95 cmH20 (variaÃÃo de 40 a 140).No pÃs-operatÃrio apresentou mediana de 150 cm H20 (variaÃÃo de 60 a 213).O escore do QuestionÃrio de impacto de incontinÃncia apresentou variaÃÃo com significÃncia estatÃstica (p=0,00) entre o prà e pÃs-operatÃrio (mediana de 50 com variaÃÃo de 10 a 95 e mediana de zero com variaÃÃo de zero a 81 respectivamente).O escore do inventÃrio de estresse urogenital que no prÃ-operatÃrio apresentou mediana de 53 (variaÃÃo de 17 a 94), apresentou apÃs a cirurgia mediana de seis (variaÃÃo de 16 a 35), alteraÃÃo com significÃncia estatÃstica (p=0,07).O coeficiente do escore do questionÃrio de impacto de incontinÃncia apresentou melhora excelente em vinte e trÃs pacientes (88,5%), melhora moderada em uma paciente (3,8%) e piora em duas pacientes (7,7%). O coeficiente do escore do inventÃrio de estresse urogenital apresentou melhora excelente em vinte e duas pacientes (84,6%), melhora moderada em duas pacientes (7,7%) e piora em duas pacientes (7,7%). CONCLUSÃO:Os resultados mostraram que os resultados objetivos nem sempre se correlacionam com os achados subjetivos e que os questionÃrios de qualidade de vida sÃo instrumentos vÃlidos e importantes na avaliaÃÃo e escolha terapÃutica em pacientes com incontinÃncia urodinÃmica de esforÃo
The Stress Urinary Incontinence is a common problem with impact on the patientâs quality of life. OBJECTIVE- to evaluate the impact on the quality of life of 26 patients with stress urodynamic incontinence that realized vaginal sling and urethrocystopexia of Burch . Quality of life was assessed with the Questionnaire of Impact of Incontinence and the Inventory of Urogenital stress, short forms. METHODS -During the period of March of 2001 to December of 2002 14 patients (group 1) realized vaginal sling and 12 patients (group 2) realized urethrocystopexia of Burch.RESULTS- After a median follow up of nine months (variation of four to 22 months) it was observed an objective cure rate of 96,2% ,twenty five patients, a subjective cure rate of 65,4%, seventeen patients , twenty five patients related cure or improvement after the surgery . At the postoperative periodo it were observed three cases of de novo urgency , patients that realized surgery of Burch, two patients with obstructive urinary dysfunction that made sling and one patient that presented with worsening of incontinence.Some demographic characteristics of the patients : the median age of the patients were of 56 years (variation of 41 to 77 years), the median of the index of corporal mass was of 25 (variation of 20 the 34). The vaginal parity varied from zero to eight childbirths with a median of three childbirths.The hospital stay time varied from two to four days with a median of three days. At the moment of delivery twenty two patients (84,6%) presented with urinary residue equal or less than 100ml. Four patients presented with urinary residue greater than 100ml, one of them had done surgery of Burch and three had done vaginal sling. The median leak point pressure at the preoperative period was of 95 cmH20 (variation of 40 to 140). At the postoperative period it was of 150 cm H20 (variation of 60 the 213). The median score of the Questionnaire of impact of incontinence showed statistically significant difference (p=0,00) between the pre and postoperative period , median of 50 with variation of 10 the 95 and a median of zero with variation of zero to 81 respectively. The median score of the inventory of urogenital stress at the preoperative period was of 53 (variation of 17 the 94), after the surgery it was of six (variation of 16 the 35) wich was statistically significant (p=0,07). The coefficient of the questionnaire of impact of incontinence presented with excellent improvement in twenty-three patients (88,5%), moderate improvement in one patient (3,8%) and worsening in two patients (7,7%). The coefficient of the inventory of urogenital stress presented with excellent improvement in twenty-two patients (84,6%), moderate improvement in two patients (7,7%) and worsening in two patients (7,7%). CONCLUSIONS- The findings of this prospective nonrandomized study showed that objective results not always are correlated with the subjective findings and that the questionnaires of quality of life are valid and important instruments in the evaluation and decision making of patients with stress urodynamic incontinence
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Pinheiro, Raimundo CÃsar. "Analise do Impacto da CorreÃÃo CirÃrgica na qualidade de vida de 26 pacientes com incontinÃncia UrodinÃmica de esforÃo". Universidade Federal do CearÃ, 2004. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=1183.
