The purpose of this study was to investigate how school principals understand HIV/AIDS and how their knowledge, attitude and interpretation filter in the implementation of the HIV policy in schools. The study comprises a literature review and empirical investigation. The results of this study can be used in planning and implementing HIV policy in schools. The data were collected by administering semi-structured interviews. Ten school principals from the Dennilton circuit in Southern Region of the Limpopo Province were interviewed. The results show that the majority of the principals involved in the study confirm that HIV/AIDS is an incurable disease caused by a virus and is mainly sexually transmitted. Some principals regard their school safe from HIV infection. Their assumption is based on the absence of HIV positive learners and educators in their schools. The principals are aware of the rights of HIV positive learners and educators. Significantly, the research findings indicate that the majority of schools lack educators with HIV/AIDS training, rules on safety precautions and first aid kits. It is recommended that ongoing HIV/AIDS training programmes be provided for educators to enable them to educate the youth on HIV/AIDS. Additionally, schools should focus on strategies to implement universal safety precautions against HIV transmission and to obtain first aid kits. Lastly, school principals should involve parents and other stakeholders in creating a positive school environment for HIV positive learners and educators. / Dissertation (MEd (Education Management))--University of Pretoria, 2005. / Education Management and Policy Studies / unrestricted

Diploma thesis deals with a suggestion of flood protection measures on the Svitava river in km 6,000 – 9,000. Solved locality is found in Brno, particularly in city parts of Husovice and Židenice. Thanks to used joined 1D and 2D model were made hydraulic calculations for peak water stages Q1, Q5, Q20 a Q100. The outputs of hydraulic calculations were used afterwards for creation of maps of flood danger and drawing documentation of flood protection measures.

The development of innovative propulsion systems requires testing in suitable facilities that reveal the efficacy of design models and allow for design refinement. The qualification process starts from ground tests and ends in vacuum chambers. The aim of this project is to design a versatile space propulsion facility capable of hosting different rocket engine architectures and providing an adequate supply line for different types of oxidizers and fuels in gaseous form. Identifying the key and critical components and implementing such components for the development of the facility and study the state of the art on safety standards and good practices for rocket engine testing. The test bed should be designed to withstand the structural stresses generated by the engine during static tests, while the supply line system should provide the mass flow required by the engine to deliver the design thrust (maximum thrust of 5kN). In this project, different types of rocket engines and their testing, fuel and oxidizers feed supply, risks involved and safety precautions in working of rocket test facilities are studied. A list of components for the development of such a rocket test facility and design of a logical layout plan consisting of various critical components for the propellant and oxidizer feed system is carried out. A total budget for the rocket test facility by evaluating the costs of various high quality and reliable components involved is produced. By accommodating different rocket architectures to withstand a maximum load of 5kN, an efficient design of the rocket test bed was realized and a static structural analysis of the same was performed that suffice for the objectives of the project.

Bakgrund Vårdrelaterade infektioner [VRI] är den vanligaste vårdskadan både globalt, i Europa liksom i Sverige. I Sverige får cirka 65 000 patienter årligen en VRI där närmare hälften av dessa beräknas kunna undvikas. De vanligaste typerna av VRI är luftvägsinfektioner, urinvägsinfektioner, infektioner i blodbanan och gastrointestinala infektioner. Vårdrelaterade infektioner är ett utbrett problem som utgör ett hot mot patientsäkerheten genom att orsaka onödigt lidande, förlängda vårdtider, medför stora kostnader för samhället samt utgör en risk för antibiotikaresistens. Följsamhet av basala hygienrutiner för hälso- och sjukvårdspersonal är den främsta åtgärden för att förebygga VRI. Säker vård och evidensbaserad vård är två av sjuksköterskornas sex kärnkompetenser. Tidigare forskning visar på brister gällande följsamhet av vårdhygien Syfte Syftet var att beskriva faktorer som har betydelse för sjuksköterskors följsamhet till vårdhygien i förebyggandet av vårdrelaterade infektioner. Metod Denna litteraturöversikt har en icke systematisk design. Utifrån litteraturöversiktens bärande begrepp gjordes sökningar i databaserna CINAHL och PubMed som resulterade i 15 vetenskapliga originalartiklar vars