Tesis sobre el tema "Preventive"

Thesis (M.S.)--George Mason University, 2008.
Vita: p. 75. Thesis director: Wallace Warfield. Submitted in partial fulfillment of the requirements for the degree of Master of Science in Conflict Analysis and Resolution. Title from PDF t.p. (viewed July 18, 2008). Also issued in print.

Thesis (M.A. in National Security Affairs)--Naval Postgraduate School, September 2003.
Thesis advisor(s): Peter R. Lavoy, James A. Russell. Includes bibliographical references. Also available online.

The New Criminal Procedure Code of 2004 provides an extensive protection in terms of fundamental rights; however, a new obstacle for the proper administration of justice has surfaced involving the judge, who is constantly being affected in its finaldecision by the media.The author of this article discusses this problem from the field of preventive imprisonment, focusing on current cases and doctrine. In addition, the author makes an analysis and classification of judges based on their way of making choices, showing a discouraging picture of the situation.
El Nuevo Código Procesal Penal de 2004 es más garantista en cuanto a derechos fundamentales; no obstante, un nuevo obstáculo para una correcta administración de justicia lo supone el mismo juzgador, quien está siendo afectado constantementeen su decisión por los medios de comunicación.El autor del presente artículo expone este problema desde el ámbito de la prisión preventiva, centrándose en casos actuales y doctrina. Además, realiza un análisis y clasificación de los jueces en base a su modo de tomar decisiones, mostrándonosun panorama poco alentador.

Background: Despite the favourable effects of new therapeutic approaches during the acute phase of cardiac diseases and consequent favourable short-term outcomes, post-acute management and long term prognosis still remain unsatisfactory. Cardiac rehabilitation (CR) is a multidisciplinary treatment with established beneficial effects for the vast majority of cardiac patients and universally considered an important aspect of secondary prevention. Although it has been shown to reduce both morbidity and mortality and it is a class I recommendation in the guidelines, its use remains still rather limited in Europe and in the rest of the world. Aim: The aim of this PhD research was to examine some aspects still little known, or unknown at all, in this field. In particular, the research aimed to evaluate safety and efficacy of a structured, exercise-based, CR in specific cohorts of patients: after transcatheter aortic valve implantation (TAVI), after left ventricular assist device (LVAD) implantation, and early after an acute myocardial infarction (AMI) in high risk subjects. Methods: All patients (78 TAVI, mean age 82.1±3.6 years, 42 LVAD, 63.4 ± 7.4 years, and 376 AMI, 64.4±12.3 years) were referred to the Institute Codivilla-Putti (in Cortina d’Ampezzo, BL, Italy) for a two week, in-hospital, CR training and comprehensive risk factors interventions early after the acute event (within two weeks TAVI and AMI, within two months after LVAD implantation). TAVI patients were compared with 80 consecutive peer patients who were admitted for CR in the same period after surgical aortic valve replacement (sAVR) and LVAD patients compared with 47 coeval chronic heart failure (CHF) patients who were admitted for CR in the same period after an acute heart failure event. In LVAD cohort, cardiac autonomic function was evaluated by means of heart rate variability. AMI patients were divided into 2 groups according to a 40% left ventricular ejection fraction (LVEF) cut-off at enrolment, in order to evaluate the influence of a reduced LVEF on the rehabilitative process; furthermore, in 326 patients a glucometabolic characterization was obtained by means of a standard oral glucose tolerance test (OGTT) in patients without known diabetes. In all patients the training protocol consisted of a low-medium intensity exercise protocol developed in three sets of exercises, 6 days per week: 30 min of respiratory workout, followed by an aerobic session on a cyclette (or on an arm ergometer in those patients who were not able to cycle) in the morning and, in the afternoon, 30 min of callisthenic exercises. Each session was supervised by a physician and a physiotherapist and all patients were ECG monitored by a telemetry system. Functional capacity was assessed by a six min walking test (6MWT) on admission, and a second test at discharge; when possible, a cardiopulmonary exercise test (CPET) was also performed. The Barthel Index (BI) was used as an autonomy index in TAVI and LVAD cohorts. In AMI patients rate of death, hospitalizations, smoke cessation, physical activity and adherence to pharmacological treatment were recorded at follow up (up to 5 years, median 2 years). Results: Despite the high risk profile of the population, the drop out rate was quite low (1.3% of TAVI, 1.1% of AMI and 11.9% of LVAD patients had to be transferred due to non fatal complications). All the subjects who completed the program had enhanced independence, mobility and functional capacity (mean BI increment was 9.9±12.6, p<0.01 and 11.9±10.5, p<0.01, in TAVI and LVAD patients respectively; mean 6MWT gain was 60.4±46.4 mt, p<0.01, 83.2±36.0 mt, p<0.05, 70.7±55.7 mt, p<0.01, in TAVI, LVAD and AMI patients, respectively). Analysing the specific cohorts, a smaller proportion of TAVI patients, compared with sAVR, was able to complete at least a 6MWT (82% vs 92%) or a CPET (61% vs 95%) but, in those who did, the distance walked at 6MWT at discharge did not significantly differ between the groups (272.7±108 vs. 294.2±101 mt, p=0.42), neither did the exercise capacity assessed by CPET (peak-VO2 12.5±3.6 vs. 13.9±2.7 ml/kg/min, p=0.16). At the end of the program, physical performance in LVAD patients was still generally poor, but not dissimilar from that found in CHF patients (peak-VO2 reached at CPET was 12.5±3.0 vs. 13.6±2.9 ml/kg/min, p=0.20). Evaluating AMI patients, subjects with LVEF<40% achieved significantly lower peak-VO2 at CPET than the controls (15.2±3.9 vs. 18.2±5.2 ml/kg/min, p<0.01). After OGTT administration, a high prevalence of abnormal glucose metabolism was found (54%). As expected, exercise capacity was poorer in diabetic and pre-diabetic patients when compared with normoglicemic (peak-VO2 at CPET 15.3±4.1 vs 17.9±4.8 vs 19.4±5.5 ml/kg/min, p<0.01). At follow up 73% of the subjects reported to exercise regularly, 77% of the smokers definitively quitted and a high adherence to the therapy was registered. Cardiac and all cause mortality resulted 5.0% and 8.0 % at 1 year and 8.0 % and 13.0 % at 5 years, respectively and resulted higher in older people and in those with lower LVEF. Conclusions: Patients who underwent TAVI and LVAD implantation are characterized by a long-term deconditioning status. In this perspective, benefit is not automatically achieved through high-technology interventions and pharmacological management alone. This study have shown that a short-term, supervised, exercise-based CR is feasible, safe and effective in elderly patients after TAVI, as well as after traditional surgery, and after LVAD implantation. An early CR programme enhances independence, mobility and functional capacity and should be encouraged in these subjects. An early and intensive CR, based on physical activity and counselling, resulted to be safe and effective also in high risk patients after AMI, both in the short and in the long period. Indeed, a significant improvement in functional capacity in the short term - independent from the basal ventricular function or glucometabolic status - and a high adherence to therapy and to lifestyle modifications in the long term were achieved. Despite the high risk profile of these patients, this produced a favourable effect on cardiac and total mortality.
Introduzione: Nonostante gli effetti favorevoli di nuovi approcci terapeutici durante la fase acuta delle malattie cardiache e conseguente prognosi più favorevole nel breve termine, la gestione della fase post-acuta di tali patologie e la prognosi a lungo termine rimane ancora insoddisfacente. La Riabilitazione Cardiologica (RC) è un trattamento multidisciplinare con chiari effetti benefici nella stragrande maggioranza dei pazienti cardiologici ed universalmente considerata un aspetto importante della prevenzione secondaria. Sebbene si sia dimostrata in grado di ridurre morbidità e mortalità e sia ormai un trattamento raccomandato in I classe nelle linee guida, il suo uso rimane ancora piuttosto limitato in Europa e nel resto del mondo. Scopo: Lo scopo del presente programma di ricerca è stato esaminare alcuni aspetti ancora pochi noti, se non del tutto sconosciuti, in questo campo. In particolare, la presente ricerca ha avuto lo scopo di valutare sicurezza ed efficacia di una RC strutturata, basata sull’esercizio fisico, in specifiche coorti di pazienti: dopo impianto di valvola aortica transcatetere (TAVI), dopo impianto di assistenza ventricolare sinistra (LVAD), e subito dopo infarto miocardico acuto (AMI) in soggetti ad alto rischio. Metodi: Tutti i pazienti (78 TAVI, età media 82.1±3.6 anni, 42 LVAD, 63.4 ± 7.4 anni, e 376 AMI, 64.4±12.3 anni) sono stati inviati presso l’Istituto Codivilla-Putti (Cortina d’Ampezzo, BL, Italia) per un periodo di riabilitazione cardiologica degenziale di due settimane, basato sull’allenamento fisico ed interventi sui fattori di rischio cardiovascolare, subito dopo l’evento acuto (entro due settimane dopo TAVI ed AMI, entro due mesi dopo impianto di LVAD). I pazienti TAVI sono stati confrontati con 80 pazienti di pari caratteristiche che nello stesso periodo giungevano in riabilitazione dopo sostituzione valvolare aortica per via tradizionale (sAVR); i pazienti LVAD sono stati confrontati con 47 pazienti di pari età affetti da scompenso cardiaco cronico (CHF) che giungevano nello stesso periodo dopo una riacutizzazione di scompenso. Nella coorte dei LVAD è stata inoltre valutata la funzione autonomica mediante lo studio dell’ heart rate variability. Per valutare gli effetti di una depressione della frazione d’eiezione del ventricolo sinistro (LVEF) sul processo riabilitativo, i pazienti AMI sono stati divisi in 2 gruppi in base alla LVEF (cut-off 40%). Inoltre, in 326 pazienti, è stata ottenuta una caratterizzazione glumetabolica mediante una curva da carico di glucosio standard (OGTT) somministrata ai soggetti senza diabete noto. Tutti i pazienti sono stati sottoposti ad un ciclo di ricondizionamento fisico con esercizi prevalentemente aerobici, distribuiti in 3 sessioni quotidiane per 6 giorni alla settimana (30 minuti di ginnastica respiratoria, seguiti da una sessione sulla cyclette, o su un arm-ergometro in coloro che non erano in grado di pedalare, nel pomeriggio 30 minuti di esercizi callistenici), sotto stretto monitoraggio telemetrico e diretta supervisione medica e fisioterapica. La capacità funzionale è stata valutata mediante six min walking test (6MWT) all’ingresso e alla dimissione e un test cardiopolmonare (CPET). Nelle coorti TAVI e LVAD è stata usata la scala di Barthel (Barthel Index, BI) per valutare il grado di autonomia. Nei pazienti AMI è stato registrato al follow up (fino a 5 anni, mediana 2 anni) l’incidenza di morte, nuove ospedalizzazioni, cessazione del fumo, attività fisica ed aderenza alla terapia. Risultati: Nonostante l’alto profilo di rischio della popolazione, il tasso di abbandono dal programma è risultato piuttosto basso (nell’ 1.3% dei pazienti TAVI, 1.1% degli AMI e 11.9% dei LVAD si è reso necessario il trasferimento all’ospedale per acuti per complicazioni non fatali). Tutti i soggetti che hanno completato il programma hanno migliorato la propria indipendenza, mobilità e capacità funzionale (incremento medio del BI 9.9±12.6, p<0.01 e 11.9±10.5, p<0.01, nei pazienti TAVI e LVAD rispettivamente; guadagno medio al 6MWT 60.4±46.4 mt, p<0.01, 83.2±36.0 mt, p<0.05, 70.7±55.7 mt, p<0.01, nei pazienti TAVI, LVAD and AMI, rispettivamente). Analizzando le specifiche coorti, una percentuale più bassa di pazienti TAVI rispetto a quelli del gruppo sAVR sono stati in grado di completare almeno un 6MWT (82% vs 92%) o un CPET (61% vs 95%) ma, in coloro che vi sono riusciti, non vi erano differenze significative tra i due gruppi in termini di distanza percorsa al 6MWT alla dimissione (272.7±108 vs 294.2±101 mt, p=0.42) e capacità funzionale al CPET (VO2 al picco 12.5±3.6 vs 13.9±2.7 ml/kg/min, p=0.16). Al termine del programma la performance fisica nei pazienti LVAD era generalmente scarsa, ma non dissimile da quella dei pazienti CHF (VO2 al picco al CPET 12.5±3.0 vs 13.6±2.9 ml/kg/min, p=0.20). Tra i pazienti AMI, coloro con LVEF<40% hanno raggiunto al CPET un VO2 al picco dell’esercizio significativamente più basso rispetto ai controlli (15.2±3.9 vs 18.2±5.2 ml/kg/min, p<0.01). Dopo somministrazione dell’OGTT è stata riscontrata un’alta prevalenza di alterazioni del metabolismo glucidico non precedente note (54%). Come atteso la capacità fisica era inferiore nei diabetici e nei prediabetici in confronto ai normoglicemici (al CPET VO2 al picco 15.3±4.1 vs 17.9±4.8 vs 19.4±5.5 ml/kg/min, p<0.01). Al follow up 73% dei soggetti hanno riferito di svolgere un’attività fisica regolare, 77% dei fumatori hanno definitivamente smesso ed è stata registrata un’alta aderenza alla terapia. La mortalità cardiaca e per tutte le cause è risultata 5.0% e 8.0% ad 1 anno, 8.0% e 13.0% a 5 anni, rispettivamente, ed è risultata più elevata nei soggetti più anziani ed in quelli con ridotta LVEF. Conclusioni: I pazienti che sono andati incontro ad intervento di TAVI e LVAD sono caratterizzati da un notevole grado di decondizionamento fisico. In tale prospettiva non si può automaticamente raggiungere un beneficio con il solo intervento ad alta tecnologia o con il trattamento farmacologico. Un breve periodo di RC, con supervisione medica, si è dimostrato fattibile, sicuro ed efficace in pazienti anziani dopo TAVI, così come dopo chirurgia aortica tradizionale, e dopo impianto di LVAD. Un programma precoce di RC aumenta l’indipendenza, la mobilità e la capacità funzionale ed andrebbe sicuramente incoraggiato in questi soggetti. Una RC intensiva e precoce basata sull’attività fisica e sul counselling è risultata sicura ed efficace anche in soggetti ad alto rischio dopo AMI, sia nel breve che nel lungo termine. Infatti è stato raggiunto un significativo miglioramento della capacità funzionale nel breve periodo - indipendentemente dalla funzione ventricolare sinistra residua o dallo stato glucometabolico - ed un’elevata aderenza alla terapia e alle modifiche dello stile di vita proposte. Nonostante l’elevato profilo di rischio di tali pazienti, questo può aver prodotto un effetto favorevole sulla mortalità.

