Made available in DSpace on 2014-06-11T19:32:05Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-02-24Bitstream added on 2014-06-13T20:42:39Z : No. of bitstreams: 1 macharelli_ca_dr_botfm.pdf: 2403268 bytes, checksum: a44fffeaff80c6818630f8724462477f (MD5) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / O tracoma ainda é um importante problema de saúde pública, causando morbidade, deficiência visual e cegueira em diversos países subdesenvolvidos ou em desenvolvimento. Em 2006 foi realizado um estudo transversal nas escolas estaduais na de Bauru, estado de São Paulo, que revelou uma prevalência de 3,7% de tracoma no município. O presente estudo tem como objetivo analisar o comportamento espacial da ocorrência dos casos de tracoma detectados na cidade de Bauru pelo referido estudo, a fim de utilizar as informações apuradas para definir áreas prioritárias para a otimização dos recursos do setor Saúde. Para atingirmos nossos objetivos lançamos mão de uma ferramenta que é o geoprocessamento em saúde ‐ uma das maneiras de se conhecer mais detalhadamente as condições de saúde da população através de mapas que permitem observar a distribuição espacial de situações de risco e dos problemas de saúde. A quantificação dos fenômenos observados pode ser feita de várias formas, sendo a estimativa de Kernel uma delas. Esse procedimento permite filtrar a variabilidade de um conjunto de dados, sem alterar as suas características locais. Os casos de tracoma foram georreferenciados com uso do GPS e depois as coordenadas transformadas em latitudes e longitudes decimais, com o auxílio do TCGeo. As análises espaciais foram feitas com o TerraView, utilizando‐se os pontos dos casos, das escolas, e dados do censo IBGE 2000, contidos nos CD‐Rom: Base de informações por setor censitário, Censo demográfico 2000, Resultados do Universo. Bauru. IBGE, 2002. O protocolo empregado possibilitou que todas as crianças detectadas pelo estudo de Ferraz (2006) fossem visitadas pela equipe executora do presente e georeferenciadas usando aparelho de GPS. As crianças que fizeram parte da amostra apresentavam média de idade de 8.5 anos, eram na sua maioria do sexo masculino e... / Trachoma still is an important issue for public health; it increases morbidity, causing visual deficiency and blindness in several underdeveloped or developing countries. In 2006, a transversal study was carried out among public schools in Bauru, São Paulo state. The study revealed a prevalence of 3.7% of trachoma in the town. This study aims at analyzing the spatial behavior of the cases detected in Bauru by the 2006 research, in order to define areas that should have priority when improving the municipal health system. We used health geoprocessing – which is done by maps that show the spatial distribution of risk situations and health problems, allowing to know details about the population health. The phenomena observed can be quantified in different manners – Kernel estimation is one of them, and the one we used, because it permits to filter the variability of a set of data without altering its local features. Trachoma cases were georeferenced with a GPS and their coordinates were converted with TCGeo into decimal latitudes and longitudes. Spatial analyses were carried out with TerraView, using points of cases and schools, and data from IBGE 2000 census found in the CD‐Rom: Base de informações por setor censitário, Censo demográfico 2000, Resultados do Universo. Bauru. IBGE, 2002 (Information database on each censual sector. Demographic census 2000, Universal Results. Bauru. IBGE, 2002). The procedures allowed our team to visit and georeference all the children detected by Ferraz (2006). The children are mostly males, with a mean age of 8.5 years and presenting uni or bilateral trachoma. Geoprocessing was important for it facilitates the process of spatial localization through Google Earth (2007) – which allowed us to notice a concentration of cases in regions with low income. We could also observe that individuals with low income are not concentrated on the ...(Complete abstract click electronic access below)

