Thesis (MTech (Tourism))--Cape Peninsula University of Technology, 2015. / Local business concerns and perceptions are generally neglected in relation to mega-event research, as most studies have, so far, focused on the broader economic impacts, as well as on the social impacts, and, more recently, on the environmental impacts of mega-events. South Africa being afforded the opportunity to host the 2010 FIFA World Cup™ created much excitement for all, and especially so for the business market. This is because the market in question is at the forefront of providing goods and services to the much anticipated increased number of tourists, whether such goods and services consist of the provision of accommodation, food and beverage, or entertainment, as well as ancillary products and services. The focus of the study was on gaining an understanding of the awareness and the impacts of the 2010 FIFA World Cup™ on businesses, especially those situated within close proximity of the Cape Town Stadium. The study was conducted three months before, and three months after, the event. The investigation explores the level of perceptions, attitudes, and experiences of the businesses in relation to the 2010 FIFA World Cup™, while simultaneously highlighting their experiences with the event. The primary objective of this approach was to ascertain whether there were any changes between the initial perceptions, and the experiences, among businesses in relation to the event. The five objectives guiding the study involved investigating: (1) business managers’ and owners’ perceptions and experiences of the event; (2) the impacts of the World Cup on businesses; (3) the level of business support for the event; (4) the impacts of leveraging initiatives on businesses; and (5) recommendations aimed at maximising the opportunities granted by future mega-events for businesses. During the pre- and post-event study, a total of 145 surveys were administered to the business owners and managers of SMMEs, using the stratified random sampling method, of which, 72 responded during the pre-event study and 104 during the post-event study.

O presente documento apresenta sucintamente os conceitos e definições das geotecnologias, com ênfase em duas ferramentas tecnológicas de suporte a utilização desta metodologia: o geoprocessamento e o sistema de informação geográfica (SIG). A proposta metodológica da utilização da geotecnologias teve como objetivo a observação dos fenômenos dos megaeventos esportivos, que serão sediados na cidade do Rio de Janeiro, a Copa do Mundo de Futebol 2014 e os Jogos Olímpicos e Paralímpicos de 2016, bem como atender as exigências de conclusão da tese de doutorado. Para tal, foram realizados dois artigos que observaram o fenômeno megaeventos esportivos no espaço geográfico da cidade do Rio de Janeiro. O primeiro verificou as mudanças urbanas com as características socioeconômicas ocorridas nas proximidades do parque olímpico, a partir de uma visão temporal da década de 2000. O segundo artigo observou o espaço geográfico da cidade junto aos sítios olímpicos e as mudanças climáticas que vêm ocorrendo nesses locais, através da observação da evolução da temperatura de superfície com a construção de mapas termais, e de dados meteorológicos. / This paper presents the concepts and definitions of geotechnology , with emphasis on two different tools to support the use of this methodology: geoprocessing and geographic information system (GIS ) .The use of this methodological proposal, the geotechnologies, had as objective at observing the phenomena of mega sporting events that will be hosted in the city of Rio de Janeiro, World Cup Football 2014 and the Olympic and Paralympic Games in 2016, as well as meet the requirements of completion of the doctoral thesis. To this end, two articles which observed the phenomenon sports mega-events in the geographic space of the city of Rio de Janeiro were performed. The first verified the urban changes with socioeconomic characteristics, which occurred near the Olympic Park, from a temporal view of the 2000s. The second article noted the geographic area of the city surrounding to the Olympic site and the climate changes that are occurring in these locations by checking the evolution of the surface temperature with the construction of thermal maps and weather data.

