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Acurácia dos critérios de risco do programa de defesa da vida dos lactentes do município de Bauru entre 1986 e 1988 / Accuracy of the risk criteria of the life-saving program for infants in the municipality of Bauru between 1986 and 1988Rumel, Davi 28 August 1989 (has links)
A partir dos dados coletados pelo Programa de Defesa da Vida dos Lactentes da Secretaria de Higiene e Saúde do Município de Bauru no período de 11 de maio de 1986 a 10 de novembro de 1987, avaliou-se a capacidade de elementos clínicos e sociais, de fácil obtenção no momento do parto, predizer a mortalidade e internação de crianças entre O e 6 meses. O critério diagnóstico com maior sensibilidade para discriminar um grupo de crianças que devem receber uma atenção especial nos períodos de O a 6 dias e de 7 dias a 6 meses foram: - O a 6 dias: peso do recém nascido abaixo de 2500 gr, mãe menor de 18 anos e malformação congênita. - 7 dias a 6 meses: peso ao nascer abaixo de 2750 gr, renda familiar per capita abaixo de 0.75 salário mínimo, e malformação congênita. Outros critérios diagnósticos são apresentados e comparados com estes, entre os quais o do Programa de Defesa da Vida dos Lactentes, calculando-se as respectivas sensibilidades, especificidades e percentual de crianças classificadas como de risco. O mesmo critério diagnóstico proposto para prevenir a mortalidade entre 7 dias e 6 meses foi utilizado para calcular a sensibilidade quando o desfecho e a internação. / According to the data of the \"Infant Life Defense Program\" of the Public Health Office of the \"Municipallity of Bauru during the period of may 11, 1986 to november 10, 1987, we tried to evaluate the capacity of clinical and social characteristics which are obtained at the moment of birth for predicting mortality and hospitalization of children until 6 monthes of life. The diagnostic criterion with more sensitivity to choose a percentage of children to require special care between the first 7 days and betwen 7 days to 6 months of life: - O to 6 days: birth weight less than 2500 g., adolescent pregnancy and congenital malformations. - 7 d. to 6 m.: birth weight less than 2750 g., family revenue less than $27 per capita in a month and congenital malformations. Other diagnostic criteria have been shown and compared by the sensitivity and specificity to the proposals above in which the \"Infant Life Defense Program\" was included. The same diagnostic criteria was used to evaluate the sensitivity for hospitalization.
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Railway Safety - Risks and EconomicsBäckman, Johan January 2002 (has links)
Safety analysis is a process involving several techniques.The purpose of this thesis is to test and develop methodssuitable for the safety analysis of railway risks and railwaysafety measures. Safety analysis is a process comprisingproblem identification, risk estimation, valuation of safetyand economic analysis. The main steps are described in separatechapters, each of which includes a discussion of the methodsand a review of previous research, followed by the contributionof this author. Although the safety analysis proceduredescribed can be used for analysing railway safety, it has suchgeneral foundations that it can be used wherever safety isimportant and wherever safety measures are evaluated. Itcombines cost benefit analysis with criteria for thedistribution and the absolute levels of risk. Risks are estimated with both statistical and risk analysismethods. Historical data on railway accidents are analysed andstatistical models fitted to describe trends in accident ratesand consequences. A risk analysis model is developed usingfault tree and event tree techniques, together with Monte Carlosimulation, to calculate risks for passenger train derailments.The results are compared with the statistical analysis ofhistorical data. People's valuation of safety in different contexts isanalysed, with relative values estimated in awillingness-to-pay study. A combination of focus groups andindividual questionnaires is used. Two different methods areused to estimate the value of safety and the results arecompared. Comparisons are also made with other studies. Different approaches for safety analysis and methods foreconomic analysis of safety are reviewed. Cost-benefit analysisas a decision criterion is discussed and a study on theeconomic effectsof a traffic control system is presented. There are several results of the work. Historical data showsa decrease in the accident rate. The average consequence ofeach accident has not changed over time. The risk analysismodel produces comparable results and enables analysis ofvarious safety measures. The valuation study shows that peopleprefer the prevention of small-scale accidents over theprevention of larger, catastrophic accidents. There are onlysmall differences in the valuation of safety in differentcontexts.
