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Strandell, Johanna. "Drug interaction surveillance using individual case safety reports." Doctoral thesis, Linköpings universitet, Klinisk farmakologi, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-70424.
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Background: Drug interactions resulting in adverse drug reactions (ADRs) represent a major health problem both for individuals and society in general. Post-marketing pharmacovigilance reporting databases with compiled individual case safety reports (ICSRs) have been shown to be particularly useful in the detection of novel drug - ADR combinations, though these reports have not been fully used to detect adverse drug interactions. Aim: To explore the potential to identify drug interactions using ICSRs and to develop a method to facilitate the detection of adverse drug interaction signals in the WHO Global ICSR Database, VigiBase. Methods: All six studies included in this thesis are based on ICSRs available in VigiBase. Two studies aimed to characterise drug interactions reported in VigiBase. In the first study we examined if contraindicated drug combinations (given in a reference source of drug interactions) were reported on the individual reports in the database, and in the second study we examined the scientific literature for interaction mechanisms for drug combinations most frequently co-reported as interacting in VigiBase. Two studies were case series analyses where the individual reports were manually reviewed. The two remaining studies aimed to develop a method to facilitate detection of novel adverse drug interactions in VigiBase. One examined what information (referred to as indicators) was reported on ICSRs in VigiBase before the interactions became listed in the literature. In the second methodological study, logistic regression was used to set the relative weights of the indicators to form triage algorithms. Three algorithms (one completely data driven, one semi-automated and one based on clinical knowledge) based on pharmacological and reported clinical information and the relative reporting rate of an ADR with a drug combination were developed. The algorithms were then evaluated against a set of 100 randomly selected case series with potential adverse drug interactions. The algorithm’s performances were then evaluated among DDAs with high coefficients. Results: Drug interactions classified as contraindicated are reported on the individual reports in VigiBase, although they are not necessarily recognised as interactions when reported. The majority (113/123) of drug combinations suspected for being responsible for an ADR were established drug interactions in the literature. Of the 113 drug interactions 46 (41%) were identified as purely pharmacodynamic; 28 (25%) as pharmacokinetic; 18 (16%) were a mix of both types and for 21 (19%) the mechanism have not yet been identified. Suspicions of a drug interaction explicitly noted by the reporter are much more common for known adverse drug interactions than for drugs not known to interact. The clinical evaluation of the triage algorithms showed that 20 were already known in the literature, 30 were classified as signals and 50 as not signals. The performance of the semi-automated and the clinical algorithm were comparable. In the end the clinical algorithm was chosen. At a relevant level, 38% were of the adverse drug interactions were already known in the literature and of the remaining 80% were classified as signals for this algorithm. Conclusions: This thesis demonstrated that drug interactions can be identified in large post-marketing pharmacovigilance reporting databases. As both pharmacokinetic and pharmacodynamic interactions were reported on ICSRs the surveillance system should aim to detect both. The proposed triage algorithm had a high performance in comparison to the disproportionality measure alone.
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Schuh, Anna Kristine. "Occupational Safety Surveillance Using a Statistical Monitoring Approach." Diss., Virginia Tech, 2013. http://hdl.handle.net/10919/24068.
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When unsafe conditions arise in a workplace, they may result in employee accidents and fatalities. However, if these problems are detected early, new hazard controls and safety initiatives can be introduced in order to actively reduce or prevent the occurrence of these events. Unfortunately, many safety systems currently monitor and report data that has been aggregated over long time periods, making it difficult to realize and respond to pattern shifts in a timely manner.
When monitoring a process over time, a commonly used tool is statistical process control charting. Traditionally used in manufacturing, control charts indicate a deviation from historically "normal" or "in-control" behavior and have become increasingly common in healthcare and public health monitoring. This dissertation studies the use of control charts to monitor the frequency of occupational safety incidents, with the overarching goal of investigating the effects of data aggregation on the detection performance of these charts.
Specifically, this dissertation 1) qualitatively establishes the need for more frequent monitoring of safety incidents; 2) investigates the comparative performance of control charts with aggregated and non-aggregated data for the detection of increased accident frequency, using a case study with data from an industrial partner; 3) more generally compares the performance of these charts for a Poisson process with a range of simulated process shifts; and 4) discusses the potential future challenges of including accident severity in quantitative safety monitoring systems. The comprehensive results indicate that lower degrees of data aggregation are preferred, and suggestions for better data collection and employee communication practices are offered to aid the transition for companies.Ph. D.
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Glenister, Helen Mary. "Surveillance methods for hospital infection." Thesis, University of Surrey, 1991. http://epubs.surrey.ac.uk/664/.
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Eight selective surveillance methods were assessed for their effectiveness in detecting hospital infection and the time required for data collection. The methods were compared with a reference method which was designed to identify all patients and infections in the study population (patients occupying 122 beds of a district general hospital). The selective methods were: - laboratory based ward surveillance - laboratory based telephone surveillance - ward liaison surveillance - laboratory based ward liaison surveillance - risk factor surveillance - temperature chart surveillance - treatment chart surveillance - temperature and treatment chart surveillance. The proportions of community acquired infection (CAI) and hospital acquired infection (HAI) detected by the selective surveillance methods varied; the highest proportion of CAI (70%) was identified by treatment chart surveillance, and temperature and treatment chart surveillance, and of HAI (71%), detected by laboratory based ward liaison surveillance. The time for data collection ranged from 1.5 hours/122 beds/week for laboratory based telephone surveillance to almost 8 hours for temperature and treatment chart surveillance. The time for the reference method was 22.1 hours/122 beds/week. Using the proportion of patients with HAI detected and time required for data collection to assess the methods, laboratory based ward liaison surveillance was the most effective and an efficient method. This method was revised minimally and introduced into six district general hospitals by infection control nurses. The time for data collection ranged from 4 to almost 8 hours/120 beds/week. The revision did not affect the proportion of HAI detected, however, the proportion of CAI identified was significantly reduced. The reproducibility of laboratory based ward liaison surveillance was good. The results will enable infection control teams to make an objective and rational choice of methods for the surveillance of hospital infection.
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Gono, Charles Saye. "Environmental surveillance monitoring XYZ-La Crosse." Online version, 2001. http://www.uwstout.edu/lib/thesis/2001/2001gonoc.pdf.
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McCracken, Selwyn, and n/a. "An injury surveillance framework for the New Zealand construction industry." University of Otago. Dunedin School of Medicine, 2009. http://adt.otago.ac.nz./public/adt-NZDU20090501.140407.
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Background: The burden of fatal and non-fatal injury for the New Zealand construction industry is larger than most other industrial sectors. Injury preventions efforts for construction have however been hampered because of insufficient, industry-specific, surveillance data that is essential for the effective targeting and evaluation of interventions.
Aim: This thesis aimed to describe and test a feasible framework of Injury Surveillance for the New Zealand construction industry. Accordingly, the specific objectives to accomplish this aim were: To identify an optimal surveillance dataset for New Zealand construction injuries; To assess potential sources of data and collection methods; To describe an ideal study design for undertaking injury surveillance; To implement an operational design based on industry stakeholder input; To undertake and evaluate an injury surveillance trial; and To suggest how a viable surveillance system could be permanently established.
Method: A trial injury surveillance system was developed by identifying known construction injury risk factors from the literature, reviewing the data collection practices of the New Zealand industry and other potential data sources and consulting with industry stakeholders about the most feasible collection methodology. This surveillance framework was then tested by combining national data from routine Government sources and data from 3 construction companies that employed approximately 720 workers between them. National construction injury data was obtained from the Accident Compensation Corporation, the Department of Labour and the Injury Information Manager. The trial Surveillance System was then evaluated in terms of its ability to collect the full range of an optimal dataset, the quality and completeness of information actually collected, the ability to identify and monitor injury priorities for the industry, and the future viability and acceptability of this surveillance design to the industry.
Results: A total of 468 medically treated injuries were recorded by the participating companies, with 15 (3.2%) considered to be Serious Harm injuries as defined by the Health and Safety in Employment Act. The level of data completeness across companies was especially low, with on average 18 out of 34 data fields (53%) completely unrecorded. The data from one company was sufficiently complete (i.e. 63% across all fields) to allow individual risk factor analyses to be conducted, whereas the absence of complete denominator data prevented the completion of the same analyses for the other two companies. Viewed overall, Government agency data was sufficiently detailed to estimate national longitudinal trends, injury agency and mechanism priorities for specific occupations and industry subsectors, and allowed a rudimentary evaluation of a national intervention programme. However, questions about data accuracy, completeness and under-reporting were raised for each of the Government data sources used.
Conclusions: Using data entirely from Government sources appears to be the most immediately viable framework of Injury Surveillance for the New Zealand construction industry. As such, the relevant range of analyses demonstrated by this study should be continued, expanded and improved. In contrast, obtaining injury surveillance data from companies in the manner that was tested does not appear to feasible, given the difficulty in recruiting companies and the poor data completeness of those companies that did participate. However, the increased range of prevention targets identified by the company that did largely contribute data as intended, demonstrated that company surveillance had merit relative to existing procedures. Suggested steps toward implementing viable construction injury surveillance within New Zealand are outlined, including a recommendation to the industry�s Health and Safety organisation, SiteSafe, to investigate the most feasible data collection protocol for its members.
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Speid, Lorna. "The safety assessment of medicines : pre and post-marketing." Thesis, Cardiff University, 1991. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.362576.
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Gillespie, Caroline. "Safety in supply chains: Evaluating sources of evidence." Thesis, Queensland University of Technology, 2020. https://eprints.qut.edu.au/203732/1/Caroline_Gillespie_Thesis.pdf.
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Focussed on supply chains and vulnerable workers, this research aims to address gaps in understanding the: • quality, completeness and usefulness of key data sources for occupational injury surveillance • occupational injury patterns and trends across different data collections (hospitalised injuries, workers' compensation claims and regulator reports) • regulator enforcement data patterns and trends • how parties communicate, consult and coordinate regarding hazards and risks to health and safety across supply chain operations.
This research identified opportunities to achieve a more complete occupational-injury surveillance profile that could better identify the at-risk worker population and enable regulators to employ more risk-responsive supply chain interventions.
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Syd, Ali Busyairah. "A safety assessment framework for Automatic Dependent Surveillance Broadcast (ADS-B) and its potential impact on aviation safety." Thesis, Imperial College London, 2013. http://hdl.handle.net/10044/1/24713.
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The limitations of the current civil aviation surveillance systems include a lack of coverage in some areas and low performance in terms of accuracy, integrity, continuity and availability particularly in high density traffic areas including airports, with a negative impact on capacity and safety. Automatic Dependent Surveillance Broadcast (ADS-B) technology has been proposed to address these limitations by enabling improved situational awareness for all stakeholders and enhanced airborne and ground surveillance, resulting in increased safety and capacity. In particular, its scalability and adaptability should facilitate its use in general aviation and in ground vehicles. This should, in principle, provide affordable, effective surveillance of all air and ground traffic, even on airport taxiways and runways, and in airspace where radar is ineffective or unavailable. The success of the progressive implementation of ADS-B has led to numerous programmes for its introduction in other parts of the World where the operational environment is considerably different from that of Australia. However, a number of critical issues must be addressed in order to benefit from ADS-B, including the development and execution of a safety case that addresses both its introduction into legacy and new systems' operational concepts, the latter including the Single European Sky (SES) / Single European Sky ATM Research (SESAR) and the US' Next Generation Air Transportation System (NexGEN). This requires amongst others, a good understanding of the limitations of existing surveillance systems, ADS-B architecture and system failures and its interfaces to the existing and future ATM systems. Research on ADS-B to date has not addressed in detail the important questions of limitations of existing systems and ADS-B failure modes including their characterisation, modelling and assessment of impact. The latter is particularly important due to the sole dependency of ADS-B on GNSS for information on aircraft state and its reliance on communication technologies such as Mode-S Extended Squitter, VHF Data Link Mode-4 (VDLM4) or Universal Access Transceiver (UAT), to broadcast the surveillance information to ground-based air traffic control (ATC) and other ADS-B equipped aircraft within a specified range, all of which increase complexity and the potential for failures. This thesis proposes a novel framework for the assessment of the ADS-B system performance to meet the level of safety required for ground and airborne surveillance operations. The framework integrates various methods for ADS-B performance assessment in terms of accuracy, integrity, continuity, availability and latency, and reliability assessment using probabilistic safety assessment methods; customized failure mode identification approach and fault tree analysis. Based on the framework, the thesis develops a failure mode register for ADS-B, identifies and quantifies the impact of a number of potential hazards for the ADS-B. Furthermore, this thesis identifies various anomalies in the onboard GNSS system that feeds aircraft navigation information into the ADS-B system. Finally, the thesis maps the ADS-B data availability and the quantified system performance to the envisioned airborne surveillance application's requirements. The mapping exercise indicates that, the quantified ADS-B accuracy is sufficient for all applications while ADS-B integrity is insufficient to support the most stringent application: Airborne Separation (ASEP). In addition, some of the required performance parameters are unavailable from aircraft certified to DO-260 standard. Therefore, all aircraft must be certified to DO-260B standard to support the applications and perform continuous monitoring, to ensure consistency in the system performance of each aircraft.
