Individuals with type 2 diabetes mellitus (T2DM) are at risk for developing life-threatening comorbidities such as cardiovascular disease (CVD). As a consequence, T2DM is associated with increased morbidity and mortality and decreased quality of life, thus highlighting the importance of prevention of T2DM. Further, the prevalence of T2DM is substantially greater in rural populations compared to urban populations, making rural individuals particularly appropriate targets for T2DM prevention. T2DM is a largely preventable disease that is associated with modifiable risk factors such as poor diet, sedentary lifestyle, and obesity. Lifestyle interventions to improve these modifiable risk factors have been used to decrease the risk of developing T2DM. There is little evidence that supports lifestyle interventions as a means to decrease T2DM risk in rural populations with prediabetes, the precursor of T2DM. The purpose of this dissertation was to determine whether rural-living individuals with prediabetes would improve modifiable risk factors, specifically diet quality by following a lifestyle intervention; thereby, decreasing their risk of developing T2DM. Specific aims for this dissertation were to, 1) examine and synthesize data from dietary interventions used to reduce risk of T2DM in rural populations on order to identify gaps and guide future research, 2) critically evaluate validity and reliability of indices used to determine diet quality in research, and 3) determine the effect of a risk reduction program on improving diet quality and glucose control (as a measure of T2DM risk) in rural adults with prediabetes and CVD risk factors. Specific aim one was achieved by a review and synthesis of literature focused on lifestyle and dietary interventions used in rural populations to decrease the risk of developing T2DM. Common goals in these studies were a decrease in weight, decrease in dietary fat and calories, and an increase in physical activity. Decreased weight and increased physical activity were demonstrated in all eight studies, and a decrease in T2DM incidence was also demonstrated in one of the studies. However, diet quality was not adequately assessed in the majority of the studies. Furthermore, none of the studies were randomized controlled trials and only half used a control group. It was concluded that research using a more robust design is needed to determine the effect of lifestyle changes, specifically diet, on T2DM risk in rural populations. Specific aim two was addressed by a critical analysis of six common indices of dietary quality. Validity and reliability of the Healthy Eating Index, the Alternative Healthy Eating Index, the DASH diet score, the Diet Quality Index-Revised, the Healthy Diet Indicator, and the Diet Quality Score were examined. Five of the six indices are valid and reliable tools for measure diet quality but all five rely on an extensive food frequency questionnaire that may be burdensome for participants. The Diet Quality Score does not provide adequate evidence to support its use in research. It was concluded that a short, reliable, and validated diet screener may be useful in research. Specific aim three was addressed by a secondary data analysis of a longitudinal, randomized controlled study of rural residents with CVD risk factors and prediabetes. Diet quality, measured by the Mediterranean Diet Adherence Screener (MEDAS), and glucose control, measured by hemoglobin A1c, were analyzed in a subpopulation of 62 participants with prediabetes. Neither diet quality nor glucose control improved between baseline, four month, and 12 month post intervention. The reliability and validity of the MEDAS in this population is not known and may have been a factor in the lack of intervention effect related to diet quality. Participants were also not informed of their prediabetes status, thus it is not known if this knowledge would have made an impact on the outcomes of the study. In addition, the small sample size limits the statistical power to determine changes between the intervention and control groups. It was concluded that further research is needed to determine if a high quality diet will reduce T2DM risk in this rural population Considering the disproportionate prevalence of T2DM in rural populations compared to their urban counterparts, the results of this dissertation demonstrate a continued need for interventions that decrease modifiable risk factors associated with this disease. Interventions that target obesity, poor diet quality, and sedentary lifestyles in at-risk rural populations that are culturally tailored are needed to decrease risk of developing T2DM and the comorbidities associated with this preventable disease.

