Managing urinary incontinence across the lifespan

In the 1996 baseline surveys of the Australian Longitudinal Study of Women's Health (ALSWH), 36.1% of mid-age women (45-50) and 35% of older women (70-75) reported leaking urine. This study aimed to investigate (a) the range of self-management strategies used to deal with urinary incontinence (UI); (b) the reasons why many women who report leaking urine do not seek help for UI; and (c) the types of health professionals consulted and treatment provided, and perceptions of satisfaction with these, among a sample of women in each age group who reported leaking urine often' at baseline. Five hundred participants were randomly selected from women in each of the mid-age and older cohorts of the ALSWH who had reported leaking urine often in a previous survey. Details about UI (frequency, severity, and situations), self-management behaviors and help-seeking for UI, types of health professional consulted, recommended treatment for the problem, and satisfaction with the service provided by health care professionals and the outcomes of recommended treatments were sought through a self-report mailed follow-up survey. Most respondents had leaked urine in the last month (94% and 91% of mid-age and older women, respectively), and 72.2% and 73. 1% of mid-aged and older women, respectively, had sought help or advice about their UI. In both age groups, the likelihood of having sought help significantly increased with severity of incontinence. The most common reasons for not seeking help were that the women felt they could manage the problem themselves or they did not consider it to be a problem.. Many women in both cohorts had employed avoidance techniques in an attempt to prevent leaking urine, including reducing their liquid consumption, going to the toilet just in case, and rushing to the toilet the minute they felt the need to. Strategies are needed to inform women who experience UI of more effective management techniques and the possible health risks associated with commonly used avoidance behaviors. There may be a need to better publicize existing incontinence services and improve access to these services for women of all ages.

Environnement dissuasif, risques et stratégies délinquantes

L‟utilité de la théorie de la dissuasion est régulièrement remise en question pour expliquer la relation entre les peines et la criminalité puisque les propriétés objectives de la peine ne semblent pas affecter les taux de criminalité, les perceptions que s‟en font les individus et la récidive des délinquants. Trois limites conceptuelles des auteurs qui remettent en question la dissuasion sont soulevées. Premièrement, les unités spatiales utilisées sont des territoires sur lesquels plusieurs corps policiers sont en fonction. Il y a donc peu de chances que tous les citoyens présents soient exposés au même message pénal. Deuxièmement, les chercheurs ont mesuré le risque objectif d‟être arrêté à l‟aide d‟un ratio entre le nombre d‟arrestations et le nombre de crimes rapportés. Cette conceptualisation est problématique puisque les résultats d‟autres études suggèrent que les citoyens ont peu de connaissances des propriétés objectives et qu‟il serait, ainsi, intéressant de se référer aux stimuli dissuasifs pour conceptualiser la notion de risques. Troisièmement, pour plusieurs chercheurs, la délinquance est considérée comme une activité pour laquelle les délits impunis découlent du hasard. Pourtant, les délinquants utilisent fréquemment des stratégies pour éviter les autorités policières. Ils sont donc proactifs dans leur impunité. De ces limites découlent quatre propositions : 1) afin de détecter les réels effets des propriétés de la peine sur la criminalité, les territoires utilisés dans les études doivent représenter des juridictions sur lesquelles un seul corps policier opère; 2) afin de détecter les réels effets des propriétés de la peine sur la criminalité, les études doivent être effectuées avec des données provenant d‟une juridiction dans laquelle les activités de répression sont augmentées significativement par rapport à leur seuil antérieur et maintenue sur une période de temps suffisamment longue; 3) les stimuli dissuasifs observés doivent être considérés comme des expériences vicariantes ; 4) l‟impunité doit être définie comme étant une expérience recherchée par les délinquants. Deux études ont été réalisées dans le cadre de cette thèse. D‟abord, une étude a été réalisée à l‟aide de données issues des rapports policiers de collisions et des constats d‟infraction rendus. Les résultats montrent que l‟augmentation de la répression policière ii sur le territoire du Service de Police de la Ville de Montréal a fait diminuer le nombre de collisions. Au même moment, les collisions sont demeurées stables sur le territoire desservis par le Service de police de la Ville de Québec. Dans un deuxième temps, une étude perceptuelle a été réalisée avec un échantillon d‟étudiants universitaires. Les résultats démontrent des effets mitigés des stimuli dissuasifs sur les perceptions que se font les individus de leurs risques d‟être arrêté et sur leurs comportements délinquants. Chez les moins délinquants, les stimuli dissuasifs font augmenter la perception que les délinquants se font de leurs risques. Par contre, les plus motivés à commettre des délits de la route développent des stratégies en réaction aux opérations policières plutôt que d‟en craindre les représailles. Ces tactiques d‟évitement n‟assurent pas une impunité totale, ni une perception moins élevée des risques de recevoir une contravention, mais elles retardent le moment où le délinquant sera confronté à la punition.

