Thèses sur le sujet « Failure to prevent »

To date, outcome research suggests that providing clinicians with patient progress feedback and problem-solving tools is effective in improving therapeutic outcome for clients who are predicted to have a negative treatment outcome. To expand upon this body of research, the current study examined the efficacy of using these problem-solving tools (Clinical Support Tools; CST) to reduce the risk of treatment failure and enhance positive outcome with 118 clients who were not identified as at -risk for a negative outcome. Results of this study indicated that the intervention failed to lower the rate of becoming an at-risk case or to enhance treatment outcome. A possible explanation for the null results observed is poor treatment compliance. Based on the findings of this study, the CST cannot be recommended as an intervention across the broad range of clients who enter treatment. However, qualitative analysis results reflect positive indicators for continued research with at-risk cases.

Background: Peripheral intravenous catheters (PIVCs) are the most common invasive medical device and up to 70% of hospitalised patients require one or more during their hospital stay. However, up to 69% of PIVCs fail before treatment is complete, resulting in pain and discomfort for patients from reinsertion attempts, and financial liability for healthcare institutions. Effective PIVC dressing and securement is an important nurse-led strategy to prevent PIVC complications and failure; however, the most effective way of achieving this is yet to be determined. PIVC securement bundles are a multiproduct combination consisting of a primary dressing and securement in addition to supplementary securement products to provide extra stability. Despite growing evidence that a single dressing or securement product is not effective at preventing PIVC complications and failure, there has been very limited research attention to date on the concept of a securement bundle for the prevention of PIVC failure. Aims and objectives The overarching aim of this PhD was to investigate the use of a securement bundle to reduce PIVC complications and failure. There were three objectives guiding the research: 1) describe global usage of dressing and securement products, including supplementary securements, to secure PIVCs; 2) determine associations between (a) PIVC dressing and securement products, individually and in combination, and PIVC complications, and (b) patient, PIVC, and institutional factors, and suboptimal dressing integrity; and 3) establish the feasibility of testing securement bundles to prevent PIVC complications and failure in a pilot randomised controlled trial (RCT). Design Two frameworks were used to guide this research. The Vessel Health and Preservation Framework was used to contextualise this research within the PIVC continuum of care. The methodological framework underpinning the research methods was the Canadian Critical Care Trials Group programmatic model of research. This work was informed by an integrative review of contemporaneous literature regarding medical adhesive tapes and supplementary securement products and consisted of two phases: a secondary analysis of an existing data set of PIVC insertion, maintenance, and outcome data; and a pilot RCT testing two dressing and securement bundles against standard care for the prevention of PIVC complications and failure. Phase 1 Study design: Secondary analysis of a global cross-sectional study of PIVC characteristics, management, and outcomes. Setting: 407 rural, regional, and metropolitan hospitals in 51 countries. Sample: 40,637 PIVCs in paediatric and adult patients. Measurements: Institution, PIVC, and patient-level data were collected in the parent study. Selected data were extracted from the parent study data set for the secondary analysis, specifically those focusing on PIVC dressing and securement policy and practice. Main results: Dressing and securement practices, and local hospital policy regarding dressing change frequency varied. One-fifth of dressings (21%, n = 8519) were not clean, dry, and intact. The prevalence of PIVC insertion site complications was 16% (n = 6503), with signs of phlebitis commonly observed (11.5%, n = 4587). Compared to non-bordered polyurethane dressings, sterile gauze and tape dressings were associated with fewer insertion site complications (odds ratio (OR) 0.58, 95% confidence interval (CI) 0.50, 0.68) and better dressing integrity (OR 0.68; 95% CI 0.59, 0.77). Compared with no securement, non-sterile tape at the insertion site was associated with more site complications (OR 2.39, 95% CI 2.22, 2.57) and poorer dressing integrity (OR 1.64, 95% CI 1.51, securement combinations were associated with fewer site and dressing complications, compared with a bordered polyurethane dressing and non-sterile tape. Local PIVC guidelines advocating 4-hourly insertion site inspection (OR 0.84, 95% CI 0.72, 0.98) and dressing replacement between 1 3 days (OR 0.80, 95% CI 0.71, 0.90) were associated with better PIVC dressing integrity than those inserted prehospital (OR 1.84, 95% CI 1.52, 2.24); or with no documentation of site assessment within the last 24 hours (OR 1.63, 95% CI 1.54, 1.72); and the absence of hospital PIVC insertion and maintenance guidelines (OR 2.58, 95% CI 2.38, 2.81). Phase 2 Study design: A non-masked, single centre, three-group pilot RCT. Setting: General medical/surgical wards of a large quaternary hospital in Queensland, Australia. Sample: Adult patients requiring a PIVC for > 24 hours, who had no laboratory-confirmed positive blood culture within 24 hours of screening. Interventions: Participants were randomised into one of three groups: 1. Standard care sterile with Border 1635, 10.5 x 8.5cm, 3M, St Paul, Minnesota, USA); plus two non-H Soft Cloth Surgical Tape, 3M, St Paul, Minnesota, USA). 2. Securement bundle 1 one sterile tape strip in chevron pattern around PIVC hub and one sterile tape strip over hub (Steri- Minnesota, USA); plus Standard care 3. Securement bundle 2 Bundle 1; plus non-compression tubular bandage (Tubifast, Mölnlycke Heath Care, Belrose, Australia). Outcome measures: The primary outcome was the feasibility of conducting a fully powered definitive RCT based on a composite of eligibility, recruitment, retention, protocol fidelity, missing data, participant/staff satisfaction at insertion and removal, and the ability to provide effect estimates. Secondary outcomes included: PIVC failure, PIVC dwell time, adverse skin events, PIVC colonisation and cost. Main results: Of 109 randomised participants, 104 were included in final analyses. Feasibility outcomes were met, except for the eligibility criterion (79%) indicating that screening processes should be streamlined. Absolute PIVC failure was 38.2% (13/34) for Bundle 2, 25% (9/36) for Bundle 1, and 23.5% (8/34) for Standard care. The incidence rate ratio for PIVC failure/1000 catheter days, compared to Standard care, was 1.1 (95% CI 0.4, 2.7) and 2.1 (95% CI 0.9, 5.1) for Bundles 1 and 2, respectively. The incidence of adverse skin events, commonly bruising, was 13%. Additional securements, either non-sterile tape and/or a tubular bandage, were applied in 45% of PIVCs; however, this practice occurred more commonly in the standard care arm compared to the securement intervention arms. Conclusion: Global PIVC dressing and securement practice is associated with site complications and poor dressing integrity, both of which are highly prevalent in clinical practice. Phlebitis symptoms and poor dressing integrity are associated with the use of non-sterile tape at the PIVC insertion site, and this practice should be de-implemented. This research introduced the novel concept of securement bundles as an intervention to address current high PIVC failure rates and showed promising results, with three of the four bundles tested in a secondary analysis of a large global data set being significantly associated with fewer site complications, and two of the four associated with fewer dressing complications. Subsequent pilot testing of two securement bundles against standard care demonstrated it is feasible and safe to conduct a large definitive trial testing this intervention to address PIVC failure. Importantly, the interventions were acceptable to staff and participants. Nurses commonly apply reinforcements to PIVC dressings, the reasons for which are not clear and require further exploration. Innovative dressing and securement solutions are needed to reduce unacceptable PIVC failure rates, and securement bundles should be investigated as a matter of priority to improve patient outcomes. This doctoral research program has advanced the understanding of the role of dressing and securement in PIVC failure, demonstrated that securement bundles should be tested in a definitive trial, and has made an important contribution to addressing the pervasive problem of PIVC failure.
Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Nursing & Midwifery
Griffith Health
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Heart failure (HF) induced by aortic pressure over-load is associated with increased coronary artery stiffness. Perivascular adipose tissue (PVAT) and advanced glycation end products (AGE) both promote arterial stiffness. However, the mechanisms by which coronary PVAT promotes arterial stiffness and the efficacy of exercise to prevent coronary stiffness are unknown. The present study hypothesized both chronic continuous and interval exercise training would prevent coronary artery stiffness associated with inhibition of PVAT secreted AGE. Yucatan mininature swine were divided into four groups: control-sedentary (CON), aortic-banded sedentary heart failure (HF), aortic-banded HF continuous exercise trained (HF+CONT), and aortic-banded HF interval exercise trained (HF+IT). Coronary artery stiffness was assessed by ex vivo mechanical testing and coronary artery elastin, collagen and AGE-related proteins were assessed by immunohistochemistry. HF promoted coronary artery stiffness with reduced elastin content and greater AGE accumulation which was prevented by chronic continuous and interval exercise training. HF PVAT secreted higher AGE compared with CON and was prevented in the HF+CONT and HF+IT groups. Young healthy mouse aortas cultured in HF PVAT conditioned media had increased stiffness, lower elastin content and AGE accumulation compared with CON, which was prevented by PVAT from the HF+CONT and HF+IT groups. HF coronary PVAT secreted greater interleukin-6 (IL-6) and IL-8 compared to CON which was prevented by both continuous and interval exercise training regimens. We conclude chronic continuous and interval exercise is a potential therapeutic strategy to prevent coronary artery stiffness via inhibition of PVAT-derived AGE secretion in a pre-clinical mini-swine model of pressure overload-induced HF.

