This dissertation project explored the privileging of knowledge production in science and technology as a Canadian national economic, political and social strategy. The project incorporated the relationship between nation-state knowledge production and how that knowledge is then systematically evaluated, prioritized and validated by systems of health technology assessment (HTA). The entry point into the analysis and this dissertation project was the Scientific Research and Experimental Design (SR&ED) federal tax incentive program as the cornerstone of science and technology knowledge production in Canada. The method of inquiry and analysis examined the submission documents submitted by key stakeholders across the country, representing public, private and academic standpoints, during the public consultation process conducted from 2007 to 2008 and how each of these standpoints is hooked into the public policy interests and institutional structures that produce knowledge in science and technology. Key public meetings, including the public information sessions facilitated by the Canada Revenue Agency and private industry conferences, provided context and guidance regarding the current pervasive public and policy interests that direct and drive the policy debates. Finally, the “Innovation Canada: A Call to Action Review of Federal Support to Research and Development: Expert Panel Report,” commonly referred to as “The Jenkins Report” (Jenkins et al., 2011), was critically evaluated as the expected predictor of future public policy changes associated with the SR&ED program and the future implications for the production of knowledge in science and technology. The method of inquiry and analytical lens was a materialist approach that drew on the inspiring frameworks of such scholars as Dorothy Smith, Michel Foucault, Kaushik Sunder Rajan, Melinda Cooper, and, Gilles Deleuze. Ultimately, I strove to illuminate the normalizing force and power of knowledge production in science and technology, and the disciplines and structures that encompass it and are hooked into it where the privileging of such knowledge becomes hegemonic within and by the regimes of knowledge production that created them.

This dissertation project explored the privileging of knowledge production in science and technology as a Canadian national economic, political and social strategy. The project incorporated the relationship between nation-state knowledge production and how that knowledge is then systematically evaluated, prioritized and validated by systems of health technology assessment (HTA). The entry point into the analysis and this dissertation project was the Scientific Research and Experimental Design (SR&ED) federal tax incentive program as the cornerstone of science and technology knowledge production in Canada. The method of inquiry and analysis examined the submission documents submitted by key stakeholders across the country, representing public, private and academic standpoints, during the public consultation process conducted from 2007 to 2008 and how each of these standpoints is hooked into the public policy interests and institutional structures that produce knowledge in science and technology. Key public meetings, including the public information sessions facilitated by the Canada Revenue Agency and private industry conferences, provided context and guidance regarding the current pervasive public and policy interests that direct and drive the policy debates. Finally, the “Innovation Canada: A Call to Action Review of Federal Support to Research and Development: Expert Panel Report,” commonly referred to as “The Jenkins Report” (Jenkins et al., 2011), was critically evaluated as the expected predictor of future public policy changes associated with the SR&ED program and the future implications for the production of knowledge in science and technology. The method of inquiry and analytical lens was a materialist approach that drew on the inspiring frameworks of such scholars as Dorothy Smith, Michel Foucault, Kaushik Sunder Rajan, Melinda Cooper, and, Gilles Deleuze. Ultimately, I strove to illuminate the normalizing force and power of knowledge production in science and technology, and the disciplines and structures that encompass it and are hooked into it where the privileging of such knowledge becomes hegemonic within and by the regimes of knowledge production that created them.

