A dissertação em tela é fruto dos questionamentos sobre minha construção identitária como professora negra e dos embates vividos no cotidiano sobre as relações etnicorraciais e educação. Compreendo que a discussão sobre relações etnicorraciais no cotidiano escolar é fundamental na sociedade brasileira. Uma sociedade marcada historicamente por desigualdades e exclusões embasadas por mitos e teorias racialistas do século XIX (MUNANGA, 1999). Por muito tempo, essas teorias atestaram a inferioridade dos indivíduos negros e a primitividade de suas culturas, legitimando a situação de racismo e discriminação sofrida pelo povo negro brasileiro (RODRIGUES, 2006). Por compreender que a temática das relações etnicorraciais não tem sido, por vezes, contemplada no primeiro segmento do Ensino Fundamental (SOUZA; CROZO, 2006) é que tenho por objetivos centrais: refletir sobre meu processo de construção identitária e compreender melhor os limites e as possibilidades de minhas contribuições, como professora negra, para a construção da identidade etnicorracial de alunos/as do primeiro segmento do Ensino Fundamental em uma escola pública do município de São Gonçalo. Para tal discussão alicerçome em autores/as tais como: Jesus (2004), Gomes (2006) e Cunha Jr (2010). Assim, compreendo que a pesquisa possibilitoume refletir sobre a construção de minha identidade etnicorracial levandome a descoberta de um nós, de uma coletividade que propiciou a construção de algumas práticas pedagógicas que eu poderia reconhecer como micro açõesafirmativas, propostas que revelam tanto os desafios, quanto a fertilidade da construção de uma educação antirracista. / A dissertation on the screen is the result of questions about my identity construction as a black teacher and lived in daily clashes on relations etnicorraciais and education. I understand that the discussion about the relationship etnicorraciais in school life is essential in Brazilian society. A society marked by inequalities and exclusions historically backed up by myths and racialist theories of the nineteenth century (Munanga, 1999). For a long time, these theories attest the inferiority of blacks and primitiveness of their cultures, legitimizing the situation of racism and discrimination suffered by black people Brazilian (RODRIGUES, 2006). By understanding that the topic of relationships etnicorraciais has been sometimes comtemplada the first segment of Elementary Education (SOUZA; CROZO, 2006) is that I have for main objectives: to reflect on my process of identity construction and better understand the limits and possibilities for my contributions as black teacher, for the construction of identity etnicorracial students / the first segment of the elementary school in a public school in São Gonçalo. For this discussion alicerço me on authors / as such as Jesus (2004), Gomes (2006) and Cunha Jr. (2010). So, I understand that research allowed me to reflect on the construction of my identity etnicorracial leading me to the discovery of a "we", a group that led to the construction of some pedagogical practices that I could recognize as microaffirmative action, proposals reveal both challenges, as the fertility of building a antiracist education.

The work deals with the development, goals and content of the open-air schools at the area of today{\crq}s Czech Republic. The theoretical part defines a term ``outdoor education{\crqq} and describes the development of the open-air schools in the Czechoslovak Republic from the 1920{\crq}s to the end of 20th century and following up until today. The practical part of this work follows up successful theoretical knowledge of open-air schools in the Czech Republic and abroad. Positive experience places the open-air schools firmly in the future.

The aim of this graduation theses is finding out the children{\crq}s conception of health, nutrition, exercise and sport. The object of research is children{\crq}s relation to exercise and nutrition. This theses is also describing influence of family, school, television and surroundings for formation of this relation. It also describes cooperation with pupils. 115 children of the third classes of primary schools were researched. These children were in the age of 8 {--} 9 years. The used methods in this research were questionnaires and observations. The research showed that the majority of pupils take right view to health, nutrition and exercise and most of the children practise some sport. This theses showed the problems of the way living of pupils in the third classes of primary schools.