Algorithms for UAS insertion in civil air space

One of the most interesting challenge of the next years will be the Air Space Systems automation. This process will involve different aspects as the Air Traffic Management, the Aircrafts and Airport Operations and the Guidance and Navigation Systems. The use of UAS (Uninhabited Aerial System) for civil mission will be one of the most important steps in this automation process. In civil air space, Air Traffic Controllers (ATC) manage the air traffic ensuring that a minimum separation between the controlled aircrafts is always provided. For this purpose ATCs use several operative avoidance techniques like holding patterns or rerouting. The use of UAS in these context will require the definition of strategies for a common management of piloted and piloted air traffic that allow the UAS to self separate. As a first employment in civil air space we consider a UAS surveillance mission that consists in departing from a ground base, taking pictures over a set of mission targets and coming back to the same ground base. During all mission a set of piloted aircrafts fly in the same airspace and thus the UAS has to self separate using the ATC avoidance as anticipated. We consider two objective, the first consists in the minimization of the air traffic impact over the mission, the second consists in the minimization of the impact of the mission over the air traffic. A particular version of the well known Travelling Salesman Problem (TSP) called Time-Dependant-TSP has been studied to deal with traffic problems in big urban areas. Its basic idea consists in a cost of the route between two clients depending on the period of the day in which it is crossed. Our thesis supports that such idea can be applied to the air traffic too using a convenient time horizon compatible with aircrafts operations. The cost of a UAS sub-route will depend on the air traffic that it will meet starting such route in a specific moment and consequently on the avoidance maneuver that it will use to avoid that conflict. The conflict avoidance is a topic that has been hardly developed in past years using different approaches. In this thesis we purpose a new approach based on the use of ATC operative techniques that makes it possible both to model the UAS problem using a TDTSP framework both to use an Air Traffic Management perspective. Starting from this kind of mission, the problem of the UAS insertion in civil air space is formalized as the UAS Routing Problem (URP). For this reason we introduce a new structure called Conflict Graph that makes it possible to model the avoidance maneuvers and to define the arc cost function of the departing time. Two Integer Linear Programming formulations of the problem are proposed. The first is based on a TDTSP formulation that, unfortunately, is weaker then the TSP formulation. Thus a new formulation based on a TSP variation that uses specific penalty to model the holdings is proposed. Different algorithms are presented: exact algorithms, simple heuristics used as Upper Bounds on the number of time steps used, and metaheuristic algorithms as Genetic Algorithm and Simulated Annealing. Finally an air traffic scenario has been simulated using real air traffic data in order to test our algorithms. Graphic Tools have been used to represent the Milano Linate air space and its air traffic during different days. Such data have been provided by ENAV S.p.A (Italian Agency for Air Navigation Services).

Cooperative Mapping and Exploration using Counter-rotational Potential Fields

This paper presents a novel technique for mapping and exploration using cooperating autonomous underwater vehicles. Rather than using the typical lawnmower sweep pattern to search an entire area, the proposed navigational plan involves guiding the formation directly towards each object of interest in turn, before arriving at a final goal position. This is achieved by the use of traditional artificial potential fields alongside counter-rotational potential fields. These clockwise and counter-clockwise fields are employed simultaneously by vehicles to ensure that the entire object is scanned rather than simply avoided as is the case with traditional collision avoidance techniques. The proposed methodology allows a formation to have fluid-like motion whilst a separation distance between cooperating agents (free of angular constraints) is maintained with a greater degree of flexibility than traditional formation control approaches. Owing to its nature, this technique is suited for applications such as exploration, mapping and underwater inspection to name a few. Simulation results demonstrate the efficacy of the proposed approach.

N-opcode analysis for android malware classification and categorization

Malware detection is a growing problem particularly on the Android mobile platform due to its increasing popularity and accessibility to numerous third party app markets. This has also been made worse by the increasingly sophisticated detection avoidance techniques employed by emerging malware families. This calls for more effective techniques for detection and classification of Android malware. Hence, in this paper we present an n-opcode analysis based approach that utilizes machine learning to classify and categorize Android malware. This approach enables automated feature discovery that eliminates the need for applying expert or domain knowledge to define the needed features. Our experiments on 2520 samples that were performed using up to 10-gram opcode features showed that an f-measure of 98% is achievable using this approach.