kvalitet säkrades utifrån Sophiahemmet Högskola granskningsmall. Datainsamlingen integrerades genom en integrerad dataanalys och kategoriserades därefter. Resultat De två identifierade huvudkategorierna i resultatet var Individens betydelse för följsamhet samt Arbetsplatsens betydelse för följsamhet. Resultatet visade att individuell riskbedömning, att bli observerad och att rationalisera, kunskap och erfarenhet, tidspress och arbetsbelastning, lokal och material samt arbetskultur hade betydelse för sjuksköterskors följsamhet till vårdhygien. Slutsats Individuella och organisatoriska faktorer har betydelse för sjuksköterskors följsamhet till vårdhygien. Tidspress, hög arbetsbelastning och otillgängligt material sågs bidra till bristande följsamhet. Individuell riskbedömning som ersatte vårdhygieniska riktlinjer liksom rationalisering av felaktiga beslut sågs ha betydelse för följsamhet av vårdhygien bland sjuksköterskor. Basala hygienrutiner är för hälso- och sjukvårdspersonal den främsta åtgärden för att förebygga vårdrelaterade infektioner. / Background  Cross infections are the most common health care injury globally, in Europe and in Sweden. Every year almost 65 000 patients suffer from a cross infection where almost 50 percent could have been avoided. Respiratory tract infections, urinary tract infections, bloodstream infections and gastrointestinal infections are the most common types of cross infections. Cross infections are a widespread threat against patient safety and causes unnecessary suffering, prolonged health care, high costs and causes risk for antibiotic resistance. Compliance to hygiene routines among healthcare professionals is the main measure to prevent cross infections. Providing safe and evidence-based care are two important aspects of nursing care. Research shows a lack of compliance with hygiene routines. Aim  The aim was to describe factors of importance for nurses’ compliance with hygiene routines in prevention of cross infections. Method This literature review had a non-systematic design. Based on the identified keywords searches were made through the databases CINAHL and PubMed which resulted in 15 scientific articles. The quality of the articles was ensured according to Sophiahemmet Högskola quality review template. The result was analysed and categorized through an integrative data analysis. Results The two main categories identified were Compliance from an individual aspect and Compliance from an organizational aspect. The results showed that individual risk assessment, to be observed and to rationalize, knowledge and experience, time pressure and workload, infrastructure, and personal protective equipment as well as work culture influenced nurses' compliance with hygiene routines. Conclusions Individual and organizational factors influence nurses' compliance with hygiene routines. Time pressure, high workload and unavailable personal protective equipment were seen as main contributors regarding non-compliance. Individual risk assessment replacing hygiene guidelines as well as rationalization of non-compliance were seen to influence the compliance with hygiene routines among nurses. Standard precautions are the primary measure to prevent cross infections.

The present study covers the causes of victory and defeat in the light of chapter eight of the Holy Qur'an. It has been prompted by the current situation facing Muslims in many parts of the world, which is characterized by despair, reversals and loss, This study is thus reflexive in nature. In order to obtain a satisfactory response to this predicament, the relevant text in addition to several of its commentaries were scrutinized. The latter search remained unsatisfactory since their focus of inquiry was merely exegetical and failed to reveal any didactic element, which is crucial for obtaining guidance. This work has successfully managed to deduce this aspect from the text which amplifies the importance of extensive sacrifice for gaining glory. / Religious Studies and Arabic / M.A. (Islamic studies)

Introdução: Visando a prevenção da transmissão de microrganismos, o Centers for Disease Control and Prevention (CDC), recomenda a aplicação de conjuntos de medidas denominadas Precauções Padrão (PP) e Precauções Específicas (PE). Assim, um dos grandes desafios dos serviços de saúde em especial na Atenção Primária à Saúde (APS) é identificar as lacunas dos conhecimentos e comportamentos concernentes a PP e PE. Objetivo: Avaliar os conhecimentos e o comportamento autoreferidos dos profissionais de saúde da APS sobre PP e PE e propor uma intervenção educativa baseada em casos. Métodos: Trata-se de um estudo longitudinal, prospectivo e de intervenção, desenvolvido por meio de uma abordagem quantitativa, cujo percurso metodológico ocorreu em seis momentos. A coleta de dados foi realizada por meio da aplicação de um questionário previamente validado de avaliação de conhecimento dos profissionais com relação à PP e PE e de avaliação de comportamento auto-referido sobre boas práticas de precauções. O questionário