Submitted by Fabio Sobreira Campos da Costa (fabio.sobreira@ufpe.br) on 2017-05-08T14:34:09Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Debora_Pereira_thesis.pdf: 4477202 bytes, checksum: 0af71560a8db492ecea51ebedad76427 (MD5) / Made available in DSpace on 2017-05-08T14:34:09Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Debora_Pereira_thesis.pdf: 4477202 bytes, checksum: 0af71560a8db492ecea51ebedad76427 (MD5) Previous issue date: 2016-08-01 / FACEPE / CAPES / In Brazil, since 2000, approximately 50,000 people are murdered every year. In a span of 30 years (1980 – 2010), more than 1 million homicides were registered. In 2012, the homicide rate in Brazil was 29 homicides per 100,000 inhabitants. All Brazilian states exceed the threshold of epidemic established by World Health Organization. In this context, the present study has the objective of to investigate homicides in Recife, taking into account temporal, spatial, environmental, and multicriteria analysis. The temporal analysis shows that the difference of homicides between seasons and months is not statistically significant. However, there is a significant increase in homicides during the weekends (42 percent of all homicides) and evenings (62 percent). Moreover, the spatial results show that the spatial patterns are different within the temporal dimensions in many cases. The findings from spatial analysis reveal that homicides are very concentrated in the city of Recife and in a time span of five years (20092013) all the homicides occurred in less than 10 percent of the street segments. In addition, our test showed that the spatial pattern was not stable over the years. However, when we consider the temporal dimensions (as suggested by temporal analysis), the patterns were stable along the years – except for weekdays and night/dawn. Furthermore, through the environmental analysis, we found that inequality, rented houses, and number of residents have a positive relationship with homicide. On the other hand, income, education, public illumination, population density, and street network density have a negative relationship. The findings of these analyses indicate that homicide in Recife can be understood by the perspective of social disorganization theory and routine activity theory. Finally, multicriteria approach was applied to highlight vulnerable areas to homicide in Recife. We considered six variables to evaluate vulnerability and the areas were identified by PROMETHEE II method and local Moran’s I. Other application was made in Boa Viagem neighborhood, so we were able to perform a more detailed analysis. Three different approaches were tested for Boa Viagem and we suggested some actions in order to reduce criminality in long term. / No Brasil, desde 2000, aproximadamente 50,000 foram mortas todos os anos. Em um espaço de 30 anos (1980 – 2000), mais de 1 milhão de homicídios foram registrados. Em 2012, a taxa de homicídio no Brasil era 29 homicídios para cada 100,000 habitantes. Todos os estados brasileiros excedem o limite de epidemia estabelecido pela Organização Mundial de Saúde. Nesse contexto, o presente estudo tem o objetivo de investigar os homicídios em Recife, levando em consideração análises temporal, espacial, ambiental e multicritério. A análise temporal mostra que a diferença de homicídios entre estações do ano e meses não é estatisticamente significativa. Porém, existe um aumento significante de homicídios durante os finais de semana (42 por cento de todos os homicídios) e noites (62 por cento). E ainda, os resultados espaciais mostram que os padrões espaciais são diferentes dento das dimensões temporais em muitos casos. Os achados da análise espacial revelam que homicídios são muito concentrados na cidade do Recife e que em um espaço de tempo de cinco anos (2009-2013) todos os homicídios ocorreram em menos de 10 por cento dos segmentos de rua. E ainda, o teste do padrão dos pontos espaciais mostrou que os padrões espaciais não foram estáveis no decorrer dos anos. Porém, quando se considera das dimensões temporais (como sugerido pela análise temporal), os padrões foram estáveis ao longo dos anos – com exceção de dias de semana e noites/madrugadas. Além disso, através da análise ambiental encontrou-se que desigualdade, casas alugadas e número de residentes têm uma relação positiva com homicídio. Por outro lado, renda, educação, iluminação pública, densidade populacional e densidade da rede de ruas têm uma relação negativa. Os achados dessas análises indicam que os homicídios em Recife podem ser entendidos pela perspectiva da teoria da desorganização social e da teoria das atividades de rotina. Finalmente, abordagem multicritério foi aplicada para destacar áreas vulneráveis aos homicídios em Recife. Considerou-se seis variáveis para avaliar a vulnerabilidade e as áreas foram identificados pelo PROMETHEE II e pelo índice local de Moran. Outra aplicação foi feita no bairro de Boa Viagem e foi possível realizar uma análise mais detalhada. Três diferentes abordagens foram testadas para Boa Viagem e sugeriu-se algumas ações no sentido de reduzir a criminalidade no longo prazo.

