The outputs that form the basis of this PhD submission include a web site that summarises a unique collection of over 200 Court Judgments in personal injury claims for work-related upper limb disorders heard in the UK, together with a number of more conventional publications. Individually, these outputs all address upper limb disorders associated with work although they each had slightly different objectives and the audiences for which they were produced significantly influenced the type of publication in which they appeared. Together, they help illustrate when, how and, to some extent, why upper limb disorders associated with keyboard use became the issue it did in the UK in the late 1980s and 1990s. While many might now regard keyboard or computer use as an innocuous task, in the late 1980s and 1990s upper limb disorders associated with keyboard use, particularly computer use, became the subject of litigation, legislation, industrial disputes and widespread publicity. The outputs on which this submission is based, together, suggest that following the importation of the concept of repetitive strain injuries (RSI) from Australia in the later 1980s, the activities of trades unions and journalists in the UK promoted work-relevant upper limb symptoms and disorders associated with keyboard use as work-induced injuries. Subsequently, a small number of successful, union-backed, personal injury claims, which involved contentious medical evidence and perhaps an element of iatrogenesis, were widely promoted as proof that computer use causes injury. Around the same time, the government chose to implement flawed Regulations relating to the design and use of computer workstations, which failed to distinguish between that which might give rise to discomfort, fatigue and frustration and that which might give rise to injury. The existence of these Regulations, which among other things require regular, individual risk assessments of computer users, unlike any other type of work, could be interpreted as further 'proof' that computer use causes injury. The approach to the prevention and management of musculoskeletal disorders advocated in current HSE guidance, including the risk assessment strategy, remain capable of generating distorted perceptions of the risks arising from keyboard and computer use.

Thesis (M.Sc.)--University of Alberta, 2009. / A thesis submitted to the Faculty of Graduate Studies and Research in partial fulfillment of the requirements for the degree of Master of Science in Agricultural and Resource Economics, Department of Rural Economy. Title from pdf file main screen (viewed on September 20, 2009). Includes bibliographical references.

Die bisherigen Untersuchungen zu den Folgen extremer Hochwasserereignisse beschäftigten sich überwiegend mit den durch hohe Wasserstände und Fließgeschwindigkeiten verursachten direkten und tangiblen Schäden an Gebäuden und Infrastrukturen. Den durch schadstoffhaltiges Hochwasser hervorgerufenen direkten und indirekten sowie in der Regel intangiblen Konsequenzen für Mensch und Umwelt ist - insbesondere im Hinblick auf deren räumliche Verteilung - im Rahmen des Hochwasserrisikomanagements nur geringe Aufmerksamkeit gewidmet worden. Während Hochwasserereignissen können toxische Stoffe - wie beispielsweise Arsen, Blei, Cadmium oder Quecksilber sowie persistente organische Kontaminanten wie DDT oder HCH - aus belasteten Gewässer- und Ufersedimenten sowie Altstandorten und Altablagerungen freigesetzt werden. Diese Stoffe werden von der Hochwasserwelle aufgenommen, zum überwiegenden Teil partikulär gebunden transportiert und bei nachlassender Fließgeschwindigkeit und ablaufendem Hochwasser als Sedimente in den Überflutungsbereichen deponiert. In Abhängigkeit von der Nutzung der überschwemmten Gebiete sind nach einem Hochwasser unterschiedliche Rezeptoren den abgelagerten Sedimenten und darin enthaltenen Schadstoffen in der Regel langfristig ausgesetzt. Mögliche Rezeptoren sind zum Beispiel Menschen, Nutz- und Wildtiere, Futter- und Nahrungspflanzen sowie Böden mit ihren spezifischen Bodenfunktionen. Kern dieser Arbeit ist die Entwicklung einer räumlich differenzierten Methodik zur integrierten Analyse und Bewertung von stofflichen Hochwasserrisiken. Um deren Anwendbarkeit zu überprüfen, wird die entwickelte Methodik im Rahmen einer Fallstudie an Überflutungsbereichen entlang des Unterlaufes der Vereinigten Mulde zwischen Bitterfeld und Priorau erprobt, wobei der Fokus auf dem Rezeptor Mensch liegt. Die Methodik basiert auf der Integration von Verfahren der Hochwasserrisikoanalyse und der Schadstoffrisikoanalyse. Diese werden unter Verwendung eines angepassten Source-Pathway-Receptor-Consequence-Konzeptes kombiniert. Die Methodik besteht aus drei größeren Hauptelementen: (1.) der Gefahrenanalyse, (2.) der Expositionsanalyse und (3.) der Schadstoffrisikocharakterisierung und -bewertung. Die Gefahrenanalyse beschreibt die Freisetzung, den Transport und die Ablagerung der Stoffe in Abhängigkeit von der Hochwassercharakteristik, den Substanzeigenschaften sowie den Verteilungsprozessen nach der Ablagerung, beispielsweise dem Transfer vom Boden in die Pflanze. Ergebnisse der Gefahrenanalyse sind Karten der Schadstoffquellen in Form räumlich verteilter Stoffkonzentrationen in Umweltmedien wie Böden und Pflanzen. Die Expositionsanalyse stellt die Verbindung zwischen den Schadstoffquellen und den Rezeptoren her. Bindeglied sind Expositionspfade, beispielsweise die orale Aufnahme von kontaminiertem Boden oder der Verzehr von Pflanzen, die auf belasteten Böden angebaut werden. Teil der Expositionsanalyse ist eine so genannte Rezeptoranalyse, die - aus Landnutzungstypen abgeleitet - Vorkommen bestimmter Rezeptoren identifiziert und diese charakterisiert. Dabei bezieht die Rezeptoranalyse sowohl die räumliche Verteilung der Rezeptoren als auch deren Eigenschaften ein. Für den Rezeptor Mensch sind dies etwa physiologische Parameter wie Körpergewicht oder Atemrate sowie verhaltensbezogene Parameter wie Zeit-Aktivitätsbudgets oder Nahrungsaufnahmeraten. Daran anschließend wird mit der Expositionsanalyse im engeren Sinne die Exposition der Rezeptoren gegenüber bestimmten Stoffen quantifiziert, indem Transfer- und Aufnahmeraten von Expositionsmedien wie