Individuals with end-stage kidney disease have the treatment options of receiving conservative care, dialysis or a kidney transplant. There are two main types of dialysis – haemodialysis and peritoneal dialysis. For a peritoneal dialysis (PD) program to be successful, close attention must be paid to preventing PD-related infections. A common and serious complication of PD is peritonitis. Peritonitis is a contributing cause of death in about 16% of PD patients and is a major cause of PD technique failure, which results in patients having to switch to long-term haemodialysis. The peritonitis rates of different renal centres are known to vary widely both within and between countries. Explanations for this variation are likely related to patient selection, patient training and infection-prevention protocols. This is a thesis by publication containing published and submitted work related to identifying barriers in practice to the uptake of relevant guideline recommendations, identifying current antimicrobial prophylaxis practice patterns in Australian and New Zealand (ANZ) PD units, assessing the evidence base for the antimicrobial agents used to prevent PD-related infections, and exploring patient experiences and beliefs about peritonitis. Chapter one is a general introduction to the topic. Chapter two is a narrative review of the literature relating to the prevention of PD-related infections. Chapter three is an original baseline study which assesses current practice and barriers to antimicrobial prophylaxis at 8 PD units. Chapter four is a systematic review of trials which have used various antimicrobial agents to prevent peritonitis in PD patients. Chapter five is an original survey study which assesses current antimicrobial prophylaxis practice at ANZ PD units. Chapter six is an original qualitative study that explores patients’ needs, experiences and beliefs about the prevention and treatment of peritonitis. The main aim of this thesis was to assess the current evidence base for the antimicrobial agents used, to establish current antimicrobial prophylaxis practice in ANZ PD units, to identify barriers to the uptake of guideline recommendations, and to explore patient experiences and beliefs about peritonitis and use the findings to suggest ways to improve the care and support they receive.

