Submitted by Maria Creuza Silva (mariakreuza@yahoo.com.br) on 2013-06-25T14:34:33Z No. of bitstreams: 1 DISS MP. Jamille Chaouí Costa. 2012.pdf: 1268414 bytes, checksum: 82ddadee8e5015fbe03cd7d9b96d3386 (MD5) / Approved for entry into archive by Maria Creuza Silva(mariakreuza@yahoo.com.br) on 2013-06-25T14:35:05Z (GMT) No. of bitstreams: 1 DISS MP. Jamille Chaouí Costa. 2012.pdf: 1268414 bytes, checksum: 82ddadee8e5015fbe03cd7d9b96d3386 (MD5) / Made available in DSpace on 2013-06-25T14:35:05Z (GMT). No. of bitstreams: 1 DISS MP. Jamille Chaouí Costa. 2012.pdf: 1268414 bytes, checksum: 82ddadee8e5015fbe03cd7d9b96d3386 (MD5) Previous issue date: 2012 / A hemodiálise é a modalidade de terapia renal substitutiva mais utilizada pelos pacientes renais crônicos, chegando a representar 89,6% de todas as terapias dialíticas disponíveis, segundo Censo de 2009 da Sociedade Brasileira de Nefrologia. O objetivo deste trabalho foi elaborar uma proposta de monitoramento da qualidade da água utilizada no procedimento de hemodiálise no Estado da Bahia e analisar os resultados alcançados pela Diretoria de Vigilância Sanitária e Ambiental (Divisa) com a implantação da mesma. A formulação desta proposta se deu através da interlocução com a Divisa e com o Laboratório Central de Saúde Pública (Lacen). Foram elaborados dois instrumentos de trabalho: o manual de procedimento operacional padrão de coleta e transporte da água usada na hemodiálise e o roteiro para caracterização dos sistemas de tratamento da água para hemodiálise e verificação de sua conformidade com a legislação vigente. A Divisa iniciou a implantação desta proposta em 13 serviços de hemodiálise e utilizou os instrumentos de trabalho elaborados. Foram coletadas 78 amostras de água para análises de monitoramento, sendo 52 para análises microbiológicas e 26 para análises de endotoxinas bacterianas; foram aplicados 13 roteiros. As análises laboratoriais apresentaram resultados insatisfatórios em 31% dos serviços de hemodiálise monitorados. Os roteiros aplicados para verificar a conformidade dos sistemas com a legislação vigente demonstraram que nenhum dos 13 serviços inspecionados cumpriu com todos os itens necessários. O grau de conformidade variou de 46% a 92% com mediana de 75%. Tanto o serviço que mais cumpriu (92%) com as exigências elencadas no roteiro quanto o que menos cumpriu (46%) são serviços privados. Concluiu-se que as legislações específicas (RDC 154/2004 e RDC 33/2008) precisam ser avaliadas quanto à necessidade de uma revisão, principalmente no que diz respeito aos padrões estabelecidos para contagem de bactérias heterotróficas no dialisato, e a inclusão de outras exigências que estão diretamente relacionados à qualidade da água utilizada na hemodiálise e não se fazem presentes nas normas atuais. / Salvador