In order to prevent power system blackout, and enhance system reliability, various forms of special protection systems (SPS) and defense plans have been implemented by utilities around the world. One of the main concerns in the design of an SPS is to assure whether the system could fit with the reliability specification requirements. The failure of SPS to detect the defined conditions and carry out the required actions, or to take unnecessary actions, could lead to serious and costly consequences. Thus, a quantitative reliability assessment for SPS is important and necessary. Using a single point value for the parameter to evaluate the reliability of SPS might give incomplete information about the system reliability due to the uncertainty of reliability model and input data. When a review study suggests that some modifications of the existing scheme are necessary, the sensitivity analysis techniques could provide the tools to do this investigation to identify the most significant components that have essential effects on the reliability of the SPS. In this dissertation, by incorporating an interval theory, a risk reduction worth importance concept, and a probabilistic risk-based index, a procedure is proposed to conduct parameter uncertainty analysis, identify critical factors in the reliability model, perform probabilistic risk assessments (PRA) and determine a better option for the refinement of the studied SPS decision process logic module. One of the existing SPSs of Taipower systems is used to illustrate the practicability and appropriation of the proposed design refinement procedure. With the advent of deregulation in the power industry, utilities have experienced a great pressure to fully utilize their current facilities to the maximum level. SPSs are often considered as a cost effective way in achieving this goal. This dissertation also presents a framework for quantitative assessment of the benefits and risks due to SPS implementation. Changes in energy, spinning reserve and customer interruption costs resulting from SPS operations are evaluated and risks of SPS operations and system security are assessed. The proposed methodologies are useful for power system planners and operators to evaluate the value and effectiveness of SPS for the remedy of transmission congestion and reliability problems.

The intensifying nature and extent of disasters together with the associated devastation and astronomical costs required to manage the rippling effects of disasters, enunciates the national and international focus on disaster risk reduction. Further the ever evolving and complex dynamics of risk as the decisive contributor to disasters has heightened the urgency to pursue effective disaster risk assessment as a prerequisite to inform the disaster risk management planning and disaster risk reduction intervention processes. A structured and systematic approach to disaster risk assessment assists in maintaining rigour thus promoting the quality and validity of the process and its outcomes. Appropriate models serve as valuable tools in enabling this methodological perspective to undertake disaster risk assessment. The nonexistence of an appropriate disaster risk assessment model in South Africa has initiated the emphasis and purpose of this study thereby underscoring the critical need for the development of an effective, holistic and integrated disaster risk assessment model for local government in South Africa. In spear heading the process towards the development of an appropriate disaster risk assessment model, the research commenced with establishing and asserting the fundamental link between disaster risk assessment and disaster risk reduction as an avenue to contextualise and ground the key issues in effective disaster risk reduction. The exploratory analysis engaged in presenting a theoretical construct of disaster risk assessment examined the core components informing the disaster risk assessment process. This discussion led to the comparative review of three disaster risk assessment models viz the Community-Wide Vulnerability and Capacity Assessment (CVCA) Model, the Community-Based Risk Reduction Model and the South African Disaster Risk Assessment Model interrogating the significant characteristics, structure and application of the models. The results of the comparison of the above three models provided the necessary insight for the development of the disaster risk assessment model for local government in South Africa. Further influenced by the outcomes of the applied research on the critical analysis of the current disaster risk assessment practice within the four selected municipalities representing local government in South Africa; viz eThekwini Metropolitan, Ekurhuleni Metropolitan, Bojanala District and Stellenbosch local Municipalities. Through the data coding, classification and interpretive process, constructive and correlated research findings were immanent guiding the final development of the integrated disaster risk assessment model for local government in South Africa. / Thesis (Ph.D. (Public Management and Administration))--North-West University, Potchefstroom Campus, 2012