Boden, Nahrung oder Luft ermittelt und mit den darin enthaltenen Stoffkonzentrationen in Beziehung gesetzt werden. Ergebnis der Expositionsanalyse sind räumlich explizite Darstellungen der inneren Exposition, d.h. täglich aufgenommener resorbierter Schadstoffmengen. Darauf folgend werden im Zuge der Risikocharakterisierung die Effekte der Exposition mit Hilfe von Dosis-Wirkungsbeziehungen analysiert, die dann in Form von toxikologisch begründeten Referenzwerten als Basis für die finale stoffbezogene Risikobewertung dienen. Diese erfolgt durch Vergleich der inneren Exposition mit toxikologischen Referenzwerten in Form von tolerablen Aufnahmeraten. Die gesundheitlichen Risiken werden durch den Quotienten aus resorbierter Dosis und tolerabler Dosis beschrieben und als stoff- und pfadspezifischer Risikoindex flächenhaft dargestellt. Abschließend erfolgt eine Bewertung der Risiken mittels einer die Unsicherheiten der Referenzwerte berücksichtigenden Bewertungsfunktion. Die Methodik ist in Form eines GIS-basierten Rechenmodells umgesetzt und im Rahmen einer Fallstudie an der Vereinigten Mulde für verschiedene hydraulische Szenarien im Sinne simulierter Abflüsse verschiedener Jährlichkeiten - 100, 200 und 500 Jahre - erprobt worden. Als ausgewählte Ergebnisse liegen räumlich differenzierte Risikobewertungen für die Stoffe Arsen, Cadmium, Quecksilber und Blei unterschieden nach den Expositionsmedien Boden/Hausstaub, Luft sowie pflanzliche Nahrung vor. Exemplarisch seien hier ausgewählte Bewertungsergebnisse in Form des sogenannten Gefahrenwertes für ein HQ500-Szenario dargestellt: Durch die orale Aufnahme von Arsen über Boden/Hausstaub wird für den Rezeptor Kleinkinder räumlich begrenzt die Risikoschwelle überschritten, wobei die Handlungsschwelle nicht erreicht wird. Die Ergebnisse für Cadmium, Quecksilber und Blei liegen deutlich unter der Risikoschwelle. Ein ähnliches Bild zeigt sich für die Aufnahme über die Luft. Hier wird bei lebenslanger Exposition für Arsen die Risikoschwelle überschritten, für die anderen Stoffe werden Gefahrenwerte weit unter der Risikoschwelle ermittelt. Bezogen auf den Verzehr von Nahrungspflanzen aus Eigenanbau zeigen sich bei lebenslanger Exposition für Cadmium großräumig erhebliche Überschreitungen des Handlungsschwellenwertes. Für die anderen Stoffe finden sich nahezu flächendeckend Überschreitungen des Risikoschwellenwertes, die aber nicht an die Maßnahmenschwelle heranreichen.:1 Zielstellung und Einführung 1.1 Zielstellung 1.2 Problemaufriss 1.3 Stand der Forschung 1.4 Kapitelübersicht 2 Grundlagen und Rahmenkonzepte zu Risiken 2.1 Grundbegriffe 2.2 Risikobegriffe und -konzepte 2.2.1 Risikodefinitionen 2.2.2 Analyse und Bewertung von Risiken 2.2.3 SPRC-Konzept 2.2.4 Zyklus-Konzepte des Risikomanagements 2.3 Hochwasserrisiken 2.3.1 Hochwasserrisikomanagement 2.3.2 Hochwassergefahrenanalyse 2.3.3 Vulnerabilitätsanalyse 2.3.4 Hochwasserrisikoermittlung 2.4 Schadstoffrisiken 2.4.1 Gefahrenidentifikation 2.4.2 Dosis-Wirkungsanalyse 2.4.3 Expositionsanalyse 2.4.4 Risikocharakterisierung 2.5 Risikobewertung 2.5.1 Allgemeine Grundlagen 2.5.2 Bewertung von Hochwasserrisiken 2.5.3 Bewertung von Schadstoffrisiken 2.5.4 Vergleichende Risikobewertung 2.6 Risikosteuerung 2.6.1 Maßnahmen 2.6.2 Rechtliche Instrumente 3 Konzeption der Methodik 3.1 Gesamtkonzept einer integrierten Analyse- und Bewertungsmethodik 3.2 Gefahrenanalyse 3.3 Expositionsanalyse mit Rezeptoranalyse 3.4 Risikocharakterisierung 3.5 Risikobewertung 3.6 Unsicherheitsanalyse 3.7 Gesamtablauf der Methodik 4 Erprobung und Implementierung der Methodik 4.1 Fallstudie Vereinigte Mulde bei Bitterfeld 4.1.1 Beschreibung des Untersuchungsgebietes 4.1.2 Szenarioansatz und Szenarien 4.2 Gefahrenanalyse 4.3 Rezeptoranalyse 4.4 Expositionsanalyse 4.4.1 GIS-Implementierung 4.4.2 Expositionsmodellierung 4.4.3 Expositionsmedien Sediment, Boden, Hausstaub 4.4.4 Expositionsmedium Luft 4.4.5 Expositionsmedium pflanzliche Nahrung 4.5 Risikocharakterisierung 4.6 Risikobewertung 4.7 Unsicherheitsanalyse 5 Empirische Ergebnisse 5.1 Gefahrenanalyse 5.1.1 Bodenkonzentrationen Basisszenario 5.1.2 Bodenkonzentrationen Hochwasserszenarien 5.2 Rezeptoranalyse 5.3 Expositionsanalyse und Risikocharakterisierung 5.4 Risikobewertung 5.4.1 Expositionsmedien Boden und Hausstaub 5.4.2 Expositionsmedium Luft 5.4.3 Expositionsmedium pflanzliche Nahrung 5.5 Unsicherheitsanalyse 5.5.1 Expositionsmedium Boden/Hausstaub 6 Diskussion und Ausblick 6.1 Methodik 6.2 Empirische Ergebnisse 6.3 Ausblick Literaturverzeichnis Abkürzungs- und Akronymverzeichnis Anhang / Research on the consequences of flood events has so far focused on direct tangible damages to buildings and infrastructure caused by high water levels and flow velocities. In the context of flood risk management only little interest has been paid to direct and indirect as well as dominantly intangible consequences caused by flood pollutants to human and ecological receptors - especially taking their spatial distribution into account. During floods toxic substances such as trace elements (e.g. Arsenium, Cadmium, Mercury, Lead, Zinc) and persistent organic pollutants (e.g. HCHs, DDX) can be released from contaminated river bank sediments or former industrial sites. These substances are taken up by the flood water, get transported - mainly bound to fine particles - and get deposited as sediments in the floodplain in case of decreasing flow velocities. Depending on the land use in the floodplain, different receptors can be exposed to the sediments with the associated contaminants. Potential receptors are humans, livestock, wild animals, food and fodder plants as well as soils with their specific soil functions. The core of this thesis is the development of a spatially explicit methodology which enables the integrated analysis and evaluation of substance-based flood risks. To test the applicability, the developed methodology is applied within a case study dealing with floodplains along the lower reaches of the Vereinigte Mulde River situated between Bitterfeld and Priorau (Saxony-Anhalt, Germany). In this case study, the focus is on the receptor man or, more specifically, human health. The methodology is based on an integration of procedures from the fields of flood risk analysis and