Technical manual, operator and organizational maintenance manual : mixer, concrete, 4 wheel trailer mounted, gasoline engine driven, non tilt, 16 cu. ft. (T.L. Smith Company model 499A), FSN 3895-444-1531.

"January 1972."

Estate of J. E. Tilt, Esq. Plan of topo. survey

Ink on linen; elevations; plan of proposed driveway; signed. 110 x 80 cm. Scale: 1" = 10' [from photographic copy by Lance Burgharrdt]

Planting plan. Grounds of M. J. E. Tilt, Esq.

Ink on linen; location, type of plantings; signed;79 x 105 cm. Scale: 1" = 10' [from photographic copy by Lance Burgharrdt]

Standing with assistance of a tilt table in intensive care: A survey of Australian physiotherapy practice

Although tilt tables are used by physiotherapists to reintroduce patients to the vertical position, no quantitative evidence is available regarding their use within intensive care units (ICUs) of Australian hospitals. The purpose of this study was to evaluate the use of tilt tables in physiotherapy management of patients in ICUs across Australia. Ninety-nine physiotherapists working in Australian public ICUs were contacted via mail and asked to complete a questionnaire regarding their use of tilt tables in practice. Reasons for the use of the tilt table, contraindications, commonly used adjuncts, monitoring, and outcome measures were also investigated. Eighty-six questionnaires were returned (87% response). The tilt table was used by 58 physiotherapists (67.4%). The most common reasons for inclusion of tilt table treatment were to: facilitate weight bearing (94.8% of those who tilt); prevent muscle contractures (86%); improve lower limb strength (81%); and increase arousal (70%). The tilt table was most frequently applied to patients with neurological conditions (63.8%) and during long-term ICU stay (43.1%). Techniques often combined with tilt table treatment included upper limb exercises (93.1%) and breathing exercises (86.2%). Standing with assistance of the tilt table is used by the majority of physiotherapists working in Australian ICUs. A moderate level of agreement is demonstrated by physiotherapists regarding indications to commence tilt table treatment and adjunct modalities combined with standing with assistance of the tilt table.

Standing with the assistance of a tilt table improves minute ventilation in chronic critically ill patients

Objective: To investigate the effect of standing with assistance of the tilt table on ventilatory parameters and arterial blood gases in intensive care patients. Design: Consecutive sample. Setting: Tertiary referral hospital. Participants: Fifteen adult patients who had been intubated and mechanically ventilated for more than 5 days (3 subjects successfully weaned, 12 subjects being weaned). Intervention: Passive tilting to 70degrees from the horizontal for 5 minutes using a tilt table. Main Outcome Measures: Minute ventilation (VE), tidal volume (VT), respiratory rate, and arterial partial pressure of oxygen (Pao(2)) and carbon dioxide (Paco(2)). Results: Standing in the tilted position for 5 minutes produced significant increases in VE (P

Ventilatory changes following head-up tilt and standing in healthy subjects

Passive tilting increases ventilation in healthy subjects; however, controversy surrounds the proposed mechanism. This study is aimed to evaluate the possible mechanism for changes to ventilation following passive head-up tilt (HUT) and active standing by comparison of a range of ventilatory, metabolic and mechanical parameters. Ventilatory parameters (V (T), V (E), V (E)/VO2, V (E)/VCO2, f and PetCO(2)), functional residual capacity (FRC), respiratory mechanics with impulse oscillometry; oxygen consumption (VO2) and carbon dioxide production (VCO2) were measured in 20 healthy male subjects whilst supine, following HUT to 70 degrees and unsupported standing. Data were analysed using a linear mixed model. HUT to 70 degrees from supine increased minute ventilation (V (E)) (P < 0.001), tidal volume (V (T)) (P=0.001), ventilatory equivalent for O-2 (V (E)/VO2) (P=0.020) and the ventilatory equivalent for CO2 (V (E)/VCO2) (P < 0.001) with no change in f (P=0.488). HUT also increased FRC (P < 0.001) and respiratory system reactance (X5Hz) (P < 0.001) with reduced respiratory system resistance (R5Hz) (P=0.004) and end-tidal carbon dioxide (PetCO(2)) (P < 0.001) compared to supine. Standing increased V (E) (P < 0.001), V (T) (P < 0.001) and V (E)/VCO2 (P=0.020) with no change in respiratory rate (f) (P=0.065), V (E)/VO2 (P=0.543). Similar changes in FRC (P < 0.001), R5Hz (P=0.013), X5Hz (P < 0.001) and PetCO(2) (P < 0.001) compared to HUT were found. In contrast to HUT, standing increased VO2 (P=0.002) and VCO2 (P=0.048). The greater increase in V (E) in standing compared to HUT appears to be related to increased VO2 and VCO2 associated with increased muscle activity in the unsupported standing position. This has implications for exercise prescription and rehabilitation of critically ill patients who have reduced cardiovascular and respiratory reserve.

