This dissertation describes a case study comparing the effectiveness of twoinformation systems that assess the quality of surgical care, the National SurgicalQuality Improvement Program (NSQIP) and the University HealthSystemConsortium Clinical Database (UHCCD). For the comparison, it develops aframework for assessing contextual data quality (CDQ) from the decision maker'sperspective. The differences in quality assessment systems to be studied areposited to be due to the differing contexts in which the data is encoded,transformed and managed impacting data quality for the purpose of surgicalquality assessment.Healthcare spending in the United States has risen faster than the rate of inflationfor over a decade and currently stands at about fifteen percent of the GrossDomestic Product. This has brought enormous pressures on the healthcareindustry to reduce costs while maintaining or improving quality. Numeroussystems to measure healthcare quality have been, and are being, developedincluding the two being studied. A more precise understanding of the differencesbetween these two systems' effectiveness in the assessment of surgical healthcarequality informs decisions nationally regarding hospital accreditation and qualitybasedreimbursements to hospitals.The CDQ framework elaborated is also applicable to executive informationsystems, data warehouses, web portals, and other information systems that drawinformation from disparate systems. Decision makers are more frequently havingdata available from across functional and hierarchical areas within organizationsand data quality issues have been identified in these systems unrelated to thesystem performance from which the data comes.The propositions explored and substantiated here are that workgroup contextinfluences data selection and definition, the data entry and encoding process,managerial control and feedback, and data transformation in information systems.These processes in turn influence contextual data quality relative to a particulardecision model.The study is a cross-sectional retrospective review of archival quality datagathered on 26,322 surgical patients at the University of Kentucky Hospital alongwith interviews of process owners in each system. The quality data includepatient risk/severity factors and outcome data recorded in the National SurgeryQuality Improvement Program (NSQIP) database and the UniversityHealthSystem Consortium Clinical Database (UHCCD).

Com o crescente número de idosos na população mundial surgem preocupações referentes a políticas que acomodem as particularidades desta população. Foi a partir desse crescimento populacional que surgiram novas políticas de saúde para a população idosa. Atualmente, revela-se uma necessidade de avaliar estas políticas. As informações são limitadas nos sistemas de informação de saúde e estão disponíveis somente dados de notificações obrigatórias. O Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ-AB) pode representar o inicio de um ciclo, instituindo a avaliação da atenção básica no país, para realizar um planejamento com melhores ações e condições de ampliação do serviço. Essa pesquisa busca analisar a percepção dos usuários idosos sobre os serviços de saúde prestados nas Unidades Básicas de Saúde a partir da avaliação do PMAQ-AB. Como objetivos específicos a) descrever as características sociodemográficas e presença de doenças de usuários idosos que utilizam os serviços de saúde nas Unidades Básicas de Saúde no Brasil e suas regiões; b) verificar a percepção de usuários idosos quanto aos serviços de saúde prestados nas Unidades Básicas de Saúde no Brasil. Para isso, foi realizado um estudo descritivo transversal. Como amostra utilizou as entrevistas do módulo de avaliação externa do segundo ciclo do PMAQ respondidas por usuários com 60 anos ou mais, totalizando 26.746 usuários idosos. Os serviços de saúde foram avaliados como acessíveis pelos usuários idosos, sendo utilizados conforme suas demandas de saúde. Os idosos estão em maior concentração nas regiões sudeste e nordeste do país; como maioria são mulheres brancas e pardas com escolaridade de ensino fundamental que não trabalham. A hipertensão e a diabetes são acometimentos presentes. O acesso as unidade de saúde é facilitado pela proximidade dos domicílios e o horário de atendimento é suficiente. Uma das formas de atendimento é a marcação das consultas, porém