Thesis (MScEng)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Uterine manipulation is integral to obtaining adequate access to the uterus during a laparoscopic procedure. A variety of mechanical manipulators have been developed to aid the surgeon with the dissection of the uterus during laparoscopic hysterectomies. Limitations of existing manipulators are that they require an additional assistant during surgery, are expensive and may cause tissue trauma to the vaginal or cervical canal. This study introduces the novel concept of a magnetic uterine manipulator, intended to overcome existing devices’ shortcomings and enabling non-invasive uterine manipulation. The first goal of the study was to investigate the strengths and weaknesses of existing mechanical manipulators and compare them to those of a magnetic device. Analysis showed that a magnetic manipulator would not be able to compete in terms of the range of motion of existing devices. A limited anteriorsagittal rotation range of 60 was seen in the magnetic manipulator compared to a range of 140 in mechanical devices. However, the magnetic manipulator could eliminate the need for an extra assistant, is reusable and thus also more economical. The second goal was to investigate which type of setup would be most successful at effective uterine manipulation. Through concept analysis a cart-on-arch system was deemed most effective. To lift an effective load of 1 N over an air-gap of 150 mm rare-earth N38 Neodymium (NdFeBr) magnets showed the most promise as magnetic actuators. FEA (Finite Element Analysis) simulations of the magnetic setup were validated experimentally which produced an acceptable MAE (mean absolute error) of 0.15 N. Furthermore, a comparative simulation study of shielded and unshielded magnets was done which concluded that shielded magnets produce a slightly higher attraction force and would be safer to use due to less magnetic flux fringing. Thirdly and lastly, potential safety hazards and risks of using magnetic actuators in surgical environments were identified. The literature research revealed that connections between magnetic fields and health risks to patients have not been conclusively proven in clinical studies to date, but nonetheless, great care should be taken in situations where the patient has a pace-maker or orthopaedic implants, as these might interact with the magnetic field. Recommendations for future work include further research into the geometry and scaling effects of magnetic shielding as well as electromagnetic actuator design. Electromagnetic actuators could replace rare-earth magnets, if coil and cooling systems are optimized, resulting in magnets that can be reversed or switched off and which are therefore easier to control and safer to handle. / AFRIKAANSE OPSOMMING: Ontwikkeling van ’n Magnetiese Intra-Uteriene Manipuleerder Baarmoedermanipulasie is van uiterste belang om sodoende voldoende toegang te kry tot die baarmoeder gedurende ’n laparoskopiese prosedure. Daar is reeds ’n verskeidenheid meganiese manipuleerders ontwikkel as hulpmiddel vir die chirurg in die ontleding van die uterus tydens laparoskopiese histerektomies. Beperkings van bestaande manipuleerders is dat ’n bykomende assistent tydens chirurgie benodig word. Die manipuleerders is ook duur en kan weefseltrauma veroorsaak aan die vaginale of servikale kanale. Die studie stel ’n nuwe konsep bekend: ’n magnetiese baarmoedermanipuleerder, gemik daarop om bestaande toestelle se tekortkominge te oorkom en nie-indringende baarmoedermanipulasie moontlik te maak. Die eerste doel van die studie was om die voordele en nadele van bestaande meganiese manipuleerders te ondersoek en dit te vergelyk met dié van die magnetiese toestel. Analise het getoon dat ’n magnetiese manipuleerder nie met bestaande toestelle sal kan kompeteer waar dit gaan om beweegruimte nie. Daar is ’n beperkte anterior-sagitale rotasiespeling van 60 in die magnetiese manipuleerder, terwyl die meganiese toestel ’n rotasiespeling van 140 het. Die magnetiese manipuleerder kan egter die nodigheid van ’n bykomende assistant uitskakel, is herbruikbaar en dus ook meer ekonomies. Die tweede doel van die studie was om die tipe opstelling wat meer suksesvol sal wees tydens doeltreffende baarmoeder manipulasie te ondersoek. Konsep-analise het getoon dat ’n "cart-on-arch"stelsel die beste sal werk. N38 Neodimium (NdFeBr) magnete het die beste vertoon as magnetiese aandrywer om ’n werklike belasting van 1 N oor ’n lugspasie van 150 mm te lig. EEA (Eindige Element Analise) simulasies van die magnetiese opstelling is eksperimenteel bekragtig en het ’n aanvaarbare gemene absolute fout (GAF) van 0.15 N gelewer. ’n Vergelykende simulasie studie het verder gewys dat beskutte magnete ’n effens hoër aantrekkingskrag oplewer en sal dus veiliger wees om te gebruik vanweë die verminderde magnetiese stromingsrand. Derdens en laastens is potensiële veiligheidsrisikos en gevare in die gebruik van magnetiese drywers in chirurgiese omgewings geïdentifiseer. Literatuurnavorsing het onthul dat die verband tussen magneetvelde en gesondheidsrisikos aan pasiënte nog nie voldoende bewys is in kliniese studies tot op datum nie. Gevalle waar pasiënte ’n pasaangeër of ortopediese inplantings het moet met groot sorg hanteer word aangesien dit dalk kan reageer met die magneetvelde. Aanbevelings vir toekomstige werk sluit verdere navorsing in in die rigting van die geometrie en die afskilferingseffek van magnetiese beskutting en ook elektromagnetiese drywer ontwerp. Elektromagnetiese drywers kan moontlik rou aarde magnete vervang indien winding en afkoelstelsels ge-optimeer word wat kan lei tot magnete wat omgekeer of afgeskakel kan word en dus makliker beheerbaar is en veiliger om te hanteer.

