Made available in DSpace on 2016-06-02T20:00:21Z (GMT). No. of bitstreams: 1 1569.pdf: 1396264 bytes, checksum: 2a759377cc77207e5bc329f78c9e4320 (MD5) Previous issue date: 2000-04-05 / Financiadora de Estudos e Projetos / The complexity of the problems deriving from urban environments has required a deeper and more integrated understanding of the reality of these environments as an essential step toward solutions. The main purpose of this study is to investigate the applicability of principles of sustainability in the process of monitoring the socioenvironmental conditions of this medium. To gain a better understanding of the ideas surrounding the perspective of sustainability, the different meanings ascribed to the term, as well as the complementary issues and aspects that interact in this world of considerations are discussed. Thus, basic conceptual elements were sought that would contribute to build aproper definition for use within the context of this work, which in turn allowed for an outline to be made of its essential characteristics and general guiding principles that were then employed to analyze a given set of indicators. Different reflections and proposals regarding the instruments used to evaluate urban conditions were examined to identify a set of variables defining the basic characteristics of projects and implementation. A critical systematization of three previously selected experiences the Agenda 21 Indicators, the Seattle Indicators and the Belo Horizonte Urban Life Quality Index led to the elaboration of an analysis based on the general principles of sustainability and on the set of variables existing in the process of creating, formulating and monitoring these indicators. This analytical repertoire allowed for a definition of the potential represented by these instruments, offering the basic references for its development and implementation in different contexts. / A complexidade dos problemas decorrentes do meio urbano tem exigido uma apreensão mais precisa e integrada da realidade como passo essencial no encaminhamento de soluções. O objeto central deste trabalho é a investigação da aplicabilidade de princípios da sustentabilidade nos processos de monitoramento das condições socioambientais existentes neste meio. Para um melhor entendimento das noções que gravitam ao redor dessa perspectiva sustentável, abordou-se a discussão de diferentes acepções atribuídas ao termo, bem como as questões e os aspectos complementares que interagem neste universo de considerações. Buscou-se, assim, a obtenção dos elementos conceituais básicos que contribuíssem na construção de uma definição própria a ser empregada no contexto deste trabalho. Tal procedimento permitiu o delineamento das suas características essenciais e dos seus princípios gerais de orientação que foram posteriormente utilizados na análise de determinados sistemas de indicadores. O exame de diferentes reflexões e proposições acerca destes instrumentos de mensuração das condições urbanas viabilizou a identificação de um conjunto de variáveis que define as características básicas dos projetos e implementações. A sistematização crítica de três experiências distintas previamente selecionadas - Indicadores da Agenda 21, Indicadores de Seattle e o Índice de Qualidade de Vida Urbana de Belo Horizonte - propiciou a elaboração de uma análise referenciada pelos princípios gerais da sustentabilidade e pelo conjunto de variáveis presentes em um processo de criação, formulação e monitoramento dos indicadores. Este repertório analítico permitiu a verificação do potencial representado por este instrumental oferecendo os referenciais básicos para o seu desenvolvimento e implementação em diferentes contextos.

