CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / IntroduÃÃo â DepressÃo à um dos transtornos psiquiÃtricos mais comuns em pessoas idosas, estando associada à maior morbimortalidade e aumento de custos. Apesar disto, 30 a 50% dos casos permanece nÃo identificada e sem tratamento, o que tem motivado o desenvolvimento de instrumentos de rastreamento a serem utilizados na prÃtica clÃnica. Um dos mais amplamente utilizados à a Escala de DepressÃo GeriÃtrica (Geriatric Depression Scale â GDS) que tem sido amplamente validada em amostras de serviÃos especializados e terciÃrios. Poucos estudos em outros paÃses, e nenhum no Brasil, no entanto, avaliaram o desempenho da GDS em nÃvel primÃrio de saÃde, o que torna incerta a generalizaÃÃo dos resultados para esse contexto, onde a maioria das pessoas idosas com depressÃo à efetivamente atendida. Objetivos â determinar a validade da GDS, nas versÃes 30, 15, 4 e 1 itens, em nÃvel primÃrio de saÃde, atravÃs de estimativa da sensibilidade, especificidade, valor preditivo positivo, valor preditivo negativo e razÃo de verossimilhanÃa. Identificar os melhores pontos de corte dos escores da GDS, em suas diferentes versÃes, para rastreamento de depressÃo em nÃvel primÃrio de saÃde. MÃtodo â Estudo transversal, com 220 pacientes idosos consecutivamente atendidos em quatro unidades primÃrias de saÃde. Foram aplicados um questionÃrio que forneceu uma visÃo global do perfil da populaÃÃo estudada; a Escala de DepressÃo GeriÃtrica (GDS) e a Entrevista ClÃnica Estruturada para Transtornos do Eixo I do DSM-IV (SCID-I), assumido como padrÃo-ouro. Os dois primeiros instrumentos foram aplicados por um entrevistador treinado e a SCID por mÃdico psiquiatra. Resultados â A prevalÃncia de EpisÃdio Depressivo Maior e/ou transtorno distÃmico foi de 17,27%. O melhor ponto de corte da GDS 30 foi 10/11 (caso/nÃo caso) que revelou sensibilidade = 92,1% (IC 95% = 77,5 - 97,9%), especificidade = 79,7% (IC 95% = 72,9 â 85,1%), acurÃcia = 81,8% e razÃo de verossimilhanÃa = 4,5. O melhor ponto de corte da GDS 15 foi 4/5 com sensibilidade = 86,8% (IC 95% = 71,1 â 95,1%), especificidade = 82,4% (IC 95% = 75,9 â87,5%), acurÃcia = 83,1% e razÃo de verossimilhanÃa = 4,9. O da GDS-4 foi 0/1 com sensibilidade = 84,2%(IC 95% = 68,1-93,4%), especificidade = 74,7% (IC 95% = 67,7 â80,7%), acurÃcia = 76,30% e RazÃo de verossimihanÃa = 3,9. A GDS-1 teve uma sensibilidade de 52,6% (IC 95%=36,0 - 68,7%). ConclusÃes: A GDS-30 à um Ãtimo instrumento de rastreamento para episÃdio depressivo maior e/ou transtorno distÃmico, em unidades de atenÃÃo primÃria, dado sua alta sensibilidade e alto valor preditivo negativo. As versÃes reduzidas com 15 e 4 itens demonstraram ser bons testes de rastreamento, com a vantagem de requererem menos tempo para aplicaÃÃo. O uso sistemÃtico da GDS, em unidades de atenÃÃo primÃria de saÃde, à recomendado para que haja uma maior identificaÃÃo desses casos, permitindo tratamento adequado / Introduction â Depression is one of the major potentially treatable psychiatric disorders affecting geriatric patients. At primary care facilities up to 30-50% of depressed patients are misdiagnosed and therefore not treated adequately. Recognition of depression is best improved by routine screening using efficient and easily applicable instruments. One of the most widely used instruments, the Geriatric Depression Scale (GDS), has been sufficiently validated in samples from specialized or out-sourced services. However, few studies, none of them from Brazil, have evaluated the performance of the GDS at the level of primary care in which most geriatric patients with depression are treated, making it hard to generalize existing results to this context. Objectives â 1) to determine the sensitivity, specificity, positive predictive value, negative predictive value and likelihood ratio in relation to the GDS comparing findings to structured clinical interviews for disorders of Axis I of the DSM-IV (SCID-I); 2) to build a Receiver Operator Characteristic Curve (ROC) determining the ideal cut-off point for primary care patients; 3) to determine the prevalence of episodes of major depression in geriatric primary care patients; 4) to identify the socio-demographic profile of geriatric primary care patients; 5) to examine geriatric patients presenting with episodes of depression and/or dysthymic disorders while taking anti-depressants. Method â cross-sectional study involving 220 geriatric patients from four health facilities. A questionnaire providing a global profile of the study population was applied, as well as the GDS and structured clinical interviews for disorders in Axis I of the DSM-IV (SCID-I). The first two instruments were applied by a trained interviewer and the SCID (gold standard) was applied by a trained psychiatrist. Results â The prevalence of episodes of major depression and/or dysthymic disorders was 17.27%. The best cut-off point with GDS-30 was 10/11 (case/non-case) with a sensitivity of 92.1% (CI 77.5â97.9), specificity 79.7% (CI = 72.9â85.1), accuracy 81.8% and likelihood ratio 4.5. The best cut-off point with GDS-15 was 4/5 with a sensitivity of 86.8% (CI = 71.1â95.1), specificity 82.4% (CI = 75.9â87.5), accuracy 83.1% and likelihood ratio 4.9. The best cut-off point with GDS-4 was 0/1 with a sensitivity of 84.2% (CI = 68.1â93.4), specificity 74.7% (CI = 67.7â80.7), accuracy 76.30% and likelihood ratio 3.9. With GDS-1 the sensitivity was 52.6% (CI = 36.0â68.7%). Conclusions â GDS-30 is an excellent screening instrument for episodes of major depression and/or dysthymic disorders at primary care facilities due to its high sensitivity and high negative predictive value. Reduced versions with 15 and 4 items proved good screening tests requiring less time to be applied. The systematic use of GDS at primary care facilities is recommended in order to identify a greater number of cases of depression and thereby offer a more adequate treatment.