abordou as seguintes dimensões relativas ao conhecimento e comportamento sobre PP e PE: Identificação de risco, Higienização das mãos, Uso de luvas comum, Uso de máscaras e a etiqueta de tosse e Medicação segura e descarte de material perfurocortante. Realizou-se uma intervenção educativa, por meio do método de Aprendizagem Baseada em Casos (ABC) no qual foram entregues estudos de casos extraídos da vivência prática do pesquisador. O questionário foi aplicado pré e pós esta intervenção. A coleta de dados foi realizada em uma Unidade Básica de Saúde do município de São Paulo, tendo como população alvo profissionais da Estratégia Saúde da Família (ESF) e do Núcleo de Apoio à Saúde da Família (NASF) que atuavam diretamente na assistência. Os dados foram analisados de acordo com cada momento, por meio de estatística descritiva e apresentada em forma de gráficos e tabelas. Resultado: A análise dos dados nos permitiu identificar que os profissionais de saúde da APS apresentaram fragilidade em relação ao conhecimento e ao comportamento auto referido sobre o uso da PP e PE. Os valores de acertos individuais variaram, respectivamente: de 36,3% a 100% no momento I e de 50% a 100% no momento IV. A intervenção educativa obteve resultados positivos, embora não tenha sido plenamente eficaz por não ter conseguido atingir mudanças relevantes em todas as dimensões avaliadas. O número de questões que obtiveram menos de 70% de profissionais que acertaram foi respectivamente 15 no momento I e 10 no momento IV. Contudo, este modelo de intervenção educativa pode ser considerada uma importante ferramenta para promover reflexão e oportunidade de aprendizagem a todos os trabalhadores da área de saúde, tornando-os críticos de suas próprias atitudes e fornecendo instrumento para combater situações de risco para aquisição de patógenos nas unidades de saúde. Conclusão: O presente estudo trouxe contribuições importantes para o conhecimento sobre o tema dentro da APS, destacando as deficiências de conhecimento e comportamento autoreferido dos profissionais na APS e propondo uma intervenção educativa que contribui potencialmente para mudança neste cenário. / Introduction: In order to prevent the transmission of microorganisms, the Centers for Disease Control and Prevention (CDC) recommends the implementation of joint measures known Standard Precautions (PP) and Specific Precautions (PE). Thus one of the challenges of non-hospital health services, especially in primary health care (PHC) is to identify gaps in knowledge and behavior concerning PP and PE. Objective: To evaluate the knowledge and self-reported behavior of APS professionals on PP and PE and propose an educational intervention. Methods: This is a longitudinal study, prospective and intervention, developed through a quantitative approach, whose methodological approach occurred in six moments.Data collection was performed by applying a previously validated questionnaire assessment of professional knowledge with regard to PP and PE and assessment of self-reported behavior on good practices precautions. The questionnaire included the following dimensions for the knowledge and behavior of PP and PE: \"Risk Identification\", \"Handwashing\", \"Use of common gloves,\" \"Using masks and cough etiquette\" and \"Safe Medication and disposal of sharps. An educational intervention was carried out, using Case- Based Learning (ABC) method in which case studies were extracted from the practice of research experience. The questionnaire was applied before and after this intervention. Data collection was performed at a Basic Health Unit in the city of São Paulo, whose target population was the Health Strategy professionals Family (ESF) and the Support Center for Family Health (NASF) working directly in assistance. Data were analyzed according to each moment through descriptive statistics and presented in graphics and tables Results: The data analysis allowed us to identify that health professionals at APS showed weakness in relation to knowledge and the selfreported conduct on the use of PP and PE. The individual values ranged, respectively: 36.3% to 100% in the moment I and 50% to 100% at moment IV. The educational intervention model positive results, although it was not fully effective for failing to achieve significant changes in all dimensions evaluated. The number of questions that have obtained less than 70% of professionals who agreed was respectively 15 in the moment I and 10 at moment IV. The educational intervention can be considered an important appliance to promote reflection and learning opportunity to all workers in the health area, making them critical of their own attitudes and providing a tool to combat risk situations for the acquisition of pathogens in units health. Conclusion: This study has brought important contributions to the knowledge on the subject within the APS, highlighting the deficiencies of knowledge and self-reported behavior of professionals in APS and proposing an educational intervention that potentially contribute to change this scenario.

