Made available in DSpace on 2017-06-01T17:57:24Z (GMT). No. of bitstreams: 1 dissertacao_eliane_lago.pdf: 4075079 bytes, checksum: a49ece6ed36ae1664f8ba47d735d6a04 (MD5) Previous issue date: 2006-03-28 / Safety in the productive chain of Civil Engineering Construction focuses on prevention, intervening through the correction of errors, imperfections, and non-conformity of processes and legislation, thereby preventing consequences that can lead to an accident. The costs of these accidents can be enormous or even incalculable, considering that a human life is priceless. Companies are beginning to realize that competitiveness and profit are not the most important elements of their organization and have demonstrated through the implementation of continuous process improvement their concern with the issue of safety in the work environment. The objective of this research is to develop an Occupational Safety and Health Management System (SGSST) for small civil construction companies, which, according to the Ministry of Work and Employment (MTE), have less than 100 employees and represent 98.28% of workers in the civil construction industry, using as a base the Directives of the International Work Organization (OIT) on Occupational Safety and Health Management Systems. To evaluate the proposed SGSST, it was implanted, applied and monitored in a civil construction company located in the state of Pernambuco. The results obtained indicate significant improvements in work environment conditions, creating a new culture within the company, through the use of preventive actions. During the implantation of the system, there was a reduction of risk of work-related accidents, guaranteeing that the implementation of the occupational safety and health management system can bring significant improvements to the productive system with productivity. / Dentro da cadeia produtiva da Construção Civil a segurança busca na prevenção seu enfoque principal, realizando sempre intervenções através das correções dos erros, das falhas e não conformidades do processo e da legislação evitando assim, as conseqüências que podem representar o acidente. Os custos dos acidentes podem ser de grandes proporções ou, até mesmo, incalculáveis, visto que a vida humana não tem preço. Assim sendo através disso as empresas passam a acreditar que a competitividade e o lucro não são os elementos fundamentais para a sua organização e demonstram através da busca da melhoria contínua de seus processos a preocupação com as questões da segurança do ambiente de trabalho. O objetivo desta pesquisa é desenvolver o Sistema de Gestão de Segurança e Saúde do Trabalho SGSST para empresas da indústria a construção civil, neste segmento, 98,28% possuem até 99 (noventa e nove) empregados segundo dados do Ministério do Trabalho Emprego MTE, tomando-se como base as Diretrizes da Organização Internacional do Trabalho OIT sobre Sistemas e Gestão da Segurança e Saúde no Trabalho. O SGSST proposto foi implantado, aplicado e monitorado em uma empresa de construção civil no estado de Pernambuco. Os resultados obtidos nos mostram uma significativa redução das situações de riscos de acidentes gerando uma melhora direta nas condições do ambiente de trabalho, instituindo uma nova cultura dentro da empresa através das ações preventivas, garantindo que a implementação do sistema de gestão de segurança do trabalho pode trazer melhorias ao sistema produtivo com produtividade.