nem sempre possível para o mesmo dia, mas a equipe busca resolver os problemas apresentados pelos usuários. As equipes estão organizadas, realizando os encaminhamentos necessários. Praticamente todos os usuários recebem a visita dos agentes comunitários e levam o tratamento até a sua conclusão. Os cuidados ofertados pelo sistema de saúde estão de acordo com as políticas contemporâneas de saúde, que indicam buscar a recuperação da saúde, estabilização e prevenção das doenças. Isso mostra que os serviços estão atendendo as necessidades de saúde da população idosa. / With the increasing number of elderly people in the world population arise concerns about policies that accommodate the particularities of this population. From this population growth that new health policies emerged for the elderly population. Currently needs to evaluate these policies. The National Program for the Improvement of Access and Quality of Primary Care (PMAQ-AB) can represent the beginning of a cycle, instituting the evaluation of basic care in the country, to carry out a plan with better actions and conditions for expansion of the service. This research seeks to analyze the perception of the elderly users about the health services provided in the Basic Health Units from the evaluation of the PMAQ-AB. As specific objectives a) to describe the sociodemographic characteristics and presence of diseases of elderly users who use the health services in the Basic Health Units in Brazil and its regions; b) to verify the perception of elderly users regarding the health services provided in the Basic Health Units in Brazil. For this, a cross-sectional descriptive study was carried out. The sample was the interviews of the external evaluation module of the second cycle of the PMAQ answered by users aged 60 years or more, totaling 26,746 elderly users. The health services were evaluated as accessible by the elderly users, being used according to their health demands The elderly are more concentrated in the southeastern and northeastern regions of the country; The majority of whom are white and grizzly women with elementary school education who do not work. Hypertension and diabetes are present complications. Access to the health unit is facilitated by the proximity of the homes and the hours of care are sufficient. One of the forms of service is the marking of appointments, but not always possible for the same day, but the team seeks to solve the problems presented by users. The teams are organized, making the necessary referrals. Practically all users are visited by community agents and take the treatment to completion. The care offered by the health system is in accordance with the contemporary health policies, which indicate the recovery of health, stabilization and prevention of diseases. This shows that services are meeting the health needs of the elderly population.

Even with advanced technology and new project management methodologies, construction company leaders continue to face challenges to improve labor productivity. This multiple case study was an exploration of the strategies that construction company leaders use to improve labor productivity in Doha, Qatar. The case population consisted of 6 construction company leaders operating in Doha, Qatar, who successfully identified and implemented strategies to improve labor productivity. The conceptual framework for this study was the expectancy theory. The data collection process included semistructured interviews and company documentation. Data were compiled and organized, disassembled into fragments, reassembled into a sequence of groups, and interpreted for meaning. Methodological triangulation and member checking bolstered the trustworthiness of those interpretations. Five themes emerged from these 6 construction company leaders: exploring, identifying, and evaluating issues affecting labor productivity; applying an appropriate leadership style; motivating the workforce; providing training and development; and implementing effective project management processes. By improving labor productivity, similar construction companies can complete construction projects faster and with lower construction costs. The implications for positive social change include the potential to lower construction costs and enable individuals with lower incomes in Doha, Qatar, to afford houses that they could not previously afford.