contaminant risk analysis. These procedures are integrated using an adopted Source-Pathway-Receptor-Consequence concept. The three main elements of the methodology are hazard analysis, exposure analysis and contaminant risk determination and evaluation. At first, the hazard analysis describes the release, transport and deposition of substances based on flood characteristics and substance properties as well as fate and transfer processes after sedimentation (e.g. soil-to-plant transfer). Results of the hazard analysis are maps of spatially distributed substance concentrations in environmental media such as soils and plants, i.e. the (secondary) contaminant sources. Within the exposure analysis the linkages between the contaminant sources and the receptors are described. Connecting elements are exposure pathways such as the ingestion of contaminated soil or the consumption of food produced on such soils. Part of the exposure analysis is a so-called receptor analysis which indicates and characterises potential human receptors that are derived from land-use types. The receptor analysis takes the receptors\' spatial distribution as well as certain properties into account. Taking the receptor human, these properties are physiological parameters such as body weight or respiration rate and behavioural parameters, e.g. activity budgets or food consumption patterns. Subsequently, with the exposure analysis in a narrower sense, the exposure of the receptors to a certain substance is quantified by calculating transfer and intake rates of exposure media such as soil, food or air taking into account the corresponding substance concentrations in these media. Results of the exposure analysis are spatially explicit representations of absorbed contaminant amounts for a certain receptor, i.e. daily resorbed exposure doses. In the course of the contaminant risk determination, the effects (consequences) of the receptors\' exposure are analysed by dose-response relationships, setting the basis for the final substance-based risk assessment in terms of toxicologically derived reference values. Health risks are expressed as ratio between calculated resorbed dose and tolerable resorbed dose and are presented as maps of substance- and pathway-specific risk indices. In a final step, an evaluation is carried out based on a method that takes the uncertainty of the toxicological reference values into account. The methodology has been implemented in a GIS-based calculation model and was applied within a case study to simulate floods with certain return periods (100, 200, and 500 years). Selected results are spatially differentiated risk evaluations for the substances arsenic, cadmium, mercury and lead distinguished based on the exposure media soil/house dust, air and home-grown vegetable food. Taking the 500-year flood-scenario and the risk evaluation value as an example, the following results have been derived: the oral intake of arsenic via soil/house dust leads to a spatially restricted exceedance of the risk level of the receptor infant, whereas the action level is not reached. The results of cadmium, mercury and lead are clearly below the risk level. A similiar pattern shows for the pulmonary intake via air. Based on lifetime exposure, the risk level for arsenic is exceeded, for all other substances the values are far below the risk level. Considering the intake of cadmium via consumption of home-grown vegetables, the action level is notably exceeded in large areas. The other substances show a nearly general exceedance of the risk level without reaching the action level.:1 Zielstellung und Einführung 1.1 Zielstellung 1.2 Problemaufriss 1.3 Stand der Forschung 1.4 Kapitelübersicht 2 Grundlagen und Rahmenkonzepte zu Risiken 2.1 Grundbegriffe 2.2 Risikobegriffe und -konzepte 2.2.1 Risikodefinitionen 2.2.2 Analyse und Bewertung von Risiken 2.2.3 SPRC-Konzept 2.2.4 Zyklus-Konzepte des Risikomanagements 2.3 Hochwasserrisiken 2.3.1 Hochwasserrisikomanagement 2.3.2 Hochwassergefahrenanalyse 2.3.3 Vulnerabilitätsanalyse 2.3.4 Hochwasserrisikoermittlung 2.4 Schadstoffrisiken 2.4.1 Gefahrenidentifikation 2.4.2 Dosis-Wirkungsanalyse 2.4.3 Expositionsanalyse 2.4.4 Risikocharakterisierung 2.5 Risikobewertung 2.5.1 Allgemeine Grundlagen 2.5.2 Bewertung von Hochwasserrisiken 2.5.3 Bewertung von Schadstoffrisiken 2.5.4 Vergleichende Risikobewertung 2.6 Risikosteuerung 2.6.1 Maßnahmen 2.6.2 Rechtliche Instrumente 3 Konzeption der Methodik 3.1 Gesamtkonzept einer integrierten Analyse- und Bewertungsmethodik 3.2 Gefahrenanalyse 3.3 Expositionsanalyse mit Rezeptoranalyse 3.4 Risikocharakterisierung 3.5 Risikobewertung 3.6 Unsicherheitsanalyse 3.7 Gesamtablauf der Methodik 4 Erprobung und Implementierung der Methodik 4.1 Fallstudie Vereinigte Mulde bei Bitterfeld 4.1.1 Beschreibung des Untersuchungsgebietes 4.1.2 Szenarioansatz und Szenarien 4.2 Gefahrenanalyse 4.3 Rezeptoranalyse 4.4 Expositionsanalyse 4.4.1 GIS-Implementierung 4.4.2 Expositionsmodellierung 4.4.3 Expositionsmedien Sediment, Boden, Hausstaub 4.4.4 Expositionsmedium Luft 4.4.5 Expositionsmedium pflanzliche Nahrung 4.5 Risikocharakterisierung 4.6 Risikobewertung 4.7 Unsicherheitsanalyse 5 Empirische Ergebnisse 5.1 Gefahrenanalyse 5.1.1 Bodenkonzentrationen Basisszenario 5.1.2 Bodenkonzentrationen Hochwasserszenarien 5.2 Rezeptoranalyse 5.3 Expositionsanalyse und Risikocharakterisierung 5.4 Risikobewertung 5.4.1 Expositionsmedien Boden und Hausstaub 5.4.2 Expositionsmedium Luft 5.4.3 Expositionsmedium pflanzliche Nahrung 5.5 Unsicherheitsanalyse 5.5.1 Expositionsmedium Boden/Hausstaub 6 Diskussion und Ausblick 6.1 Methodik 6.2 Empirische Ergebnisse 6.3 Ausblick Literaturverzeichnis Abkürzungs- und Akronymverzeichnis Anhang

