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Introdução: Avaliar o impacto das intervenções em saúde passa a ser obrigação, principalmente, daqueles que são responsáveis pelas decisões em saúde. Entre estes, estão os profissionais que prescrevem e determinam tratamentos, atuando como fontes geradoras de despesa, bem como os gestores, que devem garantir a melhor aplicação de recursos e ampliação do atendimento à população. A escassez de recursos tem levado os sistemas de saúde do mundo inteiro a incorporar metodologias de avaliação econômica para a tomada de decisão. Entre as demandas crescentes da população está a necessidade de transplantes, entre os quais o transplante de medula óssea (TMO). Um procedimento de alto custo, pela grande utilização de recursos no tratamento, tempo elevado de internação, além do investimento em prevenção de desfechos aos quais estes pacientes ficam sujeitos: infecções, rejeição ao enxerto e mortalidade. Objetivos: Este estudo tem como propósito avaliar a relação de custobenefício da criação de uma unidade de ambiente protegido (UAP) destinada a pacientes hematológicos submetidos a TMO em um hospital universitário brasileiro. Identificar os custos da criação e manutenção da UAP, estimar os custos associados à realização de transplantes de medula óssea em pacientes portadores de doenças hematológicas bem como os benefícios da implantação desta unidade em relação à freqüência de ocorrência de agravos de morbidade e mortalidade. Delineamento: Quase-experimento. Métodos: Trata-se de um estudo retrospectivo, onde a população é formada por coorte de pacientes adultos que realizaram TMO entre 5 de janeiro de 2004 e 7 de maio de 2007 – denominado Período 1 (P1) – e 4 de junho de 2007 e 18 de março de 2008 – denominado Período 2 (P2). Para a identificação do custo do paciente foram analisados todos os recursos utilizados por este a partir de sua primeira internação para a realização do transplante e as posteriores, num período de até seis meses de acompanhamento, considerando: custo da unidade de internação; nutrição; recursos de Serviços de Apoio ao Diagnóstico e Tratamento (SADT); custo em nota de sala; custos de procedimentos realizados; hemoterapia; oxigenoterapia; medicamentos utilizados; nutrição parenteral; radioterapia e quimioterapia. Para efeitos de comparação todos os custos foram ajustados para jan/08. Para medir o impacto assistencial, foram pesquisados desfechos como ocorrência de infecções e doença do enxerto contra o hospedeiro (DECH). Resultados: Foram analisadas 166 pacientes e 233 internações no período pré-intervenção enquanto no período posterior foram analisados 45 pacientes e 58 internações hospitalares. O custo mediano por paciente foi de R$ 43.087,81 em P1 e R$ 37.303,87 em P2 (p= 0,466), esse mesmo custo quando estratificado por tipo de transplante resultou em redução de R$ 122.944,69 para R$ 100.555,48 em casos alogênicos (p=0,011) e mantevese igual em casos autólogos, sendo R$ 28.453,05 em P1 e R$ 28.305,24 em P2 (p=0,237). O índice de proteção da UAP sobre a variável infecção hospitalar, demonstrado através da razão de densidade de incidências foi de 0,83 (IC de 95% 0,56 a 1,23) e a taxa de infecção foi reduzida de 2,08% para 1,75%, sendo observada uma redução de 0,17 na incidência da mesma. A mortalidade na internação de realização do transplante foi reduzida de 0,16 em P1 para 0,11 em P2 e o índice de reinternação, de 0,40 para 0,28, respectivamente. Conclusão: A intervenção realizada no tratamento de pacientes submetidos a TMO, internação em UAP, demonstrou uma redução de 13% no custo mediano dos pacientes. O resultado por tipo de TMO demonstrou-se fortemente custo-benéfico nos casos alogênicos, aqueles considerados de maior complexidade e custo. Os dados de infecção, mortalidade e reinternação sugerem uma intervenção eficaz quando analisada sob a perspectiva dos desfechos assistenciais. Do ponto de vista econômico, também foi observado resultado favorável à intervenção em estudo, ainda que o mesmo também não tenha apresentado força estatística. / Objective: To evaluate the cost-benefit of creating a protected environment (PE) ward for hematological patients undergoing bone marrow transplantation (BMT) at Hospital de Clínicas de Porto Alegre (HCPA), public school hospital with 740 beds, located in Southern Brazil. Methods: A retrospective study, quasi-experimental design, with a population made up of cohort of adult patients who underwent BMT from Jan/2004 to May/2007 (P1) and Jun/2007 to Mar/2008 (P 2). Cost information was obtained by identifying the resources used by patients from the query of the computerized system of HCPA. To measure the impact of care, outcomes, such as occurrence of infections and mortality were investigated. Results: We analyzed 166 patients and 233 admissions in the preintervention while in the later period 45 patients and 58 hospitalizations were investigated. The median cost per patient was R$ 43.087,81 in P1 and R$ 37.303,87 in P2 (p = 0.466). This same cost when stratified by type of transplant resulted in a reduction from R$ 122.944,69 to R$ 100.555,48 in allogeneic cases (p = 0.011) and remained the same in autologous cases, of which R $ 28,453.05 in P1 and R $ 28,305.24 in P2 (p = 0.237). The index of protection of the PE on the variable infection, shown through the ratio of incidence density was 0.83 (CI 95% 0.56 to 1.23) and the rate of infection was reduced from 2.08% to 1.75%, and a reduction of 0.17 in its incidence was seen. The level of mortality on hospital stay during the transplantation was reduced from 0.16 in P1 to 0.11 in P2 and the rate of rehospitalization, 0.40 to 0.28, respectively. Conclusion: The intervention performed in the treatment of patients undergoing bone marrow transplantation, hospitalization in PE ward, showed a 13% reduction in the average cost of patients, although this difference was not considered statistically significant. The result by type of BMT showed strongly cost-beneficial in allogeneic cases, those considered of greater complexity and cost. The data of infection, mortality and reinteração suggest an effective intervention when viewed from the perspective of welfare outcomes. From the economic point of view, it was also observed a favorable outcome to the intervention under study, although it has not presented statistical power.

