Made available in DSpace on 2014-06-11T19:29:46Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-12-03Bitstream added on 2014-06-13T20:28:13Z : No. of bitstreams: 1 medeiros_aa_me_fran.pdf: 636681 bytes, checksum: 4e2b64194b4056253ef7043520627d93 (MD5) / Les victimes d'accidents de travail, spécialement dans les situations de décès et de pertes de leurs capacités pour le travail, quand mouvement les structures de protection, extrajudiciaires et judiciaires, elles ont, normalement, des réponses exclusivement pécuniaires pour la réparation des maux qui leur sont imposés. Plusieurs sont les causes qui contribuent pour que celui-là soit la réalité de tels travailleurs, en consolidant, la cause principale, l'attachement démesuré des interlocuteurs sociaux à des paradigmes qui ne se figurent plus ajustés aux temps présents, ou ne s'harmonisent le moindre pas aux aspirations sociales de justice (paradigme de l'État Minime et non interventeur, de la supervalorization de l'argent, du préjugé de la science quant au religieux). Les dommages moraux, par la nature qu'ils les retiennent, ne sont pas quantifiables par le critère exclusivement pécuniaire, de façon que des indemnisations de cette espèce, tout au plus, atténuent certains maux, tutefois n'en rendant pas possible la réparation intégrale envisagée. En fait, pour qu'il ait une réparation intégrale des dommages moraux imposés à ceux qui sont morts ou à ceux qui ont moissonné leurs capacités pour le travail, il faut une réparation de la même nature à celle de la blessure, c'est-à-dire, il s'impose une réparation non pécuniaire, face à des pratiques et des procédures qui, pris à l'effet directement par des agents publics et privés, de même par les personnes responsabilisés par les dommages, confèrent aux travailleurs blessés le rachat de la modèle de dignité perdue. La bioéthique, et la science juridique qui la corresponde, le biodroit, par leurs principes inhérents (justice, autonomie, bienveillance, non médisance), par traiter avec le respect, l'éthique, de l'autre être humain, et parce qu'ils sont pleins de préoccupations pas seulement... (Résumé complet accès életronique ci - dessous) / As vítimas de acidentes de trabalho, especialmente nas situações de óbitos e perdas de suas capacidades para o trabalho, ao movimentarem as estruturas de proteção, extrajudiciais e judiciais, têm, normalmente, respostas exclusivamente pecuniárias para a reparação dos males que lhes são impingidos. Várias são as causas que contribuem para que essa seja a realidade de tais trabalhadores, consubstanciando, a causa principal, o apego desmedido dos interlocutores sociais a paradigmas que não mais se afiguram adequados aos tempos presentes, ou ao menos não se harmonizam às aspirações sociais de justiça (paradigma do Estado Mínimo e não interventor, da supervalorização do dinheiro, do preconceito da ciência quanto ao religioso). Os danos morais, pela natureza que detêm, não são quantificáveis pelo critério exclusivamente pecuniário, de sorte que indenizações dessa espécie, quando muito, atenuam certos males, não possibilitando, todavia, a reparação integral desejada. Para que haja, de fato, uma reparação integral dos danos morais impostos àqueles que morreram ou tiveram ceifadas suas capacidades para o trabalho, faz-se necessária uma reparação de igual natureza à da lesão, ou seja, impõe-se uma reparação não pecuniária, mediante práticas e procedimentos que, levados a efeito diretamente por agentes públicos e privados, inclusive pelas pessoas responsáveis pelos danos, confiram aos trabalhadores lesados o resgate do padrão de dignidade perdido. A bioética e a ciência jurídica que lhe é correlata, o biodireito, pelos seus princípios inerentes (justiça, autonomia, beneficência e não maleficência), por lidarem com o respeito, ético, do ser humano, e porque imbuídas de preocupações não somente com o homem, mas com sua ambiência e com a responsabilidade deste homem para com as suas gerações futuras, em harmonia com os princípios...

The Occupational Therapist's Intervention for Adult Patients with Neurogenic Dysphagia Abstract of the Thesis: Dysphagia is a serious disorder, often caused by a cerebrovascular accident; in many cases it may be its only or primary symptom, and even the cause of death. The main objective of this thesis is to raise awareness of swallowing disorders among occupational therapists. Despite the fact that the occupational therapist's intervention for patients with swallowing disorder is common practice among occupational therapists abroad, this issue still is not well known among occupational therapists in the Czech Republic. There is also a considerable lack of Czech literature dealing with swallowing disorders from the occupational therapy point of view. This thesis therefore not only presents theoretical findings in this field but also recommends practical procedures for occupational therapists. The theoretical part of the thesis describes functional anatomy of the swallowing structures and swallowing physiology and pathophysiology. It analyses different causes of dysphagia with a focus on neurological disorders, defines the term dysphagia and other related terms, and briefly explains several classification methods of dysphagia. While the first part of the thesis looks primarily into the diagnostics and...

