Temos aktualumas. Ekonominė aplinka svarbi tiek atskiroms šalims ar jų grupei, tiek įmonėms ir įvairioms institucijoms, tiek ir kiekvienam iš mūsų asmeniškai. Ekonominė šalies ir joje veikiančių įmonių galia priklauso nuo turimų resursų panaudojimo efektyvumo, kuris neatsiejamas nuo naujų gamybos technologinių linijų įsigijimo ir įdiegimo, esamų modernizavimo, įmonės vidinių inžinerinių tinklų, reikalingų verslo plėtrai, įrengimo. Europos Sąjungos šalyse narėse, ypač naujosiose, šios sritys yra remiamos įvairių nacionalinių ir bendrijos fondų lėšomis, tačiau, norint įsisavinti paramos lėšas, reikia gerai išmanyti šių fondų išteklių naudojimo principus ir taisykles. Paraiškos su sėkmingais verslo planais virsta realia nauda toms įmonėms, kurios gerai pasiruošusios paramos įsisavinimui. Paramos naudą, teikiamą įmonėms, tikslinga vertinti per visos įmonės vertės prizmę, tuomet įvertinama ne tik paramos teikiama nauda ar projekto vertė, bet ir realus visos įmonės vertės pokytis, gavus paramą. Todėl atsiranda įmonės vertės pokyčio, įsisavinus ES fondų lėšas, įvertinimo ir metodo, kuris įgalintų nustatyti tą pokytį ir palyginti paramą gavusių įmonių vertės pokyčius tarpusavyje, poreikis. Darbo objektas – Europos Sąjungos paramos įtaka įmonės vertei. Šio darbo tikslas – apžvelgti Europos Sąjungos teikiamos paramos principus, sąlygas ir įsisavinimo tendencijas. Išanalizuoti pagrindinius metodus, naudojamus įmonės vertės nustatymui, atsižvelgiant į juos, sudaryti indikatorių, kuris... [toliau žr. visą tekstą] / Topicality. Economical enviroment makes a direct affect on the whole country, businesses and every personality within. Proper comprehension, interpretation and application of the surrounding, possibilities, variuos financing sources and funds are essential for operating a successful business. It is more than important to take advantage of EU‘s funds available for businesses in young economies like Lithiuania. Each fund and investment is believed to take a positive affect to the company and increase the value of it. It is essential to cull from information in quantity only what’s most important and be able to evaluate the impact of an investment to an enterprise properly and determine the change of an enterprise value after the investment. The object of this graduation paper is the impact of EU‘s funds to the value of a business. Main goals: 1. Analyse and describe main theoretical EU‘s support for businesses aspects. 2. Describe and analyse main enterprise evaluation methods in use. 3. Come up with new business evaluation method, based on integrated value indicator, which enables one to evaluate EU‘s support‘s impact on enerprise value and measure the impact among number of companies. 4. Under favour of the new business evaluation method, evaluate the influence of EU‘s funding to the value of three enterprises, come up with conclusions and suggestions. The Results. Main aspects of EU‘s support for businesses and enterprise evaluation methods are presented and described in the... [to full text]

Objetivo: Este estudo objetivou avaliar a precisão de infusões de medicamentos em dois modelos de Bomba de Infusão (BI), de equipo específico do fabricante e de equipo universal, a concordância entre estes dois modelos e sua relação de custo e efetividade. Método: Foi realizado um ensaio clínico randomizado em pacientes internados em um hospital geral universitário de 740 leitos. As unidades de internação foram randomizadas através de sorteio simples para cada modelo de equipamento e os pacientes foram incluídos de acordo com indicação de uso de BI, conforme protocolo institucional. Os tipos de erros e reações adversas foram classificados por meio de algoritmos. Foi calculado o custo de cada sistema de bomba de infusão, pela vida útil da tecnologia. Resultados: Em 55 pacientes foram acompanhadas 310 infusões, 117 no grupo da bomba de infusão de equipo universal e 193 na bomba de infusão de equipo especifico. Houve semelhança (p=0,40) entre o tempo programado e o observado nas infusões por meio da bomba de equipo específico (-2,1 ± 19 min) e universal (0,08 ± 23 min). Percentualmente, também não foi observada diferença (p=0,70) entre a infusão por bomba de equipo específico (-0,15±3,8%) e universal (0,1±6,3%). Foram observados 14 (4,5%) erros de medicação, semelhantes (p=0,58) entre os