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Conselho Nacional de Desenvolvimento CientÃfico e TecnolÃgicoCoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior
The Stress Urinary Incontinence is a common problem with impact on the patientâs quality of life. OBJECTIVE- to evaluate the impact on the quality of life of 26 patients with stress urodynamic incontinence that realized vaginal sling and urethrocystopexia of Burch . Quality of life was assessed with the Questionnaire of Impact of Incontinence and the Inventory of Urogenital stress, short forms. METHODS -During the period of March of 2001 to December of 2002 14 patients (group 1) realized vaginal sling and 12 patients (group 2) realized urethrocystopexia of Burch.RESULTS- After a median follow up of nine months (variation of four to 22 months) it was observed an objective cure rate of 96,2% ,twenty five patients, a subjective cure rate of 65,4%, seventeen patients , twenty five patients related cure or improvement after the surgery . At the postoperative periodo it were observed three cases of de novo urgency , patients that realized surgery of Burch, two patients with obstructive urinary dysfunction that made sling and one patient that presented with worsening of incontinence.Some demographic characteristics of the patients : the median age of the patients were of 56 years (variation of 41 to 77 years), the median of the index of corporal mass was of 25 (variation of 20 the 34). The vaginal parity varied from zero to eight childbirths with a median of three childbirths.The hospital stay time varied from two to four days with a median of three days. At the moment of delivery twenty two patients (84,6%) presented with urinary residue equal or less than 100ml. Four patients presented with urinary residue greater than 100ml, one of them had done surgery of Burch and three had done vaginal sling. The median leak point pressure at the preoperative period was of 95 cmH20 (variation of 40 to 140). At the postoperative period it was of 150 cm H20 (variation of 60 the 213). The median score of the Questionnaire of impact of incontinence showed statistically significant difference (p=0,00) between the pre and postoperative period , median of 50 with variation of 10 the 95 and a median of zero with variation of zero to 81 respectively. The median score of the inventory of urogenital stress at the preoperative period was of 53 (variation of 17 the 94), after the surgery it was of six (variation of 16 the 35) wich was statistically significant (p=0,07). The coefficient of the questionnaire of impact of incontinence presented with excellent improvement in twenty-three patients (88,5%), moderate improvement in one patient (3,8%) and worsening in two patients (7,7%). The coefficient of the inventory of urogenital stress presented with excellent improvement in twenty-two patients (84,6%), moderate improvement in two patients (7,7%) and worsening in two patients (7,7%). CONCLUSIONS- The findings of this prospective nonrandomized study showed that objective results not always are correlated with the subjective findings and that the questionnaires of quality of life are valid and important instruments in the evaluation and decision making of patients with stress urodynamic incontinence
A IncontinÃncia UrodinÃmica de EsforÃo à problema comum com impacto na qualidade de vida das pacientes. OBJETIVO:Comparar a qualidade de vida de 26 pacientes com incontinÃncia urodinÃmica de esforÃo antes e apÃs a correÃÃo cirÃrgica. A qualidade de vida foi avaliada com o QuestionÃrio de Impacto de IncontinÃncia e o InventÃrio de Estresse Urogenital, formas reduzidas . CASUÃSTICA e MÃTODO:Durante o perÃodo de marÃo de 2001 a dezembro de 2002 , quatorze pacientes foram submetidas à cirurgia de correÃÃo por tÃcnica de sling vaginal e doze pacientes realizaram uretrocistopexia de Burch. RESULTADOS: Com um seguimento pÃs-operatÃrio com mediana de nove meses (variaÃÃo de quatro a 22 meses) observou-se uma taxa de cura objetiva em vinte e cinco pacientes (96,2%), taxa de cura subjetiva em dezessete pacientes (65,4%), tendo vinte e cinco pacientes (96,2%) relatado cura ou melhora.Observaram-se no pÃs-operatÃrio trÃs casos de urgÃncia miccional , pacientes que realizaram cirurgia de Burch, duas pacientes com padrÃo miccional obstrutivo que haviam realizado cirurgia de sling e uma paciente que apresentou piora do quadro da incontinÃncia. Quanto Ãs caracterÃsticas demogrÃficas do grupo foram observadas:mediana de idade das pacientes de 56 anos (variaÃÃo de 41 a 77 anos), Ãndice de massa corpÃrea com mediana de 25 (variaÃÃo de 20 a 34). A paridade variou de zero a oito partos vaginais com mediana de trÃs partos. O tempo de internaÃÃo variou de dois a quatro dias com mediana de trÃs dias. No momento da alta hospitalar vinte e duas pacientes (84,6%) apresentaram resÃduo urinÃrio menor ou igual a 100ml. Quatro pacientes apresentaram volume residual urinÃrio maior que 100ml, uma que realizou cirurgia de Burch e trÃs que realizaram cirurgia de sling. A pressÃo de perda aos esforÃos no prÃ-operatÃrio apresentou mediana de 95 cmH20 (variaÃÃo de 40 a 140).No pÃs-operatÃrio apresentou mediana de 150 cm H20 (variaÃÃo de 60 a 213).O escore do QuestionÃrio de impacto de incontinÃncia apresentou variaÃÃo com significÃncia estatÃstica (p=0,00) entre o prà e pÃs-operatÃrio (mediana de 50 com variaÃÃo de 10 a 95 e mediana de zero com variaÃÃo de zero a 81 respectivamente).O escore do inventÃrio de estresse urogenital que no prÃ-operatÃrio apresentou mediana de 53 (variaÃÃo de 17 a 94), apresentou apÃs a cirurgia mediana de seis (variaÃÃo de 16 a 35), alteraÃÃo com significÃncia estatÃstica (p=0,07).O coeficiente do escore do questionÃrio de impacto de incontinÃncia apresentou melhora excelente em vinte e trÃs pacientes (88,5%), melhora moderada em uma paciente (3,8%) e piora em duas pacientes (7,7%). O coeficiente do escore do inventÃrio de estresse urogenital apresentou melhora excelente em vinte e duas pacientes (84,6%), melhora moderada em duas pacientes (7,7%) e piora em duas pacientes (7,7%). CONCLUSÃO:Os resultados mostraram que os resultados objetivos nem sempre se correlacionam com os achados subjetivos e que os questionÃrios de qualidade de vida sÃo instrumentos vÃlidos e importantes na avaliaÃÃo e escolha terapÃutica em pacientes com incontinÃncia urodinÃmica de esforÃo
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Silveira, Arlon Breno Figueiredo da. "Uso de sling sintetico pre-publico para tratamento da incontinencia urinaria de esforço : eficacia, segurança e qualidade de vida". [s.n.], 2008. http://repositorio.unicamp.br/jspui/handle/REPOSIP/308657.
