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O Tratamento Supervisionado consiste num dos melhores instrumentos disponíveis na luta contra a Tuberculose. Assim propôs-se analisar a organização do Tratamento Supervisionado nos 36 municípios prioritários do Estado de São Paulo. Para o alcance dos objetivos utilizou-se uma abordagem qualitativa, que buscou entender o significado do fenômeno individual ou coletivo para a vida das pessoas, selecionando-se para este fim todos os coordenadores dos municípios prioritários do Estado de São Paulo. A técnica utilizada na análise dos dados foi analise de conteúdo, modalidade temática, evidenciando-se dois núcleos de sentido centrais: Aspectos técnicos-operacionais na execução do Tratamento Supervisionado e Estratégias de Intervenção para Adesão do paciente. Em relação ao primeiro núcleo, verificou-se que em 13 (59%) dos municípios não utilizam critérios para a inserção do paciente em TS, 13 (59%) determinam à freqüência de supervisão, seguindo normas ou protocolos institucionais, 18 (81%) dos municípios realizam a supervisão da ingesta medicamentosa predominantemente em Unidades de Saúde, sendo que na maioria desses, não há possibilidade da realização do TS no domicílio, em casos de impossibilidade do paciente deslocar até o serviço. A supervisão medicamentosa em 11 (50%) dos municípios prioritários é realizada, exclusivamente, por profissionais de saúde, entretanto importantes atores estão se integrando ao TS, como membros da família, da comunidade e Agentes Comunitários de Saúde. No que se refere ao segundo núcleo, nota-se que uma das estratégias de intervenção lançadas pelas equipes consiste na entrega de incentivos e benefícios, demonstrando as relações de solidariedade entre profissionais de saúde e paciente, observando-se assim que as relações de acolhimento e vínculo são os pilares principais para as equipes que buscam a adesão do paciente. Destaca-se ainda, que a relação de vínculo, faz com que as equipes ao realizar o TS, sintam-se tão próximas do paciente, que num processo de transferência, sentem-se responsáveis por todas as suas necessidades. Um ponto ainda a ser destacado como estratégia de adesão, corresponde a própria flexibilidade das equipes, durante a realização do TS, respeitando as escolhas dos pacientes. Conclui-se, portanto que o TS deve ser realizado dentro de um espírito democrático, tendo como protagonista principal o próprio paciente, assumindo a responsabilidade na regularidade da ingestão medicamentosa, mas dentro de uma conformação de respeito e empatia. / The Directly Observed Therapy (DOT) is one of the best available instruments used in the struggle against Tuberculosis. There for, it was intended to analyze the Directly Observed Therapy Organization, in the 36 priority counties, in the Sao Paulo State. To achieve the objectives, it was used a qualitative approach, that did not intent to understand the phenomenon, but instead, to understand the individual or collective meaning that had for the people life; for this purpose, were selected all the coordinators in the priority counties, in the Sao Paulo State. The data was analyzed using the Content Analyzes method - Thematic Mode; two central cores were emphasized: Technical-Operational Aspects in the Directly Observed Therapy Execution and Intervention Strategies Seeking the Patient Adhesion. Related to the first core, it was found that, in 13 (59%) counties, did not utilize criteria to include the patients in the DOT; 13 (59%) counties established supervision frequencies, following institutional norms and protocols; 18 (81%) counties supervised the drugs intake, specially, in the Health Units; when the patient could not attend the Unit, it was not possible to realize the DOT at their homes. The drugs intake supervision, in 11 (50%) priority counties, was controlled exclusively by the health professionals; however, other important actors were joining the DOT, such as family members, community members and Community Health Workers. In the second core, was perceived a strategy, developed by the team, that works thru benefits and incentives, demonstrating the relations of solidarity between the health professionals and the patients, and also, that the relationships created during the reception and the bonds of linkage were the main tools to be used by the teams to seek the patients adhesion. Even further, it was highlighted that the bond that links professionals and patients, made that the teams, when performing the DOT, felt very close to the patients, and in a transfer process, the team felt responsible by all the patients needs. Another point to be highlighted, as an adhesion strategy, was the team flexibility, demonstrated during the DOT, when it considered the patients preferences. It was concluded, that the DOT must be realized with a democratic spirit, having as it main actor the patient itself, who must ingest the medicine and accept the responsibility of this action – all this developed in an environment of respect and empathy.