The thesis ``Accident frequency and its social effects{\crqq} focuses on traffic accidents caused by trespassing the law of speed limit and on social effects induced by accident frequency. Every year approximately one thousand people die on the Czech roads, other thousands of traffic accident victims face lifelong injury consequences. Apart from direct loss of lives, health and property, the traffic accidents carry a lot of other hardly denumerable costs starting at financing trip of ambulance, continuing with health care service expenses followed by convalescence, eventually social benefits for disabled and impacts on relatives of traffic accident victims. The aim of this work is to map the situation of serious traffic accidents where participants are seriously injured, or die and to infer the most serious social effects of these traffic accidents. To gather information in order to meet the objective of this hypothesis and to prove it a quantity research has been carried out. Secondary analysis of data from the records of Police of Czech Republic and the Ministry of the Interior has been chosen as a method to help verify the correctness of presumed hypothesis. In order to map the most serious social impacts, dialogs with randomly selected traffic accident participants who suffered lifelong consequences of their injuries were performed. The primary file contains participants of traffic accidents that happened in the Czech Republic and are registered in the registry of Police of Czech Republic in the period 2003-2006 and where the participants died, were seriously or lightly injured. Our hypothesis proven, that the most serious consequences of traffic accidents happen due to exceeding the speed limits . Also the most serious social impacts of traffic accidents were mapped.

This work is focused on the injury analysis at Physical exercises at three chosen grammar schools. The work can be divided into two parts. The first part focuses on multitude and injury substitution. The second part deals with safety and pupils´ health protection. At the close of the work there is a suggestion of precautionary measures to cut down the pupils´ accident rate.

The objective of this thesis is to summarize the effects of drugs, especially of the cannabinoids and amphetamine type stimulants, and to analyse which of these substances leads to high-risk activities, that could endanger life, health or result in damage to property. One of these activities, an important one, is driving under the influence of drugs. Driving itself is a complex demand, involving perception, decision making, psychomotor skills, knowledge, as well as attitudes and personality characteristics. Substance use and abuse has an impact on the functioning of the brain and mental processes and therefore on the performance of the driving task. Driving under the influence of drugs is a high risk activity which endangers not only the driver but also their surroundings. In the last few years, the Czech Republic registered a rapid increase in the number of impaired drivers, namely at police check points and in car accidents. The young drivers are mostly under influence of marijuana, respectively tetrahydrocannabinol (THC). Its negative effect on driving results from impaired co-ordination, slowed complex reaction time and in space and time distortion. The second group of drugs which can impair drivers is amphetamine type stimulants. Amphetamines are frequently sought by truck drivers, especially long-haul drivers, in Western Europe for its stimulative effects. In the Czech Republic the methamphetamine, Pervitin, is much more common. Intoxication is characterized by increased wakefulness, increased physical activity, increased respiration, rapid heart rate and an irregular heartbeat. The risk factors for driving are a lack of concentration and an overestimation of one{\crq}s own capabilities. After the acute phase of intoxication subsides, fatigue or states of narcolepsy may occur. Another amphetamine-based drug is methylenedioxymethamphetamine, MDMA or Ecstasy. This synthetic substance, chemically related to mescaline, is dangerous due to its ability to regulate body temperature. On rare but unpredictable occasions, this can lead to sharp hyperthermia, resulting in liver, kidney and cardiovascular system failure, and death. It can also cause hallucinations. All common drugs are easily detectable with ``drug test-cards{\crqq}, which are used during police checks around the the world. The Czech Republic is currently testing their utilization and is preparing legislation accordingly. Utilization of these tests during random checks could help to decrease the number of fatal road accidents and could help to decrease the number of impaired drivers on the roads.

``Water-related injuries{\crqq} are the second most frequent cause of death of children in the Czech Republic. My thesis addresses the issue of safety in facilities designed for aquatic leisure activities. Within the scope of the qualitative research with the aim to analyze technical standards, to ascertain their observance and afterwards to analyze the injury risks I used the data collection technique consisting in secondary data analysis, observation in combination with photographic documentation and semi-standardized interviews. For the research I selected a swimming pool in České Budějovice and Aquaviva Wellness Centre in Aurora Třeboň spa. The reason for this selection was creation of a pilot study monitoring safety in these facilities in South Bohemia. The Czech Republic has technical standards in place that are applied to minimize the risk of injury to the largest possible extent in facilities like that. They determine the procedures that have to be observed during construction and subsequent operation of facilities designed for aquatic leisure activities. The provisions defined by the standards are observed in both facilities but in their substance they are so generalized that it is only at the operators{\crq} discretion to what extent the safety is to be secured by them. They should be more specified and applied concretely to individual units of the equipment in order to create a safe environment. As far as risk places in the facilities are concerned, it may be stated that, regardless of compliance with the requirements defined by the standard, there is a large number of risks related in particular with slippery surfaces. Within the scope of the safety evaluation, it is also necessary to take account of hazardous behaviour of users of the chutes. The results of the research indicate that in Aquaviva Wellness Centre in Třeboň safety is secured and complies with the requirements of technical standards and the prevention requirements; the swimming pool in České Budějovice shows more serious defects {--} the standards are complied with but the surfaces are not covered with materials that would secure safety. On the basis of my research and other technical studies that confirmed seriousness of water-related injuries it is obvious that the issue of injuries in this field will require modification of safety measures and more precise specification of standards and thus elements such as materials of surfaces that would secure the required safety.