tipos de BI. Os custos cumulativos entre os dois sistemas de bombas se equivaleram em 30 meses, sendo que após 11 anos, foram significativamente maiores para bomba de equipo específico em 184,29%. Conclusão: Ambos modelos de BI avaliadas mostraram-se igualmente seguras para administração EV de fármacos, sendo o modelo de equipo universal mais vantajoso economicamente ao longo da vida útil dos equipamentos. / Objective: This study aimed to evaluate the accuracy of drug infusion in two models of infusion pumps (IP), one with a specific IV set and other with universal IV set, the correlation between these two models and their relation of cost and effectiveness. Method: A randomized clinical trial was conducted in hospitalized patients in a university general hospital of 740 beds. The ward units were randomly chosen for each type of equipment, and patients were included according to indication for use of IP, based on institutional protocol. The types of errors and adverse reactions were classified by means of algorithms. The costs of each system for IP, was calculated considering the useful life of the technology. Results: 310 infusions were monitored: 117 in the universal infusion pump group and 193 in the specific equipment group, in 55 patients. The average difference between the scheduled time and the actual one in the infusions was -2.1 ± 19 min. and 0.08 ± 23 min. (p = 0.40) for the universal equipment and specific equipment, respectively, which means an average error of -0.15% ± 3.8% for the universal equipment and 0.10% ± 6.3% for the specific equipment, with no difference between the two types of pump. Fourteen (4.5%) medication errors were observed during the administration of medication, similar between the two types of IP. The cumulative costs between the two pump systems were equivalent in 30 months, and after 11 years the costs were meaningfully higher for the specific equipment pumps in 184,29 %. Conclusion: The infusion pumps do not show meaningful difference in accuracy between scheduled time and the actual one qualifying them as safe for the drugs observed. Cumulative costs were significantly distinct between both pieces of equipment.

O Brasil conta com uma rede de atenção terciária razoavelmente bem equipada nos grandes centros urbanos e com a rede de atenção primária em fase de franca expansão na maioria dos municípios. Entre estes dois extremos do sistema de saúde há um hiato deixado pela inexistência, em grande parte das regiões distantes dos grandes centros, da atenção secundária, fato que gera a necessidade de grandes deslocamentos diários de pessoas para realização de consultas e exames de média complexidade. Objetivo: Comparar, do ponto de vista econômico, duas formas de assistência: a convencional que está em prática em todos os municípios do RS; e a modalidade com a descentralização do exame de espirometria com apoio da teleassistência. Método: Estudo de custo-minimização da implantação da espirometria descentralizada com apoio de teleconsultoria em município distante 50Km da Capital do Estado do RS e que encaminha todos os pacientes que necessitam deste exame. Este trabalho foi apresentado como dissertação de mestrado ao PPG em Epidemiologia da UFRGS. Resultados: Observou-se que em um ano gastou-se R$ 16.966,35 com o encaminhamento de pacientes para consulta e realização de espirometria comparado com o custo de R$ 15.150,00 para se implantar um espirômetro descentralizado. Na análise dos gastos individualmente encontrou-se uma economia de R$ 102,71 por paciente que realizar o diagnóstico e o tratamento na forma descentralizada. Conclusão: O menor custo da espirometria descentralizada, a redução dos deslocamentos rodoviários e a possibilidade de eliminar a demanda reprimida por este procedimento de média complexidade justificam sua implantação. / Brazil has a well organized tertiary care network in major urban centers and a growing primary care network in almost all municipalities. In between, a gap exists due to the virtual absence of specialists offering secondary care services outside of major metropolitan areas. This results in a daily pilgrimage of patients to receive specialist consultations and undergo exams of moderate complexity. Objective: To compare, from an economic viewpoint, two modes of care: the conventional one currently being