Adults with dyslexia demonstrate large effects of crowding and detrimental effects of distractors in a visual tilt discrimination task

Previous research has shown that adults with dyslexia (AwD) are disproportionately impacted by close spacing of stimuli and increased numbers of distractors in a visual search task compared to controls [1]. Using an orientation discrimination task, the present study extended these findings to show that even in conditions where target search was not required: (i) AwD had detrimental effects of both crowding and increased numbers of distractors; (ii) AwD had more pronounced difficulty with distractor exclusion in the left visual field and (iii) measures of crowding and distractor exclusion correlated significantly with literacy measures. Furthermore, such difficulties were not accounted for by the presence of covarying symptoms of ADHD in the participant groups. These findings provide further evidence to suggest that the ability to exclude distracting stimuli likely contributes to the reported visual attention difficulties in AwD and to the aetiology of literacy difficulties. The pattern of results is consistent with weaker and asymmetric attention in AwD.

Efeito da cinesioterapia do assoalho pélvico na qualidade de vida, função sexual e sintomas climatéricos em mulheres com e sem fibromialgia

OBJETIVO: O presente estudo teve como objetivo avaliar e comparar o efeito da cinesioterapia na qualidade de vida, função sexual e sintomas climatéricos em mulheres climatéricas com e sem fibromialgia. MÉTODOS: Participaram do estudo 90 mulheres na fase do climatério, as quais foram divididas em dois grupos: grupo fibromialgia (47) e grupo controle (43). Todas as pacientes foram avaliadas com relação às seguintes variáveis pré e pós-intervenção: qualidade de vida (Utian Quality of Life - UQOL), função sexual (questionário do Quociente sexual/versão feminina - QS-F) e intensidade dos sintomas climatéricos (Índice Menopausal de Blatt-Kupperman - IMBK). Ambos grupos foram submetidos a programa de cinesioterapia composto de 20 sessões consecutivas, realizada duas vezes por semana com técnicas para percepção, contração voluntária, dissociação e automatização do assoalho pélvico, mobilização de pelve e treino respiratório. Análise estatística foi realizada por meio dos testes t-Student pareado, análise de variância de delineamento misto e Kappa de Cohen’s, adotando-se nível de significância de 5%. RESULTADOS: Em relação à qualidade de vida, foi observada melhora estatisticamente significante no período pós-intervenção em ambos os grupos para todos os domínios avaliados. Entretanto, na análise intergrupo foi evidenciado diferença estatisticamente significante nos domínios emocional (p=0,01), saúde (0,03) e sexual (p=0,001) com ganhos mais expressivos para o grupo controle. Quanto à função sexual, foi verificada elevação significativa dos escores em ambos os grupos, após a intervenção; na análise intergrupo as mulheres com fibromialgia apresentaram escores inferiores ao grupo controle (p<0,001). Em relação aos sintomas climatéricos não houve diferença estatisticamente significante na analise intergrupo pós-intervenção (p=0,73), entretanto, ambos os grupos apresentaram redução significativa da sintomatologia após a intervenção (p<0,001). CONCLUSÕES: A cinesioterapia do assoalho pélvico exerce efeito benéfico sobre os domínios da qualidade de vida, função sexual e sintomatologia climatérica em mulheres com e sem fibromialgia na fase do climatério, entretanto a fibromialgia parece ser fator limitante para melhores resultados em alguns aspectos avaliados.

Influência da paridade, do tipo de parto e do nível de atividade física sobre a musculatura do assoalho pélvico em mulheres na pós-menopausa