This thesis is concerned, loosely, with time series analysis. It is also, loosely, concerned with smoothers and Generalized Additive Models. And, finally, it is also concerned with the estimation of health risk due to air pollution. In the field of time series analysis, we develop two data-driven interpolation algorithms for interpolation of mixed time series data; that is, data which has a stationary or “almost” stationary background with embedded deterministic trend and sinusoidal components. These interpolators are developed to deal with the problem of estimating power spectra under the condition that some observations of the series are unavailable. We examine the structure of time-based cubic regression spline smoothers in Generalized Additive Models and demonstrate several interpretation problems with the resultant models. We propose, implement, and test a replacement smoother and show dramatic improvement. We further demonstrate a new, spectrally motivated way of examining residuals in Generalized Additive Models which drives many of the findings of this thesis. Finally, we create and analyze a large-scale Canadian air pollution and mortality database. In the course of analyzing the data we rebuild the standard risk estimation model and demonstrate several improvements. We conclude with a comparison of the original model and the updated model and show that the new model gives consistently more positive risk estimates. / Thesis (Ph.D, Mathematics & Statistics) -- Queen's University, 2012-10-26 14:32:00.678

Orientador: Silvana Artioli Schellini / Banca: Ivete Dalben Soares / Banca: Luciene Cristina Barbarini Ferraz / Banca: Paula Araújo Opromolla / Banca: Norma Helen Medina / Resumo: O tracoma ainda é um importante problema de saúde pública, causando morbidade, deficiência visual e cegueira em diversos países subdesenvolvidos ou em desenvolvimento. Em 2006 foi realizado um estudo transversal nas escolas estaduais na de Bauru, estado de São Paulo, que revelou uma prevalência de 3,7% de tracoma no município. O presente estudo tem como objetivo analisar o comportamento espacial da ocorrência dos casos de tracoma detectados na cidade de Bauru pelo referido estudo, a fim de utilizar as informações apuradas para definir áreas prioritárias para a otimização dos recursos do setor Saúde. Para atingirmos nossos objetivos lançamos mão de uma ferramenta que é o geoprocessamento em saúde ‐ uma das maneiras de se conhecer mais detalhadamente as condições de saúde da população através de mapas que permitem observar a distribuição espacial de situações de risco e dos problemas de saúde. A quantificação dos fenômenos observados pode ser feita de várias formas, sendo a estimativa de Kernel uma delas. Esse procedimento permite filtrar a variabilidade de um conjunto de dados, sem alterar as suas características locais. Os casos de tracoma foram georreferenciados com uso do GPS e depois as coordenadas transformadas em latitudes e longitudes decimais, com o auxílio do TCGeo. As análises espaciais foram feitas com o TerraView, utilizando‐se os pontos dos casos, das escolas, e dados do censo IBGE 2000, contidos nos CD‐Rom: Base de informações por setor censitário, Censo demográfico 2000, Resultados do Universo. Bauru. IBGE, 2002. O protocolo empregado possibilitou que todas as crianças detectadas pelo estudo de Ferraz (2006) fossem visitadas pela equipe executora do presente e georeferenciadas usando aparelho de GPS. As crianças que fizeram parte da amostra apresentavam média de idade de 8.5 anos, eram na sua maioria do sexo masculino e ...(Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Trachoma still is an important issue for public health; it increases morbidity, causing visual deficiency and blindness in several underdeveloped or developing countries. In 2006, a transversal study was carried out among public schools in Bauru, São Paulo state. The study revealed a prevalence of 3.7% of trachoma in the town. This study aims at analyzing the spatial behavior of the cases detected in Bauru by the 2006 research, in order to define areas that should have priority when improving the municipal health system. We used health geoprocessing - which is done by maps that show the spatial distribution of risk situations and health problems, allowing to know details about the population health. The phenomena observed can be quantified in different manners - Kernel estimation is one of them, and the one we used, because it permits to filter the variability of a set of data without altering its local features. Trachoma cases were georeferenced with a GPS and their coordinates were converted with TCGeo into decimal latitudes and longitudes. Spatial analyses were carried out with TerraView, using points of cases and schools, and data from IBGE 2000 census found in the CD‐Rom: Base de informações por setor censitário, Censo demográfico 2000, Resultados do Universo. Bauru. IBGE, 2002 (Information database on each censual sector. Demographic census 2000, Universal Results. Bauru. IBGE, 2002). The procedures allowed our team to visit and georeference all the children detected by Ferraz (2006). The children are mostly males, with a mean age of 8.5 years and presenting uni or bilateral trachoma. Geoprocessing was important for it facilitates the process of spatial localization through Google Earth (2007) - which allowed us to notice a concentration of cases in regions with low income. We could also observe that individuals with low income are not concentrated on the ...(Complete abstract click electronic access below) / Doutor