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Orientadores: Cassio Luis Zanettini Riccetto, Paulo Cesar Rodrigues PalmaDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias
Made available in DSpace on 2018-08-12T17:44:11Z (GMT). No. of bitstreams: 1 Silveira_ArlonBrenoFigueiredoda_M.pdf: 2621259 bytes, checksum: 4ce31188b66f0429c0dd69afbac24d21 (MD5) Previous issue date: 2008
Resumo: Objetivos: Com o objetivo de avaliar os resultados cirúrgicos e de modificação na qualidade de vida de mulheres submetidas ao tratamento de incontinência urinária de esforço com sling sintético de polipropileno com abordagem pré-púbica. Métodos: Foi desenvolvido estudo prospectivo, de intervenção, com seguimento por seis meses, envolvendo 20 pacientes, com idade mínima de 21 anos e com diagnóstico de incontinência urinária de esforço realizado no Serviço de Uroginecologia do Hospital das Clínicas da Universidade Estadual de Campinas, Campinas, São Paulo, com base em dados clínicos, urodinâmicos e de Pad-test compatíveis, as quais expressaram a vontade de se submeter à implantação de sling para correção cirúrgica; não gestantes; sem doença ou qualquer condição que pudesse comprometer o resultado da cirurgia, tal como: distúrbio de coagulação sanguínea, obstrução do trato urinário superior, insuficiência renal, comprometimento do sistema imune, infecção urinária ou vaginal; não submetidas a procedimento de sling sintético prévio; que concordaram em participar do estudo, por meio da assinatura do Termo de Consentimento Livre Esclarecido e em responder os questionários King's Health Questionnaire (KHQ) e International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) antes da cirurgia e decorridos seis meses do procedimento. Para o tratamento de incontinência urinária de esforço, empregou-se tela manufaturada em fibras de polipropileno, classe I, monofilamentar com 42 µm de diâmetro e macroporos maiores que 75 mm, por abordagem pré-púbica. As variáveis estudadas incluíram: idade, avaliação urodinâmica, Pad-test e resultados dos questionários King's Health Questionnaire (KHQ) e International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) . Os dados foram organizados por meio do programa Epi-INfo versão 6.04d e analisados com o programa Statistical Package for Social Sciences (SPSS), versão 13.0. As variáveis nominais e ordinais foram expressas em distribuição de freqüências absolutas e relativas e as quantitativas, pelos parâmetros da Estatística Descritiva. Para comparação dos parâmetros objetivos uroginecológicos e de qualidade de vida aferida pelos questionários International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) e King's Health Questionnaire (KHQ), do período pré-operatório e decorridos seis meses do procedimento cirúrgico, empregou-se teste de diferença de médias, em nível de significância de 0,05, determinando-se o intervalo de confiança em nível de confiança de 95%. Resultados: Comparando a avaliação pré-operatória àquela decorridos seis meses do procedimento cirúrgico, verificou-se redução significante da perda de urina mensurada através do Pad-test (p<0,001). A pressão de perda sob esforço foi negativa em 90% das pacientes decorridos seis meses da cirurgia. Os demais parâmetros urodinâmicos da cistometria não foram alterados significativamente comparando antes e depois da cirurgia. O fluxo máximo miccional despida de significância estatística (p = 0,034). Houve melhora de todos os parâmetros subjetivos avaliados pelo International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), com significância estatística da freqüência de perda de urina (0,009) e menor interferência na vida da pacientes (p= 0,001), assim como de todos os domínios do King's Health Questionnaire (KHQ). Houve 6 (30%) casos de complicações, que consistiram em extrusão vaginal do sling, instituindo-se tratamento cirúrgico por retirada do segmento da tela exposta e síntese da mucosa vaginal. Conclusão: Embora tenha havido a necessidade de interromper este estudo devido ao alto índice de complicações, confirmou-se o fato de ser a incontinência urinária um evento que compromete a qualidade de vida das pacientes exercendo tal impacto que, mesmo diante do insucesso do procedimento terapêutico, a avaliação subjetiva foi favorável, decorridos seis meses da cirurgia
Abstract: Objectives: A prospective study of intervention was developed aiming to evaluate the surgical results and impact in the quality of life of women submitted to stress urinary incontinence treatment with polypropylene synthetic sling with prepubic approach. Methods: Twenty patients were included in this study. Diagnosis of stress urinary incontinence were based on clinical data, urodynamics and Pad-test. Inclusion criteria included: minimum age of 21 years; non pregnant; without illness or any condition that could compromise surgery's result (sanguineous coagulation disorders, superior urinary tract obstruction, renal insufficiency, immune system disorder, urinary or vaginal infection); abcense of previous synthetic sling procedure; agreement to participate of the study, by means of Free Consent Term signature and to answer to the questionnaires King's Health Questionnaire (KHQ) e International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) before the surgery and after six months of the procedure. Its was used a sling made of staple fibres of polypropylene, type I, monofilamentar (42 µm diameter) and macropores. All the procedures were performed under spinal anesthesia. The sling was placed and adjusted in midurethral area with minimal periurethral dissection. The proper tension and fixation was achieved by passing the sling arms through the prepubic subcutaneous fat tissue. The variables studied included: age; urodynamic evaluation; Pad-test; King's Health Questionnaire; and International Consultation on Incontinence Questionnaire. Data were recorded using Epi-INfo version 6.04d software and analyzed with Statistical Package for Social Sciences (SPSS), version 13.0. The nominal and ordinal variables were express in absolute and relative frequency distribution and the quantitative ones by parameters of descriptive statistics. Difference of means test was used (significance level of 0,05, 95% confidence interval) for comparison of the urogynecologic objective parameters and quality of life surveyed by ICIQ and KHQ questionnaires, of pre-operative and six months post-operative evaluation. Results: Comparing pre-surgical evaluations with those after six months of the surgical procedure, there were significant reduction of urine loss assessed by the pad-test (p<0,001). Comparing urodynamics evaluations before and after surgical procedure 90% patients no there were of urine loss. Other urodynamics parameters no there were significant alterations. The max flow there was significant reduction (p=0,034). There was an improvement of all subjective parameters evaluated by ICIQ-SF, with significance for frequency of urine loss (0,009) and minor interference in life (p= 0.001), as well as of all KHQ domains. Six patients (20%) presented complications which consisted of vaginal exposition of the sling. All of them were corrected surgically by excision of the mesh and suture of the vaginal wall. The study was interrupted after six months of follow up due to the high frequency of adverse effects. Conclusion: Although the decision of interrupting the study due to the high index of complication, it allowed to confirm that stress urinary incontinence compromises the quality of life of the patients significantly, and the treatmet could promote an improvement in the quality of life, even when objective results were unfavourable
Mestrado
Cirurgia
Mestre em Cirurgia
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Zanoner, Thomas. "Processi paraglaciali su alcuni versanti alpini: i casi di studio della Valle di Slingia (Bz), del Ghiacciaio di Cima Uomo (Tn) e del Bacino del Vauz (Bl)". Doctoral thesis, Università degli studi di Padova, 2014. http://hdl.handle.net/11577/3423561.