Background: Febrile seizures are common in childhood. When a child is stricken with febrile seizures it is not only the child that is suffering, in fact the whole family is affected. There are different ways to prevent recurrence of febrile seizures, such as use of different drugs. The parents also need information about febrile seizures and support from the nurse. Aim: The aim of this literature study was to illuminate the nurse’s preventive work for children who have been stricken with febrile seizures. Method: A literature search was conducted in different databases. A qualitative content analysis of 10 scientific articles was performed. Result: The result was presented in three main categories. The first main category was the parents’ role; such as fear, lack of knowledge and concerns about the feature. The second main category was preventive caring, such as sponging, and the third one was the use of preventive drugs such as diazepam and antipyretics. Conclusion: The authors conclude that there is a large need of modern research in the aim of nursing of children with febrile seizures.

Thesis (doctoral)--Katholieke Universiteit te Nijmegen, 1988.
Text in English with a summary in Dutch. "Een wetenschappelijke proeve op het gebied van geneeskunde en tandheelkunde." Includes bibliographical references.

Thesis (Ph. D.)--West Virginia University, 2008.
Title from document title page. Document formatted into pages; contains ix, 311 p. : ill. Includes abstract. Includes bibliographical references (p. 282-288).

In manufacturing environments, machines are usually subject to down periods due to various reasons such as preventive maintenance activities, pre-accepted jobs and pre-known material shortages. Among these reasons, preventive maintenance, which is defined as the pre-planned maintenance activities to keep the machine in its operating state, has gained much more importance in recent years. In this thesis, we consider the single machine total flow time problem where the jobs are non-resumable and the machine is subject to preventive maintenance activities of known starting times and durations. We propose a number of optimality properties together with the upper and lower bounding procedures. Using these mechanisms, we build a branch and bound algorithm to find the optimal solution of the problem. Our extensive computational study on randomly generated test instances shows that our algorithm can solve large-sized problem instances with up to 80 jobs in reasonable times. We also study a two-alternative maintenance planning problem with minor and major maintenances. We give an optimizing algorithm to find the timing of the maintenances, when the job sequence is fixed.