The concern with public safety somehow defines the way of life and also the social relationships. From medieval walled cities to contemporary gated communities, it is possible to observe different strategies to prevent invasions, goods appropriations or even physical violence. There also is a complete normative setting, which responds to a historical and social time, in order to define what a crime is. In face of an event characterized as criminal there is, at least, two perspectives to be considered, one related to the involvement and reaction of the people directly involved and another one concerning the socio-institutional treatment of such event, both reflecting and revealing power relations. This study assumes that the reaction to the event is a remarkable fact and it brings revealing elements of other past events and for future projections experience both in the individual aspect or in relation to historical and collective elements. It considers, from the autobiographical testimony of people involved in criminal situations, what is collective and what is historical on such experiences. The crime in this study is considered from its institutional judgement and it brings revealing elements of a collective history. Four different people, frequent users of the several Crime Prevention Centers of Uberlândia, were asked to speak about their life histories, to talk about the crime for which they are being penalized and to talk on the institutional treatment related to the same one. The Oral Life History method was the basis for the interviews. Specialized authors on Psycho-criminology and on Critical Psychology were the main theoretical support chosen for the interviews analysis and reflections around the crime, subjectivity, interdisciplinarity and also the role of the psychologist in Law and Public Safety institutions. From such analysis, it is observed that there is a wide path redefinition of some concepts and professional positions regarding the various elements of a crime. Among the professionals, the psychologist, in such field, must assume the political role where he is inserted. It is concluded that interventions in public safety rely on facts, which are not always the most significant events for the involved individuals, and that concentrates almost all of their actions in individual interventions, insufficient to deal with the criminal matters, which are much more complex and involve historical and collective variables that go far beyond to the individuals directly involved on it. / A preocupação com a segurança pública é aspecto definidor de modo de vida e de relações sociais. É possível perceber estratégias de evitar invasões, apropriações materiais ou a violência física na própria estruturação das cidades e na forma com que as pessoas se relacionam desde as cidades muradas medievais até os condomínios fechados contemporâneos. Há, no mínimo, duas perspectivas a serem consideradas diante de um acontecimento criminal, uma relacionada ao envolvimento e reação das pessoas diretamente envolvidas e outra que diz respeito ao tratamento social deste acontecimento e que passa por instituições, ambas refletem e revelam relações de poder. Este estudo parte do pressuposto que a reação ao acontecimento é fato marcante e que traz elementos reveladores de outras vivências passadas e também para projeções de vivências futuras seja no aspecto individual, seja em relação aos elementos históricos e coletivos. Considera, a partir da narração autobiográfica de pessoas envolvidas em situações criminais, o que há de coletivo e histórico nestas vivências. O crime, neste estudo, é considerado a partir de sua inscrição institucional, no entanto, traz elementos reveladores de uma história coletiva. Quatro pessoas, usuárias dos Centros de Prevenção à Criminalidade de Uberlândia, foram convidadas a narrar suas histórias de vida, a falar sobre o crime pelo qual respondem pena e sobre o tratamento institucional ao mesmo. O método de História Oral de Vida foi a base das entrevistas. Autores em Psicocriminologia e em Psicologia Crítica foram os principais apoios teóricos escolhidos para análise das entrevistas e reflexões acerca do crime, subjetividade, interdisciplinariedade e do papel do psicólogo nas instituições de Direito e Segurança Pública. A partir da análise, percebe-se que há um caminho aberto de ressignificação de alguns conceitos e posições profissionais em criminologia, que o psicólogo, neste campo, deve assumir o papel político no qual está inserido e ainda, conclui-se que as intervenções em segurança pública se apoiam em fatos que nem sempre são os acontecimentos mais significativos para o sujeito, e que concentram a quase totalidade de suas ações em intervenções individuais, insuficientes para lidar com as questões criminais, que são muito mais complexas e envolvem variáveis históricas e coletivas que vão muito além dos sujeitos envolvidos. / Mestre em Psicologia Aplicada