Nowadays, rail transport has become one of the most widely utilised forms of transport thanks to its high safety level, large capacity, and cost-effectiveness. With the railway network's continuous development, including urban rail transit, one of the major areas of increasing attention and demand is ensuring safety or risk management in operation long-term remains for the whole life cycle by scientific tools, management of railway operation (Martani 2017), specifically in developed and developing countries like Vietnam. The situation in Vietnam demonstrates that the national mainline railway network has been built and operated entirely in a single narrow gauge (1000mm) since the previous century, with very few updates of manual operating technology. This significantly highlights that up to now, the conventional technique for managing the safety operation in general, and collision in particular, of the current Vietnamese railway system, including its subsystems, is only accident statistics which is not a scientific-based tool as the others like risk identify and analyse methods, risk mitigation…, that are already available in many countries. Accident management of Vietnam Railways is limited and responsible for accident statistics analysis to avoid and minimise the harm caused by phenomena that occur only after an accident. Statistical analysis of train accident case studies in Vietnam railway demonstrates that, because hazards and failures that could result in serious system occurrences (accidents and incidents) have not been identified, recorded, and evaluated to conduct safety-driven risk analysis using a well-suited assessment methodology, risk prevention and control cannot be achieved. Not only is it hard to forecast and avoid events, but it may also raise the chance and amount of danger, as well as the severity of the later effects. As a result, Vietnam's railway system has a high number of accidents and failure rates. For example, Vietnam Rail-ways' mainline network accounted for approximately 200 railway accidents in 2018, a 3% increase over the previous year, including 163 collisions between trains and road vehicles/persons, resulting in more than 100 fatalities and more than 150 casualties; 16 accidents, including almost derailments, the signal passed at danger… without fatality or casual-ty, but significant damage to rolling stock and track infrastructure (VR 2021). Focusing and developing a new standardised framework for safety management and availability of railway operation in Vietnam is required in view of the rapid development of rail urban transport in the country in recent years (VmoT 2016; VmoT 2018). UMRT Line HN2A in southwest Hanoi is the country's first elevated light rail transit line, which was completed and officially put into revenue service in November 2021. This greatly highlights that up to the current date, the UMRT Line HN2A is the first and only railway line in Vietnam with operational safety assessment launched for the first time and long-term remains for the whole life cycle. The fact that the UMRT Hanoi has a large capacity, more complicated rolling stock and infrastructure equipment, as well as a modern communica-tion-based train control (CBTC) signalling system and automatic train driving without the need for operator intervention (Lindqvist 2006), are all advantages. Developing a compatible and integrated safety management system (SMS) for adaption to the safety operating requirements of this UMRT is an important major point of concern, and this should be proven. In actuality, the system acceptance and safety certification phase for Metro Line HN2A prolonged up to 2.5 years owing to the identification of difficulties with noncompliance to safety requirements resulting from inadequate SMS documents and risk assessment. These faults and hazards have developed during the manufacturing and execution of the project; it is impossible to go back in time to correct them, and it is also impossible to ignore the project without assuming responsibility for its management. At the time of completion, the HN2A metro line will have required an expenditure of up to $868 million, thus it is vital to create measures to prevent system failure and assure passenger safety. This dissertation has reviewed the methods to solve the aforementioned challenges and presented a solution blueprint to attain the European standard level of system safety in three-phase as in the following: • Phase 1: applicable for lines that are currently in operation, such as Metro Line HN2A. Focused on operational and maintenance procedures, as well as a training plan for railway personnel, in order to enhance human performance. Complete and update the risk assessment framework for Metro Line HN2A. The dissertation's findings are described in these applications. • Phase 2: applicable for lines that are currently in construction and manufacturing, such as Metro Line HN3, Line HN2, HCMC Line 1 and Line 2. Continue refining and enhancing engineering management methods introduced during Phase 1. On the basis of the risk assessment by manufacturers (Line HN3, HCMC Line 2 with European manufacturers) and the risk assessment framework described in Chapter 4, a risk management plan for each line will be developed. Building Accident database for risk assessment research and development. • Phase 3: applicable for lines that are currently in planning. Enhance safety requirements and life-cycle management. Building a proactive Safety Culture step by step for the railway industry. This material is implemented gradually throughout all three phases, beginning with the creation of the concept and concluding with an improvement in the attitude of railway personnel on the HN2A line. In addition to this overview, Chapters 4 through Chapter 9 of the dissertation include particular solutions for Risk assessment, Vehicle and Infrastructure Maintenance methods, Inci-dent Management procedures, and Safety Culture installation. This document focuses on constructing a system safety concept for railway personnel, providing stringent and scientific management practises to assure proper engineering conditions, to manage effectively the metro line system, and ensuring passenger safety in Hanoi's metro operation

