Estudo de desenvolvimento metodológico que teve por finalidade disponibilizar um sistema de avaliação de Programas de Prevenção e Controle de Infecção Hospitalar (PCIH), após validação das propriedades de medidas, que possibilite aplicação prática para diagnósticos situacionais, cujos resultados subsidiem tanto melhorias na área quanto informações concretas à sociedade sobre a qualidade desses PCIH em cada instituição de saúde. Para tal, previamente, foram construídos e realizada validação de conteúdo de quatro indicadores: 1- (PCET) Estrutura Técnico-operacional do PCIH; 2- (PCDO) Diretrizes Operacionais de Controle e Prevenção de IH; 3- (PCVE) Sistema de Vigilância Epidemiológica de IH; 4- (PCCP) Atividades de Controle e Prevenção de IH. Os objetivos específicos foram: realizar validação (construto e discriminante) e testar confiabilidade (consistência interna); realizar diagnóstico parcial de conformidade dos PCIH em serviços de saúde do Município de São Paulo. Os indicadores de PCIH foram aplicados em 50 instituições de saúde, que aceitaram voluntariamente participar do estudo. As características referentes ao perfil do hospital e os escores dos indicadores foram descritos por meio de estatística descritiva. A consistência interna foi analisada usando o coeficiente de Cronbach. A análise da validade discriminante foi realizada comparando-se os escores dos indicadores entre dois grupos de hospitais, (possuem algum tipo de certificação versus não possuem certificação em qualidade). E para a análise da validade de construto foi utilizada a Análise Fatorial Exploratória com matriz de correlação tetracórica. Os indicadores 1-PCET e 3-PCVE variaram pouco, com quase 100% de conformidade em toda a amostra, já os indicadores 2-PCDO e 4- PCCP apresentaram boa consistência interna com variação de 0,67 a 0,80. A validade discriminante desses indicadores indicou médias dos escores de conformidade superiores e com significância estatística no grupo de instituições com processos de qualificação ou acreditação em saúde. Na validação de construto foi possível diferenciar e identificar 2 dimensões para PCDO (fator 1- recomendações para prevenção de IH e fator 2 recomendações para padronização de procedimentos de profilaxia), com boa correlação dos itens que o compõe, o mesmo ocorrendo para PCCP (fator 1 interface com unidades de tratamento e fator 2 interface com unidades de apoio). N avaliação parcial de conformidade do PCIH todos os indicadores, com exceção do 4 PCCP, que variou de 9,5% a 100%, apresentaram escores > 90%,o que mostra que os hospitais participantes possuem um bom nível de qualidade dos PCIH instituídos, com médias superiores nas instituições com processos de qualificação da assistência. Com esse estudo foi possível validar as propriedades de medidas dos indicadores de PCIH e disponibilizar um instrumento factível como ferramenta de avaliação de PCIH de forma ética e científica para diagnóstico de qualidade na área. / The objective of this study was to develop methodology that could ultimately be made available as a system for assessing Hospital Infection Control and Prevention Programs (HICPP), after validation of its measurement properties, which enable practical application in situational diagnoses, whose results provide both improvements in the area and reliable information about the quality of these HICPPs in each healthcare institution. To do so, the content of four indicators was constructed and validated beforehand: 1- (PCET) Technical-operational structure of the HICPP; 2- (PCDO) Operating Guidelines for Control and Prevention of HI; 3- (PCVE) Epidemiological Surveillance System for HI; 4- (PCCP) HI Prevention and Control Activities. The specific objectives were: fully validate (construct and discriminant) and test the reliability (internal consistency) of measurement properties; carry out a partial diagnosis of conformity of the HICPPs in São Paulo Municipal Healthcare Facilities. The HICPP indicators were applied in 50 healthcare institutions, which participated voluntarily in the study. The hospital profile characteristics and the scores of the indicators were described using descriptive statistics. Internal consistency was analyzed using the Cronbach coeficient; the analysis of discriminant validity was carried out by comparing the scores of the indicators between the two groups of hospitals, (those which had some type of quality certification versus those which did not) and exploratory factor analysis with a tetrachoric correlation matrix was used to analyze the validity of the construct. The indicators 1-PCET and 3-PCVE varied little, with almost 100% conformity throughout the sample, whereas the indicators 2-PCDO and 4- PCCP presented good internal consistency with a variation of 0.67 to 0.80; discriminant validity of these indicators showed higher average scores of conformity and were statistically significant in the group of institutions with certification or accreditation; in the validation of the construct it was possible to differentiate and determine 2 dimensions for PCDO (factor 1- recommendations for prevention of HI and factor 2 recommendations for the standardization of prophylaxis procedures), with good correlation of the units of analysis that composed it. The same occurred for PCCP (factor 1 interface with treatment units and factor 2 interface with support units). All of the indicators, with the exception of 4- PCCP, which ranged from 9.5% to 100%, presented scores of > 90%, which show that the HICPPs of participating hospitals have a good standard of quality, with higher average scores in the institutions with certification or accreditation. This study enabled the validation of the measurement properties of the HICPP indicators and produced a practicable HICPP assessment tool in an ethical and scientific manner for diagnosis of quality in this area.