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Leite, A. "Near real-time vaccine safety surveillance using United Kingdom electronic health records." Thesis, London School of Hygiene and Tropical Medicine (University of London), 2018. http://researchonline.lshtm.ac.uk/4649039/.
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This thesis describes the feasibility of implementing a near real-time vaccine safety surveillance system (NRTVSS) using data from the Clinical Practice Research Datalink (CPRD), a United Kingdom (UK) research-level primary care database. NRTVSS is one method in the vaccine safety post-licensure toolkit, used since 2005. To understand how NRTVSS has been applied I conducted a systematic review of studies using NRTVSS. I identified 31 systems, mainly in the USA. Several sequential tests were in use, most commonly the Poisson-based maximized sequential probability ratio test (PMaxSPRT, 44%) and its binomial version (BMaxSPRT, 24%). Only 75% of studies addressed confounding, mainly by adjusting the expected rate. Delays in data availability may hinder the feasibility of implementing a system; some studies delayed the analysis, whilst others adjusted for delays and partially accrued periods. In CPRD, delays in recording outcomes are particularly relevant. Hence, I assessed those delays for selected outcomes of interest for vaccine safety (Bell’s palsy, Guillain-Barré syndrome (GBS), optic neuritis, and febrile seizures (FS)) by comparing the deemed date of diagnosis to the date the event was recorded in the system. Three-quarters of the records accrued during the first month, considered as sufficient to implement NRTVSS. I thus trialled the implementation of a system using previously collected CPRD data, for seasonal influenza/GBS and measles-mumps-rubella/FS. This included power calculations for detecting a signal. I used PMaxSPRT for both vaccine/outcome pairs and BMaxSPRT for measles-mumps-rubella/FS. Both tests were adjusted for delays in recording outcomes, based on the previous analysis. It was possible to implement a system, but power was < 80% to detect less than a four-fold increase in the risk of GBS following influenza vaccine. For this pair, I re-evaluated power after removing delays in data availability, with no significant improvement. This work establishes the foundation of a NRTVSS using CPRD for potential application in the UK. Future research could assess further vaccine/outcome pairs and explore the use of other statistical tests. Overall, this project contributes to UK vaccine pharmacovigilance.
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Batra, Sonia. "The Impact of the Sentinel Initiative and FAERS Surveillance System on Consumer Safety." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2438.
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The U.S. Food and Drug Administration (FDA) uses the FDA Adverse Event Reporting System (FAERS) to monitor adverse events resulting from pharmaceutical drug use. However, this system has limitations such as not allowing real-time data collection. To address these limitations, the FDA launched the Sentinel Initiative in 2008. This comparative case study was conducted to describe perceptions of investigating the efficacy of the Sentinel Initiative compared with the FAERS. The study was based on the theory of preemption as it emphasized the need for efficient means for providing unquestionable proof that consumers suffered adverse drug effects. The sample included interivews of 20 individuals, who worked closely with the FAERS program and were familiar with the Sentinel Initiative. In-depth key-informant interviews had been conducted to determine the perceptions of the participants regarding the challenges and benefits of the Sentinel Initiative compared with FAERS. To analyze data, content analysis was used. The study concluded that the FAERS and Sentinel Initiative provided a systematic database, which included health data, that could be used to improve public health. Due to the FAERS and Sentinel Initiative, adverse effects of drugs will be recognized and the safety of the patients and the public will be prioritized. The findings of this study have potential social impact for positive change at the societal level, organizational level, and individual level in terms of overall safety of the drugs. Sentinel initiative at its present state complements the existing FAERS and leverage its benefits by connecting at a grass roots level patients to an organization level as well as stakeholders to make an impact in providing safer drugs on the market.
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Howard, Guy. "Effective approaches to water supply surveillance in urban areas of developing countries." Thesis, University of Surrey, 2002. http://epubs.surrey.ac.uk/1032/.
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Lilley, Rebbecca Catherine, and n/a. "The development of an occupational health and safety surveillance tool for New Zealand workers." University of Otago. Dunedin School of Medicine, 2007. http://adt.otago.ac.nz./public/adt-NZDU20071011.112802.
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World-wide, working life is undergoing major changes. Established market economies are increasingly characterised by demands for vastly greater market flexibility. New Zealand (NZ) has been no different with rapid changes occurring over the last 2 decades in the organisation of labour, of work and of the work environment. Recent international research suggests that work change significantly impacts upon worker health and safety.
Many OECD nations undertake routine cross-sectional surveys to monitor changes in working conditions and environments, assessing the health and safety impact of these changes. Similar monitoring is not undertaken in NZ, with the impact of the work environment on health and injury outcomes poorly understood. This lack of knowledge (monitoring) is considered to be a significant impediment to the progression of health and safety initiatives in NZ.
The aim of this thesis was to develop a tool (questionnaire) and methodology suitable for use in the surveillance of working conditions, work environments and health and injury outcomes using workers� surveys. The survey development was undertaken in 3 phases: i) development of tool through critical review; ii) empirical methodological testing and iii) an empirical validation study.
Questionnaire development was a stepwise process of content selection. Firstly key dimensional themes were identified via critical review of literature and existing international surveys leading to the establishment of a dimensional framework. Secondly a critical review of questions to measure key dimensions based upon selection criteria occurred. Finally the selected questions and design were pre-tested before piloting. A similar development process was undertaken for the development of a calendar collecting occupational histories.
A methodological study was undertaken piloting the questionnaire. Two methods of data collection were evaluated: face-to-face and telephone interviews, and two methods of occupational history collection: calendar and question set. Telephone interviewing was found to be the more efficient and effective data collection method while occupational history collection was found to be less time consuming by question set. Focus groups indicated questions were acceptable and suitable to NZ workers.
A validation study was undertaken with a cross-sectional study in distinctly different occupational groups: cleaners and clerical workers. Comparisons were made between the groups with cleaners expected to be identified as employed under more hazardous working conditions and be exposed to more hazards of a physical nature, while clerical workers were expected to be exposed to more psychological hazards of a psychological nature. Results indicated the questionnaire provides data capable of making valid comparisons, identifying work patterns of high risk and provides good predictive validity.
The final survey has the potential to generate population data on a wide range of work-related exposure and health variables relevant to contemporary working life. The survey results will contribute to understanding the range of working conditions and work environments NZ workers are currently exposed to and to assessing the health and safety impact of these exposures. Therefore it is recommended this tool initially be used in a national workforce survey to establish baseline surveillance data of working conditions, work environments and health and safety outcomes in NZ.
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Ham, Bruce W. "The role of the health surveillance program in the Queensland coal mining industry." Thesis, Queensland University of Technology, 2000. https://eprints.qut.edu.au/36768/1/36768_Digitised%20Thesis.pdf.
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The Queensland Coal Industry Employees Health Scheme was implemented in 1993 to provide health surveillance for all Queensland coal industry workers. Tt1e government,
mining employers and mining unions agreed that the scheme should operate for seven years. At the expiry of the scheme, an assessment of the contribution of health
surveillance to meet coal industry needs would be an essential part of determining a future health surveillance program. This research project has analysed the data made
available between 1993 and 1998. All current coal industry employees have had at least one health assessment. The project examined how the centralised nature of the Health
Scheme benefits industry by identi~)jng key health issues and exploring their dimensions on a scale not possible by corporate based health surveillance programs.
There is a body of evidence that indicates that health awareness - on the scale of the individual, the work group and the industry is not a part of the mining industry culture. There is also growing evidence that there is a need for this culture to change and that some change is in progress. One element of this changing culture is a growth in the interest by the individual and the community in information on health status and benchmarks that are reasonably attainable. This interest opens the way for health education which contains personal, community and occupational elements. An important element
of such education is the data on mine site health status. This project examined the role of health surveillance in the coal mining industry as a tool for generating the necessary information to promote an interest in health awareness. The Health Scheme Database provides the material for the bulk of the analysis of this project. After a preliminary scan of the data set, more detailed analysis was undertaken on key health and related safety issues that include respiratory disorders, hearing loss and
high blood pressure. The data set facilitates control for confounding factors such as age and smoking status. Mines can be benchmarked to identify those mines with effective
health management and those with particular challenges.
While the study has confirmed the very low prevalence of restrictive airway disease such as pneu"moconiosis, it has demonstrated a need to examine in detail the emergence of
obstructive airway disease such as bronchitis and emphysema which may be a consequence of the increasing use of high dust longwall technology. The power of the Health Database's electronic data management is demonstrated by linking the health data to other data sets such as injury data that is collected by the Department of l\1mes and
Energy. The analysis examines serious strain -sprain injuries and has identified a marked difference between the underground and open cut sectors of the industry. The
analysis also considers productivity and OHS data to examine the extent to which there is correlation between any pairs ofJpese and previously analysed health parameters.
This project has demonstrated that the current structure of the Coal Industry Employees Health Scheme has largely delivered to mines and effective health screening process. At the same time, the centralised nature of data collection and analysis has provided to the mines, the unions and the government substantial statistical cross-sectional data upon
which strategies to more effectively manage health and relates safety issues can be based.
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Lengua, Apolaya César. "Coordination, Surveillance and Administrative Responsibility of the Parent Company in Safety and Health at Work." Derecho & Sociedad, 2017. http://repositorio.pucp.edu.pe/index/handle/123456789/118037.
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This article analyzes the essential obligations arising on safety and health at work with regard to the parent company in a scheme of productive decentralization, which is characterized in our midst by the widespread use of labor intermediation and outsourcing services both modalities recognized and regulated by Peruvian law.El presente artículo analizará las obligaciones esenciales que surgen en materia de seguridad y salud en el trabajo respecto de la empresa principal en un esquema de descentralización productiva, el cual se caracteriza en nuestro medio por el empleo difundido de la intermediación laboral y la tercerización de servicios, ambas modalidades reconocidas y reguladas por la legislación peruana.
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Backe, Stefan. "Safety promotion and injury surveillance with special focus on young people´s club sports : Challenges and possibilities." Doctoral thesis, Karlstads universitet, Institutionen för sociala och psykologiska studier, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:kau:diva-34429.
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Physical activity in youth has many benefits, but parallel to these benefits, sport related injuries pose considerable risks. It is important to public health to address sport related injuries, particularly those affecting young people, who comprise the majority of participants in organised sport in Sweden. The first study in this research showed that inspections of local sport environments, where injuries often occur, did not occur uniformly. Two additional studies pointed out the need for better surveillance of injuries, and described the use of ambulance attendance reports as a possible improvement to current surveillance systems, with a possibility to improve safety for youth and other sport participants. Two other studies identify risk factors that were specific to football and climbing sports, which can be used to guide targeted safety interventions for the young participants of these sports. The studies, taken as a whole, provide new information about the factors associated with sport related injuries, particularly for young people, and point out the need for better sport injury surveillance, improved inspection strategies for fields maintained by organised sport clubs in local communities, and the need to address risk factors specific to different sport activities.
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Moore, Daniel James. "A Zone-Based Multiple Regression Model to Visualize GPS Locations on a Surveillance Camera Image." Thesis, Virginia Tech, 2015. http://hdl.handle.net/10919/73594.
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Surveillance cameras are integral in assisting law enforcement by collecting video information that may help officers detect people for whom they are looking. While surveillance cameras record the area covered by the camera, unlike humans, they cannot "understand" what is happening. My research uses multiple curvilinear regression models to accurately place differentially corrected GPS points with submeter accuracy onto a camera image. Optimal results were achieved after splitting the image into four zones with the focus on calibrating each area separately. This resulted in adjusted R2 values as high as 99.8 percent, indicating that high quality GPS points can form a good manual camera calibration. To ascertain whether or not a lesser quality GPS point associated with a social media application would allow location of the person sending the message, I used an iPhone 5s to do a follow up. Using the zone-based calibration equations on GPS point locations from an iPhone 5s show that the locations collected are less accurate than differentially corrected GPS locations, but there is still a decent chance of being able to locate the correct person in an image based off that person's location. That chance, however, depends on the population density inside the image. Pedestrian density tests show that about 70-80 percent of the phone locations in a low-density environment could be used to locate the correct person that sent a message while 30-60 percent of the phone locations could be used in that manner in a high-density environment.Master of Science
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Castagnino, Florent. "Les chemins de faire de la surveillance : une sociologie des dispositifs de sécurité et de sûreté ferroviaires en France." Thesis, Paris Est, 2017. http://www.theses.fr/2017PESC1052/document.
