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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
11

The role of private information on global factors for mutual funds holdings and performance / Le rôle de l'information privée sur des facteurs globaux pour le choix de portefeuille et la performance des fonds mutuels investis en actions

Abou Tanos, Barbara 13 December 2018 (has links)
Le lien entre le choix d’allocation des fonds mutuels et l’information privée que possède leurs gérants sur des facteurs globaux de risque n’a pas été largement analysé. La littérature manque également d'études concernant l'impact de l’information privée globale sur la performance des fonds mutuels investis en actions. Notre travail vise à apporter de nouveaux éclairages sur ce sujet en montrant que l’information privée sur des facteurs globaux de risque est cruciale pour le choix d’investissements et pour la performance des fonds mutuels lorsqu’ils investissent à l’étranger.Dans le premier papier, nous étudions comment l’information privée sur les facteurs globaux, détenue par les gérants des fonds, impacte leurs performances. Après avoir utilisé plusieurs modèles de performances et plusieurs caractéristiques managériales, nous constatons un impact positif et significatif de l'information globale privée sur la performance des fonds mutuels globaux américains. Nous montrons que l’information globale qui permet de générer de la performance est celle qui concerne les secteurs industriels. Ceci est cohérent avec les résultats d'Albuquerque et al. (2009) et de Hiraki et al. (2015). Nous montrons également que l'utilisation du degré de concentration sectorielle (DSC) est un indicateur bruité de l’avantage informationnel possédé par les gérants. Le degré de concentration sectorielle affecte positivement la performance des fonds durant les périodes de stabilité financière. Cependant, cet impact positif n'est significatif que pour les fonds ayant un fort avantage informationnel sur les facteurs globaux.Dans le deuxième article de cette thèse, nous cherchons à éclaircir les choix d'allocation des fonds globaux et l’évaluation de leurs performances au cours de la récente crise des subprimes. Spécifiquement, nous examinons si c’est l’avantage informationnel de leurs gérants sur des facteurs globaux de risque ou leur familiarité avec certains marchés financiers étrangers qui a guidé leur choix d’investissement et leur a permis d’accroître leur performance durant cette crise. Nous contrôlons nos résultats pour le rôle du degré de transparence des marchés financiers ainsi que le degré de protection des investisseurs. Nous constatons que l’avantage informationnel sur les facteurs globaux (industriels) de risque contribue positivement à la création de la performance des fonds sur toute la période d’étude. La «fuite vers la familiarité» au cours de la période de la récente crise financière est nuisible pour la performance des fonds et peut être considérée comme étant un biais. Les gestionnaires de fonds qui recherchent à investir dans des titres familiers pendant la période de crise financière ne créent pas de valeur pour leurs clients.Dans notre troisième papier, nous examinons les déterminants de la stratégie de rotation des portefeuilles dans différentes industries et l’impact de cette stratégie sur la performance des fonds globaux américains. Nous constatons que les fonds mutuels qui s'engagent dans des stratégies de rotation sectorielle améliorent leur performance. Ce résultat est conforme aux résultats de la littérature qui suggèrent que les fonds gérés activement sont plus performants. De plus, nous constatons que la stratégie de rotation industrielle des fonds est influencée positivement et significativement par l’avantage informationnel des gérants sur les facteurs globaux de risque. Cette étude est en accord avec plusieurs articles de la littérature qui soulignent l'importance croissante de l’information sectorielle pour la gestion d’actifs (Hiraki et al., 2015; Schumacher, 2017). Ce papier confirme également différents arguments selon lesquels la rotation sectorielle pourrait être considérée comme une stratégie optimale pour le choix de portefeuille dans le contexte d’internationalisation des marchés financiers (Weiss, 1998, Cavaglia et al., 2004). / This dissertation responds to a lack within the literature