Effect of intravaginal electrical stimulation on pelvic floor muscle strength

The aim of this study was to evaluate the effect of intravaginal electrical stimulation (IES) on pelvic floor muscle (PFM) strength in patients with mixed urinary incontinence (MUI). Between January 2001 and February 2002, 40 MUI women (mean age: 48 years) were studied. Urge incontinence was the predominant symptom; 92.5% also presented mild stress urinary incontinence (SUI). Selection criteria were clinical history and urodynamics. Pre-treatment urodynamic study showed no statistical differences between the groups. Ten percent of the women in each group had involuntary detrusor contractions. Patients were randomly distributed, in a double-blind study, into two groups. Group G 1 (n=20), effective IES, and group G2 (n=20), sham IES, with follow-up at 1 month. The following parameters were studied: (1) clinical questionnaire, (2) examiner's evaluation of perineal muscle strength, (3) objective evaluation of perineal muscle by perineometry, (4) vaginal weight test, and (5) urodynamic study. The IES protocol consisted of three 20-min sessions per week over a 7-week period using a Dualpex Uro 996 at 4 Hz. There was no statistically significant difference in the demographic data of both groups. The number of micturitions per 24 h after treatment was reduced significantly in both groups. Urge incontinence, present in all patients before treatment, was reduced to 15% in G1 and 31.5% in G2 post-treatment. The subjective evaluation of PFM strength demonstrated a significant improvement in G1. Objective evaluation of PFM force by perineometer showed a significant improvement in maximum peak contraction post-treatment in both groups. In the vaginal weight test, there was a significant increase in average number of cone retentions post-treatment in both groups. With regard to satisfaction level, after treatment, 80% of the patients in G1 and 65% of the patients in G2 were satisfied. There was no statistically significant difference between the groups. There was a significant improvement in PFM strength from both effective and sham electrostimulation, questioning the effectiveness of electrostimulation as a monotherapy in treating MUI.

Intravaginal electrical stimulation: a randomized, double-blind study on the treatment of mixed urinary incontinence

Background the aim of this study was to compare effective and sham intravaginal electrical stimulation (IES) in treating mixed urinary incontinence. Methods. Between January 2001 and February 2002, 40 women were randomly distributed, in a double-blind study, into two groups: group G1 (n = 20), effective IES, and group G2 (n = 20), sham IES, with follow up at one month. Different parameters was studied: 1. clinical questionnaire, 2. body mass index; 3. 60-min pad test; 4. urodynamic study. The protocol of IES consisted of three 20-min sessions per week over a seven-week period. The Dualpex Uro 996 used a frequency of 4 Hz. Results. There was no statistically significant difference in the demographic data of both groups. The number of micturitions per 24 h after treatment was reduced significantly in both groups. Urge incontinence was reduced to 15% in G1 and 31.5% in G2; there was no significant difference between the groups. In the analog wetness and discomfort sensation evaluations were reduced significantly in both groups. The pretreatment urodynamic study showed no statistical difference in urodynamic parameters between the groups. Ten percent of the women presented involuntary detrusor contractions. In the 60-min pad test, there was a significant reduction in both groups. In regards to satisfaction level, after treatment, 80% of G1 patients and 65% of G2 patients were satisfied. There was no statistically significant difference between the groups. Conclusion. Significant improvement was provided by effective and sham electrostimulation, questioning the effectiveness of electrostimulation as a monotherapy.

Assessment of Ergonomic Aspects in Dental Clinic Rooms

This study aimed to describe how to evaluate and quantify the ergonomic satisfaction level of dental clinics rooms. Requirements for design, production and selection of dental equipment as described in ISO/TC-106/SC-6-N-411, support more comprehensive studies for an ergonomic evaluation and ergo design of the dental workstations. It was created a checklist of ergonomics requirements which is supported by Standards ISO/FDI and acquired by mean of a literature review. According to information exposed at the document of the Ergonomics Society of Dental Ergonomics - ESDE we can consider that the elaboration of an ergonomic evaluation protocol regard to the dental workstation is an important demand for the ergonomics, particularly in relation to the performance of the ergonomic design which presents qualified to assist to dental equipment manufactures. By this means, the identification of the evaluation factors pointed in ISO/TC 106/SC 6 N 411 offers the basic information to the process of elaboration of this protocol addressed by the described general guidelines.