The target of the thesis was to evaluate the risk of chemical harmful substances and dust in the working air of metal production. Four research questions were asked: {\clqq}What harmful substances are fixed in the working environment of the metal production?`` {\clqq}Are the hygienic limits of chemical substances and dust in the working environment of metal production observed?``, {\clqq}What measures were taken by the employer for the purpose of the health protection of employees?`` and {\clqq}Are the measures taken by the employer for the purpose of the health protection of employees effective?`` The thesis was treated as qualitative research. The followed file consisted of three South Bohemian companies dealing with metal production. The method of the direct, non participating and clear observation was applied for the data collection, moreover the study of documents {--} testing reports. The secondary analysis of data was performed. The results of measuring were compared with the hygienic limits fixed by the Directive of government No. 361/2007 Coll.. The evaluated professions were divided in categories pursuant the Directive No. 432/2003 Coll. In the working air of metal production, the concentration of the total dust, chromium, hexavalent chromium, carbon monoxide and ozone were followed. The last measuring in the monitored workshops proved that the hygienic limits were observed, except for two cases when the highest acceptable concentration determined for chromium and the chromium (II,III) compounds as Cr, and of the hygienic limit for welding fumes were exceeded. The most important protective measure applied by the employers on their workplaces was the reconstruction of air-conditioning, or installation of local exhausting. In view of the gradual decrease of the harmful substance in the working air in connection to the taken measures may be stated that the given measures were effective. The hypothesis {\clqq}Modernisation of operations in metal production improves the working environment of employees and in the modern operations no above-the-limit values of the most monitored harmful substances were found out. ``

The objective of my diploma work is to point out the main trends of the healthy lifestyle as well as to stress the factors having a negative impact on health. In particular, the work deals with well-balanced nutrition, exercising, sleep, lifestyle health risks, stress, civilisation disorders and the media which promote this healthy lifestyle. The research has been carried out under the use of the questionnaire method analysing the lifestyle of two separate groups of adolescents.

The topic of my thesis is foreign travel issues. Its purpose is to survey the awareness of students of the University of South Bohemia about travel risks, while mapping the knowledge and use of available preventive measures. The thesis is divided into two parts, theoretical and practical. In the theoretical part I try to describe in a well arranged way the available knowledge about health risks associated with traveling, including the various forms of prevention. The aim of the practical part is to analyze the obtained data and to determine the awareness of university students about the risks associated with traveling. The survey is based on the methods of prevalence studies conducted using an anonymous questionnaire survey. In total, 652 students of the University of South Bohemia were addressed, the number of returns was 460 questionnaires. In relation to the objectives two hypotheses were proposed. H1: The awareness of students of the Faculty of Health and Social Studies about the health risks associated with a stay abroad is significantly higher than that of students of other faculties of the University of South Bohemia. H2: Statistically, the most important source of information on the knowledge and use of possible prevention measures is the Internet. These hypotheses were statistically evaluated and on the basis of the obtained results they were confirmed or refuted. The research results show that the most informed about the presented issues are students of the Faculty of Science. This fact was later explained by a number of exotic destinations visited during the last stay abroad, as well as a wide offer of the Faculty of globally-oriented practical training and research fellowships, in connection with which the students inform themselves about possible travel risks. Statistically, most of the surveyed students use the Internet to get information. This research became the basis for targeted focus of health education on minimizing health risks when traveling abroad. The real outcome of the thesis is an information poster which will be distributed to individual faculties of the University of South Bohemia.