The intensifying nature and extent of disasters together with the associated devastation and astronomical costs required to manage the rippling effects of disasters, enunciates the national and international focus on disaster risk reduction. Further the ever evolving and complex dynamics of risk as the decisive contributor to disasters has heightened the urgency to pursue effective disaster risk assessment as a prerequisite to inform the disaster risk management planning and disaster risk reduction intervention processes. A structured and systematic approach to disaster risk assessment assists in maintaining rigour thus promoting the quality and validity of the process and its outcomes. Appropriate models serve as valuable tools in enabling this methodological perspective to undertake disaster risk assessment. The nonexistence of an appropriate disaster risk assessment model in South Africa has initiated the emphasis and purpose of this study thereby underscoring the critical need for the development of an effective, holistic and integrated disaster risk assessment model for local government in South Africa. In spear heading the process towards the development of an appropriate disaster risk assessment model, the research commenced with establishing and asserting the fundamental link between disaster risk assessment and disaster risk reduction as an avenue to contextualise and ground the key issues in effective disaster risk reduction. The exploratory analysis engaged in presenting a theoretical construct of disaster risk assessment examined the core components informing the disaster risk assessment process. This discussion led to the comparative review of three disaster risk assessment models viz the Community-Wide Vulnerability and Capacity Assessment (CVCA) Model, the Community-Based Risk Reduction Model and the South African Disaster Risk Assessment Model interrogating the significant characteristics, structure and application of the models. The results of the comparison of the above three models provided the necessary insight for the development of the disaster risk assessment model for local government in South Africa. Further influenced by the outcomes of the applied research on the critical analysis of the current disaster risk assessment practice within the four selected municipalities representing local government in South Africa; viz eThekwini Metropolitan, Ekurhuleni Metropolitan, Bojanala District and Stellenbosch local Municipalities. Through the data coding, classification and interpretive process, constructive and correlated research findings were immanent guiding the final development of the integrated disaster risk assessment model for local government in South Africa. / Thesis (Ph.D. (Public Management and Administration))--North-West University, Potchefstroom Campus, 2012

This essays main focus will be on emergency shelters in disasters, and their understanding in gender awareness, by focusing on the way gender is constructed and seen. This dissertation will examine documents from Australian Red Cross and IASC (Inter Agency Standing Committee) in order to explore how they work with gender and shelter related issues. The objective is to examine and with help from these documents see how gender is constructed. The method and theory is based on Carol Bacchis; What’s the problem represented to be approach? (WPR-approach). This means that the essay have a discourse analysis basis, which the essay is built on. This was chosen because Bacchis approach interrogates the documents and therefore it is easier to get different views of how gender is constructed. Which way it is constructed and what is not constructed as a problem. The main research question is: How is the construction of gender perspective in the documents that are intended to steer the planning of the emergency shelters?   The questions will be; What or which problems seem to represent these documents, regarding gender understanding in emergency shelters? Are there any assumptions behind these formulated problems? If so, what are they? During the review of the documents, is there anything left that is seen as a non-problem, not problematized? Are there any gap or invisibility or can the problem be seen as something else? This essay will show how gender is constructed based on power imbalance. The way gender is constructed is complex and difficult. One thing is clear and that is that the way gender is constructed and how gender is represented, matters in emergency shelters. Gender is still also a topic for crisis management to integrate.

Thesis (M.P.H.)--University of Texas Health Science Center at Houston, School of Public Health, 2008. / Source: Masters Abstracts International, Volume: 46-05, page: 2672. Adviser: Margaret Caughy. Includes bibliographical references.

Sammanfattning Bakgrund: Resiliens är ett begrepp som används i allt större utsträckning inom risk och katastrofforskningen för att beskriva samhällets motståndskraft mot, förmåga att återhämta sig från samt utvecklas positivt efter större naturhändelser. Forskning visar på vikten av att involvera alla nivåer i samhället för att skapa resiliens vilket även uttrycks i internationella ramverk för katastrofriskreducering, klimatanpassning och hållbar utveckling. Det är framförallt på den lokala nivån som konsekvenserna av extrema naturhändelser manifestera och måste hanteras vilket innebär att allmänheten anses vara viktig att involvera i det katastrofriskreducerande arbetet för en ökad resiliens. Detta innebär ett så kallat ”bottom-up” sätt att arbeta. En faktor som enligt forskningen påverkar risken för katastrofer är olika sårbarheter i samhället. Hur sårbart ett samhälle är påverkas bland annat av ekonomiska, ekologiska och sociala faktorer och hur resurser är fördelade. Vissa grupper i samhället pekas ofta ut som mer sårbara, och ett led i att skapa resiliens är att tillgodose dessa gruppers specifika behov i relation till katastrofrisker. Teorier och modeller gällande samhällets resiliens mot katastrofer är ofta framtagna med fokus på miljöer med mer frekventa och dramatiska naturhändelser, och samhällen som präglas av en högre grad av socioekonomiska skillnader än vi har i dagens Sverige. Ett förändrat klimat och andra globala processer påverkar även det svenska samhället. Svenska staten och dess myndigheter påtalar allt mer vikten av att arbeta utifrån ett resiliensperspektiv i samhällsbyggandet. I den svenska kontexten ligger ett stort ansvar gällande risk och krishantering på den kommunala nivån, samt även på den enskilda individen, vilket kan tänkas borga för att involvera allmänheten i katastrofriskreduceringen och tillika skapa ett resilient lokalsamhälle. Syfte: Syftet med studien är trefaldig. Primärt syftar