practiced across the state of Rio Grande do Sul; against a modality of decentralized spirometry with interpretation using telemedicine. Methods: Cost-minimization study of the implementation of decentralized spirometry using telemedicine, taking as a model a municipality 50 km distant from the state capital which currently references all patients who need this exam. Results: In one year R$ 16,966.35 would be spent in referencing these patients compared with R$ 15,150.00 that would be spent with the implementation of decentralized spirometry. When costs are expressed per patient, we found a saving of R$ 102.71 for each patient who received decentralized care. Conclusion: The lower cost of decentralized spirometry coupled with the possibility of eliminating backed up demand for this moderate complexity procedure justify its implementation. / Telemedicina

Objetivo: Este estudo objetivou avaliar a precisão de infusões de medicamentos em dois modelos de Bomba de Infusão (BI), de equipo específico do fabricante e de equipo universal, a concordância entre estes dois modelos e sua relação de custo e efetividade. Método: Foi realizado um ensaio clínico randomizado em pacientes internados em um hospital geral universitário de 740 leitos. As unidades de internação foram randomizadas através de sorteio simples para cada modelo de equipamento e os pacientes foram incluídos de acordo com indicação de uso de BI, conforme protocolo institucional. Os tipos de erros e reações adversas foram classificados por meio de algoritmos. Foi calculado o custo de cada sistema de bomba de infusão, pela vida útil da tecnologia. Resultados: Em 55 pacientes foram acompanhadas 310 infusões, 117 no grupo da bomba de infusão de equipo universal e 193 na bomba de infusão de equipo especifico. Houve semelhança (p=0,40) entre o tempo programado e o observado nas infusões por meio da bomba de equipo específico (-2,1 ± 19 min) e universal (0,08 ± 23 min). Percentualmente, também não foi observada diferença (p=0,70) entre a infusão por bomba de equipo específico (-0,15±3,8%) e universal (0,1±6,3%). Foram observados 14 (4,5%) erros de medicação, semelhantes (p=0,58) entre os tipos de BI. Os custos cumulativos entre os dois sistemas de bombas se equivaleram em 30 meses, sendo que após 11 anos, foram significativamente maiores para bomba de equipo específico em 184,29%. Conclusão: Ambos modelos de BI avaliadas mostraram-se igualmente seguras para administração EV de fármacos, sendo o modelo de equipo universal mais vantajoso economicamente ao longo da vida útil dos equipamentos. / Objective: This study aimed to evaluate the accuracy of drug infusion in two models of infusion pumps (IP), one with a specific IV set and other with universal IV set, the correlation between these two models and their relation of cost and effectiveness. Method: A randomized clinical trial was conducted in hospitalized patients in a university general hospital of 740 beds. The ward units were randomly chosen for each type of equipment, and patients were included according to indication for use of IP, based on institutional protocol. The types of errors and adverse reactions were classified by means of algorithms. The costs of each system for IP, was calculated considering the useful life of the technology. Results: 310 infusions were monitored: 117 in the universal infusion pump group and 193 in the specific equipment group, in 55 patients. The average difference between the scheduled time and the actual one in the infusions was -2.1 ± 19 min. and 0.08 ± 23 min. (p = 0.40) for the universal equipment and specific equipment, respectively, which means an average error of -0.15% ± 3.8% for the universal equipment and 0.10% ± 6.3% for the specific equipment, with no difference between the two types of pump. Fourteen (4.5%) medication errors were observed during the administration of medication, similar between the two types of IP. The cumulative costs between the two pump systems were equivalent in 30 months, and after 11 years the costs were meaningfully higher for the specific equipment pumps in 184,29 %. Conclusion: The infusion pumps do not show meaningful difference in accuracy between scheduled time and the actual one qualifying them as safe for the drugs observed. Cumulative costs were significantly distinct between both pieces of equipment.