Submitted by Nadir Basilio (nadirsb@uninove.br) on 2016-11-30T16:37:56Z No. of bitstreams: 1 Sandra Aparecida Do Prado Pereira.pdf: 1399081 bytes, checksum: 707e1d4245785fcd308434ee4541bdc4 (MD5) / Made available in DSpace on 2016-11-30T16:37:56Z (GMT). No. of bitstreams: 1 Sandra Aparecida Do Prado Pereira.pdf: 1399081 bytes, checksum: 707e1d4245785fcd308434ee4541bdc4 (MD5) Previous issue date: 2016-10-26 / This research has as general objective the analysis of the planning and the routine on the practices of the management team and the teachers of a daycare located in the city of Santo André (SP). The specific objectives are: to identify which are the management team members and the teachers’ conceptions and the practices that are constituted in the planning and in the routine of a daycare; to verify how the management team´s intervention is implemented, not only at the space of the teachers’ continuing in-service formation, but also outside it, in the monitoring process of the daycare planning and routine; to analyze the changes’ degree of impact (if accomplished or not) on the management team and the teachers’ practices when related to the process of reflection of the daycare planning and routine. The universe of the research is a daycare of the Santo André City’s Municipal Education System, in Greater São Paulo’s ABC region, with the participants being the ten teachers that work with kids from 0 to 3 years old, the principal/researcher and the pedagogical assistant. About the focus of the qualitative research, the intervention-research covers the following proceedings of data collection: I. documental analysis of the daycare’s political-pedagogical project, of the management team’s formation plan, of the teacher’s weekly; II. Semi-structured questionnaire with the ten teachers surveyed; III. Observation of the teachers’ practices with the children, trough records in the researcher’s field diary, and video recording of the activities accomplished during the routine, using the weekly planning as basis; IV. Reflective analysis of the video recordings between the researcher and the teachers; V. Register of dialogues performed individually with the teachers; VI. Audio recorded register between the principal and the pedagogical assistant for the evaluation of the pair´s actuation during the research process concerning the practices developed; VII. Audio recording of the formation meetings with the teaching staff during the working hours, with the researcher´s participation, regarding reflections concerning the planning and the routine, as well as the process of continuous formation; VIII. Interview with the Childhood Education and the Elementary Education department´s principal; IX. Rounds of conversation with the teaching staff; X. Monitoring of the organizing meetings about the teacher´s work; XI. Encounters during the weekly pedagogical meetings for feedbacks. For the treatment of the data the information collected was systematized, both through documental analysis and the field diary, in addition to the transcription of the audio recordings for the analysis of the content, pursuant Bardin (2011). Studies about the planning and routine (BARBOSA, 2009; OSTETTO, 2015; REDIN, 2013); in the sphere of the childhood education (CAMPOS, 2011; KUHLMANN JUNIOR, 1998; ROSEMBERG, 1992), and in the sphere of management and teacher´s formation (FREIRE, 1996; LIBÂNEO, 2013; PIMENTA, 1997; TARDIF, 2002; NÓVOA, 1992; VASCONCELLOS, 2009), are theoretical references for the development of this investigation. As results, it was found that: there are different conceptions of planning in the teachers’ group, what is showed in large proportion as a bureaucratic instrument, the management team’s intervention still needs to be intensified concerning the subject, mainly with a work of continuous formation in the working hours that allows the continuity of the discussion on the subject: planning and routine; the socialization of the registers performed by the principal/researcher, as well as the individual and collective conversations about the planning-routine contributed to the group´s process of reflection, and favored the establishment of trustworthy relationships between the teachers’ group and the direction. / Esta investigación tiene por objetivo general analizar el planeamiento y la rutina en las prácticas del equipo de gestión y de las profesoras de una guardería situada en la cuidad de Santo André (SP). Los objetivos específicos son: identificar cuáles son las concepciones y las prácticas de los miembros del equipo de gestión y de las profesoras que se constituyen en el planeamiento y en la rutina de una guardería; verificar como se efectiva la intervención del equipo de gestión, tanto en el espacio de formación continuada en servicio de las profesoras, cuanto fuera de él, en el proceso de acompañamiento del planeamiento y rutina de la guardería; analizar el grado de impacto de las