<p>Uvod. Rak debelog creva predstavlja 9,7% svih malignih bolesti u svetu, i drugi ili treći je po učestalosti u onkolo&scaron;koj strukturi obolevanja, u zavisnosti od pola. Skrining, ili sekundarna prevencija populacije u prosečnom riziku ima centralnu ulogu u kontroli kolorektalnog karcinoma. Cilj. Utvrditi nivo znanja, stavove i pona&scaron;anje u odnosu na rak debelog creva i njihov uticaj na odaziv na skrining raka debelog creva, u zavisnosti od primenjenog modela skrininga. Materijal i metode. U istraživanje je pozvano 1.213 osoba oba pola, starosti 50-74 godine, za uče&scaron;će u studiji znanja, stavova i pona&scaron;anja (KAP studija) u odnosu na rak debelog creva, popunjavanjem upitnika (Sessa A). Formirane su tri grupe prema modelu skrininga: populacioni - model 0; oportuni skrining uz kontakt ispitanika sa medicinskim osobljem, bez dodatnih informacija o bolesti, skriningu i testu &ndash; model 1; oportuni skrining kada se uz kontakt sa medicinskim osobljem dobija informacija o bolesti i skriningu, uz prikaz izvođenja testa - model 2. U ovoj studiji je kao skrining metoda kori&scaron;ćen imunolo&scaron;ki test stolice -Wondfo FOB.Obrada podataka je rađena statističkim programom SPSS (version 13). Značajnost razlika je testirana parametrijskim (t-test, ANOVA) i neparametrijskim (Mann-Whitney U test) testovima, dok se komparacija kategoričkih varijabli vr&scaron;ila &chi;&sup2; testom i Fisher Exact testom. Test-retest analiza je rađena Cohen&#39;s Kappa testom. Rezultati. Od 1.213 pozvanih, 666 (55%) osoba je prihvatilo uče&scaron;će u KAP studiji. Vi&scaron;e od polovine (54,5%) ispitanika ima ukupan skor znanja manji od 50%. Nivo znanja, sociodemografske karakteristike, procena sopstvenog rizika obolevanja, stav u odnosu na korist testa, stepen sopstvenog rizika obolevanja i mogućnosti prevencije raka debelog creva, nisu faktori koji utiči na participaciju u skriningu kolorektalnog karcinoma. Najvažniji faktor za uče&scaron;će u skriningu u ovom istraživanju je kontakt i razgovor sa lekarom o bolesti, prevenciji i skrining testu.Odaziv u skrining, u odnosu na celokupno pozvanu populaciju je 51,2%. Od ispitanika koji su popunili anketni upitnik, participacija u skriningu je 93,4%. Statistički značajno manji odaziv u skriningu je u modelu 0 (12%) i modelu 1 (6%) u odnosu na model 2 (1%). Zaključak. Poznavanje bolesti, faktora rizika i mogućnosti prevencije generalno je oskudno, ali ne utiče na participaciju u skriningu. Faktor koji utiče na visok odaziv u skrining kolorektalnog karcinoma je kontakt i razgovor sa medicinskim osobljem, pre svega sa lekarom.</p> / <p>Introduction. Colorectal cancer represents 9.7% of all malignancies in the world and it is second or third in frequency in oncological structure depending on the sex. Screening, or secondary prevention of the average risk in the population has a central role in the control of colorectal cancer. Aim. Determine the level of knowledge, attitudes and behaviour in relation to colon cancer and their impact on turnout for colorectal cancer screening, depending on the applied screening model. Material and method. There were 1213 people of both sexes aged 50-74 years participating in this study of knowledge, attitudes and practice (KAP studies) in relation to colorectal cancer, by filling in the questionnaire (Sessa A). Three groups were formed with respect to model screening: population - model 0; opportunistic screening involving the contact of patients and medical staff, without receiving additional information about the disease, screening and test - model 1; opportunistic screening involving the contact of patients and medical staff while receiving information about the disease and screening, and explaining the test performance - model 2. In this study, a screening method used was fecal occult blood test - Wondfo FOB. Data processing is performed by the statistical program SPSS (version 13). The significance of differences was tested by parametric (t-test, ANOVA) and nonparametric (Mann-Whitney U test) tests, while the comparison of categorical variables was performed with &chi;&sup2; test and Fisher Exact test. Test-retest analysis was performed with Cohen&rsquo;s Kappa test. Results. Out of all the 1213 participants, 666 (55%) of them accepted to participate in the KAP study. More than half of them (54.5%) have a total score of knowledge less than 50%. The level of knowledge, socio-demographic characteristics, assessment of the risk of the disease, the attitude towards the benefit of the test, degree of the risk of disease and opportunities for prevention of colorectal cancer, are not factors in deciding to participate in the screening of colorectal cancer. The most important factor for the participation in the screening in this study is the contact and conversation with the doctor about the disease, prevention and screening test. The turnout for the screening, in relation to the number of people who participated is 51.2%. Out of those who completed the questionnaire, participation in the screening is 93.4 %. Statistically significantly lower response in the screening is in model 0 (12%) and in model 1 (6%) in relation to model 2 (1%). Conclusion. Knowledge of the disease, risk factors and prevention opportunities are generally scarce, but do not affect the participation in screening. The factor influencing the high turnout for colorectal cancer screening is contact and conversation with the medical staff, primarily the doctor.</p>

An implementation of what is currently one of the most commonly used tools for high- risk assessment of offenders, HCR-20, the 3rd version - HCR (V3) to the Czech Republic is the main goal of the submitted thesis. Specifically, a theoretical background of this tool, an illustration of the administration and data evaluation within two different case studies, an assessment of inter-rater reliability, a comparison of three versions of HCR-20 with emphasis on the second and the third vision and advantages and disadvantages of HCR (V3) are introduced. This project underlines an importance of taking part in training for a high-risk assessment tool, which is very often underestimated in the Czech Republic, and the importance of gained experiences in high-risk assessment of offenders and the unification of assessors. Moreover, the study supports the implementation of standardised high-risk assessment method. The high-risk assessment of offenders ad hoc should be replaced in our country by clinical assessment supported by results gained via standardised high-risk assessment tool as it is applied abroad. Further research is needed to gain this goal. Empirical results in the thesis are supported by theoretical background. Terms like the high- risk assessment, re-offense, rehabilitation techniques and programs...

