No description available.

Doctor of Philosophy / Department of Hospitality Management and Dietetics / Chihyung Ok, Deborah D. Canter / This study sought to apply the concepts of ‘perceived value’ and ‘customer share’ (of visits) to full-service restaurant settings for the first time. Given the strong ‘experiential nature’ of foodservice, the perceived value concept adopted in this study involved an ‘experiential view’ of the dining experience. Further, the customer share concept was expected to have implications for the foodservice context, given the multi-loyalty nature of restaurant customers. With the first conceptual model, this study sought to verify the effect of perceived value on customer share of visits in a full-service restaurant context, using a dimension-level value approach and positing customer satisfaction and brand preference as mediators between them. The conceptual model was tested based on responses from 299 general U.S. full-service restaurant customers, using a confirmatory factor analysis and structural equation modeling. The test results revealed that among four value dimensions, excellence (in food and service) and customer return on investment had dominant effects on customer satisfaction and brand preference whereas playfulness had a significant moderate effect only on brand preference; aesthetic appeals did not have significant effects on either. Affected by perceived value, customer satisfaction significantly enhanced brand preference and in turn brand preference contributed to customer share of visits and fully mediated the effect of customer satisfaction on customer share of visits. In essence, the findings highlight the significant antecedent role of perceived value in customers’ satisfaction and brand preference formation, and the pivotal role of customer brand preference in customers’ purchase decision process. With the second conceptual model, this study sought to reveal the direct effect and/or moderating effects of contingency variables in relation to customer share of visits in a fullservice restaurant context. The hypotheses included in the conceptual model were tested based on responses from 291 general U.S. full-service restaurant customers, using a confirmatory factor analysis and a series of (moderated hierarchical) regression analyses. The test results indicated that the direct effects of social switching costs, lost benefits costs, procedural costs, and intrinsic inertia were positive whereas that of intrinsic variety-seeking was negative on customer share of visits. In addition, consumer involvement and perceived brand heterogeneity were found to enhance the effect of brand preference on customer share of visits. The effects of the contingency variables appear to work by influencing the number of brands in customers’ consideration sets and/or leading customers to allocate a greater share of visits to a particular brand in a given number of brands in consideration sets.

With the increased energy usage and its affect on the environment the European Union (EU) has issued climate and environment goals which will oversee countries energy saving potential. These goals focus on several areas including the energy usage within buildings. The purpose of this thesis is to categorize and analyze the energy saving potential for buildings constructed 1945 or earlier. The building stock in focus consists of 73 apartment buildings in Vasastaden, Linköping. The buildings were all chosen with Boverket’s database within building characteristics GRIPEN. The method consisted of stocktaking via location visits, categorizing and performing simulations on the buildings. The fictive buildings were based on the categorized building stock. They were modelled and simulated with the help of IDA Indoor Climate and Energy (IDA ICE). With the results of the energy usage a greater understanding of energy saving potential was obtained. The result of the categorization displayed that typical buildings in Vasastaden are buildings out of brick, fully detached (no adjoining walls), specifically with 3 floors. The fictive buildings have an calculated energy usage of 102-144 kWh/m2,year and have an energy saving potential within ranges of 17-41% compared to the building regulations set by Boverket (BBR). The building stock obtained an calculated energy usage of 804-3 515 MWh/m2,year. GRIPEN displayed several inaccuracies compared with the collected data from the location visits which proves that more frequent updates in databases such as GRIPEN are of high significance.