Brazilian solar water heating systems evaluation

The Brazilian National Electricity Conservation Program - PROCEL - runs regular surveys in the electric-energy-consumption market. These studies are used as valuable data to better plan the actions of this program. These data also evaluate the program's performance by identifying the level of penetration of the most efficient electric equipment within the residential sector. PROCEL's main lines of action is to promote and make available the most efficient technologies. Based on the results from the latest survey, it is estimated that 24% of the electric-energy consumption of the residential sector is used by electric shower devices, which instantaneously heat the water that flows through them, normally using an electric resistance of 5 kW. These are an important factor in a country where electric-heating devices are present in about 73% of Brazilian households. Keeping that in mind, the purpose of this work is to present the main results of the Brazilian Solar-Water-Heating-Systems Evaluation, finished in 2010, where 535 installations were visited and more than 50 researchers from different universities participated in the project. Moreover, seven Brazilian cities were selected to be studied. The information was collected from field research and statistically treated. The collected information focused on the adequacy of the project to the household, installation, operation and life cycle of the systems, as well as the users' satisfaction level. Technical questionnaires were developed to summarize all the required information, such as a Web site designed to organize and manage the data collected and a Matlab application that performed the dimensioning and F-chart systems evaluation. Quality indicators were created through a full system monitoring, with thermographic analysis and evaluation of shading influence at the system's efficiency, using the Ecotect software.

Application of an iterative method and an evolutionary algorithm in fuzzy optimization

This work develops two approaches based on the fuzzy set theory to solve a class of fuzzy mathematical optimization problems with uncertainties in the objective function and in the set of constraints. The first approach is an adaptation of an iterative method that obtains cut levels and later maximizes the membership function of fuzzy decision making using the bound search method. The second one is a metaheuristic approach that adapts a standard genetic algorithm to use fuzzy numbers. Both approaches use a decision criterion called satisfaction level that reaches the best solution in the uncertain environment. Selected examples from the literature are presented to compare and to validate the efficiency of the methods addressed, emphasizing the fuzzy optimization problem in some import-export companies in the south of Spain. © 2012 Brazilian Operations Research Society.

Acessibilidade no ensino superior: instrumento para avaliação, satisfação dos alunos com deficiência e percepção de coordenadores de cursos

Pós-graduação em Educação - FFC

Avaliação da acessibilidade no ensino superior: UTFPR - Câmpus Medianeira

Pós-graduação em Educação - FFC

Plano de carreira, cargos e salários: ferramenta favorável à valorização dos recursos humanos em saúde pública

Human recourses on Brazilian Health System (SUS) are important social points because on this form the State can guarantee the health like a right of Brazilian population, based on National Constitution Dictates. The Plan of Offices, Careers and Salaries (PCCS) is an administrative tool that should be elaborated to attendance objectives of organization. It maintain the satisfaction level of workers, with a politic of Human Recourses that allows its development and so, can get higher productivity, efficiency and objectivity of services rendered at community. The aim of this study is to contextualize the PCCS like an instrument of People Management to guide and incentive one of forms to turn no precarious the work force of Public System Dental Professionals in SUS. For them, it was realized a literature review, and official documents of Health Ministry were consulted, like governmental decrees, laws, health conference written report. It was possible to verify that, although there is legal basement on the use of PCCS-SUS by Brazilian cities like a tool to attract and maintain dental surgeon developing his profession on SUS, is often the absence of valorization of this professional, and this situation no allows his exclusive dedication at health public services. Precarious work in Dentistry is still observed on many regions of Brazil.

A randomised controlled trial: can acupuncture reduce drug requirement during analgosedation with propofol and alfentanil for colonoscopy? A study protocol.