den till att få en övergripande förståelse för hur personer som är verksamma inom risk och krishantering på lokal nivå i en svensk kommun ser på att involvera allmänheten i det katastrofriskreducerande arbetet utifrån ett resiliensperspektiv. Sekundärt syftar studien till att undersöka hur man förhåller sig till olika gruppers behov i arbetet utifrån ett sårbarhetsperspektiv samt att undersöka relevansen av ett befintligt teoretiskt ramverk för community resilience i en svensk kontext. Metod: Studien är en kvalitativ explorativ fallstudie av Örebro kommun med en abduktiv ansats. Genom en kombination av strategiskt urval och snöbollsurval har nyckelpersoner som är verksamma inom kommunal verksamhet samt frivilligorganisationer inkluderats i studien. Datainsamlingen bestod av semistrukturerade intervjuer som transkriberats och vidare analyserats genom kvalitativ textanalys. För att stärka studiens validitet har även kommundokument studerats för att möjliggöra en triangulering. Resultatet diskuteras utifrån teorier om resiliens, risk-governance och sårbarhet för katastrofer samt ett teoretiskt ramverk för community resilience. Resultat: Resultatet visar på: 1) en positiv syn hos respondenterna på att involvera allmänheten, framförallt som en resurs i den akuta krishanteringen genom att nyttja frivilliga, 2) möjligheter med att involvera allmänheten genom relationsbyggande nätverk och ökad samverkan med civilsamhället för att få information om hur människor upplever sin verklighet och vilka behov allmänheten har gällande information och stöttning, 3) hinder avseende kommunikation och samverkan mellan kommun och allmänhet vilket delvis kopplades till att det saknas användbara verktyg och att ny teknik inte nyttjas fullt ut, 4) brist på kontinuitet i samverkan mellan civilsamhället och kommunen och låg frekvens av större händelser, 5) ett bristande engagemang från allmänhetens sida. Resultatet pekar även på att resiliensramverket är relevant i den svenska kontexten. / Summary Background: Resiliens is a concept that is increasingly used in risk- and disaster research to describe society's resistance to, ability to recover from and to develop positively after major natural events. Research shows the importance of involving all levels of society in order to create resilience against disasters and is expressed in international frameworks for disaster risk reduction, climate change and sustainable development. Since the consequences of extreme natural events primarily manifests at the local level, they need to be locally managed. The importance of involving the public in disaster risk reduction, also called the “bottom-up approach” with the aim of building resilience is thus highlighted. One factor affecting societal disaster risk is vulnerability. How vulnerable a society is to disasters is influenced by economic, ecological and social factors and the distribution of resources. Certain groups in society are often referred to as more vulnerable and one part of building resilience against disasters is to cater to the specific needs of these groups in relation to disaster risks. Theories and models of societal resilience against disasters are often developed with focus on environments with more frequent and dramatic natural events and societies that are characterized by a greater degree of socio-economic differences than that of today's Sweden. But a changing climate and other global processes also affect the Swedish society. The Swedish state and its authorities increasingly emphasize the importance of taking a resilience perspective on societal development. The responsibility for risk and crisis management in Sweden is primarily focused at the municipal level, as well as on the individual, which could warrant the involvement of the public in disaster reduction in order to build a resilient local community. Purpose: The purpose of the study is threefold. It primarily aims at gaining an overall understanding of the views of individuals, involved in risk and crisis management at local level in Sweden, upon involving the public in disaster risk reduction from a resilience perspective. Secondarily, the study aims at investigating how the needs of different groups in the community is incorporated into the work, based on a vulnerability perspective, and thirdly to investigate the relevance of an existing theoretical framework for community resilience in a Swedish context. Method: The study was designed as a qualitative exploratory case study of Örebro municipality with an abductive approach. Through a combination of strategic selection and snowballing, key people working in the local council and non-governmental organizations have been included in the study. The data collection consisted of semistructured interviews that were transcribed and further analyzed through qualitative text analysis. In order to strengthen the validity of the study, municipal documents were studied to enable triangulation. The results were discussed through theories of resilience, risk governance and disaster vulnerability as well as a theoretical framework for community resilience by Norris et al. (2008). Results: The results show: 1) a positive view upon involving the public, primarily as a resource in emergency crisis management by using volunteers, 2) opportunities for involving the public through relational networking and enhanced cooperation with civil society, in order to gain information and knowledge on how people perceive their reality and the needs of the public regarding information and support, 3) communication and cooperation barriers between the municipality and the public are linked to the lack of useful tools and that new technologies are not fully utilized, 4) a lack of continuity in civil society and municipality collaboration, low frequency of major events, and lack of widespread commitment among the public. The result indicates that the resilience framework is also relevant in the Swedish context.