Prominent in the pioneering and settlement of early Utah were many men of great ability. Among them was Levi Ward Hancock. He became a dedicated spiritual leader in the Mormon Church.The life of Levi Hancock began in Springfield, Massachusetts, on April 7, 1803. His father moved about quite often in his attempts to provide a better livelihood for his family. Each move took them farther west. It was while they were living in Ohio that the Hancock family heard the Mormon missionaries preach their new gospel. Levi joined this frontier religion.Joining the Mormon Church changed the whole course of Hancock's life. He immediately became active and was sent to several missions. Some were preaching and proselyting missions; others were for other purposes. One such mission, known as Zion's Camp, was sent to Missouri to relieve what the Mormons believed to be the oppression of their members living there. The intended purpose of the mission failed, but from this group of tried and tested men came the future leaders of the Church. Levi Hancock was selected to be a member of the First Council of the Seventy. This group of seven men presided over the affairs of the Seventy, one of the lay groups of Priesthood in the Mormon Church.

Thesis (MBA.) --University of Limpopo, 2016 / The Ward Based Outreach Teams (WBOT) Programme is established in South Africa as part of a series of strategies to strengthen Primary Health Care (PHC) and to improve service delivery in the country. The purpose of the study was to gain an understanding of the experiences of Community Health Workers (CHW) in the implementation of the WBOT programme. The objectives of the study were to evaluate the experiences of CHWs in the WBOT, to evaluate factors that facilitate the implementation and to make recommendations and strategies on what can be done to improve the WBOT programme. A quantitative research design was used where self-administered questionnaires were provided to respondents for data collection. Respondents were asked to complete the questionnaires; completed questionnaires were returned by only 12 of the 27 respondents, resulting in a 44% response rate. The study’s findings indicate that the Community Health Workers (CHWs) regarded the WBOT as helping the community in many ways such reducing the long queues at the clinic and providing the care of the patients in their own homes, although concerns about poor participation by the community structures and nurses in the health facilities were expressed. CHWs expressed experiences that were positive and negative when conducting their work in the community. The results from the study have shown that there are successes, challenges and lesson learned. The results of the study further indicated that the programme is being implemented well even though it is still in a pilot phase in the sub-district. The programme has managed to improve and save many lives in the communities of Kgetleng Sub-district. Despite the level of depth in this study, there is a crucial need for more for more in-depth research regarding the experiences of users of the WBOT services and to conduct similar studies looking into urban areas and to compare and contrast the rural and urban findings.