Objetivo: Reduzir a transmissão de Enterobactérias resistentes a carbapenêmicos (ERC) em uma unidade de terapia intensiva com intervenções baseadas em simulações por um modelo matemático desenvolvido. Desenho: Ensaio antes e depois com um período basal de 44 semanas e um período de intervenção de 24 semanas. Métodos: O estudo foi conduzido em uma Unidade de Terapia Intensiva Médica (UTI) de um hospital de ensino terciário. Desenvolvemos um modelo de transmissão de ERC em uma UTI e medimos todos os parâmetros necessários para a entrada do modelo. Foram estabelecidas metas de adesão à higienização das mãos e às precauções de contato com base nas simulações e conduziu-se uma intervenção focada em atingir essas métricas como metas, com auditoria semanal da unidade e reuniões com a equipe para dar feedback sobre o desempenho. Resultados: As metas para a adesão à higienização das mãos e às precauções de contato foram alcançadas na terceira semana do período de intervenção. Durante o período basal, o R0 calculado foi de 11, a prevalência mediana de pacientes colonizados por ERC na unidade foi de 33% e ultrapassou 50% por três vezes. No período de intervenção, a prevalência média de pacientes colonizados por ERC passou para 21%, com uma mediana semanal do Rn de 0,42 (intervalo: 0 a 2,1). Conclusões: As simulações ajudaram a estabelecer e atingir metas específicas para controlar as altas taxas de prevalência de ERC e reduzir a transmissão de ERC dentro da unidade. O modelo foi capaz de prever os resultados observados. Este é o primeiro estudo em controle de infecção que mede a maioria das variáveis de um modelo matemático na vida real e o aplica como uma ferramenta de apoio à decisão para a intervenção / Objective: To reduce the transmission of carbapenem-resistant Enterobacteriaceae (CRE) in an intensive care unit with interventions based on simulations by a mathematical model. Design: Before-after trial with a 44-week baseline period and a 24 week intervention period. Setting: Medical Intensive Care unit (ICU) of a tertiary care teaching hospital. Participants: All patients admitted to the unit. Methods: We developed a model of transmission of CRE in an ICU and measured all necessary parameters for the model input. Goals of compliance with hand hygiene and with isolation precautions were established based on simulations. An intervention focused on achieving these goals was conducted with weekly auditing and feedback. Results: The goals for compliance with hand hygiene and contact precautions were reached on the third week of the intervention period. During baseline period, the calculated R0 was 11, median prevalence of patients colonized by CRE in the unit was 33% and exceeded 50% on three occasions. In the intervention period, median prevalence of colonized CRE patients was 21%, with a median weekly Rn of 0.42 (range: 0 to 2.1). Conclusions: The simulations helped to establish and to achieve specific goals in order to control the high prevalence rates of CRE and reduce CRE transmission within the unit. The model was able to predict the observed outcomes. This is the first study in infection control to measure most variables of a model in real life and to apply the model as a decision support tool for intervention

As precauções-padrão preconizadas pelo Centers for Disease Control and Prevention e ratificadas pelo Ministério da Saúde, são medidas que minimizam a exposição ocupacional a material biológico potencialmente contaminado e previnem as infecções relacionadas à assistência em saúde. No entanto, constata-se que a adesão a essas medidas é problema dentre os profissionais de enfermagem e instrumentos para estudar a adesão de enfermeiros a essas medidas foram construídos para apoiar intervenções. Considerando-se que a adaptação e validação de um instrumento utilizado em diferentes culturas garante a sua maior confiabilidade e validade e que a viabilidade de um instrumento fidedigno, para aferir conhecimento e adesão de enfermeiros às precauções-padrão, se faz necessário no contexto brasileiro, este estudo teve por objetivos adaptar para enfermeiros brasileiros e validar o questionário de adesão às precauções-padrão e o questionário de conhecimento sobre as precauções-padrão (Questionnaires for Knowledge and Compliance with Standard Precaution).Trata-se de estudo metodológico, cujo processo de adaptação dos questionários seguiu as etapas: tradução inicial; síntese e consenso das traduções; realização do comitê de especialistas; retrotradução; validação semântica e pré-teste da versão final. O processo de adaptação contou com uma amostra de 42 enfermeiros de uma unidade de emergência vinculada a um hospital de ensino do interior de São Paulo, sendo que 12 enfermeiros participaram da validação semântica e 30 do pré- teste. O