O Brasil conta com uma rede de atenção terciária razoavelmente bem equipada nos grandes centros urbanos e com a rede de atenção primária em fase de franca expansão na maioria dos municípios. Entre estes dois extremos do sistema de saúde há um hiato deixado pela inexistência, em grande parte das regiões distantes dos grandes centros, da atenção secundária, fato que gera a necessidade de grandes deslocamentos diários de pessoas para realização de consultas e exames de média complexidade. Objetivo: Comparar, do ponto de vista econômico, duas formas de assistência: a convencional que está em prática em todos os municípios do RS; e a modalidade com a descentralização do exame de espirometria com apoio da teleassistência. Método: Estudo de custo-minimização da implantação da espirometria descentralizada com apoio de teleconsultoria em município distante 50Km da Capital do Estado do RS e que encaminha todos os pacientes que necessitam deste exame. Este trabalho foi apresentado como dissertação de mestrado ao PPG em Epidemiologia da UFRGS. Resultados: Observou-se que em um ano gastou-se R$ 16.966,35 com o encaminhamento de pacientes para consulta e realização de espirometria comparado com o custo de R$ 15.150,00 para se implantar um espirômetro descentralizado. Na análise dos gastos individualmente encontrou-se uma economia de R$ 102,71 por paciente que realizar o diagnóstico e o tratamento na forma descentralizada. Conclusão: O menor custo da espirometria descentralizada, a redução dos deslocamentos rodoviários e a possibilidade de eliminar a demanda reprimida por este procedimento de média complexidade justificam sua implantação. / Brazil has a well organized tertiary care network in major urban centers and a growing primary care network in almost all municipalities. In between, a gap exists due to the virtual absence of specialists offering secondary care services outside of major metropolitan areas. This results in a daily pilgrimage of patients to receive specialist consultations and undergo exams of moderate complexity. Objective: To compare, from an economic viewpoint, two modes of care: the conventional one currently being practiced across the state of Rio Grande do Sul; against a modality of decentralized spirometry with interpretation using telemedicine. Methods: Cost-minimization study of the implementation of decentralized spirometry using telemedicine, taking as a model a municipality 50 km distant from the state capital which currently references all patients who need this exam. Results: In one year R$ 16,966.35 would be spent in referencing these patients compared with R$ 15,150.00 that would be spent with the implementation of decentralized spirometry. When costs are expressed per patient, we found a saving of R$ 102.71 for each patient who received decentralized care. Conclusion: The lower cost of decentralized spirometry coupled with the possibility of eliminating backed up demand for this moderate complexity procedure justify its implementation. / Telemedicina

Submitted by Fernando de Rezende Francisco (frfrancisco@gmail.com) on 2017-04-07T11:20:44Z No. of bitstreams: 1 Dissertacao - Fernando de Rezende Francisco.pdf: 1143087 bytes, checksum: 4583241a1e35be54f0b86d1af2911fb4 (MD5) / Approved for entry into archive by Pamela Beltran Tonsa (pamela.tonsa@fgv.br) on 2017-04-07T12:23:06Z (GMT) No. of bitstreams: 1 Dissertacao - Fernando de Rezende Francisco.pdf: 1143087 bytes, checksum: 4583241a1e35be54f0b86d1af2911fb4 (MD5) / Made available in DSpace on 2017-04-07T12:42:06Z (GMT). No. of bitstreams: 1 Dissertacao - Fernando de Rezende Francisco.pdf: 1143087 bytes, checksum: 4583241a1e35be54f0b86d1af2911fb4 (MD5) Previous issue date: 2017-03-14 / There is a lack in literature about the use of Health Technology Assessment (HTA) for decision making in Brazilian’s hospitals. In addition, there is evidence that the application of HTA in hospitals can improve the use of financial investments. The objective of this study was to analyze the application of HTA methods in decision making in hospitals linked to REBRATS (Brazilian Network for the Health Technologies Assessment). Grounded Theory methodology has been applied, and the interviews data were analyzed using the ATLAS.ti software. Interviews were conducted with managers of eleven hospital-based HTA units (called “NATS”, Núcleo de Avaliação de Tecnologias em Saúde), based on a semi-structured script prepared from the 15 guiding principles for good practices in hospital-based HTA units. The results indicated that HTA is applied in an incipient way in the decision making process in hospitals. The analysis of the interviews’ content also allowed us to conclude that the success of the hospitalbased HTA units for the incorporation and disincorporation of health technologies depends on a chain of related strategic actions, and the lack of any of the stages weakens or even impedes the full application of HTA for decision-making in hospitals. / Faltam informações na literatura sobre a aplicação de Avaliação de Tecnologias em Saúde (ATS) em hospitais no Brasil. Adicionalmente, há indícios de que a aplicação de ATS em hospitais pode melhorar o uso dos investimentos financeiros. O objetivo do trabalho foi analisar a aplicação dos métodos de ATS na tomada de decisão em hospitais vinculados à REBRATS (Rede Brasileira de Avaliação de Tecnologias em Saúde). Optou-se por utilizar o método da Grounded Theory, ou Teoria Fundamentada nos Dados, e os dados foram analisados com o uso do software ATLAS.ti. Foram realizadas entrevistas com gestores de onze núcleos de ATS (NATS), baseadas em roteiro semiestruturado preparado a partir dos 15 princípios orientadores para boas práticas de ATS em hospitais. Os resultados indicaram que a ATS é aplicada de maneira incipiente no processo de tomada de decisão em hospitais. A análise do conteúdo das entrevistas permitiu, ainda, concluir que o sucesso dos NATS para a incorporação e desincorporação de tecnologias em saúde depende de uma cadeia de ações estratégicas relacionadas, e a falta de qualquer uma das etapas enfraquece, ou mesmo inviabiliza, a plena aplicação da ATS para a tomada de decisões em hospitais.

