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Background: Intrahospital transfers of intensive care patients involves multiple risks where patient safety is challenged. Aim: The aim of this study was to investigate intensive care nurses’ experiences and perceptions of patient safety during intrahospital transfers. Method: A qualitative, explorative design was utilized with a phenomenographic approach. Ten intensive care nurses with varying work experience in intensive care were interviewed. The interviews were transcribed and analysed according to the phenomenographic method. Results: The analysis of the intensive care nurses’ experiences and perceptions resulted in four categories: routines, risks, support and job allocation. Patient safety was, according to the intensive care nurses, lower during intrahospital transfers compared to the intensive care ward but perceived as good in general. Their preparations and their ability to predict risks were mostly based on their experience level. They solved emerging problems depending on the situation. According to the intensive care nurses, being new in the profession poses a greater risk. Times when the doctors are on call and night time were especially risky times for transfers. They considered good routines important for patient safety and saw possibilities for improvement. The intensive care nurses expressed both confidence and a lack thereof with regards to the transfers and perceived it as easy to ask for help. Cooperation and communication were, according to the informants, crucial for patient safety. Conclusion: The intensive care nurses’ perceptions of patient safety during intrahospital transports were mainly based on their earlier experiences. A possibility for improvement exists through the implementation of a checklist and team training in simulated scenarios. It is important to ensure that patient safety is high during intrahospital transfers irrespective of the experience level of the staff. / Bakgrund: Intrahospitala transporter av intensivvårdspatienter innebär många risker som leder till att patientsäkerheten kan sättas på spel. Syfte: Studiens syfte var att undersöka intensivvårdssjuksköterskors erfarenheter och uppfattningar av patientsäkerhet vid intrahospitala transporter. Metod: En kvalitativ, explorativ design tillämpades med fenomenografisk ansats i form av semistrukturerade intervjuer. Tio intensivvårdssjuksköterskor med varierande arbetslivserfarenhet inom intensivvården intervjuades. Intervjuerna transkriberades och analyserades enligt fenomenografisk metod. Resultat: Analysen av intensivvårdsjuksköterskornas erfarenheter och uppfattningar resulterade i fyra kategorier: rutiner, risker, stöd och arbetsfördelning. Enligt intensivvårdssjuksköterskorna var patientsäkerheten vid intrahospitala transporter sänkt jämfört med intensivvårdsavdelningen men uppfattades trots detta generellt som god. Förberedelserna intensivvårdssjuksköterskorna gjorde och förmågan att se risker berodde mycket på hur erfarna de var. De löste de problem som uppstod utifrån situationen. Enligt intensivvårdssjuksköterskorna innebar det en extra risk att vara ny i sin profession. Jourtid och nattetid var riskfyllda tidpunkter och förflyttningar av patienterna som ett speciellt riskfyllt moment. De ansåg att bra rutiner var viktigt och de såg möjligheter till förbättringar för att öka patientsäkerheten. Intensivvårdssjuksköterskorna uttryckte både en trygghet och otrygghet i samband med transporterna men uppfattade att det var lätt att be om hjälp. Samarbete och kommunikation var enligt dem avgörande för patientsäkerheten. Slutsats: Intensivvårdsjuksköterskornas uppfattningar av patientsäkerheten under intrahospitala transporter berodde till stor del på deras tidigare erfarenheter. Ett utrymme till förbättringar finns genom ett införande av en checklista samt teamträning i simulerade scenarion. Det är viktigt att säkerställa att patientsäkerheten är hög oberoende av hur erfaren personalen är.