Prediction of crack growth in encapsulating material has a critical issue on the reliability of electronic components. To prevent the risk of material rupture or to extend the lifetime of these structures, experimental and numerical methods are developed within the context of linear elastic fracture mechanics. The present study proposes to extend techniques to epoxy resins. First, an experimental procedure using compact tension (CT) specimens is applied to characterise the fracture toughness of epoxy resins. This technique is then used to compare different epoxy resins and to quantify effects due to presence of filler particles. Then, a method is proposed to determine a fracture criterion for cracks under mixed mode loading. Experiments enable to extract the direction of crack propagation for given proportions of tensile and shear loading. Based on finite element methods, a numerical analysis is used to calculate the direction of crack propagation. A comparison between experimental and numerical results confirms the capability of FE codes to predict curved crack path. As well, fatigue crack growth is investigated with CT specimens under cyclic loading. Material parameters are identified in accordance with the Paris law. With the help of the commercial software Zencrack, a crack propagation can be simulated by a sequential approach, in which the crack length is updated step by step. 2D and 3D models are generated. The influence of the crack curvature through the thickness is described. On that purpose, a modified Paris law is proposed. The simulated crack propagation provides excellent agreements with experimental measurements
La fiabilité des composants électroniques est parfois détériorée à cause de la propagation de fissures dans les matériaux de protection. Pour anticiper les risques de rupture et améliorer la durée de vie de ces structures, des méthodes expérimentales et numériques sont développées dans le cadre de la mécanique de la rupture linéaire élastique. La présente étude propose d’appliquer ces techniques aux résines époxy. Une procédure expérimentale est mise en place afin de caractériser la ténacité de résines époxy. La dispersion du test est évaluée avec une méthode statistique basée sur une distribution de Weibull. Cette technique permet une comparaison entre différents types de résines (chargées ou non chargées). Une méthode est ensuite proposée pour déterminer un critère de rupture pour les fissures sous chargement de mode mixte. Une analyse numérique, basée sur un code éléments finis, est utilisée pour calculer la direction de propagation. Une comparaison entre résultats numériques et expérimentaux confirme la capacité du code EF à prédire un chemin de fissuration incurvé. En outre, l’analyse de propagation de fissure en fatigue découle de résultats expérimentaux réalisés sur des éprouvettes Compact Tension (CT) soumises à un chargement cyclique en traction. Les paramètres matériaux sont extraits suivant une loi de type Paris. A l’aide du logiciel Zencrack, une propagation de fissure en 3D peut être simulée via une approche séquentielle, durant laquelle la fissure est propagée pas-à-pas. L’influence de la géométrie du front de fissure sur les prédictions numériques est mise en évidence. Les résultats numériques présentés sont en bon accord avec les résultats expérimentaux

La trattazione ha ad oggetto la responsabilità penale per omesso impedimento del reato e per omesso impedimento dell’evento concausato dall’azione criminosa di un terzo, nella giurisprudenza e nella dottrina italiana. Dopo un approfondimento sul controverso concetto di omissione nel diritto penale, il lavoro affronta gli orientamenti di giurisprudenza e di dottrina sull’omesso impedimento dell’evento-reato, ricostruito a partire dagli istituti della commissione mediante omissione e del concorso di persone nel reato. Il tema viene, infine, analizzato dalla prospettiva dell’omissione propria, proponendo un inquadramento del fenomeno all’interno delle “omissioni intermedie”.
The thesis deals with the criminal liability for failure to prevent crimes and failure to prevent events caused by criminal actions, in the Italian case law and literature. After a study on the controversial concept of “omission” in criminal law, the thesis addresses the judgements and the scholarship based on the commission by omission and on the criminal complicity. Eventually, the topic is addressed from the perspective of the “offences of failing to act”, suggesting the framework of the “omission of medium gravity” for the failure to prevent crimes.

Master´s thesis deals with the identification and evaluation of mistakes on the production line and their prevention. For the purpose I chose FMEA method. Theoretical part contains description of kinds of FMEA and their application. In the following part description and analysis of current state of production process of the product at NORMA Czech, s.r.o. was made. All important information were recorded to FMEA forms and finally measures for the most critical failures were designed.