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This PhD thesis has been carried out in the context of a Strategic Project of the University of Padua ("Georisk"), which aim was the study of the geological and hydrological hazards in the north-east of Italy. The project was divided into 5 workpackages (WP) and the PhD study was mainly conducted in the framework of WP1 ("slope processes"). The study focused on the geomorphological evolution of three mountain areas affected by the presence of glaciers at different times. According to the literature, after the glacial mass withdrawal the evolution of these territories is defined "paraglacial evolution".
In particular, the study areas are: the Schlinig Valley (Eastern Alps - South Tyrol), the area of Cima Uomo Glacier (Dolomites - Trentino) and the Vauz Basin (Dolomites - Belluno). In the Schlinig Valley the aim was to assess the state of the slopes which are affected by various DSGSDS (Deep Seated Gravitational Slope Deformations). At Cima Uomo the purpose was to understand how the permafrost presence can drive the evolution of the area during and after the deglaciation. Finally, in the Vauz Basin, the aim was to understand the present evolution of this area, which in the past underwent paraglacial modeling processes and modification, as documented by some relict landforms.
The detailed study of the three investigated areas allowed to: 1) characterize the current geomorphological processes, 2) understand the past morphological evolution and 3) better understand the developmental status achieved in each area with respect to the paraglacial period.
The three study areas highlight the importance of the local topo-climatic factors on the characteristics of paraglacial evolution processes, deposits and landforms respect to the wider scale climatic factors.La presente tesi di Dottorato è stata realizzata nell’ambito di un Progetto Strategico dell’Università degli Studi di Padova (“Georisk”), il quale aveva come obiettivo lo studio dei rischi geologici e idrologici nell’Italia nord orientale. Il Progetto strategico era articolato in 5 Workpackages (WP) e al loro interno hanno operato in sinergia altrettante Unità Operative. Il presente studio è stato condotto nell’ambito del WP1 “processi di versante” ed è stato rivolto particolarmente all’analisi dell’evoluzione geomorfologica di aree montane. La ricerca di dottorato, dovendosi inserire in un progetto di ricerca più ampio, ha preso in considerazione aree di studio che fossero anche di interesse per le altre unità. In particolare le aree studiate sono tre: la Valle di Slingia (Alpi Orientali – Alto Adige), il Ghiacciaio di Cima Uomo (Dolomiti – Trentino), il Bacino del Vauz (Dolomiti – Belluno). Le aree prese in considerazione sono state, in tempi diversi, interessate dalla presenza dei ghiacciai. Attualmente, solo una di queste è ancora in una certa relazione con il glacialismo. Di conseguenza, l’evoluzione che questi territori hanno avuto dopo il ritiro delle masse glaciali è avvenuta secondo quanto in letteratura è definito come “morfogenesi paraglaciale”. Nella Valle di Slingia lo scopo è stato quello di valutare lo stato di versanti interessati da varie DGPV (Deformazioni Gravitative Profonde di Versante). Al Ghiacciaio di Cima Uomo lo scopo del lavoro è stato quello di comprendere come la presenza di permafrost può controllare l’evoluzione di un’area in fase di deglacializzazione. Infine nel Bacino del Vauz l’obbiettivo è stato quello di capire l’evoluzione che interessa attualmente un’area che in passato ha subito processi di modellamento e modificazione strettamente paraglaciali come documentato da alcune forme relitte. Lo studio dettagliato delle tre aree indagate ha permesso, oltre ad una caratterizzazione da vari punti di vista dei processi in atto e dell’evoluzione morfologica passata, di comprendere meglio lo stato evolutivo raggiunto in ciscun’area, in termini di riassetto paraglaciale del sistema (periodo paraglaciale). In conclusione ciò che è emerso, analizzando le tre aree studiate, è l’importanza che assumono i fattori di tipo topo-climatico locali nel condizionare tipologie, caratteristiche evolutive dei processi, depositi e forme paraglaciali rispetto ai fattori climatici che agiscono a più ampia scala.
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Edvardsson, Mia. "Slingträning av nedre bålen : en väg tillbaka till löparslingan vid problem med löparknä?" Thesis, Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:gih:diva-1823.