about the impact of private global information on mutual funds portfolio holdings and performance. We conduct three essays that aim to explain different controversial topics about the global funds’ performance and investments choices.In the first paper we examine how the private information on global factors is affecting US global funds’ trading profits. After controlling for different performance benchmark models and for several managerial fund characteristics, we find a positive and significant impact of the private global information on mutual funds’ performance. The fund’s informational advantage on global factors is industry-specific rather than country-specific, consistent with the results of Albuquerque et al. (2009) and Hiraki et al. (2015). We also argue that the use of the degree of sector concentration (DSC) as a proxy for the manager’s informational advantage (as employed in some recent papers) is noisy. The performance of funds is mainly driven by the proxy of private information on industrial factors and not by its degree of sector concentration. DSC affects positively the trading profits of funds in periods of good financial stability. However, this positive impact is only significant for funds with a high informational advantage on global factors.In the second paper, we investigate whether this is the private global information or the familiarity with foreign markets which has driven the performance of global funds during the recent subprime crisis. In fact, it has been shown within the literature that fund managers tend to hold familiar stocks during periods of heightened markets. We find that the private information on global factors of risk is the main driver of funds’ performance for the 2005-2016 period including the subprime crisis period. This result holds when considering different familiarity, market transparency and investor’s protection proxies and when employing different performance benchmark models. On the opposite, the familiarity proxies reverse their effect during the financial crisis period. We show that the “flight to familiarity” within this period is detrimental for funds’ performance and rather can be assessed as a bias. Managers that seek familiarity during periods of financial crisis to be “on the safe side” do not create value for their investors. Our results also suggest that during periods of heightened market uncertainties, fund managers can benefit from processing information on industrial factors, consistent with the findings of Albuquerque et al. (2009) and Hiraki et al. (2015).In our third and last paper, we investigate the determinants of fund’s portfolio rebalancing decisions of foreign holdings that belong to different industries and their relative implication on US global funds’ performance. We find that mutual funds that engage in industrial sector rotation strategies enhance their performance. This result is consistent with the literature view that actively managed funds perform better. Moreover, we find that the fund’s industrial rebalancing activity is positively and significantly affected by its informational advantage on global factors. This study is in line with several papers that highlighted the increasing importance of global industry factors for asset allocation (Hiraki et al., 2015; Schumacher, 2017) and consistent with different arguments stating that industry sector rotation can be optimal for future global investing especially with the increasing integration of capital markets (Weiss, 1998; Cavaglia et al., 2004).
12

Analysis of the risk factors on the lumbar column on dressmakers from a factory of masculine underwear clothes in the city of Muriaé-MG / ANÁLISE DOS FATORES DE RISCO DA COLUNA LOMBAR EM COSTUREIRAS DE UMA FÁBRICA DE CONFECÇÃO NO MUNICÍPIO DE MURIAÉ-MG / CONDIÇÕES DE TRABALHO DOS CATADORES DE MATERIAIS RECICLÁVEIS / Evaluation of the conditions of work of the collectors of materials recycled

Grasiella Oliveira Paizante 31 March 2006 (has links)
