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The Policy Research of Quality Management from Multiphasic Environmental Assessment Procedure in Elderly Care FacilitiesTsay, Shwu-feng 20 October 2006 (has links)
The objective of this study is to test if the hypothesis of the environmental gerontology theory can be applied to a cross-cultural environment. This study examined the applicability and functionality of the Multiphasic Environmental Assessment Procedure (MEAP), a tool based on the environmental gerontology theory, and assessed the quality of elderly care facilities in Taiwan. Special emphasis was placed in examining the functionality of the MEAP from the cross-cultural standpoint and also in identifying the associations or potential impacting factors of care quality. This is the first study with the application of the MEAP to examine the quality of the two major care facilities in Taiwan. Results of this study provide not only an insight into the characteristics of the elderly care facilities ,and a reference for policy making and regulation, but also valuable data for cross-cultural comparisons.
The study employed the MEAP to achieve the stated objectives and further evaluated the differences in the characteristics of the two major elderly care facilities, namely the nursing homes and assisted-living facilities in Kaohsiung city in Taiwan. This cross-sectional research was conducted with questionnaires by 687 employees (excluding foreign workers) and 429 residents in 35 nursing homes and 41 assisted living facilities in Kaohsiung city were interviewed. Participants were selected from residents who were conscious and without cognitive disorder for face-to-face questionnaire interviews. For facilities with ten or more residents, 50% of the eligible residents were selected for this interview. For facilities having less than ten residents, all those qualified residents were interviewed. Results were analyzed on the basis of institutional units rather than the individual basis.
Results showed that the MEAP effectively evaluated the associations of the multiple environmental factors with the quality of life of the two major elderly care facilities in Kaohsiung city. Standardized multiple quality indexes mode showed that the assisted-living facilities have better overall quality than nursing homes do. The major findings are:
1.The major residents of elderly care facilities in Kaohsiung city were the socioeconomically less privileged residents, including house wifes, the disabled, and widowed. The service most needed was personal care such as bathing.
2.Based on the MEAP, a total of eight significant variables were compared between nursing homes and assisted living facilities. Among these variables, nursing homes were better in staff resource than that of the assisted living facilities. Assisted-living facilities were better in all other seven variables including functional abilities, activities in community, acceptance of problem behavior, physical amenities, social-recreational aids, and orientational aids and staff facilities.
3.The staff members of both nursing homes and assisted living facilities have better SCES than that of their residents.
4.Compared to assisted living facilities, the nursing homes were superior in staff level and staff resources but inferior in comfort, security, and control. No differences were observed in services, autonomy, rapport and morale.
5.The characteristics of organizational management, such as ownership, type and size, were important impacting factors of care quality. The nonprofit-nursing homes were better scored in six of the eight quality indexes than the ones owned by privately-for-profit.
6.Factors that influenced the quality of the nursing homes include number of workers, number of beds, number of residents, ownership, functional abilities, actively level, activities in community, occupancy rate and type of elderly care facility.
7.Factors that influenced the quality of assisted living facilities include occupancy rate, number of residents, number of workers, activity level and type of elderly care facility.
8.The regression model for the outcome of multiple environmental quality indexes with the structure and process indexes is related in nursing homes. The regression model indicates that the model significantly predicted outcome quality index (morale) (R2 = 49.4%). Both structure quality index (comfort and safety) and process quality index (autonomy and rapport) were significant predicting factors of outcome quality index (morale). Autonomy was a negative predicting factor.
9.Standardized multiple environmental quality index indicated that based on the MEAP, assisted living facilities had a little bit higher quality than that of nursing homes in Kaohsiung city.
In conclusion, this study confirmed the hypothesis that the MEAP can be applied effectively to evaluate the quality of elderly care facilities in a cross-cultural environment. However, cultural differences do have an impact on the functionality of the tool. Results of this study indicate that the two major elderly care facilities in Kaohsiung city have relatively similar characteristics, but the assisted living facilities are slightly better in overall quality than that of nursing homes. The major factors that impact the quality of elderly care facilities are the operational characteristics and efficience. Results of this study indicate that the MEAP provides very useful indicators for assessing the quality of elderly care facilities in Taiwan, especially for nursing homes. The MEAP identified more structure and process-related impacting factors than outcome-related impacting factors in this study. Concerning cultural difference, the MEAP could be benefited from some modification in certain measurements, especially in facility atmosphere(SCES), when applied in Taiwan.