Government figures put the current indigenous unemployment rate at around 23%, 3 times the unemployment rate for other Australians. This thesis aims to assess whether Australian indirect discrimination legislation can provide a remedy for one of the causes of indigenous unemployment - the systemic discrimination which can result from the mere operation of established procedures of recruitment and hiring. The impact of those practices on indigenous people is examined in the context of an analysis of anti-discrimination legislation and cases from all Australian jurisdictions from the time of the passing of the Racial Discrimination Act by the Commonwealth in 1975 to the present. The thesis finds a number of reasons why the legislation fails to provide equality of opportunity for indigenous people seeking to enter the workforce. In nearly all jurisdictions it is obscurely drafted, used mainly by educated middle class white women, and provides remedies which tend to be compensatory damages rather than change to recruitment policy. White dominance of the legal process has produced legislative and judicial definitions of "race" and "Aboriginality" which focus on biology rather than cultural difference. In the commissions and tribunals complaints of racial discrimination are often rejected on the grounds of being "vexatious" or "frivolous", not reaching the required standard of proof, or not showing a causal connection between race and the conduct complained of. In all jurisdictions the cornerstone of liability is whether a particular employment term, condition or practice is reasonable. The thesis evaluates the approaches taken by appellate courts, including the High Court, and concludes that there is a trend towards an interpretation of reasonableness which favours employer arguments such as economic rationalism, the maintenance of good industrial relations, managerial prerogative to hire and fire, and the protection of majority rights. The thesis recommends that separate, clearly drafted legislation should be passed to address indigenous disadvantage and that indigenous people should be involved in all stages of the process.

Government figures put the current indigenous unemployment rate at around 23%, 3 times the unemployment rate for other Australians. This thesis aims to assess whether Australian indirect discrimination legislation can provide a remedy for one of the causes of indigenous unemployment - the systemic discrimination which can result from the mere operation of established procedures of recruitment and hiring. The impact of those practices on indigenous people is examined in the context of an analysis of anti-discrimination legislation and cases from all Australian jurisdictions from the time of the passing of the Racial Discrimination Act by the Commonwealth in 1975 to the present. The thesis finds a number of reasons why the legislation fails to provide equality of opportunity for indigenous people seeking to enter the workforce. In nearly all jurisdictions it is obscurely drafted, used mainly by educated middle class white women, and provides remedies which tend to be compensatory damages rather than change to recruitment policy. White dominance of the legal process has produced legislative and judicial definitions of "race" and "Aboriginality" which focus on biology rather than cultural difference. In the commissions and tribunals complaints of racial discrimination are often rejected on the grounds of being "vexatious" or "frivolous", not reaching the required standard of proof, or not showing a causal connection between race and the conduct complained of. In all jurisdictions the cornerstone of liability is whether a particular employment term, condition or practice is reasonable. The thesis evaluates the approaches taken by appellate courts, including the High Court, and concludes that there is a trend towards an interpretation of reasonableness which favours employer arguments such as economic rationalism, the maintenance of good industrial relations, managerial prerogative to hire and fire, and the protection of majority rights. The thesis recommends that separate, clearly drafted legislation should be passed to address indigenous disadvantage and that indigenous people should be involved in all stages of the process.

碩士
國立臺北科技大學
土木與防災技術研究所
92
This study will collect and review the foundation failure cases in the last 10 years, and will establish the failure mechanism versus corresponding soil deposit and the reasons to cause the failure. This results can be used to educate the workers and engineers on the job site and improve their ability to confront any possible foundation incident. Secondly, this study will try to establish the relation between the type of foundation failure and the type of soil deposit. Since different soil provide quite different engineering response during excavation, and this cause different type of foundation failure. Therefore, this can provide design agent the ability to judge what need to be done to prevent the possible foundation failure based on the geotechnical exploration and soil testing report. At last, this study will recommend the local government office with some administrative measures to minimize the possibility of foundation failure.

碩士
國立彰化師範大學
生物技術研究所
101
Thioacetamide (TAA) is a hepatotoxin that can cause hepatocellular carcinoma in mice and zebrafish, but little is known about its toxic effect on embryonic development. In the previous study, we have showed TAA can enhanced ROS generation and induced the edema in pericardial sac (eps) formation, but the cellular mechanism was still unclear. In this study, we try to identify the cells which involved in TAA induced eps formation, and overexpression of manganese superoxide dismutase (Mn-SOD) to reduce eps formation in TAA treatment. First, we test that the toxicological mechanism of TAA on eps formation, and we treated with 32mM TAA of zebrafish embryos between 14 –36 hpf. The result show the heart beat rate 50-60%, and a narrow elongated heart malformations, these symptoms similar to heart failure, and also observed eps formation. We use of transgenic technology to build real-time in vivo dynamic analysis of ROS in liver specificity at zebrafish model, the results confirm the embryo can promote superoxide and H2O2 generated after 32 mM TAA treatment, and 32 mM TAA treatment zebrafish embryos can induction of TNF-α highly expressed and the SOD activity was inhibited. Overexpress Mn-SOD transgenic fish by Tol2 transposon system were generated and confirmed by RT-PCR, Western blotting and enzyme activity assay. The result obviously show the Mn-SOD mRNA expression increased approximately 2 fold, protein expression increased approximately 3 fold, and the activity increased approximately 1.3-1.5 fold. The transgenic F1 transgenic fish embryos were treated with TAA, the results showed that TNF-α expression is reduced to 1.5 fold, and the activity can rescue of SOD. We use antibody of anti-human MC tryptase to Immunohistochemistry, we found the mast cells were congregate and degranulate at the pericardial sac, and overexpression of Mn-SOD decrease amount of the mast cells in the pericardial sac in the number and protein oxidative damage is reduced by approximately 4 fold, the eps formation rate was reduced to about 10-20%. Our results showed TAA induced eps/heart failure-like syndrome are due to enhanced ROS generation, and induced mast cells activation during embryonic development. To overexpress Mn-SOD can reduce intracellular ROS, Mast cells numbers, and oxidative damages, and can partially rescue TAA induced embryo toxicity.