Esta pesquisa objetivou estudar o princípio do melhor interesse da criança tanto em seu viés teórico quanto prático, na tentativa de se concluir se é possível ou não adotar-se critérios predeterminados para serem seguidos na tomada de decisões em questões envolvendo crianças e adolescentes. Na primeira parte, teórica, estudou-se o conteúdo do melhor interesse, e se poderia ele ser entendido como regra de interpretação, direito fundamental ou princípio. Já a segunda parte, prática, buscou analisar como os tribunais vêm decidindo algumas questões que resvalam no melhor interesse. Para tal, alguns institutos foram selecionados (guarda, adoção, parto anônimo, visitas e educação). A análise da guarda passou pela sua diferenciação entre colocação em família substituta e atribuição a um dos pais em caso de separação. Discutiu-se a possibilidade de atribuição a terceira pessoa e de imposição da modalidade compartilhada. Estudou-se o direito de visitas para o caso de a guarda ter sido atribuída a somente um dos pais. Estendeu-se a pesquisa para a hipótese de garantir-se esse direito a amigos, padrastos, madrastas e padrinhos. A adoção foi estudada nas modalidades à brasileira, intuitu personae e internacional. Ainda, analisou-se a possibilidade de adoção por casal homoafetivo. Embora inexistente no direito brasileiro, o parto anônimo foi analisado para se observar se viável e necessário em nosso ordenamento. Por fim, estudou-se o direito à educação, realçando-se alguns aspectos como a possibilidade de o ensino ser realizado fora de estabelecimentos oficiais, transporte de crianças até suas escolas e a possibilidade de exigirem-se vagas em creches. / This research aimed to study the principle of the best interest of the child, both in theory and in practice, in an attempt to conclude whether it is possible or not to adopt predetermined criteria to be followed in making decisions on issues involving children and adolescents. In the first part, theoretical, the content of the best interest was studied, as well as the possibility of understanding it as a rule of interpretation, fundamental right or principle. The second part, practical, sought to analyze how the courts have been deciding issues involving the best interest. In doing so, some institutes were selected (guardianship, adoption, anonymous childbirth, visits and education). The analysis of the guardianship passed by differentiating between placement in foster family and its assignment to one of the parents in case of separation. The possibility of assigning it to a third person and the imposition of shared custody were discussed. The visitation rights in case when the custody has been awarded to only one parent was studied. The research was extended to the hypothesis of granting this right to friends, stepfathers, stepmothers and godfathers or godmothers. The research studied Brazilian, intuitu personae and international adoptions, as well as the possibility of adoption by homosexual couples. Although non-existing under Brazilian law, the anonymous childbirth was analyzed to observe if it is viable and needed in our system. Finally, the right of education was studied, and aspects such as the possibility of homeschooling, transportation of children to their schools and the requiring of vacancies in childcare facilities were highlighted.

[pt] Jardins botânicos são instituições que visam a pesquisa, o estudo e a conservação vegetal, e estão cada vez mais abertas ao público. O Jardim Botânico do Rio de Janeiro, uma das mais antigas instituições científicas do país, tem na dimensão educativa um importante elo de ligação com o público. As escolas são parte significativa do universo de visitantes, que a cada ano e para a qual, foram criados projetos específicos de educação ambiental. Este estudo teve por objetivo examinar as relações do Jardim Botânico do Rio de Janeiro com o público escolar, através de observações de práticas educativas desenvolvidas na instituição, e de entrevistas realizadas nas escolas, com professores que levam suas turmas para visitas ao Jardim. Os dados obtidos na pesquisa permitem identificar questões que favorecem e outras que dificultam a aproximação entre esses dois universos, Jardim e escola, o que pode contribuir para a construção de uma possível parceria. / [en] Botanical Gardens are institutions increasingly open to a public that seeks to study and preserve flora. The Botanical Garden of Rio de Janeiro, one of the oldest scientific institutions in Brazil, has created an important bond with the public through its educational activities. Schools, for which specific environmental educational projects have been created, are a significant portion of the universe of visitors, which is increasing every year. The present study has the purpose of examining the relationship between the Botanical Garden and the school public, by means of observation of the educational practices developed by the institution, together with interviews conducted with the teachers who bring their students to the Garden. The data obtained in the research allowed the identification of elements that favor, as well as those that hinder, the approximation of these two universes, The Botanical Garden and the school, thus contributing to the development of an effective partnership.