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Contrôles d’accès, profilage commercial, numérisation des dossiers médicaux, mais aussi capteurs de radioactivité, de polluants atmosphériques, etc. sont autant de dispositifs de surveillance qui se multiplient. Ils sont l’objet de fortes critiques, que ce soit pour en dénoncer les effets nocifs ou pour réclamer leur renforcement. Cette thèse contribue à expliquer ces gestes critiques différenciés qui participent à l’actualisation de nos sociétés de surveillance et du risque. Elle propose une analyse qui réinscrit les pratiques de surveillance dans leurs contextes organisationnels, sociaux et pratiques, à partir de deux dispositifs : la prévention des accidents (dite sécurité) et la prévention des actes de malveillance (dite sûreté) dans le milieu ferroviaire en France. La recherche montre qu’en dépit de l’éloignement des problèmes considérés, les professionnels devant surveiller sont confrontés à des enjeux pratiques similaires. La thèse éprouve ce résultat d’abord d’un point de vue historique, en montrant que les premiers gestionnaires ferroviaires du XIXe siècle ont géré ces deux problèmes à partir d’un même dispositif disciplinaire. Après une spécification de ces enjeux au XXe siècle, l’analyse sociologique des pratiques actuelles souligne ensuite un rapprochement des mondes professionnels de la sécurité et de la sûreté ferroviaires, autour de la « gestion du risque ». Dans les deux cas, l’une des activités principales des professionnels de la sécurité et de la sûreté est de se séparer de certaines données, collectées dans leurs pratiques de surveillance. À partir de ces résultats, la thèse se propose de renouveler pour partie l’analyse des pratiques de surveillance. L’attention que la plupart des travaux sur la surveillance portent aux processus d’accumulation des données masque de fait les processus d’omission, de mise à l’écart ou de destruction de données. La thèse plaide alors pour une attention aux deux processus, d’accumulation et de séparation, pour mieux comprendre et pouvoir renouveler la critique des pratiques de surveillanceThe proliferation of surveillance devices such as access controls, customers profiling, medical records digitalization, as well as radioactivity or atmospheric sensors, have become the target of strong criticism. NGOs, professionals, and researchers have all denounced their harmful effects or called for them to be reinforced. This thesis seeks to explain these diverse and critical opinions that shape the actualization of the risk society and of the surveillance society. It offers an analysis that rewrites surveillance practices in their practical, social and organizational context from two perspectives: the prevention of both accidents (known as safety) and malicious acts (known as security) in the French railway system. This research demonstrates that despite the remoteness of the issues in question, monitoring professionals face similar practical challenges. This thesis tests this result from an historical point of view by demonstrating that the first rail administrator during 19th century dealt with these two problems using the same disciplinary measures. After much specification of these issues during 20th century, sociological analysis of current measures has highlighted a relation between railway safety and security focused on the notion of "risk management". In both case studies, one of the main activities of safety and security professionals is to dispose of data collected during their surveillance measures. Based on these results, the thesis offers to partly renew surveillance practices analysis. Most research within the field of surveillance studies focuses on the processes related to the collecting of data, their social and political impacts that overshadows the omission, exclusion and destruction of data. The thesis calls for more focus on both the process of collection and separation of data to better understand and renew the critical approach of the practices of surveillance
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Albrecht, Thomas. "A vision system for mobile maritime surveillance platforms." Thesis, Curtin University, 2012. http://hdl.handle.net/20.500.11937/1240.
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Mobile surveillance systems play an important role to minimise security and safety threats in high-risk or hazardous environments. Providing a mobile marine surveillance platform with situational awareness of its environment is important for mission success. An essential part of situational awareness is the ability to detect and subsequently track potential target objects.Typically, the exact type of target objects is unknown, hence detection is addressed as a problem of finding parts of an image that stand out in relation to their surrounding regions or are atypical to the domain. Contrary to existing saliency methods, this thesis proposes the use of a domain specific visual attention approach for detecting potential regions of interest in maritime imagery. For this, low-level features that are indicative of maritime targets are identified. These features are then evaluated with respect to their local, regional, and global significance. Together with a domain specific background segmentation technique, the features are combined in a Bayesian classifier to direct visual attention to potential target objects.The maritime environment introduces challenges to the camera system: gusts, wind, swell, or waves can cause the platform to move drastically and unpredictably. Pan-tilt-zoom cameras that are often utilised for surveillance tasks can adjusting their orientation to provide a stable view onto the target. However, in rough maritime environments this requires high-speed and precise inputs. In contrast, omnidirectional cameras provide a full spherical view, which allows the acquisition and tracking of multiple targets at the same time. However, the target itself only occupies a small fraction of the overall view. This thesis proposes a novel, target-centric approach for image stabilisation. A virtual camera is extracted from the omnidirectional view for each target and is adjusted based on the measurements of an inertial measurement unit and an image feature tracker. The combination of these two techniques in a probabilistic framework allows for stabilisation of rotational and translational ego-motion. Furthermore, it has the specific advantage of being robust to loosely calibrated and synchronised hardware since the fusion of tracking and stabilisation means that tracking uncertainty can be used to compensate for errors in calibration and synchronisation. This then completely eliminates the need for tedious calibration phases and the adverse effects of assembly slippage over time.Finally, this thesis combines the visual attention and omnidirectional stabilisation frameworks and proposes a multi view tracking system that is capable of detecting potential target objects in the maritime domain. Although the visual attention framework performed well on the benchmark datasets, the evaluation on real-world maritime imagery produced a high number of false positives. An investigation reveals that the problem is that benchmark data sets are unconsciously being influenced by human shot selection, which greatly simplifies the problem of visual attention. Despite the number of false positives, the tracking approach itself is robust even if a high number of false positives are tracked.
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Peet, Jacqueline Stephanie. "Strengthening nursing surveillance in general wards: A practice development approach." Thesis, Queensland University of Technology, 2020. https://eprints.qut.edu.au/205383/1/Jacqueline_Peet_Thesis.pdf.
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This thesis evaluated an emancipatory practice development (ePD) approach to strengthening nursing surveillance on a single medical-surgical ward. A relationship was established, and a researcher embedded on a ward around a shared interest of strengthening nursing surveillance and patient safety. Ward engagement with ePD methods of critical reflection, holistic facilitation and active learning were supported through workplace workshops and the formation of an action learning set with a group of ward RNs. The ward travelled through a transformative and at time turbulent process of resistance and retreat towards a new learning culture where nursing surveillance is visible and valued.
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Russo, Philip L. "Evidence based recommendations for national healthcare-associated infection surveillance." Thesis, Queensland University of Technology, 2016. https://eprints.qut.edu.au/100034/1/Philip_Russo_Thesis.pdf.
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This thesis has provided new knowledge about the surveillance of healthcare associated infections both in Australia and internationally. Using a mixed methods approach, a series of evidence based and pragmatic recommendations for a national surveillance program in Australia have been generated. Gaps in current surveillance activities across Australia were identified, and findings from the novel application of a discrete choice experiment, have identified strong key stakeholder support for a preferred national program to reduce the burden of infections in Australian hospitals.
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Star, Kristina. "Safety of Medication in Paediatrics." Doctoral thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-197323.
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Background: In paediatrics, the limited documentation to guide medication, the lack of suitable dosage forms, and the continuous development in childhood present a scenario where safety of medication is a particular challenge. Aim: To explore reported adverse drug reactions (ADRs) and the challenges in prescribing and administering medicines in paediatrics, in order to identify and suggest areas needing international surveillance within medication safety and improvement in the clinical setting. Methods: Four exploratory studies were conducted. Worldwide reporting of suspected ADRs (individual case safety reports, ICSR) with ages 0-17 years were examined overall. Twenty published case reports and ICSRs for adolescents, who developed a rare and incompletely documented ADR (rhabdomyolysis) during antipsychotic medicine use, were analysed in-depth. Prescribed doses of anti-inflammatory medicines were studied in a UK electronic health record database. Transcribed focus group interviews with 20 registered nurses from four paediatric wards in Sweden were analysed for factors that may promote or hinder safe medication practices. Descriptive statistics, multiple regression, and content analyses were used. Results: Although, skin reactions and anti-infective medicines were most frequently reported, and more reported in paediatric patients than in adults, medication errors and adverse reactions related to psychostimulant medicines were reported with increased frequency during 2005 to February 2010. The in-depth case analysis emphasised the need for increased vigilance following changes in patients’ medicine regimens, and indicated that ICSRs could contribute with clinically valuable information. Prescribed dose variations were associated with type of dosage form. Tablets and capsules were prescribed with a higher dose than liquid dosage forms. Six themes emerged from the interviews: preparation and administration was complex; medication errors caused considerable psychological burden; support from nurse colleagues was highly valued; unfamiliar medication was challenging; clear dose instructions were important; nurses handling medications needed to be accorded higher priority. Conclusions: Age-specific screening of ICSRs and the use of ICSRs to enhance knowledge of ADRs and medication errors need to be developed. Access to age-appropriate dosage forms is important when prescribing medicines to children. To improve medication safety practices in paediatric care, interdisciplinary collaborations across hospitals on national or even global levels are needed.
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Cross, Martyn. "Occupational respiratory health surveillance at Minara Resources, Murrin Murrin mine site." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2011. https://ro.ecu.edu.au/theses/418.
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This thesis outlines the results of occupational respiratory health surveillance at Minara Resources, Murrin Murrin mine site. The research was conducted as part of a collaborative agreement between Edith Cowan University and Minara Resources, the overarching title of which was ‗Establishing best practice protocols in the management of occupational and environmental health in a high-risk mining and ore-processing environment‘. To form the basis of this research it was hypothesised that although the chemical hazards had been adequately identified, and the occupational exposures in each work area at Murrin Murrin were generally well below their respective occupational exposure levels, it was still possible that additive, or even synergistic biological effects could cause adverse respiratory health effects due to the exposure to a combination of these atmospheric contaminants. This was the perception and a concern voiced by the Murrin Murrin workforce. Therefore, in working through the hypothesis, a literature review concentrating on the gaps in current knowledge and research for the early detection of occupational respiratory diseases was conducted, and the research tool and experiment design determined. The case for using pulmonary function tests in conjunction with a respiratory questionnaire in assessing early respiratory changes due to occupational exposures was established. Over a period between 17 February 2004 and 21 June 2006, a longitudinal study was conducted to ascertain the prevalence of respiratory symptoms and lung function of employees at the Murrin Murrin Operation, and compared with a local control group consisting of catering staff who resided at the accommodation camp approximately eight kilometres from the mine site. Lung function data were also compared to established predicted normal values from a reference population with normal lung function. Lung function data were analysed to determine whether there was an effect due to the area worked, and the employee‘s length of service. The lung function parameters of the study group, corrected for age and height were compared using linear regression analysis with both the control group and the predicted normal values. Repeat lung function tests were conducted on a sample of the original study group approximately two years after the initial study and statistically analysed to determine whether there was an effect on lung function over this time period. In addition, lung function tests were conducted for a cohort of refinery workers at the start and end of their two-week work period to determine whether there was a before-and-after effect due to their working conditions. The prevalence of respiratory symptoms was less in the study group compared to the controls; and these respiratory symptoms were determined to be non-work-related. On statistical analysis, for the ‗presumed healthy‘ workers (minus the smokers and those with known non-work-related respiratory symptoms) there was no overall decrement in lung function. Similarly, there was no overall statistically significant decrement in lung function for the ‗presumed healthy‘ workers in the repeat study conducted approximately two years after the initial study. There was no decrement in lung function associated with area work; nor was there a decrement in lung function for the cohort of refinery workers from the start to completion of their two-week work period. However, there were decrements in lung function for the smokers in the study and control groups. There was a significant difference in FEV1 between non-smokers and smokers with length of service (p
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Valente, Dario. "Avaliação higiênico-sanitária e físico-estrutural dos supermercados de Ribeirão Preto, SP." Universidade de São Paulo, 2001. http://www.teses.usp.br/teses/disponiveis/17/17139/tde-22082002-101241/.