Emergency department (ED) crowding is a patient safety concern that has been increasing for more than a decade. Increased visits have resulted in ED crowding, longer wait times, ambulance diversions, and boarding of admitted patients (Hing & Bhuiya, 2012). Numerous factors affect ED crowding. Once various extraneous issues are resolved and a bed is available for a patient, it becomes the responsibility of nurses across unit boundaries to coordinate the patient transfer. This study applies Relational Coordination Theory (RCT) as a framework to provide nurses insight into the relational aspects of their work in the transfer of ED patients to inpatient beds. Relational coordination is a mutually reinforcing process of interaction between communication and relationships that is carried out for the purpose of task interaction. It is useful for coordinating work that is highly interdependent, uncertain, and time constrained (Gittell, 2002). Nurses work during ED transfers requires task interaction as they coordinate their efforts. This study, guided by RCT, will examine relational and communication dynamics among nurses within their own units and across unit boundaries as they interact during ED transfers. A cross-sectional, descriptive design will explore the seven dimensions of Relational Coordination (RC) during ED admissions and explain nurses relational and communication dimensions that may influence ED boarding times. The results of this study provide new information and a sound theoretical model on which to base future research.

My personal life experiences are reflected in my art. I use symbolic and expressive marks in developing my abstract imagery, which acts as a visual language. The combining of my past and current art work, fused together, has become what I call a creative matrix. I see my images as choreographed compositions using a mixed media approach. The open-ended interpretation of my art have expanded the never ending possibilities of creation.

L'objectif de cette thèse était d'aboutir à une meilleure compréhension du comportement thermique d'un calorimètre, différentiel non adiabatique permanent, dédié à la mesure de l'échauffement nucléaire en MTR, puis à une optimisation de ce capteur et des méthodes de mesures associées et enfin à une proposition d'une configuration calorimétrique « miniaturisée ». Du fait du principe même de la calorimétrie (quantification d'énergie à partir de mesures de températures), une approche analytique ciblant les aspects thermiques a été conduite. Cette thèse a consisté à la conception, au développement et à l'exploitation de nouveaux outils analytiques thermiques expérimentaux et numériques. Un modèle thermique 2D axisymétrique résolu par méthode des éléments finis (code CAST3M) a été mis en œuvre, validé et utilisé en conditions non irradiées ou irradiées dans le cadre d'une étude paramétrique complète portant sur la réponse de différentes configurations calorimétriques. Ces travaux ont permis le dimensionnement d'un capteur plus sensible adapté aux conditions ciblées lors des premières campagnes d'irradiation en périphérie du réacteur OSIRIS (< 2W/g). Ces travaux ont également permis de définir une nouvelle cellule calorimétrique à échange directionnel radial, plus compacte pour des expériences futures en cœur du réacteur RJH à fort échauffement nucléaire (20W/g). Un dispositif expérimental a été conçu afin d'étudier le calorimètre plus sensible pour différentes contraintes thermiques (puissance injectée, température du fluide caloporteur) et fluidiques (intensité de la convection forcée) imposées. / The aim of this thesis was to reach a better understanding of the calorimeter thermal behavior of a calorimeter, differential non-adiabatic permanent, dedicated to the nuclear heating measurement in MTR, an optimization of the sensor and measurement methods associated and finally a suggestion of a calorimetric configuration "miniaturized." Because of the principle of calorimetry (quantification of energy from temperature measurements), an analytical approach targeting thermal aspects was carried out. This thesis consisted of designing, development and exploitation of new experimental and numerical analytical thermal tools. A 2D axisymmetric thermal model solved by finite element method (CAST3M code) was implemented, validated and used in conditions unirradiated or irradiated through a complete parametric study related to the response of different calorimetric configurations. This work has allowed to design a more sensitive sensor adapted to conditions targeted for the first irradiation campaigns on the OSIRIS reactor reflector (<2W/g). These studies have also allowed to define a new calorimetric cell with radial directional exchange, more compact for future experiments in the RJH core with high nuclear heating (20W/g). An experimental set up was designed to study the most sensitive calorimeter in different thermal conditions (injected power, coolant temperature) and flow conditions (intensity of forced convection) imposed.