Porto Alegre foi uma das doze cidades-sedes da Copa do Mundo FIFA 2014. À época da sua candidatura e durante o preparo do evento, muito se divulgou acerca dos prováveis legados que a realização deste megaevento deixaria como retorno à cidade e seus habitantes. Diante disso, passados dois anos do fim da Copa, quisemos avaliar e descrever quais foram os principais impactos que sediar a Copa do Mundo deixou à Porto Alegre e seus (suas) habitantes no âmbito socioeconômico. Para cumprir com tal objetivo, fizemos um estudo de caso com enfoque qualitativo cuja coleta de dados deu-se através de pesquisa documental, entrevistas semiestruturadas, observações e registros de campo. Para compreender como se dá a realização de um megaevento, fizemos um histórico de como os megaeventos surgiram, se desenvolveram e se firmaram partindo de sua base esportiva e de sua base dentro da sociedade capitalista e globalizada. Também refizemos o caminho histórico percorrido pelas cidades em busca da reestruturação urbana – propiciada pelos megaeventos. Ao analisar os dados, elencamos duas categorias relacionadas ao âmbito social (reestruturação urbana e política/legislação) as quais subdividiram-se em: moradia e especulação imobiliária, garantias à FIFA e legislação, mobilidade urbana e segurança e violência. Percebemos que as obras de mobilidade privilegiaram veículos motorizados individuais e interesses de empreiteiras. As remoções realizadas em nome da Copa do Mundo são (ainda) um ponto de resistência de inúmeras famílias e comunidades – as quais não suportam mais a violação ao seu direto de moradia. A polícia comprou inúmeras armas e munições para conseguir proteger a Copa – e não as pessoas. Com relação à legislação, criou-se no Brasil um estado de exceção, sob qual a FIFA e seus interesses foram soberanos. O dinheiro utilizado para as obras da Copa teve sua origem no fundo público, ao contrário do prometido inicialmente. O custo final apresentou uma redução em relação ao custo inicial, porém isso deveu-se apenas à retirada de inúmeras obras (de mobilidade, na maioria) que não ficariam prontas dentro do prazo. Tivemos a FIFA, as grandes empreiteiras, políticos e a iniciativa privada como vencedores da Copa – e o legado à população de Porto Alegre ficou esquecido diante de tantos processos de corrupção e lavagem de dinheiro que os grandes ligados à Copa se envolveram. / Porto Alegre was one of the twelve host cities of the 2014 FIFA World Cup. At the time of its candidacy and during the preparation of the event, much was announced about the probable legacies that the accomplishment of this mega event would leave as a return to the city and its inhabitants. In view of this, two years after the end of the World Cup, we wanted to evaluate and describe the main impacts that hosting the World Cup left to Porto Alegre and its inhabitants in the socioeconomic context. To accomplish this goal, we conducted a case study with a qualitative approach which data collection took place through documentary research, semi-structured interviews, observations and field records. To understand how a mega event takes place, we made a history of how megaevents have emerged, developed and established themselves in sports within the capitalist and globalized society. Also, we make the historic path taken by cities in search of urban restructuring - propitiated by mega-events. In analyzing the data, we have listed two categories related to social scope (urban restructuring and politics / legislation) which were subdivided into: housing and real estate speculation, guarantees to FIFA and legislation, urban mobility and security and violence. It becomes evident that the mobility projects favored individual motor vehicles and the contractors. The removals made in the name of the World Cup are (still) a point of resistance of countless families and communities - which no longer support the violation of their housing right. The police bought numerous weapons and ammunition to protect the World Cup event- not the people. With regard to legislation, a state of exception was created in Brazil, under which FIFA and its interests were sovereign. The money used for the infrastructure works of the Cup had its origin in the public fund, contrary to the one promised initially. The final cost was reduced compared to the initial cost, but this was only due to the withdrawal of numerous infrastructure works (mostly for mobility) that would not be ready on time. We had FIFA, big contractors, politicians and private initiative as winners of the World Cup - and the legacy of the population of Porto Alegre was forgotten in face of so many corruption and money laundering scandals that the big Cup entrants got involved.