lt;p align="justify"gt; A pesquisa foi desenvolvida a partir de dados coletados em uma fábrica de confecção de moda íntima masculina no município de Muriaé-MG, para estudar os fatores de risco da coluna lombar relacionados às atividades exercidas pelas costureiras neste ambiente, visando segurança, saúde e conforto destas trabalhadoras. Os objetivos específicos foram analisados através das características do perfil, condições de trabalho e saúde das trabalhadoras; da incidência de sintomas osteomusculares; da avaliação da biomecânica postural da coluna lombar e dos fatores de risco da dor lombar. A investigação ocorreu com a aplicação de um questionário que continha dados sobre o perfil, condições de trabalho e saúde das trabalhadoras, além do questionário Nórdico Padrão. Este último é um instrumento validado que investiga a incidência de dor osteomuscular nas articulações. Realizou-se também uma análise biomecânica postural das costureiras através da Biofotogrametria® e um check list simplificado para os fatores de risco às lombalgias. Os resultados indicaram que a idade média das funcionárias é de 25, 75 anos. Já o tempo médio na empresa é de 37,92 meses e o tempo na atividade é de 31,57 meses. As maiores reclamações sobre dores no corpo ao final do dia foram relativas às dores lombares (74,20%). O questionário Nórdico Padrão revelou que 72,3% das costureiras sentiram dores na coluna lombar nos últimos 12 meses e 54,1% nos últimos 7 dias, e destas 27,1% referiram dificuldades na execução da tarefa devido à dor. Já a análise biomecânica postural apresentou 41,2% das trabalhadoras com algum tipo de assimetria na coluna lombar. Todas as atividades avaliadas sobre os fatores de risco à dor lombar pela postura estática adotada por elas num longo período de tempo foram classificadas como risco moderado no check list aplicado. Reforça-se que a alta incidência de dor na coluna lombar das costureiras pode estar relacionada à manutenção de posturas estáticas levando à fadiga muscular e à dor.lt;/pgt; / lt;p align="justify"gt; O perfil dos catadores de materiais recicláveis de uma associação, na cidade de Governador Valadares, Minas Gerais, Brasil, é apresentado neste trabalho. Não há registros sobre a realidade desses trabalhadores e mediante as dificuldades encontradas para sobrevivência desse grupo, foram descritas as condições de trabalho e de vida visando subsidiar propostas para melhoria dessas condições de vida, desse grupo social. Os catadores de materiais recicláveis são expostos, diariamente, a condições insalubres de trabalho que podem afetar sua saúde em função do tempo de exposição e do aumento de idade cronológica. Foram entrevistados 61,2% dos catadores associados na própria sede da associação, sendo abordados sobre questões referentes às condições de trabalho, moradia, lazer, renda, acesso a serviços de saúde, presença ou ausência de acidentes de trabalho e grau de satisfação pessoal. Também foram entrevistados os coordenadores da associação com abordagens sobre o histórico da associação, histórico pessoal dos catadores, a estrutura física da associação e a rotina de trabalho. Foram realizadas anotações em diário de campo, e durante as visitas, foram analisados os documentos e registros da associação desde o início das atividades. A atividade econômica da associação é fonte de renda para 67 catadores e garante a sobrevivência de 181 pessoas, catadores e seus dependentes. As variáveis dependentes (escolaridade, moradia, acidentes de trabalho e grau de satisfação pessoal) foram correlacionadas com a variável independente idade do trabalhador. A idade não tem nenhuma associação com a ocorrência de acidentes de trabalho e tipo de moradia. O nível de escolaridade dos trabalhadores é baixo, a maioria, 53,6% dos associados apresentam escolaridade igual ou inferior a três anos de estudo e teve associação negativa com a idade. Os catadores mais jovens apresentaram menor grau de satisfação com a vida, pois almejam maiores oportunidades de ascensão social. A desigualdade sócio-econômica ocasiona baixa auto-estima, desesperança e descrédito em alcançar melhores condições de vida. Contudo, para a maioria dos trabalhadores, o grau de satisfação com o trabalho e com a vida é grande.lt;/pgt; / lt;p align="justify"gt; The research was developed from data collected in a factory of masculine underwear clothes in the city of Muriaé-MG, to study the risk factors on the lumbar column related to the activities done by the dressmakers in this environment, aiming security, health and comfort of these workers. The specific objectives had been analyzed through the analysis of the profile, the conditions of work and the health of the workers; of the identification according to the incidence