Det offentliga Sverige digitaliseras i en snabb takt och om fördelarna med den tekniska utvecklingen ska kunna tas tillvara krävs det tillgång till ett antal grundläggande funktioner. En viktig grundfunktion är möjligheten att på ett säkert sätt kunna identifiera användare av e-tjänster och att kunna kontrollera att elektroniskt underskrivna handlingar är äkta. En nödvändig del av den grundläggande infrastrukturen för såväl e-förvaltning som för kommersiella aktörer är därmed elegitimering och e-underskrift. Den här studien syftar till att utforska processen för hantering av hyreskontrakt hos Uppsala kommun. För att utforska den här processen utgår studien från tre frågeställningar – (1) hur processen ser ut idag, (2) hur processen kan förbättras, samt (3) hur den förbättringen kan implementeras i organisationen. De problem som finns i processen idag är att processen är väldigt papperstung. Anledningen till att processen är papperstung är den stora mängden hyreskontrakt som hanteras. Hyreskontrakten hanteras i flera olika steg och de ska undertecknas i skrift av flera olika personer på flera olika exemplar. Teorin i den här studien är uppbyggt främst från kvalitetsteknikens egna teorier och modeller, men även från andra områden, såsom digitalisering. Kvalitetsteknikens teorier och modeller användes som en grund till förbättringsarbetet där digitaliseringen kom in och användes för att stärka upp förbättringen av det specifika fokusområdet. De metoder som användes vid datainsamlingen var främst intervjuer. De genomfördes i form av ostrukturerade intervjuer. Vid datainsamlingen gjordes även en insamling av kvantitativa data. Dataanalysen gjordes med hjälp av ett fiskbensdiagram där huvudkategorierna utgick från de olika typer av slöseri som Lean-konceptet använder. För att analysera de identifierade problemen i fiskbensdiagrammet ännu mer användes ”fem varför?” för att hitta rotorsakerna till problemen. Resultatet visade att den dåvarande processen var väldigt omfattande med alla dess steg samt komplicerad då hyreskontrakten skulle skickas mellan både interna och externa parter. Resultatet visar även att grundorsaken till majoriteten av problemen berodde på att Uppsala kommun inte har digitala funktioner som kan hantera underskrifter av hyreskontrakten. Slutsatsen av den här studien är att genom en digitalisering av processen skulle stora förbättringar kunna göras. Antal steg i processen skulle minska och hanteringen av varje avtal skulle bli enklare då processen skulle slippa hantering av papper. / Public Sweden is digitised at a rapid pace and if the benefits of technological development would be utilised, access to a number of basic functions is required. An important base is the possibility that in an appropriate way identify users of e-services and to verify that acts have electronic signatures. Electronic identification and e-signatures are a necessary infrastructure for both e-administration and commercial actors. This study leads up to explore the process for administration of rental agreements at Uppsala kommun. To be able to explore this process, the study is based on three question formulations - (1) how the process is working today, (2) how the process can be improved and (3) how the improvement can be implemented in the organisation. The current problem with the process is that it is mainly based on paper. The reason for that is the big amount of rental agreements being handled. The rental agreements are handled in many different steps and need to be manually signed by many different persons in many copies. This study is based on various theories and models from the Quality Technology, and also from the digitalisation area. The theories and models from the Quality Technology was used as a base for the work of improvements, where the digitalisation was used as a complement to strengthen the improvement of the specific area. The methods that have been used for the data collection were foremost interviews. They were made in an unstructured form. Through the data collection, quantitative data were also collected. The analyse of data was made through a fishbone diagram where the main categories were originated from the different kinds of waste from the Lean concept. To further analyse the identified problems in the fishbone diagram, the method 5 Whys were used to find the root cause of the problem. The result showed that the former process was extensive containing a lot of steps and also complicated because the rental agreements were distributed between internal and external parts. The result also shows that the main cause of the majority of the problems was caused by the fact that Uppsala kommun does not have digital functions that can handle signatures of the rental agreements. The conclusion of the study is that big improvements can be done if a digitalisation of the process would be done. The number of steps in the process would be reduced and the handling of every agreement would be easier if the process got rid of all papers.