The aim of our work was to map the process of identification, evaluation, and implementation of activities directed at prevention or management of nursing safety risks in organizations providing urgent ward care in the Czech Republic from the point of view of top management of nursing. Our work traced a quantitative research. For collecting data we used a non-standard questionnaire made up only for the purposes of this work. The questionnaire was distributed by the top representative of nursing management (ward sister/deputy in charge of nursing care) of the above specified health centres. The research was carried out in the period February - April 2008 and for assessment of the results obtained we used 110 questionnaires. For the purposes of our work we determined six hypotheses. Hypothesis 1 saying that hospitals create conditions for the development of safe organizational culture proved true. For the future it is essential to discuss this topic more profoundly, as well as to get rid of the fear of punishment for acknowledging a mistake and accept the fact that we all make mistakes, therefore we must minimalize their frequency and consequences and above all learn from them. Hypothesis 2 stating that hospitals watch risk factors for occurence of emergencies proved true, too. As a negative finding we can consider proving hypothesis 3 saying that hospitals do not reveal particulat risks of nursing care until the elimination of their consequences. Uncovering insufficient use of proactive strategy led us to a more detailed description of a FMEA method. Hypothesis 4 saying that hospitals have created a procedure for occurence of emergency and hypothesis 5 - nursing personnel is obligated to observe and report at minimum three kinds of emergencies related to nursing care proved true, too. The last hypothesis 6 presenting the fact that hospitals do not make their patients/clients involved in prevention of mistakes of medical workers was also confirmed by the results, but it was pleasant to find out that 43,3% of respondents stated that this possibility is being used at their place. We suggest to include the prevention of mistakes in the nursing process whether by means of particular nursing diagnoses or global education of patients/clients. As a suggestion of a feasible content of education we translated and adapted a document SPEAK UP into Czech named 7P.

1 Omissive offences Abstract This diploma thesis addresses the issue of omissive offences in the Czech criminal law with regard to the legislation of Germany. Given the little attention paid to this topic in the Czech Republic, the aim of this thesis is to provide the reader with a comprehensive view of the omission in Czech criminal law in the context of contemporary legal literature, case law, and relevant legislation, including critical review of the most controversial aspects of the current regulation. In the beginning, the thesis focuses on the characteristics of the offence and its individual features with an emphasis on the objective aspects of the offence, which is essential for determination of the form of action. This is followed by a detailed historical excursion into the antecedent legislation of omissions in our country, from the time of Austria- Hungary, to the unsuccessful efforts to reform the criminal law during the First Republic, followed by methodically elaborated criminal codes from the period of totalitarianism to the fine government draft of the Criminal Code from the turn of the millennium. The core of this thesis is the third chapter dealing with the valid regulation of omission and categorization of omissive offences to the authentic (genuine) and the inauthentic, while...