Diarrheal diseases are a global public health burden, killing 1.8 million people annually. Diarrhea disproportionately affects children and those in poverty. Most diarrheal cases can be prevented through safe drinking water, basic hygiene and/or sanitation measures, with drinking water interventions having the most impact on reducing diarrheal disease. A meta-evaluation was completed of studies evaluating a specific household water treatment method, the biosand water filter. Results from the meta-evaluation illustrate that biosand water filters improve drinking water quality and reduce diarrheal disease. However, there is no generally agreed upon field method for determining biosand water filter effectiveness that is useable in low-resource communities. A pilot study was conducted of potential field use indicators, including the Colilert coliform Presence/ Absence test, hydrogen sulfide, alkalinity, hardness, pH, and fluorescently-labeled latex microspheres. The study included both laboratory and field testing. The Colilert Presence/ Absence test had the highest correlation to the United States Environmental Protection Agency standard method (IDEXX Quantitrays), but more data is needed before making a recommendation. This study adds to understanding about evaluation of biosand water filters and provides preliminary data to address the need for a field use indicator for biosand water filters.

Since the passage of the Clean Water Act, concern about surface water quality has increased. Reducing exposure to pathogens and adverse impacts on human health because of contact with surface waters has become the focus of many regulatory agencies. Fecal pollution is often a cause of surface water impairment. Fecal indicators, such as fecal coliforms and Escherichia coli, are used as surrogates to evaluate the presence or absence of fecal pollution. However, a growing body of research has shown that these species lack key characteristics necessary to be adequate indicators. As such, explorations into the efficacy of indicator species in predicting fecal pollution in water are necessary. Sinking Creek is a tributary of the Watauga River Watershed, located in Northeast Tennessee. Approximately ten miles of Sinking Creek have been placed on the national 303(d) list for fecal pollution, denoting the presence of fecal contamination exceeding the regulatory limit. Salmonella and Aeromonas are two enteric pathogens that would be expected to be detected in fecally contaminated waters. The primary objective of this study was to detect the presence of Salmonella and Aeromonas in Sinking Creek. The secondary objective was to evaluate their relationship with fecal coliforms, E. coli, and water quality parameters. Six study sites along Sinking Creek were sampled and standard methods were used to enumerate Salmonella and Aeromonas. Samples for Salmonella were collected for 8 months, while samples for Aeromonas were collected for seven. Salmonella and Aeromonas were present in Sinking Creek. Salmonella had the highest concentration at site 2 (the most downstream site), and was detected during all months of the study except for November. Salmonella concentrations varied by site. Aeromonas was present only during colder months, and had the highest concentration at site 2. Both Salmonella and Aeromonas show qualitative relationships with water quality parameters, such as dissolved oxygen and conductivity. However, statistically significant correlations of Salmonella and Aeromonas with water quality parameters were not observed. The lack of statistical significance is partially due to large variability and a small data set. Neither Salmonella or Aeromonas exhibited a relationship with fecal coliforms or E. coli. Therefore, fecal coliforms and E. coli may not be adequate indicator species for the presence of Salmonella, Aeromonas and possibly other waterborne pathogens. Traditional indicator species may inflate risk of pathogen exposure. Thus, many water bodies may be unnecessarily deemed as impaired. The results from this study can be used to guide further research regarding covariates influencing pathogen densities at fecally contaminated sites, as well as to guide decisions regarding impaired surface waters and management techniques.