O Brasil conta com uma rede de atenção terciária razoavelmente bem equipada nos grandes centros urbanos e com a rede de atenção primária em fase de franca expansão na maioria dos municípios. Entre estes dois extremos do sistema de saúde há um hiato deixado pela inexistência, em grande parte das regiões distantes dos grandes centros, da atenção secundária, fato que gera a necessidade de grandes deslocamentos diários de pessoas para realização de consultas e exames de média complexidade. Objetivo: Comparar, do ponto de vista econômico, duas formas de assistência: a convencional que está em prática em todos os municípios do RS; e a modalidade com a descentralização do exame de espirometria com apoio da teleassistência. Método: Estudo de custo-minimização da implantação da espirometria descentralizada com apoio de teleconsultoria em município distante 50Km da Capital do Estado do RS e que encaminha todos os pacientes que necessitam deste exame. Este trabalho foi apresentado como dissertação de mestrado ao PPG em Epidemiologia da UFRGS. Resultados: Observou-se que em um ano gastou-se R$ 16.966,35 com o encaminhamento de pacientes para consulta e realização de espirometria comparado com o custo de R$ 15.150,00 para se implantar um espirômetro descentralizado. Na análise dos gastos individualmente encontrou-se uma economia de R$ 102,71 por paciente que realizar o diagnóstico e o tratamento na forma descentralizada. Conclusão: O menor custo da espirometria descentralizada, a redução dos deslocamentos rodoviários e a possibilidade de eliminar a demanda reprimida por este procedimento de média complexidade justificam sua implantação. / Brazil has a well organized tertiary care network in major urban centers and a growing primary care network in almost all municipalities. In between, a gap exists due to the virtual absence of specialists offering secondary care services outside of major metropolitan areas. This results in a daily pilgrimage of patients to receive specialist consultations and undergo exams of moderate complexity. Objective: To compare, from an economic viewpoint, two modes of care: the conventional one currently being practiced across the state of Rio Grande do Sul; against a modality of decentralized spirometry with interpretation using telemedicine. Methods: Cost-minimization study of the implementation of decentralized spirometry using telemedicine, taking as a model a municipality 50 km distant from the state capital which currently references all patients who need this exam. Results: In one year R$ 16,966.35 would be spent in referencing these patients compared with R$ 15,150.00 that would be spent with the implementation of decentralized spirometry. When costs are expressed per patient, we found a saving of R$ 102.71 for each patient who received decentralized care. Conclusion: The lower cost of decentralized spirometry coupled with the possibility of eliminating backed up demand for this moderate complexity procedure justify its implementation. / Telemedicina

O Brasil conta com uma rede de atenção terciária razoavelmente bem equipada nos grandes centros urbanos e com a rede de atenção primária em fase de franca expansão na maioria dos municípios. Entre estes dois extremos do sistema de saúde há um hiato deixado pela inexistência, em grande parte das regiões distantes dos grandes centros, da atenção secundária, fato que gera a necessidade de grandes deslocamentos diários de pessoas para realização de consultas e exames de média complexidade. Objetivo: Comparar, do ponto de vista econômico, duas formas de assistência: a convencional que está em prática em todos os municípios do RS; e a modalidade com a descentralização do exame de espirometria com apoio da teleassistência. Método: Estudo de custo-minimização da implantação da espirometria descentralizada com apoio de teleconsultoria em município distante 50Km da Capital do Estado do RS e que encaminha todos os pacientes que necessitam deste exame. Este trabalho foi apresentado como dissertação de mestrado ao PPG em Epidemiologia da UFRGS. Resultados: Observou-se que em um ano gastou-se R$ 16.966,35 com o encaminhamento de pacientes para consulta e realização de espirometria comparado com o custo de R$ 15.150,00 para se implantar um espirômetro descentralizado. Na análise dos gastos individualmente encontrou-se uma economia de R$ 102,71 por paciente que realizar o diagnóstico e o tratamento na forma descentralizada. Conclusão: O menor custo da espirometria descentralizada, a redução dos deslocamentos rodoviários e a possibilidade de eliminar a demanda reprimida por este procedimento de média complexidade justificam sua implantação. / Brazil has a well organized tertiary care network in major urban centers and a growing primary care network in almost all municipalities. In between, a gap exists due to the virtual absence of specialists offering secondary care services outside of major metropolitan areas. This results in a daily pilgrimage of patients to receive specialist consultations and undergo exams of moderate complexity. Objective: To compare, from an economic viewpoint, two modes of care: the conventional one currently being practiced across the state of Rio Grande do Sul; against a modality of decentralized spirometry with interpretation using telemedicine. Methods: Cost-minimization study of the implementation of decentralized spirometry using telemedicine, taking as a model a municipality 50 km distant from the state capital which currently references all patients who need this exam. Results: In one year R$ 16,966.35 would be spent in referencing these patients compared with R$ 15,150.00 that would be spent with the implementation of decentralized spirometry. When costs are expressed per patient, we found a saving of R$ 102.71 for each patient who received decentralized care. Conclusion: The lower cost of decentralized spirometry coupled with the possibility of eliminating backed up demand for this moderate complexity procedure justify its implementation. / Telemedicina