This dissertation is a participant observer’s account of implementing a multisite, randomised controlled trial within Her Majesty’s Prison Service. It adds to a scarce literature detailing the steps involved in implementing experiments in custodial settings by providing a candid account of the route from planning to successful implementation. The randomised controlled trial was designed to evaluate the effectiveness of the Sycamore Tree Programme. This programme’s goal is to teach prisoners the wider harm of crime and includes a face-to-face meeting between a victim of crime and the participating offenders. It derives its rehabilitative potential from restorative justice and seeks to foster hope that change is possible for offenders, thus aiding them to desist from crime. Its development and theoretical basis are described for the first time. In an in-depth narrative the dissertation details how at every stage strategies were developed to manage participant procurement, random assignment, maintaining treatment integrity, and preparing for final outcome measurements. The randomised controlled trial was designed to produce an individual experiment in eight prisons. These will be combined in a meta-analysis as well as analysed as a pooled sample. Overall the implementation process took close to two years and involved a charitable body, Her Majesty’s Prison Service, the National Offender Management Service, and two police forces. This work has demonstrated how the unstable nature of English prison populations and the risk-averse climate must be addressed when conducting experiments in that environment. It has also illustrated the gap between the rhetoric of evidence-based policy and the facilitation of research designed to seek that evidence. Nevertheless, developing trusting relationships and combining rapidly learnt skills with inherent abilities ensured that the evaluation methodology was supported and protected through the various challenges it met. Finally, the dissertation suggests conditions for closer collaboration between government executive bodies and researchers that might increase the number of experiments undertaken in prisons. It also aims to encourage researchers that prison experiments, although not easy, are feasible, defendable, and, above all, worthwhile.

Information security is growing in importance as the world becomes more digital, at the same time the importance of usability implementation in software development is also growing. In this study, an evaluation was done on what affects usability and how important usability is in a reporting tool handling information security risk assessment (ISRA). The research question from which the study is based on: What actions can enhance and support the information security risk assessment process in corporations? In order to investigate the research question a study was organized consisting of a survey (N=30) and a think-aloud usability test (N=7). As a part of the analysis process a usability heuristic analysis was performed. According to this study, the ISRA process is complicated and creating a well-functioning supporting tool for it is complex. In order for the tool to facilitate for the users work, usability is an important aspect and should be taken in consideration early in the development process of a tool. Based on the findings in this study actions that can contribute to enhanced usability were discussed. The recommended actions are: 1) Include all types of roles in the ISRA process to determine the purpose of the tool and what it should support. 2) Implement clear guiding information in all parts of the tool, all people involved in the ISRA process should be able to understand the tool. 3) Keep an intuitive flow throughout the tool, the user should intuitively always know what the next step is and what to expect. 4) Have a search function that supports all aspects in the tool. / Informationssäkerheten växer i betydelse i takt med att världen blir mer digital, samtidigt så ökar även betydelsen av implementering av användbarhet i mjukvaruutveckling. I denna studie gjordes en utvärdering av vad som påverkar användbarheten och hur viktigt användbarheten är i ett rapporteringsverktyg som hanterar informationssäkerhetsriskbedömning (ISRB). Den forskningsfråga som studien bygger på: Vilka åtgärder kan förbättra och stödja informationssäkerhetsriskbedömningsprocessen i företag? För att undersöka forskningsfrågan organiserades en studie bestående av en enkätundersökning (N = 30) och ett användbarhetstest med ”Think-Aloud” (N = 7). Som en del av analysprocessen utfördes en användbarhets heuristisks analys. Enligt denna studie är ISRB-processen komplicerad och att skapa ett välfungerande stödjande verktyg för att det är komplext. För att verktyget ska underlätta för användarnas arbete är användbarheten en viktig aspekt och bör tas i beaktning tidigt i utvecklingsprocessen för ett verktyg. Baserat på resultaten i dessa studie så diskuterades åtgärder som kan bidra till ökad användbarhet. De rekommenderade åtgärderna är: 1) Inkludera alla typer av roller i ISRB-processen för att bestämma syftet med verktyget och vad det ska stödja. 2) Implementera tydlig guidande information i alla delar av verktyget, alla personer som är involverade i ISRB-processen ska kunna förstå och använda verktyget. 3) Ha ett intuitivt flöde genom alla delar i verktyget, användaren bör intuitivt alltid veta vad nästa steg är och vad de kan förvänta sig. 4) Har en sökfunktion som stöder alla aspekter i verktyget

The issue of environmental risks from the pharmaceutical endocrine disrupter 17 alpha-ethinyl oestradiol (EE2), which is an active ingredient in the contraceptive pill, confronts government responsibilities for citizens' health with potential environmental risks from its presence in aquatic ecosystems. Further to a risk appraisal process conducted under the Water Framework Directive (WFD) between 2006 and 2012, the European Commission recommended the imposition of an environmental quality standard for EE2. In 2013, this recommendation was rejected by politicians. The outcome was both contested and commended. The UK Government was particularly vehement in its opposition and claimed that the risk assessment process for EE2 was not robust. The UK Government also insisted that it had swayed opinion of other EU Member States to convince them that action for EE2 was not proportionate given the extremely elevated costs of risk control options. At the present time, environmental policy for EE2 and other endocrine disrupters remains resolutely ineffective. Despite three distinct policy interventions recommending precautionary action for EE2 during the past twenty years, emissions of this potent, oestrogenic endocrine disrupter continue unabated. This thesis explains why European politicians rejected the European Commission’s risk governance recommendations for EE2 in 2013 under the Water Framework Directive. This comprises its principal empirical contribution. A novel analytical framework which draws on insights from the policy sciences, risk governance and wicked problems literature is developed. This framework is employed to determine whether the policy outcome for EE2, and the decision-making processes that preceded it, were legitimate. The research findings in this respect advance understanding of the implications of specific properties of wicked problems, of which it is argued, EE2 is an example, for the legitimacy of decision-making processes during the risk appraisal and political phases of policy development in Europe. This comprises the principle theoretical contribution of the thesis. Recommendations to promote more effective and legitimate policy development for wicked problems in similar multi-level governance contexts are also made.