Data fusion with computational intelligence techniques: a case study of fuzzy inference for terrain assessment

Dissertação apresentada para obtenção do Grau de Mestre em Engenharia Electrotécnica e de Computadores, pela Universidade Nova de Lisboa, Faculdade de Ciências e Tecnologia

Peri-insular hemispherotomy: potential pitfalls and avoidance of complications.

Techniques for cerebral hemispherectomy have progressively evolved towards more disconnection and less excision over the last 50 years. Peri-insular hemispherotomy (PIH), as described by the senior author, has the maximal ratio of disconnection to excision among all procedures for hemispheric epilepsy. In this study, we focus on surgical complications and intraoperative anatomical observations during PIH over the last 10 years. Based on this experience, the procedure has undergone some modifications, which we detail herein.

Transaction scheduling using dynamic conflict avoidance

Software transaction memory (STM) systems have been used as an approach to improve performance, by allowing the concurrent execution of atomic blocks. However, under high-contention workloads, STM-based systems can considerably degrade performance, as transaction conflict rate increases. Contention management policies have been used as a way to select which transaction to abort when a conflict occurs. In general, contention managers are not capable of avoiding conflicts, as they can only select which transaction to abort and the moment it should restart. Since contention managers act only after a conflict is detected, it becomes harder to effectively increase transaction throughput. More proactive approaches have emerged, aiming at predicting when a transaction is likely to abort, postponing its execution. Nevertheless, most of the proposed proactive techniques are limited, as they do not replace the doomed transaction by another or, when they do, they rely on the operating system for that, having little or no control on which transaction to run. This article proposes LUTS, a lightweight user-level transaction scheduler. Unlike other techniques, LUTS provides the means for selecting another transaction to run in parallel, thus improving system throughput. We discuss LUTS design and propose a dynamic conflict-avoidance heuristic built around its scheduling capabilities. Experimental results, conducted with the STAMP and STMBench7 benchmark suites, running on TinySTM and SwissTM, show how our conflict-avoidance heuristic can effectively improve STM performance on high contention applications. © 2012 Springer Science+Business Media, LLC.