This dissertation uses a methodology for attributing a stock portfolio most likely negative scenarios given a pre-defined loss. Using an extensive dataset spanning from 2007 through 2019, we calculated stock returns and their sample covariance matrix is estimated to obtain the portfolio Value at Risk (VaR). Due to idiosyncratic risk, we aggregate the returns into their corresponding indices to obtain the systematic component (the one explained by the market) and, afterwards, the Systematic Value at Risk was determined. Backward induction is then applied. Considering that returns follow a multivariate normal distribution, we derive the main scenario which could lead to the calculated VaR or even to a worst loss – the decision is up to the user. Reverse Stress Testing should be used as a framework, otherwise the risk manager could simply recalculate the VaR for different confidence intervals and investigate the evolution of the corresponding risk factors. Thus, the objective is to find multiple plausible scenarios –not only the most probable one. Principal component analysis (PCA) is applied to identify additional, less likely scenarios. These scenarios are linked to the basis scenario, which ensures plausibility. The relative likelihood is then defined manually as 0.1, meaning the central scenario is ten times more likely than the less likely one. Consequently, four scenarios were generated along with the calculation of their corresponding likelihoods. Overall, we identify the most probable loss scenarios for our portfolio given an input loss. Additionally, we explore the methodology further to determine scenarios under market extreme volatility events.
Esta dissertação aplica uma metodologia que identifica as perdas mais prováveis de uma carteira de ações, considerando como input uma perda definida. Através da utilização de um extenso conjunto de dados correspondentes ao período de 2007 até 2019, são calculados os retornos das ações e a matriz de variâncias-covariâncias é estimada de forma a obter o Value at Risk (VaR). Devido ao risco idiossincrático, os retornos foram agregados em função dos índices correspondentes, a fim de obter uma componente sistemática, i.e., explicada pelo mercado, procedendo-se ao cálculo do Systematic VaR. Invertendo o processo, e considerando que os retornos seguem uma distribuição normal multivariada, obtém-se um cenário central que dá origem ao Systematic VaR calculado, ou caso o utilizador entenda, uma perda superior. Posteriormente, o objetivo passará por encontrar diversos cenários plausíveis – e não apenas o mais provável. O método Principal Component Analysis (PCA) permitirá a obtenção de cenários menos prováveis. Estes encontram-se relacionados ao cenário mais provável através de verosimilhança, o que garante a plausibilidade dos cenários gerados. A verosimilhança relativa é definida manualmente como 0.1, refletindo um cenário central dez vezes mais provável que o menos provável. Assim, foram gerados quatro cenários, juntamente com o cálculo das respetivas verosimilhanças. Em suma, identificamos os cenários de perda mais prováveis para a carteira em questão, considerando uma perda como input. Adicionalmente, exploramos a metodologia de forma a determinar outros cenários em contexto de extrema volatilidade no mercado.

The thesis provides a concise explanation of the notions of confession and the seal of confession and observance of the same by Czech Republic criminal law. The seal of confession is especially provided for by Act No. 3/2002 Coll. on churches and religious societies. In my thesis, I also address the issue of protecting other types of non-disclosure recognized by the Czech Republic. The main topic covers respecting the seal of confession in the context of criminal law. I particularly concentrate on respecting the seal of confession in relation to Sections 167 and 168 of the Criminal Code concerning failure to prevent an offence and failure to report an offence. I also take note of the duty to testify and exceptions to the same. Whereas one of the exceptions{--}prohibition of interrogation{--}does indicate protection of the seal of confession, the other{--}the right to refuse testimony{--}includes no such unequivocal protection. Generally, Czech laws do recognize the seal of confession, and it is impossible to punish observance by priests of the seal of confession.

MSc (Med), University of the Witwatersrand, Faculty of Health Sciences, School of Physiology
The role of metabolic remodelling in heart failure is not fully understood, significant evidence has accumulated to suggest that it may be central to the development of left ventricular (LV) remodelling and LV dysfunction. Heart failure is also characterized by sustained neurohumoral activation. We have previously demonstrated that chronic low dose administration of isoproterenol contributes to cardiac structural and functional changes, however, little is known about metabolic and mitochondrial changes that may accompany the development of isoproterenol-mediated heart failure. In the current study, we hypothesised that metabolic dysregulation and loss of mitochondrial integrity mediates left ventricular hypertrophy (LVH) and left ventricular (LV) systolic dysfunction in the isoproterenol model of heart failure. Furthermore, modulation of expression of key metabolic genes and mitochondrial transcription factors by fenofibrate, a peroxisome proliferator-activated receptor alpha (PPARα) agonist, will preserve left ventricular function. To achieve this, male Sprague-Dawley rats weighing between 250-300g were injected with low dose isoproterenol (0.04 mg.kg-1.day-1) and/or administered with fenofibrate (100 mg.kg-1.day-1) for five weeks. Thereafter, metabolic substrates such as glucose, FFAs and TG concentrations were obtained. Left ventricular hypertrophy (LVH) and cardiac function were assessed using echocardiography. Expressions of metabolic and mitochondrial genes such as PPARα, AMP-activated protein kinase alpha 2 (AMPKα2), PPARγ coactivator-1 (PGC-1α), mitochondrial transcription factor (TFAM) and nuclear respiratory factor-1 (NRF-1) were determined using real-time polymerase chain reaction. Mitochondrial integrity was assessed using transmission electron microscopy. Administration of isoproterenol significantly increased left ventricular mass (LVM) and decreased endocardial fractional shortening (FSend); isoproterenol also induced myofibrillar iv derangement, mitochondrial derangement and cristae disruption. Fenofibrate prevented isoproterenol-induced increase in LVM and improved FSend. Fenofibrate co-administration prevented loss of mitochondrial integrity possibly via TFAM. Furthermore, fenofibrate may have induced metabolic remodelling via upregulation of AMPKα2 and downregulation of cardiac PPARα and PGC-1α. Therefore our data suggests that fenofibrate-mediated cardioprotection against isoproterenol-induced LVH and LV systolic dysfunction was accompanied by metabolic switching and preservation of mitochondrial integrity. While isoproterenol did not induce any changes in metabolic genes, fenofibrate-mediated cardioprotection could have been through changes in metabolic genes.