O Tratamento Supervisionado consiste num dos melhores instrumentos disponíveis na luta contra a Tuberculose. Assim propôs-se analisar a organização do Tratamento Supervisionado nos 36 municípios prioritários do Estado de São Paulo. Para o alcance dos objetivos utilizou-se uma abordagem qualitativa, que buscou entender o significado do fenômeno individual ou coletivo para a vida das pessoas, selecionando-se para este fim todos os coordenadores dos municípios prioritários do Estado de São Paulo. A técnica utilizada na análise dos dados foi analise de conteúdo, modalidade temática, evidenciando-se dois núcleos de sentido centrais: Aspectos técnicos-operacionais na execução do Tratamento Supervisionado e Estratégias de Intervenção para Adesão do paciente. Em relação ao primeiro núcleo, verificou-se que em 13 (59%) dos municípios não utilizam critérios para a inserção do paciente em TS, 13 (59%) determinam à freqüência de supervisão, seguindo normas ou protocolos institucionais, 18 (81%) dos municípios realizam a supervisão da ingesta medicamentosa predominantemente em Unidades de Saúde, sendo que na maioria desses, não há possibilidade da realização do TS no domicílio, em casos de impossibilidade do paciente deslocar até o serviço. A supervisão medicamentosa em 11 (50%) dos municípios prioritários é realizada, exclusivamente, por profissionais de saúde, entretanto importantes atores estão se integrando ao TS, como membros da família, da comunidade e Agentes Comunitários de Saúde. No que se refere ao segundo núcleo, nota-se que uma das estratégias de intervenção lançadas pelas equipes consiste na entrega de incentivos e benefícios, demonstrando as relações de solidariedade entre profissionais de saúde e paciente, observando-se assim que as relações de acolhimento e vínculo são os pilares principais para as equipes que buscam a adesão do paciente. Destaca-se ainda, que a relação de vínculo, faz com que as equipes ao realizar o TS, sintam-se tão próximas do paciente, que num processo de transferência, sentem-se responsáveis por todas as suas necessidades. Um ponto ainda a ser destacado como estratégia de adesão, corresponde a própria flexibilidade das equipes, durante a realização do TS, respeitando as escolhas dos pacientes. Conclui-se, portanto que o TS deve ser realizado dentro de um espírito democrático, tendo como protagonista principal o próprio paciente, assumindo a responsabilidade na regularidade da ingestão medicamentosa, mas dentro de uma conformação de respeito e empatia. / The Directly Observed Therapy (DOT) is one of the best available instruments used in the struggle against Tuberculosis. There for, it was intended to analyze the Directly Observed Therapy Organization, in the 36 priority counties, in the Sao Paulo State. To achieve the objectives, it was used a qualitative approach, that did not intent to understand the phenomenon, but instead, to understand the individual or collective meaning that had for the people life; for this purpose, were selected all the coordinators in the priority counties, in the Sao Paulo State. The data was analyzed using the Content Analyzes method - Thematic Mode; two central cores were emphasized: Technical-Operational Aspects in the Directly Observed Therapy Execution and Intervention Strategies Seeking the Patient Adhesion. Related to the first core, it was found that, in 13 (59%) counties, did not utilize criteria to include the patients in the DOT; 13 (59%) counties established supervision frequencies, following institutional norms and protocols; 18 (81%) counties supervised the drugs intake, specially, in the Health Units; when the patient could not attend the Unit, it was not possible to realize the DOT at their homes. The drugs intake supervision, in 11 (50%) priority counties, was controlled exclusively by the health professionals; however, other important actors were joining the DOT, such as family members, community members and Community Health Workers. In the second core, was perceived a strategy, developed by the team, that works thru benefits and incentives, demonstrating the relations of solidarity between the health professionals and the patients, and also, that the relationships created during the reception and the bonds of linkage were the main tools to be used by the teams to seek the patients adhesion. Even further, it was highlighted that the bond that links professionals and patients, made that the teams, when performing the DOT, felt very close to the patients, and in a transfer process, the team felt responsible by all the patients needs. Another point to be highlighted, as an adhesion strategy, was the team flexibility, demonstrated during the DOT, when it considered the patients preferences. It was concluded, that the DOT must be realized with a democratic spirit, having as it main actor the patient itself, who must ingest the medicine and accept the responsibility of this action – all this developed in an environment of respect and empathy.