of osteomusculares symptoms; of the evaluation of the postural biomechanics of the lumbar column and the analysis of the risk factors on lumbar pain. The inquiry happened with the application of a questionnaire that contained data about the profile, conditions of work and health of the workers, and also the Nordic Standard questionnaire. The last one is a validated instrument that investigates the pain incidence to osteomuscular in the joints. One also became fulfilled a postural biomechanics analysis of the dressmakers through Biofotogrametria® and a simplified check list for the risk factors to the low back pain. The results had indicated that the average age of the employees is of 25,75 years. And the average time at the company is of 37, 92 months and the time in the activity is of 31,57 months. The major claims on pains on the body at the end of the day had been relative to lumbar pains (74,20%). The Nordic Standard questionnaire showed that 72.3% of the dressmakers had felt pains in the lumbar column for the last 12 months and 54.1% for the last 7 days and of these 27.1% had related difficulties in the execution of the tasks due to this pain. On the other hand the postural biomechanics analysis presented that 41.2% of the workers had demonstrated to have some type of asymmetry in the lumbar column. All the activities evaluated about the risk factors on lumbar pain for the static position adopted by them in a long period of time had been classified as moderate risk in check applied list. It is important to say that the high incidence of pain on the lumbar column of the dressmakers can be related to the maintenance of static positions leading to the muscular fatigue and pain.lt;/pgt; / lt;p align="justify"gt; The profile of recycling stuff collectors of an organization in Governador Valadares , Minas Gerais, Brazil is presented in this research . There are no registrations about this workers reality and through the difficulties which have been found for this group survival Work and life conditions were described, intending to subsidize proposals for improving life conditions of this social group Recycling stuff collectors are daily exposed to insalubrious work condition which can affect their health due to exposure time and rise of chronological age. 61,2% of the associated collectors were interviewed in the own commercial trade-hall of the corporation . They were interviewed with broaching of work conditions, housing , leisure, rent, health services access, presence or absence of work accidents and personal satisfaction grade . Corporation coordinators were also interviewed with broaching of corporation description , collectors personal description ,corporation physical structure and routine work . Notes on daily field about direct observations were peformed during visits to the corporation as well as documents and corporation registrations have been analysed from the beginning of its activities. Work in the corporation is source of revenue to 67 collectors and it guarantees survival to 181 people ,collectors and their dependents. As dependent variables (scholarship ,housing, work accidents and personal satisfaction grade) were correlationed to the independent variable worker age . Age isn’t associated to ocurrence of work accidents and kind of housing . Scholarship workers level is low most of them , 53,6% of the associates present scholarship iqual or under three school years and it was negatively associated to age . Younger collectors present lower life satisfaction grade for aiming at bigger oportunities of social ascension. Socioeconomic inequality causes low self-steem, hopelessness and discredit on achieving better life conditions . However ,work and life satisfaction grade is high for most part of the workers.lt;/pgt;
13

Conhecimento dos cirurgi?es-dentistas em rela??o ao c?ncer bucal

Falc?o, Michelle Miraranda Lopes 16 December 2006 (has links)