Base teórica: O surgimento de bactérias multirresistentes levou a uma renovação no interesse de antigos antimicrobianos, como a polimixina B, medicamento que foi descartado no passado devido sua toxicidade. Nas últimas duas décadas, esse antimicrobiano tornou-se um dos mais importantes agentes terapêuticos para o tratamento de infecções causadas por bactérias multirresistentes; porém, ainda faltam estudos clínicos que avaliem a segurança da polimixina B, especialmente em altas doses. Objetivo: Avaliar eventos adversos graves relacionados à infusão e a falência renal nos pacientes que receberam altas doses de polimixina B intravenosa. Métodos: Realizamos um estudo de coorte retrospectivo, multicêntrico. Incluímos pacientes que receberam > 3mg/kg/ dia ou uma dose total ≥250mg/dia de polimixina B, no período de janeiro de 2013 a dezembro de 2015. Para a avaliação dos eventos relacionados a infusão, foram incluídos pacientes que receberam ≥ 1 dose de polimixina B e para avaliação de falência renal incluiu apenas os pacientes que receberam ≥ 48 horas de polimixina B. Os desfechos principais avaliados foram os eventos adversos graves relacionados à infusão de acordo com os Critérios de Terminologia Comuns para Eventos Adversos (CTCAE v4.0) e a falência renal, utilizamos os critérios RIFLE (Risk, Injury, Failure, Loss and End stage), para categorizar os diferentes graus de lesão renal aguda. As variáveis incluídas no estudo foram as variáveis demográficas (idade, sexo), as variáveis individuais (peso, comorbidades, escore de Charlson), os fatores de gravidade (internação em UTI, uso de vasopressor, uso de bloqueador neuromuscular), outras fármacos nefrotóxicas, dose de polimixina utilizada (total, média diária e em mg/kg/dia), associação com outros medicamentos, e características da infecção (sítio, isolamento microbiológico) foram avaliadas em análise bivariada. Variáveis com P≤0.2 foram incluídas uma a uma, em ordem crescente, em modelo de regressão de COX. Variáveis com P< 0.1 permaneceram no modelo final. Resultados: Foram incluídos 222 pacientes para análise de eventos graves relacionados à infusão. A dose média de polimixina B foi de 3.61± 0.97 mg/kg /dia (dose total media = 268 mg/kg). Ocorreram eventos adversos graves relacionados à infusão em dois pacientes, determinando uma incidência bruta de 0.9% (intervalo de confiança de 95%, 0.2-3.2): um 7 evento classificado como um risco ameaçador a vida (efeito adverso classe IV) ocorreu em um paciente, homem, de 40 anos, internado no Centro de Terapia Intensiva, com fibrose cística, que recebeu 3,3 mg / kg / dia de PMB e desenvolveu dor torácica súbita, dispnéia e hipoxemia, no quarto dia de tratamento e o outro evento adverso grave (classe III), ocorreu em um paciente, homem, 23 anos, internado na enfermaria, com linfoma, que recebeu 3,6 mg / kg / dia de PMB , que apresentou parestesia perioral, tonturas e dispnéia no primeiro dia de tratamento. A falência renal foi analisada em 115 pacientes que receberam ≥ 48 horas de polimixina B e que não estavam em diálise no início do tratamento com Polimixina B; Falência renal foi encontrada em 25 de 115 (21,7%) pacientes expostos as PMB. Nosso estudo identificou que 54 [47,0%] pacientes desenvolveram algum grau de lesão renal aguda, pelos critérios de RIFLE: risco, 15 (27,8%), injúria, 14 (25,9%) e falência, 25 (46,3%) dentro das categorias do RIFLE. Além disso, droga vasoativa, outros fármacos nefrotóxicos e clearance de creatinina foram fatores de risco independentes para falência renal. Nem a dose diária de polimixina B ajustada para o peso corporal, nem a dose diária total foram associadas a falência renal. A mortalidade intra-hospitalar foi de 60% (134 pacientes): 26% (57 pacientes) morreram durante o tratamento e nenhum óbito foi durante a infusão. Conclusão: Altas doses de polimixina B no tratamento de infecções por bactérias gramnegativo apresentaram incidência baixa de eventos adversos agudos no nosso estudo e incidência de nefrotoxicidade elevadas, mas semelhantes a alguns estudos prévios com doses usuais”. Portanto, doses elevadas podem ser testadas em ensaios clínicos, objetivando melhorar os desfechos dos pacientes gravemente doentes com infecções por bactérias multirresistentes e minimizar o surgimento da resistência a polimixina B. / Background: The emergence of multiresistant bacteria has led to a renewal in the interest of old antimicrobials, such as polymyxin B, a drug that has been discarded in the past due to its toxicity. However, at this time, this antimicrobial has become one of the most important therapeutic agents for the treatment of infections caused by multiresistant bacteria but there is still a lack of clinical studies that evaluate the safety of polymyxin B, especially in relation to the use of high doses. This strategy, high doses, may be necessary in the fight against Gramnegative bacteria with a high minimum inhibitory concentration. Patients and methods: A retrospective, multicenter cohort study; the period evaluated was from January 2013 to December 2015, included patients who received > 3mg/kg/day or a total dose of ≥250mg/day of polymyxin B. The study included the evaluation of infusion-related events, patients who received ≥ 1 dose of polymyxin B and patients who received ≥ 48 hours of PMB were included for evaluation of renal failure. Major outcomes were serious adverse events related