La thèse se situe dans le champ de la didactique professionnelle et concerne la formation initiale des sages-femmes qui s’inscrit depuis 2009 dans le cadre européen appelé processus de Bologne. Une première étude quantitative, descriptive concernant l’utilisation du référentiel métier et compétences a permis de considérer l’orientation que chaque étudiant donne à sa formation en fonction de sa motivation initiale et de son projet professionnel. Le référentiel n’est pas privilégié dans l’organisation de la formation initiale en sciences maïeutiques. Une deuxième étude quantitative, descriptive est conduite auprès des équipes enseignantes et des étudiants sur le contenu des enseignements en formation initiale. Les résultats sont paradoxaux. Si les équipes enseignantes utilisent des moyens pédagogiques innovants, elles se servent de leurs expériences personnelles pour proposer des dispositifs de formation, ce qui ne correspond pas forcément aux prérequis des étudiants en formation initiale ; les étudiants font peu de lien entre les connaissances théoriques et leur activité en stage.Une enquête qualitative est alors conduite par entretiens auprès des étudiants. Elle met en évidence que les étudiants s’inscrivent dans un apprentissage par compétences et dans une démarche réflexive. Ils utilisent certains dispositifs mis en place par les équipes enseignantes. L’encadrement en stage qui n’a pas été réformé avec l’universitarisation de la formation (2011) participe à cette démarche réflexive. La thèse précise les chemins de l’apprentissage des étudiants en formation initiale en sciences maïeutiques. Les étudiants utilisent l’autoévaluation pour se situer en formation. / The research is in the purview of professional didactics and concerned the initial training in Maieutic Sciences, that is, since 2009, in the European framework called Bologna process. A first, quantitative, descriptive study about using of the Referencial of Job and Skills take care of the direction that each student gives his training according to its initial motivation and their professional project. This referencial is not privileged in the organization of initial formation in Maieutic Sciences. A second quantitative study, descriptive is undertaken with the teaching staff and students about the content of teaching in initial formation. The results are paradoxical. If the teaching teams use innovative teaching methods, they use their personal experiences to offer training devices, which does not necessarily correspond to the prerequisites of students in initial formation; the students make little link between theoretical knowledge and training in their internship.A qualitative survey is then conducted by interviews with students. It shows that students enroll in a learning skills, as well as a reflective process. They use certain features created by the teaching staff. The coaching during the internship has not been reformed by the 2011 program participate in this reflection process.The thesis has clarified the ways of student learning in maieutic sciences. The students use self-assessment to lie in formation.

Le bruit affecte la santé humaine, provoquant de la gêne, des troubles du sommeil et augmentant le risque de crise cardiaque. Les quantifications de l’impact du bruit montrent que c’est un problème de santé publique et que le trafic routier en est majoritairement responsable. L’analyse du cycle de vie (ACV) est une méthode d’évaluation globale des impacts environnementaux d’un produit, d’un service ou d’un processus. Malgré la prise en compte de nombreux problèmes environnementaux, l’impact du bruit sur la santé humaine n’est pas encore correctement pris en compte dans l’ACV. L’objet de ce doctorat est d’intégrer dans l’ACV l’impact du bruit du trafic routier sur la santé humaine.Les différents éléments d’acoustique et d’épidémiologie qui permettent cette intégration sont présentés. Une analyse des méthodes existantes est conduite en les appliquant à un cas d’étude. Cela permet de comprendre les avantages et inconvénients des différentes approches tout en comparant les résultats qu’elles fournissent. Une méthode pour intégrer l’impact du bruit du trafic routier sur la santé humaine dans l’ACV est ensuite proposée. Cette méthode repose sur les logiciels de prédiction acoustique et les données rendues disponibles par la directive 2002/49/CE. Elle permet d’établir, avec une grande précision, des facteurs de caractérisations (CFs) reliant des flux élémentaires de l’inventaire ACV à un impact sur la santé humaine.La méthode est ensuite appliquée sur un échantillon de petites zones géographiques sélectionnées dans la région lyonnaise. L’application de la méthode et l’analyse des résultats apportent de nombreux enseignements sur l’existence potentielle d’une typologie pour la différentiation géographique, la meilleure forme pour la collecte d’information sur le bruit au niveau de l’inventaire ACV, la variabilité spatiale des CFs ou encore l’incertitude qui peut leur être associée. Les CFs obtenus montrent que l’intégration de l’impact du bruit en