FundaÃÃo de Amparo à Pesquisa do Estado do Cearà / INTRODUÃÃO: A prescriÃÃo mÃdica à o principal determinante do uso de medicamentos e contribui para a efetividade da atenÃÃo à saÃde, agravos relacionados aos medicamentos e para os gastos pÃblicos em saÃde. A avaliaÃÃo da qualidade da prescriÃÃo tem sido compreendida como uma estratÃgia para sua melhoria. OBJETIVO: Desenvolver e testar indicadores de qualidade da prescriÃÃo (IQP) mÃdica em atenÃÃo primÃria de saÃde (APS) no municÃpio de Fortaleza-CE. METODOLOGIA: RevisÃo da literatura em bases de dados indexadas. SeleÃÃo, adaptaÃÃo e listagem dos IQP; convite aos prescritores da APS e distribuiÃÃo de material para leitura crÃtica; oficina de consenso com prescritores pela TÃcnica do Consenso Informal (TCI); aplicaÃÃo dos indicadores pactuados a uma amostra das prescriÃÃes em APS em Fortaleza no perÃodo de janeiro a fevereiro de 2008. Foram identificados na literatura 99 IQP, dos quais 43 foram excluÃdos obedecendo aos critÃrios de inclusÃo e exclusÃo. Os demais foram adaptados à realidade investigada e aos objetivos do estudo obtendo-se 59 indicadores que foram classificados em dois grupos: Indicadores dos processos gerais da prescriÃÃo (10) e Indicadores orientados ao medicamento (49). Um texto explicativo acompanhado da listagem dos IQP foi distribuÃdo aos prescritores com 7 dias de antecedÃncia e trazido para discussÃo em grupo, seguida de plenÃria de consenso, moderada pelas pesquisadoras. RESULTADOS: Participaram do consenso 17 prescritores (9 mulheres), idade mÃdia de 38 anos. Destes, 35,29% graduaram-se entre 1999 e 2007. Seis eram preceptores (3 mestres) e 11 residentes em medicina da famÃlia (6 especialistas). A mÃdia de atuaÃÃo no serviÃo pÃblico era de 10 anos. Durante a plenÃria, o grupo consenso decidiu aceitar todos os IQP prÃ-selecionados e acrescentaram mais seis. Os indicadores dos aspectos gerais da prescriÃÃo foram mais simples de calcular e interpretar, enquanto os indicadores orientados ao medicamento apresentaram maiores dificuldades devido à ausÃncia de requisitos tÃcnicos na prescriÃÃo que dificultaram a aplicaÃÃo. Todavia apÃs aplicaÃÃo dos IQP foi possÃvel conhecer o perfil da prescriÃÃo mÃdica de Fortaleza. Os indicadores foram aplicados a uma amostra das prescriÃÃes (N=624, sendo 30 por unidade de saÃde), envolvendo 1582 itens de medicamentos prescritos e uma mÃdia de 2,52 medicamentos por prescriÃÃo. 87% dos medicamentos prescritos pertenciam a lista padronizada do municÃpio, sendo o paracetamol o mais freqÃente. A prescriÃÃo por denominaÃÃo genÃrica aconteceu em 90,6% dos casos. 2,1% das prescriÃÃes possuÃam injetÃveis ou psicotrÃpicos e 8,3% das prescriÃÃes eram injustificÃveis. Em mÃdia o gasto por prescriÃÃo foi de R$ 2,40. A prevalÃncia dos grupos terapÃuticos analisados foi: 22,8% - anti-hipertensivos, 8,81% - antiagregante plaquetÃrio, 6,57% antidiabÃticos, 8,17% - anti-secretores, 27,08% - analgÃsicos, 22,25% - antibiÃticos. CONCLUSÃO: AtravÃs da TCI foi possÃvel elaborar um sistema de indicadores capazes de avaliar a prescriÃÃo mÃdica em APS. Esses IQP darÃo suporte ao profissional farmacÃutico para realizar avaliaÃÃes periÃdicas e planejarem intervenÃÃes necessÃrias, no sentido de aperfeiÃoar cada vez mais a prescriÃÃo tendo em vista o benefÃcio dos pacientes. / INTRODUCTION: The medical prescription is the main determinant of the use of medicines and contributes to the effectiveness of the health care, offences related to medicines and for the public costs in health. The evaluation of the quality of the prescription has been considered as a strategy to achieve its improvement. OBJECTIVE: Develop and test indicators of quality of the medical prescription (IQP) in primary health care (PHA) in the municipal district of Fortaleza-CE. METHODOLOGY: Revision of the literature in bases of indexed data. Selection, adaptation and listing of IQP; invitation sent to the doctors of PHA and material distribution for critical reading; consensus workshop with doctors using technique of the informal consensus (TIC); application of agreed indicators to a sample of the prescriptions in PAH in Fortaleza in the period of January to February 2008. 