Bisfenol A (BPA) är ett propanderivat med två fenolgrupper. Det syntetiserades för första gången år 1905 av Thomas Zincke vid Marburgs universitet. När en polymerkemist upptäckte att det kunde användas för att bilda polykarbonatplaster växte dess popularitet. Idag är BPA-industrin en miljardindustri och många av oss använder dagligen plaster där denna kemikalie ingår. Nu har det gjorts nya toxikologiska undersökningar som visar att BPA kanske inte är så ofarligt som man tidigare trott. Vårt största intag av föreningen sker via mag-tarmkanalen genom att det kan läcka från olika slags plastföremål i kontakt med livsmedel. Enligt en panel sammansatt av USA:s National Institutes of Health finns det en risk för negativa effekter på hjärna och beteende hos barn. Reaktionerna på riskbedömningarna har varierat och detta examensarbete vill presentera några argument för vikten av att undersöka BPA: s hälsorisker mer. Syftet med detta examensarbete är att med en litteraturstudie undersöka en del av vad som finns dokumenterat om BPA: s hälsorisker för människan, typ av genomförda toxikologiska undersökningar och hur dessa resultat har påverkat företag och länder. Denna litteraturstudie visar att det finns stor bredd på tolkningen av de toxikologiska studiernas resultat och därmed är det osäkert om det finns hälsorisker eller inte. Det finns omdebatterade resultat som tyder på en ökad risk av toxikologiska effekter, till exempel skada på hjärta hos barn men det finns ingen fastställd hälsorisk för människor. Mer standardisering behövs i forskningen för att ge den en högre kvalitet och göra studier mer jämförbara. / Bisphenol-A (BPA) is a propane derivative with two phenol groups. It was synthetisized for the first time in the year of 1905 by Thomas Zincke at the Marburg University. When a polymer chemist discovered that it could be used to form polycarbonate plastics its popularity grew. Today the chemistry of BPA is a billion industry and many of us use daily plastics in which this chemical is used for. Many new toxicological studies have shown that BPA maybe is not as friendly as before thought. Our biggest exposure to it is orally because it can leak from different plastics with contact to food. According to a panel assembled by USA’s National Institutes of Health there is a risk of negative effects on brain and behaviour on children. The reactions of the risk assessment have been different and this thesis wants to show some arguments for the importance of exploring the health risks of BPA more. The purpose of this thesis is to use a literature study to investigate a part of what is documented about the health effects of BPA on humans, the kind of toxicological studies performed and how their results have affected companies and countries. The literature study shows that the width of interpretation of the toxicological studies’ results is big and thus that it is uncertain if there are health effects or not. There are some uncertain results facts funded on conflict that show a heightened risk for toxicological effects, for example damage on heart and changes in behavior in infants but there is no empirically stated health risk in humans. More standardization in research is needed for giving it a higher quality and thus making it more comparable.