mudanzas (si efectivas o no) en las prácticas del equipo de gestión y de las profesoras cuando relacionadas al proceso de reflexión del planeamiento y de la rutina de la guardería. El universo de la investigación es una guardería de la Red Municipal de Santo André, en el ABC Paulista, siendo que los sujetos participantes son las diez profesoras que actúan con niños de 0 a 3 años de edad, la directora/investigadora y la asistente pedagógica. Bajo el enfoque de la investigación cualitativa, la investigación-intervención abarca los siguientes procedimientos de recolección de datos: I. el análisis documental del proyecto político-pedagógico de la guardería, del plan de formación del equipo de gestión, del semanario de las profesoras; II. Cuestionario semiestructurado con las diez profesoras investigadas; III. Observación de las prácticas de las profesoras junto a los niños por medio de registros en el diario de campo de la investigadora, y grabación de vídeo de las actividades realizadas en la rutina, teniendo como base el planeamiento semanal; IV. Análisis reflexivo de las grabaciones de vídeo entre la investigadora y profesoras; V. Registro de los diálogos realizados individualmente con las profesoras; VI. Registro audio grabado entre la directora y la asistente pedagógica para evaluación de la actuación del dúo durante el proceso de investigación sobre las practicas desarrolladas; VII. Audio-grabación de los encuentros de formación con el cuerpo docente en el horario de trabajo en servicio, con la participación de la investigadora, envolviendo reflexiones sobre el planeamiento y la rutina, así como sobre el proceso de formación continuada; VIII. Entrevista con la Directora del departamento de Educación Infantil y Enseñanza Básica; IX. Ruedas de conversación con el grupo de docentes; X. Acompañamiento de las reuniones de organización de trabajo de las profesoras; XI. Encuentros en las Reuniones Pedagógicas Semanales para devolutivas. Para el tratamiento de los datos fueran sistematizadas las informaciones recopiladas, tanto por medio del análisis documental, cuanto por el diario de campo, además de la transcripción de los registros audio-grabados para el análisis del contenido, conforme Bardin (2011). Se constituyen en referencial teórico para el desarrollo de esta investigación, estudios sobre planeamiento y rutina (BARBOSA, 2009; OSTETTO, 2015; REDIN, 2013); en la esfera de la educación infantil (CAMPOS, 2011; KUHLMANN JUNIOR, 1998; ROSEMBERG, 1992) y, en el área de gestión y formación de profesores (FREIRE, 1996; LIBÂNEO, 2013; PIMENTA, 1997; TARDIF, 2002; NÓVOA, 1992; VASCONCELLOS, 2009). Como resultados se constató que: existen diferentes concepciones de planeamiento en el grupo de profesoras, mostrándose en gran parte como un instrumento burocrático, la intervención del equipo de gestión aún necesita ser intensificada no que respecta al asunto, principalmente en relación a un trabajo de formación continuada en el horario de servicio que permita la continuidad de la discusión del tema: planeamiento y rutina; la socialización de los registros realizados por la directora/investigadora, así como las conversaciones individuales y colectivas sobre el planeamiento-rutina contribuyeron con el proceso de reflexión del grupo y favorecieron el establecimiento de relaciones de confianza entre el grupo docente y la dirección. / Esta pesquisa tem por objetivo geral analisar o planejamento e a rotina nas práticas da equipe gestora e das professoras de uma creche localizada na cidade de Santo André (SP). Tem-se como objetivos específicos: identificar quais são as concepções e as práticas dos membros da equipe gestora e de professoras, que se constituem no planejamento e na rotina de uma creche; verificar como se efetiva a intervenção da equipe gestora, tanto no espaço de formação continuada em serviço das professoras quanto fora dele, no processo de acompanhamento do planejamento e rotina da creche; analisar o grau de impacto das mudanças (se efetivadas ou não) nas práticas da equipe gestora e das professoras quando relacionadas ao processo de reflexão do planejamento e da rotina da creche. O universo da pesquisa é uma creche da Rede Municipal de Santo André, no ABC Paulista, sendo que os sujeitos participantes são as dez professoras que atuam com crianças de 0 a 3 anos de idade, a diretora/pesquisadora e a assistente pedagógica. Sob o enfoque da pesquisa qualitativa, a pesquisa-intervenção abrange os seguintes procedimentos de coleta de dados: I. Análise documental do projeto político-pedagógico da creche, do plano de formação da equipe gestora, do semanário das professoras; II. Questionário semiestruturado com as dez professoras pesquisadas, III. Observação das práticas das professoras junto às crianças por meio de registros no diário de campo da pesquisadora e vídeo gravação das atividades realizadas na rotina, tendo como base o planejamento semanal; IV. Análise reflexiva das vídeo