Abdominal aortic aneurysms are the third leading cause of sudden death in men 60 years and over. AAAneurysm Outreach provides free screenings to residents of Louisiana and beyond. Service areas were calculated for each AAAneurysm Outreach screening event location and stroke center. Data provided by the 2010 U.S. Census, the American Community Survey, and the Behavioral Risk Factor Surveillance System were used to describe demographics of the underserved populations and to identify high-risk areas for targeted interventions. Twenty-five percent of age-eligible Louisianans reside outside optimal drive-time-to-screening-event zones but within spatially clustered areas of increased prevalence rates. The maximum drive-time-to-treatment zones excluded 1,395 residents 65 years and over from timely access to emergency medical care. Results revealed limitations in the geographic breadth of the screening program and small disparities in accessibility to emergency healthcare.

More than 270,000 km of rivers and streams are impaired due to fecal pathogens, creating an economic and public health burden. Fecal indicator organisms such as Escherichia coli are used to determine if surface waters are pathogen impaired, but they fail to identify human health risks, provide source information, or have unique fate and transport processes. Statistical and machine learning models can be used to overcome some of these weaknesses, including identifying ecological mechanisms influencing fecal pollution. In this study, canonical correlation analysis (CCorA) was performed to select parameters for the machine learning model, Maxent, to identify how chemical and microbial parameters can predict E. coli impairment and F+-somatic bacteriophage detections. Models were validated using a bootstrapping cross-validation. Three suites of models were developed; initial models using all parameters, models using parameters identified in CCorA, and optimized models after further sensitivity analysis. Canonical correlation analysis reduced the number of parameters needed to achieve the same degree of accuracy in the initial E. coli model (84.7%), and sensitivity analysis improved accuracy to 86.1%. Bacteriophage model accuracies were 79.2, 70.8, and 69.4% for the initial, CCorA, and optimized models, respectively; this suggests complex ecological interactions of bacteriophages are not captured by CCorA. Results indicate distinct ecological drivers of impairment depending on the fecal indicator organism used. Escherichia coli impairment is driven by increased hardness and microbial activity, whereas bacteriophage detection is inhibited by high levels of coliforms in sediment. Both indicators were influenced by organic pollution and phosphorus limitation.

A construção é uma atividade que exige grande volume de mão de obra e de materiais, fato este que provoca uma constante necessidade de eficiência e de eficácia na incorporação imobiliária. O desenvolvimento de parâmetros técnicos para o aumento da produtividade na produção de edifícios na fase de concepção do produto imobiliário tem papel fundamental para alcançar esse objetivo. Esta dissertação apresenta alguns indicadores de produtividade de arquitetura e de estrutura que atuam como balizadores técnicos, com a função de matematizar o projeto, a fim de subsidiar a tomada de decisão na fase de concepção do produto. A pesquisa foi realizada em uma incorporadora e construtora seguindo a metodologia de Pesquisa-ação. Como resultado, obteve-se uma proposta do processo de aplicação de indicadores de produtividade de arquitetura e estrutura ao longo do desenvolvimento do produto imobiliário. / Construction is na activity that requires a large amount of labor and materials; such an environmentdemandsa Constant need for efficiency and effectiveness in real estate development. The development of technical parameters for increasing productivity in the production of buildings in the real estate product design phase plays a key role in achieving this goal. This dissertation presents some indicators of productivity of architecture and structure that serve as technical guides, with the function of mathematizing the Project discussions, in order to subsidize the decision making in the phase of incorporation. The research was carried out in a incorporation and construction company, following the methodology of Research-action. As a resulto f this work, it provides a proposal of a process allowing the application of architectural and structural productivity indicators alongo f the development of the real estate product.