Agricultural production is highly sensitive to climate and weather perturbations. Maize is the main crop cultivated in South Africa and production is predominantly rain-fed. South Africa’s climate, especially rainfall, is extremely variable which influences the water available for agriculture and makes rain-fed cropping very risky. In the aim to reduce the uncertainty in the climate of the forthcoming season, this study investigates whether seasonal climate forecasts can be used to predict maize yields for South Africa with a usable level of skill. Maize yield, under rain-fed conditions, is simulated for each of the magisterial districts in the primary maize producing region of South Africa for the period from 1979 to 1999. The ability of the CERES-Maize model to simulate South African maize yields is established by forcing the CERES-Maize model with observed weather data. The simulated maize yields obtained by forcing the CERES-Maize model with observed weather data set the target skill level for the simulation systems that incorporate Global Circulation Models (GCMs). Two GCMs produced the simulated fields for this study, they are the Conformal Cubic Atmospheric Model (CCAM) and the ECHAM4.5 model. CCAM ran a 5 and ECHAM4.5 a 6- member ensemble of simulations on horizontal grids of 2.1° x 2.1° and 2.8° x 2.8° respectively. Both models were forced with observed sea-surface temperatures for the period 1979 to 2003. The CERES-Maize model is forced with each ensemble member of the CCAM-simulated fields and with each ensemble member of the ECHAM4.5-simulated fields. The CERES-CCAM simulated maize yields and CERES-ECHAM4.5 simulated maize yields are combined to form a Multi-Model maize yield ensemble system. The simulated yields are verified against actual maize yields. The CERES-Maize model shows significant skill in simulating South Africa maize yields. CERES-Maize model simulations using the CCAM-simulated fields produced skill levels comparable to the target skill, while the CERES-ECHAM4.5 simulation system illustrated poor skill. The Multi-Model system presented here could therefore not outscore the skill of the best single-model simulation system (CERES-CCAM). Notwithstanding, the CERES-Maize model has the potential to be used in an operational environment to predict South African maize yields, provided that the GCM forecast fields used to force the model are adequately skilful. Such a yield prediction system does not currently exist in South Africa. / Dissertation (MSc)--University of Pretoria, 2009. / Geography, Geoinformatics and Meteorology / Unrestricted

Deindividuation is a psychological phenomenon that occurs when a given environment reduces the "individuality" or identifiability of a person. These environments may cause a psychological reduction in self-consciousness, potentially leading to violations of sociocultural norms (Festinger, Pepitone, & Newcomb, 1952; Singer, Brush, & Lublin, 1965). The present research sought to empirically test deindividuation theory among automobile drivers utilizing the anonymizing factor of observation. Participants (N = 31) used a driving simulator and were either in the observed condition or an unobserved condition. Analysis of driving data did not reveal significant results, however self-report data had some interesting trends. Though limited in scope, this research begins to shed light on deindividuation of drivers and may provide a foundation for future research.