Com o crescente número de idosos na população mundial surgem preocupações referentes a políticas que acomodem as particularidades desta população. Foi a partir desse crescimento populacional que surgiram novas políticas de saúde para a população idosa. Atualmente, revela-se uma necessidade de avaliar estas políticas. As informações são limitadas nos sistemas de informação de saúde e estão disponíveis somente dados de notificações obrigatórias. O Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ-AB) pode representar o inicio de um ciclo, instituindo a avaliação da atenção básica no país, para realizar um planejamento com melhores ações e condições de ampliação do serviço. Essa pesquisa busca analisar a percepção dos usuários idosos sobre os serviços de saúde prestados nas Unidades Básicas de Saúde a partir da avaliação do PMAQ-AB. Como objetivos específicos a) descrever as características sociodemográficas e presença de doenças de usuários idosos que utilizam os serviços de saúde nas Unidades Básicas de Saúde no Brasil e suas regiões; b) verificar a percepção de usuários idosos quanto aos serviços de saúde prestados nas Unidades Básicas de Saúde no Brasil. Para isso, foi realizado um estudo descritivo transversal. Como amostra utilizou as entrevistas do módulo de avaliação externa do segundo ciclo do PMAQ respondidas por usuários com 60 anos ou mais, totalizando 26.746 usuários idosos. Os serviços de saúde foram avaliados como acessíveis pelos usuários idosos, sendo utilizados conforme suas demandas de saúde. Os idosos estão em maior concentração nas regiões sudeste e nordeste do país; como maioria são mulheres brancas e pardas com escolaridade de ensino fundamental que não trabalham. A hipertensão e a diabetes são acometimentos presentes. O acesso as unidade de saúde é facilitado pela proximidade dos domicílios e o horário de atendimento é suficiente. Uma das formas de atendimento é a marcação das consultas, porém nem sempre possível para o mesmo dia, mas a equipe busca resolver os problemas apresentados pelos usuários. As equipes estão organizadas, realizando os encaminhamentos necessários. Praticamente todos os usuários recebem a visita dos agentes comunitários e levam o tratamento até a sua conclusão. Os cuidados ofertados pelo sistema de saúde estão de acordo com as políticas contemporâneas de saúde, que indicam buscar a recuperação da saúde, estabilização e prevenção das doenças. Isso mostra que os serviços estão atendendo as necessidades de saúde da população idosa. / With the increasing number of elderly people in the world population arise concerns about policies that accommodate the particularities of this population. From this population growth that new health policies emerged for the elderly population. Currently needs to evaluate these policies. The National Program for the Improvement of Access and Quality of Primary Care (PMAQ-AB) can represent the beginning of a cycle, instituting the evaluation of basic care in the country, to carry out a plan with better actions and conditions for expansion of the service. This research seeks to analyze the perception of the elderly users about the health services provided in the Basic Health Units from the evaluation of the PMAQ-AB. As specific objectives a) to describe the sociodemographic characteristics and presence of diseases of elderly users who use the health services in the Basic Health Units in Brazil and its regions; b) to verify the perception of elderly users regarding the health services provided in the Basic Health Units in Brazil. For this, a cross-sectional descriptive study was carried out. The sample was the interviews of the external evaluation module of the second cycle of the PMAQ answered by users aged 60 years or more, totaling 26,746 elderly users. The health services were evaluated as accessible by the elderly users, being used according to their health demands The elderly are more concentrated in the southeastern and northeastern regions of the country; The majority of whom are white and grizzly women with elementary school education who do not work. Hypertension and diabetes are present complications. Access to the health unit is facilitated by the proximity of the homes and the hours of care are sufficient. One of the forms of service is the marking of appointments, but not always possible for the same day, but the team seeks to solve the problems presented by users. The teams are organized, making the necessary referrals. Practically all users are visited by community agents and take the treatment to completion. The care offered by the health system is in accordance with the contemporary health policies, which indicate the recovery of health, stabilization and prevention of diseases. This shows that services are meeting the health needs of the elderly population.