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Syfte och frågeställningar: Syftet med studien var att undersöka om slingträning av nedre bålen för individer med löparknä kan ge en reducering av skadeproblematiken. Syftet var även att studera om upplevelsen av smärta och begränsning i aktivitet förändrats hos dessa individer i en subjektiv bedömning. Löparknä innebär smärta på den yttre sidan av knät, mest vanligt hos löpare men även andra idrottare drabbas. Frågeställningar: I vilken omfattning kan slingträning av nedre bålen för individer med löparknä ge en mer funktionell styrka och även större uthållighet? Hur upplever individer med löparknä vid en subjektiv skattning att denna träning leder till en förändring av smärta och begränsning i aktivitet? Metod: Studien genomfördes som en kvantitativ experimentell studie, där en interventionsgrupp på sex löpare med löparknäproblem genomförde slingträning av nedre bålen. Detta skedde två gånger i veckan under sex veckor. Tester av funktionell styrka och uthållighet genomfördes den första veckan, efter tre veckor och efter sex veckor. Testerna innebar ett isometriskt test av höftabduktorer, ett balanstest på ett ben och att samtidigt sträcka sig framåt på samma sida, ett balanstest på ett ben med sträckning över huvudet i frontalplan, och ett test av svag länk vid sidliggande höftabduktion. En kontrollgrupp på fyra löpare utan skador genomförde enbart testerna vid samma tidpunkter. Därtill följde en subjektiv bedömning, i form av skattning på en skala 0-10, av hur individen upplevde smärta av löparknät, samt hur det begränsade hans/hennes aktivitet. Resultat: En signifikant förbättring över tid erhölls i både det skadade och friska benet hos interventionsgruppen i tre av testerna, närmare bestämt isometriskt test av höftabduktorer (51 %), balanstest på ett ben med sträckning över huvudet i frontalplan (8 %), och test av svag länk vid sidliggande höftabduktion (27 %). Ingen förändring erhölls hos kontrollgruppen. Slutsats: Denna studie tyder på att slingträning av nedre bålen för individer med löparknäproblem kan ge en mer funktionell styrka och även större uthållighet. Denna träning kan också vara orsaken till att deras upplevelse av smärta och begränsning i aktivitet tenderade att minska.
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Tušla, Václav. "Možnosti využití cihelného recyklátu v pojivových systémech s obsahem p-slínku". Master's thesis, Vysoké učení technické v Brně. Fakulta chemická, 2019. http://www.nusl.cz/ntk/nusl-401933.
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This diploma thesis deals with the preparation binder systems based on Portland clinker and recycled brick. Recycled brick is considered a waste material from construction or production of brick products. This thesis uses finely grounded brick recycled and brick dust, which is produced during final processing of burnt bricks. By incorporating brick dust in alternative system based on Portland clinker could bring ecological and economic benefits. This diploma thesis deals with option using brick dust as pozzolan admixture to Portland clinker, with the aim to prepare and test Portland cement, which is defined in v ČSN EN 197-1. This thesis also deals with possibility preparation of alternative binders based on p-clinker, but those not defined by ČSN EN 197-1. Specifically these are ternary binders with fluid bed ash and binders based on hybrid cements containing sodium sulfate.
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Forouzan, Firoozeh. "Small Finds From Chogha Gavaneh Site in the Islamabad Plain, Central Zagros Mountains, Iran". Digital Archive @ GSU, 2010. http://digitalarchive.gsu.edu/anthro_theses/46.
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This study examines small finds from the site of Chogha Gavaneh, Iran, including zoomorphic clay figurines, geometric-shaped objects, and sling bullets in order to deter-mine if they served an economic function during the Early Chalcolithic period (ca. 5000-4000 B.C.E.). A total of 104 animal figurines, sling bullets, and geometric-shaped objects have been found at Chogha Gavaneh. This research challenges previous archaeological interpretations of animal figurines that have interpreted them as being magical or lucky objects for hunting and religious rituals, or for use as game pieces, educational objects, or toys. Through the use of XRF (x-ray fluorescence spectrometry) analysis and the chaine opératoire approach, I suggest, contrary to the conventional wisdom, that some of these clay objects might represent another kind of social practice and may have had an economic function.
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Chapin, Katherine Joan. "In vivo Biocompatibilty and Time-Dependent Changes in Mechanical Properties of Woven Collagen Meshes: Comparison to Xenograft and Synthetic Mid-Urethral Sling Materials". Case Western Reserve University School of Graduate Studies / OhioLINK, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=case1462899086.
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McCoy, Allen H. "Flight testing and real-time system identification analysis of a UH-60A Black Hawk Helicopter with an instrumented external sling load". Monterey, Calif. : Springfield, Va. : Naval Postgraduate School ; Available from National Technical Information Service, 1997. http://handle.dtic.mil/100.2/ADA343449.
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Thesis (M.S. in Aeronautical Engineering) Naval Postgraduate School, December 1997."December 1997." Thesis advisor(s): E. Roberts Wood, Mark B. Tischler. Includes bibliographical references (p. 87-88). Also available online.
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Zavaleta, Bueno Jorge Augusto. "Estudio comparativo del sling suburetral transobturatriz vs pubovaginal en el tratamiento quirúrgico de la incontinencia urinaria de esfuerzo – Cusco 2005 - 2010". Bachelor's thesis, Universidad Nacional Mayor de San Marcos, 2014. https://hdl.handle.net/20.500.12672/12008.
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Publicación a texto completo no autorizada por el autorCompara la eficacia y efectividad de las técnicas quirúrgica de los Sling Pubovaginales y Transobturatrices en el tratamiento de la Incontinencia Urinaria de esfuerzo, cuando esta es realizada por el mismo cirujano y con los mismos equipos y materiales médico-quirúrgicos. Se evaluaron un total de 104 pacientes intervenidas quirúrgicamente con el diagnostico de Incontinencia Urinaria de esfuerzo, mediante las Técnicas Quirúrgicas de Sling PuboVaginal o Sling Transobturatriz en el Hospital Nacional Adolfo Guevara Velasco de ESSALUD – Cusco y en el Instituto de Urología Laparoscópica e IUE del Cusco entre Julio del 2005 y Marzo del 2010. Se concluyó que ambos grupos quirúrgicos tuvieron características comparables respecto a las variables de edad, IMC y diagnóstico de IUE recurrente. Ambas técnicas quirúrgicas tuvieron índices de curación superiores al 80% e índices de satisfacción positiva (Curación más mejoría ) superiores al 90 % , es decir que ambas técnicas son eficaces y efectivas para el tratamiento de la Incontinencia urinaria de esfuerzo.