Magister Public Health - MPH / The global problem of overweight and obesity is disturbing judging by the World Health Organization 2008 statistics which estimate that 1.4 billion and 500 million adults are overweight and obese. Thus, as a major risk for non-communicable diseases (NCDs) which are the foremost cause of disability and death, the problem of obesity needs to be addressed not only globally but in South Africa as well. South Africa’s burden of disease includes NCDs and causes of death of diseases such as diabetes (3%), cardiovascular diseases (CVDs) (11%), cancer (7%) and chronic respiratory diseases (3%). The HealthKick study is a school-based nutrition and physical activity intervention programme in the Western Cape, S.A., aimed to promote healthy behaviours such as healthful eating and physical activity in children, parents and teachers to reduce the risk of non-communicable diseases. During the formative phase of the study it emerged that educators were at high risk for NCDs because of their high levels of obesity. This study therefore aimed to describe primary school educators’ perceptions regarding body weight, related health risks and barriers to weight management. A qualitative approach was used to collect data and included focus group discussions (FGDs), and in-depth individual interviews (IDIs). In addition anthropometric measurements were taken. Four schools were purposively selected and a total of thirty one male and female educators participated in the seven focus group discussions and four in-depth interviews from the four schools. Male FGDs and IDIs and female FGDs and IDIs were conducted separately. The focus group discussions and in-depth interviews were digitally recorded and transcribed verbatim. Thematic data analysis was conducted with the use of ATLAS ti 6.1 computer software.The results of the study indicate that educator perceptions regarding their own body weight varied slightly from the actual. Positive and negative weight loss experiences and feelings regarding their own body weight were expressed. Educators appeared knowledgeable about overweight/obesity and its health risks for particular NCDs. Several personal barriers were identified by the educators; however, of particular interest were the barriers relating to the school environment, identified barriers included lack of time, heavy workloads and school responsibilities. Several factors for consideration emerged relating to implementing an educator weight management programme in the schools. These included: the involvement of the department of education (DOE), the type of activities planned and the time of implementation.

Title: Movement intervention like a tool of subject's life style influence in age from 20 to 53 years Student: Bc. Vít Živný Supervisor: prof. Ing. Václav Bunc, CSc. Purpose: To provide the informations about lifestyle of subject in age 20 - 53 years . To show risks factors of health problems derived from their current status - body weight, BMI, waist circumference, and more. Using anthropometric methods used to assess current physical condition. With physical activities intervention affect and decrease these risk factors. Methods: Aplication of physical intervention in the range of 11 to 17 weeks for the subject. Regular anthropometric measurements and filling data into tables. Comparing with common standards. Determination of the actual level of health risks. Progressive evaluation of improving the condition and reducing risks. Results: Applied movement interventions significantly reduce health risks associated with current physical condition detected by anthropometric methods. The application also affect the overall view of the lifestyle chosen people. Regular physical activity of right intensity significantly reduces the risk of health problems and other diseases. Key words: lifestyle, physical activity, hypokinesis, nutrition, obesity, BMI, WHR, reducing program, health risks

Introdução: O atual modo de produção agrícola paulista faz uso de muitos insumos para a produção de grandes safras, uma vez que o estado se destaca como maior consumidor de agrotóxicos do País e maior produtor nacional de cana-de-açúcar, laranja, banana, segundo maior produtor nacional de tomate, batata e café . Para a manutenção deste cenário, o controle de pragas, doenças e ervas daninha é feito por meio da utilização de agrotóxicos, os quais são aplicados em pulverização foliar, na superfície do solo, ou são a ele incorporados. Uma vez no solo, os agrotóxicos podem ser absorvidos, submetidos a reações químicas, decompostos e transportados pela água, por erosão ou lixiviação, podendo atingir mananciais destinados ao abastecimento público. Objetivos: identificar os agrotóxicos de maior preocupação para contaminação da água utilizada para consumo humano no Estado de São Paulo. Método: Foram identificadas as principais culturas representativas do agronegócio paulista, bem como, os agrotóxicos licenciados para uso nestas culturas e seu volume comercializado no Estado, além de suas propriedades físico-químicas. Foram então, calculados os índices de GUS, LEACH, I_EXP e IP com base nas propriedades físico-químicas dos princípios ativos, combinadas com a média dos volumes comercializados entre os anos de 2007 e 2012 e as formas de aplicação destes agrotóxicos. Resultados: Dentre os 491 princípios ativos licenciados pela ANVISA para uso no Brasil, não foram encontrados valores indicativos do comportamento