Cognitive risk perception system for obstacle avoidance in outdoor mUAV missions

La robótica ha evolucionado exponencialmente en las últimas décadas, permitiendo a los sistemas actuales realizar tareas sumamente complejas con gran precisión, fiabilidad y velocidad. Sin embargo, este desarrollo ha estado asociado a un mayor grado de especialización y particularización de las tecnologías implicadas, siendo estas muy eficientes en situaciones concretas y controladas, pero incapaces en entornos cambiantes, dinámicos y desestructurados. Por eso, el desarrollo de la robótica debe pasar por dotar a los sistemas de capacidad de adaptación a las circunstancias, de entendedimiento sobre los cambios observados y de flexibilidad a la hora de interactuar con el entorno. Estas son las caracteristicas propias de la interacción del ser humano con su entorno, las que le permiten sobrevivir y las que pueden proporcionar a un sistema inteligencia y capacidad suficientes para desenvolverse en un entorno real de forma autónoma e independiente. Esta adaptabilidad es especialmente importante en el manejo de riesgos e incetidumbres, puesto que es el mecanismo que permite contextualizar y evaluar las amenazas para proporcionar una respuesta adecuada. Así, por ejemplo, cuando una persona se mueve e interactua con su entorno, no evalúa los obstáculos en función de su posición, velocidad o dinámica (como hacen los sistemas robóticos tradicionales), sino mediante la estimación del riesgo potencial que estos elementos suponen para la persona. Esta evaluación se consigue combinando dos procesos psicofísicos del ser humano: por un lado, la percepción humana analiza los elementos relevantes del entorno, tratando de entender su naturaleza a partir de patrones de comportamiento, propiedades asociadas u otros rasgos distintivos. Por otro lado, como segundo nivel de evaluación, el entendimiento de esta naturaleza permite al ser humano conocer/estimar la relación de los elementos con él mismo, así como sus implicaciones en cuanto a nivel de riesgo se refiere. El establecimiento de estas relaciones semánticas -llamado cognición- es la única forma de definir el nivel de riesgo de manera absoluta y de generar una respuesta adecuada al mismo. No necesariamente proporcional, sino coherente con el riesgo al que se enfrenta. La investigación que presenta esta tesis describe el trabajo realizado para trasladar esta metodología de análisis y funcionamiento a la robótica. Este se ha centrado especialmente en la nevegación de los robots aéreos, diseñando e implementado procedimientos de inspiración humana para garantizar la seguridad de la misma. Para ello se han estudiado y evaluado los mecanismos de percepción, cognición y reacción humanas en relación al manejo de riesgos. También se ha analizado como los estímulos son capturados, procesados y transformados por condicionantes psicológicos, sociológicos y antropológicos de los seres humanos. Finalmente, también se ha analizado como estos factores motivan y descandenan las reacciones humanas frente a los peligros. Como resultado de este estudio, todos estos procesos, comportamientos y condicionantes de la conducta humana se han reproducido en un framework que se ha estructurado basadandose en factores análogos. Este emplea el conocimiento obtenido experimentalmente en forma de algoritmos, técnicas y estrategias, emulando el comportamiento humano en las mismas circunstancias. Diseñado, implementeado y validado tanto en simulación como con datos reales, este framework propone una manera innovadora -tanto en metodología como en procedimiento- de entender y reaccionar frente a las amenazas potenciales de una misión robótica. ABSTRACT Robotics has undergone a great revolution in the last decades. Nowadays this technology is able to perform really complex tasks with a high degree of accuracy and speed, however this is only true in precisely defined situations with fully controlled variables. Since the real world is dynamic, changing and unstructured, flexible and non context-dependent systems are required. The ability to understand situations, acknowledge changes and balance reactions is required by robots to successfully interact with their surroundings in a fully autonomous fashion. In fact, it is those very processes that define human interactions with the environment. Social relationships, driving or risk/incertitude management... in all these activities and systems, context understanding and adaptability are what allow human beings to survive: contrarily to the traditional robotics, people do not evaluate obstacles according to their position but according to the potential risk their presence imply. In this sense, human perception looks for information which goes beyond location, speed and dynamics (the usual data used in traditional obstacle avoidance systems). Specific features in the behaviour of a particular element allows the understanding of that element’s nature and therefore the comprehension of the risk posed by it. This process defines the second main difference between traditional obstacle avoidance systems and human behaviour: the ability to understand a situation/scenario allows to get to know the implications of the elements and their relationship with the observer. Establishing these semantic relationships -named cognition- is the only way to estimate the actual danger level of an element. Furthermore, only the application of this knowledge allows the generation of coherent, suitable and adjusted responses to deal with any risk faced. The research presented in this thesis summarizes the work done towards translating these human cognitive/reasoning procedures to the field of robotics. More specifically, the work done has been focused on employing human-based methodologies to enable aerial robots to navigate safely. To this effect, human perception, cognition and reaction processes concerning risk management have been experimentally studied; as well as the acquisition and processing of stimuli. How psychological, sociological and anthropological factors modify, balance and give shape to those stimuli has been researched. And finally, the way in which these factors motivate the human behaviour according to different mindsets and priorities has been established. This associative workflow has been reproduced by establishing an equivalent structure and defining similar factors and sources. Besides, all the knowledge obtained experimentally has been applied in the form of algorithms, techniques and strategies which emulate the analogous human behaviours. As a result, a framework capable of understanding and reacting in response to stimuli has been implemented and validated.

Towards automation of constellation management with analytical models for collision avoidance

The growing interest for constellation of small, less expensive satellites is bringing space junk and traffic management to the attention of space community. At the same time, the continuous quest for more efficient propulsion systems put the spotlight on electric (low thrust) propulsion as an appealing solution for collision avoidance. Starting with an overview of the current techniques for conjunction assessment and avoidance, we then highlight the possible problems when a low thrust propulsion is used. The need for accurate propagation model shows up from the conducted simulations. Thus, aiming at propagation models with low computational burden, we study the available models from the literature and propose an analytical alternative to improve propagation accuracy. The model is then tested in the particular case of a tangential maneuver. Results show that the proposed solution significantly improve on state of the art methods and is a good candidate to be used in collision avoidance operations. For instance to propagate satellite uncertainty or optimizing avoidance maneuver when conjunction occurs within few (3-4) orbits from measurements time.

Comparison Of Postoperative Stability Of Three Rigid Internal Fixation Techniques After Sagittal Split Ramus Osteotomy For Mandibular Advancement.