BACKGROUND The number of colonoscopies tremendously increased in recent years and will further rise in the near future. Because of patients' growing expectation on comfort during medical procedures, it is not surprising that the demand for sedation also expands. Propofol in combination with alfentanil is known to provide excellent analgosedation, however, its use is associated with respiratory and cardiovascular depression. Acupuncture could be a technique to reduce drug requirement while providing the same level of sedation and analgesia. METHODS/DESIGN The study will be performed as a single centre, randomised, placebo controlled trial. 153 patients scheduled for propofol/alfentanil sedation during colonoscopy will be randomly assigned to receive electroacupuncture (P6, ST36, LI4), sham acupuncture, or placebo acupuncture. Following endoscopy patients and gastroenterologists have to fill in questionnaires about their sedation experiences. Additionally, patients have to accomplish the Trieger test before and after the procedure. Patient monitoring includes time adapted HR, SpO2, ECG, NIBP, exCO2, OAA/S, and the Aldrete score. The primary outcome parameter is the dosage of propofol necessary for an adequate level of sedation to tolerate the procedure (OAA/S < 4). Effectiveness of sedation, classified by satisfaction levels measured by questionnaires is the secondary outcome parameter. DISCUSSION Moderate to deep sedation using propofol is increasingly applied during colonoscopies with a high satisfaction level among patients despite well-known hemodynamic and respiratory side effects of this hypnotic agent. Acupuncture is known to attenuate gastrointestinal discomfort and pain. We hypothesize that the combination of conventional sedation techniques with acupuncture may result in equally satisfied patients with a lower risk of respiratory and hemodynamic events during colonoscopies. TRIAL REGISTRATION This trial is registered in the Nederland's Trial Register NTR 4325 . The first patient was randomized on 13 February 2014.

PROFILE AND THE QUALITY OF LIFE OF LOGGERS

RESUMO – Objetivou-se com este estudo caracterizar o perfil e avaliar o nível de satisfação que reflete na qualidade de vida no trabalho (QVT) de trabalhadores da colheita de madeira de duas contratadas (C1 e C2), por duas grandes empresas do setor florestal, sendo uma do segmento de papel e celulose (PC) e, a outra, do segmento de carvão vegetal (CV). A avaliação ocorreu a partir da percepção dos trabalhadores das contratadas em questão, utilizando um modelo pré-concebido que contempla 11 blocos ou dimensões referentes a variáveis intervenientes e definidores da QVT, englobando 48 trabalhadores em três categorias funcionais: operador de motosserra (7 trabalhadores da C1 PC e 10 da C2 CV), ajudante de motosserrista (7 trabalhadores da C1 PC e 8 da C2 CV) e operador de carregador florestal (11 trabalhadores da C1 PC e 5 da C2 CV). Os dados referentes às variáveis intervenientes na QVT foram obtidos a partir de escala fechada do tipo Likert, com os escores variando de 1 a 7, em que 1 correspondeu ao nível "bastante insatisfeito" e 7, ao nível "bastante satisfeito". O perfil dos trabalhadores é de pessoa jovem, baixo nível de escolaridade e pouco tempo de serviço na empresa. Quanto ao nível de satisfação no trabalho, constatou-se que os trabalhadores da C1 PC se encontravam "satisfeitos" e os da C2 CV, "mediamente satisfeitos" com o trabalho e as condições proporcionadas pelas respectivas empresas, apesar de estatisticamente não ter sido detectada diferença entre os valores médios encontrados nas duas situações, pelo teste de Mediana (P>0,01). Os fatores que mais contribuíram para esses resultados favoráveis foram os benefícios extras oferecidos pelas prestadoras de serviços, as condições de segurança no trabalho e o contentamento com o emprego formal. ABSTRACT – The objective of this study was to characterize profile and satisfaction level, which reflects the quality of life (QOL) of forest workers of two contracts for harvest activities, one in the pulp and paper industry (PI) and another in charcoal industry (CI). The evaluation of the satisfaction indexes was carried out according to the workers perception by using a model including 11 parameters to reflect these workers QOL. The group study of 48 workers encompassed three functional categories: chainsaw operators (7 from C1 and 10 from C2), chainsaw operator's assistant (7 from C1 and 8 from C2), and log loader operators (11 from C1 and 5 from C2). Data regarding the factors involved in QOL were collected from a closed, Likert-type scale with scores ranging from 1-7, in which level 1 corresponded to "very dissatisfied" and level 7 to "very satisfied". The general profile of the group shows that most of them are young, with low level of education and employed in the companies for a short time. Overall, the employees of contractors of the paper and pulp industry are "satisfied" and those working for the charcoal company are only "moderately satisfied" with the work and policies offered by the respective companies, although no significant statistical difference was detected between the two groups, for the median test (P> 0.01). The main reasons behind these results are the general beneficts offered by the companies, the safety measurements and the overall satisfaction for been employed.