O Brasil conta com uma rede de atenção terciária razoavelmente bem equipada nos grandes centros urbanos e com a rede de atenção primária em fase de franca expansão na maioria dos municípios. Entre estes dois extremos do sistema de saúde há um hiato deixado pela inexistência, em grande parte das regiões distantes dos grandes centros, da atenção secundária, fato que gera a necessidade de grandes deslocamentos diários de pessoas para realização de consultas e exames de média complexidade. Objetivo: Comparar, do ponto de vista econômico, duas formas de assistência: a convencional que está em prática em todos os municípios do RS; e a modalidade com a descentralização do exame de espirometria com apoio da teleassistência. Método: Estudo de custo-minimização da implantação da espirometria descentralizada com apoio de teleconsultoria em município distante 50Km da Capital do Estado do RS e que encaminha todos os pacientes que necessitam deste exame. Este trabalho foi apresentado como dissertação de mestrado ao PPG em Epidemiologia da UFRGS. Resultados: Observou-se que em um ano gastou-se R$ 16.966,35 com o encaminhamento de pacientes para consulta e realização de espirometria comparado com o custo de R$ 15.150,00 para se implantar um espirômetro descentralizado. Na análise dos gastos individualmente encontrou-se uma economia de R$ 102,71 por paciente que realizar o diagnóstico e o tratamento na forma descentralizada. Conclusão: O menor custo da espirometria descentralizada, a redução dos deslocamentos rodoviários e a possibilidade de eliminar a demanda reprimida por este procedimento de média complexidade justificam sua implantação. / Brazil has a well organized tertiary care network in major urban centers and a growing primary care network in almost all municipalities. In between, a gap exists due to the virtual absence of specialists offering secondary care services outside of major metropolitan areas. This results in a daily pilgrimage of patients to receive specialist consultations and undergo exams of moderate complexity. Objective: To compare, from an economic viewpoint, two modes of care: the conventional one currently being practiced across the state of Rio Grande do Sul; against a modality of decentralized spirometry with interpretation using telemedicine. Methods: Cost-minimization study of the implementation of decentralized spirometry using telemedicine, taking as a model a municipality 50 km distant from the state capital which currently references all patients who need this exam. Results: In one year R$ 16,966.35 would be spent in referencing these patients compared with R$ 15,150.00 that would be spent with the implementation of decentralized spirometry. When costs are expressed per patient, we found a saving of R$ 102.71 for each patient who received decentralized care. Conclusion: The lower cost of decentralized spirometry coupled with the possibility of eliminating backed up demand for this moderate complexity procedure justify its implementation. / Telemedicina

Med anledning av det förändrade säkerhetspolitiska läget i Sverige arbetar flera myndigheter, på uppdrag av regeringen med att förbättra samhällets beredskap på flera olika sätt. Ett sätt att säkerställa att de aktörer som blir involverade vid någon typ av kris är förberedda är att låta dem träna i simulerade miljöer. Denna studie hade som uppgift att specificera räddningstjänstens roller, uppgifter och verktyg för att sedan kunna utveckla en modul för träningsverktyget Emergo Train SystemÒsom tillåter utökade träningsmöjligheter för räddningstjänstpersonal, enskilt eller i samverkan med övriga blåljusaktörer. Detta gjordes genom att samla in information från fokusgrupper med räddningstjänsten och sedan analysera detta med hjälp av hierarkiska uppgiftsanalyser. Resultatet är tabeller som specificerar roller, hierarkiska uppgiftsanalyser som beskriver räddningstjänstens uppgifter samt tabelluppgiftsanalyser som specificerar dessa i kombination med verktyg. Resultatet kan användas av ETS för att skapa symboler och simuleringsövningar för räddningstjänsten där deras prestation kan mätas såväl som utvecklas. / Due to the changed security policy situation in Sweden, several authorities work on behalf of the government to improve society's preparedness in several different ways. One way to ensure that the actors involved in any kind of crisis are prepared is to let them train in simulated environments. The aim of this study was to specify the roles, tasks and tools of the emergency services to develop a module for the Emergo Train SystemÒtraining tool, which allows for increased training opportunities for emergency staff, individually or in collaboration with other first responders. This was done by collecting information from focus groups with the rescue service and then analyzing it with hierarchical task analyzes. The result is tables that specify roles, hierarchical task analyzes that describe the tasks of rescue services and tabular data analyzes that specify these in combination with tools. The result can be used by ETS to create symbols and simulation exercises for the emergency services where their performance can be measured as well as developed.