В магистерской диссертации рассматриваются актуальные тенденции развития дистрибуции авиабилетов на российском рынке. Студент уделяет внимание современным GDS, а также проводит сравнительный анализ онлайн-инструментов продаж авиабилетов. В работе также отражена и текущая ситуация на рынке гражданской авиации страны. / The master's thesis discusses the current development trend of the distribution of airline tickets at the Russian market. The student pays attention to modern GDS, as well as a comparative analysis of online ticket sales tools. The paper also reflects the current situation at the market of civil aviation in Russia.

Submitted by Hiolanda Rêgo (hiolandarego@gmail.com) on 2014-01-30T18:02:07Z No. of bitstreams: 1 Dissertação_Med_Mônica Hupsel Frank.pdf: 1575367 bytes, checksum: 0da25e299eb33ef892bd455bd3e9486e (MD5) / Approved for entry into archive by Flávia Ferreira (flaviaccf@yahoo.com.br) on 2014-02-21T19:36:40Z (GMT) No. of bitstreams: 1 Dissertação_Med_Mônica Hupsel Frank.pdf: 1575367 bytes, checksum: 0da25e299eb33ef892bd455bd3e9486e (MD5) / Made available in DSpace on 2014-02-21T19:36:40Z (GMT). No. of bitstreams: 1 Dissertação_Med_Mônica Hupsel Frank.pdf: 1575367 bytes, checksum: 0da25e299eb33ef892bd455bd3e9486e (MD5) / O aumento do número de idosos no Brasil mudou o perfil de morbimortalidade, com predomínio de doenças crônicas, entre elas a depressão. Existe no entanto, situações nas quais os sintomas depressivos apresentados não preenchem os critérios estabelecidos pelo CID 10 ou DSM IV para qualquer transtorno do humor. No entanto, são mais comuns que estes e comprometem a qualidade de vida. Poucos são os estudos na população brasileira, especialmente rural, sobre a prevalência destes sintomas. Objetivo: determinar a prevalência dos sintomas depressivos em idosos do município de Santo Estêvão – Bahia – Brasil. Desenho do estudo: descritivo de corte transversal. Material e Métodos: foram analisados 1944 questionários preenchidos pelos Agentes Comunitários de Saúde (ACS) nos domicílios dos idosos, incluindo a aplicação da escala de depressão geriátrica de 15 itens (GDS 15). Definiram-se cinco como ponto de corte para sintomas depressivos clinicamente relevantes, sendo analisados também os pontos de corte de oito ou mais e dez ou mais sintomas, para a possibilidade de doença moderada e severa, respectivamente. Resultados: média de idade 71,9 ± 8,2 anos e média de 5,2 sintomas por indivíduo. A prevalência de sintomas depressivos clinicamente relevantes foi de 59,3%, 16,7% e 5,1% para os três pontos de corte estabelecidos. Houve significância estatística para o ponto de corte de cinco ou mais sintomas, para sexo feminino, indivíduos maiores que oitenta anos, analfabetos, não casados e os que não conviviam com companheiro. Para o ponto de corte de oito ou mais sintomas, para sexo feminino, indivíduos que permaneciam trabalhando, analfabetos e não casados ou que não conviviam com companheiro. Para o ponto de corte de dez ou mais sintomas para sexo feminino, não casados ou que não conviviam com companheiro. Conclusões: A prevalência encontrada foi superior à referida na literatura para populações semelhantes, para estudos que utilizaram o mesmo instrumento e para os estudos nacionais, possivelmente pelo perfil sóciodemográfico da população.