gravações entre pesquisadora e professoras; V. Registro de diálogos realizados individualmente com as professoras; VI. Registro áudio gravado entre diretora e assistente pedagógica para avaliação da atuação da dupla durante o processo da pesquisa sobre as práticas desenvolvidas; VII. Áudio-gravação dos encontros de formação com o corpo docente no horário de trabalho em serviço, com a participação da pesquisadora, envolvendo reflexões sobre o planejamento e a rotina, bem como sobre o processo de formação continuada; VIII. Entrevista com a Diretora do departamento de Educação Infantil e Ensino Fundamental; IX. Rodas de Conversa com o grupo de docentes; X. Acompanhamento das reuniões de organização de trabalho das professoras; XI – Encontros nas Reuniões Pedagógicas Semanais para devolutivas. Para o tratamento dos dados foram sistematizadas as informações coletadas, tanto por meio da análise documental quanto pelo diário de campo, além de terem sido transcritos os registros áudio-gravados para análise de conteúdo, conforme Bardin (2011). Constituem-se em referencial teórico para o desenvolvimento desta investigação, estudos sobre planejamento e rotina (BARBOSA, 2009; OSTETTO, 2015; REDIN, 2013); na esfera da educação infantil (CAMPOS, 2011; KUHLMANN JUNIOR, 1998; ROSEMBERG, 1992) e na área de gestão e formação de professores (FREIRE, 1996; LIBÂNEO, 2013; PIMENTA, 1997; TARDIF, 2002; NÓVOA, 1992; VASCONCELLOS, 2009). Como resultados constatou-se que: existem diferentes concepções de planejamento no grupo de professoras, mostrando-se em grande parte como um instrumento burocrático; a intervenção da equipe gestora ainda precisa ser intensificada no que diz respeito ao assunto, principalmente tendo um trabalho de formação continuada em horário de serviço que permita a continuidade de discussão do tema planejamento e rotina; a socialização dos registros feitos pela diretora/pesquisadora, bem como as conversas individuais e coletivas sobre planejamento e rotina contribuíram com o processo de reflexão do grupo e favoreceram o estabelecimento de relações de confiança entre grupo docente e direção.

Introduktion:Att basal hygien som att tvätta händerna är effektivt för att bryta smitta är väl grundat imedicinsk forskning. På vilka grunder tar människor till sig en sådan rutin? Vilka faktorerpåverkar om ett nytt beteende anammas? Syfte:Studien syftar till att undersöka förutsättningar för följsamhet till en ny hygienrutin iförskoleverksamhet utifrån uppfattningar bland vårdnadshavare och pedagoger. Studien syftaräven till att studera denna typ av preventiv insats utifrån olika perspektiv på hälsa, preventionoch hälsopromotion. Metod:Studien är utformad som en kvalitativ utvärdering av en intervention. Studiens syfte besvarasgenom en tematisk analysmetod av data som insamlats genom semistrukturerade intervjuer. Konklusion:Drivkrafter som understödjer följsamheten är fungerande kommunikation, tilltro till sin egenförmåga att klara av att följa hygienrutinen samt att hygienrutinen genererar märkbara fördelar.Utmaningarna handlar om att det finns en acceptans för smitta. Att bli sjuk uppfattas inte somtillräckligt allvarligt för att hygienrutinen ska prioriteras och att den inte kommer åt allsjukfrånvaro. Av studien framgår att det finns uppfattningar som belyser att det holistiskaperspektivet är viktigt för hälsan. Att ta hänsyn både till den salutogena och patogena synen påhälsa kan vara en väg att gå för att överbrygga att hygienrutinen inte kommer åt allt. / Introduction:The fact that basic hygiene such as hand washing is effective in preventing infections is welldocumented in medical research. But why do people adopt such routines? Which perceptionsaffect whether a new behaviour is adopted? Purpose:The study aims to investigate the conditions for adherence to a new hygiene routine in preschoolactivities, based on perceptions among parents and educators. The study also aims to examinethis type of preventive intervention from different perspectives in terms of health, preventionand health promotion. Method:The study takes the form of qualitative research into an intervention. The research question isanswered through the thematic analysis method of data collected through semi-structuredinterviews. Conclusion:The main aspects which support compliance are functional communication, confidence in one’sown ability to follow the hygiene routine and the hygiene routine generating noticeable benefits.The challenge is that there is an acceptance of infection. Becoming ill is not perceived as seriousenough for the hygiene routine to be prioritized or for the hygiene routine to prevent all sickleave. The study shows that there are perceptions which highlight that the holistic perspectiveis important for health. Taking both salutogenic and pathogenic health aspects intoconsideration would create a possible solution to the problem, as a single hygiene routine doesnot cover every aspect involved.