Submitted by JOSIANE SANTOS DE OLIVEIRA (josianeso) on 2017-10-13T13:02:58Z No. of bitstreams: 1 Daiana Fernandez Garcia_.pdf: 543125 bytes, checksum: b7d521e52dd6ee0e6d69e04532717e5b (MD5) / Made available in DSpace on 2017-10-13T13:02:58Z (GMT). No. of bitstreams: 1 Daiana Fernandez Garcia_.pdf: 543125 bytes, checksum: b7d521e52dd6ee0e6d69e04532717e5b (MD5) Previous issue date: 2017-10-01 / HCPA - Hospital de Clínicas de Porto Alegre / O estímulo ao vínculo familiar deve ser iniciado antes mesmo do nascimento, não podendo ser interrompido ou atrasado em razão de uma internação que, algumas vezes, ocorre por um longo período, dependendo da doença do recém-nascido. Por esse motivo e para a criação de um vínculo precoce, a separação dos irmãos, em razão da internação, deve ocorrer de forma branda apenas minimizando a convivência. Acolher o irmão visitante de maneira orientada permite que a relação não seja interrompida. A pesquisa teve como objetivo descrever a percepção do irmão ou irmã na visita ao recém-nascido internado no contexto da unidade de cuidados intermediário neonatal em um hospital universitário de Porto Alegre no Rio Grande do Sul. Como meta do estudo, elaborou-se uma cartilha de orientação para crianças e pais sobre a visita na unidade neonatal. Trata-se de um estudo qualitativo, exploratório-participativo realizado em uma unidade de terapia intensiva neonatal. Foram realizadas seis entrevistas semiestruturadas com irmãos e irmãs visitantes de pacientes internados em leitos de cuidados intermediários, uma vez que esses pacientes estão em preparação para alta hospitalar. Após transcrição das falas, e uma vez estas submetidas a análise de conteúdo, foram identificadas, quatro categorias emergentes: visita, espaço físico, cuidadores e motivo da internação. Através do estudo, ocorreu uma sensibilização da equipe assistencial acerca da visita. Evidenciou-se que todos os participantes consideraram a experiência como positiva, não somente os irmãos visitantes. O ambiente hospitalar não causa medo aos participantes, já que comparam a internação da mãe (de curta permanência) com a do bebê e não associam prematuridade e nascimento a doença. Também se identificou que é necessária uma maior integração da equipe assistencial com a inserção da família na unidade para a formação de vínculos e em relação a orientações básicas, como rotinas da unidade e higienização de mãos. / The stimulus to family bonding must be initiated even before birth, without being interrupted or delayed due to hospitalization, once that, it might occur for a long period depending on the disease of the newborn. For this reason and for the creation of an early bond, the separation of the siblings, due to hospitalization, must happen softly, only minimizing the familiarity. Welcome the visiting sibling in an guided way allows the relationship not to be interrupted. The research aimed to describe the perception of the sibling in the visit to the hospitalized newborn in the context of the neonatal intermediate care in an university hospital of Porto Alegre in Rio Grande do Sul. As a goal of the study, an orientation booklet for children and parents was prepared about visiting the NICU. This is a qualitative study, performed in an intensive care unit. Six semi-structured interviews were conducted with the visiting brother or sister of the patient admitted to intermediate care beds, since that these patients are in preparation for discharge from hospital. After the transcriptions of the speeches and submitted to content analysis, four categories: visiting, physical space, caregivers and reason for hospitalization. Through the study, there was an awareness of the care team regards to the visit. It was concluded that all participants considered the experience as positive, not only to the visiting siblings as the parents and nursing team. The hospital environment does not cause fear to the participants since they compare the hospitalization of the mother (short stay) with the baby’s and do not associate prematurity and birth to the disease. Also, it was identified that it’s needed greater integration of the assistance team with the insertion of the family in the unit, in the creation of bonds and regards to basic orientation such as unit routine and hands hygiene.