Este trabalho teve por objetivo principal estabelecer e comparar diferentes cenários de ocupação urbana e seus efeitos no ciclo hidrológico. Buscou-se avaliar os riscos de enchentes à jusante, causados pelo crescimento urbano e aumento das áreas de impermeabilização que ocorrerão com a implantação do novo campus da USP – São Carlos – SP e a conseqüente ocupação da bacia devido à especulação imobiliária. Dessa forma, a bacia do córrego do Alto Mineirinho foi dividida em sub-bacias, utilizando a abordagem de bacias embutidas. Foram estudados 4 cenários de ocupação urbana: cenário pré-urbanização (1972); cenário atual (2000), cenário 2025 com plano diretor (CPD) que inclui recuperação ambiental; e cenário 2025 sem plano diretor (SPD). Foram necessárias aerofotografias para demarcação do uso e ocupação do solo. Além disso, esse trabalho iniciou o monitoramento experimental de parâmetros hidrológicos e ambientais. Para avaliação e comparação dos diferentes cenários realizaram-se simulações hidrológicas com uso do modelo hidrológico IPH II. Com as análises hidrológicas foi possível verificar que a bacia, com apenas 18,6 % de urbanização (2000), apresenta qualidade hídrica inferior à recomendada para os corpos d’água classe 2 (CONAMA 357/05). Em relação às simulações hidrológicas, pôde-se observar que no cenário 2025 SPD, a vazão máxima cresceu 388,0 % quando comparada ao cenário 1972 e 319,4 % quando comparada ao cenário 2000. Entre os cenários 2025 CPD e 2025 SPD há diminuição de 22,3 % na vazão máxima e o aumento no tempo de pico é de 50 minutos. Porém, os riscos de enchente, analisados pelo método de curvas de permanência, mostraram-se que mesmo com aplicação de diretrizes do PD os riscos de inundações continuam altos, o que indica a necessidade de integrar medidas estruturais e medidas não-estruturais para amenizar os efeitos de enchentes à jusante / This work aims to establish and to compare different scenarios of urban occupation and its hydrologic effects. It evaluates downstream flood risks caused from upstream urban growth increased due to impervious areas and housing speculation surrounding the implantation of the new campus of University of Sao Paulo in Sao Carlos city, SP. The Mineirinho river basin was studied through nested sub-basin approach. Four scenarios of urban occupation have been depicted: pre-urbanization (year 1972), current situation (year 2000), prospective scenario with master plan (until year 2025; CPD), and expected situation without master plan (until year 2025; SPD). Aerial photos were used to help on the evolution of land occupation between past and current situation. The comparison of different scenarios was outlined with use of hydrologic model IPH II. Moreover, this work set the monitoring and record of hydrologic time series. Through experimental analyses it was verified that with 18,6 % of urban areas the water quality of sub-basins decreased significantly. Hydrologic modeling simulations showed that maximum streamflow discharges of scenario 2025 SPD would rise up to 388,0 % higher than scenario 1972 and 319,4 % higher than scenario 2000 respectively. Maximum stream discharges and peak timing of scenario with master plan of year 2025 (CPD) would have respectively a reduction of 22,3 % and a increase of 50 minutes in comparison to scenario without master plan of year 2025 (SPD). Permanency curves revealed with the application of master plan guidelines flood risks however continue high, thereby pointing the needs of integrate structural and non-structural measures to cope with floods downstream

O câncer configura-se como um problema de saúde pública e seu controle depende essencialmente de ações nas áreas da promoção da saúde, proteção específica e do diagnóstico precoce da doença. A efetividade das intervenções designadas para seu controle pode contar com o auxílio do processo de persuasão empregado. O presente estudo buscou avaliar o grau de risco para apresentação de câncer contemplando os fatores de risco pertinentes, bem como, avaliar a presença e as características da persuasão na comunicação para prevenção e detecção precoce de câncer. Trata-se de um estudo observacional, com caráter transversal, onde foram empregados dois instrumentos para o alcance dos objetivos; a população abordada foi de um bairro da cidade de Ribeirão Preto/SP. Constatou-se que os altos riscos foram para os cânceres de cólon/reto, cérvico e de endométrio; e moderados riscos para estes acrescidos de pulmão e mama. Quanto à persuasão, observou-se que houve o desencadeamento das informações acerca