O Brasil conta com uma rede de atenção terciária razoavelmente bem equipada nos grandes centros urbanos e com a rede de atenção primária em fase de franca expansão na maioria dos municípios. Entre estes dois extremos do sistema de saúde há um hiato deixado pela inexistência, em grande parte das regiões distantes dos grandes centros, da atenção secundária, fato que gera a necessidade de grandes deslocamentos diários de pessoas para realização de consultas e exames de média complexidade. Objetivo: Comparar, do ponto de vista econômico, duas formas de assistência: a convencional que está em prática em todos os municípios do RS; e a modalidade com a descentralização do exame de espirometria com apoio da teleassistência. Método: Estudo de custo-minimização da implantação da espirometria descentralizada com apoio de teleconsultoria em município distante 50Km da Capital do Estado do RS e que encaminha todos os pacientes que necessitam deste exame. Este trabalho foi apresentado como dissertação de mestrado ao PPG em Epidemiologia da UFRGS. Resultados: Observou-se que em um ano gastou-se R$ 16.966,35 com o encaminhamento de pacientes para consulta e realização de espirometria comparado com o custo de R$ 15.150,00 para se implantar um espirômetro descentralizado. Na análise dos gastos individualmente encontrou-se uma economia de R$ 102,71 por paciente que realizar o diagnóstico e o tratamento na forma descentralizada. Conclusão: O menor custo da espirometria descentralizada, a redução dos deslocamentos rodoviários e a possibilidade de eliminar a demanda reprimida por este procedimento de média complexidade justificam sua implantação. / Brazil has a well organized tertiary care network in major urban centers and a growing primary care network in almost all municipalities. In between, a gap exists due to the virtual absence of specialists offering secondary care services outside of major metropolitan areas. This results in a daily pilgrimage of patients to receive specialist consultations and undergo exams of moderate complexity. Objective: To compare, from an economic viewpoint, two modes of care: the conventional one currently being practiced across the state of Rio Grande do Sul; against a modality of decentralized spirometry with interpretation using telemedicine. Methods: Cost-minimization study of the implementation of decentralized spirometry using telemedicine, taking as a model a municipality 50 km distant from the state capital which currently references all patients who need this exam. Results: In one year R$ 16,966.35 would be spent in referencing these patients compared with R$ 15,150.00 that would be spent with the implementation of decentralized spirometry. When costs are expressed per patient, we found a saving of R$ 102.71 for each patient who received decentralized care. Conclusion: The lower cost of decentralized spirometry coupled with the possibility of eliminating backed up demand for this moderate complexity procedure justify its implementation. / Telemedicina

This diploma thesis is focused on evaluating the sources of environmental risks in the safety domain of the Honeywell Aerospace Olomouc company. First part of the diploma thesis is theoretical and serves as an entry to problematics of severe accidents prevention, risks identification and assessment. In the next part all the chemical substances stored in this international industrial company are valorised, the substances most dangerous to the environment are identified and certain precautions to prevent serious accidents are suggested according to valid legislation and recommended methods of the Ministry of the Environment.

The topic of this master's thesis is focused on the area of safety in lifting technology. Specifically, to prevent mistakes during bridge crane operations and to increase reliability of the human factor. The thesis summarizes the most important legislative regulations for crane operators, including the requirements for operation. Furthermore, there are analysis of bridge crane accidents including data about number of occupational accidents. Other part of the thesis deals with analysis HTA, human HAZOP, BOMECH and FMEA. Conclusions are set based on these analyzes and preventive measures are suggested.

No description available.