O presente trabalho visa analisar o problema da educação em saúde do trabalhador, por meio da Comissão Interna de Prevenção de Acidentes (CIPA), quanto ao desenvolvimento de conteúdos da promoção, prevenção e recuperação da saúde, em uma empresa em Ribeirão Preto, SP. Para isso, necessitamos conhecer os processos de trabalho dos diferentes setores da empresa; estudar as atribuições, a constituição da CIPA e da Semana Interna de Prevenção de Acidentes (SIPAT), seus conteúdos, através de seus documentos e as ações de educação em saúde dos “cipeiros”, assim como e sua vinculação com a promoção à saúde; ainda, identificar as concepções sobre educação em saúde dos integrantes da CIPA. O quadro teórico foi o da epidemiologia social e o da teoria de Paulo Freire. Assim sendo, elegemos como sujeitos da presente investigação, um grupo de profissionais que constituem a CIPA, por entender que a questão da educação em saúde, na área da saúde do trabalhador, é função privilegiada da CIPA, e SIPAT. A metodologia foi a da pesquisa qualitativa, o estudo de caso. Por esse motivo, foram considerados como dados da pesquisa, as anotações no diário de campo da pesquisadora dos conteúdos das reuniões da CIPA; a observação dos processos de trabalho; os questionários devidamente preenchidos pelos participantes e documentos como atas de reuniões da CIPA e SIPAT. A análise temática levou às seguintes categorias: a CIPA, segundo os “cipeiros”; a educação em saúde do trabalhador na CIPA, na realidade da empresa, e a relação educação e trabalho nessa empresa, sendo que as duas últimas foram divididas em subcategorias. Os resultados da observação indicam que a empresa é de médio porte, pois conta com 308 trabalhadores e tem predomínio de atividades intensas. A CIPA constitui-se em 1997. Conta com 10 integrantes efetivos, na proporção de 4 para seis, entre indivíduos eleitos e indicados, mostrando uma desproporção já na sua organização; começou a ter reuniões periódicas e com atas, a partir do ano de 2000. Verificamos que faltou a compreensão por parte dos “cipeiros” das atribuições da CIPA, em relação à educação em saúde, bem como os conceitos básicos em saúde do trabalhador. As práticas educacionais se caracterizaram, por serem anti-dialógicas e domesticadoras, tanto nas reuniões, como nas SIPAT’s. Apesar de tudo isso, os “cipeiros” conseguiram executar minimamente algumas ações educativas. Essas práticas formais e informais que buscaram contribuir para que os trabalhadores tivessem mais conhecimento sobre acidentes e sobre a saúde, não conseguiram, porém, torná-los mais conscientes efetivando, dessa maneira, a prevenção. / This research aims to analyze the process of workers health education, by the Internal Committee of Accident Prevention (CIPA), related to development of promotion contents, prevention and recovering of health, at one enterprise, at Ribeirão Preto, SP. To do that, we need to understand the working process of the different sections at the enterprise; to study the assignments, the composition of the CIPA and the contents of the Internal Week of Accident Prevention (SIPAT), through its documents and the actions of health education: as well as their connection with health promotion; yet, identify health education concepts of the CIPA members. Theoretical frameworks were social epidemiology and Paulo Freire’s theory. Therefore, we elected as subjects in this research, a group of professionals who belong to the CIPA, because we understand that the question of health education in the subject of the worker’s health, is an CIPA and SIPAT proper assignment. The methodologie used was the qualitative research, the study of a case. For that reason the research data considered were: notes on the research field diary about CIPA meetings; working process observation; questionnaires duly filled by the participants and documents as the CIPA and SIPAT meetings records. Thematic analysis generated the following categories: the CIPA, according to its members; health education by CIPA members, at the enterprise reality and the relationship between education and work on that company being the last two divided in subcategories. Results of observation show that this is a medium size enterprise; since it has 308 workers who perform intense activities. The CIPA was constituted in 1997. It has 10 effective members, 4 elected by their fellow workers and 6 chosen by the company directors, witch show a back of proportion from the beginning; the CIPA started with periodic and recorded meetings since 2000. We verified that the CIPA members missed the comprehension about their assignments, in relation to health education, as well as about the basic concepts on workers health; the educational practices are characterized by being antidialogical and aim to domesticate other workers, either at their meetings, and at the SIPAT. In spite all that, the CIPA members managed to perform at least a few educative tasks. Those formal and non-formal practices which aimed to contribute to increase the workers knowledge about accidents and about health, did not however, make them more aware making effective, that way, the prevention.

No description available.