Estudio del Fenómeno Social Media en las grandes corporaciones del sector TIC

Este trabajo trata el estudio de la implementación y desarrollo de las diversas plataformas del social media: redes sociales y del conocimiento, blogs y herramientas colaborativas en el ámbito corporativo de la empresa. El estudio recopila información de consultoras tecnológicas, de artículos y de diversas plataformas social media y se realiza una investigación sobre el tema planteado. Se incluye el análisis de 42 encuestas a profesionales de dos grandes empresas de las telecomunicaciones en España. Estas dos empresas cuentan una con cerca de 28000 empleados y la otra con más 300 empleados en sus filiales españolas. Ambas tienen una importante presencia internacional. Estas dos empresa se diferencian de otras empresas del sector de las telecomunicaciones en que están apostando en la implementación del social media en sus procesos internos. Además se incluye el estudio y análisis de las estadísticas de uso y de una series de encuestas realizadas en el muro de la red social corporativa de una multinacional de las telecomunicaciones durante tres meses. Se presenta una nueva cultura social de empresa innovadora en áreas como la gestión del conocimiento, comunicación interna, formación e innovación. Y se ofrece una visión cuantitativa y de la implantación del social media en los procesos de una empresa. Se desarrolla una exposición donde se detalla el proceso de estudio de las diferentes plataformas social media y áreas de aplicación en la empresa, el estudio de los aspectos legales de su aplicación y uso y la implementación y desarrollo. Asimismo se expone un análisis teórico-práctico del cálculo del retorno de la inversión (ROI) y por último un análisis de la información recopilada en las encuestas y en el estudio estadístico de la red social corporativa. Los datos de las encuestas fueron analizados mediante estadística descriptiva basada en gráficos y tablas de contingencia donde se calculan residuos y porcentajes totales para analizar la dependencia entre el social media, eficiencia, productividad y cuenta de resultados, además del análisis de la aportación del social media a la misión, comunicación interna y gestión del conocimiento en la empresa. También se realizan cálculos de distribuciones Chi-cuadrado para demostrar la dependencia del social media-productividad y del GAP que relaciona la importancia y el nivel de satisfacción del social media. En el análisis teórico-práctico se toman como parámetros los beneficios, costes, flexibilidad y riesgo. Los beneficios van ligados a la productividad, gestión del conocimiento, capital humano y procesos internos. Los costes a las licencias de software, administración, implementación y formación. A partir de estos parámetros se realizó el estudio de un modelo de empresa que representa a una gran empresa de las TIC en España. Los datos para el estudio son estimativos dentro de la realidad, debido a que la intención no es saber estos valores reales sino el estudio teórico-práctico del método y su aplicación para el calculo del ROI. El estudio estadístico del la red social se realizo durante tres meses y se obtuvo el progreso de uso de la red social en eventos tales como: número de participantes activos, mensajes publicados, archivos subidos, grupos activos y tipos y plataformas de acceso. Del estudio de los datos estadísticos de estos eventos se obtuvieron indicadores de participación, actividad y conocimiento de la red social que son útiles par el calculo del ROI. En conclusión, se demuestran las mejoras que ofrece el social media en campos como la comunicación interna, gestión del conocimiento, formación e innovación. Y gracias a estas mejoras el aumento de la productividad y eficiencia del profesional y asimismo un potencial retorno de la inversión (ROI). ABSTRACT. This paper deals with the study of the implementation and development of the different platforms of social media: social networks and knowledge, blogs and collaborative tools in the corporate enterprise level. The study collects information technology consulting, articles and several social media platforms and an investigation into the question raised is performed. Analysis of 42 surveys of professionals from two big companies telecommunications in Spain are included. These two companies have one about 28000 employees and another with more than 300 employees at its Spanish subsidiaries. Both have a strong international presence. These two companies differ from other companies in the telecommunications sector they are betting in the implementation of social media in their internal processes. Furthermore, the study and analysis of usage statistics and a series of surveys on the wall of the corporate social network of a multinational telecommunications is included for three months. A new social culture enterprise is presented innovative in areas such as knowledge management, internal communications, training and innovation. And a quantitative vision into implementation of social media in the processes of a company is offered. They develops an exhibition where shown the process of studying the different social media platforms and application areas in the company, the study of the legal aspects of your application and use and implementation and development. A theoretical and practical analysis also exposed of calculation of return on investment (ROI) and finally an analysis of the information collected in surveys and statistical study of corporate social network. The survey data were analyzed using descriptive statistics based on graphs and contingency tables where waste and total percentages are calculated for analyze the dependence between the social media, efficiency, productivity and income statement, plus analysis of the contribution of social media on the mission, internal communication and knowledge management in the company. Also Calculations of chi-square distributions are conducted to demonstrate the dependence between of productivity and social media and the GAP that relates the importance and satisfaction level in social media. The theoretical and practical analysis parameters are the benefits, costs, flexibility and risk. The benefits are linked to productivity, knowledge management, human capital and internal processes. The costs are linked the software licensing, management, implementation and training. Based on these parameters was performed the study of a business model that represents a large ICT company in Spain. The data for the study are estimates within the reality, because the intention is not to know these real values but the theoretical and practical study and application of the method for calculating the ROI. Statistical analysis of the social network was made during or three months and was obtained the progress of social network use at events such as: number of active participants, messages posted, files uploaded, active groups and types and access platforms. Into study of statistical data of these events were obtained indicators of participation, activity and knowledge of the social network that are useful for calculating the ROI. In conclusion, the improvements offered by the social media in areas such as internal communication, knowledge management, training and innovation are shown. And thanks to these improvements increase the productivity and efficiency of professional and also a potential return on investment (ROI).