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Railway Safety - Risks and EconomicsBäckman, Johan January 2002 (has links)
<p>Safety analysis is a process involving several techniques.The purpose of this thesis is to test and develop methodssuitable for the safety analysis of railway risks and railwaysafety measures. Safety analysis is a process comprisingproblem identification, risk estimation, valuation of safetyand economic analysis. The main steps are described in separatechapters, each of which includes a discussion of the methodsand a review of previous research, followed by the contributionof this author. Although the safety analysis proceduredescribed can be used for analysing railway safety, it has suchgeneral foundations that it can be used wherever safety isimportant and wherever safety measures are evaluated. Itcombines cost benefit analysis with criteria for thedistribution and the absolute levels of risk.</p><p>Risks are estimated with both statistical and risk analysismethods. Historical data on railway accidents are analysed andstatistical models fitted to describe trends in accident ratesand consequences. A risk analysis model is developed usingfault tree and event tree techniques, together with Monte Carlosimulation, to calculate risks for passenger train derailments.The results are compared with the statistical analysis ofhistorical data.</p><p>People's valuation of safety in different contexts isanalysed, with relative values estimated in awillingness-to-pay study. A combination of focus groups andindividual questionnaires is used. Two different methods areused to estimate the value of safety and the results arecompared. Comparisons are also made with other studies.</p><p>Different approaches for safety analysis and methods foreconomic analysis of safety are reviewed. Cost-benefit analysisas a decision criterion is discussed and a study on theeconomic effectsof a traffic control system is presented.</p><p>There are several results of the work. Historical data showsa decrease in the accident rate. The average consequence ofeach accident has not changed over time. The risk analysismodel produces comparable results and enables analysis ofvarious safety measures. The valuation study shows that peopleprefer the prevention of small-scale accidents over theprevention of larger, catastrophic accidents. There are onlysmall differences in the valuation of safety in differentcontexts.</p>
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Acurácia dos critérios de risco do programa de defesa da vida dos lactentes do município de Bauru entre 1986 e 1988 / Accuracy of the risk criteria of the life-saving program for infants in the municipality of Bauru between 1986 and 1988Davi Rumel 28 August 1989 (has links)
A partir dos dados coletados pelo Programa de Defesa da Vida dos Lactentes da Secretaria de Higiene e Saúde do Município de Bauru no período de 11 de maio de 1986 a 10 de novembro de 1987, avaliou-se a capacidade de elementos clínicos e sociais, de fácil obtenção no momento do parto, predizer a mortalidade e internação de crianças entre O e 6 meses. O critério diagnóstico com maior sensibilidade para discriminar um grupo de crianças que devem receber uma atenção especial nos períodos de O a 6 dias e de 7 dias a 6 meses foram: - O a 6 dias: peso do recém nascido abaixo de 2500 gr, mãe menor de 18 anos e malformação congênita. - 7 dias a 6 meses: peso ao nascer abaixo de 2750 gr, renda familiar per capita abaixo de 0.75 salário mínimo, e malformação congênita. Outros critérios diagnósticos são apresentados e comparados com estes, entre os quais o do Programa de Defesa da Vida dos Lactentes, calculando-se as respectivas sensibilidades, especificidades e percentual de crianças classificadas como de risco. O mesmo critério diagnóstico proposto para prevenir a mortalidade entre 7 dias e 6 meses foi utilizado para calcular a sensibilidade quando o desfecho e a internação. / According to the data of the \"Infant Life Defense Program\" of the Public Health Office of the \"Municipallity of Bauru during the period of may 11, 1986 to november 10, 1987, we tried to evaluate the capacity of clinical and social characteristics which are obtained at the moment of birth for predicting mortality and hospitalization of children until 6 monthes of life. The diagnostic criterion with more sensitivity to choose a percentage of children to require special care between the first 7 days and betwen 7 days to 6 months of life: - O to 6 days: birth weight less than 2500 g., adolescent pregnancy and congenital malformations. - 7 d. to 6 m.: birth weight less than 2750 g., family revenue less than $27 per capita in a month and congenital malformations. Other diagnostic criteria have been shown and compared by the sensitivity and specificity to the proposals above in which the \"Infant Life Defense Program\" was included. The same diagnostic criteria was used to evaluate the sensitivity for hospitalization.