Approved for public release; distribution is unlimited
In response to the 9/11 attacks and continuing threats of mass-casualty terrorism, the United States has adopted a new security strategy that emphasizes anticipatory actions including preventive war. Prevention, undertaken in the absence of an act of aggression or an imminent threat, is prohibited by modern conceptions of just war and international law. Many critics of the strategy fear that any legitimization of preventive war would endanger international stability. But an examination of the relevant ethical issues from the perspective of just war doctrine reveals contradictions within a blanket prohibition of preventive war. Preventive "strategic interventions" against illiberal regimes-states that correlate with the threats of terrorism and weapons of mass destruction-parallel humanitarian interventions in that they have an ethical basis in the relationship between human rights and the right of state sovereignty. A widely-accepted minimum standard of human rights, incorporated into new international institutions and/or an explicit revision of the definition of just war, could serve as an ethical boundary for both preventive wars and humanitarian interventions. The formal qualification of prevention and its merger with humanitarian goals could bring enhanced international legitimacy and support to preventive actions by the United States and its allies.
Lieutenant Commander, United States Navy

The perfectionism and health literature suggests that maladaptive perfectionism is associated with a plethora of negative health outcomes and adaptive perfectionism with both favourable and unfavourable health outcomes. Additionally, a small amount of research has proposed maladaptive perfectionists may refrain from engaging in preventive health behaviours whilst adaptive perfectionists may engage more readily. This thesis explored the differences between adaptive and maladaptive perfectionism in relation to engagement in preventive health behaviours as well as addressing possible intervening variables in the perfectionism, engagement relationship (e.g. self-presentation, perceived stress, self-efficacy and affect). Four studies were carried out. In study 1, (N=370), using a sample of university students, results identified maladaptive perfectionism to be associated with decreased engagement in preventive health behaviours and adaptive perfectionism with increased engagement. Self-concealment (a self-presentational strategy) was found to partially mediate the perfectionism, engagement relationship for maladaptive perfectionists. In study 2, (N= 875), again with university students, (using a different conceptualisation of perfectionism), results showed that although ‘type’ of perfectionism did not interact with perceived stress to influence engagement, significant differences were identified between type of perfectionism and a number of health related variables. In study 3, results from a qualitative study involving university students showed that factors inherent in the university environment as well as factors characteristic of perfectionism prohibited engagement in preventive health behaviours. In study 4, using a general population sample, adaptive perfectionism was associated with greater engagement but no relationship was found for maladaptive perfectionism. Various factors were found to moderate and mediate the perfectionism, engagement relationship for adaptive perfectionism and adaptive perfectionism was associated with more benefits to engagement and maladaptive perfectionism with more barriers to engagement in preventive health behaviours. In summary, the results from this thesis suggest there are differences between the two perfectionism dimensions in relation to engagement and other health variables, although this may be dependent on the population/context being studied. More research is warranted to explore the perfectionism, engagement relationship specifically looking at different populations to establish whether maladaptive perfectionists in a university environment represent a particularly vulnerable group.

The aim of this thesis is to contribute to existing knowledge. If the knowledge is not useful in building society it has limited value. In order to be a tool for decision-makers, Preventive Home Visits (PHVs) are described and discussed according to a realist synthesis approach. The premise of this approach is that a single trial cannot tell the whole story and that understanding theoutcome pattern is much more important than seeking regularities in results across different trials. In order to understand the o utcome pattern, the PHV strategy in Nordmaling is examined against other trials and scientific work, and also in grey literature such as reports and workingpapers. An increasing population of seniors means that resources for health and elderly care are being scrutinised in order to achieve the best possible health for the money invested. PHVs represent one strategy that attempts to promote health among independent seniors. This thesis is a multidisciplinary study aiming to gain knowledge about the effects of PHVs and to understand the mechanisms of importance when implementing this particular strategy. The point of departure is a study conducted in Nordmaling in the north of Sweden among healthy seniors aged 75 years and over. The study, conducted as a controlled trial during 2000 and 2001, showed a decrease in mortality as well as the utilisation of care, and an improvement in indicators of perceived health. Cost analyses showed significant savings for the municipality following a reduction in the use of home help. These and other savings combined with costs of the intervention were related to saved life years and used to conduct health economic analyses. Medical and social records from the primary health centre and the municipality, along with official registers provided information for modelling health economic analyses from a lifetime perspective. Results showed that the costs of PHVs were less than 10 000 Euros per gained life year, against an acceptable level of cost effectiveness of 50 000 Euros. Using a shorter time perspective, the result was even more favourable for PHVs. It was evident that the time window used in the analyses, the normative choice of including future healthcare costs or not, and how to handle the value of the seniors’ production were important factors in determining the results. Two years after the trial, in-depth interviews were conducted with 5 seniors who had experienced PHVs, in order to gain understanding of the outcome of the PHV trial in Nordmaling. Participants were selected with respect to their health and how they responded to advice given during the PHV trial. Grounded Theory was used to analyse the interviews. Seniors who used autonomous coping strategies in everyday life gained less from PHVs than other seniors. All participants could benefit from PHVs, but in order for these to be successful it was important for the home visitor to be professional and to understand how the different coping strategies of seniors worked. Taken together, the different aspects of this study raised normative questions that are discussed in this thesis. One, whether the production of seniors has any monetary value in health economic analyses conducted from a societal perspective, was addressed in a smaller diary study where 23 seniors were asked to keep a diary in order to identify everything they did over a oneweek period. It was evident that most of the respondents “produced” a lot, however the production of seniors is rarely taken into account in health economic analyses. The concept of “senior production” includes both the market value of what seniors do, as well as the value of what society can avoid doing if the seniors are independent and healthy.

Thesis (M.S.)--Missouri University of Science and Technology, 2010.
Vita. The entire thesis text is included in file. Title from title screen of thesis/dissertation PDF file (viewed June 7, 2010) Includes bibliographical references (p. 44-46).

There are about 4000 new hip fracture patients in Taiwan each year, and osteoporosis is the number one cause for these fractures. But, there has been no research article related to osteoporosis preventive behavior among Hakim living in countryside in Taiwan. Therefore, the purposes of this study were to assess osteoporosis preventive behavior; to measure the relationship among factors influencing OPB; to measure a model of factors influencing OPB; and to predict the direct and indirect effects of personal and social factors on OPB among Hakka living in Taichung County in Taiwan. The development of a theoretical model of factors influencing osteoporosis preventive behavior was based on the Social Cognitive Theory (Bandura, 1986, 1997, 2004) and the conceptual framework for addressing the social context of health behavior (Sorensen et al., 2003). According to the reviewed literature, the factors influencing osteoporosis preventive behavior include personal factors (age, educational level, self­ efficacy for calcium intake, self-efficacy for exercise, and knowledge of osteoporosis); and social factors (social support and social capital). The outcome variables are calcium intake and exercise. This was a non-experimental, cross-sectional design. Convenience and snowball sampling were used in this study. In all, 243 participants were recruited. Path analysis was used to assess and modify the theoretical model and to test all the paths between exogenous variables and endogenous variables. The goodness-of-fit indicators ofthe final model showed that X2 was 26.99 with 21 degrees of freedom; the P-value for this model was .17; goodness-of-fit index (GFI) was .98; adjusted goodness-of-fit index (AGFI) was .95; normed fit index (NFI) was .96; non-normed fit index (NNFI) was .98; and comparative fit index (CFI) was .99. The results suggested that the final model fit the data well. The final model demonstrated that the personal factors and environmental factors directly and indirectly influenced osteoporosis preventive behavior. It may provide guidance for the design of future nursing interventions, research and education related to osteoporosis prevention.