Made available in DSpace on 2015-07-15T13:31:39Z (GMT). No. of bitstreams: 1 Falcao Michelle_Conhecimento dos cirurgioes dentistas em re.pdf: 2106628 bytes, checksum: 9fdb7744ffb8e8bfcdccfe87d3369f9d (MD5) Previous issue date: 2006-12-16 / The oral cancer is a problem of public health in the world, including in Brazil. Most cases of the disease are detected in an advanced phase, in low-income individuais, those with little access to the health services. This neoplasia can be preventable, since the main related factors of risk related to the development of the disease are, in general, from social/environmental basis. The treatment, in the advanced period, turns out to be of high economic and social cost, with unfavorable prognostic. The purpose of this study was to verify the knowledge of the dentists from Feira de Santana- Bahia on the oral cancer. An exploratory study was carried out in which a questionnaire was applied to a random sample of 240 dentists. After the procedure of data collection, the statistics analysis proceeded through the program SPSS 10,0 for Windows, making use of Pearson's chi squared test, in the analysis of correlation of frequencies. The results have disclosed that, among the professionals who have participated in the research, 151 (62,9%) were female, 148 (62,9%) were up to 37 years of age, 125 (53,2%) up to ten years who had graduated and 122 (50,8%) were specialists. The levei of reliability to carry out the diagnostic procedures of oral cancer was considered low for 69,5% of the professionals. The professionals have reported not to investigate the presence of injuries in the first consultation in 21,1 % of the cases. Only 58.3% indicated the spinocellular carcinoma as the most frequent type of oral cancer. Tobacco consumption (100%), alcoholic beverage ingestion (89,2%), solar exposition (83,3%) and family history (93,3%) have been the most reported risk factors. Nevertheless, (96,3%) and (71,3%), respectively, believed that the use of badly adapted prosthesis and uncared teeth presence made up risk factors for the disease. Only 3.75% of the interviewed ones have gotten the highest results concerning the knowledge. The findings agree with the results disclosed in other studies and indicate the need of educational reshaping, in order to enable the professionals for an early diagnosis, and for the investment in healthful public policies in the city, which enable the adoption of strategies of primary prevention for reduction of the morbimortality of the disease. / O c?ncer bucal ? um problema de sa?de p?blica no mundo, inclusive no Brasil. A maioria dos casos da doen?a ? detectada em fase avan?ada, em indiv?duos de baixa renda e com pouco acesso aos servi?os de sa?de. Esta neoplasia pode ser prevenida, pois os principais fatores de risco relacionados ao desenvolvimento da doen?a s?o, em sua maioria, de ordem s?cio-ambiental. O tratamento, nos est?gios avan?ados, revela-se de alto custo econ?mico e social, com progn?stico desfavor?vel. O objetivo deste estudo foi verificar o n?vel de conhecimento dos cirurgi?es-dentistas de Feira de Santana -Bahia sobre o c?ncer bucal. Foi realizado um estudo explorat?rio em que se aplicou um question?rio a uma amostra de 240 cirurgi?es-dentistas. Ap?s o procedimento de coleta de dados, procedeu-se a an?lise estat?stica por meio do programa SPSS 10.0 for Windows, empregando-se o teste do qui-quadrado de Pearson, na an?lise de correla??o de frequ?ncias. Os resultados revelaram que dos profissionais que participaram da pesquisa, 151 (62,9%) eram do g?nero feminino, 148 (62,9%) tinham at? 37 anos, 125 (53,2%) at? dez anos de formados e 122 (50,8%) eram especialistas. O n?vel de confian?a para realizar procedimentos de diagn?stico de c?ncer bucal foi considerado baixo para 69,5% dos profissionais. Os profissionais relataram n?o investigar a presen?a de les?es na primeira consulta em 21' 1% dos casos. Somente 58,3% apontaram o carcinoma espinocelular como o tipo de c?ncer bucal mais frequente. O consumo de tabaco (100%), o uso de bebidas alco?licas (89,2%), a exposi??o solar (83,3%) e a hist?ria familiar (93,3%) foram os fatores de riscos mais apontados. Entretanto, (96,3%) e (71,3%) acreditavam que o uso de pr?teses mal adaptadas e a presen?a de dentes em mau estado constitu?am-se em fatores de risco para a doen?a, respectivamente. Apenas 3, 75% dos entrevistados obtiveram o maior conceito em rela??o ao conhecimento. Os achados condizem com os resultados revelados em outros estudos e apontam para a necessidade de reformula??o do ensino, de forma a capacitar os profissionais para o diagn?stico precoce, e para o investimento em pol?ticas p?blicas saud?veis no munic?pio que possibilitem a ado??o de estrat?gias de preven??o prim?ria para redu??o da morbimortalidade da doen?a.