This thesis analyzes the human as an element of accident system in the sphere of motor-vehicle traffic. Then interprets the risks, damages and injuries in this sphere which are caused by the driver. On this basis, the measures to reduce the number of injuries in the Czech Republic are drawn up. In this thesis is taken account of existing measures that were proceeded in this area. It focuses particularly on the subject "driver" and its role in traffic accidents.

My diploma work deals with issues of safety at work and accident rate at work in the field of the manipulation with agricultural products. A work accident is usually caused by a number of interrelated factors. Thus, the sources and causes of work accidents affect their frequency. Undoubtedly, the most essential element in health protection and work safety not only in our country, but in the whole of the European Union (EU), is prevention. The obligation of risk assessment seems to be one of the basic principles of the preventive approach to the maintenance of health protection and work safety standards implemented in EU countries. The objective of this paper is to carry out an analysis of factors which play a role in the occurrence of work accidents and, as a result of these analyses, to establish general rules and recommendations for the elimination of the occurrence of such accidents and to design recommendations aimed at practical application.

A dissertação tem por objetivo caracterizar as fontes de dados sobre acidentes de trânsito existentes em um município de grande porte (Porto Alegre-RS) visando o desenvolvimento e a implantação de um sistema de vigilância epidemiológica de lesões e mortes no trânsito. Para tanto, foi elaborado um modelo conceitual a partir da definição de Acidentes de Transporte Terrestre (ATT) e seus fatores determinantes, de modo a identificar oportunidades de registro das informações. Foram considerados aspectos relacionados à estrutura, processos, fluxos de informações geradas, e atores envolvidos na produção e utilização das mesmas. Partindo deste modelo e da definição de sistemas de vigilância epidemiológica, as fontes de dados foram descritas quanto as variáveis: lugar, pessoa e tempo, definição de caso, objetivos, descrição de componentes e funcionamento (população alvo, forma, método e tempo de coleta, armazenamento e transferência de dados); frequência de análise dos dados; a quem são destinadas e a forma de divulgação das informações; as intervenções às quais estão vinculadas e a possibilidade de identificação dos fatores de risco para acidentes de trânsito. Além disto, partindo do referencial teórico para estruturação de sistemas de vigilância epidemiológica de acidentes da OMS/CDC, foram identificadas potencialidades e limitações dos dados disponíveis nas diferentes fontes para vigilância de ATT. Foram estudadas seis fontes de dados: Sistema de Informação Sobre Mortalidade, Sistema de Internação Hospitalar Descentralizado, Inquérito de Violências e Acidentes em Serviços Sentinela de Urgência e Emergência da Vigilância de Violências e Acidentes, Sistema de Atendimento Pré-Hospitalar do Serviço de Atendimento Móvel de Urgência, Cadastro de Acidentes de Trânsito da Empresa Pública de Transporte e Circulação de Porto Alegre, e Sistema de Informações Policiais da Secretaria de Segurança Pública do Estado do Rio Grande do Sul. A coleta de dados foi realizada por meio de entrevistas semiestruturadas com os responsáveis técnicos pelas bases de dados e análise de material documental disponível. O artigo descreve a forma de processamento, análise e divulgação dos dados, a utilidade e vinculação das informações em relação a processos decisórios e a identificação de fatores de risco para acidentes de trânsito. A descrição operacional das fontes dados, a caracterização das variáveis e a identificação de potencialidades e limitações para vigilância de ATT foram apresentadas como detalhes metodológicos adicionais. O estudo demonstrou que a coleta de dados primários ou secundários depende da oportunidade de acesso ao evento e o processamento, análise e divulgação das informações obedecem a atribuições e objetivos setoriais. Quanto à utilidade das informações e a vinculação dessas com processos decisórios, no setor saúde, estão voltadas para o planejamento e a gestão dos serviços. Nos órgãos de segurança e trânsito, para a segurança pública e viária, planejamento educação e engenharia de trânsito. Há escassez de dados relacionados à cena do acidente e a trajetória da vítima. A totalidade das informações produzidas pelas fontes estudadas caracteriza parcialmente os eventos, muitas vezes, não apontando a dinâmica do evento, quem foram os envolvidos e os fatores de risco associados de forma a auxiliar na determinação e causalidade e direcionar medidas de prevenção e controle. Tais resultados indicam a importância da qualificação dos dados primários coletados na cena do acidente e a padronização dos dados em relação a conceitos e terminologias. Para auxiliar na determinação de causalidade, apontar fatores de risco e subsidiar a tomada de decisão em saúde é fundamental à integração, relacionamento e compartilhamento de dados bem como análise multidisciplinar dos eventos. / The aim of this thesis is to characterize the sources of data on existing traffic accidents in a large municipality (Porto Alegre, Brazil) in order to develop and implement a system of epidemiological surveillance