Ces dernières années ont connu de grandes avancées en cosmologie et en astrophysique grâce à l'incroyable précision atteinte par les mesures des paramètres cosmologiques. La matière Noire (MN) apporte un lien entre ces mesures et celles effectuées en collisionneurs comme le LHC ou le collisionneur linéaire qui permettra d'augmenter encore la précision sur les propriétés de la MN. Les prédictions théoriques doivent alors atteindre la même précision que les mesures expérimentales portant sur la MN. Le neutralino du Modèle Standard Supersymétrique Minimal (MSSM) est un excellent candidat de MN. Le travail de cette thèse porte sur le développement d'un programme de renormalisation complet et cohérent du MSSM permettant le calcul à une boucle de toutes sortes de processus. Pour faciliter l'implémentation de ce programme qui tient compte d'un grand nombre de paramètres du modèle ainsi que d'un nombre incroyable de diagrammes de Feynman, un outil automatique a été développé. Celui-ci a permis d'étudier une grande variété d'applications à une boucle, de la détermination des masses, des désintegrations, des sections efficaces aux collisionneurs jusqu'à la prédiction de la densité relique de MN froide pour différents scénarios. D'un point de vue théorique, plusieurs schémas de renormalisation du paramètre tan(β) ainsi que leur dépendance de jauge ont été analysés, ceci en partie grâce à l'utilisation d'une fixation de jauge non linéaire qui a permis de généraliser certaines identités de Ward du secteur de Higgs.

<p>Här kommer sammanfattning av vår uppsatts "Småföretagare och deras finansiering"</p><p>Sammanfattning</p><p>Det finns många faktorer, både yttre och inre, som påverkar en småföretagare vid dennes val av finansieringsform. Det finns även många olika former av finansiering att välja bland t ex banklån, leasing och riskkapital och de olika finansiärerna ställer skiftande krav på småföretagen och företagarna. Ett problem som nämns i teorin är det finansiella gapet som bygger på en asymmetrisk information mellan företagaren och finansiären. Småföretagare föredrar enligt pecking order modellen eget genererat kapital och är negativt inställda till att förlora kontroll över företaget samt självständighet. Den form av finansiering som företagarna enligt denna teori undviker därav så långt som möjligt är riskkapital då detta kortfattat innebär att företaget ”betalar” genom att ge bort ägande. Dock kan inte alla småföretag överleva samt finansiera sin verksamhet med egna vinster, speciellt inte i början och det kan vara svårt att erhålla extern finansiering då företagen kanske inte har så mycket att lämna i säkerhet för t ex ett banklån. Denna uppsats är en fallstudie över hur olika faktorer påverkat/påverkar tre företags kapitalförsörjning. En form av finansiering som de undersökta företagen alla anser vara bra är leasing och anledningen till detta är att räntorna idag är så låga. Företagen är inte helt negativt inställda till riskkapital som teorin framhåller, trots att de helst försörjer sig på eget kapital. De undersökta företagen har haft olika förutsättningar vad gäller anskaffning av kapital och de har även till viss del valt olika former. Trots detta kan deras agerande i stora drag sägas följa de teorier som finns angående små företags kapitalförsörjning.</p>