processo de validação foi realizado com uma amostra aleatória de 121 enfermeiros, sendo 91 pertencentes a estabelecimentos de saúde de alta complexidade e 30 enfermeiros pertencentes a estabelecimentos de saúde de média complexidade de outro município do interior de São Paulo (sendo um hospital filantrópico, um hospital privado e uma unidade de pronto atendimento vinculada a um plano de saúde). Para o Questionário de Adesão às Precauções-Padrão, a consistência interna foi calculada pelo alfa de Cronbach e a estabilidade pelo Coeficiente de Correlação Intraclasse. A validade de construto convergente foi calculada pela correlação com a percepção de clima de segurança organizacional e a validade de construto divergente por meio da correlação com a menor percepção de obstáculos, para seguir as precauções-padrão. A validade de construto por grupos conhecidos foi calculada entre enfermeiros que relataram ter recebido e enfermeiros que relataram não ter recebido treinamento e entre as diferentes instituições estudadas. A presença de efeito máximo e mínimo (floor and ceiling) foi avaliada. Para o Questionário de Conhecimento sobre as Precauções-Padrão foi calculada a concordância pelo coeficiente Kappa e a estabilidade foi avaliada pelo Coeficiente de Correlação Intraclasse. A validade de construto entre grupos conhecidos foi calculada entre enfermeiros com maior e menor titulação e enfermeiros que receberam e que não receberam treinamento sobre as precauções-padrão. Os resultados obtidos mostram que os questionários estão compreensíveis, fáceis de responder e adequados ao português do Brasil. O pré-teste confirmou a versão obtida pela validação semântica. O questionário de adesão apresentou consistência interna de 0,80 e estabilidade de 0,97. A validade de construto convergente e divergente evidenciaram forte correlação com a maior percepção de clima de segurança (r=0,614) e com a menor percepção de obstáculos, (r=0-537). A validade de construto entre grupos conhecidos revelou maior adesão entre os enfermeiros que receberam treinamento (p=0,028) e que os participantes pertencentes aos estabelecimentos de alta complexidade apresentaram maior adesão quando comparados aos demais estabelecimentos (p=0,006). Foi verificado efeito máximo e mínimo no Questionário de Adesão às Precauções-Padrão, o que compromete a responsividade do instrumento; porém, auto-relatos de adesão são frequentemente superiores aos índices constatados em estudos observacionais. Com relação ao Questionário de Conhecimento sobre as Precauções-Padrão, as respostas dos enfermeiros se mostraram concordantes e a estabilidade foi de 0,91, o que confirma a capacidade do instrumento de detectar possíveis alterações em características na amostra estudada. A validade por grupos conhecidos não evidenciou diferença estatisticamente significante entre os enfermeiros pela titulação e presença de treinamento (p=0,706 e p=0,209, respectivamente). Os resultados evidenciam que o Questionário de Adesão às Precauções-Padrão obteve índices psicométricos satisfatórios, o que confirma a hipótese de que o instrumento afere o construto adesão. O Questionário de Conhecimento sobre as Precauções-Padrão revelou boa concordância e estabilidade. Conclui-se que os questionários adaptados e validados são fidedignos e podem ser utilizados para medir a adesão e o conhecimento de enfermeiros brasileiros às precauções-padrão e subsidiarão a proposição de medidas intervencionistas, visando a saúde do trabalhador e a segurança do paciente / The standard precautions, established by the Centers for Disease Control and Prevention and ratified by the Brazilian Ministry of Health, are measures that minimize the occupational exposure to potentially contaminated biological material and prevent healthcare-related infections. As verified, however, compliance with these measures is a problem among nursing professionals and tools to study the nurses\' compliance with these measures have been constructed to support interventions. Considering that the adaptation and validation of a tool used in different cultures guarantees its greater reliability and validity and that the feasibility of a reliable tool to verify nurses\' knowledge and compliance with the standard precautions is necessary in the Brazilian context, the objectives in this study were to adapt for Brazilian nurses and validate the Questionnaires for Knowledge and Compliance with Standard Precaution. In this methodological study, the adaptation process of the questionnaires followed a number of phases: initial translation; synthesis and consensus of the translations; expert committee; back translation; semantic validation and pretest of the final version. The adaptation process involved a sample of 42 nurses from the emergency service of a teaching hospital