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Define-se supermercado como o local onde se pratica comércio varejista de mercadorias em geral, predominantemente de produtos alimentícios, em uma área de venda de 300 a 5000 m2. Embora responda hoje por cerca de 85,0% das vendas de alimentos no Brasil, esse setor permanece ainda muito pouco estudado, particularmente em relação aos aspectos sanitários. Em Ribeirão Preto, os supermercados representam o principal local de venda de alimentos para todas as classes sociais, ao mesmo tempo que vêm sendo causa de número crescente do total de reclamações feitas à Divisão de Vigilância Sanitária (Visa) do município. Esta investigação teve o objetivo de: avaliar as condições higiênico-sanitárias e físico-estruturais dos supermercados e hipermercados (área de venda acima de 5000 m2) de Ribeirão Preto, com vistas a classificá-los segundo essas condições; avaliar o cumprimento da legislação vigente; detectar áreas/condições de risco à saúde pública; recomendar medidas corretivas. O trabalho foi conduzido durante as inspeções de rotina da Visa, utilizando-se a Ficha de Inspeção de Estabelecimentos da Área de Alimentos (FIEAA) adotada no Estado de São Paulo, a qual padroniza os procedimentos de inspeção e divide os itens que serão inspecionados em cinco grandes blocos. Foram incluídos todos os 56 supermercados e os 2 hipermercados da cidade. Os percentuais de adequação para cada bloco foram: 32,2% para o bloco 1, correspondente à situação e às condições da edificação; 27,1% para o bloco 2, correspondente aos equipamentos e aos utensílios; 68,1% para o bloco 3, correspondente ao pessoal de produção, manipulação e venda; 35,9% para o bloco 4, correspondente às matérias-primas e aos produtos expostos à venda; 42,3% para o bloco 5, correspondente ao fluxo de produção/manipulação/venda e ao controle de qualidade. Assim, apenas o bloco 3 foi classificado como regular, ficando todos os demais como deficientes. Na classificação final dos estabelecimentos, 46 (79,3%) foram classificados como deficientes, 11 (19,0%) como regulares, e apenas 1 (1,7%), como bom. Apesar de se reconhecer a existência de algumas inadequações nos pontos de corte padronizados para a classificação dos itens estudados, concluiu-se que a situação exige intervenção rigorosa das autoridades sanitárias, para se fazer cumprir a legislação vigente. Recomenda-se a adoção de algumas adaptações à legislação, entre as quais a obrigatoriedade de inclusão, no corpo de funcionários dos supermercados, de profissional capacitado na área de alimentos, bem como a mudança dos critérios de classificação dos estabelecimentos, visando a uma maior racionalidade na programação de inspeções rotineiras da Visa.The definition of supermarket is that of a place where retail market of general merchandise, mainly food products, is practiced in a sales area beteween 300m2 and 5000m2. Though it currently represents about 85% of food sales in Brazil, this sector still remains understudied, especially when it comes to its sanitary aspects. In Ribeirão Preto the supermarkets represent the main sales area of food for all social classes, at the same time that it has been the subject of an increasing number of complaints that have arrived at the City Division of Sanitary Surveillance (DSS). This investigation aimed to evaluate the sanitary, hygiene, physical and structural aspects of the supermarkets and hypermarkets (sales area over 5000m2) of Ribeirão Preto, to classify them according to these conditions, to evaluate the applicability of the legislation, to detect areas/conditions of public health risks and to recommend correction measures. The work was conducted during DSS´s routine inspections, using the guidelines for inspection of the food enterprises adopted in the state of São Paulo, which divides the subjects to be inspected in five big blocks. All of the city 56 supermarkets and 2 hipermarkets were included. The percentage of adequacy for each block were 32.2% for block a, corresponding to the situation and conditions of the edification, 27.1% for block b, corresponding to equipments and utensils, 68.1% for block c, corresponding to the production, manipulation and sales staff, 35.9% for block d, corresponding to the raw materials and products displayed for sales; 42.3% for block e, corresponding to the flow of production/manipulation/sales and quality control. Only block c was classified as regular, being the others considered as insufficient. In the final classification of the supermarkets, 46(79.3%) of them were considered insufficient, 11(19.0%) regular and only 1(1.7%) good. Although some inadequacies in the cutoff criteria for classifying the supermarkets are recognized, it becomes clear that the situation demands a rigid intervention of the sanitary authority in order to apply the existing legislation. Based upon the findings of this investigation, some recommendations can be done. Among them is the inclusion in the supermarket staff of an employee skilled in the food field, as well as a change in the criteria used for the classification of the supermarkets, aiming a higher rationality in the DSS programming of routine inspections.
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Catchpoole, Jesani Mitsuko. "Developing and evaluating approaches for utilising injury data to support product safety initiatives." Thesis, Queensland University of Technology, 2015. https://eprints.qut.edu.au/82805/1/Jesani%20Mitsuko_Catchpoole_Thesis.pdf.
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With increasing concern about consumer product-related injuries in Australia, product safety regulators need evidence-based research to understand risks and patterns to inform their decision making. This study analysed paediatric injury data to identify and quantify product-related injuries in children to inform product safety prioritisation. This study provides information on novel techniques for interrogating health data to identify trends and patterns in product-related injuries to inform strategic directions in this growing area of concern.
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Jorge, Carlos Alexandre Fructuoso. "Received radiation dose assessment for nuclear plants personnel by video-based surveillance." Instituto de Engenharia Nuclear, 2015. http://carpedien.ien.gov.br:8080/handle/ien/1463.
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This work proposes the development of a system to evaluate received radiation dose for nuclear plants personnel. The system is conceived to operate in a complementary form to the existing approaches for radiological protection, thus o ering redundancy, what is desirable for critical plants operation. The proposed system must operate in an independent form on the actions to be performed by the operators under evaluation. Therefore, it was decided it would be based on methods used for video surveillance. The nuclear plant used as example is Argonauta Nuclear Research Reactor, belonging to Instituto de Engenharia Nuclear, Comiss~ao Nacional de Energia Nuclear (Nuclear Engineering Institute, National Nuclear Energy Commission). During this thesis research, both radiation dose rate distribution and video databases were obtained. Methods available in the literature, for targets detection and/or tracking, were evaluated for this database. From these results, a new system was proposed, with the purpose of meeting the requisites for this particular application. Given the tracked positions of each worker, the radiation dose received by each one during tasks execution is estimated, and may serve as part of a decision support system.
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Watson, Angela L. "Piecing the puzzle together : enhancing the quality of road trauma surveillance through linkage of police and health data." Thesis, Queensland University of Technology, 2014. https://eprints.qut.edu.au/79394/1/Angela%20Watson%20Thesis.pdf.
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This program of research linked police and health data collections to investigate the potential benefits for road safety in terms of enhancing the quality of data. This research has important implications for road safety because, although police collected data has historically underpinned efforts in the area, it is known that many road crashes are not reported to police and that these data lack specific injury severity information. This research shows that data linkage provides a more accurate quantification of the severity and prevalence of road crash injuries which is essential for: prioritising funding; targeting interventions; and estimating the burden and cost of road trauma.
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Fernandes, Maria de Fátima Alves. "Avaliação da implantação do sistema de hemovigilância no Estado de São Paulo." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/99/99131/tde-06092017-095855/.
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A hemovigilância é considerada uma importante ferramenta para a segurança transfusional. Os primeiros sistemas nacionais de hemovigilância, no mundo, foram implantados na década de 1990. No Brasil, o Sistema Nacional de Hemovigilância (SNH), que é coordenado pela Agência Nacional de Vigilância Sanitária (Anvisa), iniciou sua implantação, em 2002, com foco nas reações transfusionais (RT), em uma rede restrita de hospitais. No final de 2006, a possibilidade de notificar RT foi estendida aos demais serviços de saúde e os gestores de saúde da esfera estadual também foram inseridos nesse processo. O estado de São Paulo (SP), onde funciona um subsistema do SNH (SNH-SP), colaborou com 41% do total de RT notificadas, no período de 2002 a 2014, segundo a Anvisa. Contudo, apesar de decorridos cerca de 10 anos, o SNH-SP nunca foi avaliado. O objetivo desse trabalho foi avaliar a implantação do SNH-SP, a fim de obter subsídios para sua melhoria. Trata-se de um estudo avaliativo, utilizando-se metodologia de avaliação baseada no Updated Guidelines for Evaluating Public Health Systems do Centers for Disease Control and Prevention (CDC). Foram utilizadas duas bases de dados secundários: das transfusões e das notificações das RT. Foram também utilizados três questionários concebidos para identificar fatores que contribuem ou não com a adesão e com a implantação do SHN-SP, pelos hospitais, serviços de hemoterapia (SH) e pela vigilância sanitária (Visa). Eles foram respondidos por 81 hospitais, 61 SH e 22 das 28 regionais de Visa. Verificou-se que o SNH-SP tem adesão crescente dos hospitais, especialmente os de maior porte, embora a aceitabilidade destes seja baixa, quando comparada com a dos SH. Foram realizadas 12.182.981 transfusões em 947 serviços de saúde, entre 2008 a 2015, mais de 55% delas, de concentrado de hemácias. O número de notificações de RT aumenta a cada ano, mas há subnotificação geral e de alguns tipos específicos de RT. Foram notificadas 23.942 RT, por 353 serviços de saúde. As 23.734 RT ocorridas nesse período se caracterizaram, predominantemente, como imediatas (97,96%), dos tipos febril não hemolítica (51,81%) e alérgica (38,20%). Apresentaram gravidade leve (87,62%), contudo, houve 35 (0,15%) óbitos. Concentraram-se nos maiores de 50 anos (51,49%). A incidência de RT nesse período variou entre 3,44 e 4,55/1.000, sendo mais elevada nas transfusões de concentrados de granulócitos, chegando a 53,06 RT/1.000. O SNH-SP tem gestão centralizada e tanto ele quanto o sistema de informação utilizado para notificação ainda são desconhecidos de parte dos hospitais. Há déficit de pessoal para trabalhar na área, tanto nos hospitais quanto nas Visa. Há falta de integração com outros sistemas de saúde afins, sugerindo a subnotificação de doenças transmitidas pelo sangue no SNH-SP, como as hepatites B e C. A estruturação do SNH apresenta simplicidade, porém, seu funcionamento atual, em SP, prejudica a avaliação desse atributo. Ao se analisar as RT definidas como eventos sentinela, a oportunidade e a qualidade dos dados foram consideradas insatisfatórias. O SNH-SP foi considerado útil, mas ajustes são recomendados para seu efetivo funcionamento.Haemovigilance is considered an important tool for transfusion safety. The first national hemovigilance systems in the world were implemented in the 1990s. The Brazilian Hemovigilance System (BHS), which is managed by Agência Nacional de Vigilância Sanitária (Anvisa), began in 2002, focusing on the transfusion reactions (TR) in a limited hospital network. At the end of 2006, the possibility of reporting TR was extended to all health services and state health managers were also included in this process. The state of São Paulo (SP), where a BHS subsystem (BHS-SP) operates, contributed with 41% of the total reported RTs, from 2002 to 2014, according to Anvisa. However, after about 10 years, the BHS-SP has never been evaluated. The objective of this study was to evaluate the implementation of the BHS-SP, in order to obtain inputs for its improvement. This is an evaluative study, using an evaluation methodology based on the Updated Guidelines for Evaluating Public Health Systems of the Centers for Disease Control and Prevention (CDC). Two secondary databases were used: transfusions and reported TR. Three questionnaires designed to identify factors that whether or not contribute to the adherence and to the implementation of the SHN-SP, by hospitals, blood banks (BB) and by health surveillance (Visa) were also used. 81 hospitals, 61 BB and 22 out of 28 regional Visa answered them. It was verified that the BHS-SP has an increasing adherence of the hospitals, especially of the larger ones, although the acceptability of these is low, when compared with the BB. 12,182,981 transfusions were performed in 947 health services, from 2008 to 2015, more than 55% of them, of red blood cells. The number of reported TR increases each year, but there is underreporting, in general and in some specific types of RT. 23,942 TRs were reported from 353 health services. The 23,734 TR occurred in this period were characterized as immediate (97.96%), non-haemolytic (51.81%) and allergic (38.20%). They were classified as non-severe (87.62%), however, there were 35 (0.15%) fatalities. They concentrated on those over 50 years old (51.49%). The incidence of TR in this period varied between 3.44 and 4.55/1,000, higher in granulocyte concentrates transfusions, reaching 53.06 TR/1,000. The BHS-SP has centralized management. Both, the BHS-SP and the information system used for reporting TR are still unknown by the hospitals. There is a shortage of staff to work in the area, in hospitals and in Visa. There is a lack of integration with other related health systems, suggesting the underreporting of bloodborne diseases in BHS-SP, such as hepatitis B and C. The organizational structure of the BHS demonstrates simplicity, but its current functioning in SP impairs the evaluation of this attribute. When RTs defined as sentinel events were analyzed, the timeliness and the quality of the data were considered unsatisfactory. The BHS-SP was considered useful, but adjustments are recommended for its effective functioning.
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Fournier, Mélanie. "L'apport de l'imagerie satellitale à la surveillance maritime. Contribution géographique et géopolitique." Phd thesis, Université Paul Valéry - Montpellier III, 2012. http://tel.archives-ouvertes.fr/tel-00829998.
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Que l'on se situe dans les Caraïbes, en mer Baltique ou en mer Méditerranée, bassins à la fois stratégiques, fragiles et inégaux, il reste crucial pour les Etats riverains d'y établir une surveillance des activités légales et illégales. Nous avons sélectionné ces bassins maritimes comme terrain d'analyse de notre recherche qui repose sur l'étude des grands projets européens dédiés à la surveillance maritime. Ce travail vise d'abord à proposer un état de l'art : il cherche à établir une synthèse des services proposés par les grands industriels travaillant sur les marchés civils et militaires et à évaluer dans quelle mesure il serait possible d'améliorer et de compléter les technologies existantes. Il a aussi pour objectif d'évaluer les informations recueillies via une image satellitale par l'établissement d'un historique des outils d'observation utilisés pour la surveillance maritime avec leurs caractéristiques, leurs avantages et inconvénients.
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Rachedi, Nedjemi Djamel Eddine. "Modélisation et surveillance de systèmes Homme-Machine : application à la conduite ferroviaire." Thesis, Valenciennes, 2015. http://www.theses.fr/2015VALE0009.