Com o crescente número de idosos na população mundial surgem preocupações referentes a políticas que acomodem as particularidades desta população. Foi a partir desse crescimento populacional que surgiram novas políticas de saúde para a população idosa. Atualmente, revela-se uma necessidade de avaliar estas políticas. As informações são limitadas nos sistemas de informação de saúde e estão disponíveis somente dados de notificações obrigatórias. O Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ-AB) pode representar o inicio de um ciclo, instituindo a avaliação da atenção básica no país, para realizar um planejamento com melhores ações e condições de ampliação do serviço. Essa pesquisa busca analisar a percepção dos usuários idosos sobre os serviços de saúde prestados nas Unidades Básicas de Saúde a partir da avaliação do PMAQ-AB. Como objetivos específicos a) descrever as características sociodemográficas e presença de doenças de usuários idosos que utilizam os serviços de saúde nas Unidades Básicas de Saúde no Brasil e suas regiões; b) verificar a percepção de usuários idosos quanto aos serviços de saúde prestados nas Unidades Básicas de Saúde no Brasil. Para isso, foi realizado um estudo descritivo transversal. Como amostra utilizou as entrevistas do módulo de avaliação externa do segundo ciclo do PMAQ respondidas por usuários com 60 anos ou mais, totalizando 26.746 usuários idosos. Os serviços de saúde foram avaliados como acessíveis pelos usuários idosos, sendo utilizados conforme suas demandas de saúde. Os idosos estão em maior concentração nas regiões sudeste e nordeste do país; como maioria são mulheres brancas e pardas com escolaridade de ensino fundamental que não trabalham. A hipertensão e a diabetes são acometimentos presentes. O acesso as unidade de saúde é facilitado pela proximidade dos domicílios e o horário de atendimento é suficiente. Uma das formas de atendimento é a marcação das consultas, porém nem sempre possível para o mesmo dia, mas a equipe busca resolver os problemas apresentados pelos usuários. As equipes estão organizadas, realizando os encaminhamentos necessários. Praticamente todos os usuários recebem a visita dos agentes comunitários e levam o tratamento até a sua conclusão. Os cuidados ofertados pelo sistema de saúde estão de acordo com as políticas contemporâneas de saúde, que indicam buscar a recuperação da saúde, estabilização e prevenção das doenças. Isso mostra que os serviços estão atendendo as necessidades de saúde da população idosa. / With the increasing number of elderly people in the world population arise concerns about policies that accommodate the particularities of this population. From this population growth that new health policies emerged for the elderly population. Currently needs to evaluate these policies. The National Program for the Improvement of Access and Quality of Primary Care (PMAQ-AB) can represent the beginning of a cycle, instituting the evaluation of basic care in the country, to carry out a plan with better actions and conditions for expansion of the service. This research seeks to analyze the perception of the elderly users about the health services provided in the Basic Health Units from the evaluation of the PMAQ-AB. As specific objectives a) to describe the sociodemographic characteristics and presence of diseases of elderly users who use the health services in the Basic Health Units in Brazil and its regions; b) to verify the perception of elderly users regarding the health services provided in the Basic Health Units in Brazil. For this, a cross-sectional descriptive study was carried out. The sample was the interviews of the external evaluation module of the second cycle of the PMAQ answered by users aged 60 years or more, totaling 26,746 elderly users. The health services were evaluated as accessible by the elderly users, being used according to their health demands The elderly are more concentrated in the southeastern and northeastern regions of the country; The majority of whom are white and grizzly women with elementary school education who do not work. Hypertension and diabetes are present complications. Access to the health unit is facilitated by the proximity of the homes and the hours of care are sufficient. One of the forms of service is the marking of appointments, but not always possible for the same day, but the team seeks to solve the problems presented by users. The teams are organized, making the necessary referrals. Practically all users are visited by community agents and take the treatment to completion. The care offered by the health system is in accordance with the contemporary health policies, which indicate the recovery of health, stabilization and prevention of diseases. This shows that services are meeting the health needs of the elderly population.