no ambiente de 371 agrotóxicos, não sendo possível, portanto, o cálculo dos índices para estes princípios ativos. Dos 120 princípios ativos restantes, 72 foram classificados como móveis ou potencialmente móveis, e a estes foram acrescidos os outros 14 princípios ativos recomendados pela portaria MS 2914/2011, resultando em uma lista de prioridade de monitoramento e vigilância para 86 agrotóxicos considerados prioritários para o cenário paulista. Conclusão: este trabalho demonstra que a exposição da população paulista aos resíduos de agrotóxicos e seus metabólitos presentes na água destinada ao consumo humano é uma questão de extrema relevância, devendo ser priorizada nos protocolos de controle e vigilância da qualidade da água de consumo humano / Introduction: The current mode of agricultural production in São Paulo, makes use of many inputs for the production of large harvests, once the state stands out as the largest consumer of pesticides in the Country and biggest national producer of sugar cane, orange, banana, second largest national producer of tomatoes, potatoes and coffee. For the maintenance of this scenario, the control of plagues, diseases and weeds is done through the use of pesticides, which are applied in foliar spray, on the surface of the soil, or are incorporated in it. Once on the soil, the pesticides can be absorbed, submitted to chemical reactions, decomposed and transported by water, by erosion or leaching, and may reach streams intended for public supply. Objectives: to identify the toxic chemicals of highest concern for contamination of water used for human consumption in the State of São Paulo. Method: Were identified the main representative crops of agribusiness in the State of São Paulo, as well as the pesticides licensed for use on these crops and their volume sold in the State, in addition to its physicalchemical properties. They were then calculated the indices of GUS, LEACH, I_EXP and IP On the basis of physico-chemical properties of the active principles, combined with the average volumes traded between the years of 2007 and 2012 and the forms of application of these pesticides. Results: Among the 491 active principles licensed by ANVISA for use in Brazil, we have not found indicative values of behavior in the environment of 371 pesticides, it is not possible, therefore, the calculation of the indices for these active principles. Among 120 active principles remaining, 72 were classified as mobile or potentially mobile, and to these were added the 14 other active principles recommended by decree MS 2914/2011, resulting in a list of priority of monitoring and surveillance for 86 pesticides considered as priorities for the scenario in the São Paulo Stare.Conclusion: this study demonstrates the exposure of the population of São Paulo\'s city to residues of pesticides and their metabolites present in water intended for human consumption is a matter of extreme importance, and should be prioritized in the protocols of control and surveillance of the quality of water for human consumption

Introdução: O atual modo de produção agrícola paulista faz uso de muitos insumos para a produção de grandes safras, uma vez que o estado se destaca como maior consumidor de agrotóxicos do País e maior produtor nacional de cana-de-açúcar, laranja, banana, segundo maior produtor nacional de tomate, batata e café . Para a manutenção deste cenário, o controle de pragas, doenças e ervas daninha é feito por meio da utilização de agrotóxicos, os quais são aplicados em pulverização foliar, na superfície do solo, ou são a ele incorporados. Uma vez no solo, os agrotóxicos podem ser absorvidos, submetidos a reações químicas, decompostos e transportados pela água, por erosão ou lixiviação, podendo atingir mananciais destinados ao abastecimento público. Objetivos: identificar os agrotóxicos de maior preocupação para contaminação da água utilizada para consumo humano no Estado de São Paulo. Método: Foram identificadas as principais culturas representativas do agronegócio paulista, bem como, os agrotóxicos licenciados para uso nestas culturas e seu volume comercializado no Estado, além de suas propriedades físico-químicas. Foram então, calculados os índices de GUS, LEACH, I_EXP e IP com base nas propriedades físico-químicas dos princípios ativos, combinadas com a média dos volumes comercializados entre os anos de 2007 e 2012 e as formas de aplicação destes agrotóxicos. Resultados: Dentre os 491 princípios ativos licenciados pela ANVISA para uso no Brasil, não foram encontrados valores indicativos do comportamento no ambiente de 371 agrotóxicos, não sendo possível, portanto, o cálculo dos índices para estes princípios ativos. Dos 120 princípios ativos restantes, 72 foram classificados como móveis ou potencialmente móveis, e a estes foram acrescidos os outros 14 princípios ativos recomendados pela portaria MS 2914/2011, resultando em uma lista de prioridade de monitoramento e vigilância para 86 agrotóxicos considerados prioritários para o cenário paulista. Conclusão: este trabalho demonstra que a exposição da população paulista aos resíduos de agrotóxicos e seus metabólitos presentes na água destinada ao consumo humano é uma questão de extrema relevância, devendo ser priorizada nos protocolos de controle e vigilância da qualidade da água de consumo humano / Introduction: The current mode of agricultural production in São Paulo, makes use of many inputs for the production of large harvests, once