Bakgrund: För att upprätthålla en så normal kvalitet på vården som möjligt och minska det psykiska och fysiska lidandet vid stora olyckor och katastrofer måste resurserna ledas och fördelas på ett annat sätt än i sjukvårdens vardagsorganisation. Detta medför en omställning i sättet att bedriva sjukvård på till katastrofmedicinsk metodik. Anestesisjuksköterskan är en viktig del i den katastrofmedicinska beredskapen men hur anestesisjuksköterskan själv uppfattar sin roll är ett sparsamt utforskat område. Syfte: Syftet med denna studie var att beskriva anestesisjuksköterskans uppfattning om sin roll vid stora olyckor och katastrofer. Metod: En kvalitativ metod användes, där 10 semistrukturerade intervjuer med anestesisjuksköterskor har analyserats med en kvalitativ innehållsanalys. Resultat: Efter analys framkom fyra kategorier; vara en del i något större, vara närmast patienten, genom sin profession känna trygghet och medvetenhet och få förutsättningar att fungera i sin roll. Det genomgående temat i anestesisjuksköterskans uppfattningar är att genom sin profession vara en livsviktig nyckelfunktion med vilja att verka i den på bästa sätt. Konklusion: Anestesisjuksköterskan har en betydelsefull och komplex roll i den katastrofmedicinska beredskapsorganisationen men efterfrågar kunskap och utbildning för att kunna verka effektivt och säkert. Den katastrofmedicinska beredskapen måste lyftas och medvetandegöras i verksamheten.

Le risque d’accidents artériels aigus chez les patients atteints de maladie inflammatoire chronique intestinale (MICI) reste incertain. L’objectif de cette thèse est d’évaluer le risque d’accident artériel aigu chez les patients atteints de MICI et l’impact des traitements sur le risque à partir des bases de données médico administratives françaises PMSI et SNIIRAM. La prise en charge thérapeutique des patients atteints de MICI a été initialement étudiée afin de valider le code diagnostique dans les bases de données. L’exposition au traitement, les taux d’hospitalisation et de chirurgie sont similaires à ceux attendus et les taux d’incidence sont comparables à ceux rapportés dans d’autres populations. Les patients atteints de maladie de Crohn (MC) et rectocolite hémorragique (RCH) ont un surrisque d’accident artériel aigu comparé à la population générale. Le risque le plus élevé est observé chez les patients de moins de 55 ans. L’activité de la MICI est un facteur de risque indépendant d’accident artériel aigu, avec une magnitude d’effet similaire dans la MC et la RCH. Comparés aux patients non exposés, les patients exposés à la monothérapie thiopurines, anti-TNFs et combothérapie ont un risque moins élevé d’accident artériel aigu, mais cette différence est seulement significative chez les patients exposés à la combothérapie. La diminution du risque est la plus importante chez les hommes atteints de MC exposés à la combothérapie. La modulation du risque d’accident artériel aigu devrait être prise en compte dans la balance bénéfice-risque des traitements par thiopurines et anti-TNFs chez les patients atteints de MICI. / The risk of acute arterial events in inflammatory bowel disease (IBD) remains unclear. The objectives of this thesis are to assemble a nationwide cohort of IBD patients based on the French administrative health databases, in order to assess the risk of acute arterial events in IBD and the impact of immunosuppressive treatment on the risk. Disease course and therapeutic management of IBD were first studied, in order to validate the coding diagnosis of IBD in the databases. Treatment exposure, hospitalisation, and surgery rates are similar to current standard of care and incidence rates are in the range of those reported in other populations. Patients with Crohn’s disease (CD) and ulcerative colitis (UC) have an increased risk of acute arterial events compared with the general population. The highest risk is observed in patients under the age of 55 years. Disease activity is an independent risk factor of acute arterial events, with a similar magnitude of risk in CD and UC. Exposure to thiopurine and anti-TNF monotherapies, and combination therapy are all numerically associated with a decreased risk of acute arterial events compared to unexposed patients, although the difference is only statistically significant for patients exposed to combination therapy. The magnitude in risk reduction is highest in men with CD exposed to combination therapy. These studies support the concept that a tight control of inflammation is crucial in patients with IBD to avoid IBD-related systemic complications. Prevention of acute arterial events should be considered in the benefit-risk balance assessment of thiopurines and anti-TNFs treatment in IBD patients, according to age, sex and IBD subtype.