to infusion according to the Common Terminology Criteria for Adverse Events (CTCAE v4.0) and categorized renal failure by the RIFLE criteria (Risk, Injury, Failure, Loss, End stage). Factors potentially related to nephrotoxicity or mortality in 30 days were: demographic variables (age, sex), individual variables (weight, comorbidities, Charlson score), severity factors (ICU admission, use of vasopressor, use of Neuromuscular blocker), nephrotoxicity (other nephrotoxic drugs), polymyxin dose (total, daily mean and mg / Kg / day), association of drugs and infection characteristics (site and microbiological isolate) were evaluated in bivariate analysis. Variables with P≤0.2 were included one by one, in ascending order, in a Cox regression model. Variables with P <0.1 remained in the final model. Results: Two of 222 patients presented a severe infusion-related adverse event during PMB infusion, resulting in a crude incidence of 0.9% (95% Confidence Interval [CI], 0.2-3.2); one was classified as life-threatening and one classified as severe (crude incidence of each adverse event, 0.45%; 95% CI, 0.08-2.5). The life-threatening adverse effect occurred in an ICU patient (crude incidence among ICU patients, 0.67%; 95% CI, 0.12-3.7), a 40-years old male with cystic fibrosis who used 3.3 mg/kg/day of PMB and developed sudden thoracic pain, dyspnea and hypoxemia, in the fourth day of treatment. The severe adverse effect occurred in a non-ICU patient (crude incidence among non-ICU patients, 1.3%; 95% CI, 0.2-7.2), a 23- years old male with lymphoma exposed to 3.6 mg/kg/day of PMB, who presented perioral 9 paresthesia, dizziness and dyspnea in the first day of treatment. Renal failure was analysed in 115 patients who received ≥48 hours of PMB and who were not previously in dialysis. A total of 54 [47.0%] patients developed any degree of AKI, categorised as Risk [27.8%]; Injury [25.9%] and Failure [46.3%]) and 25 of 115 (21.7%) patients presented renal failure Vasoactive drug, concomitant nephrotoxic drugs and baseline creatinine clearance were independent risk factors for renal failure. Neither PMB daily dose scaled by body weight nor total daily dose were associated with renal failure. In-hospital mortality was 60% (134 patients): 26% (57 patients) occurred during treatment and none during infusion. Conclusion: Results suggest that high dose regimens have similar safety profile of usual doses and could be further tested in clinical trials assessing strategies to improve patients’ outcomes and minimize the emergence of PMB resistance.

Há mais de um século, a população pobre da cidade de Porto Alegre sofre com remoções. Percebe-se uma continuidade na prática de políticas remocionistas em determinadas localidades da capital gaúcha e, recentemente, milhares de pessoas foram removidas por causa de obras diretamente relacionadas a realização do megaevento Copa do Mundo 2014 na cidade. A forma como se deu esse processo revelou que as remoções e a consequente transformação urbana não ocorrem de forma pacífica. A cidade é uma arena de disputa entre diversos grupos sociais em que se confrontam diferentes discursos sobre a sua construção, ganhando corpo tanto em uma dimensão discursiva quanto material. São objetos de investigação deste trabalho as transformações que motivaram as desapropriações do espaço a partir das intervenções urbanas e as consequentes remoções de comunidades, favelas e vilas para a construção ou remodelação de arquiteturas urbanas, bem como o deslocamento das pessoas para outras áreas da cidade. Para tanto, são analisados três territórios que sofreram remoções: Ilhota, Dique e Tronco. A Ilhota é uma comunidade que sofreu a maior remoção da cidade no final dos anos 1970, devido a um processo de gentrificação do centro da capital Dique e Tronco são comunidades que sofreram remoções depois do anúncio que o megaevento Copa do Mundo seria realizado na cidade. Com a ideia de construir cartografias das remoções, três instrumentos foram utilizados como forma de registro, análise e construção de saberes para detectar pontos de conflitos e injustiças nesses territórios: (i) documentário sobre as violências sofridas e as resistências à remoção para a permanência de suas casas; (ii) mapas que evidenciam a periferização das pessoa que sofreram as remoções; (iii) levantamento dos mecanismos de remoção empregados pelo Estado para pressionar as famílias a saírem de suas casas. As cartografias das remoções buscam tratá-las como um dos eixos de um projeto de transformação profunda na dinâmica urbana, envolvendo de um lado novos processos de elitização e mercantilização da cidade, e de outro, novos padrões de relação entre o Estado e os agentes econômicos e sociais, marcados pela negação das esferas públicas democráticas de tomada de decisões e por intervenções autoritárias. / For more than a century, the poor population of the city of Porto Alegre have suffered with the urban removals. There is a continuity in the practice of removal policies in certain locations in the capital of Rio Grande do Sul, and recently thousands of people have been removed because of works directly related to the 2014 World Cup mega-event in the city. The way in which this process took place has revealed that the removals and the consequent urban transformation do not occur in a peaceful way. The city is an arena of dispute between several social groups