Trabajo académico
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Gonçalves, Gabriela Rodrigues. "Análise comparativa da fadiga muscular nos adultos após o transporte de bebês com e sem o auxílio de carregadores". Universidade do Estado de Santa Catarina, 2014. http://tede.udesc.br/handle/handle/2022.
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Previous issue date: 2014-07-28Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
The habit of carrying babies in baby carriers is in a significant expansion in modern culture, however there are gaps in knowledge about these new artifacts available in the market. This study aimed to evaluate and compare the feeling of weight carried and muscle fatigue perceived by adults after carry a baby with and without the aid of baby carriers. For this research we used the Soft Structured Carrier and Wrap Sling, which are considered contemporary baby carriers. A systematic literature review presented here covers concepts of ergonomics with a focus on transporting babies, as well as cultural, physical and emotional issues associated with the artifact. The results intended to add to the existing literature, new data, contributing to the construction of scientific knowledge and identifying the need for standardization of manufacturing standards and use as well as the elaboration of a recommendation of acceptable weight limits and other relevant issues order to benefit the population that chooses this type of resource.
O hábito de transportar bebês em carregadores está em significativa expansão na cultura moderna, entretanto existem lacunas no conhecimento acerca destes novos artefatos disponíveis no mercado. A presente pesquisa teve como propósito avaliar e comparar a sensação de peso transportado e a fadiga muscular percebida pelos adultos após o transporte de um bebê com e sem o auxílio de carregadores. Para a realização desta pesquisa foram utilizados o Soft Structured Carrier e o Wrap Sling, sendo estes considerados carregadores contemporâneos. A pesquisa bibliográfica sistemática apresentada neste trabalho contempla conceitos de Ergonomia com foco no transporte de bebês, além de questões culturais, físicas e emocionais associadas ao artefato. Os resultados obtidos pretendem acrescentar a bibliografia já existente, novos dados, contribuindo para a construção do conhecimento científico e identificando a necessidade de normalização dos padrões de fabricação e uso, bem como a elaboração de uma recomendação de limites aceitáveis de peso e outras questões relevantes a fim de beneficiar a população que opta por este tipo de recurso.
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Latour, Marie-Noëlle. "Artere pulmonaire gauche aberrante et malformations tracheobronchiques congenitales : le "ring sling complex" : rapport de deux nouveaux cas et revue de la litterature". Université Louis Pasteur (Strasbourg) (1971-2008), 1992. http://www.theses.fr/1992STR1M119.
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Björk, Carl Johan. "PID tuning with Ant Colony Optimization (ACO) : A framework for a step response based tuning algorithm". Thesis, Mittuniversitetet, Avdelningen för elektronikkonstruktion, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:miun:diva-33903.
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The building automation industry lacks an affordable, simple, solution for autonomous PID controller tuning when overhead variables fluctuate. In this project, requested by Jitea AB, a solution was developed, utilising step response process modelling, numerical integration of first order differential equations, and Ant Colony Optimization (ACO). The solution was applied to two control schemes; simulated outlet flow from a virtual water tank, and the physical air pressure in the ventilation system of a preschool in Sweden. An open-loop step response provided the transfer function in each case, which, after some manipulation, could be employed to predict the performance of any given set of PID parameters, based on a weighted cost function. This prediction model was used in ACO to find optimal settings. The program was constructed in both Structured Control Language and Structured Text and documented in an approachable way. The results showed that the program was, in both cases, able to eliminate overshoot and retain the settling time (with a slightly raised rise time) achieved with settings tuned per the current methods of Jitea AB. Noise and oscillations present in the physical system did not appear to have any major negative influence on the tuning process. The program performed above Jitea AB’s expectation, and will be tested in more scenarios, as it showed promise. Autonomous implementation could be of societal benefit through increased efficiency and sustainability in a range of processes. In future studies, focus should be on improving the prediction model, and further optimising the ACO variables.Byggnadsautomationsbranschen saknar en kostnadseffektiv lösning för att autonomt trimma in PID-regulatorer när överordnade variabler fluktuerar. I detta (av Jitea AB beställda) arbete, utvecklades en lösning baserad på stegsvarsmodellering, numerisk integration av första gradens ordinära differentialekvationer och myrkolonisoptimering (ACO). Lösningen applicerades i två regleringsfall; en simulerad utloppsventil från en virtuell vattentank, och det fysiska lufttrycket i ventilationssystemet på en förskola i Sverige. Ett stegsvar med öppen slinga gav en överföringsfunktion i respektive fall, som efter viss manipulering kunde nyttjas för att förutspå prestandan för en uppsättning PID-parametrar baserat på en samlad, viktad kostnadsfunktion. Predikteringsmodellen implementerades i ACO för att finna optimala parametrar. Programmet konstruerades i Structured Control Language och Structured Text, och dokumenterades på ett pedagogiskt sätt. Resultaten visade att programmet (i båda fallen) klarade att eliminera översläng med bibehållen stabiliseringstid (och något förskjuten stigningstid) jämfört med Jitea AB:s existerande trimningsmetod. Signalbrus och oscillationer i det fysiska systemet verkade inte ha någon avsevärd negativ inverkan på trimningsprocessen. Programmet presterade över Jitea AB:s förväntan, och kommer (med tanke på de lovande resultaten) fortsatt att testas i fler scenarion. Implementation av en autonom version skulle kunna innebära flera samhälleliga förmåner i form av ökad verkningsgrad och hållbarhet i en rad processer. I framtida studier bör fokus läggas på att ytterligare förbättra prediktionsmodellen, samt att vidare utforska de optimala myrkolonisvariablerna.