Submitted by Maike Costa (maiksebas@gmail.com) on 2016-03-11T11:40:35Z No. of bitstreams: 1 arquivototal.pdf: 1638271 bytes, checksum: e2629241526c1bc07d5eb288f2e080e5 (MD5) / Made available in DSpace on 2016-03-11T11:40:36Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 1638271 bytes, checksum: e2629241526c1bc07d5eb288f2e080e5 (MD5) Previous issue date: 2015-12-17 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Sensitive Conditions Primary health problems are treated by typical actions of the first level of health care, so that in situations of absence of effective service requires the use of specialized services in hospitals. Thus, hospitalizations are used as indicators to assess and monitor the effectiveness of Primary Health Care. The study is justified by the need to advance the discussion on health indicators to support managers in the decision-making process with regard to the proper planning of health actions that are often distorted and generate financial losses due to failure in planning, so that meet the needs of users of health services, primarily in the area of primary care while ordinate of health care. It is an exploratory, descriptive, ecological and inferential with quantitative and qualitative approaches. Quantitative results were analyzed based on the hypothesis tests for equal proportions and trends in proportions. Qualitative analysis was performed based on discourse analysis technique to shed proposed by José Luiz Fiorin. There was a downward trend in hospitalizations caused by primary care-sensitive conditions. in the city of João Pessoa/PB, from 2008 to 2013. However, there was an average of 16% of hospital expenses with preventable diseases. Analysis of the 19 groups of hospitalizations sensitive conditions. revealed that three groups (16%) did not show any trend and seven groups (37%) had growing trend of admissions. It was also observed that there are weaknesses in the planning process managers; failures in the network of health care and professional work process. It is suggested continuous investment in primary care in order to strengthen services so that health actions are carried out in an efficient and timely manner, aiming to avoid Sensitive Conditions Hospitalization for primary care; reduction in financial costs and unnecessary access to the services offered by the municipal health. / Condições Sensíveis à Atenção Primária são problemas de saúde tratados por ações típicas do primeiro nível de atenção à saúde, de modo que, em situações de ausência de atendimento efetivo, requer o uso de serviços especializados em hospitais. Dessa forma, as internações são utilizadas como indicadores para avaliar e monitorar a efetividade da Atenção Primária à Saúde (APS). O estudo se justifica pela necessidade de fazer avançar a discussão sobre os indicadores de saúde para subsidiar os gestores no processo de tomada de decisão no tocante ao planejamento adequado das ações de saúde que muitas vezes são distorcidas e geram prejuízos financeiros por falhas no planejamento, de modo a que atendam as necessidades dos usuários dos serviços de saúde, prioritariamente, na área da atenção primária enquanto ordenadora do cuidado em saúde. Trata-se de um estudo exploratório, descritivo, ecológico e inferencial com abordagens quantitativa e qualitativa. Os resultados quantitativos foram analisados a partir dos testes de hipóteses para igualdade de proporções e tendências de proporções. A análise qualitativa foi realizada com base na técnica de Análise de Discurso na vertente proposta por José Luiz Fiorin. Observou-se uma tendência decrescente das proporções de Internação por Condições Sensíveis à Atenção Primária (ICSAP) no município de João Pessoa/PB, no período de 2008 a 2013. Contudo, houve uma média de gastos hospitalares de 16% com doenças evitáveis. A análise dos 19 grupos de ICSAP revelou que, três grupos (16%) não apresentavam nenhum tipo de tendência e sete grupos (37%) apresentavam tendência crescente de internações. Também foi possível observar que existem fragilidades no processo de planejamento dos gestores; falhas na rede de atenção à saúde e no processo de trabalho dos profissionais. Sugere-se investimentos contínuos na Atenção Primária, no intuito de fortalecer os serviços, para que as ações de saúde sejam realizadas de forma eficiente e oportuna, objetivando evitar as Internações por Condições Sensíveis à Atenção Primária; diminuição de gastos financeiros e acessos desnecessários aos serviços oferecidos pela saúde municipal.