Introdução: As morbidades e mortalidade relacionadas ao uso de medicamentos (MRM) representam um desafio para a saúde pública e são consequências da utilização não efetiva e insegura dos medicamentos. Estudos internacionais mostram como as MRM afetam pacientes internados no hospital e como podem ser evitadas na maioria dos casos. Entretanto, pouco é conhecido sobre as MRM na prática ambulatorial. Estas pesquisas têm abordado as consequências clínicas negativas para os usuários de medicamentos e sugerem que vultosas somas de recursos financeiros são utilizadas para manejar e resolver estas morbidades ao redor do mundo. Já no Brasil, o conhecimento sobre as MRM é escasso em ambas perspectivas e o seu impacto econômico é desconhecido. Objetivo: O propósito desta Tese foi obter uma estimativa sobre os gastos com morbidade e mortalidade associadas ao uso de medicamentos no Brasil, utilizando modelos farmacoeconômicos (teórico e empírico). Métodos: Foram considerados como morbidades relacionadas a medicamentos os novos problemas de saúde advindos da utilização de uma farmacoterapia (por exemplo, reações adversas, dependência a medicamentos e intoxicação por overdose) e as falhas terapêuticas (por exemplo, efeito insuficiente dos medicamentos e problemas de saúde não tratados). Foram conduzidos dois estudos utilizando abordagens distintas (bottom up e top down) na coleta de dados sobre custos. O primeiro estimou, por meio da análise do tipo microcosting, os custos para resolução de Morbidades Relacionadas a Medicamentos em casos identificados no serviço de emergência de um hospital universitário. Resultados: O custo médio para tratar cada um desses pacientes é de aproximadamente R$ 2.200. Reações adversas a medicamentos, falta de adesão à farmacoterapia e problemas resultantes da administração de doses incorretas foram as causas mais prevalentes das morbidades. No segundo estudo, um modelo do tipo cost-of-illness foi traduzido e adaptado para a realidade brasileira, e então um painel com especialistas (farmacêuticos e médicos) foi realizado para estimar a proporção de pacientes que experimentam uma MRM, a proporção de MRM evitáveis e as consequências clínicas resultantes desta morbidade. A partir disto, o custo das MRM para o sistema de saúde brasileiro foi modelado, baseado em estatísticas nacionais sobre o consumo de serviços de saúde. Os especialistas julgaram as morbidades relacionadas a medicamentos como um evento bastante frequente. De acordo com esta estimativa central, as MRM seriam responsáveis por um uso considerável de recursos, podendo chegar a 23% do orçamento público anual total destinado à saúde no Brasil. Para cada real gasto com medicamentos, pelo Ministério da Saúde no Brasil, cinco reais seriam gastos para resolver as MRM. Da mesma forma foi verificado que mais da metade dos casos seriam evitáveis. Conclusão: As MRM são, de fato, um problema de ordem econômica-orçamentária, clínica e humanística para os usuários de medicamentos e para o sistema de saúde brasileiro, e que é imperiosa a criação de políticas públicas e ações capazes de evitar os danos gerados pelo uso não racional de medicamentos, garantir a segurança dos pacientes, bem como uma melhor alocação de recursos em saúde. / Introduction: Drug related morbidities and mortality (DRM) is a challenge to public health due to the consequences of ineffective and unsafe medicines use. It is well known that the DRM are common among hospitalized patients, and are preventable to some extent, but little is known about DRM outside the hospital. In Brazil, the knowledge on the subject is scarce and its economic impact is unknown. However, international studies suggest that DRM result in considerable amounts of financial resources to manage and resolve these morbidities around the world and the negative clinical consequences for those who use medicines. Aim: In this thesis, the drug related morbidities include: new medical problems arising from the pharmacotherapy (adverse effects, addiction to drugs and intoxication by overdose) and therapeutic failure (e.g. insufficient drug effect and untreated health problems). Methods: Two studies were conducted using different methodologies. The first study was a cross-sectional study, based on a microcosting analysis, where patients admitted to a teaching hospital emergency were identified in order to determine the proportion of people seeking health services due to a DRM, and, consequently, to obtain the cost for manage these patients. Results: It was observed that 14.6% of patients visiting an emergency service, do so because of a DRM and the average cost to treat each of these patients is approximately R$ 2,000. Adverse drug reactions, lack of adherence to pharmacotherapy and problems resulting from the administration of incorrect doses were the most prevalent causes of morbidity. In the second study, a cost-of-illness model was translated to portuguese and adapted, and then a panel of experts (pharmacists and physicians) was conducted to estimate the proportion of patients experiencing DRM, the proportion of preventable DRM, and the negative outcomes resulting from this morbidity. From this, the DRM cost for the Brazilian Health System was modeled, based on national statistics on the consumption of health services. Experts have judged drug-related morbidities to be a fairly frequent event. According to central estimate, the DRM would be responsible for a considerable use of resources, being able to reach 23% of the total annual public health budget in Brazil. For each real (R$ 1,00) spending on medicines, by the Brazilian Ministry of Health, five reais (R$ 5,00) would be spent to manage the DRM. Likewise, in this study it was also verified that more than half of the cases would be avoidable. In the second, a panel of experts (pharmacists and physicians) was performed to estimate the proportion of patients experiencing an DRM, DRM preventable ratio and the clinical consequences of this morbidity. From this, the cost of DRM for the Brazilian health system was modeled, based on national statistics on the consumption of health services. Conclusion: Based on these and many other results presented in this thesis, it is concluded that the DRM are indeed, an economic, clinical and humanistic issue for those who use medicines and to the Brazilian health system, and that is overriding the establishment of public policies and actions to prevent the damage caused by the non-rational use of medicines to ensure patient safety and to the best allocation of health resources.