in which different discourses about their construction are confronted, taking shapeboth in a discursive and material dimension. This study aims at the transformations that motivated the expropriation of space from the urban interventions and the consequent removals of communities, favelas and villages for the construction or remodeling of urban architectures, as well as the displacement of the people to other areas of the city. For this purpose, three territories that have been removed are analyzed: Ilhota, Dique and Tronco. Ilhota is a community that suffered the largest removal of the city in the late 1970s, due to a process of gentrification of the city center Dique and Tronco are communities that suffered removals after the announcement that the mega-event World Cup would be held in the city. With the idea of constructing cartographies of the removals, three instruments were used to record, analyze and build knowledge in order to detect points of conflict and injustice in these territories: (i) a documentary about the violence suffered and the resistance to removal for the permanence of their homes; (ii) maps showing the peripheralization of the people who suffered the removals; (iii) a survey of the removal mechanisms employed by the State to pressure families to leave their homes. Removal cartography seeks to treat them as one of the axes of a project of deep transformation in urban dynamics, involving on the one hand new processes of elitization and commercialization of the city, and on the other, new patterns of relationship between the State and economic and social agents, marked by the denial of the democratic public spheres of decision-making and by authoritarian interventions.

The purpose of this work is to analyze this territory from the point of the incidence of life-threatening and property-threatening incidents. The theoretical port contains all individually described kinds of insurance that eliminate the incurred losses. The practical part is reserved for specified and acknowledged risk of South Bohemia Region. Then possible arrangements are proposed leading to minimalizing of losses that may incur as a result of these risks. The practical part is closed by comparison of elected insurance products of four insurance companies. It concerns following sorts of insurance: insurance contents, insurance of buildings, insurance against damage in common civilian life, insurance against loss and damage resulting from the possession of buildings, the motor third party liability insurance and accident insurance. Every insurance company has its own general insurance conditions for its insurance products. In this part the differences in insurance conditions among the insurance companies are described. In conclusion the evaluation of gained results is presented.

My diploma thesis deals with two institutes of penal law ?detention and a court-ordered institutional education. The aim of the study was to tackle the issue theoretically and empirically, to give a comprehensive picture of both alternatives and to compare them. The aim was to add some information to contribute to decision-making in detention or alternative solutions in the issue of juvenile delinquency. The thesis is divided into two sections - theoretical and empirical. In the theoretical part, the legal basis of detention in the Czech Republic with regard to juvenile delinquents is defined, psychosocial issues of the juvenile delinquents detention are surveyed, the legislative base of the placement of juveniles into educational institutions is described, and the psychosocial issues connected with the stay of juvenile delinquents in educational institutions are outlined. In the final part, the possibilities and limits of the juvenile delinquents´ placement into educational institutions rather than detention solutions are discussed. At the beginning of the empirical section of the work, the objectives and research questions were stated. To answer these questions, a qualitative research investigation analyzing the stay of juveniles in detention and an educational institution was carried out. The respondents were chosen by a purposeful selection in educational institutions. The necessary data were obtained by conducting modeled semi-structured interviews with 7 juveniles who had gone through both detention and an educational institute. The interviews were transcribed and case studies were developed from them. The collected data were analyzed using the grounded theory method, open coding. The research has shown differences in experiencing detention and the stay in an educational institution in juvenile delinquents. It has been proved that detention is a stressful situation for juvenile delinquents, but it does not have a destructive affect on the personality of the juvenile. In contrast, the stay in an educational institution was evaluated positively by the respondents, and they emphasized its positive effect on their personalities. The research has also revealed the reasons for incidents in educational institutions, which result from boredom and the unwillingness of the juvenile to adapt to the regime. Now findings of the thesis demonstrate an insufficient use of the programs offered in penitentiaries. For this reason, as an optimization recommendation, I suggest to increase awareness and the motivation of prisoners to participate in these programs.