14

O uso de esteroides anabolizantes em praticantes de atividades físicas: um estudo de caso das análises fisiológicas e metabólicas nas academias da cidade de Manaus-AM

Mota, Vanderlan Santos 16 April 2010 (has links)
Submitted by Alisson Mota (alisson.davidbeckam@gmail.com) on 2015-07-21T19:45:42Z No. of bitstreams: 1 Tese - Vanderlan Santos Mota.doc: 5687808 bytes, checksum: 4c2e9bcb586f4406882237e819450320 (MD5) / Approved for entry into archive by Divisão de Documentação/BC Biblioteca Central (ddbc@ufam.edu.br) on 2015-07-23T18:19:04Z (GMT) No. of bitstreams: 1 Tese - Vanderlan Santos Mota.doc: 5687808 bytes, checksum: 4c2e9bcb586f4406882237e819450320 (MD5) / Approved for entry into archive by Divisão de Documentação/BC Biblioteca Central (ddbc@ufam.edu.br) on 2015-07-23T18:23:18Z (GMT) No. of bitstreams: 1 Tese - Vanderlan Santos Mota.doc: 5687808 bytes, checksum: 4c2e9bcb586f4406882237e819450320 (MD5) / Made available in DSpace on 2015-07-23T18:23:18Z (GMT). No. of bitstreams: 1 Tese - Vanderlan Santos Mota.doc: 5687808 bytes, checksum: 4c2e9bcb586f4406882237e819450320 (MD5) Previous issue date: 2010-04-16 / Não Informada / Recent studies in different countries have pointed the increase of the consumption of esteroides anabolizantes between practitioners of physical activities, and the damages to the health caused by its indiscriminate use. In Brazil, studies on the use of scarce anabolizantes are e, in this study, searched considerações siginificativas to compose theoretical referencial on the alert subject and to the users of these products. It was examined perception of risk to the health, associated with the consumption of anabolizantes between practitioners of physical activities in the academies of the city of Manaus-AM. For in such a way, the collection proceeded from qualitative data and quantitative, such as etnografia, half-structuralized interviews and focal group with users of anabolizantes, using themselves applied analytical methods in the description of each stage of the experiments, had understood, beyond the laboratorias piss analyses, the analysis of chromatography and spectrometry, by means of statistical methods, analyzing the qui-square of the result for its validation. The produced data had described main used substances and the standards of use, between practitioners of physical activities in the city of Manaus pointing preponderant evidences to the masculine sex, as bigger substantial food consumer to the organism, amongst them: Calcium, Grain, Copper, Zinc, Iron, Manganese, B1 Vitamins, and the C, and Liquids, it is fallen again substance of Carboidratos, Fruits and Oil and Fat more for the consumption of the feminine sex. In the analyses physicist-chemistry of the urinas we find eighteen positive samples for forbidden substances, of these, twelve met in the results of the masculine sex. Amongst substances we have of the bigger evidence of pH Metiltestosterona and THC, Testosterone and DHEA, causers of pathological effect in the human metabolism. The results make in them to analyze that it has absence of real cares to the organic body, therefore the interviewed ones are cliente of males that such substances can cause. One reveals, thus, the desire of the ideal physical body to the standards taxes in the society, to this overlap to the risk of harmful collateral effect how much to the bad use of these substances. It is considered that more must be promoted the prevention and the orientation with regard to the anabolizantes use of esteroides next to this population. This study it intended to well more aim at the education of the anabólicos users of esteroides and the users in potential, looking for to inform involved with the practical sport and the porting one, therefore exactly with studies related to this still it is lacked of prevention. / Estudos recentes em diferentes países têm apontado o aumento do consumo de esteroides anabolizantes entre praticantes de atividades físicas, e os danos à saúde causados pelo seu uso indiscriminado. No Brasil, estudos sobre o uso de anabolizantes são escassos e, neste estudo, buscou-se considerações significativas para compor referencial teórico sobre o tema e alerta aos usuários desses produtos. Examinou-se a percepção de risco à saúde, associada ao consumo de anabolizantes entre praticantes de atividades físicas nas academias da cidade de Manaus-AM. Para tanto, procedeu a coleta de dados qualitativos e quantitativos, tais como etnografia, entrevistas semi - estruturadas e grupo focal com usuários de anabolizantes, utilizando-se métodos analíticos aplicados na descrição de cada etapa dos experimentos, compreenderam, além das análises laboratoriais de urina, a análise de cromatografia e espectrometria, por meio de métodos estatísticos, analisando o qui-quadrado do resultado para sua validação. Os dados produzidos descreveram as principais substâncias utilizadas e os padrões de uso, entre praticantes de atividades físicas na cidade de Manaus apontando evidências preponderantes ao sexo masculino, como maior consumidor de alimentos substânciais ao organismo, dentre elas: Cálcio, Grão, Cobre, Zinco, Ferro, Manganês, Vitaminas B1, A e C, e Líquidos; recai-se a substância de Carboidratos, Frutas e Óleo e Gordura mais para o consumo do sexo feminino. Nas análises físico-químicas das urinas encontramos dezoito amostras positivas para substâncias proibidas; dessas, doze encontravam-se nos resultados do sexo masculino. Dentre as substâncias temos a de maior evidência de pH, a Metiltestosterona e a THC, Testosterona e DHEA, causadoras de efeitos patológicos no metabolismo humano. Os resultados nos fazem analisar que há ausência de cuidados reais ao corpo orgânico, pois os entrevistados são cientes dos males que tais substâncias podem ocasionar. Mostra-se, assim, o desejo do corpo físico ideal aos padrões impostos na sociedade, a isso sobrepõem ao risco de danosos efeitos colaterais quanto ao mau uso dessas substâncias. Considera-se que se deve promover mais a prevenção e a orientação com relação ao uso de esteróides anabolizantes junto a essa população. Este estudo pretendeu visar bem mais à educação dos usuários de esteroides anabólicos e dos usuários em potencial, procurando informar os envolvidos com o esporte e a prática desportiva, pois mesmo com estudos relacionados a isso ainda se carece de prevenção.