This thesis is devoted to an analysis of mandatory expenditures in the Czech Republic, their evolution, structure and quantification. During the past fifteen years, the mandatory expenditures more than tripled, and cause a serious fiscal problems. The main reason is the huge increase in social sphere expenditures in relation to domestic debt. The main attention is focused mostly on social transfers to the people, especially on pension benefits. Another part provides a description of current pension system and the main causes of the pension reform. It also contains a comparison of two basic ways of financing pensions, PAYG and FF systems. The final part is devoted to evaluation of government proposal for pension reform and its problems that go with it. The analysis is subject to capital system from perspective of profitability and fees at private pension funds.

En analysant les discours élaborés par les Lumières allemandes au sujet de La Mettrie entre 1739 et 1789, cette thèse vise à réévaluer la place du matérialisme au sein des échanges culturels franco-allemands de la période. La première partie précise les enjeux et les méthodes de l’étude : le scandale littéraire et philosophique doit être envisagé comme un révélateur des principes et des mécanismes de fonctionnement qui sous-tendent les productions de la République des Lettres. L’étude du scandale dans ce qu’il fait au texte est un prisme pertinent pour analyser le problème du matérialisme français, l’oeuvre de La Mettrie et le fonctionnement de l’espace qui la reçoit. La deuxième partie examine la réception initiale de la Mettrie en Allemagne entre 1739 et 1752. Elle mesure l’impact du scandale sur les textes, en montrant que l’oeuvre de La Mettrie est prise dans des débats qui rejaillissent de manière ambivalente sur son interprétation, allant jusqu’à entrainer de fausses lectures. La troisième partie s’intéresse à la réception ultérieure du médecin-philosophe français. Elle souligne la diversité des discours produits entre 1752 et 1789 : repoussoir, aiguillon, occasion de transfert oblique, voie de contestation et de redéfinition des Lumières, la référence à La Mettrie ne saurait être uniquement interprétée en termes d’influences ou d’absence d’influences. Ce parcours permet, in fine, de relire les débats entre philosophes et antiphilosophes français à l’aune de la réception allemande. Cette thèse souligne la richesse de la discussion menée entre France et Allemagne autour du matérialisme, reconsidère le rôle de La Mettrie et invite à redécouvrir une oeuvre méconnue. / In analyzing the discourses developed by the German Enlightenment on La Mettrie between 1739 and 1789, this thesis aims at re-evaluating the place of materialism in the Franco-German cultural exchanges of the period. The first part specifies the stakes and methods of the study: the literary and philosophical scandal must be considered as a revealing of the principles and operating mechanisms that underlie the productions of the Republic of Letters. The study of the scandal in what he does to the text is a pertinent prism to analyze the problem of French materialism, the work of La Mettrie and the functioning of the space that receives it. The second part examines the initial reception of the Mettrie in Germany between 1739 and 1752. It measures the impact of the scandal on the texts, showing that the work of La Mettrie is taken in debates that reflect in an ambivalent way on its interpretation, even leading to false readings. The third part is concerned with the later reception of the French physician-philosopher. It emphasizes the diversity of discourse produced between 1752 and 1789: a flicker, a sting, an oblique transfer opportunity, a way of contesting and redefining the Enlightenment, the reference to La Mettrie can not be solely interpreted in terms of influences or absence of influences. This course allows, in fine, to read differently the debates between French philosophers and antiphilosophers in the light of the German reception. This thesis underlines the richness of the discussion between France and Germany on materialism, reconsiders the role of La Mettrie and invites us to rediscover an unknown work.