of injuries and deaths from traffic accidents. To do so, a conceptual model from the definition of Land Transport Accidents (LTAs) and its determining factors were prepared in order to identify opportunities of information records. Aspects related to structure, processes, generated information flows, and actors involved in their production were considered. On the basis of this model and the definition of epidemiological surveillance systems, the sources of data were described according to the variables: place, person, and time; definition of case; objectives; description of components and functioning (target population, form, methods, and time of collection, storage, and transfer of data); frequency of analysis of data; to whom the information is addressed as well as its form of dissemination; interventions to which the information is linked; and the possibility of identifying the risk factors for road traffic accidents. In addition, based on the theoretical framework for organization of systems of epidemiological surveillance of accidents of WHO/CDC, both potentialities and limitations on the data available in the different sources for surveillance of LTAs were identified. Six sources of data were studied: Mortality Information System, Decentralized Hospitalization System, Investigation of Acts of Violence and Accidents in the Sentinela (Sentinel) Urgency and Emergency Services of VIVA (Surveillance System for Acts of Violence and Accidents), System of Pre-Hospital Care of SAMU (Mobile Emergency Care Service), Records of Traffic Accidents of EPTC (Government-owned Corporation for Transport and Traffic in Porto Alegre), and System of Police Information of the Secretariat for Public Security in the State of Rio Grande do Sul. Data were collected by means of both semi-structured interviews with technicians responsible for the databases and documented material available. The article describes the form of processing, analysis and dissemination of data, utility and linking of information in relation to the processes of decision-making, and the identification of risk factor for road traffic accidents. The operational description of the source of data, the characterization of variables, and the identification of potentialities as well as the limitations on the surveillance of LTAs were presented as additional methodological details. The study showed that the collection of primary or secondary data depends on the opportunity to access the event and the processing, analysis and dissemination of information obey tasks and sectorial objectives. The usefulness of the information and its relation to the processes of decision-making in the health sector are related to the planning and management of services. In the agencies for security and traffic, they are related to public and road safety, planning, education, and traffic engineering. There is shortage of data related to the scene of the accident and the victim's course. All information produced by the study partially characterizes the events, often not pointing the dynamics of the event, who the involved were, and the associated risk factors, in order to help in determination and causality, and to direct both prevention and control measures. These results indicate the importance of the classification of the primary data collected at the scene of the accident and the standardization of data regarding concepts and terminology. In order to help determine causality, identify risk factors, and support the decision-making in health, record linkage, and data sharing as well as the multidisciplinary analysis of the events are essential to integration.

Statistics showing that in-vehicle driver distraction is a major contributing cause in road accidents is presented. Driver distraction is defined building on the driving theory by Gibson and Crooks. The idea to use driver distraction countermeasures as a way of mitigating the effects of the driver distraction problem is then introduced. A requirement list is formulated with ten requirements that distraction countermeasures should meet. A simplification of regarding distraction as a gaze direction problem makes way for designing an experiment to evaluate two driver distraction countermeasures in which new eye- tracking technology plays a key role. The experiment also makes use of a simulator, a surrogate in-vehicle information system as a distractor, and thirty subjects. The most important dependent measures were in-vehicle glance time and a steering wheel reaction time measure. The evaluated countermeasures – a blue flash at middle of the road position and a kinesthetic brake pulse – could, however, not be shown to meet the most important of the requirements formulated. The lack of effect of the countermeasures in the experiment may either depend on their actual inefficiency or on methodological shortcomings of the experiment. These alternatives are discussed. It is speculated that the biggest problems with the possible lack of actual efficiency have to do with that the theoretical basis for using a flash did not transfer to the driving setting, and that the brake pulse used was too weak. The methodological problems have to do with the non-validated dependent measures used, missing data, nuisance warnings, insufficient distractors, non-precise hypotheses, and difficulties with separating the effect of the countermeasures from the psychological force to look on the road.