Abstrakt  Introduktion: Covid-19 pandemin påverkade många människors aktivitetsmönster, befintliga vanor och levnadssätt, däribland studenter som fick studera befintliga campusförlagda utbildningar på distans. Restriktioner medförde att studenter besökte färre platser och ägnade mindre tid åt sociala aktiviteter och fysiska aktiviteter. Samtidigt ägnades mer tid åt stillasittande aktiviteter, mediekonsumtion och vila. Studier visar att studenter under pandemin upplevde minskad livskvalitet, ökade stressnivåer och sämre psykisk hälsa. Syfte: Syftet med studien var att beskriva studenters upplevelse av aktivitetsbalans i relation till upplevd hälsa efter covid-19 pandemin. Metod: Studien använde en kvantitativ metod, enkätundersökning med 38 deltagare som rekryterades genom ett bekvämlighetsurval. Enkäten bestod av instrumenten the Occupational Balance Questionnarie (OBQ) och the Salutogenic Health Indicator Scale (SHIS) samt egenkonstruerade frågor. Insamlad data analyserades genom en icke-parametrisk metod. Resultat: Resultatet visar att studenterna upplevde relativt god hälsa, men att aktivitetsbalansen skattades lägre efter pandemin. Positiva samband med högre nivåer av aktivitetsbalans och salutogen hälsa återfanns i stöd från studiekamrater och campusbaserade studier. Studenter som bodde tillsammans med någon skattade högre nivåer av aktivitetsbalans och hälsa, jämfört med ensamboende.  Slutsats: Pandemin har påverkat studenternas aktivitetsbalans och hälsa. Studien fann samband mellan aktivitetsbalans och hälsa i förhållande till studieform, boendeform och upplevt stöd från klasskamrater. / Abstract  Introduction: The covid-19 pandemic affected people’s occupational patterns, habits, and lifestyles, including students who had to study existing campus-based studies online. Restrictions meant that students visited fewer places and spent less time on social and physical activity. More time was spent on sedentary activities, media consumption and rest. Studies have shown that students experienced a reduced quality of life, increased stress levels and poorer mental health during the pandemic.  Aim: The aim of the study was to describe students’ experience of occupational balance in relation to perceived health after the covid-19 pandemic. Method: A quantitative and a non-parametric method was used. 38 participants were included. The questionnaire consisted of the Occupational Balance Questionnaire and The Salutogenic Health Indicator Scale, as well as self-constructed questions.  Results: Students experienced relatively good health, but the occupational balance was possibly lower. Positive associations with higher levels of occupational balance and salutogenic health were found in support from classmates, campus-based studies and living together. Conclusions: Students' occupational balance and health was possibly affected after the pandemic. The study found relationships between occupational balance and health in relation to education form, living situation and their sense of support from classmates.

Made available in DSpace on 2014-12-17T15:43:54Z (GMT). No. of bitstreams: 1 YanNLF_DISSERT.pdf: 996679 bytes, checksum: d60527f71ba710af4baa8effe26b413a (MD5) Previous issue date: 2014-02-25 / Dentre os v?rios aspectos da sa?de do idoso, a sa?de bucal merece aten??o especial pelo fato de que, historicamente, nos servi?os odontol?gicos, n?o se considera esse grupo populacional como prioridade de aten??o. Por isso, se faz necess?ria a produ??o de um indicador multidimensional capaz de mensurar todas as altera??es bucais encontradas em um idoso, facilitando a categoriza??o da sa?de bucal como um todo. Tal indicador representar? um importante instrumento capaz de elencar prioridades de aten??o voltadas ? popula??o idosa. Portanto, o estudo em quest?o prop?e a produ??o e valida??o de um indicador de sa?de bucal a partir dos dados secund?rios coletados pelo projeto SB Brasil 2010 referente ao grupo et?rio de 65 a 74 anos. A amostra foi representada pelos 7619 indiv?duos do grupo et?rio de 65 a 74 anos que participaram da pesquisa nas 5 (cinco) regi?es do Brasil. Tais indiv?duos foram submetidos ? avalia??o epidemiol?gica das condi??es de sa?de bucal, a partir dos ?ndices CPO-d, CPI e PIP. Al?m disso, verificou-se o uso e necessidade de pr?tese, bem como caracter?sticas sociais, econ?micas e demogr?ficas. Uma an?lise fatorial identificou um n?mero relativamente pequeno de fatores comuns, atrav?s da an?lise de componentes principais. Ap?s a nomenclatura dos fatores, foi realizada a soma dos escores fatoriais por indiv?duo. Por ?ltimo, a dicotomiza??o dessa soma nos forneceu o indicador de sa?de bucal proposto. Para esse estudo foram inclu?das na an?lise fatorial 12 vari?veis de sa?de bucal oriundas do banco de dados do SB Brasil 2010 e, tamb?m 3 vari?veis socioecon?micas e demogr?ficas. Com base no crit?rio de Kaiser, observa-se que foram retidos cinco fatores que explicaram 70,28% da vari?ncia total das vari?veis inclu?das no modelo. O fator 1 (um) explica sozinho 32,02% dessa vari?ncia, o fator 2 (dois) 14,78%, enquanto que os fatores 3 (tr?s), 4 (quatro) e 5 (cinco) explicam 8,90%, 7,89% e 6,68%, respectivamente. Por