京都大学 / 0048 / 新制・課程博士 / 博士(社会健康医学) / 甲第19276号 / 社医博第67号 / 新制||社医||9(附属図書館) / 32278 / 京都大学大学院医学研究科社会健康医学系専攻 / (主査)教授 中山 健夫, 教授 川上 浩司, 教授 福原 俊一 / 学位規則第4条第1項該当 / Doctor of Public Health / Kyoto University / DFAM

A graph dynamical system (GDS) is a theoretical construct that can be used to simulate and analyze the dynamics of a wide spectrum of real world processes which can be modeled as networked systems. One of our goals is to compute the phase space of a system, and for this, even 30-vertex graphs present a computational challenge. This is because the number of state transitions needed to compute the phase space is exponential in the number of graph vertices. These problems thus produce memory and execution speed challenges. To address this, we devise various MapReduce programming paradigms that can be used to characterize system state transitions, compute phase spaces, functional equivalence classes, dynamic equivalence classes and cycle equivalence classes of dynamical systems. We also evaluate these paradigms and analyze their suitability for modeling different GDSs. / Master of Science

In the final master’s dissertation analysis on current 15below communication platform PASNGR. In addition to this there is a short analysis done on each of PASNGR components to find out usage possibilities. Furthermore, the platform is dependant on Reservation Systems, so analysis on them is done as well, including processes and data. The goal of this dissertation is to create a mobile app integrated into PASNGR. For this reason integration analysis is done, by reviewing components, data and functions. After analysis is done, Business Process Model is created to represent the workflow of the app, including internal processes and interaction with PASNGR. Furthermore a review of mobile application technologies is done, including common tools used in development. By doing this there is the best solution for current 15below developers’ environment found. The solution would mean the least resources to be used to develop the app. Finally a prototype of the mobile application is created, to show the possibilities. The app works on Android and iOS platforms, gives an ability for user to download itineraries and store for offline usage, an ability to scan a barcode at the airport straight from the app, give post flight experience feedback for the airline, receive schedule change notifications and accept them. / Baigiamajame magistro darbe atliekama kompanijos „15below“ naudojamos avialinijų komunikacijos su keleiviais platformos „PASNGR“ analizė. Atskirai atliekama trumpa kiekvieno „PASNGR“ modulio apžvalga įvertinant taikymo galimybes. Be to, kadangi platforma yra priklausoma nuo globaliųjų paskirstymo sistemų, apžvelgiamos ir jos apimant procesus, bei naudojamus duomenis. Darbe yra numatomas sukurti mobiliosios aplikacijos prototipas surištas su „PASNGR“ platforma. Tam tikslui yra atliekama integracijos analizė, apžvelgiant komponentus, duomenis ir funkcijas. Galiausiai yra sukuriamas veiklos proceso modelis atvaizduojantis mobiliosios aplikacijos prototipo veikimo principus, bei interakciją su platforma „PASNGR“. Darbo eigoje apžvelgiamos mobiliųjų aplikacijų technologijos, bei įrankiai joms kurti. Taip parenkamas priimtiniausias spendimas esamai kompanijos „15below“ programuotojų aplinkai ir lemiantis minimalias sąnaudas. Galiausiai sukuriamas mobiliosios aplikacijos prototipas veikiantis Android ir iOS platformose, gebantis atsisiųsti elektroninius bilietus į mobilųjį įrenginį ir jame išsaugoti naudojimui neprisijungus prie interneto, leidžiantis naudotojui skenuoti brūkšninį kodą oro uoste, po skrydžio pateikti nuomonę apie gautas avialinijų paslaugas, priimti pranešimus apie skrydžių pakeitimus, bei leisti juos patvirtinti.