The opportunity theory for crime is composed of three partial concepts. The first concept is the routine activity theory that works with a potential offender, a suitable target and a capable guardian. The opportunity for crime occurs in the moment when the offender faces the target while guardians are absent. The second concept, the rational choice perspective, is based on the idea that the offender considers benefit and risk stemming from the crime. The third concept is the crime pattern theory that focuses on the importance of time and space. This master thesis focuses on the usability of the opportunity theory for crime in the context of our current society. Although the opportunity theory for crime is nearly forty years old, this work shows that it is also applicable on cybercrime since some of the "classical" crimes moved from physical space to cyberspace. The potential offender and suitable target exist and behave similarly in cyberspace and in physical space. The difference between the two worlds is notable for the capable guardian, who does not occur randomly in the cyberspace but is embodied in the form of ever-present protection. The opportunity theory also claims that the opportunities are highly specific, they play role in causing all crime, they are influenced by technological...

Syftet med arbetet är att belysa och förbättra maskinunderhållet inom Sweprod. Detta med fokus på eloxeringsprocessen samt att identifiera hur förebyggande underhåll på bästa sätt kan införas på Sweprod. Målet med studien är att ge organisationen en bild av hur det förebyggande underhållet ser ut och att ge dem förslag på vad det finns för förbättringsåtgärder och hur det kan implementeras. Organisationen har, som många andra verksamheter som arbetar inom tillverkning av produkter, många maskiner som kräver någon typ av underhåll. Ytbehandlingsprocessen som studien beskriver, kallas för eloxering och är en process som hanterar ytan på plåtar för att kunna färglägga dempå ett korrekt sätt. Oplanerade driftstopp på maskiner och förseningar i leveranser av produkter inom organisationen har gjort att underhållsprocessen hamnat i fokus. Organisationen reagerar oftare när något händer i form av korrigerande underhåll istället för att planera in förebyggande underhåll eller villkorbaserat underhåll för att minska sannolikheten att något händer. Det har gjort att organisationen vill se över rutinerna kring underhållet med fokus på det förebyggande underhållet. Studien lyfter främst fram olika underhållsstrukturer med inriktning på förebyggande underhåll. Studien hanterar även förslag på hur organisationer på ett effektivt sätt kan arbeta med att implementera eventuella förbättringsområden som identifieras med hjälp av kvalitetsverktyg. Intervjuer med medarbetare och ledning inom organisationen har varit en stor faktor för att identifiera orsaker till att underhållet anses vara bristfälligt. Det har resulterat i att identifiering av grundorsaker inom eloxeringsprocessen har hittats som visar att med relation till olika underhållsstrukturer finns förbättringsmöjligheter inom främst helhetsstrukturen. Det som ligger i fokus är främst underliggande struktur i from av Maintenance Management, Routine Maintenance Program, Reliability-Centered Maintenance, Total Productive Maintenance. Inom eloxeringsprocessen finns det också flera kontrollmätningar som inte används till det förebyggande underhållet. Hade processen strukturerats med hjälp av Maintenance Management hade ett villkorbaserat underhåll varit av nytta för processen. Studien som har utförts av författaren har stegvis gett en inblick i vilka orsaker som är bristfälliga inom organisationen. Det har också gett en mer detaljerad inblick i eloxeringsprocessen, där det även identifierades grundorsaker som visar att underhållsstrukturen är en faktor till att förebyggande underhållet anses vara bristfälligt. Studien har också med hjälp av tidigare forskning identifierat angreppsätt för hur strukturen bör se ut inom organisationen med koppling till undersökningen som gjorts. Förslag har också presenterats på hur organisationen på ett effektivt sätt skulle kunna implementera underhållsstrukturen till eloxeringsprocessen med hjälp av en implementeringsprocess.