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Ce travail de thèse a pour contexte la surveillance des systèmes homme-machine, où l'opérateur est le conducteur d'un système de transport ferroviaire. Notre objectif est d'améliorer la sécurité du système en prévenant et en évitant les facteurs pouvant augmenter le risque d'une erreur humaine. Deux verrous majeurs sont identifiés : l'aspect caractérisation, ou comment déterminer les phases indicatives et discernables de l'activité de conduite et l'aspect représentation, ou comment décrire et codifier les actions de conduite de l'opérateur et leurs répercussions sur le système ferroviaire dans un formalisme mathématique permettant une analyse sans équivoque. Pour solutionner ces verrous, nous proposons en premier lieu un modèle comportemental de l'opérateur humain permettant de représenter son comportement de contrôle en temps continu. Afin de tenir compte des différences inter- et intra-individuelles des opérateurs humains, ainsi des changements de situations, nous proposons une transformation du modèle comportemental initialement présenté, dans un nouveau espace de représentation. Cette transformation est basée sur la théorie des chaines cachées de Markov, et sur l'adaptation d'une technique particulière de reconnaissance de formes. Par la suite, nous définissons une modélisation comportementale en temps discret de l'opérateur humain, permettant en même temps de représenter ses actions et de tenir compte des erreurs et des évènements inattendus dans l'environnement de travail. Cette modélisation est inspirée des modèles cognitifs d’opérateur. Les deux aspects permettent d'interpréter les observables par rapport à des situations de référence. Afin de caractériser l'état global de l'opérateur humain, différentes informations sont prises en considération ; ces informations sont hétérogènes et entachées d’incertitudes de mesure, nécessitant une procédure de fusion de données robuste qui est effectuée à l'aide d'un réseau Bayésien. Au final, les méthodologies de modélisation et de fusion proposées sont exploitées pour la conception d'un système de vigilance fiable et non-intrusif. Ce système permet d'interpréter les comportements de conduite et de détecter les états à risque du conducteur (ex. l'hypovigilance). L'étude théorique a été testée en simulation pour vérifier sa validité. Puis, une étude de faisabilité a été menée sur des données expérimentales obtenues lors des expériences sur la plate-forme de conduite ferroviaire COR&GEST du laboratoire LAMIH. Ces résultats ont permis de planifier et de mettre en place les expérimentations à mener sur le futur simulateur de conduite multimodal "PSCHITT-PMR"The scope of the thesis is the monitoring of human-machine systems, where the operator is the driver of rail-based transportation system. Our objective is to improve the security of the system preventing and avoiding factors that increase the risk of a human error. Two major problems are identified: characterization, or how to determine indicative and discernible phases of driver's activity and representation, or how to describe and codify driver's actions and its repercussions on the rail system in a mathematical formalism that will allow unequivocal analysis. In order to bring a solution to those problems, we propose, first-of-all, a behavioral model of the human operator representing his control behavior in continuous-time. To consider inter- and intra-individual differences of human operators and situation changes, we propose a transformation of the latter behavioral model in a new space of representation. This transformation is based on the theory of Hidden Markov Models, and on an adaptation of a special pattern recognition technique. Then, we propose a discrete-time behavioral modeling of the human operator, which represents his actions and takes account of errors and unexpected events in work environment. This model is inspired by cognitive models of human operators. These two aspects allow us to interpret observables with respect to reference situations in order to characterize the overall human operator state. Different information sources are considered; as a result the data are heterogeneous and subject to measuring uncertainties, needing a robust data fusion approach that is performed using a Bayesian Network. Finally, the proposed modeling and fusion methodologies are used to design a reliable and unintrusive vigilance system. This system can interpret driving behaviors and to detect driver’s risky states in order to prevent drowsiness. The theoretical study was tested in simulation to check the validity. Then, a feasibility study was conducted using data obtained during experiments on the LAMIH laboratory railroad platform “COR&GEST”. These results allowed us to plan and implement experiments to be conducted on the future multimodal driving simulator “PSCHITT-PMR”
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Samples, Agnes Mary Banks. "Validity of Self-Reported Data on Seat Belt Use: The Behavioral Risk Factor Surveillance System." [Johnson City, Tenn. : East Tennessee State University], 2004. http://etd-submit.etsu.edu/etd/theses/available/etd-0315104-172201/unrestricted/SamplesA032604f.pdf.
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Thesis (Ed. D.)--East Tennessee State University, 2004.Title from electronic submission form. ETSU ETD database URN: etd-0315104-172201. Includes bibliographical references. Also available via Internet at the UMI web site.
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Anisi, David A. "On Cooperative Surveillance, Online Trajectory Planning and Observer Based Control." Doctoral thesis, KTH, Optimeringslära och systemteori, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-9990.
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The main body of this thesis consists of six appended papers. In the first two, different cooperative surveillance problems are considered. The second two consider different aspects of the trajectory planning problem, while the last two deal with observer design for mobile robotic and Euler-Lagrange systems respectively.In Papers A and B, a combinatorial optimization based framework to cooperative surveillance missions using multiple Unmanned Ground Vehicles (UGVs) is proposed. In particular, Paper A considers the the Minimum Time UGV Surveillance Problem (MTUSP) while Paper B treats the Connectivity Constrained UGV Surveillance Problem (CUSP). The minimum time formulation is the following. Given a set of surveillance UGVs and a polyhedral area, find waypoint-paths for all UGVs such that every point of the area is visible from a point on a waypoint-path and such that the time for executing the search in parallel is minimized. The connectivity constrained formulation extends the MTUSP by additionally requiring the induced information graph to be kept recurrently connected at the time instants when the UGVs perform the surveillance mission. In these two papers, the NP-hardness of both these problems are shown and decomposition techniques are proposed that allow us to find an approximative solution efficiently in an algorithmic manner.Paper C addresses the problem of designing a real time, high performance trajectory planner for an aerial vehicle that uses information about terrain and enemy threats, to fly low and avoid radar exposure on the way to a given target. The high-level framework augments Receding Horizon Control (RHC) with a graph based terminal cost that captures the global characteristics of the environment. An important issue with RHC is to make sure that the greedy, short term optimization does not lead to long term problems, which in our case boils down to two things: not getting into situations where a collision is unavoidable, and making sure that the destination is actually reached. Hence, the main contribution of this paper is to present a trajectory planner with provable safety and task completion properties. Direct methods for trajectory optimization are traditionally based on a priori temporal discretization and collocation methods. In Paper D, the problem of adaptive node distribution is formulated as a constrained optimization problem, which is to be included in the underlying nonlinear mathematical programming problem. The benefits of utilizing the suggested method for online trajectory optimization are illustrated by a missile guidance example.In Paper E, the problem of active observer design for an important class of non-uniformly observable systems, namely mobile robotic systems, is considered. The set of feasible configurations and the set of output flow equivalent states are defined. It is shown that the inter-relation between these two sets may serve as the basis for design of active observers. The proposed observer design methodology is illustrated by considering a unicycle robot model, equipped with a set of range-measuring sensors. Finally, in Paper F, a geometrically intrinsic observer for Euler-Lagrange systems is defined and analyzed. This observer is a generalization of the observer proposed by Aghannan and Rouchon. Their contractivity result is reproduced and complemented by a proof that the region of contraction is infinitely thin. Moreover, assuming a priori bounds on the velocities, convergence of the observer is shown by means of Lyapunov's direct method in the case of configuration manifolds with constant curvature.QC 20100622
TAIS, AURES
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Goutal, Pascale. "Jeux non-coopératifs finis appliqués à la sécurité nucléaire." Paris 6, 1997. http://www.theses.fr/1997PA066362.
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Afin de dissuader les eventuels detournements de matieres nucleaires, un inspecteur est charge d'effectuer un certain nombre d'inspections dans une installation nucleaire. Deux inspections ont lieu a des dates fixes et connues de l'inspecteur et d'un eventuel detourneur. Entre les deux dates, un nombre limite d'inspections peuvent etre decidees par l'inspecteur. Nous supposons qu'un detournement est toujours detecte lors de l'inspection suivante. L'inspecteur cherche a minimiser le temps de detection et l'eventuel detourneur a le maximiser. Les jeux d'inspections sont etudies en deux temps. Nous considerons d'abord differentes familles de jeux d'inspection, et nous nous interessons tout particulierement aux jeux admettant une structure recursive. Ensuite, nous elaborons un jeu a information incomplete repondant aux donnees du probleme pose et realisons un logiciel, nomme jadis, permettant d'obtenir des strategies optimales d'inspection sur un grand nombre de periodes. Le jeu peut alors etre etudie sur un nombre de periodes suffisamment large pour confirmer le fait que l'information incomplete permet de reduire le temps de detection d'un detournement. Un second type de jeu est egalement etudie, le jeu d'infiltration, qui consiste en une poursuite-evasion sur un graphe de plusieurs arcs reliant deux noeuds. Un agent infiltrant doit se rendre de l'un de ces deux noeuds a l'autre sans etre intercepte par un gardien. Differents contextes de surveillance sont etudies.
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Vandecasteele, Arnaud. "Modélisation ontologique des connaissances expertes pour l'analyse de comportements à risque : application à la surveillance maritime." Phd thesis, Ecole Nationale Supérieure des Mines de Paris, 2012. http://pastel.archives-ouvertes.fr/pastel-00819259.
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Dans nos sociétés où l'information est devenue omniprésente, la capacité à pouvoir capter et exploiter celle-ci est un enjeu majeur pour toute entité amenée à prendre une décision. En effet, de cette capacité dépendent ensuite les actions et les moyens d'interventions qui seront engagés. Mais, face à l'augmentation des données disponibles, au nombre croissant d'acteurs et à la complexification des menaces, l'environnement dans lequel évolue le décideur est marqué par une grande incertitude. Ce constat général se retrouve également au sein de la surveillance maritime qui se caractérise par des menaces hétérogènes, par une zone d'action très vaste et par un réseau important d'acteurs.De ce fait, cette thèse se propose d'étudier les potentialités des ontologies spatiales à la fois comme objet de modélisation, de partage et d'inférence. L'objectif est de fournir aux experts du domaine un environnement adapté permettant la modélisation des connaissances relatives aux comportements anormaux de navires. Néanmoins, ces connaissances sont par nature spatio-temporelles. Il a donc été nécessaire d'étendre les fonctionnalités initiales du langage SWRL afin de prendre en compte ces caractéristiques.Enfin, l'approche adoptée a ensuite été mise en application au sein du prototype OntoMap. De l'extraction des données, à l'analyse cartographique celui-ci offre les éléments nécessaires à la compréhension d'une situation anormale.
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Gouws, Stephanus Andries. "The impact of hospital surveillance programmes on the incidence of adverse drug reaction reporting in a South African teaching hospital." Master's thesis, University of Cape Town, 1989. http://hdl.handle.net/11427/27186.
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Post-marketing surveillance refers to any non-experimental or observational study, method, or monitoring strategy that is applied to obtain information on drug experience (primarily adverse) after a drug has been approved for clinical use. One of the major problems in post-marketing surveillance studies is the lack or under-reporting of drug experiences by health care professionals. This study was developed to describe the impact of three different prescription event monitoring programmes on the reporting of adverse drug reactions (ADR's) in the hospital situation. The intensive ADR monitoring programme and two voluntary ADR monitoring programmes which followed were conducted in the medical wards of an urban teaching and referral hospital. All patients admitted to the designated wards were monitored by a dedicated pharmacist in the intensive programme, ward pharmacists in the first voluntary programme and by medical and nursing staff in the second voluntary programme. The pharmacist monitored a cohort of patients prospectively in two medical wards for a period of three months. The patient's record was linked with any suspected ADR. All details, i.e. patient drug orders, characteristics and ADR description, were recorded and then reported. From 228 patients monitored, 25 cases have been reported. The impact of the intensive ADR monitoring programme was a reporting rate of 11 percent. Reports were received on ADR's of a particularly mild, common and pharmacologically predictable (type A) nature. The first voluntary ADR monitoring programme comprised the reporting of suspected AD R's and the recording of drug orders for the patients and the patient characteristics. The ward pharmacists monitored for suspected AD R's in all patients during their regular ward rounds. Six cases were reported in a population of 1506 patients monitored during the three months. The reports were mainly on moderate to severe suspected AD R's of pharmacologically unpredictable (type B) nature. The rate of reports received by the surveillance unit in this study was 4 reports per ward pharmacist per annum. The second voluntary ADR monitoring programme comprised the prospective monitoring of 1555 patients by medical and nursing staff during their stay at the designated medical wards during the three month period. Patients were monitored for any ADR and when an ADR was suspected, the patient characteristics and drug orders were recorded and reported to the surveillance unit. Ten cases were reported represented by six reports from doctors and four by sisters. The reporting rate was 2 reports per doctor in four years and 3 reports for each member of the nursing team in 5 years. Reports were mainly received on moderate to severe suspected ADR's of a pharmacologically unpredictable (type B) nature.
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Motamed, Cina, and Alain Schmitt. "Application de la vision artificielle à la sécurité en robotique." Compiègne, 1992. http://www.theses.fr/1992COMP0511.
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Les installations robotisées sont dotées de mécanismes effectuant des tâches programmées et généralement cycliques. Notre objectif est de montrer comment la vision artificielle peut compléter les dispositifs de sécurité existants chargés de surveiller les interactions entre l'homme et les mécanismes dangereux. Notre approche est basée sur l'utilisation d'informations caractérisant le comportement "normal" des mécanismes en mouvement. Ainsi nous avons introduit la notion de modèle de comportement de la scène observée par une caméra fixe. Nous avons développé deux types d'applications de surveillance automatique dont la faisabilité a été démontrée dans un environnement industriel: Le premier consiste à vérifier le bon fonctionnement des mécanismes. Le modèle correspondant est constitué d'une suite de positions de points dans l'image, précisant la trajectoire que doit poursuivre le mécanisme. Le deuxième dispositif est une protection "proximétrique" de l'homme autour des mécanismes effectuant des tâches cycliques. Il utilise la modélisation nommée "Scénario" qui fournit des indications sur la position des organes en mouvement à chaque instant et également sur les zones dangereuses où un accident entre l'homme et la machine peut se produire. Le système de surveillance se concentre directement sur les zones pertinentes de l'image et déclenche l'arrêt d'urgence des mécanismes lors d'une détection d'intrusion dans les zones de danger. Le test de détection est basé sur un algorithme spécifique de différence entre l'image courante et une référence réactualisée. La détection a été fiabilisée vis à vis des contraintes de sécurité et supporte dans une certaine mesure des variations d'éclairage dans un environnement industriel non contrôlé.