Satisfacción en la provisión de redes de apoyo social en grupos de acompañamiento a la maternidad

Objetivos: Conocer la percepción del grado de satisfacción que tienen las madres, con hijos menores de un año y que participan en las dinámicas grupales que los CAP ofrecen, en relación al contenido y redes de provisión del Apoyo Social (AS) así como las causas que disminuyen la satisfacción en el receptor de este apoyo. Material y métodos: Estudio con diseño cualitativo y enfoque fenomenológico. La población objeto de estudio estaba constituida por madres participantes en dinámicas grupales de cinco CAP de la provincia de Barcelona. Como instrumento de recogida de datos se empleó la entrevista semiestructurada, entre julio de 2011 y julio de 2012; todas fueron grabadas, transcritas y analizadas. Resultados: AS informal: la mayoría de las madres están muy satisfechas-completamente satisfechas con el AS informativo, emocional y evaluativo procedente de las enfermeras; identificándose 4 categorías que contribuyen en esta percepción: contacto profesional/accesibilidad, disparidad y/o actualización, confianza y no procede. AS formal, la mayoría de las madres están muy satisfechas-completamente satisfechas con el AS informativo, emocional, evaluativo y técnico procedente de la pareja y madre (abuela materna); identificándose 8 categorías en esta percepción: disparidad y/o actualización en los consejos, exigencia, empatía, confianza, inseguridades, tiempo, distancia y no procede. Conclusiones: Los factores identificados deberían considerarse en los planes de mejora de la satisfacción y acompañamiento de las madres en este momento de profundos cambios en su vida; dado que aportar un AS satisfactorio repercute en la promoción de la salud y prevención de la enfermedad.