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Výběr dodavatele reklamních předmětů v mezinárodní společnosti / Selection of merchandising and gifts supplier in an international companyMatura, Marek January 2014 (has links)
The aim of this thesis is analysis and resolution of the decision-making problem "selection of merchandising and gifts supplier in an international company" using multi-criteria decision process while respecting risk. The goal of this thesis is to select a suitable supplier and offer recommendation to company's management for solving similar decision processes. The theoretical part of the thesis describes the knowledge base of methods and procedures of decision analysis that are later applied in the practical part of the thesis on the specific project with aim to optimize the decision-making process and identify the best variant. The conclusion of the thesis provides recommendations for solving similar problem in the future.
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Eficiência do pré-escrutínio rápido, revisão aleatória de 10% e critérios clínicos de risco como métodos de controle interno da qualidade dos exames citopatológicos cervicais / Efficiency of rapid prescreening, 10% random review and review based on clinical risk criteria as methods of internal quality control of cervical smear testingTAVARES, Suelene Brito do Nascimento 06 September 2007 (has links)
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Previous issue date: 2007-09-06 / Cytopathology is an effective method of screening for cervical cancer; however, this
method has high rates of false-negative results (FNR). To reduce FNR, routine
measures of internal and external quality control are required in laboratories. The
10% random review of negative smears (R-10%) is the most commonly used
method; however, it is not effective in reducing FNR. Nevertheless, there is evidence
that the review of smears selected according to clinical risk factors (RCRF) and rapid
prescreening (RPS) of all smears present good results. This study evaluated the
performance of RPS, R-10% and RCRF as methods of internal quality control of
cervical smear testing. The sample was composed of a total of 6,135 cervical
smears from women who had attended Basic Health Clinics in Goiânia Goiás
between March 2006 and March 2007. The cytopathological results were classified
according to the 2001 Bethesda System. Initially, 6,135 smears were submitted to
RPS followed by routine scrutiny (RS). Following RS, smears classified as negative
were selected on the basis of clinical risk criteria, while 10% of all the smears were
selected randomly, both sets then being submitted to the respective reviews. Four
cytologists were responsible for RPS, RS, R-10% and RCRF, and three for reviewing
the abnormal and discordant smears from any of the reviews. The smears classified
as negative in RPS, RS, R-10% and RCRF were considered to have a final diagnosis
(FD) of negative. Smears considered suspect or unsatisfactory at RPS were
analyzed separately by two other cytologists. Smears considered abnormal or
unsatisfactory at RS, R-10% and/or RCRF were likewise reviewed. When the two
reviewing cytologists reached concordant diagnoses, these were considered the FD.