meio das cargas fatoriais, o fator um foi denominado dente h?gido e pouco uso de pr?tese , o dois doen?a periodontal presente , o tr?s necessidade de reabilita??o , j? o quarto e quinto fator foram denominados de c?rie e condi??o social favor?vel , respectivamente. Para garantir a representatividade do indicador proposto, realizou-se uma segunda an?lise fatorial em uma subamostra da popula??o de idosos investigados. Por outro lado, a aplicabilidade do indicador produzido foi testada por meio da associa??o do mesmo com outras vari?veis do estudo. Por fim, Cabe ressaltar que, o indicador aqui produzido foi capaz de agregar diver sas informa??es a respeito da sa?de bucal e das condi??es sociais desses indiv?duos, traduzindo assim, diversos dados em uma informa??o simples, que facilita o olhar dos gestores de sa?de sobre as reais necessidades de interven??es em rela??o ? sa?de bucal de determinada popula??o

Assessment of machine health and prediction of future failures are critical for maintenance decisions. Many of the existing methods use unsupervised techniques to construct health indicators by measuring the disparity between the current state and either the healthy or the faulty states of the system. This approach can work well, but if the resulting health indicators are insufficient there is no easy way to steer the algorithm towards better ones. In this thesis a new method for health indicator construction is investigated that aims to solve this issue. It is based on measuring distance after transforming the sensor data into a new space using a feed-forward neural network. The feed-forward neural network is trained using a multi-objective optimization algorithm, NSGA-II, to optimize criteria that are desired in a health indicator. Thereafter the constructed health indicator is passed into a gated recurrent unit for remaining useful life prediction. The approach is compared to benchmarks on the NASA Turbofan Engine Degradation Simulation dataset and in regard to the size of the neural networks, the model performs relatively well, but does not outperform the results reported by a few of the more recent methods. The method is also investigated on a simulated dataset based on elevator weights with two independent failures. The method is able to construct a single health indicator with a desirable shape for both failures, although the latter estimates of time until failure are overestimated for the more rare failure type. On both datasets the health indicator construction method is compared with a baseline without transformation function and does in both cases outperform it in terms of the resulting remaining useful life prediction error using the gated recurrent unit. Overall, the method is shown to be flexible in generating health indicators with different characteristics and because of its properties it is adaptive to different remaining useful life prediction methods. / Estimering av maskinhälsa och prognos av framtida fel är kritiska steg för underhållsbeslut. Många av de befintliga metoderna använder icke-väglett (unsupervised) lärande för att konstruera hälsoindikatorer som beskriver maskinens tillstånd över tid. Detta sker genom att mäta olikheter mellan det nuvarande tillståndet och antingen de friska eller fallerande tillstånden i systemet. Det här tillvägagångssättet kan fungera väl, men om de resulterande hälsoindikatorerna är otillräckliga så finns det inget enkelt sätt att styra algoritmen mot bättre. I det här examensarbetet undersöks en ny metod för konstruktion av hälsoindikatorer som försöker lösa det här problemet. Den är baserad på avståndsmätning efter att ha transformerat indatat till ett nytt vektorrum genom ett feed-forward neuralt nätverk. Nätverket är tränat genom en multi-objektiv optimeringsalgoritm, NSGA-II, för att optimera kriterier som är önskvärda hos en hälsoindikator. Därefter används den konstruerade hälsoindikatorn som indata till en gated recurrent unit (ett neuralt nätverk som hanterar sekventiell data) för att förutspå återstående livslängd hos systemet i fråga. Metoden jämförs med andra metoder på ett dataset från NASA som simulerar degradering hos turbofan-motorer. Med avseende på storleken på de använda neurala nätverken så är resultatet relativt bra, men överträffar inte resultaten rapporterade från några av de senaste metoderna. Metoden testas även på ett simulerat dataset baserat på elevatorer som fraktar säd med två oberoende fel. Metoden lyckas skapa en hälsoindikator som har en önskvärd form för båda felen. Dock så överskattar den senare modellen, som använde hälsoindikatorn, återstående livslängd vid estimering av det mer ovanliga felet. På båda dataseten jämförs metoden för hälsoindikatorkonstruktion med en basmetod utan transformering, d.v.s. avståndet mäts direkt från grund-datat. I båda fallen överträffar den föreslagna metoden basmetoden i termer av förutsägelsefel av återstående livslängd genom gated recurrent unit- nätverket. På det stora hela så visar sig metoden vara flexibel i skapandet av hälsoindikatorer med olika attribut och p.g.a. metodens egenskaper är den adaptiv för olika typer av metoder som förutspår återstående livslängd.