L’accident vasculaire cérébral ischémique (AVCi) est un enjeu majeur de santé publique. L’imagerie par résonance magnétique (IRM) est de plus en plus utilisée pour la prise en charge en urgence des patients, afin de sélectionner les patients candidats aux thérapies de reperfusion, seul traitement approuvé à ce jour. La découverte de nouvelles thérapeutiques constitue donc un véritable enjeu pour protéger le cerveau à la suite d’un AVCi. La piste des thérapeutiques anti-inflammatoires est particulièrement intéressante. En effet, il a été démontré que dans l’AVCi, l’inflammation cérébrale serait à l’origine d’une aggravation de la lésion ischémique. Il est maintenant admis que les cellules du système monocluée phagocytaire ont un rôle prédominant dans la cette réaction inflammatoire, contribuant dans certains cas aux dommages tissulaires. Plus récemment, il a également été démontré que les plexus choroïdes joueraient un rôle important dans le recrutement de cellules immunitaires au niveau de la lésion ischémique. Pour améliorer la compréhension de l’implication des cellules phagocytaires dans l’AVCi et dans les pathologies neuroinflammatoires en général, l’imagerie in vivo est un outil translationnel précieux. Au sein de notre équipe, la méthode non invasive d’IRM couplée à l’injection intraveineuse de nanoparticules d’oxyde de fer, les USPIOs, a été mise au point. Cette technique permet d’imager les cellules phagocytaires présentes au niveau de la lésion ischémique, suite à leur internalisation des USPIOs. Dans ce contexte, ma thèse s’est articulée autour des deux axes suivants : 1) Evaluer le potentiel d’une nouvelle nanoparticule multimodale, la « NanoGd », pour imager les cellules phagocytaires présentes au niveau de la lésion ischémique. Un protocole expérimental précis a été mis en place dans un modèle d’occlusion permanente de l’artère cérébrale moyenne chez la souris transgénique CX3CR1-GFP. L’originalité de notre étude repose sur le fait que ces souris ont été imagées in vivo avec des sessions d’IRM combinées à des sessions de microscopie biphotonique intravitale, nous permettant d’obtenir de précieuses informations sur les origines biologiques des signaux visualisés avec l’IRM. Nos résultats indiquent que l’imagerie multimodale de la NanoGd permettent d’imager in vivo les cellules phagocytaires à la suite d’un AVCi. 2) Evaluer le potentiel de notre technique d’IRM couplée à l’injection intraveineuse d’USPIOs comme outil pour imager in vivo l’implication des plexus choroïdes dans des phénomènes inflammatoires précoces. Pour cela, nous avons travaillé avec un modèle murin de neuroinflammation induite par injection intrapéritonéale de lipopolysaccharide. La présence des USPIOs au niveau des plexus choroïdes a été quantifiée sur les images IRM à l’aide d’un système de scoring multi-opérateurs, et comparée entre le groupe de souris LPS et le groupe contrôle. Nous avons montré que l’IRM couplée à l’injection iv d’USPIOs permettait de mettre en évidence in vivo les phénomènes inflammatoires à l’intérieur des plexus choroïdes. Cette étude sur l’imagerie in vivo de l’inflammation dans les plexus choroïdes fait suite à la rédaction d’une revue sur l’imagerie clinique des plexus choroïdes en conditions physiologiques et pathologiques. Nous avons montré que les plexus choroïdes sont impliqués de nombreuses manières dans le maintien de l’homéostasie cérébrale, et que bien qu’il s’agisse d’un domaine en pleine expansion, l’imagerie clinique de ces structures est encore largement insuffisante. Ce travail de thèse a donc permis de mettre au point et de valider deux approches d’imagerie in vivo pour l’étude de l’inflammation cérébrale, dans l’AVCi et les pathologies avec une composante neuroinflammatoire, et l’utilisation de ces méthodes dans des modèles souris de neuroinflammation a d’ores et déjà permis d’améliorer la compréhension des mécanismes inflammatoires dans ces pathologies / Stroke is a major public health issue. Magnetic resonance imaging (MRI) is increasingly used for the emergency management of these patients, during the interruption of blood flow to better select patients who are candidates for reperfusion therapies, the only treatment approved to date. The discovery of new therapeutics is therefore a real challenge to protect the brain following a stroke. Among the different lines of research, anti-inflammatory therapeutics are particularly interesting. Indeed, cerebral ischemia causes an inflammatory reaction and it has been shown that the runaway of this reaction would cause an aggravation of the cerebral lesions. Although the establishment of this inflammatory reaction is still to be characterized more precisely, significant progress has been made in this area. It is now recognized that cells of the phagocytic monoclonal system play a predominant role in the establishment and maintenance of this inflammatory response, contributing in some cases to tissue damage. More recently, it has also been shown that choroid plexuses play an important role in the recruitment of immune cells to the level of ischemic injury, including circulating monocytes/macrophages. To improve our understanding of phagocytic cells involvement in ischemic stroke and neuroinflammatory pathologies in general, in vivo imaging is a promising translational tool. In our team, the non-invasive MRI method coupled with the intravenous injection of iron oxide nanoparticles, the USPIOs, has been developed and validated through pre-clinical and clinical studies. This technique enables to image the phagocytic cells present at the level of the ischemic lesion, following their internalization of the USPIOs.In this context, my thesis was articulated around the following two axes:1) Evaluate the potential of a new multimodal nanoparticle composed with gadolinium fluoride, the "NanoGd", to image phagocytic cells present in the ischemic lesion. A precise experimental protocol was implemented in a model of permanent occlusion of the middle cerebral artery in CX3CR1-GFP transgenic mouse. The originality of our study rests on the fact that these mice were imaged in vivo with MRI sessions back-to-back with intravital two-photon microscopy sessions, allowing us to obtain valuable information on the biological origins of the signals visualized with the MRI. Our results indicate that multimodal imaging of NanoGd can be used to image phagocytic cells in vivo following ischemic stroke. 2) Evaluate the potential of USPIO-enhanced MRI as a tool to image in vivo the involvement of choroid plexuses in early inflammatory phenomena. For this, we worked with a mouse model of neuroinflammation induced by intraperitoneal injection of lipopolysaccharide. The presence of USPIOs at the level of the choroid plexuses was quantified on the MRI images using a multi-operator scoring system and compared between the LPS mouse group and the control group. We have shown with our study that the MRI coupled with the iv injection of USPIOs allowed to highlight in vivo the inflammatory phenomena inside the choroid plexuses. This study on in vivo imaging of inflammation in choroid plexuses followed the writing of a review about the clinical imaging of choroid plexuses in physiological and pathological conditions. In this study, we have shown that choroid plexuses are involved in many ways in maintaining cerebral homeostasis, and that although this is a rapidly expanding field, the clinical imaging of these structures is still largely insufficient. This work has allowed to develop and validate two in vivo imaging approaches for the study of brain inflammation, in stroke and pathologies with a neuroinflammatory component, and the use of these methods in mouse models of neuroinflammation has already made it possible to improve the understanding of inflammatory mechanisms in these pathologies

