Thesis (M.Eng. (Development and Management Engineering)--North-West University, Potchefstroom Campus, 2008.

Thesis (M.Eng. (Development and Management Engineering)--North-West University, Potchefstroom Campus, 2008.

Thesis (Master of Military Studies)-Marine Corps Command and Staff College, 2005. / Title from title page of PDF document (viewed on: Jan 6, 2010). "CSC 2005" "Subject Area Topical Issues" Includes bibliographical references.

Thesis (Master of Military Art and Science)-Army Command and General Staff College, 2007. / Title from title page of PDF document (viewed on: Jan 12, 2010). Includes bibliographical references.

Thesis (Ph. D.)--University of Oklahoma. / Bibliography: leaves 247-258.

Thesis (Ph. D.)--Pardee RAND Graduate School, 2005. / Includes bibliographical references (p. 126-135). Also available via the World Wide Web.

Em 2004 o governo federal anunciou um novo mecanismo para melhorar o acesso da população brasileira aos medicamentos, chamado de "Programa Farmácia Popular do Brasil" (PFPB) que disponibiliza um rol de produtos subsidiados pelo governo, utilizando ou não sistema de copagamento. O PFPB está dividido em três vertentes: (a) no setor público, chamada Rede Própria; (b) expansão em 2006, com o comércio farmacêutico denominado "Aqui Tem Farmácia Popular" (ATFP) e; (c) isenção de copagamento, em 2011, em todas as farmácias no âmbito do Programa, para anti-hipertensivos, antidiabéticos e antiasmáticos. Este estudo examinou o modelo de provisão de medicamentos na versão ATFP, comparando-o ao tradicionalmente praticado na Secretaria Municipal de Saúde do Rio de Janeiro (SMS-Rio), com vistas a avaliar seus custos para os setores públicos envolvidos. Foram levantados os gastos do Ministério da Saúde (MS) com pagamentos no Programa ATFP em fontes secundárias, como o Fundo Nacional de Saúde e a Sala de Apoio à Gestão Estratégica, de 2006 a 2012. Dados sobre o volume de pagamentos por medicamentos, perfil dos usuários atendidos e unidades farmacotécnicas (UF) dispensadas foram mapeados por contato direto com o Sistema Eletrônico do Serviço de Informações ao Cidadão. Estimativas dos custos da SMS-Rio, com aquisição, logística e dispensação de 25 medicamentos, restritas ao ano de 2012, foram realizadas. No período ocorreu forte expansão do Programa ATFP, tanto de unidades credenciadas, como de municípios cobertos, de 750% e 528%, respectivamente. Gastos federais com medicamentos no ATFP foram de aproximadamente R$ 3,4 bilhões, em valores ajustados para 31/12/2012. Houve inversão do fluxo dos pagamentos para entidades com matriz fora das capitais, representando aumento da capilaridade do Programa, e relativa concentração de pagamentos em grandes redes varejistas. No município do Rio de Janeiro, estes gastos foram superiores a R$ 260 milhões e, desde 2008, são maiores que as transferências do MS para aquisição de medicamentos básicos. Custos comparativos entre o menor Valor de Referência (VR) do Programa ATFP, e o custo estimado por UF na SMS-Rio dos medicamentos mostrou-se, na média geral, quase 255% vezes maior que o custo municipal. A comparação de custo foi mais favorável à SMS-Rio em 20 dos 25 itens comuns. Simulação considerando a demanda de cada medicamento consumido pela SMS-Rio em 2012 mostrou que, se a municipalidade os adquirisse pelo menor VR, incorreria em mais de R$ 95 milhões no custo global para os mesmos 25 produtos. O programa ministerial representou melhoria no acesso a medicamentos, mas os gastos expressivos repercutem em sua interface com o sistema descentralizado de financiamento da assistência farmacêutica. Alguns dos VR poderiam ser objetos de exame e avaliação, frente aos custos sistematicamente mais favoráveis nos valores levantados para a SMS-Rio.