Samverkan är ett ständigt aktuellt ämne som ofta diskuteras i samhällsdebatten och ses som en lösning på många problem. När sjuktalen ökade i början av 2000-talet, fattade regeringen beslut om att avsätta medel för projekt inom och mellan myndigheter som ett steg på vägen mot att lösa problemen. Sjukskrivningstalen sjönk sedan mellan åren 2002 och 2010 för att åter vända uppåt. Idag behövs fortfarande åtgärder för att förbättra arbetsmiljön och få ner ohälsotalen i samhället. Denna uppsats beskriver samverkan i ett samarbetsprojekt avseende hälsonyckeltal. Huvudsyftet är att identifiera förutsättningarna för Centrogruppens samarbetsprojekt och studera samspelet mellan de deltagande myndigheterna. Ett andra syfte är att i teoridelen göra en litteraturgenomgång och beskrivning av begreppen samverkan, samarbete och närliggande begrepp. Det tredje syftet är att beskriva och analysera de bestående resultaten av samarbetsprojektet. I ett människa-teknik-organisation (M-T-O) och arbetsmiljöperspektiv är det intressant att se om samverkan mellan organisationer kan bidra till en bättre arbetsmiljö och minskande sjuktal. Uppsatsen är skriven under två perioder, där jag under den första delen följde Centromyndigheternas Hälsobokslutsprojekt och i den andra delen följde upp hur det gick med myndigheternas användning av nyckeltalen. Genom deltagande observation, kombinerat med individuella intervjuer, studerade jag myndigheternas samverkan under projekttiden. Utifrån den teoretiska bakgrunden om vilken plattform som behövs för ett lyckat samarbete skattade och beskrev deltagarna projektarbetets förutsättningar utifrån parametrarna; tillit, jämlika relationer, tid och resurser samt externt stöd. Resultatet visade att det fanns goda förutsättningar för projektet som också genomfördes enligt plan och levererade en slutprodukt, bestående av förslag på gemensamma hälsonyckeltal och en rapport. Sett över tid kan det ändå konstateras att hälsonyckeltalen inte fick det genomslag och den användning som avsetts, eftersom endast två av myndigheterna använder nyckeltalen i sin redovisning. De främsta skälen till att nyckeltalen inte kom att användas på det sätt som initialt var planerat uppges vara omorganisation av verksamheten, svårigheter med den digitala överföringen samt byte av medarbetare på vissa nyckelpositioner. / Collaboration is a recurring topic in the public debate, and is often seen as a possible solution to many problems. When the disease rate kept increasing in the early 2000s, the Swedish government decided to allocate funds to enable government agencies to set up projects, as a step towards reversing the trend. The disease rate in Sweden fell between the years 2002 and 2010, and then started increasing again. There is still a need for measures to be taken in order to improve the working environment and reduce ill health in society. This paper describes the interactions in a joint project concerning health ratios. The main objective is to identify the conditions for a group of government agencies, called the Centro-group, and to study the interaction between the participating authorities. A second objective is to carry out a literature review of the cooperation, collaboration and related concepts. The third objective is to describe and analyse the remaining results of the joint project. From a Human-Technology-Organisation (HTO) and Workplace Health and Safety (WHS) perspective, it is interesting to see if cooperation between organizations can contribute to a better working environment and to reducing morbidity. This paper is written during two periods. During the first part I studied the Centro authorities' Health accounting Project, and in the second part I followed up what happened with the authorities' use of key indicators. Through participant observation, combined with individual interviews, I studied the authorities' cooperation during the project. Based on the theoretical background of the platform needed for successful cooperation, the participants described the project's conditions based on the parameters; reliance, equal relations, time and resources, as well as external support. The results showed that there were good conditions for the project, as they were defined in the theoretical platform. The project was carried out as planned and delivered a result consisting of joint health indicators and a final report. Over time it has been shown that the health indicators were not used as intended, because only two of the authorities use the key indicators in their Annual Report. The main reasons that the health indicators did not have the intended impact were reported to be reorganisations, difficulties with the digital transmission, as well as replacement of employees in certain key positions.