do câncer, no entanto estas não conseguiram manter-se efetivas por longos períodos; também não se identificou o reforço dessas informações. Portanto, diante do risco de câncer e dos comportamentos preventivos levantados, considera-se que a persuasão é uma estratégia útil para diminuição desses riscos e, de incentivo e manutenção de comportamentos preventivos; porém, ela deve conter todas as etapas do processo a fim de que não se perca a oportunidade de gerar comportamentos preventivos ou de detecção precoce. / The cancer is configured as a problem of public health and its control depends essentially on action in the areas of the promotion of the health, specific protection and of the precocious diagnosis of the illness. The effectiveness of interventions assigned for its control can count with auxiliare of the process of persuasion employed. This study aims to evaluate the risk level of developing cancer, considering the pertinent risk factors, and the presence of persuasion and characteristics in the communication regarding cancer prevention and early detection. It is an observational study, conducted on 110 inhabitants of a neighborhood in the city of Ribeirao Preto, Sao Paulo, Brazil. It was confirmed there are high risks for colon/rectum, cervical, and endometrial cancer; and moderate risks for these and also lung and breast cancer. In terms of persuasion, it was observed that cancer information was spread but was not sustained for long periods. Moreover, there was no reinforcement. In view of cancer risk and the identified preventive behaviors, persuasion is considered a useful strategy to reduce these risks as well as to encourage and sustain preventive behaviors, however it must contain all the stages of these process for doesn\'t lose the chance to develope preventive behaviors or precocious detection.

The aim of this thesis is to provide theoretical evidence that a disaster risk reduction perspective within peacebuilding programmes, particularly in countries where disasters and conflict overlap, can contribute positively to the transformation of conflict into sustainable peace. An increasing number of disasters in fragile states and countries affected by armed conflict has brought the attention to know in which way disasters and conflicts collide when they come to occur in the same area, and how disasters can influence on-going peace processes. In order to demonstrate that argument the thesis draws the evolution of the disaster risk management models and peacebuilding frameworks along the last decades and make use of a comprehensive theoretical background to support the subsequent analysis. This thesis contributes to the academic literature and humanitarian reports of studies describing the relation between disasters and conflict but, more concretely, it aims to fill the gap in research studying the links between a disaster risk reduction strategy and peacebuilding programmes. The conclusions of the thesis are that disaster risk reduction initiatives contribute positively in several ways to the different key areas of peacebuilding programmes either as concrete initiatives or as a crosscutting issue. / El objeto de esta tesis es proporcionar sustento teórico a la idea de que una perspectiva de reducción de riesgos de desastre en el marco de programas de construcción de paz puede contribuir positivamente a transformar el conflicto en una paz sostenible, particularmente en países donde desastres naturales y conflicto confluyen. Un número creciente de desastres naturales que acontecen en estados frágiles o países afectados por conflicto armado atrae la atención de profesionales y académicos del ámbito humanitario con el fin de conocer mejor el modo en que conflicto y desastre natural se influyen mutuamente. Esta tesis describe la evolución en las últimas décadas de los modelos de gestión de riesgos de desastre y los marcos operacionales de construcción de paz, además, se sustenta en una amplia base teórica para llevar a cabo el análisis pertinente. La intención es contribuir modestamente a la literatura académica que se ocupa de estudiar la ayuda humanitaria, así como tratar de colaborar en encontrar posibles vínculos entre una estrategia de reducción de riesgos de desastre y los programas de construcción de paz. Las conclusiones de esta tesis indican que las iniciativas de reducción de riegos de desastre contribuyen positivamente en distintos aspectos de las áreas de trabajo de los programas de construcción de paz, ya sea como actividades concretas o como un eje transversal a todo el programa.