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Índice de Qualidade Ambiental para avaliação de metais e semimetais em sedimentos do Complexo Estuarino de Santos e São Vicente (SP, Brasil) / Environmental Quality Index to evaluate heavy metals in sediments from Santos São Vicente Estuarine Complex (SP, Brazil)Kim, Bianca Sung Mi 02 February 2017 (has links)
No estudo da contaminação ambiental utilizando sedimento superficial é preciso diferenciar a componente antrópica da litogênica. A fim de minimizar a influência litogênica e facilitar a interpretação dos resultados, normalizações e a utilização de índices de qualidade ambiental são normalmente aplicados. O objetivo deste estudo foi calcular, através dos teores de metais, diferentes tipos de índices e avaliar sua aplicabilidade em regiões estuarinas degradadas, tais como a região da Baixada Santista, na qual apresenta intensa urbanização, industrialização e atividades turísticas exercendo pressão do sistema como um todo. Para isso, níveis de metais e As foram quantificados por ICP-OES e parâmetros geoquímicos como COT, porcentagem de finos, NT e δ13C e δ15N também foram obtidos. Foram aplicados oito Índices de Qualidade Ambiental e a porcentagem de finos mostrou-se essencial no cálculo destes índices, visto que é o fator que mais influencia no controle da distribuição natural de metais no sedimento. De uma maneira geral, a contaminação existente se restringe no interior do estuário, na região do Complexo Industrial de Cubatão, e sua utilização é adequada para regiões estuarinas degradadas. No estudo da contaminação em sedimentos, características como normalização pelo tamanho de grão e por um valor de referência resultando em um único valor mostraram-se essenciais. O índice Sediment Pollution Index considera todos estes, mostrando-se completo para esta finalidade. / To study trace metal contamination in superficial sediment samples it is necessary to distinguish the anthropogenic and lithogenic contributions. Normalization methods and environmental quality indices are applied in order to minimize the lithogenic influence and simplify the interpretation. The aim of this study is to apply environmental quality indices, using levels of metals, and evaluate their applicability on estuarine environments as Baixada Santista in which industrial, touristic activities and urbanization exert pressure on the system as a whole. Levels of metals and As were analyzed by ICP-OES and geochemical parameters as TOC, NT, mud content, δ13C and δ15N were also obtained. A total of eight indices were applied and the mud content was essential on environmental studies, since it is the main factor on controlling the natural distribution of trace metals in sediments. In general, the prevailing contamination was confined in the inner part of the estuary around Cubatão Industrial Complex and the use of indices are suitable for estuarine system studies. On sediment contamination studies, features as normalization using a background value and the grain size, gathering all levels in one showed essential. The Sediment Pollution Index considers all, being a good index to this purpose.