As the public and government officials become aware of the impact of public health on communities, it is important that relevant public health statistics be available for decision making. Existing web resources have limited visualization options, cannot visually compare a county to all others in the US, and cannot compare the counties in an arbitrary region to all others in the US. The College of Public Health Indicator Visualization Tool (CPHIVT) is a web application providing visualization and ranking for a county in the US in comparison to all counties for a specific health indicator. An iterative development methodology was used to complete major features and refine the features over time. Features divided into small tasks that could be completed within two-week cycles. After the first version of the web application was completed and presented to the client, client feedback on the application was used to refine specifications and was incorporated into planning for future iterations. Iterative development was adopted with a focus on improving and expanding existing features and making the application publicly available online. A suite of automated user interface tests is being developed to verify the application’s functions. Making a complete version of the application publicly available involves significant research and software configuration to deploy the web application in a secure and performant manner. The web application has two major components corresponding to its two major user groups. The first component allows authenticated users from the Department of Public Health to upload and manage sets of data for various health indicators. Tools are included to automatically process uploaded data points. This allows the information presented on the web site to be expanded and kept up to date over time with minimal effort. The second component is accessible to anyone and allows a user to choose to a state or county with text search or hierarchical navigation. The application then provides graphical charts showing that location’s standing for various health indicators compared to all other counties nationally. This is accomplished by applying percentile rankings to the counties and plotting the percentiles against the values for a selected indicator. A user can save a generated chart to a variety of export formats including PNG image or PDF document. The application is expected to serve as a tool for many community members. Staff and students at the College of Public Health will use this tool for presentations and research. County health departments will be able to use the tool when planning community programs. County government leaders can use this tool to determine areas of need in the community. Decision makers will have the ability to visualize their county or region as compared to the nation, not just to neighboring counties or within a state.

Ce travail présente un dispositif de surveillance épidémiologique novateur en santé environnementale fondée sur des évènements de santé déclarée, au plus près de la nature des plaintes exprimées par les populations : des symptômes et une dégradation de la qualité de vie. Ce dispositif est proposé à partir d’une réflexion conceptuelle reposant sur une revue de la littérature sur les théories psychométriques et le modèle transactionnel du stress et d’une application de terrain portant sur la population (n=1 495) riveraine du site industriel chimique de Salindres (Gard). Ces travaux permettent de vérifier les principales propriétés métriques d’indicateurs de santé déclarée mesurés, par les instruments MOS SF-36 et SCL-90-R, dans le cadre d’une population exposée à une pollution environnementale. Ils vérifient également l’adéquation et la sensibilité de ces indicateurs pour étudier les facteurs de risque environnementaux qui se réfèrent aux représentations cognitives des risques, comme la perception sensoriels des stimuli émis par les sites industriels. Ils montrent, en outre, que la disponibilité de références nationales portant sur la mesure de ces indicateurs leur confère un critère de qualité essentiel d’interprétation des résultats. Ces travaux apportent enfin des éléments d’appréciation de l’acceptabilité de la mesure des indicateurs de santé déclarée dans la population, des recommandations sur la communication pour la mise en œuvre d’un tel dispositif et des pistes de réflexion pour la gestion. / This work presents an innovative epidemiological surveillance system in environmental health based on self-reported health indicators, closer to the complaints of the local population leaving around a source of environmental pollution: symptoms and loss of the quality of life. This approach is built up from a conceptual framework based on the psychometric theory and the transactional model of stress. A field application of this approach was carried out the population neighboring (n=1 495) the chemical industrial area of Salindres, Gard. This study verifies that self-reported health indicators measured with MOS SF-36 and SCL-90-R can be used to study populations exposed to multifactorial environmental risks. This study confirms that these indicators are relevant and sensitive when applied to environmental risk factors referring to the cognitive representations of risks, such as the sensorial perception of stimuli emitted by the industries. This work shows, besides, that the availability of national references for these indicators confers interpretability to these indicators, an essential quality criterion. This work discusses qualitatively the acceptability of measuring indicators of self-reported health in the population, proposes recommendations on communication for the setting of that kind of approach, and opens up avenues on management orientations.