Landscape management is often referred to as a holistic concept, which deals with large-scale processes and multidisciplinary manners in regards to natural resource use with ecological and livelihood considerations. Seen in this light, landscape transformation should be understood within the context of the human-nature relationship, viewing human activities and their institutions as an essential part of the system rather than as external agents. When it comes to the landscape planning and management related to cotton farming in Gujarat, there has been diversity of interest groups such as local communities, governments, corporations and non-governmental organisations. In the present study, I examine two case studies of cotton production pertaining to the Gujarat region in order to study the opportunities and challenges faced by local farmers in the process of developing agriculture. In the first case study on Cotton Improvement Program in the nineteenth century, I highlight the socioecological consequences of the colonial cotton project and how it relates to the social dynamics of networks and agricultural landscape management. The second case study examines current debates regarding the social, economic and environmental impacts of genetically modified (GM) cotton on India’s social and natural landscape. This thesis emphasises that there are recursive motifs between the two case studies in terms of the local resistances, power relations and possible environmental effects, which can be explained through the state of ‘global core’ and ‘periphery’, and partly the framework of ecologically unequal exchange. The analysis of recurring patterns concludes that exploring the narratives of local experiences offers a number of significant details that show complex power dynamics manifested through constant struggles and resistances by ‘peripheral agent’.

Adventists following a plant-based diet have half the prevalence and incidence of type 2 diabetes than nonvegetarian Adventists. This study used a quantitative, correlational study design to assess if there was a significant difference in type 2 diabetes prevalence rate between Adventists and non-Adventists preprogram, and if there were significant differences in biometrics between Adventists and non-Adventists with diabetes pre- and post-Complete Health Improvement Program (CHIP). This study incorporated the social ecological model for its conceptual framework and examined pre- and postprogram changes among Adventists (n=210; 20.1%) and non-Adventists (n=836; 79.9%) with type 2 diabetes. It used secondary data from participants in the volunteer-delivered CHIP intervention from 2006 to 2012 (n=7,172), a whole foods, plant-based, vegan health program. Analysis showed a significant difference in the pre-CHIP diabetic state between the two groups in step one, but not after controlling for covariates in step two (OR=0.96 and 0.91; CI=1.21 and 1.24). A repeated measures MANOVA analysis indicated that religious affiliation (Adventist or non-Adventist) was the determining factor in improved biometric outcomes pre- and post-CHIP for TC (F(1) = 5.65; p = 0.02), and LDL (F(1) = 5.76; p = 0.02) but not for HDL (F(1) = 0.00; p = 0.99), TG (F(1) = 0.19, p = 0.67), FPG (F(1) = 2.71, p = 0.10), SBP (F(1) = 2.25; p = 0.13), DBP (F(1) = 1.20; p = 0.27), and BMI (F(1) = 1.65; p = 0.20). However, both groups improved post-CHIP in all biometrics. The implications for positive social change from this study showed that CHIP is an effective lifestyle model for improving type 2 diabetes outcomes for both Adventists and non-Adventists, a model that does not involve the use of pharmaceuticals.

Os Núcleos de Apoio à Saúde da Família (NASF) foram criados em 2008 para ampliar a abrangência, o escopo e a resolubilidade das ações da Atenção Básica (AB). Passados 10 anos desde a sua criação, mecanismos de monitoramento, avaliação das ações e resultados alcançados pelo NASF ainda são insuficientes. O Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ-AB), lançado em 2011, visa incentivar os gestores e as equipes de saúde para a melhoria da qualidade dos serviços oferecidos aos usuários do SUS e o fortalecimento da AB. O objetivo dessa pesquisa foi analisar a organização e a prática profissional do NASF no Brasil, com base nos dados coletados no segundo ciclo do PMAQ-AB (2013 - 2014). Para este estudo quantitativo e descritivo utilizou-se a base de dados secundários provenientes da avaliação externa das equipes de AB que participaram do PMAQ-AB. Foram utilizados dois instrumentos de avaliação externa: 1) Equipes de Atenção Básica (Saúde da Família e Equipe Parametrizada); e 2) Núcleos de Apoio à Saúde da Família – NASF. Do primeiro, foram escolhidos três domínios do Módulo II: Adequação