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Arana, Jorge E. "Comparison of Post-Licensure Safety Surveillance of 13-Valent Pneumococcal Conjugate Vaccine and 7-Valent Pneumococcal Conjugate Vaccine: Data from the Vaccine Advere Event Reporting System (Vaers)." Digital Archive @ GSU, 2011. http://digitalarchive.gsu.edu/iph_theses/159.
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Comparison of Post-licensure safety surveillance of 13-Valent Pneumococcal Conjugate vaccine and 7-Valent Pneumococcal Conjugate vaccine: Data from the Vaccine Adverse Event Reporting System (VAERS).
Background: On February 24, 2010, Food and Drug Administration (FDA) licensed a 13-valent pneumococcal conjugate vaccine (Prevnar 13®, [PCV13]) for use among children aged 6 weeks--71 months. The Advisory Committee on Immunization Practices (ACIP) recommended PCV13 routine vaccination of all children aged 2--59 months, children aged 60--71 months with underlying medical conditions, with PCV13 replacing PCV7 for all doses.
Methods: We searched case reports to the Vaccine Adverse Event Reporting System (VAERS), a US passive surveillance system, for adverse events (AEs) reported after immunization with PCV13 vaccine from February 24, 2010 through February 24, 2011 for persons vaccinated from February 24, 2010 through December 31, 2010 and compared them with AEs reported by persons who were vaccinated with PCV7.
Results: VAERS received 1503 reports of AEs after PCV13; multiple vaccines were given in 79.0% of reports. One hundred eighty (11.9%) were coded as serious, including nineteen reports of death. The most frequently reported symptoms were injection site reactions, fever, irritability and vomiting. Seven hundred fifty-eight (50.4%) reports comprised males. Most reports (37.7%) were from children 1-2 years. Total number of reports received for PCV13 was very similar to those received after vaccination with PCV7.
Conclusions: AEs reported to VAERS following 13-valent pneumococcal conjugate vaccine were consistent with AEs previously observed in pre-licensure trials. We did not identify any major safety concerns or outcomes.
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Belli, Carla Viotto. "Novas perspectivas no controle dos produtos para saúde no Brasil : a visão do setor regulador e do setor regulado." Universidade de São Paulo, 2006. http://www.teses.usp.br/teses/disponiveis/6/6135/tde-20042007-153337/.
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Este estudo qualitativo e prospectivo baseou-se em entrevistas com os principais atores do sistema de controle de produtos para a saúde no país. No total 44 profissionais participaram da pesquisa de campo, sendo: 25 representantes do setor regulado, envolvidos predominantemente em áreas de assuntos regulatórios e qualidade, atuantes em empresas do segmento médico-hospitalar, nacionais e multinacionais; 19 profissionais representando o setor regulador, alocados em Brasília ou no Estado de São Paulo, envolvidos com o processo de registro e fiscalização de produtos médicos ou de entidades que produzam, façam uso ou comercializem estes itens. Os entrevistados responderam a quatro questões de referência sobre a função do registro, seu papel na garantia da segurança e eficácia dos produtos para a saúde e a fiscalização pós-comercialização. Os procedimentos éticos vigentes (relativos à pesquisa em seres humanos - RE CNS 196/96) foram observados na condução deste estudo. Todas as entrevistas foram gravadas, assim como o consentimento livre e esclarecido verbal do respectivo entrevistado, expresso através de declaração. Posteriormente, as falas foram transcritas para a análise de opiniões sobre o controle de produtos para a saúde. Os resultados (176 discursos individuais)foram avaliados de acordo com a metodologia do discurso do sujeito coletivo. A fiscalização de boas práticas de fabricação estabelecida pela RDC nº 59/00 é percebida como importante por ambos os setores para a garantia da segurança, qualidade e da eficácia dos produtos médicos. A boa-fé não é uma crença da maioria dos entrevistados, pois há grande desconfiança sobre as informações declaradas pelo setor regulado nos processos de registro de produtos para saúde. A falta de fiscalização no mercado foi enfatizada, bem como de infraestrutura e de conhecimento do setor regulador. A atuação das autoridades sanitárias é sustentada por denúncias do próprio setor regulado. O controle pré-comercialização é visto pelo setor regulado como necessário para liberar o produto médico no mercado e como uma responsabilidade da ANVISA (Agência Nacional de Vigilância Sanitária); entretanto, este não garante a qualidade do produto para a saúde, pois é documental e não há fiscalização eficiente. Os discursos expressam que o sistema atual não cumpre com as diretrizes de vigilância sanitária preconizadas por legislação de eliminar, diminuir ou prevenir riscos à saúde pública. Os atores deste estudo entendem que a adoção da tecnovigilância é uma boa perspectiva para melhorar o controle de produtos para saúde na pós-comercialização, contando com o comprometimento de todos os envolvidos, inclusive profissionais de saúde e usuários.This is a qualitative and prospective study based on interviews performed with the main stakeholders of the healthcare products regulatory control in Brazil. A total of 44 professionals were involved in the survey: 25 were predominantly employees responsible for regulatory affairs or quality assurance areas in medical device vendors, manufacturers or distributors, including national or multinational companies; 19 were government members responsible for pre-market review and postmarketing surveillance at the vendors or hospitals, located in Brasília or in the state of São Paulo. The participants have answered to four reference questions regarding to the register role, its purpose in assuring the safety and effectiveness of a medical device and the post-market vigilance. The ethical proceedings related to clinical trials in human subjects (Brazilian law RE-CNS 196/96) were followed in the execution of this study. All interviews were recorded, as well as the spoken agreement in participating of the study. Then, the speeches were written to perform the analyses and search for the collective opinions about the medical device controls. The results (176 speeches) were evaluated according to the qualitative methodology of the subjects collective speech. Both vendors and government participants understand the good manufacturing practices issued by the Brazilian law RDC n. 59/00 as important to maintain the medical devices safety as well as their effectiveness and quality. The majority of the stakeholders surveyed do not trust in the good faith since most of them mistrust the information declared in the register submission by the vendors. During this survey, it was reinforced that there is a lack of infrastructure and expertise in the governing bodies and not enough on-market inspecting. The health authorities often acknowledge the medical devices problems when the vendors themselves denounce. The vendors perceive the model of register as mandatory to marketing clearance under the National Agency of Sanitary Surveillance (ANVISA) responsibility. However, this procedure does not assure the quality of the medical devices as a bureaucratic process not followed by an efficient postmarketing control. The speeches express that the system in place does not guarantee the health surveillance objectives described in the Brazilian laws in accomplishment - eliminate, decrease or prevent risks to public health. The participants of this study feel that the postmarketing surveillance is the main prospective to improve the medical device control, linked with the commitment of all stakeholders, including users and health care professionals.
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Polisena, Julie. "Factors that Influence the Recognition, Reporting, and Resolution of Incidents Related to Medical Devices and an Investigation of the Continuous Quality Improvement Data Automatically Reported by Wireless Smart Infusion Pumps." Thesis, Université d'Ottawa / University of Ottawa, 2015. http://hdl.handle.net/10393/33414.
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Medical devices are used to diagnose, treat, or prevent a disease or abnormal physical condition without any chemical action in the body. They can also result in unintended incidents and other errors. This thesis was divided into three chapters: i) a systematic review on the recognition, reporting and resolution of incidents related to medical devices and other health technologies; ii) telephone interviews with physicians and registered nurses (RNs) to solicit information on the resolution, reporting and resolution of medical device-related incidents based on their professional experience; and iii) a case study to review the continuous quality improvement (CQI) data retrieved from the wireless smart infusion pump system at The Ottawa Hospital (TOH) and to propose a CQI data analysis process. The systematic review included 30 studies on factors that influence the recognition, reporting and resolution of incidents in hospitals and interventions to improve patient safety. Central themes that emerged for incident reporting were personal attitudes, awareness and perception of incident reporting systems, organizational culture, and feedback to healthcare professionals. In our telephone interviews, physicians and RNs attributed incident recognition to devices not operating based on the manufacturer’s instructions, and to the hospital staff’s knowledge of and professional experience with the use of the medical device, and clinical manifestations of patients. Suggestions to improve medical device safety surveillance centered on education and training to ensure that the staff is able to use the medical device properly and know what would be considered an error, and how to report these errors. The results of the systematic review and interviews helped to inform the design of a medical device surveillance framework in a hospital setting. Our case study assessed the Dose Error Reduction Software compliance and frequency of soft and hard limit alerts with wireless smart infusion pump systems over a one year period. A CQI data analysis process to monitor the performance of wireless smart infusion pumps is proposed. The findings of this doctoral thesis can contribute to the development of a medical device surveillance system that would help to improve health care delivery and patient safety in a health care institution.
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Shockey, Taylor Morgan. "Analysis and Interpretation of Occupational Exposure Monitoring Data from the Occupational Safety and Health Administration’s Integrated Management Information System (IMIS) and OSHA Information System (OIS), 1979 – 2015." The Ohio State University, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=osu155715411553358.
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Lutz, Eric Anthony. "Human and Animal Exposure to Airborne Methicillin-resistant Staphylococcus aureus (MRSA): Laboratory Evaluations and Veterinary Hospital Pilot Study." The Ohio State University, 2010. http://rave.ohiolink.edu/etdc/view?acc_num=osu1276101615.
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Värnild, Astrid. "Vägtrafikskadade i Västmanlands län idag och för tjugo år sedan : Regional uppföljning av det nationella trafiksäkerhetsmålet." Thesis, Mälardalens högskola, Akademin för hälsa, vård och välfärd, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:mdh:diva-15022.
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Studiens syfte är att undersöka hur det nationella målet för trafiksäkerhet går att följa upp på länsnivå via befintlig statistik från polis och sjukvård. Ger de två källorna en likartad bild av förändringen av antalet vägtrafikskadade under den gångna tjugoårsperioden? Undersök- ningen omfattar personer som skadats och överlevt vägtrafikolyckor i Västmanlands län. Data från 1989/1990 respektive 2008/2009 jämförs. De två statistikkällorna ger en likartad bild av förändringen av antalet vägtrafikskadade bilister, motorcyklister och mopedister. Skillnaderna är däremot stora beträffande gång- trafikanter och cyklister. Antalet skadade personer registrerade av sjukvården i länet har minskat under den studerade tidsperioden. Det beror på att antalet skadade gångtrafikanter och cyklister har blivit färre. På grund av förändringar inom sjukvården kan minskningen inte kvantifieras. Det lägre antalet frakturer, främst hos gångtrafikanter men även hos cyklister, visar att det varit en minskning. Antalet skadade bilister har däremot blivit fler, men de skadas lindrigare än 1989/1990. Gruppen allvarligt skadade bilister (ISS > 8) har dock ökat. För perioden 1997 – 2009 har det inte funnits något nationellt definierat trafiksäkerhetsmål för allvarligt skadade. Enligt polisens statistik är antalet svårt skadade vägtrafikanter i länet oförändrat under perioden. Om allvarligt skadad i sjukvårdens mätning definieras som inlagd på sjukhus har antalet allvarligt skadade under perioden minskat med 27 %. Antalet allvarligt skadade definierat som ISS > 8 är oförändrat.The purpose of the study is to investigate the extent to which it is possible to make a follow- up on the regional level of the national road safety target by using existing police and hospital statistics. Do the two sources provide a similar picture of the changes of the number of persons injured in road traffic accidents during the past twenty years? The survey covers persons injured but survived in road accidents in the county of Västmanland. 2008/2009 figures are compared with 1989/1990 figures. Both sets of statistics provide a similar picture of the changes with regard to the number of injured motorists, motorcyclists and moped drivers. However, concerning pedestrians and cyclists there are significant differences. During the time period being studied, the number of injured persons registered by the hospitals of the county has decreased. This is due to the fact that the number of pedestrians and cyclists injured has decreased. However, it is due to structural changes of the health care difficult to quantify the reduction. The lower number fractures, primarily of pedestrians but also of cyclists, shows that there has been a decrease. On the contrary, the number of injured motorists has increased, but their injuries are less serious than in 1989/1990. However, the number of those motorists with serious injuries (ISS > 8) has increased. For the period 1997 – 2009 there has not had an established national target for the number of seriously injured. According to police statistics, the number of severely injured road users in the county has remained unchanged during the time period being studied. If those being hospitalized in the medical statistics are defined as seriously injured, the number of seriously injured has decreased with 27 %. However, if seriously injured is defined as those with ISS > 8, the number has remained unchanged.
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Bouzillé, Guillaume. "Enjeux et place des data sciences dans le champ de la réutilisation secondaire des données massives cliniques : une approche basée sur des cas d’usage." Thesis, Rennes 1, 2019. http://www.theses.fr/2019REN1B023/document.