Introdução: A busca pela qualidade e segurança é uma preocupação de instituições de saúde. A análise de risco é um dos caminhos para a melhoria da qualidade e minimização de eventos adversos nas organizações de saúde. A sessão de hemodiálise é um processo complexo e por esta característica pode estar submetida a uma alta incidência de erros, lapsos e falhas. Por isto, a preocupação com a segurança dos pacientes em diálise e conhecimento dos riscos a que estão suscetíveis é de extrema importância para o resultado e o sucesso do tratamento. Os Modos de Falha e Análise de Efeitos (FMEA) é uma ferramenta de análise prospectiva amplamente utilizada na engenharia industrial que tem sido aplicada em algumas instituições de saúde. Além disso, instituições acreditadoras sugerem que as revisões anuais sejam realizadas para a prevenção ativa de riscos em instituições hospitalares. Esta ferramenta pode ser usada para identificar possíveis falhas de sistemas ou processos, mesmo antes que eles aconteçam. Compreendendo a magnitude do problema e sua relevância, optamos por aplicar esta avaliação em uma unidade de hemodiálise em um hospital do sul do Brasil. Objetivos: Aplicar a ferramenta análise de modos de falha e seus efeitos em uma unidade de hemodiálise, a fim de conhecer os principais riscos e implementar sugestões de melhorias. Metodologia: Este é um estudo exploratório. Um estudo descritivo é descritivo no sentido de que FMEA é aplicado em uma Unidade de Hemodiálise de identificar os principais riscos do tratamento dialítico prospectivamente em um hospital filantrópico do Sul do Brasil. O instrumento foi aplicado por uma equipe multidisciplinar composta por nefrologistas, enfermeiros e gestores. Fase 1 - A escolha de um processo de risco; Fase 2 - Recrutamento da equipe multiprofissional; Fase 3 - Projetando o processo; Fase 4 - Identificar os modos de falha e seus efeitos; Fase 5 - Priorizar os modos de falha. Após a definição de cada modo de falha, a equipe estabeleceu a probabilidade de ocorrência do evento e sua classificação de acordo com a serveridade e frequência. A análise dos dados foi realizada com estatísticas.A metodologia utilizada para elaboração do FMEA foi a proposta pelo Institute for Healthcare Improvement em cinco etapas. A definição da Priorização de Risco foi calculada pelo Risk Profile Number (RPN). E a construção da matriz de riscos foi elaborada de acordo com a proposta do U.S Veterans Affairs. Resultados: Os principais resultados encontrados no estudo foram 41 modos de falha no processo. Destes, 12 foram considerados de alto risco com RPN (70-100) e estão relacionados aos cuidados com os acessos vasculares, falha na coleta de exames, confirmação de reações alérgicas que podem levar ao choque e cuidados com a punção e conexão das linhas na fístula arteriovenosa. Identificou-se 17 processos de médio risco com RPN (10-40), que foram relacionados à prescrição da hemodiálise e a ausência de verificação de sinais vitais. Os demais 12 modos de falha foram em processos de baixo risco com RPN (1-9). Conclusões: Os modos de falha encontrados em sua maioria não possuíam controles de processos atuais, em 36,6% dos processos, que são as chamadas barreiras para a ocorrência de eventos adversos e, portanto, foram sugeridas medidas de minimização do risco. / Introduction: The quality of care is a concern of Health Institutions. Risk analysis consists of complex actions for quality and safety of care. Routine hemodialysis session is a complex process and because these characteristics may be subjected to a high incidence of errors, lapses and failures. Concern for patient safety in dialysis and knowledge of the risks they are susceptible is of extreme importance for the outcome and treatment success. The Failure Modes and Effects Analysis (FMEA) is a prospective analysis tool widely used in industrial engineering that has been applied in some health institutions. In addition, the Joint Commission International (JCI) suggests that annual reviews be made for active prevention of risks in hospitalar institutions. This tool could be used to identify potential failures of systems or processes, even before they happen. Understanding the magnitude of the issue and its relevance, we choose to apply this evaluation in a hemodialysis unit in a South Brazil Hospital. Objective: To