The post-menopause stage is characterized by hormonal and organic alterations of ovarian failure. One of the most important of these is muscles alterations of the pelvic floor (MPF). According to current literature, in young women gynecological and obstetric factors, as well as lifestyles and habits influence that loss of function. However, there is still uncertainty about the influence of those variables in the MPF functions in post-menopause women. Thus, this study aimed at seeing if there is an influence from number of births, the type of birth and the level of physical activity on the MPF of post-menopause women. Another objective of this study was to compare MPF force in women who had had vaginal births with those who had been subjected to cesarean sections, those with different levels of physical activity and those with artificial and natural menopause in the initial and latter stages. Furthermore, the test of muscular force was compared to perineometry. Using observational, analytical and transversal observations, 100 women in the post-menopausal stage of life, between the ages of 45 and 65, were examined. They were divided according to the menopausal stage into three groups: women who had undergone hysterectomies, those in the initial stages of postmenopause and those in the late stage of postmenpause. The patients were questioned about social, demographic, gynecological and obstetric factors. All the volunteers were submitted to a physical examination where their height and weight were measured to arrive at the corporal mass index and their waist measurements were taken. The evaluation of the pelvic floor was conducted with muscular force tests and perineometry. These results were analyzed with statistical description and ANOVA statistical tests, multiple regression and Kolmogorov-Smirnov evaluations. The results showed homogeneity with regard to social demographic and anthropometric characteristics among the women in the final test sample (n=85). It was also seen that most of the women in all three groups were married (p=0.51) and catholic (p=0.13). The average per capital income varied between $R585.47 (+/-466.67) and $R1,271.83 (+/-1,748.95), with no significant difference between the groups (p=0.05). The G>6 group presented an average age between 58.95 (+/-3.96) which was significantly greater that the G<6 group´s average age (53.21+/- 3.88) (p=0.000). There was no difference between the groups´ anthropometric characteristics of weight (p=0.32), height (p=0.72) and corporal mass index (p=0.34), nor in the waist measurements (p=0.33). Furthermore, no significant difference was noted in the MPF function of women who had had normal births, cesarean sections or a combination of the two (TFM p=0.897; perineum measurement p=0.502). Likewise, no differences were seen in the MPF function of women who had one, two to three or four or more births (TFM p=0.28, perineum measurement p=0.13). Finally, no difference was perceived among those with different levels of physical activity (TFM p=0.663; perineum measurement p=0.741). Therefore, we found that the type of delivery, number of births and physical activity had no influence on the muscular function of the pelvic floor among the women studied. It is believed that decline in muscular function in post-menopause women is fundamentally related to the process of aging.

Correlação entre força muscular do assoalho pélvico, função sexual e qualidade de vida em mulheres de meia idade

Introduction: Menopause is characterized by the depletion of ovarian follicles and the gradual decline in estradiol levels, which ends with the definitive cessation of menstrual periods (menopause). As a result of hypoestrogenism, characteristic symptoms, such as hot flashes, night sweats, vaginal dryness, dyspareunia, insomnia, mood swings and depression can be observed. There is also the weakening of the pelvic floor muscles (MAP) as a result of progressive muscle-aponeurotic and connective atrophy with consequent decreased sexual function. Objective: To evaluate the strength of MAP, sexual function and quality of life of menopausal women. Methodology: This is an observational, analytical, cross-sectional design. The sample consisted of 55 women (35 postmenopausal and 20 perimenopausal), aged between 40 and 65, who were assessed by muscle strength and perineometry test. For the assessment of sexual function and quality of life, used the Female Sexual Function Index (FSFI) and Utian Quality of Life (UQOL), respectively. Statistical analysis was performed using Pearson's correlation and multivariate analysis. Results: The mean age was 52.78 (± 6.47 years). Sexual dysfunction presented, 61.8% of participants (43.62% of postmenopausal and perimenopausal 18.17%). Muscle strength test and the maximum perineometry had a median of 3.00 (Q25: 2 e Q75: 4) and 33,50 cmH20 (Q25: 33,5 e Q75: 46,6), respectively. No correlation was found between sexual function and muscle strength (r = 0.035; p = 0.802) and between sexual function and perineometry (r = 0.126; p = 0.358). The mean total score of UQOL was 74.45 (± 12.23). Weak positive correlation was found between sexual function and quality of life (r = +0.422 p = 0.001). Multivariate analysis identified associations between sexual function and variables: quality of life, climacteric symptoms, physical activity and education level. Conclusions: These results suggest that the climacteric symptoms, quality of life, physical activity and level of education are associated with sexual function in menopausal women. However, the muscular component of sexual function needs to be further investigated in this context.