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DeLorenzo, Tami Michelle. "Retrospective medical record study: timing & order of anatomical structural movement within hyolaryngeal elevation in stroke patients - a continuation of the two-sling model". Thesis, Boston University, 2013. https://hdl.handle.net/2144/12084.
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Thesis (M.A.)--Boston UniversityEffective pharyngeal swallowing requires the neuromuscular coordination of several important events. Swallowing is a complex neuromuscular activity that consists of three phases; oral, pharyngeal and esophageal phase. This thesis proposes and investigates that timing and order of the anatomical structures due to the movement of the “two-sling model” musculature in hyolaryngeal elevation during the pharyngeal swallow and activation of such during a swallow are crucial to the difficulties faced post-stroke. It focuses on the question: does the timing and order of anatomical structural movement within the complex of movements causing hyolaryngeal elevation in stroke patients affect the efficiency of the overall swallow? Test and control groups were created, by age and gender matching the 20 subjects in each group (40 subjects total). The data was collected from patient records, using the Boston Medical Center – Medical Record Database, and video fluoroscopic swallowing studies. A total of 4 swallows were analyzed per subject (160 total swallows analyzed), one for each of the four bolus types used in the recorded modified barium swallows: thin barium, nectar thick barium, pudding barium, and cracker with barium. Points of interest within the video swallows were located on the anterior hyoid, and the anterior and posterior vocal fold edges (above the air column); all measured at both minimum and maximum values to obtain time and distance calculations. Those results were then averaged for each subject before analyzed against the rest of the subject set (a total of 40 averaged data sets). Coordinates were recorded from two time points using the ImageJ program: minimum and maximum hyolaryngeal excursion and then mathematically converted into multiple kinematic measurements of hyolaryngeal movement. Linear regressions analyzed to evaluate the strength of relationship to hyoid-laryngeal order did not reveal strong statistical correlations of how well the produced regression lines approximated the real data points. Using two-tailed paired t-test analysis, we failed to reject Ho since the t-values were greater than -1.729 and less than 1.729. We did not have statistically significant evidence at α = 0.05 to show that there is a difference between the experimental and control groups for all three of the analyzed variables. Even though the t-test data showed no difference between the three tested variables within the experimental and control groups, we did see 40% of the experimental group show an abnormal anatomical initiation of movement during the swallow, showing the larynx moving prior to the hyoid. Pearson coefficient calculations analyzed the relationships between (1) hyoid excursion (cm), (2) laryngeal elevation (cm), and (3) timing (ms) to hyoid-laryngeal latency (ms) and revealed the strongest positive association of predictability, r = 0.993, to be found in the experimental group within the timing to hyoid-laryngeal latency comparison; predicting timing duration from the hyoid-laryngeal latency. The experimental group relationship of laryngeal elevation to hyoid-laryngeal latency produced the weakest association of predictability of r = 0.056. [TRUNCATED]
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Nilsson, Margareta. "Female urinary incontinence : impact on sexual life and psychosocial wellbeing in patients and partners, and patient-reported outcome after surgery". Doctoral thesis, Umeå universitet, Obstetrik och gynekologi, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-55006.
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Background: Urinary incontinence (UI) and urgency are common conditions and can have a profound influence on many aspects of life. Approximately one in four women has UI and one in ten has daily symptoms. Knowledge is lacking, however, on the impact of UI and urgency on the lives of affected women and their partners and on the situation of women with urinary leakage one year postoperatively. Aims: To study the consequences of female UI and urgency for patients and their partners on quality of life (QoL), the partner relationship, and their sexual lives. Also to evaluate the success rates of three operation methods: tension-free vaginal tape (TVT), tension-free vaginal tape-obturator (TVT-O), and transobturator tape (TOT) for stress urinary incontinence (SUI), with a particular focus on women who still have urinary leakage one year after surgery. Methods: Women seeking healthcare for UI and/or urgency and their partners were invited to answer questionnaires. The women completed disease-specific questionnaires and both the women (n = 206) and their partners (n = 109) answered questions about their psychosocial situation, partner relationship, and sexual life. Patient-reported outcomes one year after surgery with TVT, TVT-O, or TOT (n = 3334) were derived from the Swedish National Quality Register for Gynaecological Surgery. Results: Most of the women reported that their urinary problems negatively affected their physical activities, and almost half reported negative consequences for their social life. Women aged 25–49 years were less satisfied with their psychological health, sexual life, and leisure than women aged 50–74 years. One third of both the women and their partners (all the partners were men) experienced a negative impact on their relationship, and sexual life was negatively affected in almost half of the women and one in five of their men. Coital incontinence was reported in one third of the women. Most of their men did not consider this a problem, but the majority of the affected women did. Satisfaction with outcome of the operation did not differ between TVT, TVT-O, and TOT, but TVT showed a higher success rate for SUI than TOT did. Higher age, higher body mass index, a diagnosis of mixed urinary incontinence, and a history of urinary leakage in combination with urgency each constitute a risk for a lower operation success rate. After one year, 29% of the women still had some form of UI, but half of these were satisfied with the outcome and most reported fewer negative impacts on family, social, working, and sexual life than before the operation. Conclusions: Female UI and/or urgency impaired QoL, particularly in young women, and had negative effects on partner relationships and on some partners’ lives. Sexual life was also affected, more often in women with UI and/or urgency than in their partners. At one-year follow-up after surgery, about one third of the women still had some form of UI, but the negative impact on their lives was reduced. A challenge for health care professionals is to initiate a dialogue with women with urinary symptoms about sexual function and what surgery can realistically be expected to accomplish.