in a city from São Paulo state, 12 of whom participated in the semantic validation and 30 in the pretest. The validation process was accomplished with a random sample of 121 nurses, 91 were located in high complexity healthcare institutions and 30 from intermediate healthcare institutions in another city from São Paulo state (including one non-for-profit hospital, one private hospital and the emergency service of a health insurance). For the Questionnaire for Compliance with Standard Precaution, the internal consistency was calculated using Cronbach\'s alpha and the stability using the Intraclass Correlation Coefficient. The convergent construct validity was calculated through the correlation with the perceived organizational safety climate and the divergent construct validity through the correlation with the lesser perception of obstacles to compliance with the standard precautions. The construct validity using the known-groups method was calculated among nurses who indicated they had received and nurses who indicated they had not received training and among the different institutions under analysis. The presence of floor and ceiling effects was assessed. For the Questionnaire for Knowledge about Standard Precaution, the agreement was calculated using the Kappa coefficient and stability was assessed through the Intraclass Correlation Coeficient. The construct validity among known groups was calculated between nurses with higher and lower degrees and nurses who did and did not receive training about the standard precautions. The obtained results show that the questionnaires are understandable, easy to answer and appropriate to Brazilian Portuguese. The pretest confirmed the version obtained in the semantic validation procedure. The internal consistency of the compliance questionnaire equaled 0.80 and the stability 0.97. The convergent and divergent construct validity showed a strong correlation with a greater perceived safety climate (r=0.614) and a lesser perception of obstacles (r=0-537). The construct validity among known groups revealed greater compliance among the nurses who received training (p=0.028) and that the subjects at the high complexity healthcare institutions showed higher compliance levels when compared to the other institutions (p=0.006). Floor and ceiling effects were found in the Questionnaire for Compliance with Standard Precaution, which compromises the responsiveness of the tool; nevertheless, self-reported compliance levels are frequently higher than the indices found in observation studies. As regards the Questionnaire for Knowledge about Standard Precaution, the nurses\' answers demonstrated agreement and the stability corresponded to 0.91, which confirms that tool\'s ability to detect possible alterations in characteristics of the study sample. The validity among known groups did not show a statistically significant difference among the nurses according to the degree and presence of training (p=0.706 and p=0.209, respectively). The results show that the Questionnaires for Compliance with Standard Precautions obtained satisfactory psychometric coefficients, which confirms the hypothesis that the tool verifies the compliance construct. The Questionnaire for Knowledge about Standard Precaution revealed good agreement and stability coefficients. In conclusion, the adapted and validated questionnaires are reliable and can be used to measure the compliance and knowledge of Brazilian nurses about the standard precaution and will support the proposal of intervention measures directed at occupational health and patient safety

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Landuse for farming purposes is an indispensable part of management in specially protected areas although the process of farming has been importantly limited by restrictive arrangements, as agrotechnological terms which are caused by the needs of environmental protection. This diploma thesis deals with the impact of some limiting rules on running of the farms which are farming in convenction way, situated in the area CHKO Šumava. Field research was performed in the form of dialogs and was focused on detection of owner´s opinions concerning their relationship with CHKO authority, impact of agrotechnological terms on running of the farm and revealing of their future plans. Based on the analysis it is possible to say that all the farmers declare the cooperation with CHKO authority as definitely negative whereas the present payments for natural disadvantage compensation appears to be clearly positive and they cannot imagine future farming without them. Agrotechnological terms followed from specific regime of specially protected areas have been declared as minimally restrictive because the owners have adopted them the farm working.