15

Untersuchungen zur Altersassoziierten Innenohrschwerhörigkeit: Master Thesis Präventionsmedizin in 2 Teilen - Teil 1 Theorie, Teil 2 Praxis-Fallstudie, Untersuchung an 202 Patienten

Lauterbach, Hans-Heinz 20 January 2014 (has links)
In Europa leiden etwa 120 Millionen aller 18- bis 80-jährigen an einer Hörbehinderung (16% Prävalenz). Die altersassoziierte Innenohrschwerhörigkeit (Age related hearing impairment, ARHI) hat damit Anschluss gefunden an die großen Volkskrankheiten: Ischämische Herzerkrankungen (5,9 %), Demenz (5,8 %), Diabetes mellitus und Cerebralen Erkrankungen (je 5,5 %). Der erste Teil der Arbeit befasst sich mit der Theorie des Hörens und seinen Störungen, der cochleären Durchblutung, den metabolischen Risikofaktoren, der Molekularbiologie und Epigenetik des Innenohres. Obwohl in der Literatur weitgehend Konsens über den Einfluss exogener Faktoren auf ARHI herrscht, wie Diabetes mellitus, Herz-Kreislauferkrankungen (Framingham Studie und CVD), Hypertonie, Rauchen, Body mass index (BMI) und genderspezifische hormonelle Einflüsse, gibt es kaum HNO-ärztliche Studien dazu. Der zweite Teil geht in einer Praxis-Fallstudie an 202 Patienten folgenden Fragen nach: 1. Gibt es zwischen metabolischen Erkrankungen, wie Adipositas, Störungen des Fett- und Glucosestoffwechsels, der Hypertonie und der Zunahme von Innenohrschwerhörigkeiten im Erwachsenenalter klinische Zusammenhänge? 2. Könnte eine erste Ohrsymptomatik Prädikator einer okkulten pathologischen Stoffwechselveränderung sein? 3. Gibt es Möglichkeiten einer Prävention? Im Ergebnis zeigten sich bei Patienten mit ARHI im Verhältnis Männer/Frauen: Störung des Glukosestoffwechsels bei 97 %/84 %, Lipidstoffwechselstörungen bei 76 %/85 %, eine Homocysteinämien bei 70 %/62 %, ein Anstieg des Plasminogen-Aktivator-Inhibitors (PAI) bei 65 %/38 % und eine Harnsäureerhöhung bei 48 %/15 %. Auch bei ersten Ohrsymptomen (Ohrdruck, Tinnitus, einzelne Frequenzsenken) fanden sich in jedem einzelnen Fall metabolische Veränderungen, die entweder allein oder in unterschiedlichen Kombinationen vorlagen. Männern mit metabolisch initiierten KHK-Erkrankung haben als Prädikator häufig eine erektile Dysfunktion. Erste auditorische Symptomen könnten Prädikator okkulter metabolischer Störungen bei Männern und Frauen sein. Anamnestisch unklare Innenohrprobleme sollten daher auf Stoffwechselstörungen untersucht werden, da diese Risikofaktoren darstellen, die leitlinienbasiert zu therapieren sind. Eine Prognose ist in keinem Einzelfall möglich, da die Folgen auf die molekularbiologischen Prozesse im Innenohres individuell nicht erkennbar sind. Doch sahen wir bei einigen Patienten deutliche Verbesserungen der Symptome und einen Hörschwellenanstieg. Andere Patienten zeigten innerhalb des Beobachtungszeitraums keine Änderung der audiogenen Symptomatik. Behandlungen über einen längeren Zeitraum an einer größeren Fallzahl wären daher sinnvoll. Die Ergebnisse könnten als erste sekundärpräventive Behandlung betrachtet werden, die im Einzelfall eine Hörgeräteversorgung entbehrlich machte. Sie stellen einen Beitrag zu Pfisters Empfehlung dar, mit den vorhandenen Erkenntnissen exogener Risikomechanismen, dringend neue therapeutische Präventionsstrategien für die HNO-ärztliche Tätigkeit zu entwickeln, die die neurale und molekulare Basis anstelle der Symptome der Erkrankung fokussieren.