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Virágová, Tereza. "Porovnání různých metod stanovení melitelnosti práškových pojiv". Master's thesis, Vysoké učení technické v Brně. Fakulta stavební, 2017. http://www.nusl.cz/ntk/nusl-295662.
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The aim of this thesis is to summarize the knowledge gained in the field of grinding medium-hard and hard materials. Work has focused on examining the grindability of the material using available laboratory mill. The part of the work is subsequent optimization of the grinding process on the device and evaluation of the results.
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MELONI, ALESSIO. "Advanced random access techniques for satellite communications". Doctoral thesis, Università degli Studi di Cagliari, 2014. http://hdl.handle.net/11584/266421.
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In this thesis, Advanced Random Access techniques for Satellite Communications are studied. In the last years, new advances in multi-access communication protocols together with the increasing need for bidirectional communications in consumer type of interactive satellite terminals have revived the interest for a set of schemes able to guarantee high-speed and low latency communications in bursty traffic conditions. In this work, starting from the latest findings on Aloha-based Random Access schemes, the optimization of such techniques and their use in closed-loop scenarios is investigated with particular regard to the Return Channel over Satellite of Digital Video Broadcasting.
The thesis starts with a summary on the state of the art of Demand Assigned and Random Access techniques as well as on the recent evolution from the first to the second version of the Return Channel over Satellite of the Digital Video Broadcasting specification. In chapter 2 a stability and packet delay model for channel analysis and design are presented, showing that proper design through this tools can ensure high performance of the new access scheme. The use of control limit policies is also introduced and its use is thoroughly discussed both for finite and infinite users population showing that, differently from Slotted Aloha, in some cases static design over dynamic policies might be preferable if long propagation delay is present. In chapter 3 the same models and tools introduced for CRDSA are extended to the case of asynchronous Random Access schemes and a comparison of the two families of schemes is put in place demonstrating that asynchronous techniques are convenient only when the signal-to-noise ratio is high enough to ensure decodability of partially colliding packets. In chapter 4 a new access scheme currently patent pending is presented. In this scheme terminals access the channel in an unframed manner. It is shown that such a change brings improvements that further diminish latency due to immediate transmission of the first replica and further boost throughput because the number of loops on the corresponding bipartite graph representation is mitigated.
The thesis concludes with a call for a new discussion of resource allocation in multi-access satellite communication scenarios such as DVB-RCS2 in light of the obtained results and of the new requirements in interactive satellite networks.
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Molsner, Jochen. "Effektivitäts- und Kostenanalyse verschiedener Harninkontinenzoperationsverfahren in einem Krankenhaus mittlerer Grösse im Zeitraum von 1996 bis 2004 Vergleich von Kolposuspension tension free vaginal tape (TVT), suprapubic arc sling (Sparc), transobturator subfacial hammock (Monarc) /". [S.l.] : [s.n.], 2005. http://deposit.ddb.de/cgi-bin/dokserv?idn=975038486.
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FARIAS, JUNIOR Henry Alves de. "Avaliação ultra-sonográfica das modificações da uretra proximal e junção uretrovesical pós cirurgia para correção de incontinência urinária de esforço em mulheres, utilizando Sling de Fascia Lata do músculo vasto lateral da coxal". Universidade Federal de Pernambuco, 2004. https://repositorio.ufpe.br/handle/123456789/3082.
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Previous issue date: 2004Com o objetivo de determinar as alterações anatômicas, nas distâncias vertical e horizontal da junção uretrovesical (respectivamente DVJUV e DHJUV), na distância pubouretral (DPU) e no comprimento da uretra proximal (UP), que a cirurgia pela técnica de colocação de sling de aponeurose de coxa provoca, o autor estudou 15 pacientes, do sexo feminino, com idades variando entre 38 e 68 anos (50,3 ? 9,6 anos), com queixa prioritária de IUE, no período de março de 2002 a setembro de 2004, atendidas na Unidade de Pesquisa de Incontinência Urinária (UPIU) do Hospital das Clínicas da Universidade Federal de Pernambuco (HC/UFPE), Recife, Pernambuco, para diagnóstico ultra-sonográfico transvulvar. Foram determinadas as medidas da DPU, da DHJUV, da DVJUV e da UP, no período pré-operatório e 30 dias após a cirurgia, tendo-se considerado cada paciente como seu padrão. O autor concluiu que a cirurgia promoveu melhora estatisticamente significativa da IUE, cura da cistocele em 71,2% das pacientes, melhora ou desaparecimento da urgência urinária, melhora ou redução da incontinência urinária de urgência e da polaciúria diurna e noturna. Tomando o bordo inferior da sínfise púbica como referencial: a cirurgia deslocou a posição vertical da JUV, no sentido cranial, na situação de repouso, com redução significante da DHJUV, assim como redução significante da mobilidade do colo vesical no esforço, em virtude da redução do deslocamento da DPU, associada ao aumento da UP.. A técnica de sling de fascia lata do músculo vasto lateral da coxa, por ter oferecido bons resultados na redução dos sintomas e na correção da IUE, em ausência de complicações nos sítios de coleta e cirúrgico, pode ser considerada uma boa opção para o tratamento da IUE, com menor custo operatório, em relação ao uso de materiais sintéticos; e menor tempo de internamento em relação às técnicas que utilizam fáscias abdominais