U.S. incarceration rates have soared over the past three decades and the demographic characteristics of those who end up in prison are a reflection of the nation's structural inequality. Incarcerated fathers are a socially disadvantaged group and spending time in prison compounds already significant risk factors that these men experienced throughout their lives. In addition, it increases the risk that their children will suffer from the intergenerational transmission of social inequality. While studies indicate that maintaining contact between incarcerated fathers and their children has the potential to benefit them both and improve a variety of outcomes, there is limited research on the factors that impact incarcerated father-child contact. Based on the ecological model and the cumulative risk framework, this thesis attempts to help fill this gap in the current literature by examining whether an incarcerated father's cumulative risk factors impact the frequency of contact he has with his children. Using a nationally representative data set of men in state prisons and a negative binomial regression analysis, this study found that number of childhood risk experiences was a significant predictor of an incarcerated father's contact with his children. In addition, minority status moderated the relationship between childhood risk and frequency of visits, with an increased effect of risk on father-child contact for African American and Hispanic men. While the quadratic term of Risk² was not significant, disproving the hypothesis that there is a non-linear relationship between risk and contact, a visual representation of the distribution showed that contact between fathers and their children dropped substantially for men with the highest number of risk factors. This study provides valuable information about the relationship between the childhood experiences of incarcerated fathers and their subsequent social ties. The knowledge that childhood risk impacts frequency of father-child contact has the potential to inform interventions aimed at improving outcomes for these at-risk families. / Graduation date: 2013

No description available.

Šiame darbe išanalizuota iki šiol Lietuvoje netyrinėta sąsaja tarp depresija sergančių pacientų ambulatorinių apsilankymų ir pirminės asmens sveikatos priežiūros įstaigos apkrovos. Šis tyrimas moksline ir praktine prasme yra vertingas tolesniems depresijos simptomų patiriančių asmenų pirminės sveikatos priežiūros organizavimo bei vystymo tyrinėjimams. Darbo tikslas. Įvertinti depresijos simptomų sąsają su ambulatorinių pacientų apsilankymų kiekiu ir pirminės asmens sveikatos priežiūros įstaigos apkrova. Darbo uždaviniai: 1. Nustatyti depresijos simptomus patiriančių pacientų ambulatorinių apsilankymų per pusmetį pas bendrosios praktikos (šeimos) gydytojus dažnį ir palyginti su depresijos simptomų nepatiriančių pacientų apsilankymų dažniu. 2. Nustatyti depresijos simptomus patiriantiems pacientams per pusmetį suteiktų gydytojų specialistų konsultacijų dažnį ir palyginti su depresijos simptomų nepatiriančių pacientų konsultacijų dažniu. 3. Nustatyti depresijos simptomus patiriantiems pacientams per pusmetį atliktų laboratorinių tyrimų kiekį bei struktūrą ir palyginti su pacientų, nepatiriančių depresijos simptomų, laboratorinių tyrimų dažniu. Tyrimo metodika. Tyrimui atlikti naudoti penki tyrimo metodai: mokslinės literatūros analizė ir apibendrinimas, anketinė apklausa, testavimas HADS skale, laiko biudžeto analizė ir matematinė statistika. Pagal HADS-D rezultatus, visi tyrimo dalyviai buvo suskirstyti į dvi grupes: pirmą (HADS-D>=8) sudarė 24 tiriamieji, kuriems... [toliau žr. visą tekstą] / In this study we investigated the association between the symptoms of depression of ambulatory patients and the rate of outpatient visits and workload of primary health care centre. This problem was investigated for the first time in Lithuania. The results of this study are of great scientific and practical value for further investigations, cocerning the organization and development of the primary health care for patients with symptoms of depression. Aim of the study. To identify the association between the symptoms of depression of ambulatory patients and the rate of outpatient visits and the workload of the primary health care centre. Objectives: 1. To evaluate the rate of outpatient visits that patients with symptoms of depression make to the general practioner during the past six months and to compare with the patients having no symptoms of depression. 2. To evaluate the rate of consultations of specialists for patients with symptoms of depression during the past six months and to compare it with the patients having no symptoms of depression. 3. To evaluate the amount and structure of laboratory tests done for the patients with symptoms of depression during the past six months and to compare it with the patients having no symptoms of depression. Methods. Data was collected using questionnaire, Hospital Anxiety and Depression Scale (HADS), time budget analysis. According to the scores of HADS, 24 participants were assigned to the group of great or undeterminated risk... [to full text]