No description available.

A master’s thesis deals with a problem of traffic accidents on pedestrian crossings. A theoretical part describes causes and following responsibilities of all participants of the traffic accident. Furthermore, the theoretical part analyzes a traffic system and its individual parts. A practical part of this thesis describes all measuring tools used for collection of data during the analysis. The data was obtained during a real traffic on chosen pedestrian crossing in Brno A tool used for analysis is called eyetracer. Furthermore, an evaluation of collected data and following analysis were carried out. Eventually, results were compared with reports about accidents which happened on chosen pedestrian crossings.

The topic of this Diploma's thesis is Road safety inspection in the Zlín region. To start off, I was given 14 dangerous locations in the region of Zlín by the Road Services of Kroměříž; 7 of them at crossroads and 7 outside of crossroads. Then I analysed accident risks and compared the locations among each other according to safety features. Based on the outcome of my analysis, then I chose 2 locations at crossroads and 2 outside of crossroads which I personally visited and conducted analysis on how safe they are. I uncovered potential risks which could lead to traffic accidents and suggested solutions that eliminate or minimise that risk.

This thesis deals with the solution of the crossroads of the 1st Máje and Palackého in Moravské Budějovice. Part of the work is security inspection, calculation of uncontrolled intersection capacity, traffic survey. The findings are applied to possible solutions of crossing of the 1st Máje and Palackého in Moravské Budějovice.