O tema do abandono escolar é uma preocupação social, não só a nível internacional, mas também nacional, que passa pelo Estado, por diferentes agências da administração pública e pelo setor solidário social e privado. Este tema tem-se mantido atual na documentação oficial portuguesa sobre educação e estudos continuam a ser feitos no que se refere ao mesmo. A preocupação pelo abandono escolar não se confina apenas a Portugal, mas estende-se à escala europeia. Em Portugal, pelos diversos estudos já existentes, a taxa de abandono escolar tem vindo a reduzir, no entanto, o fenómeno continua presente nos dias de hoje, mantendose ainda um atraso considerável em relação à meta europeia definida. O fenómeno do abandono escolar é muito visível nos cursos profissionais, pelo que a nossa investigação visa alcançar a resposta para uma questão de âmbito geral: Que perceções têm alunos, docentes e lideranças sobre os fatores que contribuem para o abandono escolar precoce nos cursos profissionais? No sentido de obtermos resposta a esta questão procedemos à formulação de subquestões: Como se organiza a escola para prevenir o abandono escolar precoce? Como são diagnosticados os alunos que se encontram em risco de abandono escolar precoce? Que ações concretas se desenrolam para evitar que os alunos em risco de abandono acabem por sair efetivamente da escola? Como viveram e sentiram a escola os alunos que abandonaram os cursos profissionais sem concluir o 12º ano? Como vivem e sentem a escola os alunos que se encontram em risco de abandono escolar precoce? Para tal, procedemos a uma revisão da literatura que nos permitiu esboçar a evolução do fenómeno em termos nacionais e europeus e analisar as medidas que foram implementadas para o prevenir. Elegemos para a nossa investigação duas técnicas de recolha de dados, a análise documental (registos biográficos dos alunos, atas dos conselhos de turma, pautas de avaliação e documentos estruturantes do Agrupamento, nomeadamente, Contrato de Autonomia, Projeto Educativo, Regulamento Interno, e Plano de Desenvolvimento do Currículo) e a realização de entrevistas semiestruturadas. As entrevistas foram aplicadas à Diretora do Agrupamento, a um Diretor de Turma de um curso profissional, a docentes, a alunos em risco de abandono e a jovens que abandonaram o sistema educativo. Os dados recolhidos e analisados neste estudo permitem-nos concluir que os agentes educativos entrevistados, nomeadamente a diretora e os docentes, têm a mesma perceção relativamente aos fatores que contribuem para o abandono escolar nos cursos profissionais, identificando como principais fatores: as dificuldades económicas que levam as famílias a emigrar à procura de melhores condições de vida, a procura pela autonomia financeira, as dificuldades acumuladas que levam a um total desinteresse pela escola, também devido ao facto de pertencerem a famílias desestruturadas que muitas vezes desincentivam à frequência da escola. São também relatados os problemas de comportamento, aliados ao elevado número de faltas e à falta de empenho como fatores que normalmente conduzem a situações de abandono escolar. As conclusões alcançadas pelo nosso estudo parecem ir ao encontro das correntes de pensamento de outros investigadores, no sentido em que apontam para a falta de respostas adequadas, por parte da escola, para a maioria das situações de insucesso, esperando que os alunos aprendam por si, o que faz com que muitos deles acabem por abandonar o sistema de ensino. Concluímos ainda que o modelo escolar que temos, com a sua tradicional e inquestionada gramática escolar, acaba por ser o maior responsável pelas situações de abandono escolar.
The issue of early school dropout is a social concern, not only internationally, but also national, passing by the State, by different agencies of public administration and social solidarity and private sector. This issue has remained present in the Portuguese official documentation of education and researches continue to be made. The concern for the early school dropout is not confined only to Portugal but it extends to an European level. In Portugal, by the various existing studies, the early school dropout rate has been reduced, however, the phenomenon is still present today, remaining still a considerable delay in relation to the European target set. The phenomenon of school dropout is very visible in vocational courses, so our research aims to achieve an answer to a question of general range: What perceptions have students, teachers and leaders about the factors that contribute to early school dropout in vocational courses? In order to answer this question we proceeded to the formulation of sub-questions: How is school organised to prevent early school dropout? How are students at risk of early school dropout diagnosed? What concrete actions are taken place to prevent students at risk of early school dropout from effectively dropping out of school? How have students who left the vocational courses without completing the 12th form experienced and felt school? How do students at risk of early school dropout experience and feel school? In order to obtain an answer to these questions, we proceeded to a review of literature that allowed us to sketch the evolution of the phenomenon at national and European terms and analyse the measures that have been implemented to prevent it. We have elected to our investigation two data collection techniques, document analysis (biographical records of students, minutes of class meetings, final evaluation grids and structuring documents of the School, Educational Project, Rules, and Curriculum Development Plan) and semi-structured interviews. The interviews were conducted to the School Principal, a Class Director of a vocational course, teachers, students at risk of early school dropout and young people who have dropped out the educational system.The data collected and analysed in this study allows us to conclude that the educators interviewed, namely the School Principal and teachers have the same perception regarding the factors that contribute to early school dropout in vocational courses, identifying the main factors: the economic difficulties leading families to emigrate in search of better living conditions, the demand for financial autonomy, the accumulated difficulties that lead to a total lack of interest in school and the fact of belonging to dysfunctional families that often discourage the frequency of school. Behavioural problems and the high number of absences and lack of engagement are reported as factors that often lead to situations of school dropout. The conclusions reached by our study seem to meet the currents of thought of other researchers to the extent that there is a lack of adequate answers, by the school, for most school failure situations, expecting students to learn by themselves, what makes them to drop out of the educational system. We also conclude, that the school model that we have, with its traditional and unquestioned grammar of schooling, tends to be the most responsible for the situation of school dropout.