Här kommer sammanfattning av vår uppsatts "Småföretagare och deras finansiering" Sammanfattning Det finns många faktorer, både yttre och inre, som påverkar en småföretagare vid dennes val av finansieringsform. Det finns även många olika former av finansiering att välja bland t ex banklån, leasing och riskkapital och de olika finansiärerna ställer skiftande krav på småföretagen och företagarna. Ett problem som nämns i teorin är det finansiella gapet som bygger på en asymmetrisk information mellan företagaren och finansiären. Småföretagare föredrar enligt pecking order modellen eget genererat kapital och är negativt inställda till att förlora kontroll över företaget samt självständighet. Den form av finansiering som företagarna enligt denna teori undviker därav så långt som möjligt är riskkapital då detta kortfattat innebär att företaget ”betalar” genom att ge bort ägande. Dock kan inte alla småföretag överleva samt finansiera sin verksamhet med egna vinster, speciellt inte i början och det kan vara svårt att erhålla extern finansiering då företagen kanske inte har så mycket att lämna i säkerhet för t ex ett banklån. Denna uppsats är en fallstudie över hur olika faktorer påverkat/påverkar tre företags kapitalförsörjning. En form av finansiering som de undersökta företagen alla anser vara bra är leasing och anledningen till detta är att räntorna idag är så låga. Företagen är inte helt negativt inställda till riskkapital som teorin framhåller, trots att de helst försörjer sig på eget kapital. De undersökta företagen har haft olika förutsättningar vad gäller anskaffning av kapital och de har även till viss del valt olika former. Trots detta kan deras agerande i stora drag sägas följa de teorier som finns angående små företags kapitalförsörjning.

Hurricane Katrina struck the Gulf Coast on August 29, 2005 and drastically altered the city of New Orleans causing the most damage to minority and low socioeconomic status communities such as the Lower Ninth Ward. Prior to Hurricane Katrina, African American women in the New Orleans constituted the group most marginalized in society. Following Hurricane Katrina, several studies have explored Hurricane Katrina and disaster recovery in New Orleans. However, few studies have explored gender as it relates to natural disasters and recovery. Therefore, this study explores the experiences of African American women with disaster recovery in the Lower Ninth Ward.

This is a research-based thesis building upon the study conducted over the past two years with Dr. Elizabeth English on the Buoyant Foundation Project (BFP). The BFP is currently developing an amphibious foundation system to retrofit vernacular wooden ‘shotgun’ houses in the Lower Ninth Ward in New Orleans. This neighbourhood was chosen because of its unique cultural heritage and the severe, but recoverable, damage incurred in the aftermath of Hurricane Katrina. The BFP system will allow homes to float when flooding occurs, rising and descending vertically to avoid flood damage. It provides an alternative solution to permanent static elevation, the mitigation strategy currently recommended by the United States federal government. The thesis will demonstrate how the Buoyant Foundation Project is a culturally supportive, technically feasible, economical, sustainable and resilient form of flood mitigation for post-Katrina New Orleans.

This dissertation addresses two questions fundamental to Russian nineteenth-century intellectual history: 1) Why does literature about paranoid psychosis figure so centrally in the nineteenth-century canon? and 2) How did the absence of an epistemological tradition of reflexive self-consciousness influence the development of Russian ideas of subjectivity? I propose that the presence of paranoia in Russian fiction extends beyond the medical or psychoanalytic aspects of character traits or themes. I argue that literary representations of paranoia perform fundamental philosophical gestures and function as "epistemological speech acts." Russian narratives of paranoia (e.g., Pushkin, Gogol, Dostoevsky, Chekhov, Garshin, Sologub) constitute a means of exploring the operations of a self-reflexive consciousness, familiar in the West through the Cartesian Cogito. In other words, the theme of paranoia in nineteenth-century Russian fiction actively responds to the regnant philosophical discourse and functions as a praxis for the exploration of philosophical questions. However, this is done in an alternative discourse to the propositional language generally favored in philosophical texts; as a result, the philosophical function of the fictions of paranoia has gone unrecognized, and the genre has been "exiled" from philosophical discourse. I argue that Russian texts of paranoid psychosis should be reconceived as venues for the play of the transcendental ego outside social or communal axes. Paranoia emerges as the Jakobsonian “dominant” within these texts, in that it is paranoia that engages with other narrative components and transforms them. Further, as prose fiction, these texts had the discursive and social capacity to resonate and divagate in ways impossible to philosophical texts. Ultimately, these narratives of paranoia are meta-epistemologies that interrogate their own discursive function and status. They raise critical questions not only about the ways in which we represent truth but about the ontological status of truth itself. / Slavic Languages and Literatures