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Índice de Qualidade Ambiental para avaliação de metais e semimetais em sedimentos do Complexo Estuarino de Santos e São Vicente (SP, Brasil) / Environmental Quality Index to evaluate heavy metals in sediments from Santos São Vicente Estuarine Complex (SP, Brazil)Bianca Sung Mi Kim 02 February 2017 (has links)
No estudo da contaminação ambiental utilizando sedimento superficial é preciso diferenciar a componente antrópica da litogênica. A fim de minimizar a influência litogênica e facilitar a interpretação dos resultados, normalizações e a utilização de índices de qualidade ambiental são normalmente aplicados. O objetivo deste estudo foi calcular, através dos teores de metais, diferentes tipos de índices e avaliar sua aplicabilidade em regiões estuarinas degradadas, tais como a região da Baixada Santista, na qual apresenta intensa urbanização, industrialização e atividades turísticas exercendo pressão do sistema como um todo. Para isso, níveis de metais e As foram quantificados por ICP-OES e parâmetros geoquímicos como COT, porcentagem de finos, NT e δ13C e δ15N também foram obtidos. Foram aplicados oito Índices de Qualidade Ambiental e a porcentagem de finos mostrou-se essencial no cálculo destes índices, visto que é o fator que mais influencia no controle da distribuição natural de metais no sedimento. De uma maneira geral, a contaminação existente se restringe no interior do estuário, na região do Complexo Industrial de Cubatão, e sua utilização é adequada para regiões estuarinas degradadas. No estudo da contaminação em sedimentos, características como normalização pelo tamanho de grão e por um valor de referência resultando em um único valor mostraram-se essenciais. O índice Sediment Pollution Index considera todos estes, mostrando-se completo para esta finalidade. / To study trace metal contamination in superficial sediment samples it is necessary to distinguish the anthropogenic and lithogenic contributions. Normalization methods and environmental quality indices are applied in order to minimize the lithogenic influence and simplify the interpretation. The aim of this study is to apply environmental quality indices, using levels of metals, and evaluate their applicability on estuarine environments as Baixada Santista in which industrial, touristic activities and urbanization exert pressure on the system as a whole. Levels of metals and As were analyzed by ICP-OES and geochemical parameters as TOC, NT, mud content, δ13C and δ15N were also obtained. A total of eight indices were applied and the mud content was essential on environmental studies, since it is the main factor on controlling the natural distribution of trace metals in sediments. In general, the prevailing contamination was confined in the inner part of the estuary around Cubatão Industrial Complex and the use of indices are suitable for estuarine system studies. On sediment contamination studies, features as normalization using a background value and the grain size, gathering all levels in one showed essential. The Sediment Pollution Index considers all, being a good index to this purpose.
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Subsidios para avaliação da qualidade ambiental de campi universitariosRodrigues, Maria Aparecida 28 February 2002 (has links)
Orientadores: Emilia Rutkowski, Orlando Fontes Lima Junior / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Engenharia Civil / Made available in DSpace on 2018-08-03T15:55:49Z (GMT). No. of bitstreams: 1
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Previous issue date: 2002 / Resumo: As Universidades, pelas suas atividades de ensino, pesquisa e extensão desempenham papel importante na promoção da sustentabilidade do desenvolvimento da sociedade. No século XX, em sua última década, um número representativo de universidades implementou políticas ambientais ou processos de planejamento e gestão ambiental em seus campi. Esses processos se fundamentaram em princípios de minimização de impactos, conservação e uso adequado dos recursos naturais, obediência à legislação ambiental, proteção do meio e da biodiversidade, conscientização com motivação e comprometimento ambiental da comunidade universitária. Os programas e políticas propostas para as universidades, internacionais e nacionais, em seus macro-objetivos se compromissaram com a sustentabilidade do meio, estabelecendo um conjunto de indicadores - ambientais, sociais, institucionais e econômicos - como instrumentos de avaliação de seus campi. o presente trabalho pretende explorar a possibilidade de avaliar a qualidade ambiental de campi universitários através de indicadores ecológicos e sócio-econômicos com base na metodologia Battelle. Como estudo de caso a metodologia foi aplicada, com as adaptações necessárias, para avaliar a qualidade ambiental da Cidade Universitária Zeferino Vaz campus de Barão Geraldo da Unicam / Abstract: Universities have an important role to promote the sustainability of society's development. In the last decade of the 20th Century, environmental policies were implemented by an expressive number of universities. These processes were based on impacts minimization, natural resources conservation, obedience to the environmental legislation, biocomplexity protection, conscientiousness and motivation of their community to environmental commitments. The universities programs and policies aim environmental sustainability, establishing a set of indicators to evaluate their campuses. The present work intends to examine the universities environmental quality through Battelle Methodology. Cidade Universitária "Zeferino Vaz", the campus of UNICAMP at Barão Geraldo district of Campinas/SP (Brasil), is the case of study of the present work / Mestrado / Saneamento e Ambiente / Mestre em Engenharia Civil