[pt] Esse artigo realiza um estudo dos efeitos do Programa Bolsa Escola Federal sobre as despesas das famílias. A base de dados utilizada foi a Pesquisa dos Orçamentos Familiares (POF), que por tratar de forma detalhada das despesas das famílias e por fornecer o valor recebido pelas famílias do Programa Bolsa Escola Federal, propicia uma excelente oportunidade de responder a questão referente ao destino do dinheiro recebido do programa. O principal resultado é que famílias que recebem a bolsa do Programa Bolsa Escola tendem a gastar mais em alimentos e não reduzem seus gastos em educação. / [en] This article studies the effects of the Brazilian conditional cash transfer program, the Bolsa Escola Federal, on household expenditures. The dataset used was a survey of household budgets (Pesquisa dos Orçamentos Familiares), which, in providing detailed information regarding family expenditures and the value households received through the Bolsa Escola Federal Program, offers an excellent opportunity to answer the question concerning the destination of the money received through the program. The main result of the article is that households receiving the grant from the program tend to spend more on food and do not reduce their expenditures on education.

Submitted by admin tede (tede@pucgoias.edu.br) on 2016-10-07T12:25:37Z No. of bitstreams: 1 Rafael Jesus de Oliveira.pdf: 1124242 bytes, checksum: fa371be37cc03a3dc85c778e22d63002 (MD5) / Made available in DSpace on 2016-10-07T12:25:37Z (GMT). No. of bitstreams: 1 Rafael Jesus de Oliveira.pdf: 1124242 bytes, checksum: fa371be37cc03a3dc85c778e22d63002 (MD5) Previous issue date: 2015-10-06 / The purpose of this dissertation is to analyze the use of semi-trailer vehicles with single and double floors process transfers and transshipments, common in logistics operations when they have more than one distribution center or industrial complex. These different manifestations contribute very little to the final value of the product, and is characterized by a high cost to organizations, resources aimed at reducing costs or increasing efficiency should be the subject of academic studies. To this end the research approaches in a comparative way the two models, with quantitative data obtained in a company that uses the two models presented trough case study in order to explore the pattern of transshipment and drives. / A proposta desta dissertação é a de analisar a utilização de veículos semirreboque com piso simples e duplo em processos de transferências e transbordos, comuns em operações logísticas quando possuem mais de um centro de distribuição ou complexo industrial. Como estas movimentações diversas pouco ou nada agregam em valor ao produto final, e tem como característica um elevado custo paras as organizações, recursos que visam diminuir despesas ou aumentar eficiência devem ser alvo de estudos acadêmicos. Com este intuito a pesquisa aborda de forma comparativa os dois modelos, com dados quantitativos conseguidos em uma empresa que utiliza os dois modelos apresentado através do estudo de caso, com o objetivo de explorar o padrão dos transbordos e movimentações.

This thesis has two main objectives. First, it investigates how social support relationships - embedded within kinship systems, friendship networks and associational groups - contribute to the wellbeing of cash transfer beneficiaries in two urban districts in Ghana. Second, it explores how a formal social protection programme affects the wellbeing of beneficiaries both directly and indirectly via its effect on these other support relationships. The thesis takes the Ghana Livelihood Empowerment Against Poverty (LEAP) cash transfer programme as a case study, examining how it is implemented in practice within an urban setting, and how social support relationships influence its effect on the wellbeing of cash recipients. Throughout this thesis wellbeing is used as a discursive space for looking at the often neglected non-material dimensions of wellbeing. In particular, it takes a relational wellbeing approach which emphasises how material, emotional and cognitive dimensions of wellbeing are embedded in social relationships. It uses a Qualitative Longitudinal Research (QLR) approach, complemented by a qualitative social network analysis to map the constellation of relationships on which urban recipients of LEAP transfers rely, and to explore the motivations and rationalities underpinning them. The findings of the thesis add to existing research on social relationships and cash transfers in Africa by extending the analysis to a contemporary urban context. They challenge the assumption that urban residents can draw upon a vibrant support system, by finding that such relationships can be unreliable, provide inadequate support and can be associated with exclusion and marginalization. In addition, the thesis finds that norms underpinning support relationships are constantly being reshaped and challenged. The thesis also highlights the important but diverse effects that formal social protection programmes can have on material, emotional and cognitive wellbeing of recipients, both directly and indirectly via their effect on other significant social relationships of beneficiaries.