Hernia perineal canina: reconstrucción del diafragma pélvico con malla de polipropileno a través de doble abordaje

La hernia perineal es una patología que se presenta en el macho de la especie canina de forma casi exclusiva, apareciendo de forma muy esporádica en la hembra y el gato, pero no se presenta en las otras especies domésticas. Se ha descrito en la especie humana sobre todo asociada a cirugías agresivas del abdomen caudal y siempre en relación a trastornos del suelo pélvico. En el perro la hernia perineal se produce por un fallo del diafragma pélvico, en el que destaca la atrofia y a veces la total desaparición del M. elevador de ano de forma uni- o bilateral. La debilidad-ausencia-desaparición de este músculo conduce a un posicionamiento más caudal de todos los órganos contenidos en el canal pélvico, vejiga, próstata, uretra post prostática, grasa periprostática y recto. Aparece en un rango muy amplio de edades aunque su tendencia más frecuente es alrededor de los 7-8 años de edad. Las manifestaciones clínicas de la hernia varían en función de la gravedad y antigüedad del proceso; el síntoma más frecuente es el estreñimiento y la deformación (tumefacción) de la fosa isquiática, pero se han descrito también la diarrea paradójica, vómitos y hasta la anuria obstructiva. La etiología de la hernia perineal esta poco clara, aunque existen diferentes hipótesis relacionadas con fenómenos que producen estreñimiento como hipertrofia prostática, o la existencia de quistes prostáticos y/o paraprostáticos. También se ha relacionado con saculitis o con la existencia de hernias inguinales. Otras teorías han relacionado la hernia con trastornos hormonales, desequilibrios entre receptores de andrógenos/estrógenos. Recientemente se la ha relacionado con la producción de relaxina en los quistes prostáticos y por último se la ha relacionado con alteraciones neurológicas del plexo pudendo. Pero lo cierto es que los porcentajes de perros con enfermedad prostática son muy altos sobre todo a partir de los 7- 8 años de edad y la incidencia de la hernia es muy baja. Tampoco todos los animales que padecen la hernia tienen quistes prostáticos y existen muchos animales con grandes quistes que no la desarrollan. En resumen, esta afección parece ser multifactorial aunque la lesión es siempre la misma, la debilidad progresiva del diafragma y la falta de funcionalismo hace el resto. Respecto a la cirugía ofrece también dificultades, se han descrito varias técnicas y las que mejores resultados ofrecen son las basadas en la elevación del obturador interno. No obstante en ocasiones este músculo también se encuentra atrofiado y la restauración del plano anatómico no es todo lo sólida que se desearía por lo cual se añade a la elevación del obturador, la utilización de mallas de polipropileno, la sobreposición del m. glúteo caudal, del músculo semitendinoso o la fijación intrabdominal de la vejiga, colon y conductos deferentes. A pesar de todo las recidivas siguen presentándose, aunque cada vez en menor porcentaje según las técnicas desarrolladas con posterioridad.

Additional evidence for fisheries acoustics : small cameras and angling gear provide tilt angle distributions and other relevant data for mackerel surveys

Acknowledgements This work received funding from the Marine Alliance for Science and Technology for Scotland (MASTS) pooling initiative and their support is gratefully acknowledged. MASTS is funded by the Scottish Funding Council (grant reference HR09011) and contributing institutions. We thank Joshua Lawrence and Niall Fallon for their assistance in collecting some of the video data.

Design and analysis of a compliant parallel pan-tilt platform

In combination of the advantages of both parallel mechanisms and compliant mechanisms, a compliant parallel mechanism with two rotational DOFs (degrees of freedom) is designed to meet the requirement of a lightweight and compact pan-tilt platform. Firstly, two commonly-used design methods i.e. direct substitution and FACT (Freedom and Constraint Topology) are applied to design the configuration of the pan-tilt system, and similarities and differences of the two design alternatives are compared. Then inverse kinematic analysis of the candidate mechanism is implemented by using the pseudo-rigid-body model (PRBM), and the Jacobian related to its differential kinematics is further derived to help designer realize dynamic analysis of the 8R compliant mechanism. In addition, the mechanism’s maximum stress existing within its workspace is tested by finite element analysis. Finally, a method to determine joint damping of the flexure hinge is presented, which aims at exploring the effect of joint damping on actuator selection and real-time control. To the authors’ knowledge, almost no existing literature concerns with this issue.

Calibrated Polarisation Tilt Angle Recovery for Wireless Communications

In this paper, we show how the polarisation state of a linearly polarised antenna can be recovered through the use of a three-term error correction model. The approach adopted is shown to be robust in situations where some multipath exists and where the sampling channels are imperfect with regard to both their amplitude and phase tracking. In particular, it has been shown that error of the measured polarisation tilt angle can be improved from 33% to 3% and below by applying the proposed calibration method. It is described how one can use a rotating dipole antenna as both the calibration standard and as the polarisation encoder, thus simplifying the physical arrangement of the transmitter. Experimental results are provided in order to show the utility of the approach, which could have a variety of applications including bandwidth conservative polarisation sub-modulation in advanced wireless communications systems.