碩士
國立高雄大學
電機工程學系碩士班
102
The oil-immersed power transformers are utilized to voltage transform and power dispatch in electric power systems. The power supply would interrupt while failures occurred in power transformers, and also caused the economic lost. The priority issue is to maintain the transformers operating safely and prevent the causing of the accident. This thesis integrated some diagnosis techniques and the gases analysis of the insulated oil. To detect and identity the possible types of fault and its location prior to breaking down.

AIMS/HYPOTHESIS: We previously demonstrated that animals fed a high-fat (HF) diet for 10 weeks developed insulin resistance and behavioural inflexibility. We hypothesised that intervention with metformin would diminish the HF-feeding-evoked cognitive deficit by improving insulin sensitivity. METHODS: Rats were trained in an operant-based matching and non-matching to position task (MTP/NMTP). Animals received an HF (45% of kJ as lard; n = 24), standard chow (SC; n = 16), HF + metformin (144 mg/kg in diet; n = 20) or SC + metformin (144 mg/kg in diet; n = 16) diet for 10 weeks before retesting. Body weight and plasma glucose, insulin and leptin were measured. Protein lysates from various brain areas were analysed for alterations in intracellular signalling or production of synaptic proteins. RESULTS: HF-fed animals developed insulin resistance and an impairment in switching task contingency from matching to non-matching paradigm. Metformin attenuated the insulin resistance and weight gain associated with HF feeding, but had no effect on performance in either MTP or NMTP tasks. No major alteration in proteins associated with insulin signalling or synaptic function was detected in response to HF diet in the hypothalamus, hippocampus, striatum or cortex. CONCLUSIONS/INTERPRETATION: Metformin prevented the metabolic but not cognitive alterations associated with HF feeding. The HF diet protocol did not change basal insulin signalling in the brain, suggesting that the brain did not develop insulin resistance. These findings indicate that HF diet has deleterious effects on neuronal function over and above those related to insulin resistance and suggest that weight loss may not be sufficient to reverse some damaging effects of poor diet.

1 Abstract The diploma thesis deals with three innovative models of childcare. The work is divided into theoretical and practical part. The object of the work is to inform about innovative child care models and to map the implementation possibilities of one described model. The theoretical part deals with the theme of family and its importance for the society. The disorders of family, reasons for child removals out of family, prevention of family failures and family preservation are farther described in this part. Other chapters are focused on already mentioned three models of care. The first model describes sharing care within providing support of volunteers, the second model inheres in sharing care within the residential care and the last model describes the sharing care within care provided by foster parents. The practical part addresses the research which was undertaken as semi-structured dialogs with social workers of foster parents and with foster parents too. A part of the research is formed by the analyse of reasons for child removals out of family. It was found out within the research that the implementation possibilities of sharing care within care provided by foster parents are low with regards to its demandingness and the general settings of our society.

This diploma thesis explores the phenomenon of formation and development of alcohol dependence. In the first series focuses on the historical description, which demonstrates considerable anchored in the life of our ancestors already. It also defines the concept of addiction, its causes and consequences, whether psychological, medical or social. Its objective is to describe the possibilities of social work in this phenomenon. defines therefore primarily targets and understanding of social work and consequently specifics of client alcoholism. An important element is the role of the social worker in the client's motivation to change, which uses Nešpor's model of spontaneous changes in motivation. Then, on the basis of available social services selects several most suitable, which can help to improve the client's situation. Has an essential role in this issue also primary prevention, ie it discusses the methodology, target groups, focusing on adolescents and the focus is on the firm role of the family. Finally contains some official documents on primary prevention, which are discussed current issues of primary prevention practice and subsequent survey, mapping aspect of social workers on the incidence risk of alcohol dependence among adolescents attending social facilities.

This work follows the studies focused on obesity, its global extent and its serious health and economic impact. At the same time, the work examines the unsuccessful fight of public policies which try to reverse growing prevalence of obesity. Nevertheless, the main goal of the thesis is a discussion about priorities of new orientation in the research on the causes of the obesity epidemic and effectiveness of precautions that were taken in many countries and international organizations with the main aim to stop the obesity and its consequences. The discussion leads to the more detailed description of the problems connected with obesity, for instance, environmental aspects, housing culture in relation to physical activities, lifestyle in relation to advertisement/marketing, psychological and socio- psychological aspects, combating stress, etc. My intention was to find out utility of contemporary research on obesity for setting of policy fighting against obesity. At the same time, I wanted to find out other possible directions in the research into this field and discover how the discussion about priorities of the research in the experimental community proceeds. Two international dimensions of paradigmatic approaches separated to the certain degree can be considered as relevant with regard to the global...