ACV pourrait doubler l’impact du transport routier sur la santé humaine. Ce doctorat identifie également des pistes de recherche. Des travaux similaires doivent être menés pour les autres moyens de transport (principalement trains et avions) pour permettre une comparaison équitable des études ACV les impliquant. Répéter la méthode dans d’autres zones géographiques, avec d’autres modèles d’émission et de propagation acoustique et/ou d’autres logiciels de propagation acoustique apporterait également des éléments intéressants. / Noise affects human health, causing annoyance, sleep disturbance and increasing the risk of cardiovascular disease. The quantification of noise impacts highlights it as a public health problem for which road traffic is mainly responsible. Life cycle assessment (LCA) is a technique to assess the environmental impacts of a product, a service or a process. Despite taking into account many environmental problems, the impact of noise on human health is not yet properly taken into account in LCA. The aim of this PhD thesis is to integrate the impact of traffic noise on human health in the LCA framework.The scientific elements of acoustics and epidemiology that allow this integration are presented. An analysis of the existing methods is conducted by applying them to a case study. This helps to understand the advantages and drawbacks of the different approaches while comparing the results they provide. A method to integrate the impact of road traffic noise on human health in the LCA framework is then proposed. The method is based on noise prediction software and data made available by the Directive 2002/49/EC. This makes it possible to establish, with great precision, characterisation factors (CFs) connecting elementary flows of the LCA inventory with an impact on human health.The method is then applied to a sample of small geographic areas selected in the region surrounding the city of Lyon (France). The application of the method and the analysis of the results provides a multitude of information regarding the potential existence of a typology for spatial differentiation, the best form for the collection of noise information at the LCA inventory level, the spatial variability of the CFs and the uncertainties that may be associated with them. The CFs obtained show that integrating the impact of noise into LCA could double the impact of road transport on human health. This PhD thesis also identifies further potential research topics. Similar work needs to be done for other transport modes (mainly trains and airplanes) to allow for a fair comparison of different transport modes in LCA studies. Repeating this method in other geographical areas with other acoustic emission and propagation models and/or other noise prediction software would also help the generalisation of this work and the assessment of possible sources of uncertainties.

The thesis deals with the use of hydrophilic mineral wool in green roof structures. In the first part of the thesis, based on current legislation, there are summarized relevant technical properties of the hydrophilic wool. Specific demands on the green roof parts were classified and the work was consequently updated by the research of available products from the national market. A large part of the thesis consists of the extended documentation of technical properties of new products and also the changes that are associated with ageing after the material incorporation into the structure. Not only the laboratory properties of the material itself, but also properties of the material embedded in green roof structure were measured, for example an acoustic capabilities. Water accumulation properties of the mineral wool were documented on the real roof models too. Various impacts were observed by using mineral wool in comparison with substrate assemblies. Additional experiments were applied on using different types of mineral wool for an assessment of specific green roof vegetation adaptation. The environmental product declarations for each mineral wool product were calculated with the specific software using LCA methodology. In this way, the environmental impacts of mineral wool could be compared with other materials, such as artificial substrates, foils, etc. As a conclusion of the research results were summarized and reported demands for the hydrophilic mineral wool use in the green roof structures.

The work was focused on the verification of influence of quality of raw material and time-temperature conditions on the retention of nutritionally and sensory important components of the ketchups and other tomato based products. The goal of the theoretical part of this diploma thesis was the optimization of procedure of Czech tomato cultivar selection according to the highest refraction and intensive red colour. The influence of tomato ketchups production technology on retention of nutritionally significant ingredients was observed within the practical part. The samples of ketchups were sampled during different steps of production within one batch in company OTMA Sloko Mařatice. It was ketchup which was preserved by pasteurization in the glass bottle and ketchup which was preserved by hot filing to the plastic bottles. The content of lycopene, ascorbic acid, colour, viscosity, refraction and pH were measured in those samples. Furosine had been chosen as marker of thermal stress on material. The technologies can be compared on the basic of measured values from the view of retention or changes of nutritionally and sensory important components.