Discordant results were analyzed by a third cytologist and a consensus meeting was
held to define the FD. All stages of the study were performed blinded except for the
consensus meeting. Smears classified as negative at RS, which were suspect at RPS and/or considered abnormal at R-10% and RCRF and confirmed abnormal in
the FD, were considered FN results. Of the 6,135 smears, 5,522 were classified as
negative, 84 as unsatisfactory and 529 as abnormal in the FD. Sensitivity of RPS
was 63.0% for all abnormalities and 96.7% for high-grade squamous intraepithelial
lesion (HSIL) compared to RS. The sensitivity of RPS was 74.9% for all
abnormalities and 95.0% for HSIL compared to FD. The sensitivity of R-10% was
53.8% for all abnormalities when compared to FD. R-10% failed to detect any cases
of HSIL. The sensitivity of RCRF was 64.0% for all abnormalities and 75.0% for HSIL
compared to the FD. RPS identified an additional 132 (2.15%) abnormal smears,
whereas R-10% and RCRF identified an additional 7 (0.11%) and 32 (0.52%),
respectively. In conclusion, RPS is an effective method of internal quality control and
has better sensitivity than R-10% and RCRF for the detection of FN results. It also
allows the FN rate of the laboratory to be monitored and permits continuous
evaluation of the prescreening cytologist and the routine screening cytologist. / O exame citopatológico é um método eficiente para prevenir o câncer do colo do
útero, no entanto, apresenta altas taxas de resultados falso-negativos (RFN). Para
reduzir os RFN, são necessárias medidas de controle interno e externo da qualidade
na rotina dos laboratórios. O método de revisão aleatória de 10% dos esfregaços
negativos (R-10%) é o mais utilizado, no entanto, não é eficiente para reduzir os
RFN. Porém, há evidências de que a revisão dos esfregaços selecionados por
critérios clínicos de risco (RCCR) e o pré-escrutínio rápido (PER) apresentam bons
resultados. Esse estudo comparou o desempenho do PER, R-10% e RCCR como
métodos de controle interno da qualidade dos esfregaços cervicais. A casuística foi
constituída por 6.135 esfregaços citopatológicos cervicais de mulheres atendidas
nas Unidades Básicas de Saúde de Goiânia GO, no período de março de 2006 a
março de 2007. Os resultados citopatológicos foram classificados de acordo com o
Sistema de Bethesda 2001. Inicialmente 6.135 esfregaços foram submetidos ao PER
e em seguida ao escrutínio de rotina (ER). Após o ER os esfregaços classificados
como negativos foram selecionados com base em critérios clínicos de risco e
aleatoriamente 10% do total de esfregaços e submetidos às respectivas revisões.
Quatro citologistas foram responsáveis pelo PER, ER, R-10% e RCCR e três pelas
revisões dos esfregaços alterados e discordantes em qualquer revisão. Os
esfregaços com resultados negativos no PER, ER, R-10% e RCCR foram
considerados diagnóstico final (DF). Os esfregaços com resultados suspeitos ou
insatisfatórios, pelo PER, foram analisados separadamente por dois outros
citologistas. Também os esfregaços cujos resultados foram considerados alterados
ou insatisfatórios pelo ER, R-10% e/ou RCCR foram igualmente revisados. Quando
os dois citologistas revisores emitiram diagnósticos concordantes estes foram
considerados DF. Os resultados discordantes foram analisados por um terceiro
citologista e em uma reunião de consenso foi definido o DF. Todas as etapas do
estudo foram realizadas às cegas, exceto na reunião de consenso. Os esfregaços
classificados como negativos pelo ER que foram suspeitos pelo PER e/ou alterados
nas R-10% e RCCR e confirmados pelo DF foram considerados RFN. Dos 6.135
esfregaços, 5.522 foram classificados como negativos, 84 como insatisfatórios e 529
como alterados pelo DF. A sensibilidade do PER foi de 63,0% para todas as
anormalidades e de 96,7% para lesão intra-epitelial escamosa de alto grau (HSIL)
quando comparado ao ER. A sensibilidade do PER foi de 74,9% para todas as
anormalidades e de 95,0% para HSIL quando comparado ao DF. A sensibilidade da
R-10% foi de 53,8% para todas as anormalidades quando comparado ao DF e não
detectou nenhuma HSIL, enquanto a sensibilidade da RCCR foi de 64,0% para
todas as anormalidades e de 75,0% para HSIL quando comparado ao DF. O PER
acrescentou 132 (2,15%) esfregaços alterados, enquanto que a R-10% e a RCCR
acrescentaram sete (0,11%) e 32 (0,52%), respectivamente. Enfim, o PER é uma
alternativa eficiente de controle interno da qualidade, apresentando maior
sensibilidade que as R-10% e RCCR na detecção de RFN. Permite, ainda, monitorar
a taxa de RFN do laboratório, assim como avaliar continuamente o desempenho
tanto do pré-escrutinador quanto do escrutinador de rotina.
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