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Submitted in fulfilment of the requirements of the Degree of Master of Technology: Environmental Health, Durban University of Technology, 2011. / Worldwide Tuberculosis (TB) is a major public health concern. The Directly Observed Treatment Strategy (DOTS) has been used widely internationally and in South Africa (SA) to control the disease yet defaulting on treatment has still not achieved its World Health Organization (WHO) guideline of 5.0%. The eThekwini Municipality reported a defaulter rate of 18.9% in 2007 even with the adoption of DOTS in 1996. This study aimed to investigate the predictors of default amongst informal dwellers of eThekwini and to evaluate the implementation and the efficiency of the DOTS programme within the eThekwini Municipality, KwaZulu-Natal (KZN), and SA. The study population comprised of 102 defaulters from informal settlement, 16 nurses and 5 health personnel that are involved in TB management and control. The study was a mixed method cross sectional descriptive study that generated both quantitative and qualitative data. The Cyril Zulu Communicable Disease Centre (CDC) Electronic TB Register was used to trace the defaulters from the informal settlements that were interviewed. Non-defaulters were matched from the CDC Electronic TB Register but could not be traced due to accessibility and financial issues. Due to the low response from nurses 16(53%), semi structured qualitative interviews were conducted with health personnel. The three sets of data generated were analysed using descriptive statistics and content analysis. Multivariate logistic regression models found smoking, drinking and having a family member with TB as statistical significant predictors of default. Based on the multivariate model with a 95% confidence interval (CI), smoking (OR: 11.23, CI: 5.79, 21.78; p<0.005), alcohol consumption (OR: 15.22; CI: 7.66, 30.25; p<0.005) and had family member with TB (OR: 4.60, CI: 2.34, 9.04; p<0.005) were all significantly associated with defaulting. It was apparent that DOTS implementation was partly implemented due to lack of human resources. Tracing of defaulters, DOTS supporters, DOTS sites and incentives to patients and volunteers were major challenges hindering the iv effective implementation of the DOTS programme in eThekwini. Defaulting occurs as a result of an association between patient and health care characteristics. This study provides useful information specific to predictors of default amongst informal dwellers and the implementation and efficiency of the DOTS programme specific to informal settlements. The results from this study could be used to improve TB control and management specifically in informal settlements addressing factors that predict default and tracing and supporting patients to ensure adherence to TB treatment. / DUT Finance

A tuberculose se constitui historicamente como um dos grandes desafios para os serviços de saúde. A política pública do Tratamento Diretamente Observado objetiva o fortalecimento da adesão do doente ao tratamento e requer que a gestão em saúde se responsabilize no desenvolvimento e implantação da mesma, junto à organização dos serviços de saúde. Este estudo teve como objetivo analisar a discursividade dos gestores de saúde na transferência de política do Tratamento Diretamente Observado da tuberculose no município de Manaus/AM. Pesquisa qualitativa no campo analítico da Análise de Discurso de linha francesa. Participaram oito gestores de saúde que atuavam como integrantes de equipes gestoras. As entrevistas transcritas foram organizadas com uso do software Atlas.ti versão 6.0. Após leitura minuciosa do material empírico procedeu-se a análise por meio da base conceitual da Análise de Discurso onde procurou-se compreender os processos polissêmicos, parafrásticos e metafóricos, além da interdiscursividade dos gestores, os quais possibilitaram a identificação de três blocos discursivos: atenção à saúde na tuberculose; multiculturalidade do cenário na atenção à tuberculose; e, sentidos da transferência de políticas. Nos discursos dos gestores evidenciam-se elementos constitutivos da atenção à saúde na tuberculose, da multiculturalidade do cenário na atenção à doença e na transferência de políticas do Tratamento Diretamente Observado, os quais estão ancorados em movimentos discursivos promissores para novas formas de organização dos serviços de saúde; novas composições e desafios na gestão em saúde; na adoção da transferência de políticas enquanto políticas de Estado; e, discursos que movimentam e se assentam em formações ideológicas. Conclui-se que o atual momento vivenciado pelo cenário sugere benefícios quanto a real incorporação da política do TDO em Manaus/AM / Tuberculosis constitute, historically, in one of the big challenges to health services. The public policy of Directly Observed Therapy aims to improve patient adherence to treatment and requires that health management became responsible for the development and implementation of them, together with the organization of health services. This study had the goal to analyze the discourse of health managers in policy transfer of Directly Observed Therapy in Manaus/AM. Qualitative research in the analytical field of French Discourse Analysis framework. Eigth health managers, who worked as management teams members, participate of the study. The interviews were transcribed and then organized using Atlas. TI 6.0. After carefully reading of the empirical data, the analyze was performed through conceptual base in Discourse Analysis, when there was sought to comprehend the process of polysemy, paraphrase and metaphor, besides of health manager\'s interdiscursivity, which enable the identification of three discursive blocks: attention to health in tuberculosis; multiculturality in tuberculosis\' attention setting; and, senses of policy transfer. In the discourses of health managers, it were evident the constitutive elements of health attention in tuberculosis, of the multiculturality at the setting of disease attention and policies transfer of Directly Observed Therapy, which are anchored in promissory discourses movements to new ways of health services organization; new compositions and challenges in health management; in the adoption of policies transfer as State Policies; and discourses that moves and solidify in ideological formations. Concluding that the actual setting suggests benefices regarding the real incorporation of Directly Observed Therapy policies in Manaus/AM