South Africa‟s participation in international peace missions is guided by the White Paper of 1998 and premised specifically on the country‟s foreign policy objectives based on its vision of “a better South Africa, a better Africa and a better world”. South Africa recognises itself as an integral part of the African continent and therefore sees its national interests as being intrinsically linked to Africa‟s stability, unity and prosperity. Since 1994, South Africa has placed itself at the forefront of Africa's peace and security endeavours, trying to transform itself from international villain during apartheid years to Pan-Africanist peacemaker. The country has played an instrumental role in both shaping and setting the normative agenda of the African Union and Southern African Development Community. South Africa‟s participation in conflict resolution and peace missions in Africa is informed by an understanding of the nexus that exists between peace, security and sustainable development. This research focuses on South Africa‟s diplomatic and peacekeeping engagement in Lesotho, covering the constitutional and electoral crises from 1994 - 2015 constitutional crisis. The author shows the importance and way forward to resolve conflicts before they become escalated and deadly. The study calls for a „timely‟ reaction to disputes and conflicts on the African continent via preventive diplomacy, conflict provention and addressing of underlying issues that give rise to disputes and conflict.

Background Stroke is a serious condition that can have significant impact on an individual’s health and is a significant burden on public health and public finances. Secondary preventive drug treatment after stroke is important for decreasing the risk of recurrent strokes. Non-adherence to drug treatment hampers the treatment effect, especially in long-term preventive treatments. The aim of this thesis was to study the use of secondary preventive drugs after stroke among Swedish stroke patients in terms of inequalities in implementation in clinical practice and patient adherence to treatment over time. Methods Riks-Stroke, the Swedish stroke register, was used to sample stroke patients and as a source of information on background characteristics and medical and health care-related information including information on prescribed preventive drugs. The patients that were included had a stroke between 2004 and 2012. Individual patient data on prescriptions filled in Swedish pharmacies were retrieved from the Swedish Prescribed Drug Register and used to estimate patient adherence to drug treatment. Data on education, income, and country of birth were included from the LISA database at Statistics Sweden. A questionnaire survey was used to collect information about patients’ perceptions about stroke, beliefs about medicines, and self-reported adherence. Results Results showed that a larger proportion of men than women were prescribed statins and warfarin after stroke. There was also a social stratification in the prescribing of statins. Patients with higher income and a higher level of education were more likely to be prescribed a statin compared to patients with low income and low level of education. Statins were also more often prescribed to patients born in Nordic countries, Europe, or outside of Europe compared to patients born in Sweden. Primary non-adherence (not continuing treatment at all within 4 months of discharge from hospital) was low for preventive drug treatment after stroke. Data on filled prescriptions, however, indicated that the proportion of patients who continued to use the drugs declined during the first 2 years after stroke. For most drugs, refill adherence in drug treatment was associated with female sex, good self-rated health, and living in institutions and (for antihypertensive drugs and statins) having used the drug before the stroke. For statins and warfarin, a first-ever stroke was also associated with continuous drug use. Self-reported adherence 3 months after stroke also showed associations with patients’ personal beliefs about medicines; non-adherent patients scored higher on negative beliefs and lower on positive beliefs about medicines. Conclusion Inequalities between men and women and between different socioeconomic groups were found in the prescribing of secondary preventive drugs after stroke. Only a small proportion of Swedish stroke patients did not continue treatment after discharge from hospital, but the proportion of non-adherent patients increased over time. Poor adherence to preventive drug treatment after stroke is a public health problem, and improving adherence to drug treatment requires consideration of patients’ personal beliefs and perceptions about drugs.

Prostate cancer is an ideal candidate for chemoprevention. Tea drinking is a possible explanation for the rarity of prostate cancer among Chinese men. Tea (Camellia sinensis) contains flavonoid polyphenols called catechins, believed to be responsible for this anti-carcinogenesis. In black tea these catechins are oxidised into theaflavins. Catechins and theaflavins both inhibit human prostate cancer cell proliferation in vitro. Catechins inhibit prostate cancer in the TRAMP mouse animal model of the disease. To determine if tea polyphenols warrant investigation in large trials, evidence is required from animal models and biomarkers of cancer prevention identified in small human studies. In the work presented here, prostate carcinogenesis was inhibited by orally administered tea polyphenols in the TRAMP mouse. Following 26 weeks of polyphenol administration median prostate masses were 0.54g, 0.28g and 1.01g for the theaflavin, catechin and control group respectively. This is the first in vivo evidence of prostate cancer chemoprevention by black tea theaflavins and adds to the previously published evidence for the same effect by green tea catechins. In the catechin group, this chemoprevention was associated with a significant reduction in the concentration of oxidative DNA adduct malondialdehydedeoxyguanosine (M1G) in prostate tissue. M1G, a marker of oxidative DNA damage, was therefore proposed as a putative biomarker of prostate cancer chemoprevention. A human trial was then performed involving 18 men randomised to receive four weeks of catechins, theaflavins or no polyphenol prior to transurethral resection of prostate. A significant reduction in M1G was detected in the DNA from prostate tissue of men who had received catechins. Tea polyphenols and particularly catechins may therefore represent prostate cancer prevention agents suitable for study in a larger human intervention trial however, this finding should be first be tested in further better designed biomarker studies using this result to inform decisions on study population size.

The work presented in this paper is a master thesis performed at the division of Optimization and Systems Theory at the Royal Institute of Technology in Stockholm. The problem is formulated by Systecon AB, a consultancy firm focusing on life support cost analysis and optimization. In the software that Systecon uses for optimization (OPUS10) there are certain simplistic assumptions. Namely, that preventive maintenance is always fully regulated and in the case where several bases are requesting spare units for preventive maintenance from the same depot there is full coordination between bases, thus assuming full regularity also at the depot. These assumptions work sufficiently at base level but not necessarily in a support system with multiple levels where spare parts for preventive maintenance is requested from a central depot. To investigate the effects of these assumptions a user survey has been conducted and based on the result a simulation tool has been constructed in MATLAB. The results suggest that due to the simplistic assumptions made in OPUS10 there is a risk of underestimating the number of systems demanding spare parts for preventive maintenance, thereby affecting the accuracy of OPUS10. Furthermore, to investigate the possibility of refining the model two approaches have been made. Firstly, the built in OPUS10 factor PMCF has been analyzed on how it may be utilized to compensate for underestimating demand from preventive maintenance. Secondly, the Binomial distribution has been suggested and discussed as a potential replacement for the mathematical modeling of preventive maintenance. A combination of the two distributions has also been included as a final investigation. In conclusion, PMCF may be used quite effectively, but setting the value for PMCF is complicated and no distinct guidelines can , from the conclusions of this thesis, be presented on how to determine a value for PMCF. Even though there are possibilities of constructing such guidelines it is not within the scope of this thesis. The Binomial distribution turns out to be very accurate in modeling of preventive maintenance. But it does require knowledge of the variance from preventive maintenance, something that is not required by the current models in OPUS10. However, the last approach, assuming Bernoulli distribution at base level and Binomial distribution at central level of the support system, gives accurate results while knowledge of the variance is not required.
Arbetet som presenteras i denna uppsats är ett examensarbete utfört på avdelningen för Optimering och Systemteknik på Kungliga Tekniska Högskolan i Stockholm. Problemet har formulerats av Systecon AB, en konsultfirma med inriktning mot livscykelkostnadsanalys och optimering. I programvaran som Systecon använder för optimering (OPUS10) finns det vissa förenklade antaganden. Modellen för förebyggande underhåll bygger nämligen på ett antagande om maximal regularitet och maximal koordinering av olika åtgärder på olika system. Vilket fungerar bra på lokal nivå nära de tekniska systemen men fungerar sämre när efterfrågan av reservdelar från flera lokala platser aggregeras till ett centralt lager. För att undersöka effekterna av dessa antaganden har en användarundersökning utförts och baserat på resultatet av denna har en simulering modellerats i MATLAB. Resultaten tyder på att de förenklade antagandena bidrar till risken att underskatta behovet av reservdelar från förebyggande underhåll och därmed kan noggrannheten av OPUS10 påverkas. Två tillvägagångssätt har använts för att undersöka möjligheten att förfina modellen. Först och främst har den i OPUS10 inbyggda parametern PMCF analyserats om huruvida den kan användas för att kompensera för underskattning av efterfrågan från förebyggande underhåll. Vidare har Binomialfördelningen föreslagits och diskuterats som en potentiell ersättning för den matematiska modelleringen av förebyggande underhåll. Avslutningsvis har en analys av kombinationen mellan den nuvarande fördelningen och Binomialfördelningen också inkluderats. Slutledningsvis, faktorn PMCF kan användas och är relativt effektiv, men att bestämma värdet på parametern är svårt och inga precis riktlinjer för detta kan, via slutsatserna från detta arbete, presenteras på hur man hur man ska avgöra värdet av PMCF. Binomialfördelningen visar sig vara väldigt noggrann vid modellering av förebyggande underhåll. Den kräver dock vetskap om variansen av efterfrågan från förebyggande underhåll, något som inte krävs av de nuvarande modellerna i OPUS10. Kombination av Bernoullifördelning på basnivå, nuvarande modell i OPUS10, och Binomialfördelning på central nivå ger noggranna resultat och någon vetskap om variansen krävs ej.