Purpose: This thesis investigates the accessibility in the existing housing stock in Jönköping. The inventory was carried out with the help of the handbook Accessibility in Existing Housing abbreviated as TIBB.  The aim is to investigate the extent of accessibility problems based on the selection in Jönköping city with TIBB, and to calculate costs for eliminating these problems. This provides a basis that contributes to improving social sustainability. To achieve the goal, the following questions were asked: (1) How many multi-family houses from the selection of 40, 50 and 60s in Jönköping, have problems with accessibility according to TIBB? (2) What is the occurrence of different types of accessibility problems in the surveyed apartment buildings? (3) What might the cost estimate be to meet the requirements of TIBB, with and without subsidization for an elevator? Method: The main method that was used for this thesis where a case-study with observation. A total of 15 real estate’s where investigated and gave data that was analyzed and gave results through data processing. A document analysis was made for cost estimate to use the same calculations to obtain generalizable figures, as well as compare costs. To give background to the problem a literature study has been accomplished which confirms that there are accessibility problems in the existing housing stock. Findings: The findings that shows that all investigated multifamily housing in the city of Jönköping have accessibility problems. Since they only reach the lowest level in TIBB. The most common accessibility problems for the investigated housing are that the lowest and highest step of stairs aren’t marked, no place for a walker outside and inside the entry, no elevator and the thresholds are higher than 15 mm. To address accessibility problems with the highest possible accessibility level for each property, the cost was estimated to amount to approximately SEK 20.0 million without subsidization when installing an elevator. The cost amounts to approximately SEK 10.4 million with subsidization when installing a elevator. Implications: The conclusions drawn are that the identified the accessibility problems based on the selection in Jönköping's city must be addressed to accommodate housing for the increasing proportion of elderly people in the future. Real estate companies may raise the rent by a maximum of SEK 450 per month if an elevator is installed. For real estate companies to be able to adapt their properties, which contributes to improved social sustainability, the proposal for subsidization when installing an elevator needs to go through, otherwise property companies will lose at a loss if they address accessibility problems. Limitations: Limitations in the thesis is for the year’s forties, fifties and sixties and only five multifamily houses from each decade has been inventoried. Costs relate to many different factors from a socio-economic perspective and will be limited to reasonable rent increases according to the property managers. / Syfte: Detta arbete undersöker tillgängligheten av det befintliga bostadsbeståndet i Jönköping stad. Inventeringen utfördes med hjälp av handboken Tillgänglighet i befintligt bostadsbestånd, TIBB.  Målet är att undersöka omfattningen av tillgänglighetsproblem utifrån urvalet i Jönköping stad med TIBB, samt att beräkna kostnader för att eliminera dessa problem. Detta ger ett underlag som bidrar till en förbättring av den sociala hållbarheten. För att uppnå målet ställdes följande frågeställningar: (1) Hur många flerbostadshus utifrån urvalet från 40-, 50- och 60-tal i Jönköping stad, har problem med tillgängligheten enligt TIBB? (2) Vad är förekomsten av olika typer av tillgänglighetsproblem i de undersökta flerbostadshusen? (3) Vad kan kostnadsuppskattningen vara för att uppfylla kraven i TIBB, med och utan subventionering för en hiss?  Metod: Antalet fastigheter som undersökts var 15 stycken. En fallstudie med observation gav rådata som analyserats och gett resultat genom databearbetning. En dokumentanalys gjordes inför kostnadsuppskattningen för att använda sig av samma beräkningar för att kunna få fram generaliserbara siffror, samt jämföra kostnader. För att ge bakgrund till problemet har en litteraturstudie utförts vilket bekräftar att det finns tillgänglighetsproblem i det befintliga bostadsbeståndet.  Resultat: Resultatet utifrån arbetet visade att samtliga undersökta flerbostadshusen i Jönköping har problem med tillgängligheten då de endast uppnådde den lägsta nivån enligt TIBB. De vanligaste tillgänglighetsproblemen för de undersökta flerbostadshusen är att trappans nedersta och övertas steg är ej markerade, avsaknad av uppställningsplats för rollator utanför och innanför entrén, hiss saknas samt är trösklarna över 15 mm. För att åtgärda tillgänglighetsproblemen med högsta möjliga tillgänglighetsnivå för respektive fastighet beräknades kostnaden fram till cirka 20,0 miljoner kronor utan subventionering vid installation av hiss. Kostnaden uppgår till cirka 10,4 miljoner kronor med subventionering vid installation av hiss.  Konsekvenser: Slutsatserna som dras är att de identifierade tillgänglighetsproblemen utifrån urvalet i Jönköpings stad måste åtgärdas för att tillgodose bostäder för den ökande andelen äldre människor i framtiden. Fastighetsföretagen får höja hyran med max 450 kronor i månaden om hiss installeras. För att fastighetsbolagen ska kunna tillgänglighetsanpassa sina fastigheter, vilket bidrar till en förbättrad social hållbarhet, behöver förslaget till subventionering vid installering av hiss gå igenom, annars kommer fastighetsbolagen gå med förlust om de åtgärdar tillgänglighetsproblemen.  Begränsningar: Avgränsningar i arbetet är utifrån årtal, 40-, 50- och 60-talet samt att enbart fem objekt från varje tidsepok inventeras. Kostnader berör många olika faktorer inom ett samhällsekonomiskt perspektiv och kommer i arbetet begränsas till rimliga hyreshöjningar enligt fastighetsförvaltarna.