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Dimensionering och optimering av ett solcellssystem för en industribyggnad i Mellansverige : En simuleringsstudieÖstlund, Christine January 2019 (has links)
Vid omställningen till förnybara energisystem är solkraften som energikälla ett möjligt alternativ, för att uppnå klimat och energimålet med 100% förnybar energiproduktion år 2040. Detta är något regeringen eftersträvar genom infört bidrag i form av subventioner och skattereduktion vid installation av solceller. I denna fallstudie undersöks vilken effekt två olika solcellssystem har för en industribyggnad i Mellansverige, där studien tar hänsyn till ekonomisk-, teknisk- och klimatrelaterade aspekter. Systemen dimensioneras i strävan av optimala förhållanden samt av byggnadens begränsningar, med kostnadsförslag från en lokal återförsäljare få en bild av om återbetalningstiden är motiverande i frågan. Den lokala klimatpåverkan analyseras med växthusgasutsläpp i fokus, detta genom resultat av litteraturstudie. Dimensioneringen av solcellssystemen baseras på empiriskt material av studieobjektet och simuleras i programmet Winsun PV. Studien resulterade i två storlekar på system med tillhörande kostnadsförslag som ligger till grund för återbetalningstiden. System fall 1 dimensionerades i syfte att hålla den nominella systemeffektens storlek till 255 kWp, detta för att undgå extra energiskatt. Systemet gav ett årligt utbyte av 228 MWh/år som gav återbetalningstid mellan 18 – 22,5 år. Systemet simulerades med optimal lutningsvinkel av 39° i 15° azimutriktning av modulerna. System fall 2 dimensionerades till 1200 kWp i syfte att täcka effektivt användbar takyta, med årligt utbyte på 886 MWh/år och återbetalningstiden blev mellan 22,5 – 25,1 år. Modulerna simulerades med takets lutning ±4,7° i -15° azimutriktning. För att solceller ska ge ett mer lönsamt utbyte i högre latituder krävs en vidare effektivitetsutveckling för solcellstekniken samt ett förlängt investeringsstöd från Länsstyrelsen för framtida installationer. Om solcellssystemet ger en positiv inverkan på det ekologiska fotavtrycket beror av vart solcellen är tillverkad samt vilken elmix som byts ut mot den producerade solenergin. / When converting to renewable energy systems, solar power as an energy source is a potential option; in order to achieve the climate and energy goal with 100% renewable energy production in year 2040. This is something the government try to achieve by making installation of solar cells more attractive through allowances such as subventions and tax reduction. The aim of this study was to analyze the effect of solar cell system on an industrial building in the midst of Sweden, in regard of economical-, technical- and climate related points of view. This was performed by replacing purchased electricity with locally produced electricity, where optimal circumstances for the solar power systems and the limits of the building has been taken into consideration during the dimensioning. With cost suggestions from a local authorized dealer the magnitude of the pay off time as a motivating factor was estimated. The local climate impact will be investigated through a litterature study, focusing on green house gas emissions. The dimensioning of the solar cell systems were based on empirical input from measurements in combination with documented data regarding the industrial building and simulated in the program Winsun PV. The study resulted in two different-sized systems with cost sheets that formed the basis for the calculated pay off time. System case 1 was dimensioned to keep the size of the nominal system effect to 255 kWp, this to avoid extra energy tax. The system gave an annual exchange of 228 MWh / year which gave the repayment period between 18 - 23 years. The system was simulated with an optimum angle of 39 ° in 15 ° azimuth direction of the modules. System case 2 was dimensioned to 1200 kWp in order to cover the effective usable surface of the roof, the system gave an annual exchange of 886 MWh / year and the repayment period was 22.5 - 25.1 years. The modules were simulated with the roof slope ± 4.7 ° in -15 ° azimuth direction. A further efficiency development for solar cell technology is required as well as an extended investment support from the County Administrative Board, to provide a more profitable exchange of solar cell systems in higher latitudes. If the solar cell system has a positive effect on the ecological footprint depends on where the solar cell is made and which electrical mix replaced by the produced solar energy.