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Análisis comparativo de la incorporación de la gestión del riesgo de desastres en los instrumentos de ordenamiento y planificación territorial : el caso de San Bernardo y Calera de Tango

Espinace Vidal, Josefa January 2018 (has links)
Memoria para optar al título de Geógrafo / En esta investigación se realiza un análisis y comparación respecto de la incorporación de la Gestión del Riesgo de Desastres (GRD) en los instrumentos de ordenamiento y planificación territorial de las comunas de San Bernardo y Calera de Tango, identificando factores críticos que determinan las diferencias entre ellas. Si bien las comunas en estudio son colindantes y poseen características físicas similares, cada una ha ido adoptando caracteres de acuerdo a su funcionalidad dentro de la Región Metropolitana. Sin embargo, las dinámicas que se han desarrollado no responden a la planificación vigente, lo que ha generado condiciones de riesgo para la población, sus bienes y economía. En la investigación fue posible determinar que los instrumentos de planificación y ordenamiento territorial aún no incorporan de manera íntegra la GRD debido en parte, a que existen confusiones conceptuales, y al tipo de gestión que se intenta proponer, ya que sigue siendo mayoritariamente reactiva. La principal diferencia entre las comunas estudiadas radica en que San Bernardo, al poseer un Plan Regulador Comunal, gestiona y ordena el territorio disminuyendo la exposición de la población a las amenazas de origen natural y antrópico existentes en la comuna, vale decir presenta una gestión preventiva. Por su parte, Calera de Tango nunca ha contado con este instrumento en particular. Al ser una comuna de carácter rural, los instrumentos de planificación actuales no son de gran ayuda debido a que se enfocan en la gestión de las zonas urbanas principalmente, por lo cual gran parte del territorio comunal no tiene regulación. A pesar de las ventajas con las que cuenta San Bernardo aún son insuficientes para reducir el riesgo de desastre. / This project consists of comparative analysis of the integration of the Disaster Risk Management (GRD) in the regulation and territorial planning of the San Bernardo and Calera de Tango municipalities, with the intent of identifying critical factors differentiating the two. While these municipalities are adjacent to each other and share many physical characteristics, they have developed distinct characteristics in accordance with the role each plays within the wider Metropolitan Region. The dynamics developed within each nonetheless do not share policy frameworks – something that has created risky conditions for their local populations, properties and economies. This investigation determined that the current methods used for territorial planning and legislation have yet to meaningfully integrate the GRD due to both conceptual ambiguities and the fact that management has up until now been largely reactive. The principal distinguishing factor separating the municipalities under investigation is that San Bernardo, in possessing a Regulatory Communal Plan, manages its territory with an eye towards reducing its population’s exposure to local natural and man-made threats. In contrast, Calera del Tango has never possessed this particular policy framework. As a rural municipality, current planning frameworks are of limited effectiveness due to their focus on urban locations. In spite of their advantages San Bernardo possesses, the current policy framework is insufficient as a means of reducing risk in the face of possible disasters.

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