This research models the behavior of a multi-task system with respect to time. The type of multi-task system considered here is one in which not all system components are required to perform each task. Each component may, however, be used for more than one task. Also, it is possible that some of the components may be required for every task that the system performs. The components that are required for a subset of the tasks are considered to be intermittently demanded components and those components required for every task are continuously demanded components. This modeling approach assumes that the system is subject to a Modified Age Replacement Policy (MARP.) With a MARP the intermittently demanded components are maintained during their idle periods and the continuously demanded components are replaced according to their age replacement times. A renewal theory approach is used to develop an availability expression for the multi-task sytem. Past research has focused on systems consisting of continuously demanded components and typically does not distinguish between elapsed clock time and elapsed operating time in the renewal density function expressions. This research recognizes that the operational age of an intermittently demanded component is different than the chronological age of the component. The renewal density function and availability measures are modeled using joint density functions defined on both clock time and operating time. The expressions are evaluated numerically using a multidimensional numerical integration routine. The results show logical behavior of the joint density functions used to define the availability measure. The availability measure also displays behavior consistent with the definition of a multi-task system. This model is an important development in the need for stochastic models of highly complex systems. The model is also a first step in defining performance measures for systems composed of both intermittently demanded components and continuously demanded components.
Ph. D.

Thesis (Ph. D.)--University of North Carolina at Chapel Hill, 2008.
Title from electronic title page (viewed Dec. 11, 2008). "... in partial fulfillment of the requirements for the degree of Doctor of Philosophy in the Department of Economics." Discipline: Economics; Department/School: Economics.

Para identificarmos a forma pela qual professores de Ensino Fundamental compreendem a sexualidade/ sexo na escola, procuramos levantar dados relativos a estas questões no cotidiano escolar verificando a posição da escola frente a essa temática e como lidam com isto no contexto escolar. Posteriormente, procuramos desenvolver um programa educativo com eles, visando prepará-las para lidar com o assunto, em foco. Esta investigação trata-se de uma pesquisa qualitativa, humanista, por meio de pesquisa-ação constando de um tratamento estatístico complementar para análise dos dados sócio-demográficos. A amostra foi constituída de 13 professores de ensino fundamental de ambos os sexos, de uma Escola Estadual, localizada numa cidade do interior de São Paulo, que aceitaram participar desta investigação, após assinatura do termo de consentimento livre e esclarecido, aprovado no CEP da EERP-USP. Foi adotado como critério de inclusão, ser professor do local, no nível de ensino (fundamental) e participar voluntariamente, da pesquisa. A coleta dos dados foi realizada de forma qualitativa, por meio da observação participante para melhor conhecer a realidade em estudo e da entrevista individual, usando um questionário com questões norteadoras. Os dados levantados foram construídos através de quadros e para análise, classificamos os achados em categorização. Verificamos que os professores pesquisados, se caracterizam em sua grande maioria do sexo feminino, acima de 40 anos. No que se refere à vida pessoal, poucos falaram desses dados. No que se refere ao profissional e do sentido de ser professor, todos destacaram de maneira significativa, a importância que dão à sua profissão revelando, a sua forma vocacional como educador, ao lidar com a educação e com o educando. O Significado que deram à Sexualidade é o ligado à descobertas, desejo, auto- conhecimento, naturalidade e atração. O significado que dão ao Sexo é a prática do ato em si, o interesse pelo sexo oposto, fisiologia, mudança de interesses com a idade, realização, amor e companheirismo. Citam a sexualidade como algo natural e mostram importância em tratar adequadamente do assunto na educação sexual. Quando os professores são questionados pelos alunos sobre temas gerais relacionados à Sexualidade e Sexo, referiram que costumam, em sua maioria, orientá-los, tratando o assunto com naturalidade, usando alguns materiais como elementos didáticos facilitadores. A maioria dos professores dá grande relevância ao diálogo aberto com os alunos, para envolvê-los à orientação, à informação, à prevenção, destacando haver necessidades de contar com o apoio de profissionais qualificados nesta área, bem como integrar o familiar nesse processo. Finalmente desenvolvemos ações/intervenções educativas conjuntamente com os professores, visando prepará-los para atuarem no cotidiano escolar, bem como prepará-los como agentes multiplicadores. A grande maioria dos professores já deu aula para alunas grávidas na escola e reforça que a causa da gravidez precoce é ligada à falta de orientação, tentando tratar o assunto, mostrando deveres e responsabilidades diante desta questão. Os professores sugerem buscar parcerias e formas de trabalhar a prevenção, através de palestras, oficinas e o cuidado, entre outros.
For we identify the form of the which the teachers of the Fundamental Teaching understand the sexuality /sex in the school, we tried to lift relative data to these subjects in the daily scholar verifying the position of the school front to that thematic one and as they work with this in the school context. Later on, we tried to develop an educational program with them, seeking to prepare them to work with the subject, in focus. This investigation is a qualitative research, humanist, by means of research-action consisting of a complementary statistical treatment for analysis of the partner-demographic data. The sample was constituted of 13 teachers of fundamental teaching of both sexes, of a State School, located in a city of the State of São Paulo, in which they accepted to participate in this investigation, after signature of the term of free and illustrious consent, approved in CEP of EERP-USP. It was adopted as inclusion approach, to be teacher of the place, in the teaching level (fundamental) and to participate voluntarily, of the research. The collection of data was accomplished in qualitative way, by means of the participant observation for best to know the reality in study and of individual interview, using questionnaire with intriguing questions. The lifted up data were built through pictures and for analysis, we classified the discoveries in categorizations. We verified that researched teachers are characterized in its great majority of the feminine sex, above 40 years. In which refers to personal, few life they spoke about those data. In which refers to professional and of the sense of being a teacher, everybody highlighted in significant way, the importance that they give to profession revealing, its form vocational as educator, when working with education and with students. The Meaning that they gave to Sexuality is tied up to discovery, knowledge, naturalness and attraction. The meaning that they give to Sex is practice of the act in itself, interest for opposite sex, physiology, change of interests with the age, accomplishment and love. They mention the sexuality as something natural and show importance in negotiating appropriately of subject in sexual education. When the teachers plows questioned on general themes related to Sexuality and Sex, they referred in majority, treating the subject naturally, using adds materials facilitative didactic elements. Most of the teachers gives relevance to dialogue open with the students, to involve them to orientation, information, prevention, there needs to count with professionals support qualified in this area, as well to integrate the relative in that process. Finally we developed educational actions/interventions jointly with teachers, seeking to prepares them to act in the daily school, as well as to prepares them as multipliers agents. The majority of teachers already gave class for pregnant students in the school and they reinforce that cause of precocious pregnancy is linked to orientation lack, trying to treat the subject, showing duties and responsibilities. The teachers suggest to look for partnerships, forms of working prevention, lectures, shops and care, among others.