99 IQP were identified in the literature, of which 43 were excluded according to the criteria of inclusion and exclusion. The others were adapted to the reality investigated and the objectives of the study resulting in 59 indicators that were classified into two groups: indicators of processes of the general prescription (10) and targeted drug indicators (49). An explanatory text added of a list of IQP was distributed to prescribers 7 days in advance and brought to discussion groups, followed of full consensus, moderated by the researchers. RESULTS: Seventeen prescribers had participated of the consensus (9 women), average age 38 years. Among these, 35.29% graduated between 1999 and 2007. Six of them were preceptors (3 masters) and 11 residents in family medicine (6 experts). The average performance in the public service was 10 years. During the session, the consensus group decided to accept all IQP pre-selected and added six more. The indicators of the general aspects of the prescription was simple to calculate and interpret, while indicators targeted drug showed greater difficulties due to lack of technical requirements in the prescription that hampered the implementation. However after applying the IQP was possible to know the profile of the medical prescription in Fortaleza. The indicators were applied to a sample of prescriptions (N = 624, being 30 per health unit), involving 1,582 items of prescribed drugs and an average of 2.52 drugs per prescription. 87% of prescribed drugs were the standard list of the municipality, the paracetamol as being the most frequent drug. The prescription by generic denomination occurred in 90.6% of cases. 2.1% of prescriptions had injected drugs or psychotropics and 8.3% of prescriptions were unjustifiable. On average the cost per prescription was R $ 2.40. The prevalence of treatment groups was analyzed: 22.8% - antihypertensives, 8.81% - platelet aggregation inhibitor, 6.57% - antidiabetics, 8.17% - antiulcer, 27.08% - analgesics, 22.25 % - antibiotics. CONCLUSION: Through the TCI it was possible to devise a system of indicators able to evaluate the prescription in APS. These IQP will support the professional pharmacist to conduct periodic assessments and to plan necessary interventions, in order to improve prescribe aiming at the benefit of patients.

O objetivo deste estudo foi avaliar a prevalência de cárie dentária e sua associação com índice de massa corpórea (IMC), bem como seus fatores de risco demográficos (sexo e idade), socioeconômicos, familiares (escolaridade dos pais, número de filhos) e comportamentais (dieta e práticas de higiene bucal) de crianças e adolescentes. Duzentos e trinta e sete crianças e adolescentes foram inseridos neste estudo. Após a autorização de participação, aplicou-se um questionário, realizou-se exame clínico intrabucal das crianças e a coleta dos dados antropométricos. Os parâmetros analisados neste estudo foram peso, altura, IMC-para-idade e número de dentes cariados, extraídos e obturados para posterior cálculo do ceo-d ou CPO-D para dentes decíduos e permanentes, respectivamente. Teste do Qui-quadrado e o teste T foram usados para analisar a associação entre as variáveis (idade, etnia, gênero, hábitos de higiene bucal e alimentar) e alterações do IMC. A média e desvio padrão do índice ceo-d nos grupos de baixo peso, peso normal, grupos de sobrepeso e obesidade, foram de 9.5 (± 0.70), 5.06 (± 4.54), 7.66 (± 4.41), e 6 (± 5.19), respectivamente (p>0,05). A porcentagem de indivíduos que estavam com a dentição hígida foi de 13,5%. Houve uma associação entre prevalência de cárie e etnia (p<0,05), indivíduos de cor branca e parda apresentaram maiores índices de cárie do que os indivíduos pretos. Características sociodemográficas como escolaridade materna e paterna não influenciaram na experiência de cárie das crianças e adolescentes (p>0,05). Em relação aos hábitos alimentares na primeira infância, o tempo de aleitamento materno não influenciou na experiência de cárie (p>0,05), por outro lado, o açúcar acrescido na mamadeira esteve associado à doença cáries (p<0,05). A escovação diária realizada somente pela criança, sem supervisão dos pais ou responsáveis, foi significativamente associada com a cárie. Não houve associação entre cárie dentária e IMC. / The aim of this study was to evaluate the prevalence of dental caries and its association with body mass index (BMI), as well as their demographic risk factors (gender and