Renovation of the existing buildings in Sweden represents a great potential to achieve the energy efficiency and carbon emission targets set by the European Union and the Swedish government. The Energy Performance Contracting (EPC) is regarded as an efficient way to manage and to outsource the risks of energy efficiency (EE) measures. The thesis aims to identify the theoretical framework of EPC in the Swedish scenario and, through a real case, develop a model that relates EE measures and its results considering the capital investment versus running costs of renovation projects. The work is based on the incorporation with the Morastrand AB. The research expects to assess EPC processes and measures as in Energy Service Companies (ESCO) and consequently help in the decision making and the management of the projects. The thesis is composed of two parts. The first part identifies the theoretical framework of energy contract models focusing on the EPC, while a case study with Morastrand AB is subsequently presented. It is suggested one approach for the preliminary comparison of different renovation measures in EE projects, corresponding to the first step of the planning phase of an EPC. General recommendations and sensitive factors were identified and can assist Morastrand AB to effectively implement EE projects in the future. For orienting investments, the Lifecycle Cost Analysis (LCCA) is a method to study solutions under economic aspects and further it can be extended to the complete Lifecycle Assessment of the upcoming projects. The theoretical framework of the EPC is composed by identifying the projects, performing the technical analysis, determinizing the potential in energy savings, deepening the analysis with auditions, tendering the project, designing and executing the project, commissioning, operating and supporting the systems with constant monitoring and maintenance. The biggest challenge for the EPC in Sweden is the relation between the ESCOs and their clients. The figure of the facilitator could improve the results and balance the knowledge gap between the parts. The actors of these projects are the ESCO, the client, the facilitator and the financing part. In Sweden, very frequently the client finances the operation. There are a few models of contracting, and the most popular are guaranteed savings and shared savings. The thesis performed the LCCA of three options for window replacement in a building at the end of its lifespan. The results show that the trends in prices and interest rates are sensitive factors. In this case, the projects with higher initial investments were more profitable. Those solutions can shield the company against energy prices escalates and contribute to the green policies.