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal.

The work focuses on the use of online reservation systems for the hotel industry. The first part is dedicated to the development of the Internet and describes the online sales. The second part describes the electronic distribution systems, global distribution systems and Internet reservation systems. The third section demonstrates the practical use of these systems in practice applied to a concrete hotel. At the end is described the current situation of on-line sales and the assumption of its development in the future. The goal is to unify the information about the online reservation systems currently used in the hotel industry.

Cada vez es mayor el número de personas que componen el segmento de edad que está por encima de los 65 años y se va incrementando el de aquellas que superan los 80 años. Ese aumento va paralelo al de personas que padecen enfermedades visuales relacionadas con el envejecimiento. Los déficits visuales graves pueden afectar a las actividades desarrolladas por el individuo y a su participación en las situaciones vitales, provocando limitaciones en las actividades y restricciones en la participación y como consecuencia discapacidad y dependencia. También afecta a la eficacia de las estrategias usadas habitualmente y aprendidas a lo largo de los años para resolver las diversas exigencias de la vida.Al proceso por el que la persona reaprende o modifica esas estrategias habituales de resolución de las exigencias de la vida en todos los ámbitos, incluido el emocional, se denomina proceso de ajuste a la discapacidad visual. En esta tesis se expone la propuesta de un modelo estructural de proceso de ajuste a la discapacidad visual en personas mayores de 65 años, con pérdida de visión superior al 90% y en las que no hay otras patologías relevantes, además de la visual.El protocolo de recogida de datos, que incluía varias escalas (NAS, Escala de Ajuste de Nottingham , Dodds, 2006; EBS escala de bienestar subjetivo, Pallero y Ferrando, 2003; GDS, escala geriátrica de depresión de Brink y Yesavage, 1982, en su adaptación española de Izal y Montorio, 1996 y AVLS, escala de ajuste a la pérdida visual sobrevenida con la edad de Horowitz y Reinhardt, 2006 cuya adaptación a la población española es parte de la tesis) se aplicó a una muestra de 335 personas.La adaptación española de la escala AVL mantiene el mismo número de ítems, 24, y de factores, 1, de la versión original. Su fiabilidad es de O.8 (alpha de Cronbach). Se realizó siguiendo los criterios para la traducción y adaptación de los tests de Muñiz y Hambleton (1996 y 2000).El modelo fue planteado como un modelo de ecuaciones estructurales, realizándose su análisis a partir de la matriz de covarianzas, con un submodelo de medida (indicadores) y un submodelo estructural (predictores). Los resultados indican que los datos no contradicen el modelo propuesto y que el ajuste podría considerarse bueno. El factor general de ajuste parece tener suficiente consistencia y muestra como los indicadores son buenas medidas del factor, todos los coeficientes estructurales muestran valores por encima del 0,60, siendo las variables propuestas, depresión (presencia/ausencia de sintomatología) y autoestima (percepción de valía) significativamente superiores a ideación suicida (presencia/ausencia de pensamientos de suicidio y deseo de muerte) y a bienestar psicológico (percepción de bienestar). Los predictores muestran un comportamiento más dispar: de entre las variables propuestas, actitudes (evaluación de la percepción sobre la deficiencia visual en general), aceptación (evaluación de la percepción de la deficiencia visual sobre la propia persona afectada) y adaptación (incluiría la aceptación desde una perspectiva más cercana al aprendizaje de las habilidades adaptativas y considerando la interrelación con los familiares) son las que muestran un buen comportamiento, destacando aceptación sobre las otras.En resumen se considera que se ha podido establecer una interesante propuesta de modelo relacional del proceso de ajuste a la discapacidad visual sobrevenida en la vejez. Modelo que muestra tener suficiente consistencia para servir de base para futuras investigaciones que permitan aumentar el conocimiento de ese proceso. Ese mejor conocimiento ha de permitir a los profesionales de diversos ámbitos (psicología, trabajo social, pedagogía y rehabilitación) una mejor comprensión de las personas que han perdido la vista de mayores, mejorando así sus intervenciones y, en consecuencia, la calidad de vida de la persona mayor con discapacidad visual, facilitando el ajuste a la pérdida visual