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La dématérialisation des données de santé a permis depuis plusieurs années de constituer un véritable gisement de données provenant de tous les domaines de la santé. Ces données ont pour caractéristiques d’être très hétérogènes et d’être produites à différentes échelles et dans différents domaines. Leur réutilisation dans le cadre de la recherche clinique, de la santé publique ou encore de la prise en charge des patients implique de développer des approches adaptées reposant sur les méthodes issues de la science des données. L’objectif de cette thèse est d’évaluer au travers de trois cas d’usage, quels sont les enjeux actuels ainsi que la place des data sciences pour l’exploitation des données massives en santé. La démarche utilisée pour répondre à cet objectif consiste dans une première partie à exposer les caractéristiques des données massives en santé et les aspects techniques liés à leur réutilisation. La seconde partie expose les aspects organisationnels permettant l’exploitation et le partage des données massives en santé. La troisième partie décrit les grandes approches méthodologiques en science des données appliquées actuellement au domaine de la santé. Enfin, la quatrième partie illustre au travers de trois exemples l’apport de ces méthodes dans les champs suivant : la surveillance syndromique, la pharmacovigilance et la recherche clinique. Nous discutons enfin les limites et enjeux de la science des données dans le cadre de la réutilisation des données massives en santéThe dematerialization of health data, which started several years ago, now generates na huge amount of data produced by all actors of health. These data have the characteristics of being very heterogeneous and of being produced at different scales and in different domains. Their reuse in the context of clinical research, public health or patient care involves developing appropriate approaches based on methods from data science. The aim of this thesis is to evaluate, through three use cases, what are the current issues as well as the place of data sciences regarding the reuse of massive health data. To meet this objective, the first section exposes the characteristics of health big data and the technical aspects related to their reuse. The second section presents the organizational aspects for the exploitation and sharing of health big data. The third section describes the main methodological approaches in data sciences currently applied in the field of health. Finally, the fourth section illustrates, through three use cases, the contribution of these methods in the following fields: syndromic surveillance, pharmacovigilance and clinical research. Finally, we discuss the limits and challenges of data science in the context of health big data
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Barbosa, Fabiana Gasperazzo. "Alimentos seguros: percepção dos manipuladores." Universidade de São Paulo, 2014. http://www.teses.usp.br/teses/disponiveis/10/10134/tde-06012015-141656/.
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Treinamento e educação em higiene e segurança alimentar são fundamentais à manipulação adequada dos alimentos, mas não necessariamente resultam em mudanças de atitudes e comportamentos. A avaliação da efetividade de treinamentos deve considerar não só o conhecimento teórico mas a investigação de atitudes. Utilizando-se o método do Discurso do Sujeito Coletivo (DSC) para conhecer a percepção dos manipuladores de alimentos quanto às atitudes para garantir a segurança alimentar, foi elaborado um questionário com cinco questões abertas, cada qual relacionada a uma das \"cinco chaves para uma alimentação mais segura\" recomendadas pela OMS, e aplicado a trabalhadores de estabelecimentos comerciais com atividade de restaurantes e similares da região central do município de São Paulo. Participaram da pesquisa 48 indivíduos, do sexo masculino (83,3%) e feminino (16,7%), de idade entre 18 e 76 anos, sendo que apenas 39,6% relataram ter participado de curso de boas práticas na manipulação de alimentos. A presença de prestadores de serviços relacionados à segurança alimentar nos estabelecimentos foi relatada por 22,9% dos entrevistados. Na questão 1 foram identificadas cinco categorias de respostas: deve-se lavar as mãos para evitar contaminação cruzada, deve-se lavar as mãos, deve-se lavar as mãos porque mexeu no lixo, o manipulador de alimentos não pode mexer no lixo, bem como um conceito incorreto sobre o uso de luvas; e uma ancoragem: lavar as mãos é um dever do funcionário. Na questão 2 foram identificadas três categorias de respostas: deve-se usar utensílios diferentes para manipular diferentes tipos de alimentos, \"passar uma água\" não é um processo de higienização adequado e \"passar uma água\" é suficiente para higienizar utensílios. Na questão 3 foram identificadas seis categorias de respostas: ovo pode ser servido com gema mole, ovo com gema mole pode ser servido para satisfazer o cliente mas oferece risco à saúde, ovo com gema mole pode ser servido para satisfazer o cliente mas não é permitido, ovo com gema mole não deve ser servido porque não é permitido, ovo com gema mole não deve ser servido porque oferece risco à saúde, ovo com gema mole não deve ser servido porque é proibido pela Vigilância Sanitária; e uma ancoragem: \"o cliente tem sempre razão\". Na questão 4 foram identificadas três categorias de respostas: descongelamento de alimentos não deve ser feito à temperatura ambiente, descongelamento de alimentos pode ser feito à temperatura ambiente desde que o produto esteja embalado, e descongelamento de alimentos pode ser feito à temperatura ambiente. Na questão 5 foram identificadas três categorias de respostas: o produto pode estar contaminado ou com prazo de validade expirado sem alteração de suas características organolépticas, não se deve utilizar produto sem etiqueta informando seu prazo de validade, e é possível saber se o produto está apto para consumo avaliando-se suas características organolépticas. De modo geral, a percepção dos entrevistados foi heterogênea sobre os temas pesquisados independentemente de ter participado de cursos de boas práticas ou de pertencer ao quadro de estabelecimento com assessoria, consultoria ou responsável técnico.Food safety training and education are essential to ensure adequate food handling, but not always results in practice and behavioral changes. The evaluation of training effectiveness must consider not only the theoretical knowledge but also the practices in place. In order to assess the perceptions of food handlers about practices used to ensure food safety, a questionnaire was developed using the Collective Subject Discourse technique. The questionnaire consisted of five open questions, each one related to one of the \"five keys to safer food\" recommended by the World Health Organization, and applied to food workers from commercial restaurants and similar establishments in the São Paulo city downtown area. Forty-eight individuals were interviewed, males (83,3%) and females (16,7%), 18 to 76 years old. Only 39,6% of the interviewed individuals received training on good manufacturing practices. The presence of a food safety consulting service in the establishment was reported by 22,9% of the respondents. In response to Question 1, five categories were identified in answers: must wash hands to prevent cross-contamination, must wash hands, must wash hands after handling garbage, the food handler must not handle garbage. Wrong concepts about wearing gloves were also identified, as well as the anchorage: \"employees must wash hands\". In response to Question 2 three categories were identified in answers: use separate equipment and utensils to manipulate different kinds of food, washing with water alone is an appropriate cleaning practice and washing with water alone is not an appropriate cleaning practice. In response to Question 3 six categories were identified in answers: eggs may be served with a soft yolk, eggs with a soft yolk may be served per customer request but present a health risk, eggs with a soft yolk may be served to please the customer but it is not allowed, eggs with a soft yolk may not be served because it is not allowed, eggs with a soft yolk may not be served because it is a health risk, eggs with a soft yolk may not be served because it is forbidden by the sanitary surveillance department. The anchorage: \"the customer is always right\" was also identified in this question. In response to Question 4 three categories were identified in answers: frozen food should not be thawed at room temperature, frozen food may be thawed at room temperature as long as the product is in a package, and frozen food may be thawed at room temperature. In response to Question 5 three categories were identified in answers: food may be contaminated or expired despite preservation of its organoleptic properties, a product without an expiration date label may not be used, and it is possible to know if food is safe to be consumed by assessing its organoleptic properties. In conclusion, respondents\' perceptions about the researched subjects were heterogeneous regardless if they participated in good manufacturing practices training or if they worked in establishments where consulting service or a technical manager was available.
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Vilas-Boas, Vanessa Aparecida 1981. "Carga microbiana dos trocartes de laparoscopia ginecológica, possíveis fontes de contaminação e repercussão clínica." [s.n.], 2014. http://repositorio.unicamp.br/jspui/handle/REPOSIP/283894.
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Orientadores: Maria Isabel Pedreira de Freitas, Carlos Emílio LevyTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Enfermagem
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Resumo: Introdução: Instrumentos cirúrgicos utilizados em cirurgias minimamente invasivas podem oferecer risco de infecção cruzada. Identificar sua fonte de contaminação contribui para prevenção de infecção e prestação do cuidado com qualidade e segurança. Contudo, a infecção de sítio cirúrgico é complexa, multifatorial e pode ser subnotificada se não houver programa de vigilância pós-alta efetivo. Objetivos: avaliar a relação entre carga microbiana de trocartes e microbiota da paciente, bem como a ocorrência de infecção de sítio cirúrgico após laparoscopia ginecológica; validar um instrumento de vigilância pós-alta por contato telefônico para cirurgias vídeo-assistidas. Método: estudo realizado em hospital público especializado em saúde da mulher. Fase I - estudo longitudinal prospectivo, 2011-2012, no qual amostras da microbiota da paciente foram coletadas no dia da internação por esfregaço com zaragatoa nas regiões da pele, ponto de McBurney esquerdo, cicatriz umbilical e fundo de saco vaginal. Após laparoscopia, trocartes foram coletados com técnica asséptica, obtendo-se o lavado microbiológico por adição de água destilada estéril e agitação, filtrados por membrana. As amostras foram incubadas para análise microbiológica. Após alta hospitalar, realizou-se vigilância por retorno ambulatorial e por contato telefônico. Realizada análise descritiva dos dados e aplicação dos testes de concordância de Kappa e Mc Nemar com nível de significância de 5%. Fase II - desenvolvida em duas etapas, a primeira 2011-2012, estudo metodológico com elaboração do instrumento de vigilância pós-alta por contato telefônico, para investigação de sinais e sintomas de infecção de sítio cirúrgico, seguida pela validação por peritos. O instrumento foi avaliado por cinco peritos quanto à pertinência, clareza e abrangência do conteúdo. A validação foi feita analisando-se a porcentagem de concordância entre peritos, sendo válidas as questões que obtiveram 80% de concordância. A segunda etapa, 2013, estudo transversal com aplicação do instrumento validado a pacientes submetidas aos procedimentos de histeroscopia e/ou laparoscopia ginecológica. Os dados foram analisados por estatística descritiva. Resultados: Fase I - a amostra foi composta por 24 pacientes, 68 esfregaços e 52 trocartes. Nos esfregaços encontrou-se predomínio de microbiota de pele Gram-positiva, mas também foram isoladas Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, dentre outros. Trocartes de 5 mm apresentaram crescimento bacteriano em 33,3% dos casos, com carga microbiana de 0-6 UFC. Trocartes de 10 mm apresentaram crescimento em 29,2%, com carga microbiana de 0-366 UFC. Observou-se grau de concordância pobre na comparação entre trocartes e microbiota da paciente (Kappa= 0,05; p= 0,08), exceto para Staphylococcus spp (p< 0,0001) e Corynebacterium spp (p= 0,0002). Não houve infecção decorrente da laparoscopia. Fase II - houve discordância entre peritos na primeira avaliação, o instrumento foi reformulado obtendo-se concordância na segunda avaliação. A amostra foi composta por 68 pacientes, sendo o contato telefônico possível em 86,36% dos casos. Queixas de dor abdominal, sangramento e edema incisional foram mais frequentes. Nenhuma apresentou infecção. Conclusão: Este estudo encontrou baixa contaminação nos trocartes, com a maioria das bactérias pertencentes à microbiota de pele da paciente sugerindo ser esta, sua principal fonte de contaminação. O questionário de vigilância pós-alta para cirurgias vídeo-assistidas foi validado, aplicado e encontra-se disponível para utilização
Abstract: Background: Surgical instruments used in minimally invasive surgery may offer risk of cross infection. Identify its source of contamination contributes to infection prevention and provision of quality and safety care. However, surgical site infection is complex, multifactorial and may be underreported if there is no post-discharge surveillance effective program. Aim: To evaluate the relationship between microbial load of trocars and patient flora as well as the occurrence of surgical site infection after gynecological laparoscopy; validate an instrument of post-discharge surveillance by telephone for video-assisted surgery. Method: study developed in public hospital specializing in women's health. Phase I - longitudinal prospective study, 2011-2012, in which the patient flora samples were collected with swabs the skin regions, left McBurney's point, umbilicus and vaginal fornix, on day of the admission. After the laparoscopy, trocars were collected using sterile technique, obtaining microbiological wash by addition of sterile distilled water and stirring, filtered through the membrane. The samples were incubated for microbiological analysis. After discharge, patients were followed up by outpatient and telephone call. Descriptive statistics, Kappa coefficient and McNemar¿s test were applied with significance level of 5%. Phase II - two stages, the first 2011-2012, methodological study with development of the post-discharge surveillance instrument for investigation of signs and symptoms of surgical site infection by telephone, addied with validation by experts. The instrument was evaluated by five experts on the relevance, clarity and completeness of contents. The validation was performed by analyzing the percentage of agreement among experts being considered valid the questions that have obtained 80% agreement. The second stage, in 2013, was a cross-sectional study with application of validated instrument to patients undergoing to hysteroscopy or gynecological laparoscopy. Data were analyzed using descriptive statistics. Results: Phase I - The sample consisted of 24 patients, 68 swabs and 52 trocars. In smears by swab there was a predominance of Gram-positive skin flora, but were also isolated Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, among others. The 5 mm trocars presented bacterial growth in 33.3% of cases with microbial load of 0-6 CFU. The 10 mm trocars presented bacterial growth in 29.2% with microbial load of 0-366 CFU. Noted poor agreement degree when comparing trocars and patient flora (Kappa= 0.05, p= 0.08), except for Staphylococcus spp (p<0.0001), and Corynebacterium spp (p= 0.0002). There was no infection resulting from laparoscopy. Phase II - there was disagreement among experts in the first evaluation, the instrument was redesigned obtaining agreement in the second evaluation. The sample consisted of 68 patients being telephone call possible in 86.36% of cases. Complaints of abdominal pain, bleeding and incisional edema were more frequent. No patient had infection. Conclusion: This study found low contamination in trocars, with most of the bacteria belonging to patient skin flora, their main source of contamination. The instrument of post-discharge surveillance for video-assisted surgery has been validated, implemented and is available for use
Doutorado
Enfermagem e Trabalho
Doutora em Ciências da Saúde
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Persson, Anders J. "Ethical problems in work and working environment contexts." Licentiate thesis, KTH, Infrastructure, 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-1741.