There have been many studies conducted on television and its effects. Since the 1950's, when television emerged, there has been an influx of patterns and behaviors associated with television viewing and programming. Many researchers are fascinated with television and the reactions of those who are directly affected by it. People have been known to act out in many ways as a result of something they saw on television. Many believe that television viewing directly affects a person's mind. An analysis of the results of this qualitative study indicates that college students perceive television has an impact on viewers. Throughout the course of both the focus group and individual interviews, several themes were strongly developed among participants. These included: 1.College students do not believe that television influences the way they individually dress, act, and eat, but it does influence the same behaviors of other people their age. However, these same students reported that they recognized that television has an influence on their lives, and in combination with how they were raised in their families, it made them who they are today. 2.College students continue to believe there is too much violence on television. 3.Television often does not depict reality.

The presence of pathogenic viruses in coastal environments is an important tool in evaluating water quality and health risks. Millions of viruses are excreted in fecal matter and bacterial indicators do not correlate with the presence of pathogenic viruses. Enteroviruses have been used to identify fecal pollution in the environment; however, other viruses shed in fecal matter could be used to indicate fecal pollution. The purpose of this research is to develop a baseline understanding of the diversity of viruses found in raw sewage and to assess their presence in the marine environment. PCR was used to detect adenoviruses, herpesviruses, hepatitis B viruses, morbilliviruses, noroviruses, papillomaviruses, pepper mild mottle viruses, picobirnaviruses, reoviruses, rotaviruses, and sapporoviruses in raw sewage collected from throughout the United States and from five marine environments ranging in their proximity to dense human populations. Adenoviruses, noroviruses, pepper mild mottle viruses, and picobirnaviruses were detected in raw sewage but absent in the marine environment, making these viruses potential indicators of fecal pollution in marine environments. These viruses were also found in many of the final effluent samples. Pepper mild mottle viruses may be useful for source tracking fecal contamination since it was consistently found in human sewage and is not expected in the feces of other animals due to its dietary origin. Furthermore, this research uncovered previously unknown sequence diversity in human picobirnaviruses. This baseline understanding of viruses in raw sewage and the marine environment will enable educated decisions to be made regarding the use of viruses in water quality assessments.

The San Andreas Fault stretches for over 800 miles through California. Along the foothills of the San Bernardino Mountains, areas in close proximity to the San Andreas Fault Zone may be subject to site amplification of ground motion caused by seismic activity via wave propagation through the subsurface. These seismic hazards are being addressed via the Alquist-Priolo Earthquake Faulting Zone Act and the National Earthquake Hazards Reduction Program (NEHRP). Shear wave velocity of the subsurface has served as a proxy for ground motion amplification and is therefore a useful parameter to help analyze and reduce seismic hazards. Low shear wave velocities of the subsurface have been known to correlate with higher amplitude ground motion. This study focuses on refraction microtremor analysis (ReMi) of the subsurface in Northern San Bernardino; more specifically, areas encompassing California State University San Bernardino, in close proximity to the San Andreas Fault. The technique will resolve shear wave velocity values for the top 30 meters (Vs30) of the subsurface. This depth of investigation has proven to be an effective means in determining subsurface conditions. ReMi profiles were situated 0.25 to 2.0 miles away from the San Andreas Fault, and in some instances, strategically positioned next to housing developments and structures. Phase velocity dispersion curves were generated by processing ReMi seismic data and subsequently inverted to attain average shear wave velocity profiles with depth. The geologic units in the study area consist of very young wash deposits, young alluvial fan deposits and Pelonist schist deposits. These geologic units may be an indicator to how seismic waves behave in subsurface lithology. To highlight differences in Vs30 values across the project area, a microzonation map was constructed.

This research analyzes the relationship between local land use regulations and commercial development in the City of Bakersfield, California, specifically focusing on how the regulations are used to inform commercial development to be sustainable or not. This research contributes to similar research efforts through its contribution of the Sustainable Development Indicator Checklist, the tool used to measure sustainable development within the regulations as well as the built environment. Analysis of six case study locations falling under the C-B (Central Business), C-C (Commercial Center), and PCD (Planned Commercial Development) zone designations indicated the local land use regulations were not informing development to be particularly sustainable, mostly due to vague language, constraining language, and sometimes a combination of the two. Recommendations are made for how the City of Bakersfield can improve the land use regulations to be more pertinent to the process of informing future commercial development to be more sustainable.