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O contexto socioambiental da tuberculose pulmonar em Juiz de Fora (MG) / The social and environmental context of pulmonary tuberculosis in Juiz de Fora (MG)Lima, Maria de Fátima Furtado 18 December 2013 (has links)
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Previous issue date: 2013-12-18 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Juiz de Fora (JF) had a high prevalence of tuberculosis (TB) in the set of municipalities
in the state of Minas Gerais (MG) and Brazil, whose causes are not known. Get to know
them and analyze the relationships involving environmental quality of neighborhoods
and areas of the municipality of JF (MG), with a higher incidence of pulmonary TB, the
public health policy of Primary Care (AB) in controlling the disease, with focus on the
profile of Community Health Agents (ACS) and the carriers of the disease, especially
those who discontinue treatment constitute the main scope of this thesis. How socioenvironmental
context proceeded to the rescue of knowledge about TB, its introduction
in Brazil and the historical evolution of the treatment, the current international situation
and the recommendations of international organizations especially the World Health
Organization (WHO) for countries with a high burden of disease, such as Brasil. The
text that results from research on TB in JF uses theoretical sources from different areas
of knowledge, empirical research, document and database of the Ministry of Health, in
consultation with the reporting forms / TB research model SINANand statistical
analyzes of the type control case, calculating the "odds ratio" as a measure of strength of
association between the correlated parameters. The results revealed multifactorial
causation. The TB concentrates in the neediest regions in that the Environmental
Quality Index (IQA) is low revealed by unhealthy housing, lack of sanitation, low
education and income. The profile of these ACS integrated into to the healthcare teams
at the level the AB confirms frailties in their knowledge, insufficient number for
demand and low involvement in disease control. The sociodemographic and clinical
epidemiological profile of TB patients related to treatment dropout reveal prevalence of
self-administered treatment to the detriment the supervised treatment as determined the
National Programme Tuberculosis Control (PNCT) and the predominance of the more
socioeconomically disadvantaged groups. It can be concluded that TB disease is in fact
associated with poverty and somewhat neglected by the national public policy.
Recommendations are done to resolve the causes found, as the need for awareness
among the local health authorities and investment in trainings for family healthcare
teams, addition to initiatives in health education for the community in general, mainly
as to the benefits arising from the early diagnosis and supervised treatment. At the same
time is recommended improve infrastructure conditions in the regions where the IQA is
low. / Juiz de Fora (JF) apresentou elevada prevalência da tuberculose (TB) no conjunto de
municípios do estado de Minas Gerais (MG) e do Brasil, cujas causas não são
conhecidas. Buscar conhecê-las e analisar as inter-relações envolvendo a qualidade
ambiental dos bairros e regiões do município de JF (MG) com maior incidência da TB
pulmonar, a política pública de saúde da Atenção Básica (AB) no controle da doença,
com foco no perfil dos Agentes Comunitários de Saúde (ACS) e dos portadores da
doença, sobretudo daqueles que abandonam o tratamento, constituíram-se no escopo
principal desta tese. Como contexto socioambiental procedeu-se ao resgate de
conhecimentos acerca da TB, sua introdução no Brasil e a evolução histórica do
tratamento, a situação internacional atual e as recomendações dos organismos
internacionais especialmente da Organização Mundial de Saúde (OMS) para os países
com alta carga da doença, como é o caso do Brasil. O texto que resulta da investigação
sobre a TB em JF utiliza fontes teóricas de diversas áreas do conhecimento, da pesquisa
empírica, de documentos e banco de dados do Ministério da Saúde, de consulta às fichas
de notificação/investigação da TB modelo SINAN e análises estatísticas do tipo caso
controle, com cálculo do “Odds Ratio” como medida de força de associação entre os
parâmetros correlacionados. Os resultados obtidos revelaram causalidade multifatorial.