da composição das equipes às necessidades do território; Acesso das equipes ao NASF; e Articulação das ações de apoio técnico-pedagógico e clínico-assistencial. Do segundo, os seguintes domínios: Educação permanente; Organização do apoio matricial às EAB; e Gestão da demanda e da atenção compartilhada. Para a análise dos dados utilizou-se o SPSS versão 22.0. Os resultados indicaram a inserção de novos profissionais na AB, em especial o Fisioterapeuta, o Profissional de Educação Física e o Médico Veterinário. Ficou evidente o planejamento de ações conjuntas entre o NASF e a eSF, embora a literatura aponte muitas dificuldades para essa atividade. Principais meios de contato entre as equipes: em dias programados ou pelo telefone, já o e-mail era pouco usual. Dentre as atividades realizadas em conjunto, as visitas domiciliares e as consultas individuais foram destaque para as eSF. Para os profissionais do NASF: discussão de casos e visitas com profissionais da sua equipe. Discussões sobre monitoramento e avaliação de resultados da atenção compartilhada tiveram um resultado pouco expressivo na rotina das equipes. Público-alvo atendido pelo NASF: adultos e idosos, destacando-se atividades voltadas para a atenção nutricional e atenção às pessoas com doenças crônicas. / The Family‟s Health Support Centers were created in 2008 to broaden the coverage, scope and solvability of Basic Attention‟s programs. Ten years after its creation, monitoring mechanisms, measurement of programs and results achieved by NASF are still scarce. The National Improvement Program of Access and Quality of Basic Attention (PMAQ-AB), launched in 2011, aims to motivate managers and health teams to improve quality of services offered to SUS‟ users and to strengthen Basic Attention. The goal of this research was to analyze the organization and the professional practice of NASF in Brazil, based on data collected in the second cycle of PMAQ-AB (2013-2014). To this quantitative and descriptive study, we used the secondary database from the external evaluation of AB teams that participated in PMAQ-AB. Two instruments were used for the external evaluation: 1) Attention Basic teams (Family‟s Health and Parameterized Teams); and 2) Family‟s Health Support Centers – NASF. From the first, we picked three domains from the II module: adjustment of team‟s composition to the territory needs; access from teams to NASF; and articulation of actions from technical-pedagogical support, as well as clinical-care. From the second, the following domains: Perennial education; organization of matrix support to the EAB; and demand and shared attention management. For data analysis we used SPSS version 22.0. Results pointed to the insertion of new professionals at AB, especially Physical Therapist, Physical Education professional and Veterinarian. It was evident the lack of joint action planning between NASF and eSF, although literature references many difficulties in this activity. The main points of contact between teams: in scheduled days or thought the phone, since e-mail was barely used. Among shared activities, residential visits and individual appointments were highlights for eSF. To NASF professionals: discussions of cases and visits with team professionals. Discussions about monitoring and evaluation of results from shared attention had a small impact in the team‟s routine. Target audience supported by NASF: adults and senior citizens, especially activities designed to nutritional attention and people with chronic diseases.

From the Proceedings of the 1974 Meetings of the Arizona Section - American Water Resources Assn. and the Hydrology Section - Arizona Academy of Science - April 19-20, 1974, Flagstaff, Arizona / In the lower reaches of the Colorado River, damages from the increase in salinity to U.S. water users are now estimated to be about 53 million dollars per year and will increase to about 124 million dollars per year by the year 2000 if no salinity control measures are taken. Physical, legal, economic, and institutional aspects of the salinity problem and proposed actions to mesh salinity control with a total water management plan for the basin are discussed. A scheme is presented for planning under the Colorado River water quality improvement program. Recent legislative action is also discussed which provides control plans to improve the water quality delivered to Mexico as well as upper basin water users. These efforts now under study will assure the continued, full utility of Colorado River water to U.S. users and Mexico. However, more extensive development of the basin's natural resources puts new emphasis on total resources management through improved water and land use planning to conserve a most precious western resource - water.