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This thesis identifies and systematizes two categories ofpractical problems that stem from work and working environmentcontexts: workplace privacy and occupational health risks. Thefocus of the discussion is on ethical justification. Do we havereason to accept a certain level of (potential) harm toemployees by virtue of the fact that they are employees, and ifso, under what circumstances? The thesis consists of a briefintroduction and three essays.
InEssayI, it is argued that employees have a prima facieright to privacy, but that this right can be overridden bycompeting moral principles that follow, explicitly orimplicitly, from the contract of employment. Three types ofjustification are specified: those that refer to the employer'sinterests, those that refer to the interests of the employee,and those that refer to the interests of third parties. A setof ethical criteria is developed and used in the subsequentessay to determine the moral status of infringement ofworkplace privacy.
InEssayII, these criteria are applied to three broadcategories of intrusive workplace practices: (1) monitoring andsurveillance, (2) genetic testing, and (3) drug testing.Scenarios are used to show that such practical ethical problemscan be handled systematically using proposed guidelines. It isalso shown that some practices are dubious and at least some ofthem can be replaced by less intrusive means of ensuring thedesired outcome, for instance efficiency or safety in aworkplace.
EssayIII deals with the fact that health and safetystandards for employees are less protective than those thatapply to the public. Emphasis is put on the distinction betweenexposure and risk, and this distinction is claimed to be a keyfactor in the relevance of arguments in favour of such doublestandards. The analysis of 'double standards' for public andoccupational exposure to risk aims to show that a justificationof such standards is closely linked to two separate types ofissues, namely empirical and normative issues. It is claimedthat this kind of differentiation seems to be supported neitherby a reasonable conception of the contract of employment nor byany obvious ethical principle that is applicable to workplacesor work situations in general.
Key words:Contract of employment, double standards,drug testing, ethics, ethical justification, exposure, genetictesting, health and safety standards, privacy, surveillance,risks, work, work environment
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Flaspoehler, Timothy Michael. "FW-CADIS variance reduction in MAVRIC shielding analysis of the VHTR." Thesis, Georgia Institute of Technology, 2012. http://hdl.handle.net/1853/45743.
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In the following work, the MAVRIC sequence of the Scale6.1 code package was tested for its efficacy in calculating a wide range of shielding parameters with respect to HTGRs. One of the NGNP designs that has gained large support internationally is the VHTR. The development of the Scale6.1 code package at ORNL has been primarily directed towards supporting the current United States' reactor fleet of LWR technology. Since plans have been made to build a prototype VHTR, it is important to verify that the MAVRIC sequence can adequately meet the simulation needs of a different reactor technology. This was accomplished by creating a detailed model of the VHTR power plant; identifying important, relevant radiation indicators; and implementing methods using MAVRIC to simulate those indicators in the VHTR model.
The graphite moderator used in the design shapes a different flux spectrum than water-moderated reactors. The different flux spectrum could lead to new considerations when quantifying shielding characteristics and possibly a different gamma-ray spectrum escaping the core and surrounding components. One key portion of this study was obtaining personnel dose rates in accessible areas within the power plant from both neutron and gamma sources. Additionally, building from professional and regulatory standards a surveillance capsule monitoring program was designed to mimic those used in the nuclear industry. The high temperatures were designed to supply heat for industrial purposes and not just for power production. Since tritium, a heavier radioactive isotope of hydrogen, is produced in the reactor it is important to know the distribution of tritium production and the subsequent diffusion from the core to secondary systems to prevent contamination outside of the nuclear island.
Accurately modeling indicators using MAVRIC is the main goal. However, it is almost equally as important for simulations to be carried out in a timely manner. MAVRIC uses the discrete ordinates method to solve the fixed-source transport equation for both neutron and gamma rays on a crude geometric representation of the detailed model. This deterministic forward solution is used to solve an adjoint equation with the adjoint source specified by the user. The adjoint solution is then used to create an importance map that can weight particles in a stochastic Monte Carlo simulation. The goal of using this hybrid methodology is to provide complete accuracy with high precision while decreasing overall simulation times by orders of magnitude. The MAVRIC sequence provides a platform to quickly alter inputs so that vastly different shielding studies can be simulated using one model with minimal effort by the user. Each separate shielding study required unique strategies while looking at different regions in the VHTR plant. MAVRIC proved to be effective for each case.
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Lok, Wai-shing. "The food health policy of Hong Kong SAR Government." Hong Kong : University of Hong Kong, 2001. http://sunzi.lib.hku.hk/hkuto/record.jsp?B23530145.
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Barbosa, Ana de Oliveira. "Risco, vigilância e segurança sanitária: desafios à proteção da saúde." Programa de pós-graduação em saúde coletiva, 2006. http://www.repositorio.ufba.br/ri/handle/ri/10317.
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A expressão segurança sanitária (SS) tem sido freqüentemente referida no debate internacional, sobretudo, em função das crises sanitárias emergentes. Todavia, o sentido conferido a essa expressão não se faz claro, sendo tratada como uma noção. A dissertação tem por objetivo analisar a noção de segurança sanitária incorporada na vigilância sanitária brasileira com a criação da Agência Nacional de Vigilância Sanitária (Anvisa). Para tanto, foi realizado um estudo de caso, do tipo exploratório, contemplando a análise de documentos de cunho técnico e normativo emitidos pela Anvisa, referente ao período de 1999 a 2004, bem como a realização de entrevistas semi-estruturadas com informantes-chave que participaram do processo de formulação do desenho institucional. A partir da massa de dados, identificaram-se situações, em que o termo foi utilizado, extraindo os significados associados à expressão em estudo. Constatou-se que a noção de segurança sanitária, no caso em estudo, gira em torno dos binômios risco-benefício ou risco-proteção da saúde, apresentando-se tanto como uma relação risco/benefício aceitável na perspectiva da proteção e promoção da saúde individual e coletiva quanto uma relação de obrigação do Estado para com a sociedade com vistas à proteção da saúde. No que concerne à extensão da noção, observa-se que ela abrange produtos e serviços de interesse à saúde humana; incorpora ainda, de forma pouco expressiva, questões ambientais, incluindo meio ambiente e ambiente de trabalho. As preocupações em relação à SS recaem sobre questões referentes à produção e ao consumo de medicamentos e tecnologias de interesse da saúde, sobretudo, aquelas que têm como finalidade o diagnóstico e tratamento médico; entretanto, os dados revelam que tem havido uma ampliação do escopo da noção de segurança sanitária.
Salvador
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Belleaubre, Micaël. "Contrôle, surveillance et promotion des eaux-de-vie Quel rôle pour l’État ? Angoumois, Aunis, Saintonge et sud Poitou (1709-1870)." Thesis, La Rochelle, 2022. http://www.theses.fr/2022LAROF001.
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Au XVIIIe siècle, la production des eaux-de-vie est la principale activité économique d’un territoire limité dont le marché de référence devient Cognac. De nombreux métiers sont impliqués dans l’élaboration de ces produits avant et après le passage à l’alambic. Rapidement, des taxes sont appliquées sur ces boissons. L’État trouve ainsi de nouvelles ressources d’autant que toute la société est concernée, malgré l’existence de privilèges. Afin de faciliter les échanges, la règlementation cherche à harmoniser les mesures et les contenants. Des contrôles tentent de démasquer les fraudes. Au cours du XIXe siècle, la présence de l’État à l’échelon local et national se confirme selon trois tendances principales. Tout d’abord, par la protection des entrepreneurs et de la propriété privée qui débouche sur la prise en compte de questions environnementales et de santé publique. Ensuite, dans un contexte de grande créativité, d’innovation et de transformation du matériel distillatoire, par la préservation des droits des inventeurs grâce au dépôt de demande brevet qui donne la possibilité de dénoncer la contrefaçon. Enfin, les autorités développent des procédures afin de protéger les marques de commerce. Des arrêtés préfectoraux complètent l’arsenal juridique qui se déploie. Néanmoins, les contestations et d’autres pratiques limitent la réalité de l’exercice du pouvoirIn the 18th century, the production of brandy was the main economic activity in a limited area whose reference market became Cognac. Many trades were involved in the production of these products before and after the still. Taxes were soon applied to these drinks. The State thus found new resources, especially as the whole society was concerned, despite the existence of privileges. In order to facilitate trade, the regulations sought to harmonize measures and containers. Controls were carried out to detect fraud. During the 19th century, the presence of the state at local and national level was confirmed in three main ways. Firstly, through the protection of entrepreneurs and private property, which led to the consideration of environmental and public health issues. Secondly, in the context of great creativity, innovation and transformation of distilling material, by the preservation of the rights of inventors through the filing of patent applications which gives the possibility to denounce counterfeiting. Ultimately, the authorities are developing procedures to protect trademarks. Prefectural decrees supplement the legal arsenal that is being deployed. Nevertheless, challenges and other practices limit the reality of the exercise of power
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Perroud, Junior Mauricio Wesley 1971. "Avaliação de viabilidade, tolerância e segurança da vacina com células dendríticas autológas maduras em pacientes com carcinoma de pulmão não pequenas células avançado = Assessment of feasibility, safety and tolerance of mature autologous dendritic cells vaccine in patients with advanced non-small cell lung carcinoma." [s.n.], 2012. http://repositorio.unicamp.br/jspui/handle/REPOSIP/310256.
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Orientador: Lair ZambonTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: Os resultados terapêuticos globais do carcinoma de pulmão não pequenas células em estádio avançado são bem limitados. A imunoterapia com células dendríticas foi desenvolvida como uma nova estratégia para o tratamento de câncer de pulmão. O objetivo deste estudo foi avaliar a viabilidade, segurança e respostas imunológicas em pacientes com carcinoma de pulmão não pequenas células tratados com vacina autóloga de células dendríticas maduras pulsadas com antígenos. Cinco pacientes HLA-A2 com carcinoma de pulmão não pequenas células inoperável (estádio III ou IV) foram selecionados para receber duas doses de 5 x 107 de células dendríticas administradas por vias subcutânea e intravenosa, duas vezes em intervalos de duas semanas. A segurança, tolerabilidade e respostas imunológica e tumoral à vacina foram avaliadas pela evolução clínica e laboratorial, ensaio de linfoproliferação e critérios de RECIST, respectivamente. A dose utilizada para a imunoterapia demonstrou ser segura e bem tolerada. O ensaio de linfoproliferação mostrou uma melhora na resposta imune específica após a imunização, com uma resposta significativa após a segunda dose (p = 0,001). Esta resposta não foi persistente e houve uma tendência à redução após duas semanas da segunda dose da vacina. Dois pacientes apresentaram uma sobrevida quase duas vezes maior que a média esperada e foram os únicos que expressaram os antígenos tumorais HER-2 e CEA Apesar do pequeno tamanho da amostra, os resultados sobre o tempo de sobrevida, resposta imune, segurança e tolerabilidade, combinado com os resultados de outros estudos, são animadores para a condução de um estudo clínico com doses múltiplas em pacientes com câncer de pulmão que foram submetidos a tratamento cirúrgico, seguindo as diretrizes do Cancer Vaccine Clinical Trial Working Group
Abstract: Overall therapeutic outcomes of advanced non-small-cell lung cancer (NSCLC) are poor. The dendritic cell (DC) immunotherapy has been developed as a new strategy for the treatment of lung cancer. The purpose of this study was to evaluate the feasibility, safety and immunologic responses in use in mature, antigen-pulsed autologous DC vaccine in NSCLC patients. Five HLA-A2 patients with inoperable stage III or IV NSCLC were selected to receive two doses of 5x107 DC cells administered subcutaneous and intravenously two times at two week intervals. The safety, tolerability and immunologic and tumor responses to the vaccine were evaluated by the clinical and laboratorial evolution, lymphoproliferation assay and RECIST's criteria, respectively. The dose of the vaccine has shown to be safe and well tolerated. The lymphoproliferation assay showed an improvement in the specific immune response after the immunization, with a significant response after the second dose (p = 0.001). This response was not long lasting and a tendency to reduction two weeks after the second dose of the vaccine was observed. Two patients had a survival almost twice greater than the expected average and were the only ones that expressed HER-2 and CEA together. Despite the small sample size, the results on the survival time, immune response, and safety and tolerability, combined with the results of other studies, are encouraging to the conduction of a large clinical trial with multiples doses in patients with early lung cancer who underwent surgical treatment, following the guidelines of the Cancer Vaccine Clinical Trial Working Group
Doutorado
Clinica Medica
Doutor em Ciências