age), socioeconomic, family (parents\' education, number of children) and behavioral (diet and oral hygiene practices) of children and adolescents. Two hundred and thirty-seven children and adolescents 3-15 years treated were entered into this study at the Ribeirão Preto Dental School - USP. After the authorization of participation, we applied a questionnaire and an intraoral clinical examination of children was held and the collection of anthropometric data. The parameters analyzed in this study were weight, height, BMI-for-age and number of decayed teeth extracted and sealed for subsequent calculation of the dmft and DMFT for deciduous and permanent teeth, respectively. It was used the Chi-square test and T test to analyze the association between variables (age, ethnicity, gender, oral hygiene and dietary habits) and changes in BMI. The mean and standard deviation of the DMFT in groups of underweight, normal weight, overweight and obese groups were 9.5 (± 0.70), 5:06 (± 4:54), 7.66 (± 4:41), and six (± 5.19), respectively (p> 0.05). The percentage of subjects who were healthy female with the teeth was 13.5%. There was an association between caries prevalence and ethnicity (p <0.05), white and brown colored individuals had higher caries rates than black individuals. Sociodemographic characteristics such as maternal and paternal schooling did not influence the caries experience of children and adolescents (p> 0.05). With regard to eating habits in early childhood, the duration of breastfeeding did not affect the caries experience (p> 0.05), on the other hand, sugar plus the bottle was associated with caries disease (p <0.05). Daily brushing performed only by the child without supervision of parents or guardians, was significantly associated with caries. There was no association between dental caries and BMI.

Orientadores: Telma Teixeira Franco, Cristiana Maria Pedroso Yoshida / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Engenharia Química / Made available in DSpace on 2018-08-23T11:24:55Z (GMT). No. of bitstreams: 1 KatoJunior_EdisonTutomu_D.pdf: 14133160 bytes, checksum: 4ca041ce9eb1c6a78d7e55bb1e39489f (MD5) Previous issue date: 2013 / Resumo: Um sensor inteligente foi desenvolvido neste estudo, visando detectar a presença de gás sulfídrico (H2S). A aplicação deste sensor pode ser abrangente, desde aplicações em controle de vazamentos na indústria petroquímica, até o controle de qualidade de produtos alimentícios, uma vez que o H2S é um dos metabólitos liberado por microrganismos contaminantes em condições de anaerobiose. Este sistema tem a função de comunicar a presença de H2S no caso de vazamentos na linha de recuperação em pontos críticos (juntas, válvulas, conecções, etc.) ou informar ao consumidor possíveis alterações microbiológicas no produto durante o transporte e armazenamento, indicando o estado de frescor do produto. O sensor biodegradável e inteligente foi desenvolvido a partir de filmes de quitosana, um polímero natural proveniente do descarte da indústria pesqueira, biodegradável e capaz de formar filmes resistentes, flexíveis e com eficiente barreira a oxigênio. A incorporação dos indicadores de H2S produz um sinal colorimétrico como uma reposta rápida para a presença deste composto. O objetivo deste estudo consistiu na obtenção do sensor inteligente com indicadores de presença de H2S, na caracterização do sensor quanto suas propriedades mecânicas, correlação da gramatura calculada/prática e capacidade de absorção de água, aplicação e avaliação de eficiência do sensor em ambiente real na análise da identificação de contaminação microbiológica e análises visando caracterizar a interação entre o indicador colorimétrico e a matriz de quitosana. O presente trabalho deu origem ao depósito de uma patente junto ao INPI no dia 18 de dezembro de 2009, sob o número de protocolo 018090056144 e junto ao Patent Cooperation Treaty (PCT) no dia 24 de novembro de 2010, sob o número do processo internacional PCT/BR2010/000394 / Abstract: A smart sensor was developed in this study to detect the presence of hydrogen sulphide gas (H2S). This sensor can be applied for leakage control in the petrochemical industry and also in quality control of food products, once the H2S is one of the metabolites released by contaminating microorganisms under anaerobic