the state stands out as the largest consumer of pesticides in the Country and biggest national producer of sugar cane, orange, banana, second largest national producer of tomatoes, potatoes and coffee. For the maintenance of this scenario, the control of plagues, diseases and weeds is done through the use of pesticides, which are applied in foliar spray, on the surface of the soil, or are incorporated in it. Once on the soil, the pesticides can be absorbed, submitted to chemical reactions, decomposed and transported by water, by erosion or leaching, and may reach streams intended for public supply. Objectives: to identify the toxic chemicals of highest concern for contamination of water used for human consumption in the State of São Paulo. Method: Were identified the main representative crops of agribusiness in the State of São Paulo, as well as the pesticides licensed for use on these crops and their volume sold in the State, in addition to its physicalchemical properties. They were then calculated the indices of GUS, LEACH, I_EXP and IP On the basis of physico-chemical properties of the active principles, combined with the average volumes traded between the years of 2007 and 2012 and the forms of application of these pesticides. Results: Among the 491 active principles licensed by ANVISA for use in Brazil, we have not found indicative values of behavior in the environment of 371 pesticides, it is not possible, therefore, the calculation of the indices for these active principles. Among 120 active principles remaining, 72 were classified as mobile or potentially mobile, and to these were added the 14 other active principles recommended by decree MS 2914/2011, resulting in a list of priority of monitoring and surveillance for 86 pesticides considered as priorities for the scenario in the São Paulo Stare.Conclusion: this study demonstrates the exposure of the population of São Paulo\'s city to residues of pesticides and their metabolites present in water intended for human consumption is a matter of extreme importance, and should be prioritized in the protocols of control and surveillance of the quality of water for human consumption

Cette thèse examine différents aspects du financement de la santé et ses effets sur l'accumulation de variables stratégiques pour le développement. Le deuxième chapitre analyse les effets des risques de maladie sur l'éducation des enfants en utilisant un model théorique et empirique qui lie les risques (pour les parents) de tomber malade et le choix de l'éducation. Nous trouvons que, s'il est impossible pour les parents de demander plus d'argent en cas de maladie, une augmentation de la probabilité de tomber malade implique une réduction de l'éducation des enfants. Le chapitre trois étudie empiriquement l'effet de l'assurance maladie sur l’enfant en employons la méthode de scores de propension pour analyser l'effet moyen du traitement (chef de ménage ayant une assurance santé ou non) sur les traités. Nous trouvons que l'assurance maladie favorise l'éducation des enfants. Le chapitre quatre étudie, en utilisant le modèle de générations imbriquées, les effets du financement de la santé sur la croissance économique. Le gouvernement a deux possibilité: soit de co-financer la santé, soit la financer tout seul en utilisant une taxe sur la production. Nous trouvons que, s'il y a hétérogénéité des préférences des agents, le financement public domine le co-financement public-privé. Le dernier chapitre étudie les effets d’épidémies sur la pauvreté, dans un modèle de générations imbriquées continu. Nous trouvons que l'investissement dans les variables qui réduisent la transmission de la maladie est nécessaire pour pousser d'un état stationnaire avec faible consommation/niveau d'actifs vers un état stationnaire avec un mixe consommation-niveau d'actifs plus élevé. / This thesis explores different aspects of the financing of health care and how it affects various facets of the economy. Chapter two we studies the relationships between health risks and education using both a theoretical and an empirical model. We find that considering a child's income as an insurance asset can reverse the usual negative relationship between disease prevalence and educational investment. Chapter three empirically looks at the impact of health insurance on the child using the propensity score matching technique. We find that while the health insurance status of the household has a positive effect on the enrolment of children, its effect on child work is negative. In chapter four we analyse the impact of health care financing on economic growth, focusing on the issue of joint public-private financing of health care using an overlapping-generations model with endogenous growth based on health human capital accumulation, where families pay for childhood preventive care and the government can either fully finance or co-finance adulthood curative care. From a growth maximising perspective, if agents are assumed have heterogeneous preferences, full public financing can become the best option. Finally in chapter five we study how health shocks in the form of epidemics affects the economy in a continuous OLG model by focusing on how the economy could be pushed to a higher consumption-assets combination. We find that it is necessary for the government to invest more in the reduction of transmission rates if its goal is to eradicate the disease from the economy, achieving a higher consumption-assets mix.