describe the application of FMEA in a Hemodialysis Unit Methods: This is an exploratory study. A Descriptive Study is descriptive in the sense that FMEA is applied in a Hemodialysis Unit to identify the main risks of dialytic treatment prospectively at a Philanthropic Hospital in the South of Brazil. The tool was applied by a multidisciplinary team composed of nephrologists, nurses and managers. Stage 1 – Choosing a Risk Process; Stage 2 – Recruiting the Multiprofessional Team ; Stage 3 – Designing the Process ; Stage 4 – Identifying the failure modes and their effects; Stage 5 – Prioritizing the failure modes: after defining each failure mode, the team established the probability of occurrence of the event and its severity. The classification of the failure mode took into account criticity, the frequency at which the event can occur, its severity, and to what extent it will be detected if it happens. The data analysis was based on descriptive statistics and according to the FMEA methodology. Results: The main results found in the study were 41 failure modes in the process, and 12 processes presented high risk RPN (70-100). This is related to the care of vascular accesses and failure in collection for tests, the confirmation of allergic reactions that may lead to shock, care with the puncture and connection of lines in the arteriovenous fistula. In the medium risk processes RPN (10-40) 17 were identified involving the prescription of hemodialysis and the absence of verification of vital signs. And the low risk RPN processes (1-9) were the other failure modes. Conclusion: analyzing the failure modes it was seen that most of the stages, 36.6% of the processes did not have controls of current processes which are the so-called barriers to the occurrence of adverse events, and therefore risk minimization measures were suggested.

abstract: Earth-system models describe the interacting components of the climate system and technological systems that affect society, such as communication infrastructures. Data assimilation addresses the challenge of state specification by incorporating system observations into the model estimates. In this research, a particular data assimilation technique called the Local Ensemble Transform Kalman Filter (LETKF) is applied to the ionosphere, which is a domain of practical interest due to its effects on infrastructures that depend on satellite communication and remote sensing. This dissertation consists of three main studies that propose strategies to improve space- weather specification during ionospheric extreme events, but are generally applicable to Earth-system models: Topic I applies the LETKF to estimate ion density with an idealized model of the ionosphere, given noisy synthetic observations of varying sparsity. Results show that the LETKF yields accurate estimates of the ion density field and unobserved components of neutral winds even when the observation density is spatially sparse (2% of grid points) and there is large levels (40%) of Gaussian observation noise. Topic II proposes a targeted observing strategy for data assimilation, which uses the influence matrix diagnostic to target errors in chosen state variables. This strategy is applied in observing system experiments, in which synthetic electron density observations are assimilated with the LETKF into the Thermosphere-Ionosphere- Electrodynamics Global Circulation Model (TIEGCM) during a geomagnetic storm. Results show that assimilating targeted electron density observations yields on average about 60%–80% reduction in electron density error within a 600 km radius of the observed location, compared to 15% reduction obtained with randomly placed vertical profiles. Topic III proposes a methodology to account for systematic model bias arising ifrom errors in parametrized solar and magnetospheric inputs. This strategy is ap- plied with the TIEGCM during a geomagnetic storm, and is used to estimate the spatiotemporal variations of bias in electron density predictions during the transitionary phases of the geomagnetic storm. Results show that this strategy reduces error in 1-hour predictions of electron density by about 35% and 30% in polar regions during the main and relaxation phases of the geomagnetic storm, respectively. / Dissertation/Thesis / Doctoral Dissertation Applied Mathematics 2018