Impacto do contexto de trabalho e da resiliência sobre o bem-estar no trabalho de profissionais dos Centros de Atenção Psicossocial

Este estudo teve como intuito investigar o impacto do contexto de trabalho e da resiliência sobre o bem-estar no trabalho em profissionais dos Centros de Atenção Psicossocial (CAPS). Os CAPS são serviços públicos substitutivos ao modelo asilar para tratamento de pessoas em sofrimento psíquico, preconizado e fundamentado na Política Nacional de Saúde Mental (PNSM). Para medir o contexto de trabalho utilizou-se a Escala de Avaliação do Contexto de Trabalho (EACT) que investiga as condições de trabalho, a organização do trabalho e as relações sócio profissionais. Já o instrumento utilizado para medir a capacidade dos trabalhadores em manter o nível de desempenho no trabalho mesmo em situações complexas e desgastantes foi a Escala de Avaliação de Resiliência no Trabalho (EART). Por último, investigou-se o nível de bem-estar do público pesquisado através do Inventário de Bem- Estar no Trabalho (IBET-13). O bem-estar no trabalho tem sido considerado como um construto psicológico resultado de vínculos positivos com o trabalho e com a organização. Participaram 81 profissionais dos CAPS das cidades de Petrolina PE e São Bernardo do Campo SP, com idade média de 37 anos (DP= 10,45), em sua maioria do sexo feminino (65,4%), com níveis de escolaridade acima do ensino superior e pós-graduação completa (ambos com 29%), que se declararam casados ou em união estável (39%). Neste estudo, considerou-se bem-estar no trabalho como variável critério e resiliência no trabalho e contexto de trabalho como preditores. Foram realizadas análises estatísticas exploratórias e descritivas, análises de regressão e análises de variância (ANOVA) para descrever participantes, variáveis e testar o modelo. Os resultados apoiaram parcialmente o modelo de predição, pois apenas o fator relações sócio profissionais se confirmou como preditor significativo de Bem-estar no Trabalho, e não houve predição significativa com as demais variáveis (Condições de Trabalho, Organização do Trabalho e Resiliência no Trabalho). Estes dados podem revelar que boas relações sócio profissionais tendem a aumentar o nível de satisfação e comprometimento organizacional afetivo com a instituição, bem como o aumento do nível de envolvimento desses profissionais com seu trabalho.

Optimization of physical distribution problem in logistics management

Physical distribution plays an imporant role in contemporary logistics management. Both satisfaction level of of customer and competitiveness of company can be enhanced if the distribution problem is solved optimally. The multi-depot vehicle routing problem (MDVRP) belongs to a practical logistics distribution problem, which consists of three critical issues: customer assignment, customer routing, and vehicle sequencing. According to the literatures, the solution approaches for the MDVRP are not satisfactory because some unrealistic assumptions were made on the first sub-problem of the MDVRP, ot the customer assignment problem. To refine the approaches, the focus of this paper is confined to this problem only. This paper formulates the customer assignment problem as a minimax-type integer linear programming model with the objective of minimizing the cycle time of the depots where setup times are explicitly considered. Since the model is proven to be MP-complete, a genetic algorithm is developed for solving the problem. The efficiency and effectiveness of the genetic algorithm are illustrated by a numerical example.

Ensuring QoE in contemporary mobile networks for video content distribution

A framework that aims to best utilize the mobile network resources for video applications is presented in this paper. The main contribution of the work proposed is the QoE-driven optimization method that can maintain a desired trade-off between fairness and efficiency in allocating resources in terms of data rates to video streaming users in LTE networks. This method is concerned with the control of the user satisfaction level from the service continuity's point of view and applies appropriate QoE metrics (Pause Intensity and variations) to determine the scheduling strategies in combination with the mechanisms used for adaptive video streaming such as 3GP/MPEG-DASH. The superiority of the proposed algorithms are demonstrated, showing how the resources of a mobile network can be optimally utilized by using quantifiable QoE measurements. This approach can also find the best match between demand and supply in the process of network resource distribution.