<p>Увод: Ризик оперативног лечења у кардиохирургији посматра се са становишта постоперативног морталитет или одређених компликација. Стратификација ризика подразумева преоперативно утврђивање оперативног ризика, у односу на одређен период након операције, на основу тежине стања сваког пацијента посебно. Оно се процењује на основу броја и тежине његових фактора ризика. Предмет истраживања јесте математички статистички модел за предвиђање исхода оперативног ризика у кардиохирургији за период од једне године од датума интервенције. Популација Војводине је, у демографском смислу, специфична. Висока је стопа гојазних, пушача, оболелих од шећерне болести и артеријске хипертензије. Ове специфичности популације, морају се узети у обзир приликом процене ризика од кардиохируршке интервенције. Осим тога, оперативна тактика и техника (примена артеријских графтова, реваскуларизација у ургентним стањима, хибридна хирургија итд.), као и оптимална преоперативна припрема и постоперативни третман имају велики утицај на исход оперативног лечења. Циљ истраживања јесте идентификација свих фактора ризика који значајно утичу на исход оперативног лечења и развој сопствених модела за предикцију морталитета и значајних кардијалних и церебрoваскуларних компликација, као и њихова валидација. Методе: Узорак је чинило 2664 консекутивних болесника оперисаних на Клиници за кардиоваскуларну хирургију, Института за кардиоваскуларне болести Војводине у периоду од 01.07. 2011. до 21.12.2013. године. Анализирано је укупно 48 потенцијално релевантних фактора ризика. Подаци о морталитету и компликацијама у периоду хоспитализације и о рехоспитализацијама преузимани су из болничког информационог система (БИС). Болесници који, 365 дана од операције, нису били регистровани у БИС-у, позивани су телефоном како би се добио увид у њихово стање. Модел за процену једногодишњег оперативног ризика креиран је помоћу мултиваријантне бинарне логистичке регресије. Дискриминативна моћ модела испитана је помоћу Receiver Operating Characteristic (ROC) кривих, при чему су одређени гранични пресек, сензитивност и специфичност одговарајуће варијабле. Резултати: Добијени модел је добар маркер за предикцију морталитета годину дана од операције (area = 0,712: р &lt; 0,0005). Вредност граничног пресека је 3,04, сензитивност је 0,700; специфичност је 0,626. Хосмер - Лемешов тест за креирани модел износи 0,125 (р &gt; 0,05). На узорку на коме је направљен модел, у односу на значајне, неповољне кардијалне и цереброваскуларне догађаје вредност површине испод ROC криве су: area = 0,713; p &lt; 0,0005 , вредност граничног пресека 7,87, сензитивност 0,667, специфичност 0,635. Када се модел примени на контролну групу, вредност површине испод ROC криве су следеће: area = 0,518, p = 0,581. Хосмер - Лемешов тест за креирани модел показује да је вредност р = 0,007. Закључак: Модел за предикцију морталитета је прецизан како у односу на целу групу болесника, тако и у односу на тип кардиохируршке инервенције. Креирани модел има добру моћ дискриминације. Најбољу моћ разликовања болесника са ниским и високим ризиком, модел показује у коронарној а нешто слабију у комбинованој хирургији. Модел за значајне кардијалне и цереброваскуларне догађаје функционише само на целокупном узорку, на којем је креиран, а не може да да задовољавајући одговор сваком болеснику понаособ, колика је вероватноћа да ће се код њега, у периоду од годину дана од операције, десити неки од наведених догађаја.</p> / <p>Uvod: Rizik operativnog lečenja u kardiohirurgiji posmatra se sa stanovišta postoperativnog mortalitet ili određenih komplikacija. Stratifikacija rizika podrazumeva preoperativno utvrđivanje operativnog rizika, u odnosu na određen period nakon operacije, na osnovu težine stanja svakog pacijenta posebno. Ono se procenjuje na osnovu broja i težine njegovih faktora rizika. Predmet istraživanja jeste matematički statistički model za predviđanje ishoda operativnog rizika u kardiohirurgiji za period od jedne godine od datuma intervencije. Populacija Vojvodine je, u demografskom smislu, specifična. Visoka je stopa gojaznih, pušača, obolelih od šećerne bolesti i arterijske hipertenzije. Ove specifičnosti populacije, moraju se uzeti u obzir prilikom procene rizika od kardiohirurške intervencije. Osim toga, operativna taktika i tehnika (primena arterijskih graftova, revaskularizacija u urgentnim stanjima, hibridna hirurgija itd.), kao i optimalna preoperativna priprema i postoperativni tretman imaju veliki uticaj na ishod operativnog lečenja. Cilj istraživanja jeste identifikacija svih faktora rizika koji značajno utiču na ishod operativnog lečenja i razvoj sopstvenih modela za predikciju mortaliteta i značajnih kardijalnih i cerebrovaskularnih komplikacija, kao i njihova validacija. Metode: Uzorak je činilo 2664 konsekutivnih bolesnika operisanih na Klinici za kardiovaskularnu hirurgiju, Instituta za kardiovaskularne bolesti Vojvodine u periodu od 01.07. 