Objectives: The management of patients with multifocal motor neuropathy (MMN) under everyday clinical conditions has been insufficiently studied. We therefore collected comprehensive observational data on patients with MMN who received intravenous (IV) or subcutaneous (SC) immunoglobulins (IGs) as maintenance therapy. Methods: This was a prospective, noninterventional study (registry) in neurological centres (hospitals and offices) throughout Germany. Results: As of 1 December 2015, 80 patients with MMN were included (mean age 55.4 ± 9.8 years, 67% males, mean disease duration 10.7 ± 10.2 years). The affected limb regions were predominantly distal muscle groups of the upper extremities. On the inflammatory neuropathy cause and treatment (INCAT) scale, 94% of the patients had some disability in the arms and 61% in the legs. At inclusion, 98.8% received IVIG and 1.3% SCIG. Substantial variation was observed between IVIG treatment intervals (every 0.7 to 17.3 weeks) and dosage (0.2–2.1 g/kg body weight received during a single administration; mean monthly dosage, 0.9 g/kg body weight). However, the mean monthly dosage was steady over time. At 1-year follow up, improvement was seen in muscle strength, INCAT and quality of life (QoL) scores (SF-36 questionnaire). Conclusions: The management of patients with MMN in everyday clinical practice demonstrates a wide range of absolute dosages and treatment intervals of IG, supporting the recommended practice of determining treatment dose on an individual patient basis. The improvements in muscle strength and reduction in disability, accompanied by increased QoL, strengthen the case for use of IG as a maintenance treatment for MMN.

研究の目的 : 多変量解析とGISを用いて、乳幼児を対象とする日本の予防接種率の地域差の実態を把握し、その要因を検討する。研究の背景 : 公衆衛生上の課題である予防接種率の地域差の特定と改善を目的として、多様な地域スケールからその要因を分析する研究が行われている。しかしながら、日本における既往研究では個人を対象とした研究が多く、接種率の地域差の検討や関連要因を用いた生態学的研究もほとんど行われてこなかった。研究手法 : 日本の1737の市区町村における7種類19回の予防接種を対象として、重回帰分析と市区町村―都道府県間の階層を用いたマルチレベル分析を行った。被説明変数には推計した2013年から2018年までの予防接種率を、説明変数には9つの個人要因と4つの環境要因を用いた。これらの変数の作成には国勢調査などの政府統計を用いた。予防接種率の分布図と予測モデルの残差プロットを用いて、地理的な関連要因を探索した。結果 : 一人当たり課税所得と乳幼児健診受診率は市区町村レベルで、世帯の児童数は都道府県レベルで全般的に有意な関連を示した。その他の変数は予防接種の種類や接種時期(回数)によって関連の有無が異なった。接種率は西日本で低く、大都市圏で高い傾向がみられた。残差は内陸部と接種率の偏差が大きい地域に多く見られた。考察 : 市区町村の所得格差と都道府県の世帯あたり児童数の差が、地域の接種率の格差に関連すると示唆された。また、人口減少と高齢化が進む小規模地域には接種率に関連する固有の因子が存在する可能性がある。結論 : 接種率の向上には、その地域の社会経済的状況や人口構造、地域の文脈、予防接種の種類、それらの要因の影響するスケールを踏まえた施策が求められる。 / Objective: Examining geographical variation and the factors of infant immunization coverage in Japan. Background: Incomplete vaccination coverage is one of the largest public health threats. Many interdisciplinary studies have investigated factors that might increase immunization rates or cause Vaccine Hesitancy. However, most studies in Japan have focused on individuals and few studies have considered regional disparities of vaccination coverage. Methods: We conducted a multiple regression analysis and a multilevel analysis (municipality-prefecture hierarchy) for 19 vaccinations in 1737 municipalities in Japan, during 2013-2018. The dependent variable was the estimated vaccination rate, and nine individual factors and four environmental factors were used as explanatory variables. Data were collected from publicly available sources. We used distribution maps of vaccination rates and residuals of the predictive models to explore geographical factors. Results: In general, per capita taxable income and infant health checkup rate showed generally significant positive associations at the municipal level, and the number of children in the household negative association at the prefectural level. Other factors showed various associations depending on the type and the timing of vaccines. Vaccination rates were likely to be lower in western Japan and higher in metropolitan areas. Residuals were found mostly in inland areas and areas with large deviations in vaccination rates. Discussion: These results suggested that vaccination rates were associated with regional differences in municipal income inequality and in the number of children per household in prefectures. Smaller villages with declining and aging populations might have unique factors. Conclusions: To increase vaccination coverage among infants, it requires to consider the effect size at various spatial scales, in addition to compositional and contextual effects as the socioeconomic status, demographic structure, the local contexts, and the type of vaccination. / 京都大学 / 修士 / 修士(文学) / Kyoto University / TFtmp