Maintaining strong healthy teeth for life is important; therefore the present study was concerned with the recognition of the significance of exploring some of the preventive and therapeutic products on the surface loss of enamel slabs subjected to acidic erosion and tooth brushing abrasion challenges using in vitro and in situ experiments. Study 1 In vitro assessment of the effect of fluoridated toothpastes on bovine and human enamel subjected to acidic erosion and tooth brushing abrasion. Aims: To assess the anti-erosive potential of toothpastes containing different delivery fluoride systems using bovine dental enamel (Part Ι) and human enamel (Part ІΙ) subjected to both acidic erosion and tooth brushing abrasion. Part Ι: Methods: Fifty bovine enamel slabs were mounted in acrylic blocks, ground flat, tested for flatness by scanning profilometry (Proscan 2000, Scantron, UK), standardised for hardness using a Knoop hardness tester (under 100 g load for 15 s) and divided into five experimental groups (E1-E5) including 10 specimens per group. The tested toothpastes were : E1 Meridol® group, (AmF/SnF2; 0.14%), E2 Elmex® anti-caries group (AmF; 0.14%F), E3 Pronamel®, (NaF, 1450 ppm F), E4 Elmex® sensitive plus (AmF; 0.14%F), and E5 Aronal® 0 ppm F. De/remineralisation cycling procedures were achieved with immersion of the slabs under static conditions in aliquots of citric acid (0.3%, pH 3.6) for 2 mins followed by soaking for 1hr in artificial saliva between the erosive challenges. The erosive challenges procedures were repeated 5 times daily for 28 days. All groups were subjected twice a day to brushing abrasion during application of a slurry of toothpaste/saliva (1: 3) with 15 tooth brushing strokes using a 300 g load and incubated overnight at 37 ̊C in night time saliva at the end of the last brushing of the enamel slabs. Erosion and abrasion depths (μm) were quantified using profilometry scanning (Proscan 2000, Scantron, UK) at 7, 14, 21 and 28 days. Part ΙΙ: Similar erosive / abrasive experimental procedures were used on human enamel specimens. Results: After 28 days of erosion cycling with tooth brushing abrasion, all groups showed different enamel surface loss (μm). One-way ANOVA, demonstrated that E1 showed similar trends with E5, whereas (E2, E3, E4 showed significantly less surface loss (p < 0.05) compared to E1 and E2. Conclusions: The effect of dental erosion and tooth brushing abrasion combined can be decreased by toothpastes containing amine fluoride and sodium fluoride, whereas no protection was observed with the stannous and amine fluoride paste. Similar result trends were observed for both bovine and human enamel specimens under this erosive/abrasive model. Study 2 The effect of therapeutic products in combination on prevention of tooth surface loss. Aims: To study combined topical fluoridated measures on erosive and abrasive enamel wear in vitro. Methods: Sixty bovine enamel specimens were divided into four groups containing (15 samples per group) were subjected to cyclic de/remineralisation procedures. Demineralisation was performed with 0.3% citric acid (pH 3.6) 2 min / five times per day. The enamel slabs were immersed in day artificial saliva between each erosive challenge for 1 hour and incubated overnight in night saliva at 37 oC. Two times daily fluoride application with toothpaste and artificial saliva slurry (1:3 ratio) plus a tested mouthrinse with automated tooth brushing (15 strokes, 300 g load) for (2x2 min/day) during the experimental process. The test product treatments were: group 1 Elmex® sensitive plus toothpaste (AmF, 1400 ppm F) Plus Elmex® erosion mouthrinse containing (500 ppm F as AmF/NaF and 800 ppm Sn as SnCl2) stannous chloride rinse (Elmex TP plus MR) 2 times/day; group 2 Pronamel® toothpaste (NaF, 1450 ppm F+ 5%KNO3) + Pronamel® (NaF) mouthrinse (Pronamel® TP plus MR) 2 mins x2 times/day; group 3 Pronamel® toothpaste (NaF, 1450 ppm F) 2/day plus GC tooth mousseTM once/ a day for 5 mins (Pronamel® TP plus TM) after the last brushing; group 4 (0 ppm F toothpaste) as a control. Enamel loss was determined by scanning profilometry after the last experimental days at 7, 14, 21, and 28 days. Results: after 28 days significantly less enamel surface loss (μm) was observed with group1: (Elmex TP plus MR) (0.40±0.23) and group 2: (Pronamel TP plus MR) (0.60±0.28)(Pronamel TP plus TM) had (2.65±1.79) (p < 0.01) compared to 0 ppm F control (1.84±1.85). Conclusions: The topical applications of preventive therapeutic measures in the form of AmF, 1400 ppm F toothpaste plus Elmex® erosion dental rinse (500 ppm F + 800 ppm Sn) or applications of NaF/5% KNO3 toothpaste plus NaF mouthrinse significantly decreased the effect of erosion and tooth brushing abrasion compared to combinations containing remineralising agent or fluoride-free toothpaste. Study 3: Investigations of therapeutic products on prevention of enamel surface loss under erosive and abrasive challenges in situ Aims: To investigate the effect of fluoridated toothpaste alone or in combination with mouth rinse on the prevention of tooth surface loss under acidic erosion and tooth brushing abrasion in situ. Methods: Seventeen healthy participants wore a small upper removable mouth appliance holding two sterilised bovine enamel slabs that were randomly assigned to investigate one of the five test products for 14 days entered a prospective controlled, double-blind, crossover with five phases trial. All participants that signed informed consents and fulfilled the inclusion criteria were enrolled in the study. The five treatment groups were: group A (Elmex® erosion protection toothpaste (1400 ppm F as AmF/NaF and 3500 Sn2); group B (non-fluoride® toothpaste as a control); group C (Sensodyne Pronamel® 1450 ppm F as NaF/5%KNO3 toothpaste); group D (.Sensodyne Pronamel® 1450 ppm F as NaF toothpaste plus Pronamel® mouth wash as 450 ppm F NaF) and group E (Elmex® erosion protection toothpaste (1400 ppm F as AmF/NaF and 3500 Sn2) with Elmex® erosion protection dental rinse as AmF and NaF 500 ppm F plus stannous chloride 800 stannous (Sn2). The enamel slabs were dipped extra-orally in 0.3% citric acid solution at predetermined times for 2 minutes/ five times daily. In addition the enamel slabs were brushed for 1min extra-orally then 1 min intra-orally using the standard toothpaste/natural saliva slurry and 10 ml mouthrinse was used for 60s twice per day (10 ml x2). Enamel loss was determined by surface profilometry (Proscan 2000, Scantron, UK). Results: Treatment with therapeutic products Elmex® erosion protection toothpaste, Sensodyne Pronamel® toothpaste, Sensodyne Pronamel® toothpaste plus Sensodyne Pronamel® mouthrinse and Elmex® protection erosion toothpaste and Elmex® erosion protection rinse demonstrated a highly statistically significant difference in reducing the erosive and abrasive enamel surface loss (p ≤ 0.001) compared to the control group (0 ppm F). Conclusion: Elmex® erosion protection (1400 ppm F) toothpaste combined with Elmex® erosion protection mouthrinse gave the greatest outstanding benefit. Furthermore, using combined anti-erosive therapeutic products in the form of Sensodyne Pronamel® 1450 ppm F NaF toothpaste plus Pronamel® mouth wash 450 ppm F NaF; Elmex® erosion protection toothpaste (1400 ppm F as AmF).and Sensodyne Pronamel® 1450 ppm F as NaF toothpaste significantly reduced the daily effect of erosive/abrasive tooth wear and provided better enamel surface loss reduction compared to the non-fluoride® toothpaste.

In questo lavoro si affronta il problema di applicare le politiche di manutenzione preventive su un impianto in avviamento, non conoscendo o conoscendo poco i dati storici, necessari all'ottimizzazione o all'applicazione di una strategia manutentiva. Tramite lo studio e l'analisi della letteratura si cerca di determinare quali tecniche o procedure vengono implementate per superare la mancanza di dati. Dopo l'analisi degli autori e l'introduzione delle tecniche utilizzate si propone una procedura in grado di coniugare costi, qualità e sicurezza.