conditions. This system has the function of communicating the presence of H2S in the case of leaks in the recovery line at critical points (seals, valves, connections, etc.) in petrochemicals. It can inform the consumer possible microbiological changes in the product during transport and storage, indicating the state of freshness of the product. The biodegradable and smart sensor was developed using chitosan, a natural polymer derived from the disposal of the fishing industry, biodegradable and capable of forming resistant, flexible films and efficient barrier to oxygen. The accumulation of trash of hard degradation is increasing worldwide. The incorporation of H2S indicators produces a colorimetric signal as a rapid response to the presence of this compound. The aim of this study was to obtain intelligent sensors with H2S indicators, the characterization of the sensor as its mechanical properties, correlation of the calculated thickness / practice and ability to absorb water, efficienty evaluation in a real environment on the analysis of the identification of microbiological contamination and analysis to characterize the interaction between the chitosan matrix and the colorimetric indicator / Doutorado / Engenharia Química / Doutor em Engenharia Química

In this article we develop a comprehensive conceptual framework for resource efficiency indicators with a consistent link of resource use to the socio-economic system and activities therein as well as to the natural system and its ecosystem functioning. Three broad groups of indicators are defined: (1) resource use indicators representing pressures on the environment; (2) resource efficiency indicators relating resource use indicators to the socio-economic side; and (3) environmental impact indicators linking resource use impacts on the state of the natural system. Based on this conceptual framework we develop a structure for possible resource efficiency indicators and conduct a RACER evaluation on the Relevance, Acceptance, Credibility, Easiness and Robustness of indicators. With the RACER evaluation, we identify areas where indicators are well established and available as well as areas where indicators still need further development or even need to be designed first.

Magister Psychologiae - MPsych / Substance abuse has been identified internationally and in South Africa as an escalating problem that has harmful effects on the substance user and on society. The cost of treating substance-related disorders places a strain on the allocation of financial resources to treat the problem. When relapse occurs in substance users who have already undergone rehabilitation, it increases the costs of treatment. Waiting lists at treatment centres are also negatively affected for first-time admissions when relapsed substance users are re-admitted. The study aimed to identify relapse indicators by post-discharge follow-up of adult substance users in a registered, non-profit, state-subsidised treatment facility in Cape Town. Marlatt’s Dynamic model of relapse was used to explore the individual and socio-cultural factors which were potentially associated with relapse. A quantitative research design using archival data and purposive sampling was used to identify possible relapse indicators. The participants were ex-patients who had undergone an inpatient treatment programme and who had been followed up post discharge. Ethical clearance was obtained from the University of the Western Cape Higher Degrees Committee. Written permission was granted by the treatment centre who is the original data owner.The majority of participants were male. More than half of the sample reported polysubstance use and, for more than half of them, the age of onset of substance use was between 11 and 15 years. Severe depression was present for more than a third of the participants, whilst the majority of the sample was assessed as being substance dependent. A large proportion of patients had family members who also used substances. The majority of the sample was unemployed and more than half had received previous substance abuse treatment. Significant associations were not established between the identified variables within the groups of factors. Additional studies are required to explore the factors contributing to relapse in this patient population.