Made available in DSpace on 2015-07-22T20:50:12Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-10-27 / Objetivo: Descrever os achados mamográficos, avaliar os indicadores de desempenho das mamografias e descrever o custo direto dos mutirões de mamografia dos anos de 2005 e 2006 na Direção Regional de Saúde de Marília. Métodos: Trata-se de um estudo observacional transversal dos achados radiográficos dos mutirões de mamografia dos anos de 2005 e 2006, na região da Direção Regional de Saúde de Marília. Foram realizadas 11.952 mamografias em 8 serviços, em mulheres dos 37 municípios da região, a classificação do resultado da mamografia foi pelo sistema padronizado BI-RADS, os indicadores de desempenho analisados foram os utilizados em auditoria de resultados e a análise de custos foi baseada nos valores pagos pelo Sistema Único de Saúde com base nas Tabelas SIA/SUS e SIH/SUS de 2005. Os dados foram armazenados em planilhas do Excel e posteriormente analisados utilizando o pacote estatístico SPSS Versão 15. Resultados: Das 11.592 mamografias, 9,35% (1.117) foram classificadas na Categoria BI-RADS 0, nas categorias BI-RADS 1 e 2 foram 87,86% (10.501), na categoria BI-RADS 3 foram 2,53% (302) e nas categorias 4 e 5 de 0,26%. A maior participação nos mutirões foi de mulheres na faixa etária de 40 a 49 anos. As faixas etárias de 50 a 59 e 60 a 69 anos representaram 45,59% do total. O Valor Preditivo Positivo dos BI-RADS 4 e 5 foram de 29,63% e 50% respectivamente. Foram diagnosticados 10 casos de câncer de mama (0,84 por 1.000 mamografias), 70% estavam na faixa etária de 50 a 69 anos. O custo total desses mutirões e acompanhamento foi de R{dollar} 450.019,91, sendo R{dollar} 431.467,20 com o pagamento de 11.952 mamografias e R{dollar}18.552,71 para a investigação diagnóstica de 29 casos suspeitos, para o tratamento de três casos de tumores benignos e de 6 casos de câncer. O custo de cada caso diagnosticado foi de R{dollar} 43.268,10. Conclusões: A prescrição médica de exames mamográficos fora da faixa etária recomendada pelo Ministério da Saúde, a baixa proporção de casos de câncer de mama detectados pelos exames e o alto custo de cada caso diagnosticado apontam para a necessidade de implementação de programas de rastreamento efetivos e de qualidade da mamografia nesta região do estado, investimento em programas de capacitação médica em todos os níveis de atenção à saúde, garantia de acesso rápido aos centros secundários e terciários para atendimento integrado e resolutivo dessa população. / Objective: to describe the mammography findings, and to evaluate the performance indicators of the mammographies and describe the direct cost of the mammography campaigns in 2005 and 2006 realized by the Regional Health Section of Marilia. Methods: It is a cross sectional observational study of the radiographic findings during the mammography campaigns of 2005 and 2006, in the Regional Health Section of Marilia. A total of 11.952 mammographies, in 8 health institutions, comprising women from 37 nearby municipalities and the classification of the mammographies outcomes was done according to BI-RADS; the performance indicators analyzed were the ones employed in outcomes auditory and the cost analysis was based on the amount paid by the Unique Health System (SUS), based on the Tables SIA/SUS of 2005. The data were stored in Excel and furthermore analyzed, employing the statistical method SPSS, version 15. Results: From the 11.592 mammographies, 9.35% (1.117) were classified into BI-RADS 0 and for BI-RADS 1 and 2 87.86% (10.501), for the classification BI-RADS 3, 2.53% (302) and for classification 4 and 5, was 0.26%. The highest participation on the campaign comprised women from 40 to 49 years old. Women whose ages ranged from 50 to 59 and 60 to 69 represented 45.59%. The predictive positive value of BI-RADS 4 and 5 were 29.63 and 50% respectively. A total of 10 cases of breast cancer were diagnosed (0.84 per 1000 mammographies), 70% of the ages ranged from 50 to 69 years. The cost of these campaigns and the follow-up cost totaled R{dollar} 450.019.91, considering that R{dollar} 431.467.20 was destined for he payment of 11.952 mammographies and R{dollar}18.552.71 for the diagnoses of 29 suspicious cases, for the treatment of 3 cases of benign tumors and 6 cases of cancer. The cost of each diagnosed case was R{dollar} 43.268.10. Conclusion: The medical prescription for mammographic exams out of the age range recommended by the Ministry of Health, the low proportion of breast cancer cases detected by the exams and the high cost of each diagnosed case, indicate the necessity of implementation of effective screening programs in this region of the state, investing in specific medical programs comprising all levels of health care and fast access to secondary and third party health units for integrated and effective attendance to this specific population. / TEDE / BV UNIFESP: Teses e dissertações