2011. do 21.12.2013. godine. Analizirano je ukupno 48 potencijalno relevantnih faktora rizika. Podaci o mortalitetu i komplikacijama u periodu hospitalizacije i o rehospitalizacijama preuzimani su iz bolničkog informacionog sistema (BIS). Bolesnici koji, 365 dana od operacije, nisu bili registrovani u BIS-u, pozivani su telefonom kako bi se dobio uvid u njihovo stanje. Model za procenu jednogodišnjeg operativnog rizika kreiran je pomoću multivarijantne binarne logističke regresije. Diskriminativna moć modela ispitana je pomoću Receiver Operating Characteristic (ROC) krivih, pri čemu su određeni granični presek, senzitivnost i specifičnost odgovarajuće varijable. Rezultati: Dobijeni model je dobar marker za predikciju mortaliteta godinu dana od operacije (area = 0,712: r &lt; 0,0005). Vrednost graničnog preseka je 3,04, senzitivnost je 0,700; specifičnost je 0,626. Hosmer - Lemešov test za kreirani model iznosi 0,125 (r &gt; 0,05). Na uzorku na kome je napravljen model, u odnosu na značajne, nepovoljne kardijalne i cerebrovaskularne događaje vrednost površine ispod ROC krive su: area = 0,713; p &lt; 0,0005 , vrednost graničnog preseka 7,87, senzitivnost 0,667, specifičnost 0,635. Kada se model primeni na kontrolnu grupu, vrednost površine ispod ROC krive su sledeće: area = 0,518, p = 0,581. Hosmer - Lemešov test za kreirani model pokazuje da je vrednost r = 0,007. Zaključak: Model za predikciju mortaliteta je precizan kako u odnosu na celu grupu bolesnika, tako i u odnosu na tip kardiohirurške inervencije. Kreirani model ima dobru moć diskriminacije. Najbolju moć razlikovanja bolesnika sa niskim i visokim rizikom, model pokazuje u koronarnoj a nešto slabiju u kombinovanoj hirurgiji. Model za značajne kardijalne i cerebrovaskularne događaje funkcioniše samo na celokupnom uzorku, na kojem je kreiran, a ne može da da zadovoljavajući odgovor svakom bolesniku ponaosob, kolika je verovatnoća da će se kod njega, u periodu od godinu dana od operacije, desiti neki od navedenih događaja.</p> / <p>Introduction: Risk assessment in cardiac surgery can be realized from the point of postoperative mortality or certain complications. Risk stratification involves preoperative determination of operative risk in relation to a certain period after the operation, based on the health status of each patient individually. It is estimated through the number and severity of its risk factors. The subject of research is mathematical statistical model which is able to predict the outcome of operative risk in cardiac surgery for a period of one year from the date of intervention. The population of Vojvodina is, in demographic terms, specific. There is a high rate of overweight people, smokers, patients with diabetes and hypertension. These specifics of the population must be taken into account when assessing the risk of cardiac intervention. In addition, operative tactics and techniques (use of arterial grafts, revascularization in emergency situations, hybrid surgery etc.) as well as the optimal preoperative preparation and postoperative treatment have a major impact on the outcome of operative treatment. The aim of the research is the identification of risk factors that significantly affect the outcome of operative treatment and development of specific models for the prediction of mortality and major cardiac and cerebrovascular complications, as well as their validation. Methods: The sample was comprised of 2664 consecutive patients who underwent surgery at the Clinic for Cardiovascular Surgery at the Institute of Cardiovascular Diseases Vojvodina in the period 01.07. 2011 - 21.12.2013. A total of 48 potentially relevant risk factors were analyzed. Data on mortality and complications during hospitalization, and the rehospitalization rates were obtained from the Hospital Information System (BIS). Patients not registered within the BIS during 365 days from the operation day, were contacted by phone in order to gain insight about their status. A model for one-year operative risk assessment was created using multivariate binary logistic regression. The discriminative power of the model was tested using the Receiver Operating Characteristic (ROC) curves, with determination of the following parameters: cut-off value, sensitivity and specificity of the response variables. Results: The model is a good marker for the prediction of mortality one year after the operation (area = 0.712: p &lt;0.0005). The cut-off value is 3.04, the sensitivity was 0.700; specificity was 0.626. Hosmer - Lemeshov test for the created model is 0.125 (p&gt; 0.05). In a sample in which the model was developed, with regard to significant adverse cardiac and cerebrovascular events, the value of the area under the ROC curves were: area = 0.713; p &lt;0.0005, cut-off value 7.87, sensitivity of 0.667, specificity of 0.635. When the model is applied to the control group, the value of the area under the ROC curve is 0.518, p = 0.581. Hosmer-Lemeshov test for the created model shows the value of p=0.007. Conclusion: The model for mortality prediction is precise both when applied to the entire group of patients, and in relation to the type of cardiac procedure. The created model possesses good discriminatory power. The model shows best power of distinguishing patients with low and high risk in a subset of coronary surgery patients, and somewhat weaker power in combined surgery subset. The model for major cardiac and cerebrovascular events only works on the entire sample, in which it has been created, but cannot provide satisfactory answer to each patient individually, how likely the patient is to experience the event within a period of one year starting from the operation.</p>