Background: Since 2008, more than half of the world's population now live an urban area. The consequences of this are strains on existing resources such as access to healthcare, housing and infrastructure. Therefore, access to data at the urban level is important for those involved in policy making in order to assess and address these issues. This is especially important for developing countries where resources are already limited without the added strain of urbanisation. This PhD study is nested within the EURO-URHIS 2 project, a DG Research, FP7 Programme project which is collecting data on a series of indicators deemed to be important to urban health. The first part of this PhD study investigates whether the EURO-URHIS 2 data collection tools designed for use in Europe can be replicated in Vietnam. During a preliminary fieldwork trip to Vietnam it was found that it would not be possible to obtain permission to interview policy makers or the urban population of Ho Chi Minh City within the study time frame. Therefore, the second part of this PhD study is to explore the use of existing data sources, functions and activities of Non-Governmental Organisations (NGOs) in Vietnam. Methods: The EURO-URHIS 2 existing data survey was used to collect country and urban area level data from Vietnam. The data for the NGO study was collected using an online questionnaire hosted on a server by the University of Manchester. Results: The study found that it was possible to use the EURO-URHIS 2 existing data tool to collect a range of health indicator data at the country and urban level in Vietnam. The online study determined the role of international NGOs working in Vietnam and barriers to using existing sources of information. The study also found low levels of NGO engagement with other NGOs, policy makers, local authorities and Vietnamese government organisations. Conclusions: The successful implementation of EURO-URHIS 2 existing data survey allowed the examination of the potential health implications of urbanisation in Vietnam. The NGO study identified key areas where international NGOs in Vietnam were active, barriers to using existing sources of data and NGO relationships with other actors. The study also suggested opportunities for further NGO engagement.

An economic valuation methodology was developed in order to monetarily quantify the benefits resulting from the Indian River Lagoon - South (IRLS) $995 million Everglades restoration project. Service flows of the IRLS were identified and their associated economic baseline values were estimated utilizing existing research. A water quality baseline for the IRLS was also established and compared with the best available standards. Benefits accruing beyond the baseline values given the completion of the IRLS restoration were estimated via benefit transfer to be approximately $159 million annually, importantly factoring in the established IRLS water quality baseline. Given these benefit results of a lower bound estimate, the project was determined not to be economically feasible, i.e., NPV < $0, via a cost-benefit analysis. However, Monte Carlo analyses provided further insights into the probability of an economically feasible restoration (36%) given the uncertainty surrounding the benefit estimation, as well as specific variables to focus on to improve this probability. This research highlights the potential significant economic value of the IRLS and the importance of properly estimating this value given the magnitude of costs.

Disasters such as the recent parliament shooting in Ottawa, Superstorm Sandy, and the Great Japan Sea Earthquake and tsunami are reminders of the roles essential service organizations have in maintaining public health. On a daily basis, organizations are expected to operate under normal conditions, providing goods, services, and community supports. In crisis situations, it is critical that these organizations continue to operate and contribute to adaptive response and recovery in a community. Business continuity planning focuses on ensuring continued functioning of core operations during a disruption. Inherent to the business continuity field is a prevent-and-protect approach to preparedness activities. Asset-mapping exercises have the potential to balance the predominantly risk-based field by focusing on the strengths and capabilities already present within an organization. To understand the value of asset-mapping activities in business continuity plans (BCPs), indicators for organizational resilience are needed. Indicators have the potential to provide essential service organizations with a way to gauge the value of their BCP activities. In addition, this information can help guide decision-makers when developing BCPs. This research is part of a larger project at the University of Ottawa focused on building the empirical evidence base for BCPs and organizational resilience. This thesis, as a sub-study within the larger project, explores assets and indicators for organizational resilience to contribute to the effective evaluation and engagement of organizations in business continuity planning efforts. Emergent themes highlight the importance of assets and their contribution to the adaptive capacity of an organization in the event of a disaster. This study also provides an example list of 28 SMARTT organizational resilience indicators directly derived from organizational assets, providing information that researchers and essential service organizations can use to evaluate business continuity planning activities in relation to organizational resilience.

The aim of this paper is description of the accreditation process in a healthcare facility, mapping out the possible problems related to the implementation of accreditation standards and the influence of accreditation on the quality of health care in a healthcare facility. The basic conditions of the healthcare facility readiness for the national SAK-ČR accreditation are the same as for any other quality management system. The point is to look at the individual processes from a different viewpoint and to find a way of engaging all employees in the entire process. It is necessary for them in particular to understand the programme philosophy, the process management, the term client, the strategy of solving problems, the rules of implementation and the organizational structure of the healthcare facility. The most demanding job is to motivate the employees and keep them aware of the continuous improvement. This paper consists of a theoretical part, a practical part and a proposal for improvement of observed shortcomings.