The aim of this investigation was to compare the skeletal stability of three different rigid fixation methods after mandibular advancement. Fifty-five class II malocclusion patients treated with the use of bilateral sagittal split ramus osteotomy and mandibular advancement were selected for this retrospective study. Group 1 (n = 17) had miniplates with monocortical screws, Group 2 (n = 16) had bicortical screws and Group 3 (n = 22) had the osteotomy fixed by means of the hybrid technique. Cephalograms were taken preoperatively, 1 week within the postoperative care period, and 6 months after the orthognathic surgery. Linear and angular changes of the cephalometric landmarks of the chin region were measured at each period, and the changes at each cephalometric landmark were determined for the time gaps. Postoperative changes in the mandibular shape were analyzed to determine the stability of fixation methods. There was minimum difference in the relapse of the mandibular advancement among the three groups. Statistical analysis showed no significant difference in postoperative stability. However, a positive correlation between the amount of advancement and the amount of postoperative relapse was demonstrated by the linear multiple regression test (p < 0.05). It can be concluded that all techniques can be used to obtain stable postoperative results in mandibular advancement after 6 months.

[health Protection For Rural Workers: The Need To Standardize Techniques For Quantifying Dermal Exposure To Pesticides].

Quantification of dermal exposure to pesticides in rural workers, used in risk assessment, can be performed with different techniques such as patches or whole body evaluation. However, the wide variety of methods can jeopardize the process by producing disparate results, depending on the principles in sample collection. A critical review was thus performed on the main techniques for quantifying dermal exposure, calling attention to this issue and the need to establish a single methodology for quantification of dermal exposure in rural workers. Such harmonization of different techniques should help achieve safer and healthier working conditions. Techniques that can provide reliable exposure data are an essential first step towards avoiding harm to workers' health.

Comment On 'practical Advice For Avoidance Of Pain Associated With Insertion Of Intrauterine Contraceptives': Authors' Response.

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Construction Of A Manual Of Work Processes And Techniques From Centro De Dispensação De Medicamentos De Alto Custo (cedmac), Hospital De Clínicas, Unicamp.

The Centers for High Cost Medication (Centros de Medicação de Alto Custo, CEDMAC), Health Department, São Paulo were instituted by project in partnership with the Clinical Hospital of the Faculty of Medicine, USP, sponsored by the Foundation for Research Support of the State of São Paulo (Fundação de Amparo à Pesquisa do Estado de São Paulo, FAPESP) aimed at the formation of a statewide network for comprehensive care of patients referred for use of immunobiological agents in rheumatological diseases. The CEDMAC of Hospital de Clínicas, Universidade Estadual de Campinas (HC-Unicamp), implemented by the Division of Rheumatology, Faculty of Medical Sciences, identified the need for standardization of the multidisciplinary team conducts, in face of the specificity of care conducts, verifying the importance of describing, in manual format, their operational and technical processes. The aim of this study is to present the methodology applied to the elaboration of the CEDMAC/HC-Unicamp Manual as an institutional tool, with the aim of offering the best assistance and administrative quality. In the methodology for preparing the manuals at HC-Unicamp since 2008, the premise was to obtain a document that is participatory, multidisciplinary, focused on work processes integrated with institutional rules, with objective and didactic descriptions, in a standardized format and with electronic dissemination. The CEDMAC/HC-Unicamp Manual was elaborated in 10 months, with involvement of the entire multidisciplinary team, with 19 chapters on work processes and techniques, in addition to those concerning the organizational structure and its annexes. Published in the electronic portal of HC Manuals in July 2012 as an e-Book (ISBN 978-85-63274-17-5), the manual has been a valuable instrument in guiding professionals in healthcare, teaching and research activities.

Comparison Of Different Transfer Impression Techniques Accuracy For Osseointegrated Implants.

Abstract The aim of this study was to evaluate three transfer techniques used to obtain working casts of implant-supported prostheses through the marginal misfit and strain induced to metallic framework. Thirty working casts were obtained from a metallic master cast, each one containing two implant analogues simulating a clinical situation of three-unit implant-supported fixed prostheses, according to the following transfer impression techniques: Group A, squared transfers splinted with dental floss and acrylic resin, sectioned and re-splinted; Group B, squared transfers splinted with dental floss and bis-acrylic resin; and Group N, squared transfers not splinted. A metallic framework was made for marginal misfit and strain measurements from the metallic master cast. The misfit between metallic framework and the working casts was evaluated with an optical microscope following the single-screw test protocol. In the same conditions, the strain was evaluated using strain gauges placed on the metallic framework. The data was submitted to one-way ANOVA followed by the Tukey's test (α=5%). For both marginal misfit and strain, there were statistically significant differences between Groups A and N (p<0.01) and Groups B and N (p<0.01), with greater values for the Group N. According to the Pearson's test, there was a positive correlation between the variables misfit and strain (r=0.5642). The results of this study showed that the impression techniques with splinted transfers promoted better accuracy than non-splinted one, regardless of the splinting material utilized.