O presente trabalho apresenta um estudo de caso de contaminação de solo e água subterrânea por derivados do petróleo em uma refinaria da região Sudeste do país, para o qual foram aplicados todos os níveis ou tiers da metodologia RBCA de avaliação de risco à saúde humana. Diferentes vias de exposição foram consideradas ao longo de toda a metodologia, a qual foi dividida em determinística, compreendendo os dois primeiros níveis, e estocástica, no caso do terceiro nível. Sobre a abordagem determinística, o modelo de Domenico (1987) para transporte de contaminantes em água subterrânea foi substituído por um conjunto de soluções analíticas que considera diferentes geometrias de fonte de contaminação para casos instantâneos e contínuos de liberação de contaminantes, permitindo que a metodologia RBCA também possa ser empregada mesmo quando o modelo de Domenico (1987) não se aplica. A comparação deste conjunto de soluções com outro utilizado apenas para comparar e confirmar a validade dos modelos escolhidos demonstrou grande estabilidade nas soluções, enquanto os modelos de comparação apresentaram instabilidade nas soluções para altos valores da variável tempo. Tal fato comprovou a viabilidade do emprego do conjunto de soluções analíticas proposto para avaliação de risco à saúde humana. No contexto da abordagem estocástica da estimativa do risco, o método de Monte Carlo foi empregado para propagação das incertezas sobre uma das soluções analíticas citadas anteriormente, da qual, por sua vez, foram extraídos os resultados para a simulação estocástica do risco para a via de contato dermal com água superficial contaminada por Benzeno. Os resultados da simulação estocástica demonstraram uma correlação muito grande do risco com a variável C (concentração do contaminante), a qual, por sua vez, foi modelada pela simulação estocástica da condutividade hidráulica. Logo, pode-se concluir que a condutividade hidráulica afeta a estimativa do risco, para o qual observou-se uma diferença de seis ordens de magnitude entre o valor mínimo e o máximo simulados e duas ordens de magnitude para o valor real do risco. / This dissertation presents a case study on soil and ground water contamination by components derived from petroleum in a refinery located in the Southeast region of Brazil. All of the RBCA health risk assessment methodology tiers were applied in this study. Different exposure pathways were considered throughout the methodology. Firstly, the deterministic approach which encompasses the first two tiers and secondly, the stochastic approach which addressed the third tier. Regarding the deterministic approach, the Domenico (1987) ground water contaminant transport model was replaced by a new set of analytical solutions that consider different geometries of contamination sources used in cases of instantaneous and continuous release of contaminants. This replacement allowed for the utilization of the RBCA methodology whenever the Domenico (1987) analytical model does not apply. A comparison between this set of analytical solutions with another set used to validate and testify the chosen set only, showed great solution stability response; whereas, the models of comparison have demonstrated instability for high values of the time variable. Such a fact proved the validity of the use of the proposed set of analytical solutions inserted in a health risk assessment context. In the context of the stochastic approach of risk estimation, the Monte Carlo method was employed to propagate uncertainties over one of the analytical solutions mentioned above, from which results were obtained to simulate dermal contact with contaminated surface water while swimming exposure pathway. The results of the stochastic simulation demonstrated a high correlation between the risk and the variable C (contaminant concentration), which was modeled by the hydraulic conductivity stochastic simulation. Hence, it may be concluded that the hydraulic conductivity affects the risk estimation, for which a difference of six orders of magnitude between the minimum and maximum simulated values and two orders of magnitude for the real risk value was observed.

Relatively little is known regarding trait anxiety and its relationship with negative health risk behaviors such as alcohol consumption and physical inactivity in adults. This study aimed to examine whether negative health risk behaviors differ by sex and whether trait anxiety is associated with the negative health risk behaviors above and beyond sociodemographic factors and depression. Data used in the present study came from a published dataset from the Midlife in the United States 2 (MIDUS 2) study and include a sample of 1,054 adults whose age range from 34 to 84 years. There were significant sex differences in alcohol consumption, but not in physical inactivity. Age, sex, BMI, and depression were significantly associated with alcohol consumption or physical inactivity, whereas trait anxiety was not. These results suggest that sociodemographic variables and depression should be taken into consideration when studying negative health risk behaviors. / Det finns relativt lite kunskap om ångest och dess förhållande till negativa hälsobeteenden som alkoholkonsumtion och fysisk inaktivitet hos vuxna individer. Denna studie avsåg undersöka om negativa hälsobeteenden varierade beroende på kön och om ångest har en relation till negativa hälsobeteenden utöver sociodemografiska faktorer och depression. De data som användes i denna studie kommer från ett offentligt data-set från the Midlife in the United States 2-studien (MIDUS 2) som omfattar 1054 vuxna deltagare med en ålder mellan 34 och 84 år. Det påfanns signifikanta könsskillnader inom alkoholkonsumtion men inte inom fysisk inaktivitet. Variablerna ålder, kön, BMI och depression hade en signifikant koppling till alkoholkonsumtion och fysisk inaktivitet, men ett liknande samband kunde inte påfinnas mellan ångest och de två hälsobeteendena. Detta indikerar således att man bör studera sociodemografiska variabler och depression i relation till negativa hälsobeteenden då det verkar finnas en tydlig koppling.