sobrevenida y modulando la posible dependencia. / There are increasingly more people in the over sixty-fives age bracket and the number of over eighties is also growing. This increase is hand-in-hand with the number of people suffering age-related visual diseases. Serious visual impairments can affect the activities pursued by the individual and their participation in life events, leading to limitations in activities and restrictions in participation and, as a consequence disability and dependency. It also affects the efficacy of the strategies that are commonly used and learned over the years to deal with life's varying requirements.The process by which a person relearns or changes such habitual strategies to solve the requirements posed by life in all fields, including the emotional, is known as the adjustment process to visual disability. This thesis presents the proposal of a structural model of the adjustment process to visual disability in the over-65s, with visual impairment of greater than 90% and not suffering any other relevant pathology other than the visual one.The protocol for data collection, which included several scales (NAS, Nottingham Adjustment Scale, Dodds, 2006; EBS escala de bienestar subjetivo or subjective welfare scale, Pallero and Ferrando, 2003; GDS, geriatric depression scale by Brink and Yesavage, 1982, in the Spanish adaptation by Izal and Montorio, 1996 and the AVLS, or age-related vision loss scale by Horowitz and Reinhardt, 2006, whose adaptation to the Spanish population forms part of the thesis) was applied to a sample of 335 people.The Spanish adaptation of the AVL scale maintains the same number of items, 24, and of factors, 1, of the original version. Its reliability is 0.8 (Cronbach's alpha). It was done following the tests translation and adaptation of Muñiz and Hambleton's (1996 and 2000) criteria.The model was approached as being a model of structural equations, their analysis being carried out based on the covariance matrix, with a measurement submodel (indicators) and a structural submodel (predictors). The results indicate that the data do not contradict the proposed model and that adjustment could be considered as being good. The general adjustment factor seems to be sufficiently consistent and shows how the indicators are good measures of the factor, all structural coefficients showing values of over 0.60, and the proposed variables are depression (presence/absence of symptomatology) and self-esteem (perception of value) significantly greater than suicide ideation (presence/absence of suicidal thoughts and the will to die) and psychological well being (feeling of well being). The predictors show a more disparate behaviour: from among the proposed variables, attitudes (assessment of perception on the visual discapacity in general), acceptance (assessment of the perception of the visual discapacity on the affected person him or herself) and adaptation (which would include acceptance from a viewpoint closer to the learning of adaptive skills and considering interrelationships with family members) are seen to behave well, acceptance standing out above the rest.In short, it is considered that it has been possible to establish an interesting proposal of a relational model of the adjustment process to visual discapacity attendant upon old age. It is a model which proves to be sufficiently consistent as to serve as a basis for future research to allow furthering our knowledge into this process. Such further knowledge must allow the professionals of a variety of fields (psychology, social work, pedagogy and rehabilitation) to better understand people who have lost their sight later in life, thus improving their interventions and, as a consequence, the quality of life of the visually impaired elderly person, easing their adjustment to the visual loss experienced and modulating possible dependency.

This thesis focuses on the distribution and comparison of different distribution channels, which are used in aviation. Theoretical knowledge is applied to the example of two major European airlines, KLM and Air France, which together form a group of Air France-KLM. The main objective is to compare the various distribution channels and to confirm or to refute the thesis that the vast majority of airline bookings is realized through the travel agencies. The first part focuses on the history of aviation, international organizations active in the aviation and on the actual distribution. Another section is devoted to airlines KLM and Air France. The last part deals with the differences between the various distribution channels and compares them based on specific data.