This thesis is based on noise recordings and health evaluations carried out at preschools in the northern part of Sweden. Sound level recordings were made on individuals and by use of stationary devices in dining rooms and play halls. Health evaluations were based on ratings by use of questionnaires and by analyses of cortisol. The average equivalent individual noise exposure was 71 dB(A). The average equivalent noise levels in the dining room and playing halls were 64 dB(A). The hearing loss of the employees was significantly higher for the frequencies tested than in an unexposed control group. Symptoms of tinnitus were reported among 31% of the employees. Noise annoyance was rated as somewhat to very annoying, and the voices of the children were the most annoying noise source. The dB(A) level and fluctuations of the noise exposure were significantly correlated with the number of children per department. Stress and energy output were pronounced among the employees. About 30% of the staff experienced strong burnout syndromes. Mental recovery was low as indicated by noise fatigue and high levels of stress after work. Increased cortisol levels during work were associated with higher number of children present at the department. An essential finding of the thesis was that noise and noise sources may impair the pedagogic work, thereby increasing the work load of employees. It is concluded that noise exposure in the preschool, isolated or in combination with other stressors, plays a fundamental role in the building up of acute as well as long term stress. An intervention study implementing six acoustical and seven organizational measures was tested, aimed to improve the noise situation in the departments. Acoustical measures improved the noise situation as well as the rated noise experiences better than the organizational measures.
Avhandlingen baseras på ett samarbete med förskoleverksamheten inom Umeå kommun och har innefattat medverkan från 101 pedagoger i delstudie 1 och 24 pedagoger i en delstudie 2. Studie 1 som redovisas i tre delarbeten, I, II och III, har innefattat personburna och stationära bullermätningar i lekhallar och i matsalar. Påverkan på upplevelser samt hälsoeffekter av ljudmiljön har analyserats via frågeformulär och analyser av kortisol. Kontroll av hörselstatus har genomförts via audiometrisk screening. Studie 1 innefattar analys av bullrets effekter på såväl hörselrelaterad (Delarbete I) som stressrelaterad ohälsa (Delarbete II). Olika typer av åtgärder för att förbättra ljudmiljön och minska den bullerrelaterade ohälsan redovisas i delarbete III. Delarbete IV fokuserar på hur samverkan mellan buller och arbetsorganisation kan påverka den stressrelaterade ohälsan. Genomförda analyser av buller visar på förhållandevis likvärdiga bullerexponeringsnivåer förskolor och avdelningar emellan. Skillnaderna i exponeringsnivåer veckodagar emellan var små, skillnader mellan individer var däremot stora. Påtagliga skillnader i exponeringsnivåer förelåg som väntat under arbetsdagen. I synnerhet den personburna bulleranalysen pekade på en bullerexponering med påtagliga inslag av variation och transienter i exponeringen. Ljudmiljön karaktäriserades av medverkande pedagoger som den enskilt mest besvärande arbetsmiljöfaktorn. Barnens röster och ljud från deras aktiviteter klassificerades som de mest besvärande bullerkällorna. Personalen uppvisade sämre hörtrösklar för samtliga testade frekvenser jämfört med svensk ej bullerexponerad referenspopulation. De försämrade hörtrösklarna var relativt låga och föranledde inte i något fall remittering till hörselklinik. Prevalensen för tinnitus var 31 %, vilket motsvarar en överfrekvens på 15-20 %, jämfört med svenskt normalvärde. Ljudtrötthet efter arbetsdagens slut utgjorde ett uttalat symptom bland pedagogerna liksom försämrad sömnkvalitet och förhöjd sömnighet vid uppvaknande. Analyser av arbetsbelastning baserat på skattning och kortisolmätningar, indikerade höga energiuttag under arbete och inslag av utpräglad stress, och i flera fall utbrändhet. Signifikanta samband mellan upplevd dålig ljudmiljö, maskering av tal, försämrade förutsättningar för det pedagogiska arbetet och därmed ökad ohälsa kunde påvisas. Ljudmiljön, såväl nivåer som fluktuationer påverkades på ett uttalat sätt av antalet barn på avdelningen. Detta utgjorde också den enskilt viktigaste faktorn för att förbättra såväl ljudmiljön som den till ljudmiljön relaterade hälsan. Akustiska åtgärder visade sig genomgående mer framgångsrika för att förbättra ljudklimatet än organisatoriska åtgärder.

This thesis comprises a review of studies on the diffusion of recommended guidelines on preventive practices and three papers evaluating the preventive practice patterns of general practitioners in Torino, Italy.
The first paper presents estimates of preventive practices and perceived effectiveness of preventive interventions. Patterns of practice were found to be consistently similar to those in other studies.
The second and third papers explore an array of determinants for ten primary and secondary preventive interventions.
An analysis of determinants indicates that complex patterns of behaviours are rather condition-specific, while the application of techniques is influenced to a varying extent by organizational and attitudinal factors.

Background Depression in older people often goes undetected but has severe consequences on physical health, functioning and quality of life. As the aging population is growing, mental ill-health already is and will continue to be an important public health problem. There is a need for adequate strategies to meet this challenge. Aims (1) To investigate the prevalence of and the association between depressive symptoms and loneliness in relation to age and sex in a random Swedish sample in the age group 65-80 years, and to investigate to what extent those scoring ≥ 8 in the depression dimension of the Hospital Anxiety and Depression Scale (HAD) had visited health care professionals and/ or used antidepressive medication. (2) To evaluate the effect of group discussions, in which structured reminiscence and a Problem Based Method (PBM) were used, on depressive symptoms, Quality of Life (QoL) and Self-Rated Health (SRH) among older people. (3) To describe the individual´s experiences of the year before and the time after retirement. (4) To evaluate the factorial structure of the HAD in a general older population 65-80 years and to examine the possible presence of differential item functioning (DIF) related to sex. Result More men than women reported depressive symptoms, few were offered psychological treatment and a quarter used antidepressant medication. Depressive symptoms were associated with loneliness and this association decreased with increasing age.   Participation in group discussions resulted in a decrease in depressive symptoms and an increase in QoL and SRH. Both expectations and fears were experienced the year before and the time after retirement. The psychometric evaluation of the HAD showed a two-factorial structure and invariance regarding sex. Conclusion The result highlights the importance of detecting depressive symptoms and loneliness in older people and offer adequate treatment. Transition into retirement should receive more attention both from a health care and organizational perspective. Group discussions with structured reminiscence and PBM as a nursing intervention, seem to be a promising method to prevent depressive symptoms in older people, but further research is needed. The HAD can be recommended to assess anxiety and depression among a general population 65-80 years old.

Phishing is an internet security issue whose shape is still changing and size is still increasing. This thesis shows the possibility of a phishing attack on open, private Wireless LANs. Private WLANs which use a login page to authenticate users in hotels, airports and academic campuses are all vulnerable to this attack. Virginia Tech's WLAN is used as an example to show that the attack is possible. The attack combines two very well known attacks: one is to deceptively guide a user into logging into a fake website, which shows similar log-in page to the page of the website the user intends to go to, and the second attack is to show users a valid certificate, which does not show a warning. The rogue server takes the user to a log-in page which is similar to Virginia Tech's log-in page and shows him a valid security certificate. We present a solution to the proposed problem. Software is implemented that runs on Windows Vista. The software warns the user if there are servers with more than one type of security certificates, claiming to be from the same network. We contrast our method to already existing methods, and show in what respects our solution is better. The biggest advantage of this method is that it involves no change on the server side. It is not necessary for the users to have any prior knowledge of the network, which is very helpful when the users access WLAN at airports and hotels. Also, when using this method, the user does not need to connect to any network, and is still able to get a warning. It however, requires the user to be able to differentiate between the real and fake networks after the user has been warned.
Master of Science