O presente trabalho apresenta um estudo de caso de contaminação de solo e água subterrânea por derivados do petróleo em uma refinaria da região Sudeste do país, para o qual foram aplicados todos os níveis ou tiers da metodologia RBCA de avaliação de risco à saúde humana. Diferentes vias de exposição foram consideradas ao longo de toda a metodologia, a qual foi dividida em determinística, compreendendo os dois primeiros níveis, e estocástica, no caso do terceiro nível. Sobre a abordagem determinística, o modelo de Domenico (1987) para transporte de contaminantes em água subterrânea foi substituído por um conjunto de soluções analíticas que considera diferentes geometrias de fonte de contaminação para casos instantâneos e contínuos de liberação de contaminantes, permitindo que a metodologia RBCA também possa ser empregada mesmo quando o modelo de Domenico (1987) não se aplica. A comparação deste conjunto de soluções com outro utilizado apenas para comparar e confirmar a validade dos modelos escolhidos demonstrou grande estabilidade nas soluções, enquanto os modelos de comparação apresentaram instabilidade nas soluções para altos valores da variável tempo. Tal fato comprovou a viabilidade do emprego do conjunto de soluções analíticas proposto para avaliação de risco à saúde humana. No contexto da abordagem estocástica da estimativa do risco, o método de Monte Carlo foi empregado para propagação das incertezas sobre uma das soluções analíticas citadas anteriormente, da qual, por sua vez, foram extraídos os resultados para a simulação estocástica do risco para a via de contato dermal com água superficial contaminada por Benzeno. Os resultados da simulação estocástica demonstraram uma correlação muito grande do risco com a variável C (concentração do contaminante), a qual, por sua vez, foi modelada pela simulação estocástica da condutividade hidráulica. Logo, pode-se concluir que a condutividade hidráulica afeta a estimativa do risco, para o qual observou-se uma diferença de seis ordens de magnitude entre o valor mínimo e o máximo simulados e duas ordens de magnitude para o valor real do risco. / This dissertation presents a case study on soil and ground water contamination by components derived from petroleum in a refinery located in the Southeast region of Brazil. All of the RBCA health risk assessment methodology tiers were applied in this study. Different exposure pathways were considered throughout the methodology. Firstly, the deterministic approach which encompasses the first two tiers and secondly, the stochastic approach which addressed the third tier. Regarding the deterministic approach, the Domenico (1987) ground water contaminant transport model was replaced by a new set of analytical solutions that consider different geometries of contamination sources used in cases of instantaneous and continuous release of contaminants. This replacement allowed for the utilization of the RBCA methodology whenever the Domenico (1987) analytical model does not apply. A comparison between this set of analytical solutions with another set used to validate and testify the chosen set only, showed great solution stability response; whereas, the models of comparison have demonstrated instability for high values of the time variable. Such a fact proved the validity of the use of the proposed set of analytical solutions inserted in a health risk assessment context. In the context of the stochastic approach of risk estimation, the Monte Carlo method was employed to propagate uncertainties over one of the analytical solutions mentioned above, from which results were obtained to simulate dermal contact with contaminated surface water while swimming exposure pathway. The results of the stochastic simulation demonstrated a high correlation between the risk and the variable C (contaminant concentration), which was modeled by the hydraulic conductivity stochastic simulation. Hence, it may be concluded that the hydraulic conductivity affects the risk estimation, for which a difference of six orders of magnitude between the minimum and maximum simulated values and two orders of magnitude for the real risk value was observed.

The construction industry is considered to be an extremely dangerous working environment, and therefore the health status of construction workers needs to be considered prior, during and on leaving the industry. Occupational hazards relative to the construction worker are well researched internationally; however few countries undertake routine medical surveillance to identify the health status of the construction worker relative to these hazards. Employers have a higher duty of care to identify workers who could be a risk at work from non-occupationally related conditions such as hypertension and diabetes mellitus. Work could exacerbate these conditions, leading to absenteeism, poor performance and eventually leaving the industry due to ill health. The dissertation explores, inter alia: the risks to which workers are exposed; the legal aspects; relevant literature regarding medical surveillance, and the use of a medical surveillance instrument used to determine the health status of 142 construction workers who consented to participate in the study. The methodological approach used in this study was a quantitative descriptive design, more specifically, using a randomised cross-sectional survey design. The instrument used to determine health status included a full medical, occupational and social history, as well as a physical examination undertaken by Occupational Health Nursing Practitioners (OHNs). Findings indicate that most construction workers believe they are healthy. However only a small percentage of construction workers did not require referral for further investigation and / or treatment.

