799 resultados para COMFORT


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Dissertação de mestrado em sustentabilidade do ambiente construido

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Dissertação de mestrado Internacional em Sustentabilidade do Ambiente Construído

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Dissertação de mestrado Internacional em Sustentabilidade do Ambiente Construído

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Dissertação de mestrado Internacional em Sustentabilidade do Ambiente Construído

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Dissertação de mestrado integrado em Engenharia Civil

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Dissertação de mestrado integrado em Engenharia Civil

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Fundação para a Ciência e a Tecnologia, Grant SFRH/BPD/46515/2008. Jiajia Fu acknowledges the support of Jiangsu Provincial Natural Science Foundation of China (No. BK2012112) and the National Natural Science Foundation of China under Grant No. 3120113

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Dissertação de mestrado em Técnicas de Caracterização e Análise Química

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Dissertação de mestrado em Optometria Avançada

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Dissertação de mestrado em Optometria Avançada

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Dissertação de mestrado em Educação Especial (área de especialização em Intervenção Precoce)

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Tese de Doutoramento em Engenharia Civil.

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Scholars and local planners are increasingly interested in tourism contribution to economic and social development. To this regard, several European cities lead the world rankings on tourist arrivals, and their governments have promoted tourism activity. Mobility is an essential service for tourists visiting large cities, since it is a crucial factor for their comfort. In addition, it facilitates the spread of benefits across the city. The aim of this study is to determine whether city planners respond to this additional urban transport demand pressure by extending supply services. We use an international database of European cities. Our results confirm that tourism intensity is a demand enhancing factor on urban transport. Contrarily, cities do not seem to address this pressure by increasing service supply. This suggests that tourism exerts a positive externality on public transport since it provides additional funding for these services, but it imposes as well external costs on resident users because of congestion given supply constraints.

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Perinatal care of pregnant women at high risk for preterm delivery and of preterm infants born at the limit of viability (22-26 completed weeks of gestation) requires a multidisciplinary approach by an experienced perinatal team. Limited precision in the determination of both gestational age and foetal weight, as well as biological variability may significantly affect the course of action chosen in individual cases. The decisions that must be taken with the pregnant women and on behalf of the preterm infant in this context are complex and have far-reaching consequences. When counselling pregnant women and their partners, neonatologists and obstetricians should provide them with comprehensive information in a sensitive and supportive way to build a basis of trust. The decisions are developed in a continuing dialogue between all parties involved (physicians, midwives, nursing staff and parents) with the principal aim to find solutions that are in the infant's and pregnant woman's best interest. Knowledge of current gestational age-specific mortality and morbidity rates and how they are modified by prenatally known prognostic factors (estimated foetal weight, sex, exposure or nonexposure to antenatal corticosteroids, single or multiple births) as well as the application of accepted ethical principles form the basis for responsible decision-making. Communication between all parties involved plays a central role. The members of the interdisciplinary working group suggest that the care of preterm infants with a gestational age between 22 0/7 and 23 6/7 weeks should generally be limited to palliative care. Obstetric interventions for foetal indications such as Caesarean section delivery are usually not indicated. In selected cases, for example, after 23 weeks of pregnancy have been completed and several of the above mentioned prenatally known prognostic factors are favourable or well informed parents insist on the initiation of life-sustaining therapies, active obstetric interventions for foetal indications and provisional intensive care of the neonate may be reasonable. In preterm infants with a gestational age between 24 0/7 and 24 6/7 weeks, it can be difficult to determine whether the burden of obstetric interventions and neonatal intensive care is justified given the limited chances of success of such a therapy. In such cases, the individual constellation of prenatally known factors which impact on prognosis can be helpful in the decision making process with the parents. In preterm infants with a gestational age between 25 0/7 and 25 6/7 weeks, foetal surveillance, obstetric interventions for foetal indications and neonatal intensive care measures are generally indicated. However, if several prenatally known prognostic factors are unfavourable and the parents agree, primary non-intervention and neonatal palliative care can be considered. All pregnant women with threatening preterm delivery or premature rupture of membranes at the limit of viability must be transferred to a perinatal centre with a level III neonatal intensive care unit no later than 23 0/7 weeks of gestation, unless emergency delivery is indicated. An experienced neonatology team should be involved in all deliveries that take place after 23 0/7 weeks of gestation to help to decide together with the parents if the initiation of intensive care measures appears to be appropriate or if preference should be given to palliative care (i.e., primary non-intervention). In doubtful situations, it can be reasonable to initiate intensive care and to admit the preterm infant to a neonatal intensive care unit (i.e., provisional intensive care). The infant's clinical evolution and additional discussions with the parents will help to clarify whether the life-sustaining therapies should be continued or withdrawn. Life support is continued as long as there is reasonable hope for survival and the infant's burden of intensive care is acceptable. If, on the other hand, the health care team and the parents have to recognise that in the light of a very poor prognosis the burden of the currently used therapies has become disproportionate, intensive care measures are no longer justified and other aspects of care (e.g., relief of pain and suffering) are the new priorities (i.e., redirection of care). If a decision is made to withhold or withdraw life-sustaining therapies, the health care team should focus on comfort care for the dying infant and support for the parents.

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El present projecte té com a objecte d’estudi l’anàlisi de la situació ambiental en que es troben els ETR de l’àrea d’influència del Parc del Garraf (PG). En una primera fase, s’inventarien i analitzen els 12 ETR més propers als límits del sistema natural del PG, Parc d’Olèrdola i Foix a partir d’una ecofitxa de criteris ambientals d’àmbit general. Posteriorment, s’estudia la viabilitat d’implantació del Distintiu de Garantia de Qualitat Ambiental (DGQA) en els 6 ETR pilot escollits a partir d’una segona ecofitxa creada a partir dels criteris del distintiu. D’aquest detallat estudi s’extreuen relacions interessants com per exemple, que els ETR més aïllats del nucli urbà fan servir el doble de sistemes per obtenir energia que els establiments ubicats al recinte urbà i que actualment, el preu segueix estant més associat a confort que no pas a compromís ambiental. Finalment, s’elaboren unes propostes de millora i els pressupostos associats per que aquests ETR puguin complir les exigències del distintiu.