A TB concentra-se nas regiões mais carentes e pobres em que o Índice de Qualidade
Ambiental (IQA) é baixo, revelado por moradias insalubres, insuficiência de
saneamento básico, renda e escolaridade baixos. O perfil dos ACS integrados às equipes
de saúde no nível da AB confirmam fragilidades no seu conhecimento, número
insuficiente para a demanda e baixo envolvimento no controle da doença. O perfil e os
aspectos sociodemográficos e clínicos epidemiológicos dos portadores de TB ligados ao
abandono do tratamento, revelam prevalência do tratamento autoadministrado em
detrimento ao tratamento supervisionado como determina o Programa Nacional de
Controle da Tuberculose (PNCT) e o predomínio dos grupos socioeconomicamente
mais carentes. Conclui-se a TB é de fato doença associada à pobreza e de certo modo
negligenciada pela política pública nacional. Recomendações são feitas para resolver as
causas encontradas, como necessidade de conscientização das autoridades de saúde
locais e investimento em treinamentos para as equipes de saúde da família, além de
iniciativas de educação em saúde para a comunidade em geral, sobretudo quanto aos
benefícios advindos do diagnóstico precoce e tratamento supervisionado. Paralelamente
recomenda-se melhorar as condições de infraestrutura nas regiões onde o IQA é baixo.
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Qualidade do solo e percepção socioambiental de produtores e agentes rurais no cultivo de fumo em Pilões/RN / Soil quality and socio-environmental perception of producers and rural agents in smoke cultivation in Pilões /RNPontes, Nadja Cristina 30 August 2016 (has links)
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Previous issue date: 2016-08-30 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Environmental quality has been much discussed as a result of human awareness of the sustainable use of natural resources, although restricted conservation actions are being developed. In the panorama of environmental impacts from agriculture it is common to observe the decrease in soil quality and the difficulty of quantifying the loss of these attributes as well as the environmental partner perception of the main actors in the rural context. In view of this problem, the objective was to evaluate the chemical attributes of the soil In tobacco growing areas based on soil environmental quality index, as well as to evaluate the environmental partner impact of this activity according to the perception of farmers and rural agents of the city of Pilões/RN through semi-structured interviews. It was possible to improve the environmental quality for P, Ca, Mg and Al in relation to the native forest, unlike the changes observed for CE, pH and Al + H, which did not present favorable results for soil quality. According to the environmental partner perception of the producers and rural agents, the cultivation of tobacco has negatively altered the environment in which they live, even though these farmers know good practices for the preservation of the soil. According to the interviewees, the main dissatisfaction generated by the tobacco company installed in the municipality was the absence of contribution to the social development of Pilões, however, tobacco production represented a major source of income and job creation for the municipality of Pilões. / A qualidade ambiental tem sido bastante discutida em decorrência da conscientização humana do uso sustentável dos recursos naturais, ainda que restritas ações de conservação estejam sendo desenvolvidas. No panorama de impactos ambientais provenientes da agricultura é comum observar a diminuição da qualidade do solo e a dificuldade de quantificar a perda desses atributos bem como a percepção socioambiental dos principais atores do âmbito rural Diante dessa problemática, objetivou-se avaliar os atributos químicos do solo em áreas de cultivo de fumo com base em índice de qualidade ambiental do solo, bem como avaliar o impacto socioambiental dessa atividade segundo a percepção de produtores e agentes rurais do município de Pilões/RN através de entrevistas semiestruturadas. Foi possível conferir melhoria da qualidade ambiental para P, Ca, Mg e Al em relação à mata nativa, diferentemente das alterações verificadas para CE, pH e Al+H, que não apresentaram resultados favoráveis à qualidade do solo. Conforme a percepção socioambiental dos produtores e agentes rurais, o cultivo de fumo alterou negativamente o ambiente em que vivem apesar desses agricultores conhecerem boas práticas para a preservação do solo. De acordo com os entrevistados a principal insatisfação gerada pela empresa fumageira instalada no município foi a ausência de aporte ao desenvolvimento social de Pilões, contudo a fumicultura representou maior fonte de renda e geração de empregos para o município de Pilões / 2017-03-31
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