M.Cur. / Occupational health nurses are qualified registered nurses with a post-graduate qualification in occupational health nursing as a specialised discipline, and provide the basic healthcare aspect of the occupational health programme. Their most important activity is to identify and assess the health hazard risks in the workplace. Health risk assessments are conducted by occupational health nurses to determine all the stresses, e.g. hazardous chemicals, vibration, insufficient lighting, noise exposure and thermal exposure, which may affect employees‟ health and working efficiency. The researcher conducted audits and, over a period of time, observed that 85% (n=23) of occupational health nurses in different settings conduct health risk assessments only to a certain extent. The following questions were raised: To what extent do occupational health nurses conduct health risk assessments? What are the possible reasons for them conducting the health risk assessments only to a certain extent, or not at all? What can be done to improve this? The purpose of this study was thus to explore and describe the extent to which occupational health nurses conduct health risk assessments; and the possible reasons for not conducting them or conducting them only to a certain extent. Guidelines were developed to assist occupational health nurses in conducting health risk assessments. A quantitative, descriptive design was used in this study. A sampling frame was developed from a list of all the members of the South African Society of Occupational Health Nursing Practitioners (SASOHN) in Gauteng. From the target population of occupational health nurses in Gauteng, a systematic cluster sampling method was used. A developed questionnaire was distributed by mail and e-mails, and reminders were sent by the researcher to the respondents (Burns & Grove, 2006). The researcher ensured validity and reliability throughout the study by means of theoretical review, content securing and statistical assistance (Burns & Grove, 2006). Ethical standards of the right to self-determination, right to privacy, right to confidentiality and autonomy, right to fair treatment and right to protection from discomfort and harm were adhered to. The findings revealed that the occupational health nurse is a mature, predominately female experienced practitioner who operates on behalf of a disproportionably large number of employees. Four factors influencing these nurses in conducting a health risk assessment to a certain extent were identified: competence, ignorance about the role of the occupational health nurse, workload and attitude. The researcher formulated guidelines to assist practising occupational health nurses to conduct health risk assessments.

No description available.

Magister Psychologiae - MPsych / Tobacco smoking is the second major cause of preventable deaths in South Africa. The Western Cape has the second highest smoking rates in South Africa and the highest smoking rate among young women. Previous studies indicate that female smokers are more vulnerable to the harmful effects of smoking than males. The aim of this study was to investigate the knowledge, attitudes and beliefs regarding health risks of tobacco use among female undergraduate students at the University of the Western Cape. A sample of 210 female psychology 1 students were recruited and served as research participants. Data was collected using a self-administered questionnaire adapted from instruments measuring knowledge, attitudes and beliefs regarding the health risks of tobacco smoking. Descriptive and Inferential statistics were used to analyse the data. The Health Belief Model was used as the theoretical framework for this study. The results showed a 20% prevalence of smoking among the students. Differences were found among smoking and non-smoking participants regarding their knowledge, attitudes and beliefs about the health risks of tobacco smoking. The results of the study may inform smoking prevention and intervention strategies aimed at female students on campus.

College students and emerging adults have been found to be at risk for smoking cigarettes, drinking to excess, using illicit drugs, driving dangerously, and engaging in risky sexual and delinquent behaviour. Psychosocial correlates (Sensation Seeking, peer behaviour, parent behaviour, and peer and parent anti-substance use messages) from three domains of influence (personality, parent, and peer) were examined together to provide a greater context for the occurrence of such health-risk behaviours. The strongest predictor(s) of each behaviour were identified to better inform intervention practices. Three groups were compared— 1) those who never tried substances, 2) those who tried substances in the past, and 3) those who continue to use substances at present, in a population of emerging adults. Self-report data was gathered from 203 Collèges d'Enseignement Général Et Professionnel (CEGEP) students in the Montreal region. Measures included: Reckless Behaviour Questionnaire, Reckless Driving Measure, Health Behaviour Survey, Sensation Seeking Scale—Form V, and the Marlowe-Crowne Social Desirability Scale. Results revealed that peer behaviour was the most significant predictor of substance use in emerging adults, whereas parent behaviour was only a significant predictor of reckless driving. Sensation Seeking, specifically Disinhibition, was found to predict more global reckless behaviours, including illegal activities, such as stealing or using marijuana (p < .01). Neither peer nor parent anti-substance messages were significantly related to any of the health-risk behaviours measured in this study. It would appear that health-risk behaviours tend to be related to the same underlying factors but to varying degrees. Intervention implications are discussed.

The goal of San Bernardino County Medical Information Resource is to develop, coordinate, and implement a centralized information and referral database that contains information about health and human services provided by public and private entities throughtout the county of San Bernardino and is accessible to the public via the Internet.