Doutoramento em Bioquímica
A hipertensão arterial pulmonar (HAP) é uma doença grave, caracterizada por remodelação progressiva da vasculatura pulmonar, frequentemente culminando em insuficiência do ventrículo direito (VD) e morte prematura. Apesar do progresso que tem sido feito nos últimos anos em termos de opções de tratamento, a HAP permanece uma doença incurável, com um mau prognóstico e uma elevada taxa de mortalidade. No presente trabalho, pretendeu-se explorar o potencial de diferentes abordagens preventivas e terapêuticas na HAP experimental. Para isso, três estudos experimentais foram realizados a fim de avaliar o impacto do exercício físico (Estudos I e II) ou do fármaco terameprocol (TMP) (Estudo III) na HAP. No Estudo I mostramos que o exercício físico moderado realizado ao longo da vida induziu diferentes adaptações moleculares nos ventrículos esquerdo e direito. Especificamente, o VD de animais treinados apresentou maiores alterações mitocondriais, mostrando um aumento na expressão de MnSOD e SIRT3, sugestivo de uma melhoria da capacidade antioxidante. Para explorar o impacto do exercício físico na HAP, no Estudo II avaliou-se o seu potencial efeito preventivo na insuficiência do VD secundária a HAP, no modelo animal da monocrotalina (MCT) submetido a 4 semanas de exercício físico em tapete rolante antes do desenvolvimento da doença. Os resultados indicam que o pré-condicionamento com exercício físico preveniu a remodelação da artéria pulmonar e a disfunção, hipertrofia e fibrose do VD. A nível molecular, o exercício físico preveniu o aumento do rácio MHC-beta/alfa e modulou a via de sinalização TWEAK/NF-κB. O exercício físico também preveniu o aumento da expressão da atrogina-1 e induziu um aumento da atividade da MMP-2. Com o objetivo de desenvolver novas estratégias farmacológicas para o tratamento da HAP, no Estudo III foi utilizada uma abordagem proteómica baseada em espetrometria de massa para procurar as vias moleculares moduladas pelo TMP em culturas primárias de células musculares lisas da artéria pulmonar isoladas de ratos injetados com MCT. A análise bioinformática dos dados de proteómica destacou a "regulação do tamanho da célula" e "resposta ao stress do retículo endoplasmático", como processos biológicos sobre-expressos pelo TMP, enquanto os processos biológicos "resposta ao TGF-beta" e "transcrição do ADN" foram encontrados sub-expressos. Dos fatores de transcrição modulados pelo TMP, a sub-expressão do HMGB1 parece estar relacionada com o efeito anti-proliferativo deste fármaco. Estas alterações moleculares induzidas pelo tratamento com TMP podem ter contribuído para a redução da remodelação vascular e consequentemente atenuado a disfunção e hipertrofia do VD associadas à HAP induzida pela MCT. Em geral, os nossos resultados sugerem que o pré-condicionamento com exercício físico e o tratamento com TMP podem ter relevância clínica na HAP. A modulação de vias de sinalização associadas à inflamação parece estar relacionada com os efeitos benéficos destas estratégias preventivas e terapêuticas.
Pulmonary arterial hypertension (PAH) is a severe disease, characterized by progressive remodeling of the pulmonary vasculature, usually culminating in right ventricle (RV) failure and premature death. Despite the progress that has been made in the last few years in terms of treatment options, PAH remains an incurable disease, with a poor prognosis and a high mortality rate. In the current work, we intended to explore the potential of different preventive and therapeutic approaches in experimental PAH. To accomplish that, three experimental studies were performed in order to assess the impact of exercise training (Studies I and II) or the drug terameprocol (TMP) (Study III) in PAH. In Study I, we show that lifelong moderate exercise training induced different molecular adaptations in the left and right ventricles. Specifically, the RV of trained animals presented greater mitochondrial changes, showing an increased expression of MnSOD and SIRT3, suggestive of improved antioxidant capacity. To explore the impact of exercise training on PAH, in Study II we evaluated its potential preventive effect on RV failure secondary to PAH, in the monocrotaline (MCT) animal model submitted to a 4-week treadmill exercise training before disease development. Data indicate that exercise preconditioning prevented pulmonary artery remodeling and RV dysfunction, hypertrophy and fibrosis. At a molecular level, exercise training prevented the increase in beta/alpha-MHC ratio and modulated the TWEAK/NF-κB signaling pathway. Exercise training also prevented the increase of atrogin-1 expression and induced an increase in MMP-2 activity. Envisioning the development of novel pharmacological strategies for PAH treatment, in Study III we used a mass spectrometry-based proteomic approach to search for the molecular pathways modulated by TMP in pulmonary artery smooth muscle cell primary cultures isolated from rats injected with MCT. Bioinformatic analysis of proteome data highlighted the “regulation of cell size” and “response to endoplasmic reticulum stress” as biological processes up-regulated by TMP, while the biological processes “response to TGF-beta” and “DNA-templated transcription” were found down-regulated. From the transcription factors modulated by TMP, the down-regulation of HMGB1 seems to be related with the anti-proliferative effect of this drug. These molecular alterations induced by TMP treatment may have contributed to the reduction of the vascular remodeling and consequently attenuated RV dysfunction and hypertrophy associated to MCT-induced PAH. In overall, our results suggest that exercise preconditioning and TMP treatment can be of clinical relevance in PAH. The modulation of inflammation-related signaling pathways seems to be behind the benefits of these preventive and therapeutic strategies.

Purpose: To assess a caregiver’s oral health attitudes, habits, and behaviors pre and post intervention, and to determine whether a particular delivery-style (verbal-only or with visual supplementation) of a motivational interviewing session is more effective in improving oral health behaviors as well as improving success of a chosen preventive goal. Methods: N=140 caregivers of pediatric dental patients were given questionnaires to assess readiness to change and current preventive oral health behaviors. Oral health education was communicated in a MI style (verbal-only or with visual supplementation). One preventive oral health goal was selected to focus on. The home preventive behavior survey was re-administered at follow-up. Results: Preventive home behaviors improved, with no significant difference between interventions. There was significance in the amount of change in items specified as a goal. Conclusions: Behaviors improved significantly after a MI educational intervention. Goal setting and providing oral health education in a MI style can improve home preventive behaviors.

Thesis (M.S. in Operations Research)--Naval Postgraduate School, September 1990..
Thesis Advisor(s): Bailey, Michael P. Second Reader: Bloch, P. "September 1990." Description based on title screen viewed on December 16, 2009. DTIC Descriptor(s): Carrier based aircraft, *preventive maintenance, aircraft, theses, operational effectiveness, availability, naval operations, simulation, computerized simulation, operational readiness DTIC Identifier(s): E-2C aircraft Author(s) subject terms: Availability, imperfect preventive maintenance Includes bibliographical references (p. 21). Also available in print.

碩士
國防大學
法律學系
102
In recent years, we could often find a term “preventive detention” in criminal cases. The difference of requirements, compared to general detention, for preventive detention is “there is enough facts to determine that the suspects may repeatedly commit the same crimes.” However, although the detention is the most severe violation of personal freedom, for the purposes of preservation of evidences and ensuring the enforcement of criminal procedure law, it is the most effective means. Currently many American and European legal systems still retain this practice, even European Convention on Human Rights also expressly provided it. Although academic circles argue that “preventive detention” violates the principle of resumption of innocence and question its accuracy of prediction, so it should be abolished, the practical uses of it even more frequently, especially the suspects in many major cases are bailed out in courts that have triggered public criticism, protests and discontent. Under the atmosphere that is prone to be dominated by mass sentiment, how legal system strikes a balance and gives fair trials? Based on the reasons of preventive detention legislation in our country and the operation under the current legal norms of European Convention on Human Rights and Human Rights Court, this study tries to present our recommendations. It is hoped that a balance could be stricken between safeguarding social security and protection of human rights to establish conditions and systems in line with requirements of a country of rule of law.

Relatório Final de Estágio do Mestrado em Engenharia Informática apresentado à Faculdade de Ciências e Tecnologia da Universidade de Coimbra.
The exception handling mechanism has been one of the most used reliability tools in programming languages for over four decades. Nearly all modern languages have some form of “try-catch” model for exception handling and encourage its use. Nevertheless, this model has not seen significant change, even in the face of new challenges, such as concurrent programming and the advent of reactive programming. As it stands, the current model is reactive, rather than proactive — exceptions are raised, caught, and handled. Online Failure Prediction techniques generally work at a very high level, showing potential for prediction of program crashes. However, these techniques have never been at the hands of the programmers as an effective tool to improve software quality. This work proposes an alternative exception handling model — PreX — where exceptions are no longer caught but, rather, predicted and possibly prevented. By applying recent advances in Online Failure Prediction to Exception Handling, PreX aims to fully prevent exceptions, bringing failure prediction techniques to a much more fine-grained level that the programmer can control. Predicting exceptions enables a range of preventive measures that enhance the reliability and robustness of a system, offering new revitalization strategies to developers. In addition to introducing the concept of PreX, this work defines its model and architecture and provides a full evaluation of its prototype implementation, showing that it offers significant advantages to developers and that it can be applied to real-world projects.

This diploma thesis deals with problematics of children with risk behavior in elementary schools and possible means of prevention. The thesis is divided into two main parts. Theoretical part lists types of risk behavior, their causes and prevention of these problems. It also informs about prevention programs in elementary schools. The practical part then presents the results of hybrid research - questionnaire surveys and interviews. The target of the quantitative survey is to find out what types of risk behavior are most common in elementary schools, what is the techers' point of view at this issue and how they work with such a student. The qualitative research further informs about specific problems of children with risk behavior and offers more detailed results about occurrence of preventive programs in primary schools. The thesis was created as a part of GAJU Project (GAJU 154/2016/S) "Preparedness of students and fresh graduates of PF JU to solve educational problems of pupils."